Building Trust in Telephone Nurse Triage

The nurse-patient relationship is an important part of any patients total treatment plan. Trust is an essential component to that relationship and helps to improve compliance leading to better patient outcomes. Patients who do not trust their nurses tend not to follow their instructions, which can, in turn, lead to a delay of care and negative outcome for the patient.
Communication plays a big part in building trust. Studies have shown that only 6 percent of communication is the actual words being said, 38 percent is through the tone of voice and as much as 55 percent of communication occurs through body language (Barkley, P. April 2015).
From the very first encounter, nurses start to build trust with their patients. Typically this is done when the nurse first enters the patient’s room and introduces herself. She uses all of her senses to connect with her patient- facial expressions, tone of voice, words, body language and a sense of touch (such as a firm hand shake or placing a comforting hand on the shoulder of an anxious patient).
Telephone triage nurses realize from their first phone call that they are at a disadvantage and must work extra hard to build that trust. The telephone triage nurse has only about 10-12 minutes, on average, to get their patients to open up, discuss their issues, develop a plan and assure their patient is able and willing to follow through with the plan. To add an extra layer of difficulty, the nurse cannot see or touch her patient making her verbal communication and listening skills her most important ally.
Patients have very few “wants” from their healthcare providers- they want to be heard, they want to be cared about, they want to feel respected and they want to be a team player in their treatment plan. A patient must feel that the nurse understands their condition and has their best interests at heart.
Not all nurses are born with the instinct of knowing just what to say and how to say it but with practice it is something that can be learned and perfected. Here are some ways to help build trust and relationships with your patients.
Make the patient part of the plan. Ask empowering questions- what does the patient feel is causing their symptoms? What have they already tried to get relief? Be sure to compliment their efforts.
Focus on their needs. This is not the time to discuss your personal ailments or how bad your day was. Leave your personal life out of your work and focus on your patient and how you can best help them.
Respect. Don’t come across as a dictator! Include your patient in the treatment plan. Always address your patient by name, never terms such as “Sugar” or “Darling”, which can be viewed as disrespectful in some cultures.
Be empathetic. You don’t have to like or agree with the other person’s personal views but you have to at least understand them. As nurses, we need to be sensitive to patients’ needs and feelings, so try making one empathic statement during each patient encounter. You might say, for example, “I’m so sorry you are in pain”, this must be very difficult to talk about” or “It is always hard to see your child sick but you are doing a great job taking care of him”.
Allow your patient to be emotional- don’t minimize what they are going thru. Pain, fear and exhaustion drive many people to act out or say things they normally wouldn’t. Don’t take it personally, instead, try putting yourself in their shoes- sometimes a different perspective helps us to be more understanding.
Above all- Listen! Most of what you need to know you can learn by putting your pen down and your proverbial listening hat on and focusing on the patient’s words and tone of voice. By asking, listening and learning, telephone triage nurses can connect with their patients and show them that we really do have their best interests at heart.

Reference:
Barkley, P. Building Rapport with your Patient: Positive Case Management Outcomes. April 20, 2015. http://www.nahc.org/news/building-rapport-with-your-patient-positive-case-management-outcomes.

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