Term Paper: Communication in a Nursing Environment

Pages: 10 (3106 words)  ·  Bibliography Sources: 1+  ·  Level: College Senior  ·  Topic: Communication  ·  Buy This Paper


[. . .] Deintensification is just the opposite. If a nurse gives a patient bad news, the patient may downplay their disappointed look. The danger here is that the nurse believes everything is fine when it is not.

Neutralization is when one eliminates all expression from their face, this may be to not give away how one is feeling.

Masking is when an expression showing true feelings is replaced by one showing what the person feels is expected of them. An example may be when a patient is feeling unwell. They may feel concerned about this and even guilty about it, and replace an expression showing their true feelings with a happier face. For the nurse, care must be taken not to assume that the expression on one's face is a true indication of how they are feeling.

Body Motion

Bolton (1987, p. 36) reports that a listener who remains still is seen as controlled, aloof, and reserved while a listener who is more active is seen as friendly, warm and as not acting in a role. This body motion is usually lesser when the person is listening and more when they are speaking. Body motion should however, not be like fidgeting.

Effective body motion involves blinking, nodding and occasionally gesturing. It is also noted that a still listener is generally viewed as one who is not listening.

Body motion also refers to gestures. These can be either obvious or less so. Stroking one's chin is an obvious gesture, showing a person is thinking or considering something. Folding your arms is also another gesture that may indicate you are disturbed about something. This can also include nervous habits such as playing with one's hair or playing with one's ring. All these offer some indication of how a person is reacting.

From a nursing perspective, a nurse must be aware of what their gestures communicate. A nurse who has nervouse habits, may indicate to a patient that there is something wrong, causing them to worry unnecessarily. Instead, a nurse should make use of enough body motion that they appear interested, but not too much that they appear nervous.

Body motion can also be an effective tool for analyzing how a patient is feeling. If the patient is smiling and saying they are fine, it would at first appear that they are fine. But if they are also fidgeting and showing nervous habits, it is a sign that they are concerned.This is a sign that the nurse should question the patient further to ensure they are comfortable.

Eye Contact

Eye contact is an indicator of involvement (Friedrich et al., 1995, p. 202), it expresses interest and a desire to listen (Bolton, 1987, p. 36).

Bolton (1987, p. 36) describes effective eye contact as "focusing one's eyes softly on the speaker and occasionally shifting the gaze from his face to other parts of the body, to a gesturing hand, for example, and then back to the face and then to eye contact once again."

Poor eye contact would be either not looking at the speaker at all, staring at the speaker or making darting eye movements.

It is also noted that "the eye area is one of the least controllable regions of your face, and as a result, your eyes can expose your emotional state" (Friedrich et al., 1995, p. 202). As we have seen, facial expressions can be fakes to hide true emotions, but looking at a person's eyes is one way you can establish their true feelings.

From a nursing perspective this is an important tool for assessing the patient's state. While they can adjust their facial expressions, their eye movements are capable of communicating how they are really feeling.

Illustrators, Regulators, Adapters and Affect Displays

All non-verbal messages can be broken down into categories based on what they are meant to achieve (Friedrich et al., 1995, p. 197).

An illustrator is a movement that goes along exactly with what is being said, such as saying 'the fish was big' and moving one's hands to show exactly how big.

Regulators are meant to regulate the conversation in some way, usually by sending the message 'I'd like to speak now.' Raising your hand or clearing your throat are two examples.

Adapters are the next kind, they are gestures that indicate some need. They may include rubbing your eyes, which indicates tiredness or moving in your chair to indicate you have been sitting too long.

Affect displays are indicative of emotional state. These are usually unintentional and give an insight into the true feelings of others. Unlike many gestures, these are subtle and are usually not even noticed by those doing them. This means that the person will not intentionally adjust them. Being aware of affect displays is an important tool to gaining understanding into how the other person is really feeling.

Affect displays can be used by nursing staff as a clue to determining the patient's real emotional state. Just as with eye contact, these are useful as identifiers because they are not intentionally controlled by the patient, they are more like natural emotional indicators.


Paralanguage refers to how something is said (Friedrich et al., 1995, p. 203). The tone of voice you use when saying something can mean as much as what you say. Consider a simple example of asking someone how their day was. They could answer 'fine' in many different tones, some meaning that they are fine and others meaning the opposite. The tone can also indicate a person's emotional state, such as a wavering voice conveying nervousness. It is also worth noting that the tone can also often express a person's true feelings.

In a nursing situation, a nurse must be aware of their own tone and how patients and their families may interpret their tone. A nurse must also be aware of a patient's tone. A tone may indicate that the patient is nervous, depressed or distressed.


The first way that a nurse can use body language is to be aware of their own. In dealing with patients they should appear both interested and attentive. They should lean back to encourage open conversation, keep their body open to ensure the patient feels free to speak and make gestures that show they are listening. In speaking to the patient they should also make sure they use appropriate tone and that their body language matches what they say.

This is important as it will allow the patient to feel comfortable and express their real needs and feelings.

The worst case scenario may be if a nurse appears impatient, causing the patient to decide not to tell them they are in pain. This could lead to distress for the patient and even to potential problems not being diagnozed and acted upon. In the worst case scenario, health complications could result.

Making the patient feel comfortable enough to speak freely, is the best way to ensure that the patient communicates fully with the nurse. The better the communication process, the better the hospital can meet the needs of the patient.


Even more important as a tool, is the ability to understand the body language of others. An effective communication is one where both sides understand each other. In the nurse-patient communication this becomes even more important as the nature of the situation means that the patient may be uneasy and may not say what they are really feeling.

This can lead to major problems if a nurse accepts that a patient is fine, when in fact they are distressed.

When listening to a patient, a nurse can gain insight into their real thoughts by looking them in the eye, by taking note of their posture, by listening to their tone and taking note of any affect behaviour. It is also important to keep in mind that what appears on the surface does not always represent real feelings. There is a need to look beyond what is a surface smile and look to body language for clues about real feelings. Once you are aware of these feelings you can then discuss them and rectify any problems by taking appropriate action.


From the research, we can see that body language is an important part of communication and has great effect on communication. From the nursing perspective, we have seen how it can be used to determine the patients and their families real state. We have also seen how the body language of the nurse can be used to ensure that the patients and their family feel comfortable enough to speak freely and communicate the truth.

By training and ensuring that nurses are aware of body language, effective communication can be better established. This is especially important because the nature of the situation means that understanding the patient's state is critical to providing… [END OF PREVIEW]

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