Improve communication with good phone skills

Use clear speech with nontechnical words

By Kathy Ordelt, RN-CPN, CRRN
Patient and Family Education Coordinator
Children’s Healthcare of Atlanta

Clinical staff and physicians routinely use the telephone for triage, patient education, and follow-up care. Although the phone is both necessary and vital in any health care setting, it can create a barrier to communication because it prevents us from seeing facial expressions and body language. The impression the patient or family receives depends on what they hear — using good phone skills and proper phone etiquette can help make the phone encounter more productive and enjoyable.

Whether you’re doing the dialing or the patient is calling you, here are a few tips for using the telephone that can help you maximize your communication efforts:

First impressions

  • Smile. Even though the caller can’t see your expression, your smile communicates a caring and compassionate attitude. It shows — even over the telephone.
  • Add a personal touch. Answer with a friendly greeting and use the patient’s name when possible during the conversation. This shows the patient that you are interested in him or her.
  • Be polite and focus on the caller. Put yourself in the listener’s place and act accordingly. Avoid distractions such as chewing gum, eating, drinking, or having secondary conversations with others in the room.
  • Lower your voice if it is normally loud. Keeping the phone about two-finger widths from your mouth may help as well.

Communicate effectively

  • Be an active listener. This is simple advice, but often overlooked. The patient may express important information informally during your conversation, and not even realize it. Take notes, if necessary, so you can recall information correctly.
  • Speak slowly and clearly. The caller may be confused, upset, or need clarification of something he of she does not understand. Pause occasionally to let the listener digest what you have said and to ask questions. If you leave a message on an answering machine, say your name and phone number slowly, and spell your name if needed.
  • Use "living-room" language. Try to assess the caller’s level of understanding within the first minute or two of the call. This will help you decide how to present information. Communicating medical information in an understandable way is important for both the spoken and written word.
  • Express interest and address the patient’s concern first, even if it’s different from yours. Let him or her know that you care and want to help. Once you discuss the patient’s concerns, he or she can relax and answer your questions.
  • Don’t expect patients to have good assessment skills. They really don’t know the significance of symptoms or what is serious. Ask open-ended questions to explore any problems that need to be addressed.
  • Stay calm and stay focused. Patients who are angry, upset, or difficult to communicate with are those who need your patience and compassion the most.

Hold and transfer

  • Say please and thank you. Before you put a caller on hold, ask permission and provide a reason if needed (e.g., "Would you mind holding while I get your chart?"). Be sure to return to the call within a reasonable length of time, or provide updates to let the patient know you haven’t forgotten about them. When you pick up the call again, thank them for holding.
  • Keep them informed. When transferring a call, tell the patient what you are doing, and give him or her the new phone number in case you get disconnected. If possible, stay on the phone until the transfer is completed.

A great finish

  • Evaluate understanding. Before you hang up, make sure the patient understands the information you have given and that you have answered any questions to his or her satisfaction.
  • Let the patient know when to call back, if necessary. Provide information about who to contact, what symptoms to watch for, and whether to call immediately or during regular operating hours.
  • End on a positive note. Saying, "Have a nice day," or "It was nice talking with you," is a nice way to end the conversation.

Write it down

  • Document. Finally, remember to document your telephone conversation and educational efforts on the appropriate medical record form.


For more information about the ideas or issues discussed in this article, contact: Kathy Ordelt, RN-CPN, CRRN, Patient and Family Education Coordinator, Children’s Healthcare of Atlanta, 1600 Tullie Circle, Atlanta, GA 30329. Telephone: (404) 785-7839. Fax: (404) 785-7017. E-mail: