communication skills nursing essay

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Nursing MSN & DNP

| 20 May 2024

The Importance of Effective Communication in Nursing

To be a successful healthcare provider, clinical nurse or nurse leader, you need exceptional communication skills—and you need to be able to use them during high-stress situations.

Why Is Communication Important in Nursing?

Having good communication skills is essential to collaborating on teams with your fellow nurses and colleagues from other disciplines. It’s also important to patient-centered care.

Nurses who take the time to listen and understand the concerns of each of their patients are better prepared to address issues as they arise, resulting in better patient outcomes.

On the other hand, poor communication, or lack of communication in healthcare , can lead to patients misunderstanding directions and failing to follow treatment protocols. It can also lead to workflow breakdowns on the team, resulting in a medical error . A report by the Joint Commission found that poor communication in healthcare during patient transfers contributed to 80% of serious medical errors.

Additionally, patients who have established an open and secure dialogue with a nurse or healthcare provider are more likely to disclose the true extent of their symptoms. According to the book Interpersonal Relationships: Professional Communication for Nurses by Arnold and Boggs , healthcare communication competency offers a primary means for establishing a trusting, collaborative relationship with patients and families. Interpersonal communication skills influence the quality of decisions made, as well as the level of patient motivation to follow treatment protocols and achieve desired clinical outcomes.

10 Effective Communication Skills for Nurses

For nurses, good communication in healthcare means approaching every patient interaction with the intention to understand the patient’s concerns, experiences, and opinions. This includes using verbal and nonverbal communication skills, along with active listening and patient teach-back techniques. Below, we explore 10 communication skills that are important for nurses.

1. Verbal Communication

Excellent verbal communication is key. Aim to always speak with clarity, accuracy, and honesty. It’s also important to know your audience and speak appropriately according to the person’s age, culture, and level of health literacy. If you are feeling stressed out or frustrated, be aware of your tone of voice and don’t let these emotions leak into your patient interaction. You can:

• Encourage patients to communicate by asking open questions like, “Can you tell me a bit more about that?”
• Avoid condescending pet names like “honey” or “sweetie” and instead use the patient’s first name or name of choice.
• Speak in clear, complete sentences and avoid technical jargon.

2. Nonverbal Communication

Using elements of nonverbal communication—such as facial expressions, eye contact, body language, gestures, posture, and tone of voice—is also essential in creating rapport. Simply smiling can go a long way. You can also:

• Show interest in what the patient is saying by maintaining eye contact and nodding your head.
• Smile, but don’t stare.
• Sit down when you can, and lean forward to show you’re engaged.
• Use nonthreatening body language that conveys openness.

3. Active Listening

“Active listening” means listening in order to understand the other person’s experience. The highest and most effective form of listening requires complete attention and engagement. This skill is important not only for clinical nurses but also for nurse executives and other healthcare providers as a tool for building trust and commitment with their staff. Active listening includes both verbal and nonverbal communication skills. For example:

• Nod your head, but never interrupt.
• Lean forward and maintain eye contact to let the person know you’re engaged.
• Include minimal verbal encouragement, such as “I understand,” and “go on.”

4. Written Communication

Written communication skills are also essential for effective nurse-to-nurse communication. As a nurse, you will be responsible for creating and updating the patient ’s medical record . It is critical that the medical record is accurate and current so your patients can receive the best care possible. Also, remember to protect patient confidentiality. Some tips:

• Make notes immediately following patient care so you do not forget anything.
• Write legibly and clearly, using simple language.
• Be sure to note accurate dates and times.

5. Presentation Skills

Effective presentation skills are most applicable during “handover”—when you are transferring patient care to another nurse or other healthcare providers . These skills will also help you demonstrate your knowledge and expertise clearly in a variety of workplace settings, such as presenting at conferences, participating in job interviews, giving case reports to physicians, and more. It’s a good idea to:

• Plan out your presentation and practice.
• Pay attention to both your verbal communication and body language.
• Add visuals to your presentation for a better explanation.
• Understand your audience and know what they want and need from the presentation.

