By Phyllis Morton MSN, RN, SD and N. Tamara Ramirez MASF, BSN, RN, SD
Nursing is marked by immense responsibility and emotional strain, often leading to elevated stress levels that can adversely affect nurses’ health and wellbeing. To address these challenges, we encourage nurse leaders to incorporate active listening and verbatim tools—traditionally used by hospital chaplains and counselors. These techniques promote self-awareness, improve communication, strengthen team connections, and ultimately improve nurse wellbeing and mitigate stress injuries.
Active Listening
Active listening is an art that involves holding your internal dialogue, releasing a level of control, and listening with purpose, or with the intent to understand. It’s more than just hearing words; it’s about fully engaging with the speaker and comprehending their message on a deeper level. Imagine active listening as being on a seesaw—overall, it is fun but also a little scary, an act of trust and a practice of constraint.
According to Bregenzer (2020), active listening is crucial for a healthy workplace culture, employee wellbeing, job satisfaction, and improved retention rates. Despite its importance, active listening is rarely taught in nursing education. Nichols and Strauss (2020) find that the healthcare setting and culture offer numerous barriers to the practice. These barriers stem from both external and internal environmental factors, as noted by Some common barriers include:
Trouble suspending personal needs or having a listener’s agenda Distractions Hidden assumptions or preconceived notions Defensive emotional reactions to the topic Personality or cultural differences
Many of our struggles with active listening arise from the difficulty of quieting both external and internal chatter and focusing solely on the person in front of us. Aleja Parsons, Ph.D., emphasizes the challenge of active listening: “Being an active listener means choosing not to speak, not to contribute your opinion, not to defend your perspective, and not to offer solutions” (Parsons, 2020). Effective nurse leaders must turn off their problem-solving mindset to listen
We encourage nurse leaders to incorporate the six pillars of active listening: posture, environment, preparation, open-ended questions, paraphrasing, and reflecting feelings (Nemec et al., 2017) into their leadership practice.
The most important thing you can do in active listening is prepare. You will set yourself up for success by stopping other tasks and making sure you have the mental, physical, and emotional capacity to focus on the conversation. This includes meeting your physical needs and completing a mindfulness practice to prepare your heart and soul.
Next, be aware of the environment in which you are conversing. Is it in the middle of a busy hallway during rounds? Removing all distractions, ensuring privacy, and finding a safe space for the conversation is vital for any healthy conversation.
It is also important to note your posture. Throughout the conversation, do a self-check-in and note if you are maintaining an open posture, leaning forward, mirroring expressions, positioning appropriately, making culturally appropriate eye contact, and nodding regularly.
Finally, use paraphrasing and reflection to show you are listening to the speaker and understanding and empathizing with their feelings and experiences.
The Verbatim Tool
The verbatim tool is another valuable technique for improving communication and building connections. Traditionally, verbatims are word-for-word accounts of chaplains’ encounters with patients and their families. Nurse leaders can use this tool to reflect on conversations with team members.
Writing a verbatim involves three parts. First, one must write background information about the team member and the context. Next, they document the conversation word-for-word, along with one’s thoughts, emotions, and body movements. Finally, one conducts a comprehensive analysis using specific reflection questions (Powers et al., 2023).
The verbatim practice invites writers to consider their internal experiences during a conversation and how these impact the interaction’s outcome. According to Powers et al. (2023), “The verbatim invites the fellow to look deeply at how and why they respond in difficult encounters. Facilitators offer guidance and support for considering other communication practices that foster compassion and growth.”
Conclusion
Integrating active listening and verbatim techniques into nursing leadership practices has the capacity to transform nursing from the inside out, significantly enhancing nurse wellbeing and mitigating stress injuries.
References
Bregenzer, A. (2020). The impact of active listening on organizational culture and employee well-being. Journal of Workplace Psychology, 32(1), 45-58.
Nichols, M., & Strauss, M. (2020). Barriers to active listening in healthcare settings. Healthcare Management Review, 27(3), 150-160.
Parsons, A. (2020). The challenge of active listening in healthcare. Journal of Medical Leadership, 18(2), 89-95.
Nemec, P., Spagnolo, A. B., & Soydon, K. (2017). The six pillars of active listening in leadership. Leadership in Healthcare Journal, 22(4), 34-41.
Powers, R., Smith, J., & Lee, K. (2023). Reflective practices in healthcare: The verbatim tool. Journal of Healthcare Communication, 15(1), 102-115.
