1. Section Editor(s): Modic, Mary Beth MSN, RN, Column Editor
  2. Schoessler, Mary EdD, RN, Column Editor

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As preceptors, we are constantly looking for techniques to help us become better teachers with orientees. We review the day's events and contemplate whether we were clear enough in our explanations, descriptive enough in our feedback, and thoughtful enough in our questioning. All of these strategies-directing, describing, and evaluating, rely on the use of the spoken word. We all place great importance on our ability to speak cogently and thoughtfully. Yet, speaking is just one means of communication. What strategies do we employ to evaluate our listening skills? This month's column will be devoted to the topic of listening.


When we learned about therapeutic listening in our nursing programs, we were taught the basic tenets of listening: Listen not just to the words but to the intent of the words, use eye contact, seek clarification by paraphrasing the message, and be empathic and nonjudgmental. The lesson may have even begun with the quotation attributed to Epictetus, "We have two ears and one tongue so that we may listen twice as much as we speak," to remind us to refrain from talking when another is speaking.


Listening is such a basic skill that we often take it for granted. Most of us rate ourselves as better listeners than we truly are. How effective are you as a listener? Use these self-assessment questions to gain some basic insight into your listening effectiveness.


1. How would you rate your listening skills?


2. How would others rate your listening skills?


3. How often do you interrupt someone during a conversation?


4. How easily distracted are you in a meeting when another is speaking?


5. How often are you forming your response to a remark rather than waiting until the other person has finished speaking?


6. How often are you multitasking when someone is speaking to you?



If you answered honestly, you may want to identify listening as an area for self-improvement.


Listening serves three major purposes: It bears witness to another's experience, conveys information, and identifies discrepancies in thinking. When we step out of our own frame of reference and really listen to another person, we acknowledge and affirm that person (Nichols, 2009). We identify flaws in our own and others' thinking when we truly listen. We gain knowledge when we listen intently. We get into and out of difficulties with each other to a large extent by the way we listen and by what we hear, mishear, and fail to hear (Myers 2000).


How can we enhance our listening? We can employ these five strategies:


1. Listen with presence.


2. Listen with our eyes.


3. Listen with an open mind.


4. Listen with our heart.


5. Listen with respect.



Listen with presence. To be an effective listener, we must be committed. The best listeners give their undivided attention to a person who is speaking. They convey the message that there is nothing more important or as interesting as what is being said at the moment. The listener is attentive, focused, and alert (Scanlon, 2007). Resist the impulse to control the process by trying to accelerate problem solving or self-reflection. The orientee will have his or her own natural rhythm in resolving the concern that was shared. If you cannot devote the time to truly listen at the moment an orientee wishes to speak with you, be honest. Tell the person the truth, "I want to give you my undivided attention, but now is not a good time. I am preoccupied with another matter. Can your concern wait until I resolve this other situation?"


Listen with our eyes. Assessing nonverbal communication is crucial in effectively receiving messages from others. Mehrabian, who conducted seminal research on nonverbal communication in the early 1970s, identified the importance of evaluating congruence between the spoken word, intonation, body gestures, and expressions.


Affect display (Mehrabian, 2007) concentrates on the facial expressions that reinforce the verbal message or discredit it. Facial affects include displays of happiness, anger, disgust, surprise, sadness, or interest. Additional nonverbal cues include the use of hand gestures, posture, and position. Excellent listeners "listen" to faces.


Listen with an open mind. Listening is hard work. As preceptors, it is important to listen to the criticisms of orientation that may be verbalized by an orientee. The initial reaction may be to defend our current behavior or approach. We need to remind ourselves that criticism is an unmet need. To listen effectively, we must suspend judgment and refrain from expressing disagreement. We must be aware of our reactions to words or phrases that elicit a visceral reaction. We want to be open to a fresh perspective.


Listen with our heart. Carl Rogers (1980) described empathy as, "temporarily living in another's life, moving about in it delicately, without making judgments. To be with another person in this way means that for the time being you lay aside the views and values you hold for yourself in order to enter the other's world without prejudice" (p. 137).


We are willing to let the orientee dominate the conversation, and we take great care not to interrupt. Through authentic engagement, we are able to listen for what is not being said. We make the other person feel important and are sensitive to the emotions being expressed. We must refrain from sharing our own experiences unless asked because we unconsciously divert the subject to ourselves when we do this. We express solidarity with orientees when we validate their experience. Use comments such as "sounds as if you felt pretty discouraged[horizontal ellipsis]," "seems as if you wish[horizontal ellipsis]," "are you hoping for[horizontal ellipsis]?" "that must have been really hard for you[horizontal ellipsis]," and "it sounds like you're really frustrated with me. I get frustrated when people seem to disregard my efforts. Is that what you are feeling?"


Listen with respect. When a nurse is new, he or she often feels alone and overwhelmed. The new nurse must demonstrate competence to garner respect from other staff members. You, as a preceptor, have a unique opportunity to foster a climate of collegiality. When there is a perceived partnership, orientees feel that they can confide in you and that their concern will be heard. When you honor orientees' concerns, you foster a climate of respect. Use comments such as "I'd like to hear more about that[horizontal ellipsis]could you tell me more?" and "I take your concerns very seriously[horizontal ellipsis]."


Listening takes practice and feedback from others. We need to ask orientees for feedback about our listening skills. Use questions such as "When you shared your concern with me the other day, did you feel that I listened and understood you?" and "Can you give me one recommendation on how I can improve my listening skills?"


If you rearrange the letters in the word listen, you get the word silent.


Listening is a great gift.




Mehrabian, A. (2007). Nonverbal communication. Piscataway, NJ: Transaction Publishers, Rutgers. [Context Link]


Myers, S. (2000). Empathic listening: Reports on the experience of being heard. Journal of Humanistic Psychology, 40, 148-174. [Context Link]


Nichols, M. (2009). The lost art of listening. New York: Guilford Press. [Context Link]


Rogers, C. (1980). A way of being. New York: Houghton Mifflin. [Context Link]


Scanlon, S. (2007). The gift of listening. Fairfax Station, VA: The Type Reporter. [Context Link]