by Frances Meupe

Created on: June 06, 2009   Last Updated: June 22, 2009

Patients come to long term care facilities for different reasons. Sometimes they come from independent living at home and are no longer able to care for themselves. Or perhaps they were living with a family member who was no longer able to provide care for them. Maybe they came from the hospital after surgery or an acute illness; and plan to return home after rehabilitation. Sometimes patients even come for respite care. No matter the reason, your responsibility is to meet the needs of your patients. Your goal is to have a successful professional nurse/patient relationship.

A good rapport with your patient begins with effective communication. First impressions are important. Begin by greeting your patient and introducing yourself. Make sure that your name badge is visible. Address your patient by name in a professional manner. Even though you may have reasons not to-try and put on a friendly face. A patient must not be made to feel you resent taking care of him. Sometimes patients are fearful and nurses can relieve some anxiety by what is said in that initial conversation. Orient the patient to the room and what to expect during his stay.

Allow the patient to ask questions. Most patients will not understand medical terminology, so answer questions in layman's terms if they don't understand. Some people are visual learners so offer reading material with pictures and diagrams if possible. It is always a good idea to have material available in large print as well. Make sure you find out how much the patient knows before you discuss the patient's diagnosis. You should not reveal something that the doctor or family has not told the patient. And if you are asked a question that you don't know the answer to, never say "I don't know". Just say that you will find out about it and let him know.

Some patients are hearing impaired. If a patient has a hearing aid, make sure that the hearing aid is in place when you are communicating with him. If the patient does not wear a hearing aid, don't shout, but speak in a tone of voice that can be clearly understood. Sometimes due to a stroke or other disease or illness, a patient may not speak clearly but is able to write, so have writing implements available. A patient with dysphasia will get agitated if you don't understand what he is trying to convey to you. If you, in all of your wisdom, can't figure it out-get another nurse (sometimes two heads are better than one). I have even resorted to calling a family member who told me exactly what the patient wanted.

From my experience in long term care, the most common questions are as follows: when can I get a pain pill, when can I get something for sleep and what time does the dining room open. The most common statement or demand is "I need something to make my bowels move". I always let my patient know there is a cut-off time for sleeping pills so that they won't be drowsy for morning ADLs (activities of daily living). Unless a pain pill is given routinely, I tell the patient to request a pain pill at the onset of pain . I explain that pain is harder to relieve once it worsens.

Effective communication also entails knowing how to read body language and facial expressions. Nurses know that restlessness, repetitive movements, facial tension and grimacing are forms of non verbal communication. Effective communication also includes anticipating the needs of the patient and providing care accordingly. With effective communication patients are often more compliant with their plan of care, which can make a nurse's job a little easier.

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