Warmth

1. Discuss the benefits of warmth in communication with clients and colleagues

2. Identify behaviors that demonstrate warmth

3. Review a tool to analyze warmth in interpersonal communications

4. Describe a variety of ways in which warmth is displayed and articulate the importance of warmth in human interactions

5. Become aware of opportunities to embellish your life with warmth in day-to-day encounters with clients and colleagues

6. Participate in exercises to build skills in demonstrating warmth

All the statistics in the world can’t measure the warmth of a smile.

Chris Hart

Close your eyes for a moment and imagine someone for whom you feel warmth. Experience this sense of warmth. Now ask yourself, “If I feel warm toward someone, how do I show it?” Consider what you experienced in this brief exercise and reflect upon how you can demonstrate warmth in your nursing practice.

“Speak with me in a warm and caring voice” (Lee-Hsieh et al, 2004, p. 26). Let your voice inflection say, I care about you as we share this moment (Pullen and Mathias, 2010). Warmth is the glue in the bonding between people and the magnetism that draws us to a closer intimacy with others. It is a special ingredient, even a catalyst, in our human relationships. It is comfort, as in the lines of a prayer, “May comfort be yours, warm and soft like a sigh” (Tabron, 2001). The expression of warmth makes us feel welcomed, relaxed, and joyful. Although clients may not be able to judge our intelligence, certifications, or degrees, they can judge our hearts by the care we give and the warmth we demonstrate at their sides (Carver, 1998). A student nurse struggling with injection skills and the potential effect of her lack of confidence on her clients reflected that “a dose of genuine warmth is as essential as skill with a syringe” (O’Connor, 2005, p. 28).

Warmth has been identified as an essential attribute in psychotherapists. The therapist’s warmth, along with empathy and genuineness, contributes to client improvement and leads to more open, full relationships for clients in and out of therapy. Warmth sets the tone for clients, families, and colleagues to share their own stories. Baker and Diekelmann (1994) called these “connecting conversations.” Most of you will not be psychotherapists. Your expression of warmth to your clients, however, will make them feel welcomed and not judged. These positive emotions will foster feelings of well-being and likely promote healing. The warmth communicated in family support has a direct effect on the well-being of clients because family members can often offer better support than staff (Cooper and Powell, 1998). Caring acts that show warmth and genuineness have been associated with increased hope in clients with cancer (Koopmeiners et al, 1997). In a study to identify and validate the dimensions for caregiver reciprocity in intergenerational exchanges, warmth and regard were found to be important factors (Carruth, 1996). Clients who sense your warmth are more likely to engage in dialogue and provide information about their health conditions. This communication helps the nurse to make a nursing diagnosis, determine expected outcomes, work out a nursing care plan, and evaluate the progress of nursing care with the client.

WIT&Wisdom

Warmth, kindness, and friendship are the most yearned-for commodities in the world. The person who can provide them will never be lonely.

Ann Landers

Exchanging warmth with colleagues makes the workplace a more pleasant environment. Warmth enhances closeness, which has social and work-related benefits. A study by the American Management Association (Ekeren, 1994) identified eight traits that often lead to failure for executives. The first two were “insensitivity to co-workers” and “aloofness and arrogance.” Extending our warmth to our colleagues makes us more approachable. Increased communication among colleagues ensures that important messages about clients or unit policies and procedures are transmitted.

Although we often refer to others as warm, as a human quality warmth is difficult to describe and one of the most difficult interpersonal communication behaviors to learn. Warmth involves not only attitudinal and psychomotor behavior but also a total way of offering oneself to another person. Showing warmth to others means conveying that you like to be with them and that you accept them as they are. In this sense warmth is a way of showing respect to clients and colleagues.

Warmth is not communicated in isolation. It enhances and is enhanced by other facilitative communication behaviors that you will learn about in later chapters (such as respect, genuineness, and empathy). By itself, warmth is not sufficient for building an effective helping relationship, developing mutual respect, or solving problems, but warmth enhances these processes.

According to Levine and Adelman (1982), a study conducted in the United States found that 93% of a message is transmitted by tone of voice and facial expression and only 7% by words. We may possibly tune into the nonverbal expression of emotions and attitudes more than the verbal. Because expression of warmth is predominantly nonverbal, it is wise to heed these findings.

Ways to display warmth to your clients and colleagues

Warmth is displayed primarily in a nonverbal manner. Subtle facial and body signs, as well as gestures (small movements of a hand, brow, or eye), convey our inner relaxation and attentiveness to another person (Table 7-1).

Table 7-1

Facial Signals of Warmth

FACIAL FEATURE	HOW WARMTH IS DISPLAYED
Forehead	Muscles are relaxed, and forehead is smooth; there is no furrowing of the brow
Eyes	Comfortable eye contact is maintained; pupils are dilated; gaze is neither fixed nor shifting and darting
Mouth	Lips are loose and relaxed, not tight or pursed; gestures such as biting a lip or forcing a smile are absent; jaw is relaxed and mobile, not clenched; smile is appropriate
Expression	Features of the face move in a relaxed, fluid way; worried, distracted, or fretful looks are absent; the face shows interest and attentiveness

There is a lot that you do with your face to convey warmth. When you are talking to another person, attention is largely focused on the face, so it is important to know how to make facial expressions that maximize your warmth.

