Understanding Communication in Nursing (With Examples, Importance, & How to Improve)
Written By: Darby Faubion BSN, RN
Communication is one of the most powerful tools nurses use when providing patient care. Because communication can impact every aspect of work and nurse-patient relationships, nurses must learn how to improve communication in nursing and implement measures for effective communication. In this article, you will learn the importance of therapeutic communication and find 18 useful tips to improve communication in nursing.
Who Do Nurses Communicate With?
A nurse's job requires communication with several people each day. Nurses must collaborate with nursing peers and other members of the healthcare delivery team, including physicians and nursing assistants. Interdepartmental communication is necessary to provide effective patient care and involves nurses speaking with dietary workers, radiology technicians, and laboratory staff. Nurses also communicate with patients, family members, and other caregivers.
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7 Reasons Why Communication Is So Important in Nursing
1. Effective communication in nursing is essential in assessing a patient’s response to treatment.
Nurses must learn how to communicate verbally with patients and recognize nonverbal cues, which could indicate a change in their patient’s status. For example, a patient may report his pain is a 2 on a scale of 1 to 10, but exhibit grimacing facial expressions and guarded behavior, indicating his pain is higher than his verbal report.
2. Communication with patients and their loved ones helps relieve stress and improves patient outcomes.
The fear of the unknown can cause undue stress for patients and their families. Nurses can alleviate some of the stress clients and their loved ones experience by keeping communication open and honest.
3. Effective Communication among the healthcare team can help reduce the risk of errors in patient care.
Communicating with one another and documenting when care is provided or withheld, the likelihood of errors related to treatment lessens.
4. Effective communication in nursing care is necessary to advocate for patients.
According to the Code of Ethics for Nurses
established by the American Nurses Association, patient advocacy involves a therapeutic relationship and communication between the nurse and patient. Advocating for patients involves identifying patient concerns and working to alleviate fear, creating better experiences for the patient.
5. Communicating with patients and their families will help identify special needs.
Many patients have needs that extend beyond their immediate medical concerns. For example, you may be assigned to a patient with a history of diabetes who requires a special diabetic diet or one who has religious beliefs that prohibit them from engaging in certain activities. Taking the time to discuss your patient’s medical history and personal preferences is an essential part of developing a plan of care conducive to their physical and mental well-being.
6. Communication with your patients will help you identify and understand the social determinants impacting their health.
Social determinants such as lack of stable housing, poverty, food insecurity, and unemployment are associated with increased rates of chronic health conditions that lead to morbidity and mortality. Communicating with patients to understand the social determinants affecting them is essential to developing care plans focused on addressing these factors and positively impacting patient outcomes.
7. Effective communication in nursing is vital for understanding the status of your patient's emotional and physical well-being.
Nurses typically spend more time with patients than other caregivers. By using effective communication skills, the nurse can better understand the patient's status, allowing them to provide care on a deeper, more personal level.
What Are The 8 Essential Components of Good Communication in Nursing?
There are several things you can do to help promote good communication in nursing. The following are examples of components that foster an environment conducive to therapeutic communication between patients, their loved ones, nurses, and peers.
1. Eye Contact:
Be engaged by making eye contact with the other person. Even if your patient does not keep eye contact with you, it is important for you to maintain eye contact as people tend to look up when they finish a sentence or ask a question. If your patient looks at you and finds your eyes wandering elsewhere, she may feel like what she is saying is not important to you.
2. An Attentive Listener:
One of the fastest ways to lose the interest of someone else is to make them feel as if what they are saying is not important to you. You can prevent this by becoming an attentive listener. In addition to maintaining eye contact, nod your head and smile, when appropriate. Anything you can do to signal the other person that what they are saying is important to you will help foster effective communication in nursing.
3. A Clear Message:
When you communicate with others, it is necessary to keep in mind there is a difference between simply talking and talking with intention. Use words that are meaningful and relevant to the topic. Avoid wandering to different subjects as this can cause confusion, especially if your patient is already experiencing issues with orientation.
