Improving Patient Communication with Jennifer George
Improving patient communication is an effective way to provide patient care. Without proper communication, it is easy to miss out on your patient’s needs. But how can you become effective in this situation? Will this help lessen the stress nurses feel?
In this episode, we will talk about effective communication and how nurses can improve the way they speak to their patients to get the message out. We also welcome our guest, Jennifer George. She is a compassion-focused physiotherapist with vast experience in the private and public care sectors.
Jennifer has spent the last 14 years learning and reflecting on the importance of communication in our health and education systems.
She is also a mentor to future and current health providers on discovering their purpose, achieving fulfillment, and creating empowering patient experiences. Author of her book, Communication is Care: 9 Empowering Strategies to Guide Patient Healing.
QUESTIONS FOR GUESTS
As a physiotherapist, what do you do, and what are some significant takeaways or life lessons from your career?
Work on inputs rehab currently
Patients need a team of professionals; physical therapy is only one piece of a much bigger picture in the healing process
Helped me to recognize the whole person
How was your role as a caregiver for your father shape your personal experience of healthcare and later your professional career?
The power of communication and connection on healing – feeling disempowered, unheard, rushed, at times – good: learned to empathize and be an advocate for patients and families
When did you realize how important communication was and its importance in healthcare?
After the first two years of my practice – I learned to better connect with patients before conditions and diagnoses and look at the bigger picture of their life and the impact of pain and suffering
Then after my dad died, it was like I became super conscious of the fact that my life as a caregiver/daughter shaped my professional interactions
Is there a difference between communicating in social engagements vs. communicating with patients? How should this differ?
How can you keep a professional yet personal communication style with patients?
Is there such thing as communication burnout? I talk to my patients and many other people in/outside of work. Sometimes that gets tiring, and I need a day to myself and silence.
Where do you think misunderstandings arise from? When there is a break in communication, it causes misunderstandings.
How/when does communication fail? What goes wrong?
When speaking to patients, what do they mainly seek to learn? Or how can you pick up on what they are looking for? Does it vary between situations?
Learn how you can communicate more effectively with your patients by watching the full episode here 👇
00:00 Intro 02:37 Episode Introduction 04:08 The feeling of seeing your patient progress 06:00 The importance of communication in improving patient care 09:54 Building rapport with your patient 12:12 What are the barriers that affect communication with patients 15:06 How to be true to your patient’s care 17:36 How to start a conversation with a patient 19:43 Gauging patient for a good conversation 24:42 How to solve miscommunication 28:39 Guiding and educating patients to empower themselves again 33:35 The importance of Interprofessional Communication 35:41 The inspiration of how the book came up. 39:20 Caretakers aren’t taken care of 46:26 Patient safety as the main goal 49:33 Healthcare’s reactive approach to solving the problem 57:08 Wrapping up the episode
Survive floating as a nurse? It’s possible! You may have heard the term “floating” from nurses one way or another. While this term seems new, it has been used by many nurses in the unit before. So what is it?
The term floating is used for a registered nurse who fills the short-staffed unit. They are also sometimes called float pool nurses and can be seen working in any area of a health care facility.
A floating nurse is the “reassignment of staff from one nursing unit to another, based upon the patient census and acuities.” They are an essential part of the healthcare staff and help to ensure that all areas are adequately staffed.
Hospitals consider this a positive solution for saving money through resource utilization. It continues to be a staffing practice in health care facilities throughout the country. If you happen to be a floating nurse, this episode is for you.
Today we will talk about how to survive floating as a nurse. It’s another day in the office when you walk into your unit, and you look at the assignment sheet and discover you have been assigned to float to another department. How you respond to this news can make or break the assignment.
How to Survive Floating as a Nurse
Not every nurse needs to float but there are many hospital positions that you can enter that allow you to float. Most of the time, floating nurses pay well. It is also a good reason why many nurses join the float pool. It is even better if you are a travel nurse.
Floating is challenging to get used to. Sometimes, a little bit impossible. It is because many nurses are unfamiliar with how things work in different units. The new environment can also be overwhelming. But the good news is that many nurses thrive in this position, no matter where they are.
In some cases, nurses choose to float because they like the idea of helping out units that need nurses the most.
1. Remain Calm
Why are you taking me off my unit? The first thing when you realize you’re floating usually your mood changes but don’t feel like to world is ending. Positivity and confidence are the keys. Go to the floating unit with a positive attitude to be welcoming to the new unit.
It makes such a difference when you ground yourself in positivity. Knowing no matter what happens, this shift will end and I will provide great patient care. This attitude will also set the mood for how your shift will go.
