Running head: NONVERBAL COMMUNICATION IN NURSING 1

Nonverbal Communication in Nursing

Madison Lovette

Louisiana State University

Author Note:
This paper was prepared for English 2001, taught by Ms. Jean Coco for the purpose of
demonstrating nonverbal communication and the importance of it in the field of nursing.
Abstract
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This paper evaluates the importance of nonverbal communication skills in the field of nursing.
Through the use of the head, eyes, and hands one can portray many cues of communication to
others. This paper looks at the different meanings that may be associated with the head, eyes, and
hands and how the gestures associated with these areas can be used to evaluate a patient. The
effective use of all communication methods, in this paper specifically nonverbal, is extremely
important for ensuring quality of patient care. This paper is intended for first year nursing
students to further develop an understanding of communication skills in nursing and in general.

Preface
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Focus is a +1, because I feel that I stayed on topic, but maybe not in line with what is
being specifically asked for. Organization is a +1, because I made focused paragraphs for each
body portion and tried to make the paragraphs flow into each other. Development is a -1, because
I dont think I am using the correct form of the examples being asked for or portraying them the
way that I need to. Audience awareness and voice I feel is a +2, because I made sure that anyone
who read this would be able to tell that it was written for a nursing student and my voice I feel is
also accurate for the audience I am targeting.
I feel as if my fourth paragraph works the best in the paper because it gives a strong
example that may affect the reader. I am worried that what I have written is not exactly what the
assignment is supposed to be. I am also worried that my examples are not elaborated enough or
that I did not develop my paragraphs correctly. Lastly, I am worried that my paper is not
organized the way it should be to get the information across that I am trying to present.
Ms. Cocos comments of the teacher comment draft of this paper helped me
significantly. The comments on where to add citations were the most helpful due to the fact that I
thought I was including sufficient citations. The comment about making my first paragraph more
focused on nonverbal communication instead of small descriptions of each mode of
communication was very very helpful because I did not understand what I needed to include in
the introduction originally and now that I have corrected it, it has made my paper stronger. I also
found that the comments on where to make my larger paragraphs become two paragraphs were
helpful because I feel that by doing this, it makes my paper flow better. I was slightly confused
by the comment about improving my transition to paragraph two because I thought the transition
I originally used was a smooth transition. There were no comments on my paper that I found
questionable. I feel that all the comments you made helped me make my paper a lot stronger and
more focused. Thank you!

Nonverbal Communication in Nursing

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Introduction and Overview of Genres

The field of nursing is complex and immersive in all aspects. One of the most important

aspects in a job as a nurse is to communicate effectively. Nonverbal, or therapeutic,

communication is the use of things like body language and touch to connect with someone. The

use of nonverbal communication is an important and useful form of communication in nursing

because it can do more than just express information. Lester M. Sielski shares in his article

Understanding Body Language, that Brill (1973) perceives nonverbal communication as the

basic, primitive form of conveying information from one person to another (Sielski, 1979.)

Through the observation of body language and the utilization of physical touch, a nurse can

evaluate the state of the patient, like if they are confused or uncomfortable, or put a patient at

ease by letting them know that they are there to help. Nonverbal communication through the use

of body language can be observed specifically with the head, eyes, and hands. These certain

areas are important in nonverbal communication in evaluating and altering patient status.

Nonverbal Communication Examples

As mentioned above, the eyes can be used to evaluate a patients emotional status. In the

article Body Language in Healthcare: A Contribution to Nursing Communication, the eyes

were highlighted in a study done to evaluate nurses interacting with their patients (Rezende,

2015). Renzendes work is the result of a masters thesis that was made to help others understand

the different aspects of communication in nursing and how these aspects effect the hospital

environment (Rezende, 2015). Rezendes research showed that nurses who held eye contact with

and without talking associated had more patients keep eye contact with them which helped the

patient understand the information being given to them and let the nurse know if the patient was

understanding or not (Rezende, 2015). The nurses who looked away when talking had lower
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rates of eye contact on the patients end (Rezende, 2015). This information contributes to the fact

that eye contact with patients makes them feel more comfortable and as if they are being paid

attention to. A nurse who comes in the room and does not even look the patient in the eyes will

not have a patient who is interested in what the nurse is saying or doing and may make them feel

uncomfortable.

The information also showed that nurses and patients were more likely to not keep eye

contact while talking, this may be due to the fact that the patient is uncomfortable with the nurse

or the nurse is looking down to read the information that he or she is saying (Rezende, 2015).

Either way, the results of the study show that patients seem more interacted with the nurses when

eye contact is kept (Rezende, 2015). The act of eye contact shows patients that the nurse is

speaking with the patient and not at the patient which is very important in the aspect of respect

and professionalism in nursing. The eyes are not just important for eye contact, they can also

convey emotions that the patient or nurse may not verbally express. Lester M. Sielski mentions

in his article that a wink can be a sign of affinity (Sielski, 1979). Drooping of the eyes can

express hardship, tiredness, and worry, which are all signs that need to be paid attention to, to

fully address the problems of the patient and know the state of the nurse (Sielski, 1979). Wide,

open eyes can signify good news, excitement, and/or happiness which are what nurses look to

see in their patients and can indicate satisfaction (Sielski, 1979). Eye contact can be incorporated

in the observation of head movements which are equally as important for understanding and

acknowledgment.