6. Patient Education (Patient Teach-Back)

Nurses are in charge of most of the communication between the healthcare team and patients. This includes informing patients and family members of health conditions, diagnoses, treatment plans, and medication protocols. This skill is especially important for family nurse practitioners who work with patients and families to provide health and education counseling.

Patient teach-back is an effective communication strategy where providers ask patients to repeat the information back to them. This method improves patient understanding and encourages adherence to care instructions. Poor understanding of information can cause patients and their family members to feel anxious or become defensive. For example, you can say:

• “We’ve gone over a lot of information. Now I’d like you to repeat it back to me to make sure you remember everything.”
• “Can you repeat the instructions for taking this medicine back to me?”
• “Let’s review what we just discussed. Can you explain it to me in your own words?”

7. Making Personal Connections

It’s important to get to know the person behind the patient. Patient-centered relationships are critical in helping patients feel safe and comfortable. Creating meaningful connections with patients can improve outcomes and trust. Some ideas:

• Spend a couple of extra minutes every day with each patient getting to know them.
• Find out a fun fact about each patient.
• Show interest in their lives and share stories of your own.

It’s important for healthcare professionals to inspire trust in patients by listening actively and taking every complaint and concern seriously. Building trust takes time. Healthcare settings are scary for some patients. It’s important to make them feel as comfortable as possible.

Trust is something that nurse educators and leaders should also cultivate as they work to develop the next generation of nurses. To inspire trust, nurse leaders and educators should:

• Always tell the truth.
• Share information openly.
• Be willing to admit mistakes.

9. Cultural Awareness

You will likely work with people every day who come from a wide range of social, cultural, and educational backgrounds. Every patient and coworker is unique, and it’s important to be aware and sensitive. For example, gauge the patient’s fluency with English and grade your vocabulary accordingly or bring in a translator if necessary and possible. With trans and gender nonbinary patients, be sure to use their preferred name and pronoun.

10. Compassion

Conveying compassion is an essential communication skill in healthcare. According to the Journal of Compassionate Healthcare , “studies show that compassion can assist in prompting fast recovery from acute illness, enhancing the management of chronic illness, and relieving anxiety.” You can deliver compassionate nursing care by putting yourself in the patient’s shoes and understanding their needs and expectations.

How to Overcome Communication Barriers in Nursing

Sometimes the message sent is not always received the way it was desired. Communication barriers in nursing result in weak patient-nurse interactions and relationships. To overcome these, we must first understand the types of communication barriers that nurses face. In the article “ Communication and Language Needs ,” Dawn Weaver identifies three common communication barriers in nursing: physical, social, and psychological.

Physical Barriers

The environment in which you communicate with a patient can make a huge difference in effective communication. Busy, loud, and distracting settings can increase patient stress. To create a safe and comfortable environment, try closing doors, opening blinds, and mitigating outside noises whenever you can.

Social Barriers

Social barriers include differences in language, religion, culture, age, and customs. Understanding each patient’s cultural background can help nurses avoid prejudice and communicate clearly. It’s a good idea to tailor your communication strategies depending on the patient’s age, as well: A 12-year-old and a 70-year-old will have very different ideas of what health and healthcare mean to them.

Psychological Barriers

For many patients, a trip to the doctor is anxiety-inducing. Anxiety and stress are psychological barriers, as are dementia and other cognitive conditions. To help reduce their influence, it helps to take extra time to listen, empathize, and be supportive. Such psychosocial care has been proven to improve patient health outcomes and quality of life.

Nurses may also need to overcome their own psychological barriers. Speaking to patients and family members about death, disease, and other sensitive topics can be distressing. A study in the Journal of Advanced Nursing explored the fact that many nurses experience feelings of anxiety when discussing patient medical needs and conditions.

Get Started Developing Crucial Communication Skills Today

Learning these and other communication skills should be part of your education, whether you’re enrolled in undergraduate nursing school or a graduate nursing program . They are also easy to practice on the job, as you will get plenty of opportunities for communicating with patients and your colleagues. Put your favorite idea into practice today!

