Tales From the ER: How to Connect With Your Patients


Tips to connect with ER patients

By Laura Winzeler, contributor

For many Americans, the only thing they know about ER nursing comes from a TV medical drama. But the healthcare professionals who choose this career specialization are well-acquainted with the chaotic practice "fueled by a steady drip of adrenalin with a periodic bolus of the unexpected."

While ER nurses need stellar clinical and technical skills to survive in this intense environment, their ability to communicate with patients is vital for ensuring high-quality care and positive clinical outcomes. We asked a group of healthcare professionals with years of ER nursing and patient care experience for some pointers on how to connect with patients during a stressful time. Here's what they had to offer.

1. Understand who your patient is as an individual

"Getting to know a little bit of your patient's background, both medical and personal, will allow you to understand them and their situation and react and treat them accordingly. Be empathetic, approachable and honest with your patients. They respect your honesty and humility," says Adil Bhaloda, Clinical Lead at Prescription Doctor.

Dr. H. Eva Hvingelby, palliative care practitioner and faculty member for Walden University's Master of Science in Nursing program, has more than 25 years of experience working in hospice and palliative care settings. She echoes the importance of approaching patients with humility while employing active listening skills, saying, "Be confident in your knowledge, purposeful in your actions and humble when approaching the suffering of others. Being a good listener eases fear and builds trust. Pay attention, utilize repetition to ensure accurate understanding, be aware of and respond to nonverbal body language and frequently look up from the computer and make eye contact."

2. Meet a patient's vulnerability with nonjudgmental acceptance

Health Services Psychologist Mirsad Serdarevic, Ph.D., stresses the importance of helping patients feel understood and accepted, "especially when feeling vulnerable, like when in the ER." She adds, "Providing the patient with nonjudgmental acceptance is the best way to connect...and to establish a good rapport. Practically, this may mean asking open-ended questions (e.g., ‘Mr. Z, can you tell me more about x, y and z?')."

"Also, it's helpful to get in the mode of indirectly communicating to the patient that you want to understand them. This can be accomplished by saying something like, 'It sounds like you are concerned about x, y and z. Could you tell me more about your concern?' Or, 'It seems like you are concerned about x, y, and z. Am I understanding that correctly?'" Serdarevic continues.

Dr. Crystal Slaughter, DNP, APRN, faculty member for Walden University's Bachelor of Science in Nursing (RN-BSN) program, agrees on the importance of bringing a compassionate presence to the interaction. She says, "The emergency department is the first contact point for many patients. They are scared and most likely do not feel well, and their stress levels may be at an all-time high. Patients are therefore vulnerable and in need of a caring face, voice and attitude. It can be difficult to pause and see a patient for the person they are, rather than the illness they have. However, when nurses can do this, the patient is able to establish trust and a connection on more of a human level."

3. Communicate genuine concern for the patient's welfare

James Cobb, RN, MSN, has been an emergency department nurse since 2003 and primarily works the night shift. He acknowledges that connecting with patients in the ER can be challenging due to the high patient turnover "and the almost constant demands on an ER nurse's time."

James shares what works best for him "is to show interest in what the patient is telling you during triage or the physical assessment. Ask lots of questions that help the patient frame their thoughts. Not only does this improve your assessment, but it also shows you're taking interest in them as an individual. If they don't want to answer, explain that by answering, they're helping you help them. ‘We want to get you feeling better,' I say."

James continues, "When it comes to rote patient safety questions that you have to ask everyone, explain they're screening questions related to their safety. Most people feel down in the dumps from time to time and asking about falling, depression and suicide starts raising questions in their mind about how they're coming across to others. If you explain that you're asking for reasons related to their safety, they understand. By doing these things, you present yourself as an ally and advocate and connect with them easily."

4. Let yourself be seen and known

Hvingelby notes that emotional intelligence is essential to providing high-quality patient care. She says, "Don't be afraid of your own vulnerability. It's normal to experience emotions related to life and loss with your patients, so don't feel like you are expected to or need to hide those feelings. As nurses, we are an integral part of a patient's journey."

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