Communication and Interpersonal Skills
What you must understand
Communication is a two-way exchange, and on a nursing unit most of it is nonverbal: facial expression, posture, tone, touch, and distance. Active listening means facing the resident, getting to eye level, letting them finish, and reflecting back what you heard ("So the noise from the hallway is what keeps you awake"). Use open-ended questions to invite information and closed yes/no questions when a resident is short of breath, confused, or has aphasia. Use the name the resident prefers, never "honey" or "sweetie," and avoid jargon and baby talk.
Sensory and cognitive adjustments matter. For hearing loss: get the person's attention, face them, reduce background noise, speak slowly and in a slightly lower voice, and do not shout. For vision loss: announce yourself and say what you are about to do before you touch. For aphasia: allow long pauses, offer picture boards, and never pretend to understand. With confusion, give one direction at a time and reorient gently rather than arguing. Report to the nurse in objective terms, and share only what the care team needs to know.
Traps the exam sets
- Answers that have you explain a procedure in medical terms, or use a resident's diagnosis as small talk in public areas.
- Repeating the same sentence louder when a resident does not understand - change the wording, not the volume.
- Reporting judgments ("she was being difficult") instead of observations ("she pulled her arm away and said 'no'").
- Discussing a resident in an elevator, at lunch, or with a neighbor - that is a confidentiality breach.
Rule of thumb
When a resident does not understand you, change how you say it, not what you say: shorter sentence, simpler word, one idea at a time. Worked example: Mrs. R wears a hearing aid in her right ear, which is her better ear. You turn off the television, approach from her right side, crouch to eye level, and speak slowly in a low voice without shouting.