The best communicators acknowledge that it sometimes takes others longer to process information or form a response. As nurses, we understand illness or disease can hinder one’s ability to comprehend what they hear or the way they convey responses. Good communication in nursing means being patient and giving others time to say what they want or need to say.
5. Being Receptive:
It is normal to have expectations when you have a conversation with someone else. You may begin communication anticipating a certain response or reaction from the other person. Although it is okay to have a goal in mind when you begin communicating, it is also important to remember to be flexible. Being receptive to what the other person is trying to tell you is an excellent way to build a therapeutic relationship, as it leaves your patients and peers feeling like what they say is important.
6. Body Language:
You may be surprised to learn how much you say when you are not speaking. Good communication in nursing requires being aware of your body language and the message(s) that it sends. Standing with your arms crossed or hovering over a patient can make them feel anxious or nervous. Instead, try to find a chair and sit beside your patient. Be relaxed and attentive as this will help your patient relax and foster therapeutic communication.
It is possible to demonstrate understanding and compassion, even if you have not been in the same situation your patient is now facing. Taking the time to listen to what others say and putting forth the effort to understand their thoughts and feelings helps promote trust which can build strong nurse-patient relationships.
One of the most important, and often overlooked, components of effective communication is feedback. Giving and receiving feedback allows you and others to verify information was received and understood. When communicating with patients, a great way to get feedback to determine their understanding is to ask open-ended questions and allow time for them to respond.
EXAMPLES OF BAD COMMUNICATION VS. GOOD COMMUNICATION IN NURSING
The way nurses communicate with one another, their patients, and caregivers can significantly impact relationships. Your tone of voice, body language, and willingness to listen reflect how you feel and can cause a patient to feel at ease or increase anxiety. In the following scenarios, you will find examples of effective communication skills in nursing. You will find a mock situation and examples of good and bad nurse responses for each scenario.
Mr. Simms presents to the emergency department with hypertension and complaints of chest pain and states, “I just lost the biggest contract I’ve ever had and am scared my business is going to close.”
“I know you're upset about your business deal going bad, but you need to calm down before you have a heart attack."
The nurse responds to Mr. Simms by saying, "I understand you must feel overwhelmed. Were you experiencing chest pain before you learned about the contract? If so, can you tell me when your symptoms began?"
Miss West is a patient in triage accompanied by her boyfriend. Although Miss West is alert and appears oriented, her boyfriend continually interrupts her and answers your questions. Miss West does not make eye contact and seems anxious every time her boyfriend speaks.
"Sir, I need you to stop interrupting Miss West, or I'll have to ask you to leave. She is the patient and does not need you to speak for her."
"Thank you so much for bringing Miss West in. I'm sure it is a relief to have someone to count on. At this time, I need to ask you to step outside for a few moments so I can help Miss West prepare to be examined. As soon as she is ready, I will come to get you so you can be with her."
Mrs. Jones’ husband passed away two years ago. Despite visits from her children and friends, she still cries almost daily. Mrs. Jones tells you, “I just don’t know if I can keep living like this. He was my world.”
“Mrs. Jones, it has been two years since your husband died. You need to gather your composure and move on. There are other things to worry about that you can help with. I know it's hard, but you are making things harder on yourself."
"Mrs. Jones, I realize the loss you must feel since your husband passed away. It is okay to feel sad and cry. Grief is a natural part of life and is the price of loving someone. I want you to know I am here if you need someone to talk to or if you just want someone to sit with you a while."
Mr. Gordon visits his wife at the nursing home daily. Earlier today, Mrs. Gordon had to be moved to a temporary room due to flooding on her hallway from burst water pipes. Mr. Gordon, who had not yet been notified about the reason for his wife’s relocation, comes to the nurse’s desk yelling at the nursing staff. He states, “If you people don’t have any more respect for me than to ask me before moving my wife, I’ll take her somewhere else!”
“Mr. Gordon, I don't have time to listen to you griping about something that isn't my fault. Maybe if you had a better attitude, nurses wouldn't dread talking to you when changes need to be made. Your wife will be back to her room as soon as we can get to it."