A lot of times floating nurses face unfamiliarity. This unfamiliarity may result in losing their confidence. Don’t forget you studied for over 4 years + to get your degree. Being in the position you’re in today, or the number of years of experience you have under your belt.
Start that positive self-talk with yourself. Remember, as a nurse you know what you have to do to take care of your patients. You’re good enough to be in the position that you’re in. Keeping calm and gathering your thoughts before working can also help.
2. Ask questions/learn the unit preferences
The best way to figure out the unit protocols or fit in is by asking what they do and why. After the huddle, go introduce yourself to the charge nurse. Tell her you’re floating from another floor. If possible, ask if she can show you around the important thing you need to know about the unit.
Remember, don’t hesitate or be afraid to ask questions. You have the whole shift to do that. Ask as many questions as you can so you are familiar with how the unit works.
Where is the medication room?
Do you have access to the pyxis?
Where is the supply room?
Are there standard charting or orders for this unit?
Where is the equipment room?
Where is the nutrition room?
There might be different standing orders or charting protocol
Rhythm strips, pt weights
Specific handoff reports?
Specific medications to be signed off?
Accuchecks in the morning, are you covering the insulin
3. Speak up
No one knows if you don’t know something or if you’re struggling. Like any relationship communication is key. If you’re having a busy shift because you spent a lot of time getting yourself familiar with the unit, speak up. Make your needs known, most of the time everyone is helpful.
When floating from the ICU: you can’t do everything for every patient
This isn’t the ICU, you can’t do everything
Importance of time management
Give recommendations but ultimately its the physician’s call
This is All a Learning Experience
In the younger nursing days, we pray not to get floated. We still to this day prefer to work in our home unit, but we have a positive outlook when it comes down to floating. Being challenged is a good thing, new experiences are what creates growth. Don’t be stuck in your own bubble because you hinder your growth.
You too can survive being a floating nurse, here’s what you need to know 👇
00:00 Intro 00:44 Plugs 01:55 Episode Introduction 03:41 Tip #1: Remain Calm 07:39 Tip #2: Ask Questions 09:13 Things to ask: Where is the medication and nutrition room? 11:03 Things to ask: Where are the supply room and the equipment room? 17:47 Tip #3: Speak up 22:44 Tip #4: This is All a Learning Experience 25:08 Shadowing other nurses to learn 27:34 Sometimes Floating is not always good times
What’s a nurse without their backpack? A lazy one, probably! But jokes aside, have you ever wondered what is inside a nurse’s bag? As a nurse, you have to be prepared all the time. Does this mean you have to pack your bag with nurse equipment? No, not really, but there are a few things you need to have in yours.
In this episode, we will talk about the items that are in our nurse’s bags or backpacks. If you are a nursing student or new nurse, you are probably wondering what you will need in your work bag or backpack. Aside from your personal stuff, what are the things you bring with you?
Items that are in our nurse backpacks:
This is one of the most important tools for the medical field. Nurses use this tool all the time to hear breath sounds, or heartbeats. It is also for nasogastric tube placement, equal breath sounds on intubation and the list goes on.
2. Writing items
The 4-in-1 pen. Some nurses have a highlighter with them.
We tend to always check pupils as part of our standard assessment. Some hospitals may provide flashlights in every room for your neuro checks.
3. Scissors and tape
Bandage scissors are for cutting dressings, bandages, and other things. Micropore tape is also essential. It should be available, for example, when your patient pulls his/her IV. If your whole unit is on isolation precautions then, there isn’t a need to carry your own tape.
A handy reference guiding listening down common medicine, procedures, and conditions. Since we work in the ICU a reference book for critical care is what we like to carry. You’ll have patients you haven’t taken care of in a while. These could be patients on paralytics and you need to perform a train of four. This makes to look information up without panicking or needing to ask.
5. Nursing documents/folder
This includes report sheets that you use to take notes of patient care. While traveling nursing you may want to hold onto all documentation.
The nursing documents must be in a reliable folder. Place it in a folder where you can use it for writing on it while getting a report.
Usually, we are fasting during our shift, so we ingest a lot of liquids. This includes water, tea, or coffee. Usually, nurses bring two beakers. One for water and the other with their personal choice liquid.
7. Lotion and Hand Sanitizer
As nurses, we wash our hands so it’s important to prevent your skin from going dry, especially in the wintertime. Having to sanitize while having cracked hands isn’t painless, burn baby burn. Sanitizers help nurses steer clear of germs, along with other contagious agents.
8. Hair mask/bandanna
This is something we started to include during the pandemic of 2020. Since we have beards, we use PAPR’s to get into isolation rooms, the bandanna protects your hair and keeps it clean.
