SPEAKING

GREETING

 Good Morning
 Good Afternoon
 Good Evening

INTRODUCTION

I. Hospitalward/ clinic/ emergency department

 I am ..... one of the registered nurses working in this
clinic/ hospital ward/ emergency department.
 My name is ..... a registered nurse working in this
clinic/hospital ward/ emergency department.
II. Home visit
 Good morning. I am the community nurse (assigned ) .
my name is.......
Is this Mr/Ms/Mrs ‘s house?
Am I talking to Mr/Ms/Mrs.........?

 Good morning. I am the community nurse (assigned ) .

my name is.......
Am I talking to Mr/Ms/Mrs.........?

MAKING PATIENT/ BYSTANDER COMFORTABLE

 Please make yourself comfortable

 Please take your seat
 Please be seated
REASON FOR VISIT

 Could you please tell me what brings you here today?

 Please tell me, what has brought you in to see me
today?
 How can I help you?

Second visit:

 Good afternoon, nice to meet youagain. How are

you so far? /How can I help you?

REASSURANCE AFTER VISIT ENQUIRY

 Please don’t worry. You are in safe hands.

CHECKING NAME

 Could you please tell me your full name?

 For further documentation purpose, may I know
your name and age?
 Would you please tell your name and age for the
documentation purpose?
 May I know your name and age for further
communication purpose? (to bystanders)
 Ms/ MR ..... may i know ......’s name?
 Before we start can Icheck your name?
 Firstly, can I check how you would prefer to be
called?
SYMPATHY & HISTORY

A. Starting
 Oh, I am really sorry to hear that, it must have been very
painful/ it must be stressful for you, but can Iask you some
questions first if you don’t mind?
 all right Mr. … I appreciate your (fears, worries, concern,
etc.) would you mind if I ask you a few further questions
regarding this situation?
B. Second visit
 your test results are back and I am so sorry to tell you that
you have a condition called…

Social history

 Will anybody be at home to look after you when you are

discharged?
 Do your family live nearby?
 Do you have any friends and neighbours who can help you?
 Is there anything you need help with at home such
as.....or...? ( from hospital’s side)

medical history

 have you ever had a serious illness in the past? ( open ended question)
 Are you allergic to anything? ( open ended question)
 Are you allergic to.......? ( ask in particular)
 How long have you been feeling this way?
 Have you ever been in hospital before?
 Have you tried/taken any medication for it?
Asking clarification

 What about .....? Are you eating well?Can you tell me more
about your lifestyle? Do you eat healthy food? Open ended question
 Do you inclue.....in your diet? (Close ended question)
 Can you tell when you first noticed....? Close ended question
 Do you have....? / Have you had any symptoms like …? Close
ended question

 Has your condition improved since you started taking

(drug)? Close ended question
 Could you describe the pain? Does it occur all the time or
just now and again? Open ended question
 Can you please rate the pain on a scale of 1 to 10?
 Are you in any pain at the moment? Close ended
question
 Does anything special make it worse or relieve it?
 Does anything seem to bring it on or aggravate it?
 Do you drink alcohol every day ? Do you smoke? What do
you do for exercise? Close ended question
 How often do you...? Close ended question
 How many hours of sleep do you get? Close ended question
 Please tell me more about your occupation? Open ended question
 Doe your job include any activities like.......? Close ended question
 Could you open your bowels this morning/today?

Asking the site of pain

 Which part of your body is affected?

 I would like to check/examine you if you don’t mind. May I?
 Could you tell me where the pain is?
  Can you tell me where it hurts?

Duration

 When did it start?

 How long have you had it?
 How long have you been suffering from this problem?
 How long have you been feeling like that?

End of history

 Is there anything else that is bothering you?

Embeded questions always increases scores. Try to add Could you tell
me, Do you remember, Can you tell me and Can you explain

Could you tell me what/when/why.......?

Do you remember what/why/when/.....?
Can you tell me i/what/why/when.....?
Can you explain when/why/how....?
Do you mind explaining when/why/how....?

