Effective communication is central to the establishment of relationships among nurses, patients, family members, and health care professionals. Nurse educators are responsible for preparing students to appropriately engage in the communication process. The first step in effective and safe communication is a professional introduction. A simple approach for teaching nursing students the basics (ABCDs) of a professional introduction is outlined in this article. These guidelines can be used in simulated or clinical settings to teach and evaluate student competency in performing this fundamental yet critical skill:
Always introduce yourself to the patient. Use your full name (first and last name) unless you believe it will interfere with establishing a therapeutic relationship or if you feel your safety is at risk.
Be transparent. Tell the patient, family or health care professional your credentials and role in the patient's care.
Clarify how you would prefer to be addressed.
Document your full name and role on the bedside communication whiteboards, orientation, or other educational materials given to patients and family members.
Establishing a Therapeutic Relationship
Reciprocity in the professional introduction is also essential for establishing both therapeutic and collaborative working relationships. This same approach can be used for teaching students to develop relationships that honor the identity of the patient and assist in providing a foundation for trust:
Ask the patient how they would like to be addressed.
Be culturally sensitive and respectful and use inclusive language; for example, qualify the patient's identified pronoun (he, she, they, ze, etc).
Confirm the patient's answers by restating the preferred method of identification, and be sure to use it correctly when addressing the patient.
Document this important information in the health record.
Discussion
Despite a commitment to improving communication skills and increasing interprofessional collaboration, communication failures in the health care setting are common, and collaboration remains an elusive goal.1,2 According to the Interprofessional Education Collaborative,3 professional introductions that include the nurse's first and last name, credentials, and role in the patient's care are essential elements of effective interprofessional and patient-centered communication. The Patient Bill of Rights also includes the patient's right to know the identity of nurses, physicians, and other health care professionals involved in his/her care.4
An essential element of patient-centered care includes creating a foundation of trust based on cultural sensitivity and respect for patients and their unique identity. Do not assume that the name on patient's identification (ID) wristband or medical record is their preference but instead ask and respect individual values and the meaning of their identity as an important aspect of the preservation of patient autonomy.5 The essential components of professional introductions will be more consistently integrated into professional practice if the importance and rationale are introduced and reinforced in nursing education programs.
In preparing for future practice, nursing students should be taught early in their nursing program to introduce themselves in a professional manner to patients, family members, and health care team members, as well as be comfortable with the relational communication that respects their patient's identity and choice of how they wish to be addressed. This preparation for practice is as essential to safe practice as hand washing and using a double-identifier to confirm the patient's identity.
Nursing students at our college are taught correct professional introductions and relational communication that centers on respect in their first nursing course often using role play and group discussions. Students may be surprised to spend time and attention on what is often an assumed but nonstandardized aspect of care introductions. The use of professional introductions should be reinforced again when students participate in clinical simulation. For example, in a simulation, the student might use the following introduction, "Good morning, Mrs Geary. My name is Patricia Diaz, and I am the nursing student from (school name) who will be caring for you today. I will be working with your nurse Mary Jones. Please call me Patty."
Nursing students frequently report that nurses in the practice setting do not always use their last names, may cover up their last names on their ID badges, and typically address the patient using the name on the medical record or name band without asking how the patient prefers to be addressed. These practices should be discussed during clinical postconferences. There are also nurses who role model professional introduction, identifying themselves by first and last name. This helps students realize that this standard is possible and desirable.
Students should be informed of the difference between the information provided by the nurse during a professional introduction and the personal identification information displayed on a hospital-issued ID badge. The information displayed on the ID badge is subject to both state-legislated statute and hospital policy. For example, some states allow the identification on the ID badge to be limited to the first name and credentials only under certain limited circumstances such as when there are safety or therapeutic concerns.6 Nurse educators should inform students of the need to be aware of the state statutes where they are practicing as well as hospital policies regarding identification.
The reality of the clinical workplace is that the standard for professional introduction is inconsistent, and many nurses introduce themselves with first names only. The lack of professional introductions is often based on long-held yet unsubstantiated concerns (eg, threats to personal safety) that have been described in the literature and should be discussed with students7-11 (also R. A. LeBlanc, M. E. Burke, E. A. Henneman, unpublished data, 2015).
Physicians are taught professional greetings in medical school and traditionally introduce themselves using first and last names or last name only prefaced by the title of doctor. Evidence related to the best practices regarding professional introduction is limited and related mainly to physician-patient interactions. Patients have indicated they prefer physicians to introduce themselves with both first and last names.12 Using first and last names conveys respect and also is critical to differentiating among patients and health care professionals in a facility who have the same first name.13
Unlike other practices or standards, a professional introduction is completely within the control of the student and nurse. Nurse educators should stress this fact and use it as an example of the nurse's professional role in establishing a contract between themselves and their patients as deemed by the American Nurses Association Social Policy Statement.13 When the importance of professional introduction has been taught and reinforced, students will retain the practice as part of their professional nursing role. It is hoped that this practice will effect positive change in the culture of nursing and improve communication, safety, and professional identity.
Acknowledgment
The authors thank Jordon Bosse for feedback on assessing a patient's personal identity and how to address the patient.
References