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This site is for student nurses or nurses starting out. Letters to a Young Nurse are blog posts written like letters to help you find your way and make your journey as a nurse less difficult. 


Active Listening

Updated: Jul 29, 2023

It took me many, many, many years to become good at listening. Active listening requires that we set aside everything else and really listen to the patient and their concerns. It is not an easy task to do it well. For me, it is about vulnerability and silence. To do it well you have to put everything else aside and sit on the edge of the cliff with the patient or family member or both. You have to quiet your mind, put the cellphone away, close the door and sit down near the patient. All of these tasks must be done in order for the patient to trust you and what you need to teach him or her to go home safely. Every single day, every single encounter with the patient is an opportunity to teach them. When you bring the pain pill in, you should talk about the side effects and what to do about them. But before you can teach you have to listen.

Here is an example, Mrs. Smith needs to learn how to take care of her diabetes when she is discharged. She will need to learn how to perform finger sticks and give herself insulin with a sliding scale. What is the best way to teach her these skills? Give her a handout and tell her to read it? Demonstrate the skills once and send her home? Have her watch a video on the hospital’s educational channel? All of these ways are effective but will Mrs. Smith learn? The best way is the one that works for Mrs. Smith. How do you find out how Mrs. Smith learns best? Ask her then actively listen to her story.

She tells you that she has macular degeneration and she cannot read the handouts. Then she tells you her hearing is bad but she left her hearing aids at home. So she can’t watch a video. You paraphrase what she said, ask questions that are open-ended and probing and continue to actively listen. When she tells you that she knew she had diabetes but was afraid of getting a definitive diagnosis. Her mother had the “sugar problem” and lost toes and then both her feet. If she didn’t find out maybe it wasn’t true. You nod and smile and tell her it doesn’t have to end like that. You put yourself in her place and see the fear and empathize with what she must be feeling. You tell her about the time a few years ago when you were diagnosed with breast cancer and you didn’t think you could get through all of the chemotherapy and radiation. You tell her with confidence that she can do this and that she doesn’t have to end up like her mother. And the whole time you are maintaining eye contact and paying attention.

The difference between active listening and passive listening is your whole attention is with the speaker, you are not thinking about what you will say when the person stops talking. You put yourself in their place because if you do not you are wasting her time and your time. When I began my career my spinal cord injury patients stayed in the hospital for months. If you look at hospital stays for the same diagnosis those stays have been shortened to a week or less. Total hip replacement patients stayed for 2 weeks but are lucky to get 2 days now. So the time you have to make sure those patients are safe at home is shortened and valuable. If you were to hand Mrs. Smith the handout and tell her, “let me know if you have questions” and walk away you put her at risk of bad outcomes. But by actively listening and finding out her specific learning style you will have a good outcome and isn’t that why we are nurses?

Active listening takes practice like any other skill in nursing. If you would like more information there is an excellent article at

The next time you sit down with a patient practice these steps and see if it makes a difference in their receptivity to your teaching and suggestions.

  1. Prepare - close the door, turn off your phone, sit at their level, maintain eye contact and listen without thinking of your response, be silent

  2. Clarify - paraphrase what was said and ask probing and open-ended questions in areas where more information is needed

  3. Withhold judgement - put yourselves in their shoes and empathize (don’t sympathize)

  4. Share an experience (briefly) to build trust and understanding, be vulnerable

  5. Pay attention to non-verbal cues

  6. Reflect back what was said

Let me know if these steps worked for you.

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