DIAGNOSIS

 Well, based on your symptoms and after examination, I

believe that you have what is called …. , and let me explain
….
 You are suffering from a condition known as… have you ever
heard of that?
  sorry for the medical term, you are diagnosed with/ you
have ....., have you ever heard about this?
 The X ray indicates that you have ….. /the tests show that it
is probably a conditionknown as ….. and let me explain….I
would like to see you in a week
 It is a condition caused by …. The symptoms include ….. the
best treatment is...

MANAGEMENT

 I think we would start with …I shall give you a prescription

for …and shall write a referral letter to …We will run some
tests to see …
 And now we have some treatment plan to discuss, would
you like to go though this with me?
 First of all …… it is also important to ….do you think you can
do it?
 There are some very effective strategies to cope with …… I
would like to explain them for you Is that okay?
 I see that must be a very difficult situation for you but the
good news is that there are several options available which
will help you. Would you like to hear more aboutthat?
 It is a good time to start …. , in terms of ……. , it will be
necessary for you to…

ASKING TO REVISIT AND FOLLOW UPS

 Please come and see me again in a week/......

 I would like to see you/your...again in.... Please take care
now.
ASKING TO WAIT

 I ‘ll come back in an hour to check on you. Please wait.

 I ‘ll come back and check on your condition later today.
 If your condition/situation gets worse please let me know.
 If you need me again just press the buzzer.

ENDING

 Do you have any more question?

 Hope you feel better soon.
 Wish you a speedy recovery.
 I would like to see you in a week, don’t hesitate to call me if
you have any concerns.
 Here are some brochure that explains ......please go through it
in case of doubts and contact us if any help needed.

A USEFUL PHRASE FOR WHEN YOU AND THE PATIENT DISAGREE

 “I want to ensure your daughter gets the best possible

treatment, and it isfor that reason that I am referring her to
hospital”
 “I can see we have a difference in opinion, but I can assure you
I have your best interests at heart”

ASKING PERMISSION AND CONSENT TO PROCEED

 “I can see you are understandably upset, but is it OK if I ask you a

few more questions?”
  “Many people feel embarrassed about such topics, but it is
important I ask somemore questions in order for me to help you,
would that be OK?”

PHRASES TO DEMONSTRATE A NON-JUDGEMENTAL APPROACH

( avoid telling patients what they must do)

 “I would strongly advise that you…...

 ”“It is understandable to think that….however studies have shown
that in fact….”
 “I can see that this is a big decision. Why don’t I give you a leaflet
and you can discuss it with your family. I will make you an
appointment to discuss this further in the future”

PHRASES TO SHOW EMPATHY

 “It sounds like this has been a stressful time for you”
 “It seems to me that this has been a big worry for you”
 “I can see that you appear to be very upset by this, would you like
to talk more about that?”“I’m sorry to hear that”
 “It is understandable to feel worried/upset/frustrated in
thissituation”
 “I appreciate that this has been worrying/upsetting for you”
 I know this must be difficult (but…)
 This must seem really scary, but …
 I know this is hard but …I’m so sorry to hear that
 I’m so sorry you’re experiencing this
 That sounds really hard/tough/difficult
 It’s okay
 Try not to worry
REASSURING

• Plesae don’t worry

• You'll be fine. / It'll be fine

• What are you worrying for?

• There's no need to worry.

• There's nothing to worry about.

• It'll turn out all right.

• It isn't as bad as all that.

• Whatever you may have heard…..rest assured,……….....

• I can assure you that... * Rest assured, this is quite a common.

 It is nothing to get alarmed about…

 Let me reassure you that eczema is self limited.
 Don’t worry, if you can follow my advice you will get much better
soon.
 Don’t worry it will go away by itself in a few days with some rest.
 I know it sounds difficult at first but with practice, I am sure you
will be able to
 I am sure you won’t have any more trouble
 The staff here are very experienced and will take good care of you

RELUCTANT PATIENT
  I really appreciate your concern / I can understand your worries/ I
know how you feel but let me …
 I completely understand your busy time, but yourhealth is my
priority
 Let me assure you, if you follow my advice the risk of .......... will
be reduced; however, if you do not follow my advice and continue
to ..... then the risk of heart ........ is much higher. you don’t want
that to happen, do you?
 Let me explain to you why the insulin therapy is necessary for you.
Please listen.
 Of course you will need to continue…However, I don’t think …. will
be helpful in your situation.I would prefer alternatives.
 I understand … but let me explain to you why it is not a good
choice for you to …

