When nurses think of the big responsibilities in their careers, patient safety is predominant. But communication skills? Those aren’t often at the top of the list.
Nurses train for years to ensure the safety of their patients. Their unwavering advocacy for patients has done nothing less than transform healthcare. But patient safety can’t happen without clear communication skills. Nurses must have excellent communication skills to provide the best care for patients and to earn the respect of their peers.
What kinds of communication skills will nurses use? Here is just a small sample of how nurses use various communications skills throughout the day:
- Communicating with healthcare team members on a patient’s condition, diagnosis, treatment, complications, progress
- Explaining to patients about self care, about their diagnosis and prognosis, about resources, and about everything from medications to diet and exercise
- Talking with family and loved ones about patient needs, follow-up care, disease, recovery, medication
- Communicating with professionals in non-healthcare fields to help secure grants, influence policy, or explain a professional need
- Educating the public on healthcare issues that are important to their age, region, or personal health, or educating students on nursing practices or nursing career options
How can you improve your communication skills? Here are a few pointers:
- Be precise and clear. If you need information or you need someone to do something, say so. If you are giving information, present it in basic terms.
- Ask if anyone has questions. Your audience could be a roomful of academics at a conference, a team of colleagues in your unit, or a single patient—always ask if anyone has follow-up questions. Don’t assume that your audience heard and understood everything you said. This last step gives you an opportunity to recognize where your communication can be strengthened and to convey the needed information.
- Write clearly. Whether you are writing a memo or a research paper, use fewer words and make them have greater impact. Decide what you are trying to say, use short paragraphs for ease, add bullet points to emphasize your main points, and make sure you reread everything before you send it..
- Consider your tone and body language. The way you speak and hold yourself can support your words and intent, but if they are out of whack, your unspoken actions can cause confusion. Make sure you speak in even tones when possible and that your body language is approachable.
- Learn about best practices. You’ll find books, seminars, presentations, and even casual discussions that can all help you sharpen your skills. If you’re a nurse manager, bring this up in each employee review and ask for it in turn from your own supervisor.
Communication can always be improved. Each time it is, your capability as a nurse is strengthened.
Can a simple B vitamin like folic acid really prevent serious birth defects? The answer is a resounding yes, but taking the vitamin in the easiest days and weeks of pregnancy is key.
When women find out they are pregnant, staying healthy often becomes a top priority. Making sure they are eating nutritious foods, getting enough rest, remaining active, and generally taking care of themselves comes to the forefront. But one of the most critical times for preventing certain birth defects is before a woman even knows she is pregnant.
Sufficient intake of folic acid (folate) can prevent serious birth defects, so January 7 to 13 marks Folic Acid Awareness Week. The observation offers a timely opportunity for nurses to become aware of their own folic acid intake and to open up discussions with their female patients of child-bearing age.
According to the National Birth Defects Prevention Network (NBDPN), sufficient folic acid intake before pregnancy occurs can “prevent up to 70% of some serious birth defects of the brain and spine, called neural tube defects.” Specifically, the vitamin has protective benefits against spina bifida and anencephaly, which begin to develop in the early weeks of pregnancy, often long before a woman even realizes she is pregnant.
Because approximately half of all pregnancies in the United States are unplanned, raising awareness about the protective benefits of sufficient folic acid intake before a pregnancy happens is essential. Luckily, getting the recommended 400 mcg of folic acid is as easy as taking a daily multivitamin or eating fortified pasta, rice, breads, or cereals (at mealtime or as a snack). Often, one small bowl of a fortified cereal can supply the minimum amount for the whole day.
Women who prefer to get enough folic acid from unfortified sources can turn to dark leafy greens, some juices, and many beans. But they need to be aware of the amounts they need to consume to meet the minimum requirement. According to the National Institutes of Health, these non-fortified foods are top sources of folate: beef liver, boiled spinach, black-eyed peas, asparagus, Brussels sprouts, and romaine lettuce.
According to the NBDPN, babies born to Hispanic women have the highest rates of these birth defects and that, in general, Hispanic women consume less folic acid overall and are less aware of the protective benefits of the vitamin during pregnancy.
For nurses, using Folic Acid Awareness Week to open up a conversation and give patients some easy-to-follow information for preventing these birth defects is worthwhile.
As the demand for educated and qualified nurses continues to grow, prospective nursing students might wonder how they can afford nursing school now to open their career possibilities over a lifetime.
If you have applied to schools and are receiving acceptances and award letters, it’s time to crunch the numbers to figure out the best choice for your money. Schools offer many awards including merit scholarships, grants based on merit or need, and loans that fall into many categories. You can also make some other adjustments to shave off some costs without impacting your education.
How do you know you can afford nursing school? Here are some questions to ask.
Will You Be a Full-time or Part-time Student?
Some colleges and universities award scholarships based on the student’s academic load. If you are trying to decide which route is for you, check with the schools to see if there is substantially more money available that could impact your choice. Consider your employment potential as well. Part-time status takes longer to complete, but you may be able to work and go to school (and your employer might pay for part of your education).
Where Will You Live?
Living on campus generally costs more money. Attending a college that’s closer to home lets you save thousands of dollars on campus housing and meal plan fees. If you are already living at home, you’ll save by continuing to live at home and commuting to school.
Can You Take a Hybrid Route?
Are there any online courses that cost less? If you are aiming for a BSN, could you take a prerequisite class and some of your basic classes at a cost-saving community college and then transfer to a four-year college to finish your degree?
