Nonviolent Communication™ Skills and Healthcare

“Look at what really prevents patients from getting the care they need and health care workers from getting the support needed to thrive in the stressful environment of health care”

-Mel Sears

What is the role of Nonviolent Communication in the healthcare industry?

In her book, Humanizing Healthcare, Melanie Sears, RN, MBA, describes the wonderful potential NVC has to improve the experience of both patients and healthcare workers.

And she makes the point that NVC in a healthcare setting could actually save lives!

When healthcare workers don’t understand or engage with emotional needs — patients’ or their own — quality of care is diminished.

When there are misunderstandings or conflicts among staff, if healthcare workers allow hurt feelings to get in the way of teamwork, then essential information can be misheard, delayed, or withheld. This negatively impacts patients.

If hurt feelings, unprocessed grief, or unresolved conflicts get in the way of the quality of care, then there are deeper issues to explore, likely in the areas of organizational culture, teamwork, and individual skill-development. NVC informs all of these areas in a powerful way!

Nonviolent Communication in the healthcare industry produces measurable results. More effective teamwork translates into better patient outcomes and happier staff. This results in lower staff turnover, which in turn means lower costs for a clinic or hospital because re-hiring and training new staff is costly.

Unfortunately, healthcare is known as an area that really needs NVC!

Implementing NVC in the healthcare industry would mean that healthcare itself would become not only more effective but more compassionate, giving it as a field much more integrity and congruence.

The Importance of Effective Communication in Healthcare

Effective communication has the potential of positively impacting, or even resolving, multiple problem areas simultaneously: this is the importance of effective communication in healthcare.

The lack of effective communication in healthcare leads to the breakdown of both individual relationships and quality teamwork. These in turn lead to diminished patient attention and decreased staff satisfaction.

Effective communication — such as the tools NVC provides — produces closer connections between individuals, within teams, and among teams. This is because applying NVC by its very nature contributes to trust-building.

When we have trust between us, we aren’t second-guessing each other’s intentions, we get our feelings hurt less easily, and we prevent and resolve conflicts more readily.

When the interpersonal environment in a healthcare setting is toxic, no one enjoys going to work and the patients can feel it.

This is the importance of NVC in healthcare: an environment of trust and emotional safety in which people enjoy each other as both an added benefit and an important foundation of the shared work.

The Role of Empathy in Communication Between Healthcare Providers and Patients

What is the role of empathy in communication between healthcare providers and patients?

First, let us define empathy.

Empathy is a Universal Human Need which can be defined as a respectful understanding or a compassionate understanding. Your need for empathy is met when you trust that you have been deeply understood.

Colloquially we use the expression “giving empathy” — though technically we do not actually give empathy. What we give is our full presence, with our whole being, rather than letting this become merely an intellectual exercise. As a result of being listened to with full compassionate presence, the other person’s need for empathy is met.

What is empathy for?

When someone is listened to empathically, afterwards they are more connected to their feelings, needs, and potential requests, and they come away with a lowered emotional charge.

When someone is unable to listen because they are in too much emotional pain, empathy can help them re-connect with themselves and settle to the point that often they are able to listen with empathy afterwards.

Empathy also functions as a pressure-release valve, in the sense that the pain that felt so intense at some point is allowed to “dissipate” to a certain extent through this high quality listening. Most of us make better decisions and enjoy life more when we don’t have the internal pressure of uncomfortable emotions due to unmet needs.

How does empathy help patients?

What is often distressing to patients is that their feelings are left out of what is considered important by healthcare providers — and therefore their felt-sense of being cared for is much less than it could be. Simply being heard — or even a brief connection — can go a long way toward helping someone relax.

When someone is heard with empathy it builds trust, rapport, care, and the sense that their needs matter.

This also has its physiological correlates regarding stress and the body’s ability to heal.

So, how do you do empathy?

In essence, all you need is to be present, with the intention to understand.