"Mr. Gordon, I understand you must have been taken by surprise to find your wife was not in her normal room. A water pipe burst in her hallway, and several residents were moved to prevent falls and injuries. Our maintenance team is working as fast as possible to repair the leak. Housekeeping is on stand-by to make sure all water is cleaned up so we can get your wife and the other displaced residents back to their rooms. Why don't I show you to your wife so you can visit while we get things taken care of?"
HOW TO IMPROVE COMMUNICATION IN NURSING?
Every aspect of patient-centered care involves some type of communication. Patients and healthcare teams rely on effective communication to build strong relationships and work together. As a nursing instructor, I cannot stress the importance of effective communication skills in nursing enough. Here are some tips on ways you can improve your communication skills.
1. Use the right tone when speaking to others.
Effective communication skills in nursing include the way you relate to patients, their loved ones, and your peers. When speaking with patients or their caregivers, use concise language without talking to them in a demeaning way. When communicating with healthcare team members, use correct terminology and be direct, making sure to ask for clarification if needed.
2. Be aware of others’ body language.
Body language is the process of nonverbal communication through conscious or unconscious use of gestures and movements. Conscious efforts of body language include using hand motions or facial expressions such as a smile or frown to differentiate between happiness and sadness. Unconscious body language may occur when your patient grimaces in pain or turns away from an unpleasant smell. Observant nurses learn to recognize changes in their patient's body language and compare what the patient says to what his body language suggests.
3. Be mindful of your own body language.
Much like your tone of voice can send a message, nonverbal communication has a tone of delivery. For instance, your body language can convey a sense of empathy and compassion, which promotes healthy dialogue between nurses and their patients.
4. Show interest in what others say.
It can be difficult for some people to open up to others, especially if they are sick or afraid. An excellent way to promote communication in the nurse-patient relationship is to show genuine interest in what your patient says. Please pay attention to nonverbal cues as much as you do their verbal communication.
5. Be patient.
When patients feel that their nurses or other healthcare providers are rushed or disinterested, it can hinder therapeutic communication. Remember that illness, disease, and some medications, may alter a patient's mental status or cause confusion. Give them time to process the questions you ask and formulate answers. Allow them to find the words they need to answer you without feeling like you would rather be somewhere else.
6. Demonstrate a positive attitude.
It is normal for patients to feel anxious or afraid, especially when faced with a new diagnosis or sudden illness or injury. When a nurse has a positive attitude, it can ease patients' tension or frustration. Keep in mind having a positive attitude does not mean you should be dishonest. Instead, you can be honest but try to find something good in every situation. For example, if Mr. Smith has been diagnosed with cancer, you should acknowledge his thoughts and feelings but follow up by encouraging him that you (and the rest of the healthcare team) will work alongside him throughout his treatment.
7. Create an atmosphere conducive to effective communication.
One of the first things a nurse should do when preparing to talk with a patient or family member is to create an atmosphere that promotes comfort and effective communication. When appropriate, pull the privacy curtain and/or close the patient's door. Sit at the bedside instead of standing over your patient. Talk calmly and allow your patient time to respond to questions. Creating an atmosphere for comfortable conversation is much easier than bridging the gap caused by ineffective communication.
8. Practice active listening.
Active listening means you listen to understand, not just respond. When speaking to a patient or colleague, sit close enough to make them feel comfortable and like they have your attention. Not your head to help them feel engaged. Do not cross your arms and allow your body to be relaxed instead of rigid. Always make eye contact, as looking around the room can make others feel you are not concerned with their thoughts or feelings.
9. Exercise emotional intelligence.
Emotionally intelligent nurses find it easier to identify nonverbal cues and articulate their own thoughts more effectively, reducing the risk of miscommunication. When nurses exercise emotional intelligence, nurse-patient and interprofessional relationships are strengthened.
10. Ask open-ended questions.
Patients who are sick or worried may not feel like talking. One of the best ways to foster effective communication in nursing is to use open-ended questions. Imagine you have a patient being treated for a fractured forearm. Instead of saying, "Are you in pain?" ask your patient, "Can you describe the pain for me?" By asking a question that requires more than a yes or no answer, you promote effective communication between you and your patient.
