Purpose: This study seeks to understand what words, phrases and actions nursing students use to communicate caring to their patients, families and colleagues.
Background: As hospital systems struggle with meeting regulatory and quality compliance, evaluating the quality of the patient experience takes on a high priority. The Centers for Medicare and Medicaid (CMS) use such questions from patients such as: “how often did the nurse treat you with courtesy and respect?” or ‘how often did the nurses listen carefully to you?” to evaluate care. Understanding the how nurses and patients interpret communication methods will give insight into developing patient centered care (Balik, Conway, Zipperer, & Watson, 2011; Kay Hogan & Cleary, 2013). Communication using language perceived as caring will lead to overall improvements in the patient experience (Logan, 2017; Weger, Castle Bell, Minei,& Robinson, 2014). What is not well understood is, what are the words that nurses use in the provision of care that patients perceive as caring?
Methods: Undergraduate nursing students at a public mid-west university from three cohorts; pre-licensure nursing students, accelerated second degree nursing students, and RN/BSN nursing students, were invited to participate in an online survey in the two weeks prior to beginning their fall semester in 2018. The survey collected brief demographic data and three open ended questions. All of the university’s Internal Review Board guidelines were followed in this study.
The questions were:
- List 5 words or phrases you would use in providing patient care that you feel display caring or kindness.
- List 5 word or phrases when you hear them from your patient would signal a ‘call to nurse’.
- List 5 actions you do in providing care that show you care.
Data was analyzed using a hermeneutic phenomenological qualitative method with a Heideggerian approach (Horrigan-Kelly, Millar, Dowling, 2016).
Results: The words, actions reported and phrases that would prompt a caring response revealed the following themes: the language of caring, offering self, direct invitation, emotional interpretation, relationship building and active listening. The language of caring revealed a consistent set of words such as ‘listening’, ‘understanding’ and ‘empathy’ students used to display caring or kindness. Offering self used phrases such as “I am here for you” or “I will help you get through this”. Direct invitation from the nursing perspective would be “How can I help you?” or from the patient’s perspective, “I need….” or “help me”. Emotional interpretation was when nursing students interpreted nonverbal cues in patient observations such a crying, withdrawal. Overall, the themes of relationship building and active listening were present in all questions.
Conclusion: Results from this study show that nursing students have an innate understanding of caring and compassion in terms of communication. Using this knowledge, nursing educators could conceivably incorporate and encourage the use of caring language into existing classroom, simulation, and clinical experiences. Furthermore, hospitals can use this information to nurture newly licensed nurse’s abilities to communicate caring in a clinical setting.