Employ ‘NURS’

Continue Reading

Jane Schell, MD, a palliative care nephrologist and clinician educator at the University of Pittsburgh Medical Center, said physicians often go wrong by heaping information on patients so they understand the care they are receiving. Physicians should avoid medical jargon and give patients big-picture information.

Dr Schell recommends back-and-forth communication between physicians and patients—an “ask-tell-ask” approach. 

The objective is to learn what patients know about their condition, the barriers they may face, what, if anything, they want to do about it, and what they want to know about their condition.

An ask-tell-ask approach can help improve communication by encouraging physicians not to lead patient encounters with their agenda, but rather to take into account what patients want out of a visit. It also can get physicians out of the habit of interrupting patients.

Physicians should expect that patients may react emotionally to information given to them, and they may cry or exhibit anger. Using the NURS tactic—name, understand, respect, and support—can help. 

When patients get emotional after hearing bad new physicians could start with a phrase like, “I can see this information really shocked you.” That, Dr Baile said, is more powerful than saying, “Don’t worry, we have a cure,” or “Survival rates for this condition are good.” 

Support for the patient may include praising them for their endurance such as  “ you really toughed it out through this harsh treatment”.

Along with asking patients what they understand about their condition, Dr Baile recommends asking patients what worries them most. One might be surprised that while many patients may be afraid of dying from their disease, others may be worrying how to get a ride to the next doctor visit .

This article originally appeared on Renal and Urology News