Some valuable things to remember:

1. You are not responsible for the other person’s feelings; you can be present and caring without taking responsibility for either causing or having to resolve the other person’s emotional discomfort. It’s neither advisable nor practical to attempt to rescue others from feeling uncomfortable emotions. Instead, we are present. Curiosity and care are great attitudes to bring to this. And empathy by itself has therapeutic benefits.
2. Empathy does not mean agreement! You can give someone the experience that you understand their needs even if you have a very different perspective.

Of course, training in NVC will be valuable especially so that the process of translating any judgments you hear into feelings and needs becomes more fluid and natural.

For example, if someone says “they lied to me!” you can put your attention on what might be important to this person at a deeper level: in this case, it’s possible that this person values honesty, truthfulness, and/or integrity.

Empathy is fulfilled when the other person trusts that we understand their deeper needs — not when we merely understand their judgmental thinking! Usually, reinforcing judgmental thinking will only lead to more pain.

What gets in the way of offering someone empathy?

Usually what will get in your way of being able to offer another your full presence is that you are in too much emotional pain.

In these circumstances, you can get empathy from someone else — and/or offer yourself self-empathy — until you are sufficiently self-connected to go back to the conversation.

One of the most important functions of NVC in a healthcare setting is the realization that you cannot be fully present for the people you serve if you yourself are in an empathy deficit.

Doctors, nurses, and other healthcare staff need to be supported to find ways to process the emotional load of their work so that they can stay human, present, and compassionate for the people they intend to serve.

This can be accomplished in many ways, including peer-to-peer empathy-and-honesty sessions.

Empathy is also a crucial factor for effective bedside manner.

A patient who experiences their doctor or nurse as cold, indifferent, or as regarding them as simply a mechanically functioning body — will not experience the relaxation that happens when someone trusts that their emotional needs also matter.

We know medically that stress impacts immune function negatively. Therefore, anything we can do to help someone feel heard, safe, that they belong, and that they matter will also contribute to physical healing — though on the surface the patient will simply be happier, or at least in less distress. NVC — and the practice of empathy — contribute greatly to reducing stress and helping people feel more comfortable.

The role of empathy in communication between healthcare providers and patients means providing a deep understanding of what patients are going through emotionally. This does not need to take a long time! And as mentioned earlier — not only does it build a sense of trust in the patient for the healthcare provider — it also has physiological correlates that impact health outcomes.

The Role of Compassionate Communication Between Doctors, Nurses and Staff

Patients are best served when they are attended to by a team that works effectively and harmoniously. This is an important part of the role of Compassionate Communication between doctors, nurses, and staff.

(Note: We use the terms Nonviolent Communication, NVC, and Compassionate Communication interchangeably.)

NVC gives us the most effective tools and skills for the kind of communication that leads to:

• Better relationships
• Effective teamwork
• Higher job satisfaction, and
• Lower employee turnover.

As a result, healthcare facilities save money and connected teams enjoy the work together more. The efficiency and positivity rubs off on patients, leading to
higher patient satisfaction ratings.

Below is a link to an audio interview titled “My Lessons Trying to Transform a 4,000 Person Organization.” In the interview, Wes Taylor — who at the time of the interview was both a CNVC Certified Trainer and Manager of Leadership and Team Development at Mercy Medical Center in Baltimore, Maryland — describes both the cost-savings for the hospital and the increased staff retention and patient satisfaction scores that were a direct outcome of the systematic NVC training Wes brought to the organization.

My Lessons Trying to Transform a 4,000 Person Organization, Alan Rafael Seid interviews West Taylor. 

Compassionate Communication between doctors, nurses, and staff has multiple roles: (1) offering a paradigm shift around people showing up at work as whole human beings who can share their vulnerability with one another; (2) that individuals and teams can get the work done fully, with integrity, and with human warmth and compassion; (3) a revolution in patient care when the needs of the whole person are attended to with care and compassion.

NVC is the Cornerstone of Effective Interpersonal Communication Skills

“NVC provides us with the most effective tools to foster health and relationships.”
Anthony Robbins, Awaken the Giant Within and Unlimited Power

NVC is the cornerstone of effective interpersonal communication skills, in part because it integrates so many crucial components in a very simple model.