11. Be attentive to your patient’s efforts at communicating with you.
Nurses are busy people. It is common for some nurses to be responsible for several patients during one shift. When you have multiple patients who require your attention, it can be easy to rush through your work. Unfortunately, doing so can create a barrier to effective communication. Take the time to be attentive when your patient tries to communicate with you. Some patients have trouble communicating, whether it is due to physical impediments or anxiety. However, all patients deserve the courtesy of your attention.
12. Practice cultural awareness.
Patients have diverse religions, cultures, and backgrounds that may impact how they communicate with others. Common hand gestures or practices are not accepted by all cultures. Nurses should strive to practice cultural awareness, promoting effective communication in nursing.
13. Ask for input from colleagues.
You may have an outgoing personality and find communicating easy, but not everyone does. If you find communicating with a patient or their loved one difficult, ask for input from a member of your team. The solution may be as simple as your patient knowing your coworker personally and feeling comfortable with them. The important thing to remember is your patient needs to communicate, and sometimes that means you need to ask for help.
14. Be mindful of your patient’s situation.
Effective communication in nursing requires being attentive to and aware of your patient's unique situation(s). Using a holistic nursing approach to find out any events your patient may have experienced which has impacted their well-being can help you better understand your patient's concerns. For example, your patient may have received news of a diagnosis with a poor prognosis or experienced the loss of a loved one. The way you communicate with your patients during challenging times can strengthen the nurse-patient relationship and improve patient outcomes.
15. Exercise diverse types of communication.
Depending on your patient's education and mental abilities, you may need to use different methods of communication to promote a therapeutic relationship. Effective communication in nursing means knowing when alternative ways of communicating are required and successfully implementing efforts to foster communication. Children may communicate by drawing or pointing to pictures or the part of their body that hurts. Adults may have experienced a stroke that left them unable to speak but able to write. In this case, having a pen and paper or a dry erase board may help facilitate effective communication.
16. Incorporate role-play when appropriate.
Role-play is a type of communication where verbal communication, nonverbal communication, or a combination of both are used to demonstrate a patient's experiences. While role-play can be used with adults, it is a common type of communication used with children who may not be unable to convey their thoughts or feelings verbally.
17. Involve your patient’s friends and/or family.
When alone, patients may experience increased anxiety or stress. When possible, and if your patient agrees, include their loved ones when discussing care plans and teaching. Patients in complex situations tend to be more at ease when they have someone they know and trust, and nurses who understand this need find communication easier.
18. Show compassion.
Being in a hospital or other healthcare facility can be scary. Your patients may feel helpless or depressed. Showing compassion by treating patients with dignity and respect promotes therapeutic relationships, which foster an environment suited for improved patient outcomes.
7 Consequences of Bad Communication in Nursing
Effective communication is an essential part of any business or relationship. While therapeutic communication between nurses, patients, and peers can build solid relationships and positively impact patient outcomes, there are also consequences of poor communication in nursing. The following are examples of outcomes of poor communication skills and behaviors in nursing.
1. Miscommunication of vital patient information:
When nurses fail to practice effective communication, it can lead to misconstrued or misunderstood information about a patient's condition or symptoms. This issue can lead to improper treatment decisions or delayed treatment, hurting the patient's potential outcome.
2. Poor communication skills in nursing can cause increased workload pressure.
The lack of effective communication among the nursing team can lead to misinformation about treatments or procedures being performed or withheld. In some cases, nurses feel increased pressure to get a job done that another nurse may have already accomplished, making their workload more stressful.
3. Patients may not understand important information such as when to take a medication or possible side effects to report.
Ineffective communication between patients and nurses can result in patients who feel confused about their treatment plan or follow-up instructions.
