Communication is an exchange of information between people through either verbal or non-verbal forms. Dëger, Sibiya, Johnson & Uno (2018) stated that communication is an essential component in cooperation, collaboration, and relationships, which makes communicating in professional practice such as nursing vital. Conversations between nurses and patients are crucial to their overall safety, they can prevent medical mistakes, aid in the level of care provided and act as a support system. There are many different strategies in verbal communication within nursing, including being able to read the entry points, active listening, and showing empathy through touch.
Not only is communication important in nursing, but it is also part of the code of conduct. The Nursing and Midwifery Board of Australia (NMBA, 2018) Code of Conduct states in section 3.3 ‘Effective Communication’ that positive professional relationships are built on effective communication. Section 3.3 details the importance of recognizing: health literacy issues different cultures and possible language barriers, verifying the patient completely understands the information, the ability to communicate clearly and accurately information, being non-judgmental, and finally always maintaining a professional manner.
There are different procedures and communication styles and strategies in place to ensure the overall safety of the patient. If the patient doesn’t understand English, it becomes more difficult to communicate. It is the nurse’s responsibility to recognize this and bring in an interpreter to ensure the patient fully understands. Nursing is defined as caring for a patient and communication is paramount in being able to provide the best care. Bullington, Söderlund, Sparèn, Kneck, Omēror & Cronquist (2019) proclaimed that a nurse’s caring relationship with the patient was reliant on the effectiveness of communication between the nurse and the patient. Patient handover is another example where a lack of effective communication can result in unnecessary care. Fixing and forgetting is another example of a lack of communication between healthcare providers. Hewitt & Chreim (2015) described this as one of the most re-occurring situations in the medical field. For example, if a problem arose and an individual fixed it, if they forgot to record it, another individual may come along and try to fix something that had already been fixed, which could result in harm to the patient, prioritizing time incorrectly and creating re-occurring safety issues. Being a nurse, acting as an advocate is part of the role, whether it be the patient, their family, or colleagues, the correct communication skills must be developed and demonstrated throughout the practice. If the competency to communicate decreases, the situation becomes more difficult and stressful, as the recommended procedures may not be possible due to a lack of understanding, culture, or language barriers. This results in compromising the safety of the patient.
There are many different strategies within verbal communication that nurses require to succeed in caring for their patients. Gurdan (2016) expressed the importance of identifying the ‘entry points’ when talking to patients. Gurdan defined this as the ability to decode what the patient is saying and know whether to ask more questions. If a patient says, “I am having a debulking surgery, so I will be fine because they are taking the whole tumor out in one go”, this indicates to the nurse that informed consent has not been given as the patient is unaware of the correct procedure, the nurse is in a position to educate and inform so that the consent can be gained. Another strategy is recognizing each patient’s differences and being able to actively listen and respond to each situation in an empathetic manner. By doing these actions it constructs an effective nurse-patient relationship. It is important to have empathy when caring for a patient, as it allows the nurse better relate to the patient’s experience, understand it, and provide a higher level of care. Turner, Locke, Jones, & Carpenter (2019) gave examples of demonstrating empathy, including treating patients with respect, caring for the patient with compassion, engaging in conversations with the patient and listening to what they have to say, knowing the importance of a smile, and being present at the moment. Empathy can have a major role in the outcomes for patients as they are more willing to allow the help being provided and work with the health care team.
However, not only verbal communication helps with the progress of caring for a patient. Non-verbal communication is also used regularly by nurses while caring for patients, however, can act as a barrier between the patient and nurse. Dëger, Sibiya, Johnson & Uno (2018) gave an example of a barrier as the noise around the communication setting. Hospitals can be very loud, so it is important that nurses maintain awareness of others while communicating with their patients. It may be that the patient is an elderly person who has trouble hearing. If you incorporate their hearing impairment with the background noise, it can make it very difficult for the patient to understand the information being given, which can result in miscommunication. However, non-verbal communication doesn’t always act as a barrier. It can be used to enhance the level of care, help nurses connect to their patients, and help maintain the patient’s safety. Benbenishty & Hannink (2015) stated that communicating through touch was crucial when creating the nurse-patient relationship, including two specific modes of touch: touch during interventions and conveying an emotional message. A simple touch can convey many different messages so it is important that nurses recognize what their touch is saying. Benbenishty & Hannink explained that a simple gesture can make a patient feel safe and supported, can change their hospital experience, and help with their overall recovery. For example, a trauma patient that has just come into the ward may be in shock and won’t understand what is going on. However, a simple gesture of washing their face or touching their hand may effectively help them understand what is happening. Mohammed, Hons, Hutchinson, Sungkar & Considine (2018) stated that in a situation like this one or more critical situations, it is the nurse’s responsibility to obtain written consent if verbal consent isn’t viable. This can fast-track procedures required to keep the patient safe.