Finally, after agreement

 I’m pleased to hear that. Now …

CHECKING UNDERSTANDING

 Is that clear / am I clear so far?/ How does that sound/ Am I clear

till now?
 Do you think you can do that /Do you feel comfortable about my
advice?
 Do you have any question so far ?
 would you like me to tell you more about that?Have I made
everything clear?
 Does that make sense?
 Are we on the same page?
  Is there anything you don’t quite understand?
 Are there any (more, further) questions?

CONFIRM THE CLARIFICATION/ PROVIDE QUICK REMINDERS

• Let me repeat that.

• Let’s go through that again.

• If you don’t mind, I’d like to go over this again.

SIGNPOSTING

 First of all …...as I said before / as I told you earlier it is important

to / necessary to .......
 Firstly....secondly....thirdly...and finally....
 I have to highlight/ emphasize the importance of … it is very
beneficial for you.
 I recommend that // I strongly advice that you should lose weight.
 For this reason … therefore..., so… however…, in addition... also...,
now…

RESPONDING TO DOUBTS

 that is a good question and let me explain to you that

…
 It is a good idea to…Explaining:
 The reason for ……
 One possible explanation is that….
 What’s responsible for this effect is….
 Let me explain,……
 There’s no doubt in my mind……..
 It could well be that…………
  I’d say that ………..
 What I mean is…
 What I meant was…
 Let me put that another way…
 What I’m trying to say is…
 Let’s see if I can explain myself better.
 Let me try to explain that another way

BREAKING BAD NEWS

 Mr/Ms.... , we have the test results back and I’m

sorry to tell you that the cause of your symptoms
could be more serious than you think and that is a
risk that…
 I realize that this come as a shock to you (pause)
 It is a very important that we do a few further
investigations including …
 Fortunately, we caught it early and there are some
treatment options such aschemotherapy
 We will keep a close eye on you and be sure you
are in very good hands.
 It may be a good idea to talk to someone about
this.Do you have any relative or close friend who
can help you and provide support?
SAMPLE SENTENCES
REFER TO A DIETICIAN
  Now regarding your diet, I can refer you to a
dietician and they can provide reallygood
guidelines and healthy food options.

REFER TO PHYSIOTHERAPIST

 One way to speed up the recovery process

and to increase mobility is to visit
aphysiotherapist.They will be able to design a
rehabilitation program based on your needs
and it canmake a big difference. Would you
like to try that?

RECOMMENDING TO QUIT SMOKING

 Now in order to quit smoking, I recommend

that you attend our hospital’s quitsmoking
program.They run regular classes and I can tell
you that it has helped many patients
succeedin giving up smoking. Would you like
to do that?

PHRASES ON ALCOHOL ADDICTION

 It is really important/ It is quite a serious

condition, and you really need some outside
support to help you overcome this.Therefore,
I recommend that you contact alcoholics
anonymous, or I can contact themon your
behalf, and arrange an appointment.How
does that sound?
STARTING INSULIN

 I understand that self-injecting insulin can be

challenging at first, but at our clinic werun
weekly training programs which are run by
our nurses.They can take you through the
process step by step and help you gain
confidence.Would you like me to make an
appointment for you?

EXERCISE

 It is very important that you need to start an

exercise program, and I recommend joining a
local gym or sports Centre.They will be able to
create a fitness program that can help you
lose weight and feelhealthier. Do you think
you can do that?

STRESS MANAGEMENT

 To manage your stress, I think you need to

follow some relaxing techniquesWould you
like to discuss this?/ Would you like to try
this?
o First of all, you need to reduce working hours. It
is important to eat healthy diet. Reduce alcohol
consumption and caffeine drinks.
o For comfortable sleep you need to follow healthy
habits of good sleep,
o regulate rhythm is very important, it is one of the
main ways to treat your insomnia
o avoid caffeine drinks and alcohol
o have a hot bath before sleeping time
o make sure that sleeping area is pleasant.