August 18, 2010 | | Comments 0
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Enhance the patient experience: Four pointers on nonverbal communication

I’ve been doing a lot of communication skill training recently and I’m repeatedly impressed by the impact that nonverbal dynamics have between staff and customers on rapport, trust, and mutual respect.

I’ve been privileged to observe many people’s nonverbal behavior as they try their hand at various everyday scenarios. And here’s what I see:

  • Some people say the right thing, but their nonverbal behavior doesn’t support what they’re saying
  • Some staff respond to the content of what their customer is saying, even when the customer’s nonverbal behaviors communicate a completely different message
  • When asked to help each other communicate better, most people focus on “what you can say that might be better,” not on opportunities to communicate better nonverbally

These observations have prompted me to think more about how to make nonverbal communication work for us as we strive to create great patient/customer experiences.

I want to share four thoughts with you:

1. If your verbal and nonverbal messages don’t match, people believe your nonverbal messages. Picture this. You’re furious, with a scrunched up forehead and sharply bitter tone, and you say, “I am NOT angry!” There will be no doubt in people’s minds that you are angry, despite you saying you are not. This point is at the heart of why use of great scripts or key words can fail miserably if people’s nonverbal behavior doesn’t support the key words. At a fast food chain, for example, most employees say “have a good day” as they complete your order. Some of them say this while making eye contact and smiling, and that makes it believable. But others say it in a robotic or resentful tone, and that does not accomplish its purpose. In those situations, I want to say, “If you want me to have a good day, first tell your face.”

2. If you don’t tune in to the nonverbal signals of the people you serve, you’ll miss really important information and respond in ways that appear insensitive or uncaring. My sister Linda is having a lot of undiagnosed pain. Upon arriving one morning, her caregiver Debbie asked her, “How are you feeling today, Linda?” Linda answered with a pained expression and a defeated tone, “Fine!” If Debbie hadn’t noticed Linda’s nonverbal cues, she would have taken her words at face value and said exuberantly, “great!” Debbie would have missed Linda’s real message entirely. Instead, Debbie noticed Linda’s expression and tone and believed these signals, not her words. So, even though Linda said, “I’m fine,” Debbie responded with empathy, saying, “You look really uncomfortable. I bet it’s really hard to have so much pain and not know what’s wrong.” These words of empathy connected Linda to Debbie and helped her feel less alone. One more thing: When Debbie is with Linda, Debbie really tunes in. She’s fully present to her. If you aren’t present to the person you’re with, you’re going to miss their signals entirely, be unable to meet their real needs, and miss the chance to show you’re caring.

3. People’s nonverbal signals are often not about you. It is often the situation, not the person, that triggers negative nonverbal signals.  Anxiety, stress, nervousness, fear, newness, pain-all of these cause patients and families to feel distress and show it in their nonverbal behavior. So, when the people you serve scowl, groan, harrumph, raise their eyebrows, use snapping tones, shake their heads, and clench their teeth, consider first that these are signs of their distress over their situation, not about you. Instead of taking it personally, cut people a break and use these as triggers for responding with empathy.

4. One nonverbal communication guideline will protect you from appearing culturally insensitive. While communication research has shown that some nonverbal behaviors are universally understood (e.g., expressions of happiness, sadness, fear, disgust, surprise, and anger), the meaning of most other nonverbal behaviors depends on one’s culture.

In some cultures:

  • Shaking the head sideways means you agree
  • The thumbs-up gesture is considered rude
  • Looking down and not making eye contact is considered respectful
  • Standing close to someone while talking with them is considered an invasion of personal space

So what can you do? After all, knowing the cultural meaning of thousands of nonverbal behaviors and many diverse cultures is utterly impossible, and even when you try to learn this, you risk stereotyping people and that can be offensive. There is a solution. Mirror the other person’s nonverbal behavior. Match your body language signals to theirs. If they look intense, you look intense. If they are speaking quickly, speed up your speaking pace. If they show a sense of urgency, then respond with a sense of urgency, not only in your words, but also in your body language and tone. If they back away from you, back away a bit yourself. When you synchronize your body language with theirs, it’s affirming to the other person. They feel accepted and this builds rapport and trust.

Remember: Nonverbal communication has an enormous impact. Your posture, tone, pace, and face all give away your real meaning.

Click below for great tools you can use to raise staff awareness about nonverbal behavior:
Feeling Charades

Nonverbal Behavior Inventory

View video examples of nonverbal communication applied to healthcare realities now. Click here to watch “Showing Caring Nonverbally.” After you click, scroll down to the jukebox video player, and choose the video “Showing Nonverbal Caring.”

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Filed Under: Healthcare communication


Wendy Leebov About the Author: Wendy Leebov is a passionate advocate for creating healing environments for patients, families and the entire healthcare team. A mission-driven expert, Leebov provides outcomes-based consulting services, culture change strategies with healthcare organizations, training and tools for enhancing the patient and employee experience. With more than 30 years of experience and skills in communication, training design and delivery, she is known for making hard skills accessible and motivating people to stretch and apply skills which set them apart. Author of 12 books for healthcare, Wendy has produced two groundbreaking video-based skill building systems that educate and empower all staff to deliver the exceptional patient experience consistently by excelling at caring communication. Wendy writes a free monthly e-newsletter - HeartBeat on the Quality Patient Experience - packed with concrete tips and tools for managers who champion the great patient and employee experience. Visit Wendy’s website for more great tips and tools.

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