The utilization of head movement can clearly convey attentiveness (Birdsall, 1991).

Nodding can show that the nurse or patient is understanding what is being said (Birdsall, 1991).

Dropping of the head or leaning back of the head could show that the nurse or patient is
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disturbed or discouraged by what is going on or being said (Birdsall, 1991). Carole Anne Birdsall

says in her article about empathy that nurses who used head nodding while conversing with their

patients performed better (Birdsall, 1991). This improved performance was due to the fact that

the patient was satisfied with the level of attention given to them and the assurance that

information was administered properly (Birdsall, 1991). The position of the head can again

shows if the patient is comfortable or not. When the patient turns away they may be avoiding

seeing something that makes then uneasy, like getting a shot or their blood taken. When the

patients head is tilted it may indicate that they are confused or not interested in being there.

Maybe it was not the patients idea to be at the hospital and they are not listening to what the

nurses have to say so they tilt their head as if they are resting or could possibly fall asleep. The

patient may be looking at the nurse straight forward and then a sudden tilt occurs, this can be

seen as a sign that the patient has no idea what the nurse said or that in the patients mind the

information does not add up. The head being straight forward as so keep eye contact will tell the

nurse or patient that he or she is listening and interested which can ensure clear communication.

Along with the use of head movement comes eye orientation and with both of these things comes

the act of touch.

Courtney Davis, the author of The Hearts Truth: Essays on the Art of Nursing,

experiences the power of touch with a patient, Mrs. Cardiff, during her work as a nursing student

(Davis, 2009). Davis explains that the only true thing that impacted Mrs. Cardiff during her stay

was getting her feet washed by Davis (Davis, 2009). Though they exchanged no words, Davis

could sense the relaxing of Mrs. Cardiff during the times of washing her feet (Davis, 2009). The

act of washing Mrs. Cardiffs feet gave a lasting realization to Davis that touch, even without any

words, can keep patients hopeful and comfortable (Davis, 2009). Touch can convey empathy,
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compassion, and tenderness to a patient in their times of need. Without the words, a nurse tells

his or her patient I am here for you and I am going to take care of you. The power of touch can

heal patients. There may be a patient who has lost all hope, until you express hope and support to

them through even the smallest contact like placing hand on hand. The influence that nurses have

in the lives of their patients is so important, they can be the difference between giving up and

continuing to fight. That choice can be made through the act of touch to show that the patient is

not alone, that the nurse is here for them and they will get through what they are facing. Nurses

can also change a patient through touch even if it is a clinic patient coming in for something

minor. People go through things silently and that one moment of physical touch may help them

in more ways than one would think. Touch is a powerful tool and the use of touch is important

when communicating with patients. Through the use of touch a nurse can help a patient better

understand their diagnosis, a child feel like you really are there for them and can help, or an

elderly patient know they are going to be okay.

Common Pitfalls and Potential Problems

Nonverbal communication may not be effective in all instances. There are pitfalls that

may prevent efficient communication. Tan Jla Xing Jasmine evaluated the gaps in

communication in nursing, one thing that she points out is that culture may create issues in

communication (Jasmine, 2009). In Jasmines research, she find that there are many small

mistakes that nurses can make while caring for a patient through nonverbal communication that

may add up to some major issues (Jasmine, 2009). She also finds that without truly caring for the

patient, a nurse cannot provide the right care (Jasmine, 2009). For nonverbal communication,

this may pertain to the fact that in certain cultures it is seen as disrespectful for a woman to look

a man in the eyes. In that case, the use of eye contact for a means of communication would not
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be practical. While dealing with another patient, his or her culture may outline that responses are

to express verbally and that nodding is a sign that the person is not really listening or interest

(Jasmine, 2009). In this case, it may be difficult to know if the patient is understanding what the

nurse is saying because there is no indication that the information is being clearly expressed.

Another pitfall may be that nurses arent trained well enough in nonverbal communication and

they lack the discipline to use the form to care for their patients.

Conclusion

Nursing incorporates many forms of communication and nonverbal is an essential form.

Through the use of nonverbal communication, nurses can calm a patient, relay information

clearly, adjust their composition to make the patient more comfortable through observation, and

many other things. All of these things can be done through the evaluation of nonverbal cues,

specifically body language. Nurses need to be thoroughly educated in all forms of

communication, with special attention on how to utilize nonverbal communication aspects.

References
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Birdsall, C. (1991, January). Self-reported and patient-reported nonverbal communication and

empathy levels of nurses. Self-reported & Patient-reported Nonverbal Communication &

Empathy Levels of Nurses, 210 p.

Davis, C. (2009). Washing Mrs. Cardiffs Feet, The Heart's Truth: Essays on the Art of

Nursing. Kent, Ohio: Kent State University Press.

Jasmine, T. (2009). The use of effective therapeutic communication skills in nursing practice.

Singapore Nursing Journal, 36(1), 35-40.

Rezende RC, Oliveira RMP, Arajo STC, Guimares TCF, Esprito Santo FH, Porto IS. Body

language in health care: a contribution to nursing communication. Rev Bras Enferm.

2015;68(3):430-6. DOI: http://dx.doi.org/10.1590/0034-7167.2015680316i.

Sielski, L. M. (1979). Understanding Body Language. Personnel & Guidance Journal, 57(5),

238.