Counseling Skills for Nurses

Healthcare settings often require professionals to have overlapping, interdisciplinary skills, and no one works in isolation. Nurses are generally the frontline employees working directly with the patients, and they need to bring a variety of skills with them to be successful on the job.

While you may not be a licensed counselor or a psychologist, your role as a nurse will likely include a less formal form of counseling, especially with patients and their loved ones who are dealing with hard diagnoses and other intensive situations. Learning some basic counseling skills can help you to feel more confident in your ability to help your patients navigate these tough situations.

These basic counseling skills will help you get started: 

1. Active Listening

We’ve all had conversations in the past where we could tell that the person on the other end was hearing what we were saying but wasn’t really processing the information. This may have been due to outside distractions, difficulty maintaining attention, poor timing, or even just a lack of interest.

Actively listening means communicating your attention through your own body language. This can be done via eye contact, head nodding, or any other type of motion that indicates you are focused on the person speaking. Try not to listen to respond! Instead, listen to what the person is saying without drafting your response in your head.

2. Building Rapport 

It’s hard to trust anyone when you don’t have any rapport. Patients, in particular, are in a vulnerable position in a hospital or clinic setting. If you are working with a patient and want to try to build rapport, be sure to approach with authenticity. It can also be helpful to find something in common with the patient, such as a hobby or experience that you can both relate to. Be careful about relating your past medical experiences with the patient, as this could be seen as belittling the current situation. 

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3. Avoid Judgment 

As a nurse, you’ll get the patient’s documented reasons for admission and maybe some of the  past medical history or a record of chronic conditions. Although this information is representative of components of a patient, it doesn’t tell the whole story of the patient’s past or even current situation. Be careful to keep an open mind and avoid making judgments, as this can further isolate a patient who is already upset. Everyone has their own story, and everyone has made mistakes. 

4. Be Authentic 

We live in a world where we are often expected to put on a façade, especially while at work or out in public, in general. Being your true, authentic self can be really refreshing to a patient, and it can also help you to build a connection much more quickly. Be sure to maintain your ethics and professionalism in all of your work interactions, but don’t be afraid to show your personality and to allow yourself to relate to the patient. 

5. Demonstrate Empathy

Being empathetic with your patients will help to increase their sense of safety and security. You can show empathy by truly listening to your patient and by validating his or her emotions. Empathy is being able to understand how the person could feel a certain way and listening to their story without judgement or preconceived notions. Empathy is a skill that can be developed over time by raising your level of self-awareness through reflection and then applying those skills the next time you listen to someone who is going through a difficult time.

6. Repeat the Information 

One way to show the patient that you are really listening is to paraphrase their story back to them to make sure you have understood correctly. This is a skill we often ask patients to utilize to ensure they have understood the education we’ve provided as medical professionals. Being able to paraphrase a patient’s concerns shows that you have not only heard but are also trying to process what has been said. 

7. Offer Resources

Although nurses are often considered the primary caregivers in hospital settings, they are not the sole providers there to assist the patient. Remember the importance of calling on your colleagues. If the situation becomes escalated or the patient expresses the possibility of harming the self or others, be sure to contact the appropriate professionals for help. 

On a smaller scale, if you have a patient who isn’t necessarily in danger but is in need of more support, don’t forget about your hospital chaplains. Some patients even benefit from having a psych consult while in the hospital to help steer them in the right direction prior to discharge.

8. Check In

The role of a nurse is busy. In an ideal world, you could spend as much time as needed with your patient who is struggling emotionally, but you likely have several other patients to take care of. Medications need to be passed, documentation needs to be completed, and orders need to be filled. If you are having a busy shift but still want to express your support for a struggling patient, take a minute every now and then to just check in and see how they are doing. Taking the extra moment to acknowledge the patient shows that their struggles matter to you and that you are there for support. 

While nurses are technically not required to utilize these skills with their patients, many nurses go into the field because they want to care for others on a personal level. These basic counseling skills can be made applicable to many work environments, and they can even be used outside of work. 

Although you can certainly do a lot to make a patient feel more comfortable and empowered, be sure to remember to draw boundaries as needed and to know your limitations as someone who is not a licensed therapist or psychologist. 

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