The University of St. Augustine for Health Sciences (USAHS) offers Master of Science in Nursing (MSN), Doctor of Nursing Practice (DNP), and Post-Graduate Nursing Certificates designed for working nurses. Our degrees are offered online, with optional on-campus immersions* and an annual interprofessional trip abroad. Role specialties include Family Nurse Practitioner (FNP), Nurse Educator (MSN only) , and Nurse Executive . The MSN has several options to accelerate your time to degree completion. Complete coursework when and where you want—and earn your advanced nursing degree while keeping your work and life in balance.

*The FNP track includes two required hands-on clinical intensives as part of the curriculum.

The Joint Commission. “Joint Commission Center for Transforming Healthcare Releases Targeted Solutions Tool for Hand-Off Communications.” Joint Commission Perspectives 32, no. 8 (August 2012): 1, 3. https://pubmed.ncbi.nlm.nih.gov/22928243/. Accessed: January 26, 2022

Agency for Healthcare Research and Quality. “Use the Teach-Back Method: Tool #5.” Last reviewed September 2020. https://www.ahrq.gov/health-literacy/quality-resources/tools/literacy-toolkit/healthlittoolkit2-tool5.html. Accessed: January 26, 2022

Chen, Cassandra Siyun, Sally Wai-Chi Chan, Moon Fai Chan, Suk Foon Yap, Wenru Wang, and Yanika Kowitlawakul. “Nurses’ Perceptions of Psychosocial Care and Barriers to Its Provision: A Qualitative Study.” The Journal of Nursing Research 25, no. 6 (2017): 411–418. doi:10.1097/JNR.0000000000000185.

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Understanding Communication in Nursing (With Examples, Importance, & How to Improve)

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?

7 reasons why communication is so important in nursing, 1. effective communication in nursing is essential in assessing a patient’s response to treatment., 2. communication with patients and their loved ones helps relieve stress and improves patient outcomes., 3. effective communication among the healthcare team can help reduce the risk of errors in patient care., 4. effective communication in nursing care is necessary to advocate for patients., 5. communicating with patients and their families will help identify special needs., 6. communication with your patients will help you identify and understand the social determinants impacting their health., 7. effective communication in nursing is vital for understanding the status of your patient's emotional and physical well-being., what are the 8 essential components of good communication in nursing, 1. eye contact:, 2. an attentive listener:, 3. a clear message:, 4. patience:, 5. being receptive:, 6. body language:, 7. understanding:, 8. feedback:, examples of bad communication vs. good communication in nursing, 1. scenario:, bad communication:, good communication:, 2. scenario:, 3. scenario:, 4. scenario:, how to improve communication in nursing, 1. use the right tone when speaking to others., 2. be aware of others’ body language., 3. be mindful of your own body language., 4. show interest in what others say., 5. be patient., 6. demonstrate a positive attitude., 7. create an atmosphere conducive to effective communication., 8. practice active listening., 9. exercise emotional intelligence., 10. ask open-ended questions., 11. be attentive to your patient’s efforts at communicating with you., 12. practice cultural awareness., 13. ask for input from colleagues., 14. be mindful of your patient’s situation., 15. exercise diverse types of communication., 16. incorporate role-play when appropriate., 17. involve your patient’s friends and/or family., 18. show compassion., 7 consequences of bad communication in nursing, 1. miscommunication of vital patient information:, 2. poor communication skills in nursing can cause increased workload pressure., 3. patients may not understand important information such as when to take a medication or possible side effects to report., 4. when there is bad communication in nursing, there is an increased risk to the patient's safety., 5. when nurses communicate poorly with one another, there is an increased risk of malpractice suits., 6. poor patient satisfaction scores:, 7. increased chance of medication errors., useful resources to improve communication in nursing, • the importance of listening in healthcare, • empowering communication, • therapeutic communication, calming people down and dealing with patient complaints, • how can i improve my communication skills with my patients, • communication mishaps between patients and nurses, youtube videos, • nursing fundamentals: therapeutic communication & coping, • nurse to nurse communication skills, • therapeutic communication for nurses: avoid these 5 traps, • nursing standard: inclusive communication and how to avoid making assumptions, • stitcher: healthcare communication- effective techniques for clinicians, • audible: healthcare communication solutions, • therapeutic communication: knowing what to say when, • communication for nurses: how to prevent harmful events and promote patient safety, • 4 essential keys to effective communication, my final thoughts, frequently asked questions answered by our expert, 1. as a nurse, how do i know if i am a good communicator, 2. will lack of communication impact my nursing career, 3. usually, how long does it take for a nurse to improve the skill of therapeutic communication, 4. do all types of nurses require very good communication skills, 5. as a nurse, do i need to be good at all types of communication.

