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We tend to avoid silence because it makes us uncomfortable (lots of excuses – the ward’s noisy, we’re busy, it’s not private etc etc). We’re the professionals, we should have the answers is often what’s in our heads. BUT the patient needs time to think, they also can be testing if you’ll stay with them so they’re silent for a while. Can they trust you to stay? Often people give a summary of what they want to say; if you stay and are encouragingly silent (yes it can be done – keep looking interested) it can help them to describe the situation in more detail which helps you understand better and telling their story in more detail helps them.

Sitting silently with a patient may sound like a luxury on a frenetic ward, unless it’s the ICU. But even a few seconds of comfortable, supportive silence can be very powerful and comforting for a patient.

Silence doesn’t = nothing happening. On the contrary, some of the most important thinking and emotional progress can be made during pauses in conversation. But first we have to get past the anxieties that silence can stir up in us!



Q.1 Why can silence feel scary?


Staff can be worried that:

  • they’ll be seen as disinterested in the patient or not listening properly
  • the patient will think they’re boring
  • the patient will feel under pressure to come up with something to say
  • it could look like they’re not working, or perhaps other staff will look at you and think you’re not competent you don’t know what to say


These concerns are understandable. But the benefits of silence during a conversation should outweigh the anxieties. Have some confidence, try it out, maybe firstly with a friend or partner, or boldly try it out with a patient then ask them if they noticed.


Q.2  What are some of the benefits of silence?

  • gives time for you and the patient to reflect on what has been said and what you both feel about this
  • allows the chance for some mind-awareness – for both of you to consider what’s going on in your own and the other person’s mind, including what feelings may have been stirred up for each of you
  • a lovely breather. Just like having a rest during a walk
  • shows you’re not in a rush as a listener. This really helps patients feel valued and able to take their time in getting to the issues which matter to them and which might be very difficult to say at first



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