This post was originally published on August 29, 2018.
The benefits of effective communication in nursing are often unseen and undervalued. Nurse communication is just as much an art as a science, where the art involves establishing a human connection with the patient or care team. In contrast, the science relates to the tool and technology that facilitates connections. People are social beings; we need care from others, especially when we are most vulnerable. With hospitals typically employing four times as many nurses as physicians, nurses are likely the ones that provide patients with the compassion and empathy needed on the journey to recovery.
Nurses provide patients with deep interpersonal, intellectual, technical abilities and skills at the point of care and beyond. To do so, they must possess more than just clinical knowledge – they need interpersonal communication skills. According to the US National Library of Medicine at the National Institutes of Health (NIH), communication in nursing is a “vital element in nursing in all areas of activity and in all its interventions, such as prevention, treatment, therapy, rehabilitation, education, and health promotion.”
Nurse care is delivered primarily through dialogue through specific skills of verbal communication and non-verbal communication. “Communication in nursing” defines exchanging information, thoughts, and feelings among people using speech or other means. The patient conveys their fears and concerns to their nurse to help them make a correct diagnosis. Thus, the benefits of nurses being able to communicate effectively are overwhelmingly critical.
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The benefits of effective communication in nursing require an understanding of the patient and the experiences they express, NIH says. This communication “requires skills and simultaneously the sincere intention of the nurse to understand what concerns the patient.” Nurses, to be successful, must understand the patient’s needs and convey the patient’s communicated message back. “It is a reflection of the knowledge of the participants, the way they think and feel, and their capabilities.”
Nurses must be prepared to learn, understand and apply various aspects and applications of communication in various fields of nursing. Emphasis must be placed “on the importance of communication between nurse and patient and nursing education must focus on the communication skills of nurses.”
Likewise, (patient) communication is rarely “unidirectional,” and the failure by nurses to recognize two-way communication can lead to negative conclusions and attitudes. However, communication is not only verbal; it can happen without words and is an ongoing process. Non-verbal communication includes facial expressions, gestures, posture, and physical barriers, such as distance.
Nurses must analyze patient communications during stressful situations and understand non-verbal cues to ensure patient safety. Additionally, nurses must understand that no two people communicate in exactly the same manner. Listening is vital in communication; listening lets a nurse assess a situation to formulate a response for care.
Nurse and patient communication begin at first contact – at the initial moment of patient care. This communication lasts the duration of the care cycle. For the most benefit, the patient must feel comfortable, which requires a peaceful and private environment (as much as is allowed) and confidentiality. If such an environment is not made available, the patient may rescind speaking openly. Time also is a required element of quality communication between a nurse and patient. It takes time to create the confidence necessary to best support the patient. “The patient who has the undivided attention of the nurse reveals his problem sooner, with the satisfaction that the nurse has listened and observed him,” the NIH paper, “Communication in Nursing Practice,” points out.
During nurse-patient conversations, the nurse must use language that does not bombard the patient with technical terms or words of little meaning. A patient may become quickly ashamed of their lack of complete understanding and hesitate, halting progress. They may also avoid seeking an explanation and bail on trying to understand the situation thoroughly. Nurses should bring the conversation to the language level of the listener so they may best meet the patient understanding of what is being communicated. Eye contact also is extremely important.
Finally, honesty and transparency are vital to effective communication between caregiver and patient. Nurse communicators should “leave no suspicions, doubts, and misunderstandings,” researchers concluded in their NIH report.
When a patient enters the point of care — under stress and emotional fatigue — reactions such as “anger, disbelief, moaning, aggression, and denial of reality are known defense mechanisms, which are recruited to help him adjust to the new situation he is facing.” People differ in their needs for communication. Some simply want caregivers to listen. Others want answers for everything they are going through. Nurses must communicate accordingly and must avoid “silence and indifference.”
Communication with patients requires training and experience, but also education. Researchers point out that good communication improves the quality of care and is considered an “inalienable right and a pre-requisite for building a genuine and meaningful relationship between patients and nurses and other health professionals,” researchers point out.
Nurses are the front line regarding communicating and understanding patient needs. They have the most direct contact during patient interaction, so they come away with the best insights about needs and care. The ways nurses communicate vary, but if it’s effective, their ability to do so is vital to generate better patient outcomes.
The benefits of effective communication in nursing include the following:
From the initial point of care and triage and throughout treatment and release (from an acute care environment) and beyond, nurses are the first and primary caregivers. These caregivers quickly assess, evaluate, and work to understand a patient’s condition. In nearly every case, nurses are the first and best line of communication regarding patient health to other team members. Their ability to communicate effectively is critical to providing excellent care.
Because nurses spend more time with patients than most other caregivers, the amount of personal communication they have with patients is essential for understanding the patient’s physical and emotional well-being. The communication nurses have with patients means they may provide a deeper level of care individually. This granular information can be significant in a patient’s long-term health. This level of communication also can help them make decisions on appropriate treatment plans and when implementing care protocols with other healthcare professionals.
Social determinants of health are the social, physical, and environmental conditions in a person’s life that affect overall health status. The social determinants of health, such as poverty, unemployment, food insecurity, and lack of stable housing, have increased rates and severity of chronic conditions and led to greater morbidity and mortality. Communicating effectively with patients to understand what some of their social determinants may be can significantly increase patient health and wellness, key components in the Department of Health and Human Service’s Healthy People 2020 initiative.
Understanding patient needs and concerns allows nurses to target their communication and clinical strategies toward specific patient preferences. Doing so also means they can track patient progress regularly, measuring deviations in near real-time. Outcomes based on regular communication can then be forwarded to other caregivers on the team. When a nurse is a good listener and frequently checks in on their patients, they can reduce physical and emotional distress.
A patient may have needs outside their medical care. For example, some patients may have specialized diets or particular religious beliefs. Nurses can ensure this information is provided to the right people so that the quality of care isn’t compromised and the patient’s requirements are met.
According to the American Nurses Association’s (ANA’s) “Code of Ethics for Nurses,” patient advocacy includes a therapeutic relationship and communication between nurse and patient. As an advocate, a nurse acts as an informer to the patient’s decision-making, standing by the patient and enabling them to make their own decisions. Nurse advocates bridge communication gaps between the patient, other professions, and the healthcare system. Likewise, when nurses can identify patient worries, they can help alleviate fears and create a better experience for the patient. Nurses provide reassurance and assistance for patients. They can help explain a diagnosis or give recommendations on following a treatment plan or taking medications. They also follow up with the physician for things like lab results or critical information.
Health IT can play a major role in supporting strong nurse-patient communication. For example, tablets can contain tools to help patients become acquainted with the hospital and their care teams and promote a more positive experience during their stay. Thus, nurses don’t just need to rely on their interpersonal skills and memory. Clinical communication and collaboration solutions can help nurses communicate with other care team members and record important information about patients.
These same technologies can help nurses communicate important information to patients. Nurses can reconcile meeting documentation requirements through healthcare technology with their interpersonal skills to create a positive patient experience.
Nurse communication goes far beyond just talking to patients and other nurses. Nurses are the front line for communication. Providing them with the right skills and technology can enhance every part of your healthcare organization. To achieve these goals and achieve patient satisfaction, effective communication skills by nurses require good interpersonal skills, understanding of patient needs, training, and continuing education of nurses. Nurse communication includes a balanced, compassionate approach, active listening, clinical expertise, and even technology that can meet demand while creating a quality care encounter that supports patient health and emotional needs.