Bedside manner is a skill many nurses take for granted, yet like any other skill it requires development. Overtime your ability to connect with your patients will change and evolve. Sometimes these changes are for the better but at other times stress, various emotional states, and complacency may negatively affect these skills. Therefore, it is important to evaluate your patient interactions, not only during your years as a nursing student, but throughout your career.
The most important assessment of bedside manner is performed not by the nurse but by the patient. Your patient may not blatantly give their critique but there are a multitude of signs that can clue you into whether or not your bedside manner needs more work.
* Do your patient's facial features relax over the course of your interaction with them? Often we expect to see an immediate smile plastered on our patient's faces in response to our mere presence. This is unrealistic! What we should be seeing is a gradual relaxation. Stress, pain and depression features should begin to relax as we reach out and support our patients through our interactions with them.
* How often do you get questions from your patients? People invariably fear looking dumb, especially around those that may judge them. For this reason, asking questions is often a form of trust. Patients will typically only ask questions of health care professionals that make them feel comfortable.
* What emotional reactions do you perceive most often around your patients? Anger, frustration, embarrassment and fear are all clear signs that our bedside manner is not what it should be. However, more subtle signs may include flat affects or strained jocularity and happiness. Patients that are uncomfortable will often try to hide their true emotions by keeping their facial features stony, cracking jokes, or masking their face with a smile. A good bedside manner results in patients being able to truly express their emotions. Therefore you want to see a wide range of emotions being expressed by your patients in general.
Another good way to assess your bedside manner is to ask your supervisor, fellow nurses, and other nursing staff members for their critiques. Remember that nurse-aids often have the best bedside manners of all hospital staff. Choose co-workers that exemplify the quality of bedside manner about which you are concerned. This is particularly helpful if you find that there is a certain grouping of patients that you seem to have difficulty connecting with such as a certain age group, gender, or ethnicity.
The final check on any skill is how you feel about performing it. If you find that you were nervous or dissatisfied, your patients probably were too. Think back to your interactions with your patients on any given shift. Did you project confidence? Were the patients treated with respect? Did you interact with the patient in a culturally appropriate manner? What should you have done differently?
Once you have assessed your bedside manner skills, you can work to improve them.
* Learn about culturally relevancy. Various cultures have different ways of handling social interactions. Sometimes a failure to connect with a patient is merely a cultural misunderstanding.
* Control your emotions. Your patient should never be subjected to your frustrations. Practice cleansing yourself of any negative emotions prior to entering a room. A trick I've learned is to envision a waterfall flowing down from the door sill of each patient's room. Each time I walk through the doorway I try to let my negativity just flow away from me with the water.
* Connect personally with each patient. Address them by their name and look for clues as to interests in their lives such as family pictures or what they are watching on television. Compliment or ask questions such as, "What a lovely girl. Is that your granddaughter?" Always take the time to allow your patient to talk. Lack of social interaction can play a big part in negative medical outcomes, especially in elderly patients.
* Never lie to your patients. It is easy to say "everything will be fine" or to pretend you know things that you don't. Eventually, your patient will come to distrust you if they realize you are just making generalizations or being false. Instead, take the time to explain what you can or offer to find out the answers for them.
* Practice good time management. Try to group all your tasks at one time so you have more uninterrupted time with a patient. It is hard to form a therapeutic relationship when you are running in and out of the room.
* Review nursing article in journals such as the American Nursing Journal or in books such as the Nursing Made Easy series. You can also visit websites such as the American Nursing Association, AllNurses.com, or Nurselink.com for more assistance in developing your bedside manner.
Not every patient and nurse will work together seamlessly. Just like any other social contact, some personalities just clash. If possible, see if another nurse can take over a patient with whom you are unable to connect. If not, treat the patient with courtesy and respect. Do what you feel comfortable with and pass on your concerns to the incoming nurse. Often another nurse will be able to build a therapeutic relationship with the patient even if you could not.