9. Charger and electronic accessories
Nowadays we always have the need to connect to the internet. If you’re working the night shift you listen to podcasts while charting on headphones.
10. Eye drops
The hospital always has low humidity for infection prevention measures. So having dry eyes can be a common thing. If you wear contacts during work your eyes may tend to dry up even more often.
No one likes chapped lips, chap up! Little humidity air causes chapped lips. Another common cause of chapped lips is habitual licking. Lips don’t contain oil glands like other parts of the skin.
When there are a few minutes of downtime, it’s always good to plan out your schedule. This can also include taking out a journal and writing your thoughts down.
These miscellaneous items are not really as important as the ones listed above. However, they might come in handy at certain times. So, it’s better to have them ready in our bags in case we need to use them:
Loose bags of tea
Tylenol or ibuprofen
What’s in your nurse bag? Click here to find out what’s in ours! 👇
There are three basics every nurse should know by heart. You must understand that being a nurse comes with significant responsibilities. It’s like being a superhero, but your powers are stripped off when you make a mistake! You can say goodbye to your career and beloved profession if that is the case.
Because medical errors are common these days, you must know all the nursing basics. Knowing all the basic procedures, SOPs, etc., will save your patient and your license as a nurse.
As a nurse, you have to perform your job to the best of your abilities. It will also help you if you can memorize all the nursing basics there is to know so you can also serve your patients better.
Keep in mind that there are many work-related basics that every nurse should know. These are all essential in making your job more effective. Nursing is composed of many different units and fields, each requiring its level of competence. Here’s what you need to know:
Basics Every Nurse Should Know About
Not every nurse works in the ER or ICU. But there are specific medications that are often shared amongst most if not all units. Over the course of your work, you will get used to your unit’s medications. Those are unit-specific, but there are also medications that you’ll be familiar with.
Some of these are emergency medications and are often used as a quick solution to acute issues. The meds we’d like to address are more for emergent use and used as problem solvers. Medications like levothyroxine or pancrelipase are essential. But those are more unit-based. These are usually given the next day. We want to focus on meds that can benefit nurses in stressful situations.
Vasopressors are among the common medications you’ll see in the ER or ICU. But if you don’t work in these units, you might think you’ll never use them.
Before you call that rapid or even during a rapid there are things you can do. If the patient is hypotensive there are 2 major things you can do; give fluid and/or start levophed. For patients with low blood pressure, norepinephrine is a good backup med. Levophed, Levo, norepi, and norepinephrine all mean the same thing.
You don’t have to memorize all vasopressors. Remember only the basic medications used like levophed. It is usually the first line of meds used in emergencies.
There are many ways to lower blood pressure and many meds. The most common ones we’ve seen are Nicardipine, metoprolol, and hydralazine. Each works differently but has the same functional effect on lowering blood pressure.
Beta-blockers like metoprolol tartrate (Lopressor) or metoprolol succinate
Metoprolol tartrate is also referred to as Lopressor. It’s different than succinate because Lopressor wors quicker but not as long. We use Lopressor to bring down a patient’s blood pressure quickly. Metoprolol succinate is a common med prescribed outside the hospital because it can be taken once or twice a day vs. 4-6 times.
Keep in mind that this is a beta-blocker, which lowers blood pressure and heart rate. You’ll need to find a delicate balance in the amount of med to give for that reason, you need blood pressure control, but you can only give them so much before you throw them into heart block and need to pace them.
Vasodilators like hydralazine
Hydralazine is one of the main antihypertensives used in heart failure. It is an interesting medication because it primarily affects the arteries causing decreased peripheral resistance; reduced blood pressure; and reflexively increased heart rate, stroke volume, and CO.
The main contraindication is coronary artery disease because increased cardiac output increases cardiac work and may provoke angina and myocardial ischemia or infarction.
Calcium channel blockers like nicardipine
Calcium channel blockers are medications used to lower blood pressure. They work by preventing calcium from entering the cells of the heart and arteries.
It also causes the heart and arteries to squeeze vigorously (contract). By blocking calcium, calcium channel blockers allow blood vessels to relax and open.
Nicardipine is given intravenously. Sometimes, patients with a stroke get placed on it for strict blood pressure management. It is a titratable drug.
So many different insulins. You don’t have to remember the exact hourly effect or half-life, just the basics. Lantus or glargine is long-acting. You’ll give it once a day, twice tops.
NPH: this is the insulin you will give with meals. Regular is usually used for coverage.
Each unit is going to have its own specific things they like in the report. For example, a cardiac ICU nurse gets more information about the heart. In the report, they write about the cardiac index, output, and pulmonary artery pressures.
