Studies show that non-verbal communication represents over 55 percent of all communication. If that estimate is accurate, then positive body language is essential to nursing communication. Because we have a patient-nurse professional relationship, our conversations must be therapeutic, goal-directed and aimed at helping patients heal. Those conversations not only include what we say but how we say it.
Kinesics is the study of non-verbal communication. This includes body movements such as nodding, smiling and expressions. Additionally, proxemics comes into play – the amount of physical space between you and the person you are speaking to.
5-Step Body Check/Reality Check
It’s no secret that the face conveys emotion. An excellent emergency nurse told me this week that one of her patients asked, “Are you upset with me? You look angry.” This nurse said she was absolutely not upset with the patient, but because she was rushed, she had not paid attention to her facial expression while in the room. She had let her own experience spill over onto the patient.
Patients see our hearts though our eyes. It takes an incredible amount of nursing professionalism to appear relaxed, make eye contact and help our patient know - for that brief moment – we are “with them.” And that we see them not just as a label, but as a human being.
Tip: If you are currently on EMR, practice speaking to the patient for a few moments prior to starting to document. Look up frequently and make eye contact with the patient, nodding and engaging them as you go.
Many people carry their stress in their shoulders. The more frustrated, rushed or tired you are, the more you may have a tendency to carry your shoulders high and tight. This posture is not only unhealthy, but will produce frequent back and neck pain.
Tip: Take frequent, slow cleansing breaths. As you exhale, drop your shoulders into a relaxing posture. Slowly move your head back and forth two to three times, as if shaking your head “no.” Gently stretch your neck and then shrug your shoulders tightly to your face 2-3 times. Each time you do, take a slow deep breath and drop your shoulders as you exhale. Your patients will read your correct posture as non-aggressive and non-confrontational.
Make sure your hands are open and relaxed. In some cultures, it is rude to have your hands out of sight. Palms should be relaxed and facing the patient openly as much as possible. Try to not fidget with pens or equipment unnecessarily. Your movements should be smooth, rhythmic and purposeful. As you complete tasks with your hands, explain to the patient verbally what you are doing.
Tip. Hands can have a healing touch. If you have developed a quick rapport with the patient, a soft touch to the shoulder or hand – even a pat on the back – conveys confidence and reduces anxiety in most people. If in question, always ask permission before touching a patient.
Make sure your hips are facing towards the patient. Where your hips are pointed it is where your attention is focused. This kind of body language in nursing will let your patients know that you are listening and engaged in their needs, swivel your hips toward them as squarely as possible when speaking. If in a standing position, men may find this position aggressive, so adjust to a slight angle that is not confrontational. If possible, sitting is usually the most relaxed and open posture, with your knees pointing towards the patient.
Tip: If you want to appear totally relaxed to an angry or over anxious patient or family member, shift your weight to one hip. This automatically relaxes the spine and makes you appear in control but carefree at the same time.
Where are your toes in the room? Proxemics is how much space is between you and the person you are talking to. What are you conveying to the patient by where you are standing in the room? Body spacing and posture according to Edward Hall, author of “The Hidden Dimension,” are unintentional reactions to sensory fluctuations or shifts. These also include subtle changes in the sound and pitch of a person's voice.
The following summary shows how social distance between people correlates with physical distance as do intimate and personal distance:
- Intimate distance for embracing, touching or whispering: less than 6 - 18 inches
- Personal distance for interaction among good friends/family members: 1.5 feet to 4 feet
- Social distance for interaction among acquaintances: 4 to 13 feet
Although hospital rooms are not always condusive to appropriate proxemics, when you are discussing personal information with a client, strive to be close to their personal space. The conversation is more intimate for sharing and you can better observe facial expressions. This is not to say you can’t stick your head in a patient’s door to let them know you will be with them shortly. However, if you need to offer or request information, you should take the time to move closer to the bedside to show respect and open communication.
Tip: The same idea is true for the nurses’ station. If possible, you want to get your toes out from behind the nurses’ station and pointing towards whoever needs your attention.In a busy work environment, positive body language is difficult and takes practice. But if you will make an effort to correct any poor body language habits, you will find your nursing communication to be smoother and more efficient. Positive body language rarely costs time. In fact, it is a time saver and makes for happier, more relaxed patients. This in turn makes for happier and more relaxed nurses.
Want to be more confident in talking with your patients? Use body language in communication as a nurse. Remember to use properly because patients can see your mood through actions.
Hall, Edward T. (1966). The Hidden Dimension. Anchor Books. ISBN 0-385-08476-5.