Communication is vital in the profession of nursing as it is required in maintaining the health and safety of the patient. In the nursing code of conduct, effective communication is discussed as part of the nurse’s obligation to the patient and forms part of the nurse’s duty of care. There are many verbal strategies used within nursing, including active listening, expressing empathy, and the ability to identify entry points when conversing with patients. Both verbal and non-verbal communication strategies and methods are vital in the medical field, especially nursing as they are the first point of contact for the patient. These strategies aid the nurse in getting the required information, the level of care provided, and the overall safety of the patient. Poor communication can have a significant negative effect on the patient’s safety, quality of care, outcomes and satisfaction, and the staff's satisfaction as well.
References
Degër V.B., Sibiya N., Johnson F., Uno M. (2018). Nursing. Nilgun Ultasdemir. https://books.google.com.au/books?hl=en&lr=&id=Ib-QDwAAQBAJ&oi=fnd&pg=PA19&dq=effective+communication+in+nursing&ots=7fsAIXv4nF&sig=u6TP3krLDp38rn9pc4RMxsZbsXE&redir_esc=y#v=onepage&q=effective%20communication%20in%20nursing&f=false
Nursing and Midwifery Board of Australia (2018). Code of Conduct for Nurses. Cusack Lynette. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx
Price B. (2020). Nursing Standard. Optimising Professional Communication with Patients. DOI:10.7748/ns.2020.e11457. https://journals.rcni.com/nursing-standard/cpd/optimising-professional-communication-with-patients-ns.2020.e11457/pdf
Webb L. (2018). Nursing Standard. Exploring the Characteristics of Effective Communicators in Health Care. 33, (9), 2. https://search-proquest-com.libraryproxy.griffith.edu.au/docview/2165293013/fulltextPDF/453BEFA63B3744C7PQ/5?accountid=14543
Bendenishty B., Hannink J.R (2015) Non-Verbal Communication to Restore Patient-Provider Trust. Heidelberg 41(7), 2. https://search-proquest-com.libraryproxy.griffith.edu.au/docview/1691395720?pq-origsite=summon
Hewitt, T.A., & Chreim, S. (2015). Fix and Forget or Fix and Report: A Qualitative Study of Tensions at the Front Line of Incident Reporting. BMJ Quality & Safety, 24(5). https://www.ncbi.nlm.nih.gov/pubmed/25749025
Bullington J., Söderlund M., Sparèn E.B., Kneck A., Omēror P., Cronqvist A. (2019). Communication Skills in Nursing: A Phenomenologically-Based Communication Training Approach. Nurse Education in Practice, 39. https://search-proquest-com.libraryproxy.griffith.edu.au/docview/2290041878/fulltextPDF/32F3BB582F54CAEPQ/1?accountid=14543
Turner K., Locke A., Jones T., Carpenter J. (2019). Empathy Huddles: Cultivating a Culture of Empathy. Neuroscience Nursing 51(3). http://dx.doi.org.libraryproxy.griffith.edu.au/10.1097/JNN.0000000000000444
Mohammed S., Hons B.N., Hutchinson A.F., Sungkar Y., Considine J. (2018). Nurses’ Role in Recognising & Responding to Clinical Deterioration in Surgical Patients. Wiley Journal of Clinical Nursing. https://onlinelibrary-wiley-com.libraryproxy.griffith.edu.au/doi/epdf/10.1111/jocn.14331