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Learn to Speak With Confidence
by Donna Cardillo, RN, BS

EVERY NURSE HAS TO MAKE a presentation of one type or another in his or her professional life. Whether presenting at grand rounds, conducting a department in-service, doing community education, teaching health-related classes or speaking at orientation, good speaking skills are a necessity.

The ability to speak well in public is something that will serve you well throughout your professional life, for many reasons. Those who can do it are well-respected, admired, and more inclined to be promoted. It builds confidence, credibility, and gives you an opportunity to express yourself on many different levels. The ability to speak well is one of the most sought-after skills in our society. Besides, nursing needs more articulate spokespersons to get the word out about who we are and what we do and to help promote a positive image for our profession.

While it is a well-known fact that most people dread public speaking, anyone can significantly improve their speaking skills by knowing the basics, conquering their fears, and getting a little practice. The good news is that nurses are natural teachers and possess excellent communication skills. So it is just a matter of transferring those skills to some common speaking situations, learning some new skills, and diving in.

Perception
It’s all in how you look at things. Many people think of public speaking as “giving a speech.” We envision a politician or other public figure delivering a rousing address and think we must somehow do the same with each word carefully crafted. Don’t forget that public figures have Teleprompters, speechwriters and speech coaches. “Speeches” are reserved for a few formal occasions in life but not required in most common speaking situations. So shed that notion right off the bat. Rather, think of speaking more as an enlarged conversation. When you talk with your audience, rather than at them, they get much more out of your presentation. They are the most important part of the equation, so shift the focus off of yourself and onto them. Connect with them by making good eye contact, getting them to participate, and allowing ample time for questions and discussion.

Be Yourself
Getting back to the “speech” mentality, many of us think that once we are in front of an audience we have to be different persons, acting in certain ways and speaking differently than we are accustomed. Actually, the opposite is true. The more you speak naturally, both in your choice of words and in style of speaking, the more comfortable and relaxed you will be, and the more effective at getting your message across. Try to be as natural as possible when speaking. Use your own language, style, and emphasis. Don’t worry about getting every word in your notes correct. Remember, the audience doesn’t know what you had intended to say. Therefore, they don’t know if you left something out or put things in a different order than originally intended. If you flub a word, don’t even think twice about it. That’s the way we speak naturally and listeners think nothing of it. Pausing is also a natural part of speaking. And while a pause may seem like an eternity when you are the speaker, it is a welcome break for the listener who needs to take time to digest what you are saying.

Don’t Apologize
Don’t make excuses for yourself in an attempt to lower your audience’s expectations. That will backfire. I often hear speakers say, “You’ll have to excuse me, I’m not used to speaking in public.” Or “You’ll have to forgive me; I’m a little nervous tonight.” Or “You’ll have to forgive me, I have a cold.” The ultimate no-no is to say, “You’ll have to forgive me; I didn’t have time to prepare anything.” What an insult to those who came to hear you speak! If you are unprepared for some reason, give it your best shot and hope for the best, and try not to let it happen again. You have to inspire confidence in people and make them believe you have something of value to say. If you keep apologizing, they will lose confidence in you and tune you out. You don’t have to be the world’s best speaker to be effective at getting your message across.

Give Them Something They Can Use
You don’t have to be the world’s authority on something to be able to impart some useful information to your audience. Most people don’t have time to read everything out there or even do Internet research. So you can help them out, save them some time, and come off as authoritative by doing just that. People are always impressed when you say something like "The latest issue of US News and World Report said that…” Look up the latest info relevant to your subject matter on the Internet or in some journals and magazines. Develop a simple one-page handout with some useful, relevant information like phone numbers, web sites, recommended reading, statistics. All people look for is something that can help them do their jobs better or make their lives easier, happier, or healthier.