Regardless of what unit you are in, you need to know the basic information that is standard for each report. If by chance you are new, floating, or a travel nurse, your report improves over time. But, you will always be in the clear if you know the core basics. These are:
Room, name, age, code status, and allergies
Past medical history, contact info
Admission day, why they came in, and events during hospital stay/shift.
Planned procedures, able to DC or transfer, patient plan.
GI/GU: Drains/tubes (NG, PEG, ostomy, etc..), output, last BM, and diet
Drips and important meds
3. Emergency basics every nurse should know
Not all floor requires ACLS, but BLS is a standard in the hospital. You should also know what to do in certain situations. Even though you may not perform all tasks during an emergency, it is always a good thing that you know what to do.
Having a basic understanding during an emergency situation is essential. It is also good to know some of the algorithms, so you have an understanding of what to do in case of emergencies.
Assess your patient, what has changed? Are they hard to arouse? Breathing? Pulse?
You’ve probably heard someone ask you a would you rather question once in your life, right? How did you answer back? Life is full of options to take, and we have to make the best choices when faced with situations. Sometimes, these choices are not as favorable, but we make them work. And how we wish that our life, work, and relationships are easy as making a “this or that” choice. Wouldn’t that be more manageable?
In this episode, we will be taking a break from our usual topics and let a little loose in this one. Today we will ask our “Would You Rather” questions nurse edition and share our thoughts about them. We hope you find this episode entertaining as much as we enjoyed answering these questions. Check it out!
Would You Rather: Nursing Edition Questions
Would you rather do admission or discharge?
Would you rather work a 24-hour shift or oversleep and be late for your shift?
Would you rather be punched in the face or spit in the mouth?
Would you rather have a rude, ungrateful patient or a patient with a difficult helicopter parent/family member?
Would you rather be a nurse on a cruise ship or a nurse at a music festival?
Would you rather have co-workers love you and your manager hate you? Or have your co-workers hate you and your manager love you?
Would you rather be ignorant and blissful or smart and never happy?
Would you rather have a C. Diff vs. GI Bleed patient?
Would you rather do the laundry or the dishes for the hospital?
Would you rather be the strongest man on earth or the smartest man on earth?
Would you rather get shit slapped in the face while trying to subdue a psych patient or have to give a bed bath to a patient with bed bugs?
Would you rather love your hospital, pay, co-workers and managers and hate your city and your life outside of work? Or would you rather hate your hospital, pay, co-workers and managers but love your city and life outside of work?
Would you rather have spilled urine on your pants or trach sputum on your shirt?
Would you rather have vomit in your hair and mouth? Or poop down your shirt?
Would you rather live the rest of your life as a Buddhist monk or be followed continuously by the paparazzi?
Join us as we answer these questions! Watch the full Episode 160 by clicking here 👇
00:00 Intro 00:53 Plugs 02:57 Episode Intro 03:42 Admission or discharge? 05:12 Work a 24-hour shift or oversleep and be late for your shift? 06:24 Redo your nursing school program or high school? 07:50 Punched in the face or spit in the mouth? 09:14 A rude, ungrateful patient or a patient with a difficult helicopter parent/family member? 11:05 A nurse on a cruise ship or a nurse at a music festival? 12:54 Have co-workers love you and your manager hated you? Or have your co-workers hate you and your manager love you? 14:14 Ignorant and blissful or smart and never happy? 16:26 C. Diff vs. GI Bleed patient? 18:00 Do the laundry or the dishes for the hospital? 19:33 The strongest man on earth or the smartest man on earth? 20:16 Get shit slapped in the face while trying to subdue a psych patient or have to give a bed bath to a patient with bed bugs? 22:49 Love your hospital, pay, co-workers and managers and hate your city and your life outside of work? Or would you rather hate your hospital, pay, co-workers and managers but love your city and life outside of work? 24:11 Have spilled urine on your pants or trach sputum on your shirt? 26:02 Have vomit in your hair and mouth? Or poop down your shirt? 28:25 Live the rest of your life as a Buddhist monk or be followed continuously by the paparazzi?
Being an ICU nurse is not for the weak. Nurses are witnesses to a patient’s most vulnerable time of their life. And for us nurses, it is a blessing to be a part of that. Working as an ICU nurse taught us many things workwise and experiencing the negative and positive impacts of being one.
In this episode, we will talk about the pros and cons of being an ICU nurse, share our experiences and inspire those interested in becoming one in the future.
How we became ICU nurses started at the hospital when we were still new nurses ourselves. In Matt’s case, becoming an ICU nurse was easy – he was inspired by an ICU nurse who showed him what’s it like to handle a situation, which left him with a good impression. Moments like this are rare because when you are a new grad nurse, you often get assigned to one area where you get to work for a year or so and not be able to explore other areas in nursing.
Being an ICU nurse is interesting because we get involved in the littlest thing with our patients. Every orifice, drop, whatever comes in or out – we know it all. It’s like doing science and history at work. We all get to see where our patient came from, their present condition, and working ways to help them be better in the future.
Nurses as Role Models
Imagine if Matt’s interaction with that ICU nurse was a negative one? Perhaps he wouldn’t even try exploring the ICU or being an ICU nurse. As nurses, we have to be a good example to people because our actions can either impress or distress others who have the potential to be good nurses someday. That said, here are the pros and cons of being an intensive care unit nurse:
Pros of Being an ICU Nurse
Collaboration with other healthcare professionals to help the patient as a team – you get to see the whole picture of the situation.
Easy access to the medical team. Intensivists vs hospitalists.
Larger autonomy and scope of practice – nurses can practice using their critical thinking skills to help the patients.
Great career progression to reach CCRN or even management.
2:1 and 1:1 patient ratios.
Learning curve – learning to prioritize/critical thinking.
Cons of Being an ICU Nurse
We get the worst of the worst like ETOH withdrawals – you want to help but sometimes the situation can be stressful because of unruly patients.
Crashing patients a lot of drip management – is the opposite of the “worst of the worst”. Your patient keeps crashing no matter how much you try to help them.
High stress – we don’t respond stressed out all the time but the tasks/care we give is a constant level of stress. It can be exhausting by the end of the day.
Difficult dealing with family, decision making & family drama. – an emotional strain that can put you in a tough spot. You are the response team.
Physical labor – this is not just ICU, we are in charge of full care usually because patients in our unit don’t participate in our care. There’s a possibility of workplace injury.
Nasty wounds and messy patients – you get to clean up the body fluids that come out of your patients like sputum, drool, urine, feces, etc. If you are easily squeamish, this is not the place for you.
Loss of patient care – higher mortality in the ICU. dealing with the hardships. How to cope.
No extra pay – some healthcare facilities don’t pay ICU nurses much given all the responsibilities that they have.
How did C19 affect the ICU as far as workload?
Usually, an intensive care unit is limited only to two patients, but hospitals have been flooded with critical patients since the pandemic broke out. More patients are sent to the ICU nowadays, and nurses’ role has tripled over time. From monitoring patients to dealing with the loss, and helping families, it’s a tough job, to be honest.
The idea that nurses are navigating new territories adds to the emotional stress of your work, more critically ill patients, dying patients, and dealing with the emotions of the families who just lost a loved one. It is a stressful time to be an ICU nurse. But then again, it is something worth taking because of how rewarding our job is.
How to know if ICU Nursing is right for you?
Being an ICU nurse is not for everyone. It’s a tough job, to be honest. But as you grow with the job, your perspective in life changes too. There’s no specific personality or knowledge to being an ICU nurse. You don’t need to be perfect for the job because you will never know if it is the right job for you unless you give it a try.
As you go, you learn with experience. We all learned from experience in nursing school and now in real life. Nursing school was hard, but you made it. The same goes with ICU nursing, it may be hard from the beginning, but that doesn’t mean it won’t help you grow in your career.
Of course, you have an option to give it a try and see where it goes. As a nurse, there are so many fields of nursing that you can explore. Maybe ICU nursing is your thing, maybe not. And that’s fine too. The important thing is that you know where your heart is in this profession, so you can excel at the work you have chosen.
There are so many ways being a nurse can take you. It would be best if you didn’t waste your time doing something you are not happy with. Our time as ICU nurses have been a real blessing. It taught us wisdom and humbled us in many ways. We wouldn’t want to change that.
Of course, we enjoy being travel nurses, but the lessons we have learned as ICU nurses will always have a special place in our lives. Hopefully, you can also find that as you embrace being an ICU nurse in the future.
To watch the full Episode 159, click here for more and other Cup of Nurses episodes:
00:00:00 Intro 00:55 Plugs 02:36 Episode Introduction 07:06 Pro: Health Care Team Collaboration 10:38 Pro: Access to other medical teams 12:40 Pro: Larger autonomy and scope of practice 15:03 Pro: Great career progression 15:52 Pro: Patient ratio 18:36 Pro: More on the critical task 19:59 Con: ETOH or unruly patients 21:20 Con: Crashing patients 23:51 Con: High stress 27:12 Con: Physical Labor 30:59 Con: Dealing with nasty wounds, blood, sputum, etc. 32:16 Con: Compensation 34:16 ICU is for you if… 36:08 Wrapping up the episode