During interaction, your face can communicate information regarding your personality, interests, and responsiveness, as well as your emotional state. Your facial expression can open or close a conversation. The context, including the relationship, determines the meaning of facial expressions. Also, the degree of facial expressiveness varies among individuals and cultures. In relationships with clients and colleagues, it is wise to remember that although people from other cultures may not express emotions (such as warmth) openly, this does not mean that they do not experience these emotions.

Americans express themselves to varying degrees. People from certain ethnic backgrounds in the United States may use their hands, bodies, and faces more than others. Warmth can be expressed in a variety of ways, but to have a poker face or deadpan expression is usually considered suspicious.

We may interpret insufficient or excessive eye contact as communication barriers. No specific rules govern eye behavior, except that to stare, especially at strangers, is considered rude. Eye contact can have different meanings in different cultures.

Your posture can communicate warmth. Movements or ways of holding yourself that encourage communication and indicate interest and pleasure in being with the other person constitute warmth (Table 7-2). The list in Table 7-2 may sound like your mother telling you to sit up straight at dinner, yet the details provide solid guidelines for communicating the warmth you feel even if you are anxious.

Table 7-2

Postural Signals of Warmth

POSTURAL FEATURE	HOW WARMTH IS DISPLAYED
Body position	Client is faced squarely, with shoulders parallel to the client’s shoulders
Head position	Head is kept at the same level as the client’s; periodic nodding shows interest and attentiveness
Shoulders	Shoulders are kept level and mobile, not hunched and tense
Arms	Arms are kept loose and able to move smoothly, rather than held stiffly
Hands	Gestures are natural, with no clenching or grasping of a clipboard or chart; distracting mannerisms such as tapping a pen or playing with an object are avoided
Chest	Breathing is at an even pace; the chest is kept open, neither slouched nor extended too far forward in feigned attentiveness; a slight forward leaning shows interest
Legs	Whether crossed or uncrossed, legs are kept in a comfortable and natural position; during standing, knees should be flexed and not locked
Feet	Fidgeting, tapping, and kicking are avoided

Warmth indicators include a shift of posture toward the other person, a smile, direct eye contact, and motionless hands. In a study by Knapp (1980), gestures such as looking around the room, slumping, drumming fingers, and looking glum detract from warmth. In a dialogue situation, positive warmth cues, coupled with verbal reinforcers such as “mm-hmm,” are effective in increasing verbal output from the interviewee (whereas verbal cues alone are insufficient). These findings from an early study have implications for nursing, in which so much client information is gathered through interviewing.

Purtilo and Haddad (2002) pointed out that in addition to whole-body posturing and positioning, gestures involving the extremities—even one finger—can suggest the meaning of a message. Think about how the following gestures would affect your message of warmth: shrugging your shoulders, folding your arms over your chest, rolling your thumb, shuffling your foot, or silently clenching your fist. Even if other parts of your body are focused on conveying warmth, these partial gestures might minimize or erase the message of warmth you are trying to send.

Remember not all gestures have universal meaning. A wink or a hand gesture may not be received in the same mood of warmth in which it is delivered. For example, the American “OK” sign (circle made with thumb and forefinger) is a symbol for money in Japan and is considered obscene in some Latin American countries.

The spatial distance or closeness we create between us and our clients and colleagues can affect the perception of warmth. For Americans, distance in social conversation is about an arm’s length to 4 feet. In our exuberance to display warmth, we may invade this unseen but well-defined circumference. Not all clients or colleagues feel comforted by this gesture; some may feel intruded upon, and others may feel threatened and act defensively.

Touching is another way to affectionately transmit warmth. From the briefest pat on the shoulder to an embracing hug or extended hand, you can convey warmth to others. Your comfort or lack of comfort with touch is communicated. The gentle, sincere touch of your hand can express warmth, caring, and comfort (Reynolds, 2002; Gleeson, 2004).

Warmth can be conveyed verbally as well as nonverbally. The volume of the voice is related to warmth. Softer, modulated tones convey warmth more than loud, aggressive tones that are harsh to the ears. A pitch that seems comfortable for the speaker transmits warmth more than an unnatural pitch that seems to be out of the speaker’s range. The pacing of words is also important. Pressured, stilted, or stoic speech detracts from the warmth that can be conveyed through rhythmic speech, whose pacing is in keeping with the speaker’s natural breathing. The actual words also have the power to extend warmth to others. Loving, soft words are warmer than harsh, thoughtless words: “So, you’ve never exercised before and now you think you’ll become a ‘super-jock’ and take up jogging?” is cold and judgmental compared with “You’d like to improve your fitness level so you’re taking a new lease on life and learning to jog.”

As you may have noticed, many of the features of warmth are those of a relaxed person. Not only must you be relaxed, but you can communicate warmth only when you have a genuine interest in the other person and a wish to convey that welcome and pleasure to him or her. A desire to be warm is based on the belief that each person you encounter is worthy of receiving the acceptance and comfort that your warmth generates. The ability to be warm was so valued by a psychiatric facility in Surrey, England, that it was included in an online recruitment ad. When you display high-level warmth, you are completely and intensely attentive to the interaction between yourself and your clients or colleagues, making them feel accepted and important. The opposite—cold behavior—conveys disapproval or disinterest.