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Home > Books > Nursing

Effective Communication in Nursing

Submitted: 27 October 2017 Reviewed: 06 February 2018 Published: 21 March 2018

DOI: 10.5772/intechopen.74995

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Nurses are critical in the delivery of essential health services and are core in strengthening the health system. They bring people-centred care closer to the communities where they are needed most, thereby helping improve health outcomes and the overall cost-effectiveness of services. Nurses usually act as first responders to complex humanitarian crises and disasters; protectors and advocates for the community and communicators and co-ordinators within teams. Communication is a core component of sound relationships, collaboration and co-operation, which in turn are essential aspects of professional practice. The quality of communication in interactions between nurses and patients has a major influence on patient outcomes. Increases in nursing communication can lessen medical errors and make a difference in positive patient outcomes. This chapter explores how effective communication and interpersonal skills can enhance professional nursing practice and nursing relationships with various stakeholders. It explains principles of communication, communication process, purpose of communication, types of communication, barriers to effective communication, models of communication and strategies of improving communication and guidelines for successful therapeutic interactions.

• communication
• communication skills
• non-verbal communication
• nurse–patient relationship
• nursing verbal communication

Author Information

Maureen nokuthula sibiya *.

• Durban University of Technology, Durban, South Africa

*Address all correspondence to: [email protected]

1. Introduction

Nurses are critical in the delivery of essential health services and are core in strengthening the health system [ 1 , 2 ]. They bring people-centred care closer to the communities where they are needed most, thereby helping improve health outcomes and the overall cost-effectiveness of services [ 3 ]. Nurses usually act as first responders to complex humanitarian crises and disasters; protectors and advocates for the community and communicators and co-ordinators within teams. Communication skills for nurses are essential but may be difficult to master. Communication is the exchange of information between people by sending and receiving it through speaking, writing or by using any other medium. Clear communication means that information is conveyed effectively between people. To be a successful nurse, excellent communication skills are required [ 4 ]. Nurses speak to people of varying educational, cultural and social backgrounds and must do so in an effective, caring and professional manner, especially when communicating with patients and their families [ 5 ]. The quality of communication in interactions between nurses and patients has a major influence on patient outcomes. This influence can play a very important role in areas such as patient health, education and adherence [ 6 ]. Good communication plays an important role in the organization’s effective functioning [ 7 , 8 , 9 ]. A nurse must therefore, continuously try to improve his/her communication skills as poor communication can be dangerous and lead to confusion.

2. Principles of communication

Communication is a process;

Communication is not linear, but circular;

Communication is complex;

Communication is irreversible; and

Communication involves the total personality [ 5 ].

3. Communication process

A clear message; and

A receiver [ 12 ].

4. Purpose of communication

To convey information/opinion, for example, “I have headache” or “I am here to give you medication”.

To request information/opinion/behavior, for example, “Are you allergic to penicillin?” or “Tell me more about the injury”.

To give social acknowledgement, for example, “Hello” or “Good morning”.

These three primary types of messages can be combined in many ways so that they form an interaction (conversation). The goals of the interaction can be comprehensive. Nurses strive to make all their communication with patients therapeutic, that is, their communication is purposefully and consciously planned to promote the patient’s health and wellbeing.

5. Types of communication

Verbal and non-verbal communications are the two main types of communication used by human beings.

5.1. Verbal communication

Verbal communication is associated with spoken words and is vitally important in the healthcare context. Members of the multi-disciplinary healthcare team communicate verbally with one another and with patients as well as family members.

