Recognizing when specificity is useful

Being specific means being detailed and clear in the content of our speech. It means being concrete, so that our communication is focused and logical. In contrast, vagueness can be frustrating, and lack of clarity creates distance between people who are trying to communicate. Miscommunication has been estimated to account for as much as $236 billion in unnecessary healthcare expenses according to the Institute for Healthcare Advancement (2008). A lack of specificity contributes to miscommunication. In addition to clarifying our own speech, the technique of specificity assists clients (or colleagues) in moving from broad, elusive areas of discussion to narrower, more pinpointed areas of concern.

Using concrete communication is especially advantageous in certain interpersonal situations. Being specific is important when we are doing the following:

This list covers situations that nurses repeatedly encounter with clients and colleagues. Being specific or concrete benefits communication in three ways (Arnold and Boggs, 2011; Stuart, 2009):

Being specific when explaining your thoughts and feelings

Gradients exist to any emotion, and it is important to choose the descriptor that says exactly what you want to convey to your listener. In the anger category, for example, you might be feeling enraged, frustrated, furious, annoyed, or irritated. Each subtle variation conveys a slightly different mood. Hitting the mark by expressing exactly the right flavor of emotion ensures that your meaning is completely clear.

If you tell clients that you are enraged with them for being late for their clinic appointments when you are really only mildly irritated, you may create a gulf between you by overstating your case.

With the emotion of sadness, you might feel “blue,” depressed, hopeless, or discouraged. If you tell your co-workers that you are merely out of sorts when you are really in despair because your child support check has not arrived and your taxes are due, such minimizing of your feelings risks diminishing the intimacy and trust between you.

When we are not specific in describing our thoughts and feelings, we invite misunderstanding. Because the purpose of communicating is to enhance the understanding between two people, being indirect or unclear is unproductive.

In addition to hitting the mark about the quality of emotion, saying specifically what makes you feel a certain way clarifies your feelings further. For example, you are happy that your client has initiated a reduced-calorie diet and has begun to walk 2 miles a day. You convey your pleasure by saying the following:

Being specific by adding a rationale for your feelings enhances the sincerity of your message. Your explanation has built-in rewards for Mr. Weller. Such a response would make a lot more sense to him than the following:

In this example, it is unclear why you are pleased: because he is a dutiful client? Because you will not have to spend time reminding him to eat well and exercise?

Here is another example from the workplace. You are grateful that your colleague on the night shift has highlighted all abnormal laboratory results and displayed them clearly for your inspection when you arrive for the day shift. You tell her:

This specific articulation about why you feel grateful adds depth and conviction to your feelings. It respectfully conveys your appreciation, more than a glib “Great” or “Thanks” would have.

Some nurses, clients, families, and colleagues prefer logical, rational thinking processes; they are proficient at appreciating, and being specific about, facts. They may not readily consider feelings or be comfortable dealing with them. Because their strength lies in logical, objective thinking, they may lack the vocabulary to be specific when discussing feelings. Those who prefer thinking over feeling tend to decide things impersonally, are more analytical, and respond more easily to others’ thoughts. Nurses, clients, families, and colleagues who prefer to make decisions on the basis of personal feelings and human values are more attuned to others’ feelings and likely have more vocabulary and the comfort to talk about feelings. They tend to be more concerned about the human feelings and values in communication than with factual, objective information (Myers and Myers, 1995).

You can learn more about specificity in relation to expressing your thoughts and feelings in Chapter 11.

Being specific when reflecting others’ thoughts and feelings

Listening is not a silent pastime. It is active and vocal. Through your warmth and respect you can show that you are attending to what your clients or colleagues are saying. By being specific, you can convince them that you have heard and understood the meaning of their dialogue.

When you reflect others’ thoughts and feelings, you are like a recording, giving them a chance to hear what they are really saying. When helpers respond with clear, concise, detailed statements about others’ concerns, it helps the people with problems to clarify them.

For example, one of your clients has given you a lengthy description of her son’s epilepsy:

Here is an example of a specific reflection:

You can pinpoint the essence of other people’s meanings by being specific when they become engrossed in relating their thoughts and feelings. This tactic helps them grasp more fully both the sense and the significance of what they are saying.

Contrast the clarity of this response with these nonspecific alternatives:

Neither of these statements captures the exact meaning that Mrs. Cant was trying to convey. Replying accurately and specifically demonstrates that you fully understand your listener. Chapter 10 provides more detail about the communication behavior of reflecting others’ thoughts and feelings in a concrete way.

Being specific when asking questions

As an interviewer, at times you might wish purposefully not to be specific so that the interviewee takes the lead. This open-ended strategy generally is used at the beginning of an interview (“How may I be of help to you?” or “What is the pain like?”) or at a point in an interview at which you want more information (“Could you tell me more about your family?” or “Could you describe your exercise habits?”).

As clinicians, we often want specific information from our clients. To get exactly what we want, we must specifically ask for it. You may wish to know more about a client’s family health history, for example. If you ask, “Tell me more about your family’s health,” you might get everything from “It’s fine!” to “Well, let me see, in 1901 my great-grandfather was ill on his sailing venture.” A brief response provides you with no information, and a lengthy response requires sifting through to glean the essential details.

Occasionally clients’ historical recountings may be jumbled or confused, either because they are unsure of dates and details or because their emotional reactions to their changed health status are interfering with their clarity. When this occurs, it is helpful to stop undirected digressions, backtrack, and reestablish specific points. This process helps clients’ thinking to become clearer and more focused.

You likely will need to know specific aspects of your clients’ family history: history of cancer, history of cardiovascular diseases, and so on. Getting to the point and asking for specific information simplifies what you want and increases your chances of getting it from your clients. Using the skill of specificity, you can prevent frustration or fruitlessness in the communication encounter. As nurses, if we fail to achieve clarity, our clients may be left feeling confused and may even doubt our ability to contribute to the interaction. Phrases such as “I’m not sure I understand that” or “Would you go over that again?” let our clients know we are interested and that we need help in understanding what they want us to know (Sundeen et al, 1998).