Helpful strategies

  • Privacy. Is it appropriate to talk to your patient or relative in an open ward?
  • Timing. Find a time when your patient is feeling calm and relaxed, and also when those close to them are settled and haven’t just arrived.
  • Prompts. Listen to what the person is saying as there may be times in the conversation where prompts could lead you to discuss nutrition and hydration.
  • No euphemisms. Using the words ‘dying’ or ‘die’ is honest and accurate.
  • Watch and learn. Watch how more experienced nurses communicate with their patients, and talk with them about it afterwards.
  • Open questions. Questions beginning with “What” or “How” can help encourage someone to give more than single word answers. Allowing time after asking the question gives the patient or family member time to consider their response, and asking if there is something else they wish to say can encourage further conversation.
  • Additional help. Is there a need for an interpreter or other aids to enable communication to and from the person? Use of accessible information like pictures and straightforward language can be helpful.
  • Summarise.  Recapping what has been said to the patient or their family can be useful and even prompt them to add something else. It will also give them confidence that as a professional you are genuinely concerned.
  • Don’t be afraid of silence. Using pauses can encourage the person you are speaking with to open up more. Showing that you are listening and pausing for responses will allow the person time to think and they are likely to give a more full response.
  • Read. Is there any documentation about the patient’s preferences? Anything you need to know that will affect the situation?
  • Write. Sometimes your patient may have a number of issues. Asking permission to write these issues down will help you fully understand them and help to prioritise them.

Body language

It is important to remember that communication is not just about what you say or hear but also about your body language – the expressions you make or how you stand. For example, closed body language such as standing with crossed arms will make a person less likely to want to approach you than when you are smiling at them. It is important to be aware of what your body language says to the people around you.

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