5.2. Verbal communication

Bodily contact

Direction of gaze

Emotive tone in speech

Facial and gestural movements

Physical appearance

Speech errors

Timing of speech [ 5 , 8 , 9 , 10 ].

6. Communication process

The communication process may be explained by means of a linear model of communication, interactive model of communication or transactional model of communication [ 11 ].

6.1. Linear model of communication

Linear model of communication entails a sender, a message, a receiver and noise ( Figure 1 ).

Linear model of communication.

6.2. Interactive model of communication

Interactive model of communication gives a slightly more complex explanation of the communication process. Communication is seen as a process in which the listener gives feedback or responds to a message after a process of interpretation. A communicator creates and interprets a message with a personal field of expertise and/or a frame of reference Figure 2 ).

Interactive model of communication.

6.3. Transactional model of communication

Transactional model of communication acknowledges and gives emphasis to the dynamic nature of interpersonal communication and the multiple roles of the communicators. Features such as time, messages, noise, fields of experience, frames of reference, meanings, shared systems of communicators and personal systems all pay a role in the process of communication. Communicators often participate simultaneously (sending, receiving and interpreting). The unique interpretive and perceptual processes of individuals thus play an essential role in the communication process.

7. Barriers to effective communication

Effective communication skills and strategies are important for nurses. Clear communication means that information is conveyed effectively between the nurse, patients, family members and colleagues. However, it is recognized that such skills are not always evident and nurses do not always communicate well with patients, family members and colleagues. The message sent may not be the message received. The meaning of a message depends on its literal meaning, the non-verbal indicators accompanying it and the context in which it is delivered. It is therefore, easy to misinterpret the message, or to interpret it correctly, but to decide not to pursue its hidden meaning this leads to obstruction to communication. Continuous barriers to effective communication brings about a gradual breakdown in relationships. The barriers to effective communication outlined below will help nurses to understand the challenges [ 8 ].

7.1. Language barrier

Language differences between the patient and the nurse are another preventive factor in effective communication. When the nurse and the patient do not share a common language, interaction between them is strained and very limited [ 9 , 10 , 11 ]. Consequently, a patient may fail to understand the instructions from a nurse regarding the frequency of taking medication at home.

7.2. Cultural differences

Culture is another hindrance. The patient’s culture may block effective nurse–patient interactions because perceptions on health and death are different between patients [ 12 , 13 , 14 ]. The nurse needs to be sensitive when dealing with a patient from a different culture [ 9 , 15 , 16 ]. What is acceptable for one patient may not be acceptable for another. Given the complexity of culture, no one can possibly know the health beliefs and practices of every culture. The nurse needs check with the patient whether he/she prefers to be addressed by first name or surname. The use of eye contact, touching and personal space is different in various cultures and rules about eye contact are usually complex, varying according to race, social status and gender. Physical contact between sexes is strictly forbidden in some cultures and can include handshakes, hugging or placing a hand on the arm or shoulder. A ‘yes’ does not always mean ‘yes’. A smile does not indicate happiness, recognition or agreement. Whenever people communicate, there is a tendency to make value judgements regarding those perceived as being different. Past experiences can change the meaning of the message. Culture, background and bias can be good if they allow one to use past experiences to understand something new; it is when they change meaning of the message that they interfere with the communication process [ 12 ]. It is important for nurses to think about their own experiences when considering cultural differences in communication and how these can challenge health professionals and service users.

7.3. Conflict

Conflict is a common effect of two or more parties not sharing common ground. Conflict can be healthy in that it offers alternative views and values. However, it becomes a barrier to communication when the emotional ‘noise’ detracts from the task or purpose. Nurses aim for collaborative relationships with patients, families and colleagues.

