As people communicate, they express themselves through words, movements, facial expression and use of space (Stuart & Laraia, 2005). Messages can be conveyed verbally, nonverbally and symbolically. Unlike verbal communication, nonverbal communication includes all forms of communication that do not involve true spoken or written word. However, it can be a powerful form of communication when used appropriately; especially when you have older adult clients who commonly have limited hearing or visual deficits. Thus, it is imperative for nurses to use nonverbal communication when they establish a relationship with the patient.


Touch is one of a nurse’s most powerful forms of nonverbal communication. Nurses are privileged to experience more intimate form of personal contact than almost any other healthcare professional. Touch can convey many messages, such as affection, emotional support, encouragement, tenderness, and personal attention. A comforting touch, such as holding a hand, is especially important for vulnerable clients who are experiencing severe illness with its accompanying physical and emotional losses. For older people, touch increases a sense of safety, increases self-confidence, and decreases anxiety (Gleeson & Timmins, 2004). Research has also found that for children having a lumbar puncture, a nurse’s soothing nonessential touch decreased anxiety and lowered the child’s distress. (Vannorsdall et al., 2004)

Eye contact

People signal readiness to communicate through eye contact. It allows a nurse or a patient who is speaking to check whether the information that is being conveyed is understood. Maintaining eye contact during conversation shows respect and willingness to listen. Eye contact also shows that you are interested in what the other person is saying. In contrast, lack of eye contact may indicate anxiety, defensiveness, discomfort, or lack of confidence in communicating.


Facial expressions convey emotions such as surprise, fear, anger, happiness, and sadness. Smiling is a positive facial expression and considered as a sign of good humor, warmth, and immediacy. With your beautiful smile, first-time patients may think of you as a friendly and easy going person, and smiling can have powerful soothing effects on them. Thus, keep your smile even when you are experiencing stress as smiling brings an affirmative aura to people. Although it is hard to control all of your facial expressions, do try to avoid showing shock, disgust, dismay, or other distressing reactions in the patient’s presence.

Lean forward

The way people sit, stand, and move reflect attitudes, emotions, self-perception and health status. For example, an erect posture and a quick, purposeful gait communicate a sense of well-being and confidence. Meanwhile, leaning forward conveys attention, awareness and immediacy. During an interaction, leaning forward may indicate that you are interested in the conversation.

Head nodding

Head nodding has an important social function. It helps to regulate interactions between people, especially when people change turns in speaking. Hence, head nodding indicates that you understand what the person is saying, and can help create a rapport between you and your client.

All kinds of nonverbal communication are important, but interpreting them is often problematic. Nonverbal communication is subconsciously motivated, and may reflect a person’s intended meaning more accurately than verbal communication. Besides improving therapeutic communication between nurses and their patients, the patient’s level of satisfaction will also increase when nurses make full use of nonverbal communication while delivering care. MIMS

Read more:
Healthcare professionals: 4 non-verbal ways of communication that you should be using with your patients
Patient satisfaction vs. job responsibility: A nurse's call of duty
7 types of patients nurses encounter every day

Gleeson, M., & Timmin, F. (2004). Touch: a fundamental aspect of communication with older people experiencing dementia. Nurs Older People. 16(2):18
Stuart, G.W., & Laraia, M.T. (2005). Principles and practice of psychiatric nursing. Ed 8.St Louis. Mosby
Vannorsdall, T et al. (2004). The relation between nonessential touch and children’s distress during lumbar punctures. Child Health Care. 33(4): 299