Career advice

Communication: Express yourself without ambiguity

In the final article of a three-part series, health coach Mandy Day-Calder explains why what you want to say and what patients think you mean can be very different, and offers tips on how to avoid misunderstandings

In the final article of a three-part series, health coach Mandy Day-Calder explains why what you want to say and what patients think you mean can be very different, and offers tips on how to avoid misunderstandings


Picture: iStock

One of the arts of verbal communication is being able to express yourself in such a way that people don’t have to guess what you are trying to say. For example, you may know that a ‘positive test result’ isn’t necessarily always a good thing, but do your patients?

Similarly, when someone is talking to you it’s easy to hear what you want to hear instead of what’s being said. This is what fell-walkers call ‘making the map fit’ instead of looking at where you really are. Just as this approach can lead hikers astray, it can result in you losing your way in a conversation.

Low health literacy

It’s important that what you are saying can easily be understood. As effective communication is a two-way process this means considering your listener’s ability to interpret what you are saying. Remember that most of the population aren’t as fluent as you in medical language. In fact, approximately 40% of adults in England have low levels of health literacy, meaning they lack the skills and resources to help them make decisions about their health and well-being.

As a nurse your role involves empowering your patients to make informed choices about their care, so you need to ensure that patients are not left confused or misinformed by anything you say.

The ‘teach back’ technique is an easy-to-use method to check your patients’ understanding of discussions you have with them. This involves asking patients to describe in their own words what has been said and allows you to gauge what they have absorbed and rephrase information as necessary.

Keep it simple

Patients are often at their most vulnerable when you are talking to them so though teach-back may at first appear to be time-consuming, by reducing risks of misinterpretation it helps to improve patient safety. Try following these tips:

  • Check for understanding. Avoid closed questions such as ‘have you understood everything?’ Patients may simply say ‘yes’ to avoid embarrassment or awkwardness. Instead try open phrases, such as ‘so that I know that you understand, can you tell me how you will take your medications?’
  • Avoid medical jargon or colloquialisms.
  • Use clear and simple language. Consider if there is more than one way of interpreting what you are saying.
  • Break down complex bits of information. Sometimes using diagrams can complement what you are saying – you don’t need to be a great artist.
  • Listen to what’s being said and avoid projecting your own judgement onto it.
  • Be flexible in your approach to suit your words to the person you are speaking to. If English is not someone’s first language you may need to speak more slowly, but avoid shouting or over emphasising words as this can appear to be condescending.

Mandy Day-Calder is a freelance writer and a life/health coach


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