Study the Art and Science of Public Speaking
Good public speakers, like good managers, are not born; they are developed. Experience without foundation is not necessarily the best teacher. So make a study of good speaking skills by reading good books on the subject, attending a seminar on the subject, or by joining a club such as Toastmasters International. How I wish I had done some of these things when I was first required to start speaking early in my profession. But I didn’t have a clue as to how to get started back then. Why reinvent the wheel and start from scratch when you can save yourself a lot of time and trouble, never mind mistakes and embarrassment, by learning what the experts already know. Whenever you have the chance, observe experienced speakers, either live or on videotape, and take note of their techniques and styles. Then try to emulate that. Face Your Fears Head On

You know the drill. You get nervous so your body goes into the fight or flight response and starts to pump adrenaline into your blood stream. Your heart starts to beat faster, your breath becomes shallow, your skin becomes clammy and pale, and your mouth gets dry. Even experienced speakers get nervous before a presentation. The fear itself is unlikely to go away, so focus on minimizing the symptoms and moving forward in spite of it.

The old advice of taking a few deep breaths actually has physiologic benefit. It will calm your heartbeat, slow your breathing and lower your blood pressure. Try a few shoulder shrugs or “shaking out” your hands to relieve tension, too. When it is time to step up to the mike or get in front of the group, be conscious of striding to the podium with your head up and a smile on your face. Forcing assertive body language will make you feel better. When you first get to the podium, take a moment to look around the room while smiling at the audience, take a deep breath and then begin speaking. It is not necessary to start speaking the instant you get to the podium. This gives you a moment to orient yourself to the audience and for the audience to orient themselves to you. You will also be surprised to find out that the audience can never see how nervous you feel. Even if you “hear” a quiver in your voice, it is likely not apparent to the audience.

Learn to Rehearse
After preparing your presentation, go through a dry run. Start by reciting it out loud. This gives you a different perspective than reading it. Make any necessary modifications. Work on gestures, emphasis, and pauses. The next step is to record your presentation on audiocassette. Hearing yourself “speak” the program helps you begin to become more familiar with the material. You can also listen to the presentation for content. Make whatever changes you care to and rerecord the program. Do this as often as necessary until you are fairly comfortable with the program content. Listen to your delivery style. Ask yourself, “Am I enunciating clearly? Am I speaking too fast? Am I using a lot of ‘ums’ and ‘ahs’?” Recording your presentation also gives you an opportunity to time it. This is critical since you almost always have a specific amount of time to fill. You certainly don’t want to go over but you also don’t want to go substantially under the time you were allotted or asked to speak.

Once you have a decent product on tape, listen to it as often as possible before you have to deliver it. I frequently listen to my upcoming speeches while driving in the car. This will help you to become familiar with the program content and make it easier for you to remember it and deliver it.

Use Presentation Aids as Appropriate
Make notes for yourself in outline form to use during your presentation. Even if you think you have the presentation down pat, notes serve as a security blanket. There are some presentations that I can deliver in my sleep but every now and then my mind goes blank. I quickly refer to my notes and get back on track.

I recommend using large white index cards for your notes, rather than typed sheets of paper. Write your notes in outline form on only one side of the card. Number the cards. Paper pages are noisy and floppy and can be awkward to go through when you are trying to find something. And if you have your entire presentation typed out, the tendency is to read it, which is deadly.

Visuals
Audiovisual aids, such as overheads, 35mm slides, computer presentations, or even flip charts should only be used if they will enhance your presentation in some way. Many people have a tendency to rely too heavily on these aids and make them the focal point of the presentation. Rather, they should serve to support and underscore what you are presenting. You can learn more about the proper use of audiovisuals in some of the recommended reading.

Make It Interesting
Use personal stories and anecdotes, as appropriate, in your presentation. A litany of facts and figures is boring and difficult to follow. An age-old formula for good speaking is to make a point, give an example, and then tell a story to support your point. It may take a little practice to do that, but you can learn. Use quotes by famous people for impact and drama. One of my favorites is by Babe Ruth, “Never let the fear of striking out get in your way.” People like catch phrases that they can remember, too. Here’s one often used by nursing instructors with students and new graduates, referring to patients, “They don’t care how much you know until they know how much you care.” These elements add texture, interest, and sometimes humor to your presentation.

I hope I’ll have the opportunity to hear you speak with confidence soon.