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Posted: 11/14/2017 12:23:09 PM

Communication Issues in Nursing

Communication failures rank first among the most common causes of medical errors, significantly impacting hospitals and healthcare delivery. And because nurses are at the forefront of patient care, the situation puts the spotlight directly on them.

Communication is crucial in healthcare because it builds trusting nurse-patient relationships and facilitates inter-professional collaboration. Communication must be understood in a different context as that of information. Information is something that you just give out or disseminate, while communication is getting your message across and receiving a reply in the process.

Nurses serve as a common gateway that accommodates the messages relayed among various professionals. Physicians give the orders out and ask about the patient’s condition through nurses. RNs coordinate the care of other clinicians and therapists. Nurses talk to the patient and their families to know their concerns. They act as a liaison between care providers and patients, so their role calls for excellent collaboration skills. When nurses fail to properly communicate, various patient care processes, as well as the interrelationships within the organization, will be on the line.

Here are common communication problems that nurses need to address in the workplace:

1. SPEAKING WITHOUT CLARITY. When there is not enough clarity as nurses speak, errors are bound to happen.

Consider this scenario:

The nurse says to the patient, “Take your pill for hypertension once a day.” The patient obliges. But because the patient considers their diuretic as the main medication for hypertension, the patient took it before bedtime. The next day, the patient complains of a lack of sleep during the night because they were up too many times to go to the bathroom. Being clear, in this case, is saying, "Take one tablet of Quinapril every night before bedtime," while showing them the medication.

2. USING A DISRESPECTFUL TONE OF VOICE. Whether talking with a patient or colleague, the tone of voice conveys the most meaning. If someone says “sorry” without really meaning it, we would certainly know that they are not sincere. A disrespectful tone is a formidable barrier to communication. It breeds anger, resentment, and the need to retaliate. It fosters a culture of fear, where bullying and incivility become an accepted part of a nurse’s job. Additionally, using a monotonous, robotic tone to talk with a patient, conveys a lack of sensitivity and empathy, which will make the patient hold back information and become uncooperative.

3. FAILURE TO RECEIVE OR GIVE FEEDBACK. Receiving feedback makes communication closed-loop. Without affirming that a message is understood, the message becomes open to misinterpretations that can easily lead to errors. Without receiving or message becomes open to misinterpretations that can easily lead to errors. Without receiving or giving a reply, the nurse is simply informing, not communicating. So, if a nurse performs health teaching with a patient without evaluating what they understood, proper communication has NOT taken place. Similarly, when a staff nurse consults the charge nurse and does not receive a reply, they readily interpret this as lack of interest on the part of their supervisor. In a fast-paced environment such as the operating room, it is important to be completely understood as a speaker and to understand clearly as a recipient. Closed-loop communication is tantamount to saving patients’ lives. The success of the unit lies primarily on this concept of collaboration.

4. FAILING TO SPEAK UP. Nurses who consider themselves to be “at the bottom of the food chain” rarely speak up when they see a potential error or become witness to a mistake. Keeping quiet about matters of safety is as dangerous as injuring a patient. Both put patients’ lives in jeopardy. Nurses tend to be quiet when they see that their own interests are at stake if they take a stand, so they choose not to get involved and live with the difficulties. But failing to point out possible areas of improvement blocks the way for solutions and results in both unsafe practices and unhealthy inter-professional relationships.

Nurses cannot be effective in their work if they do not master the art of communication. Failing to get your message across and be understood will ultimately lead to career setbacks and negative feelings about nursing. Proper communication must, therefore, be learned and practiced.