4. When there is bad communication in nursing, there is an increased risk to the patient's safety.
Nurses and nursing staff should keep an open line of communication with one another and with their patients. Some things that seem simple, like lowering a patient's side rails or assisting a patient to a bedside commode, can result in patient accidents if staff is not aware to check on the patient or the patient does not understand to use the call light to ask for help.
5. When nurses communicate poorly with one another, there is an increased risk of malpractice suits.
In 2016, the CRICO Strategies CBS Report, Malpractice Risks in Communication Failures
, found that thirty percent of all malpractice claims involve failed communication. Of the 23,000 malpractice lawsuits filed, more than 7,000 were related to poor communication, costing nearly 2,000 lives.
6. Poor patient satisfaction scores:
Unless you have an administrative or management position in nursing, you may not realize how patient satisfaction affects your job. Funding resources often consider patient satisfaction surveys to determine whether to support healthcare facilities financially. Poor patient satisfaction means less private funding and increased chances of patients seeking care elsewhere, both of which can be detrimental to the stability of your job.
7. Increased chance of medication errors.
Nurses participate in report at the end/beginning of their shifts. During report, nurses can discuss their patients' status, physicians' orders, and any other pertinent information. Even if something is missed during the verbal report, nurses rely on documentation, which is a form of nonverbal communication. Failure to follow through with effective communication when documenting patient care increases the chance of medication errors, leading to issues with patient safety and the potential for loss of jobs.
Useful Resources to Improve Communication in Nursing
One thing successful nurses have in common is that they strive to learn something new each day. Developing effective communication skills in nursing requires deliberate effort. There are several resources available for nurses to help improve communication skills. The following are examples of resources, including TEDx Talks, Reddit communities, YouTube videos, podcasts, and books.
My Final Thoughts
The way nurses communicate with patients and their peers can determine work environment, patient responses, and affect patient outcomes. Throughout this article, we addressed how to improve communication in nursing in the hopes of helping you develop stronger relationships with patients and your healthcare team. By implementing these 18 useful tips to improve communication in nursing, you can help foster therapeutic relationships with your patients, significantly impacting patient outcomes.
FREQUENTLY ASKED QUESTIONS ANSWERED BY OUR EXPERT
1. As A Nurse, How Do I Know If I Am a Good Communicator?
Several things could indicate you are a good communicator. If you are approachable, a good listener, open-minded, and well-spoken, these are positive signs of good communication skills in nursing.
2. Will Lack of Communication Impact My Nursing Career?
Everyone communicates on some level, verbally or nonverbally. Nurses must communicate effectively with patients, caregivers, and team members to do their jobs. A lack of good communication skills can undoubtedly impact your nursing career.
3. Usually, How Long Does It Take for a Nurse to Improve the Skill of Therapeutic Communication?
Therapeutic communication is a skill nurses should strive to use daily with patients, their loved ones, and coworkers. Nurses can implement methods to improve communication skills in nursing almost immediately. Nursing students learn the importance of therapeutic communication and ways to implement effective communication measures and are advised to build upon those skills daily. Improving the skill of therapeutic communication should be a lifelong process.
4. Do All Types of Nurses Require Very Good Communication Skills?
Communication is a vital tool for all members of the healthcare team. Good communication skills help develop strong nurse-patient and interdisciplinary relationships and help improve patient outcomes. Effective communication is also instrumental in reducing healthcare costs, preventing medication errors, and minimizing the risk of injuries. Therefore, all nurses should strive to develop good communication skills.
5. As A Nurse, Do I Need to Be Good at All Types of Communication?
While verbal communication is the primary source of relaying messages between nurses, patients, and the healthcare team, nurses must also be aware of nonverbal cues, indicating things patients may not be forthcoming about. Therefore, it is vital for all nurses to develop effective communication skills and learn different types of communication.
Darby Faubion BSN, RN
Darby Faubion is a nurse and Allied Health educator with over twenty years of experience. She has assisted in developing curriculum for nursing programs and has instructed students at both community college and university levels. Because of her love of nursing education, Darby became a test-taking strategist and NCLEX prep coach and assists nursing graduates across the United States who are preparing to take the National Council Licensure Examination (NCLEX).