NVC does not give us a recipe or a formula. Instead, it gives us three essential toolboxes, one in each of the following areas: empathy (how we listen), honesty (how we speak), and self-connection (which includes self-empathy, healthy self-talk, increasing our distress tolerance, and self-responsibility, among others).

NVC is rooted in clinical psychology — Dr. Marshall Rosenberg was a student of the famous psychologist Carl Rogers — but is also informed by the world’s wisdom traditions, without associating itself with any religion or path.

The focus of NVC is a high quality of connection along with a willingness to work toward mutually satisfying outcomes.

NVC is so powerful because it has both a distinct and practical model, and it is based on clarity of intention and skillful deployment of attention. What do we mean by this?

As the cornerstone of effective communication skills, the purpose of NVC is to create a high quality of connection out of which people naturally choose to contribute to one another’s well-being.

It is not a set of techniques we try on others.

It is not a process for getting others to do what we want.

The intention is to create the conditions — high quality of connection — out of which we will most easily find a win-win outcome, or a mutually satisfying solution.

Our attention is deployed skillfully and with intentionality. We focus on:

• clear observations (what happened rather than evaluations or interpretations),
• feelings (what is the current emotional reality),
• needs (what is deeply important at the level of a core motivator) and
• requests which could lead to making life more wonderful. We are aware that communication can be full of blame, judgment, criticism, and demands. We choose where we put our attention because we are wise to the fact that it meets our own — and others’ — needs best to do so.

When we support our medical professionals by making training available in these tools and skills, we up-level the quality of the work environment AND the quality of care for patients.

It would make sense, then, that medical administrators and professionals would avail themselves of the cornerstone of effective interpersonal communication skills, NVC.

“No matter what issue you’re facing, NVC will set you up to win every time.”
Deepak Chopra, The Seven Spiritual Laws of Success.

Dr. Marshall Rosenberg on Communicating with Compassion in Medicine

Dr. Marshall B. Rosenberg, Ph.D. advocated for love, compassion, understanding, and the power of the truth and truthfulness in all contexts.

Healthcare is a field that ironically has lost much of its human touch, at least in part because healthcare workers are in an empathy deficit. Bringing the tools and skills of NVC into healthcare would go a long way toward humanizing the field.

We highly recommend the book, Humanizing Healthcare, by Melanie Sears, RN, MBA. In her book she brings an insider’s perspective to the field, combined with her years of NVC experience, to cast light on areas that could be vastly improved with remarkably simple interventions.

Dr. Marshall Rosenberg left us with an exceptional methodology for creating a high quality of connection with ourselves and each other, in both the best and worst of times.

When we forge strong personal and professional relationships we are at our best for addressing issues such as workplace burnout and conflicts.

Healthcare is an area in which it would seem natural to have the highest levels of professional coordination and cooperation — and NVC gives you the most powerful tools for interpersonal effectiveness in a healthcare setting.

Puddledancer Press Books for Improving Communication Skills in Healthcare

PuddleDancer Press is the foremost proponent and publisher of books on Nonviolent Communication and healthcare.

NVC has shown time and again that human beings are capable of arriving at mutually satisfying outcomes, even in challenging contexts.

Because of the trust-building process involved, and the fact that the solutions include everyone’s buy-in, using NVC in a healthcare setting predictably gives us outcomes that meet a greater number of needs and are more durable.

Our books on NVC in healthcare can help you:

• Create exceptional personal and professional relationships,
• Offer compassionate understanding to others,
• Know when and how to ask for that same understanding for yourself,
• Prevent and resolve misunderstandings and conflicts,
• Speak your truth in a clear, powerful way more likely to lead to harmony than conflict,
• Create mutual understanding without coercion.

Whether you are a long-time student — or are brand new to NVC — PuddleDancer Press has the educational resources, including the books on NVC & healthcare, to help you grow your emotional intelligence, interpersonal skills, and communication prowess. Check out our catalog of books on how to apply NVC in all areas, including healthcare… and give yourself the gift of Compassionate Communication!

Topic written by Alan Seid, a Certified Trainer, on behalf of PuddleDancer Press for use on www.nonviolentcommunication.com.