What Aid Is Available?
A strong academic record and solid application will likely land you some merit scholarship funding. Like a grant, that’s money the school gives to you. You don’t have to pay it back, but you do need to find out if the award will be renewed each year you are at the school. If you apply to a four-year college, you need to know you can afford all four years.
How Much Debt Are You Willing to Take On?
After any merit or need-based scholarships and grants, you can be awarded loans. Loans always have to be paid back. Federal loans come from the government and while they have to be paid back, they often have low interest rates, and you don’t start repayment until after graduation. If federal loans don’t meet your entire need, you can apply for private loans, which have higher interest rates and varying repayment policies.
What Are Your Post-graduation Plans?
Some nurses can have some student debt forgiven if they apply for and fulfill the requirements of the NURSE Corps Loan Repayment Program. In addition, some states offer specific loan repayment or forgiveness plans for nurses.
Figuring out how to afford nursing school is going to be different for each student, but there are many options and choices available. For many students, finding the right balance just takes some investigating.
As an experienced nurse, a new nurse, or a nursing student in 2018, it’s tough to admit you might be biased toward some of your patients. But it happens, and the best approach to fixing implicit bias is to recognize its presence, and then constantly reassess how you feel and your approach.
Why do nurses have inherent bias? It’s a subconscious human trait and frequently interferes with best nursing practices. An inherent bias doesn’t mean you are racist and it doesn’t mean you shouldn’t be a nurse. Recognizing an inherent bias means that you understand you might have certain feelings about populations, appearances, or mannerisms that need to be addressed and dealt with to provide the best possible care.
In 2017, BMC Medical Ethics published a systematic review assessing a decade’s worth of publications for implicit bias in health care professionals. The conclusions stated a need for additional reviews and more homogeneous methodologies, but determined that implicit bias exists in health care settings and impacts quality and equity of care. Authors Mahzarin Banaji and Anthony Greenwald address the issue in books like Blindspot: Hidden Biases of Good People, as does Augstus White, III, MD, in Seeing Patients: Unconscious Bias in Health Care.
Here’s how to pay attention and fix it.
Notice Your Assumptions
Everything from language barriers to job status to regional inflections can cause people to assume a patient has certain traits, behaviors, or beliefs that you might not agree with. Notice that feeling when you are trying to explain treatments to a patient, when responding to their needs, or when dealing with an extended and involved family.
Understand What Assumptions Trigger in You
You might find there are certain accents, specific items of clothing, or ways of speaking that cause you to tag someone with undeserved qualities. A patient’s race, accent, clothing style, or appearance can spark an instant judgment in you. Do you hold back certain levels of compassion for patients who are more short-tempered? Do you assume low standards in a disheveled, unkempt patient? Does someone’s race affect how you see them?
Know Why It Matters
An implicit bias is not only harmful because it is undeserved, but it can also lead to disparities in care. Even if you are unaware of how you are feeling, your body language, your focused attention, and your level of care can be impacted directly by the way you are feeling. Each patient deserves your full care, so understanding what might trigger you to act differently will make you a better nurse.
Know Your Patient
Talking with your patients is a good way to learn more about them. Understanding cultural differences can also help you become aware of any unconscious bias and begin to overcome it.
Talk About It
You have a bias, but you are not alone. Talking about implicit bias in your work setting opens the conversation, removes the taboo, and paves the way for better patient care and outcomes. When nurses are able to address this topic in an open and nonjudgmental manner, everyone benefits. If you are a nurse manager, holding talks, open sessions, one-on-ones, and seminars gives your staff nurses the tools to confront the issue head on and make significant changes.
Everyone knows about overt bias and the harm it causes, but implicit bias is just as dangerous, and many nurses aren’t even aware they may have a bias. Becoming aware of the problem and realizing if you have any bias is a first step toward fixing the problem.
Once again, the annual Gallup poll has recognized nursing as the most honest and trusted profession.
This is the 16th consecutive year nurses have held onto the top spot, and they have been number one in each year since the poll started in 1999 except for one. In 2001, firefighters were included on the list, and with their overwhelming bravery in response to 9/11 attacks, they earned the top spot.
In the yearly telephone poll, a random selection of citizens are asked to rate the professions they find most trustworthy. Of the top five professions rated for ethics and honesty, the medical field is well represented with nurses (no. 1), medical doctors (no. 3), and pharmacists (no. 5). Rounding out the top five are military officers (no. 2) and grade school teachers (no. 3).
Of the respondents, 82 percent rated nurses as “high” or “very high” for honesty and ethical standards (choices included those two plus “average,” “low,” and “very low”). Military officers had a 71 percent rating in the same category. Overall, the Gallup poll rated 22 professions including police officers, bankers, television reporters, car salespeople, lobbyists, lawyers, and clergy. Lobbyists took the bottom spot with only 8 percent of respondents rating their honesty and ethical standards as “high” or “very high.”
This year’s poll was conducted in early December, with a total of 1,049 respondents. The respondents were a mix of political parties, which reflected larger party-based gaps for some professions, but not nursing.
The Gallup poll reflects a worldwide sense of trust in nurses. Britain’s Ipsos MORI Veracity Index 2017 (from a social research institute) also ranked nurses as number one most trusted profession by respondents.
Nurses know the poll is a public acknowledgment of the caring, life-saving work they do every single day. Congratulations to all the nurses out there—the ethical standards you follow every day are noticed by the people you care for those who love them.