7.4. Setting in which care is provided

The factors in care setting may lead to reduction in quality of nurse–patient communication. Increased workload and time constraints restrict nurses from discussing their patients concerns effectively [ 16 ]. Nurses work in busy environments where they are expected to complete a specific amount of work in a day and work with a variety of other professionals, patients and their families. The roles are hard, challenging and tiring. There is a culture to get the work done. Some nurses may consider colleagues who spend time talking with patients to be avowing the ‘real’ work and lazy. Nurses who might have been confident in spending time with patients in an area where this was valued, when faced with a task-orientated culture have the dilemma of fitting into the group or being outside the group and spending time engaging with patients. Lack of collaboration between the nurses and the doctors in information sharing also hinder effective communication. This leads to inconsistencies in the information given to patients making comprehension difficult for the patient and their families.

7.5. Internal noise, mental/emotional distress

Internal noise has an impact on the communication process. Fear and anxiety can affect the person’s ability to listen to what the nurse is saying. People with feelings of fear and anger can find it difficult to hear. Illness and distress can alter a person’s thought processes. Reducing the cause of anxiety, distress, and anger would be the first step to improving communication.

7.6. Perception

If a healthcare professional feels that the person is talking too fast, not fluently, or does not articulate clearly etc., he/she may dismiss the person. Our preconceived attitudes affect our ability to listen. People tend to listen uncritically to people of high status and dismiss those of low status.

7.7. Difficulty with speech and hearing

People can experience difficulty in speech and hearing following conditions like stroke or brain injury. Stroke or trauma may affect brain areas that normally enable the individual to comprehend and produce speech, or the physiology that produces sound. These will present barriers to effective communication.

7.8. Medication

Medication can have a significant effect on communication for example it may cause dry mouth or excess salivation, nausea and indigestion, all of which influence the person’s ability and motivation to engage in conversation. If patients are embarrassed or concerned that they will not be able to speak properly or control their mouth, they could be reluctant to speak.

Equipment or environmental noise impedes clear communication. The sender and the receiver must both be able to concentrate on the messages they send to each other without any distraction.

8. Improving communication

Listen without interrupting the sender.

Show empathy at all times and try to understand.

Try to stay focused on the conversation. Do not however, force the patient to continue if he/she becomes anxious or seems to wish to change the subject.

Use the body language that indicates your interest and concern. Touch the patient if it seems appropriate. Lean forward, listen intently and maintain eye contact if it culturally acceptable.

Offer factual information. This relieves anxiety. Do not offer your personal opinion. Assure the patient that you have professional discretion.

Try to reflect the feelings and thoughts the patient is expressing by rephrasing questions and comments using their own words.

Avoid unclear or misleading messages.

Avoid giving long explanations.

Give your co-workers your full attention when communicating with them.

Ask questions to clarify unclear messages.

Do not interrupt until the sender has completed the message.

Provide a quiet environment without distractions.

Be convincing wen communicating [ 17 ].

9. Communicating with patients

Be open, respectful and gracious in all your interactions with the patient and keep his/her cultural preferences in mind.

Answer nurses’ bells promptly.

Make sure you have the patients’ attention when communicating.

Use words that are non-threatening – explain what you would like to do and do not give orders to the patient.

Use simple, understandable phrases, not medical terms as most patients do not understand these terms.

Speak clearly and courteously.

Use a pleasant and normal tone of voice to the hard of hearing.

Always stand so that the patient can see the nurse’s face when communicating, as lip reading is part of all normal hearing.

Use body language that is appropriate.

Explain facts and procedures before donning a mask that covers the wearer’s mouth and lower face.

Be alert to the patient’s needs. Allow time for answers to your requests and to answer patient’s questions [ 17 ].

10. Communicating by phone

Always speak clearly into the mouthpiece of the phone.

Offer a greeting for example, good morning or good afternoon.

Identify the unit or place of work.

Identify yourself by indicating who you are and where you are phoning from.

Identify the person to whom you are speaking.

Politely listen to the message and make notes if you think you may not remember all the information.

If you are asked to call another person, note the date, time, caller’s name and telephone number together with the message.

Date and sign the message [ 17 ].

11. Assertive communication

Content – where the rights of the people involved are embedded gently in the statement. This could be done by using an explanation, empathy for the listener, and praise for the listener, an apology for the consequence for the listener or a compromise that is favorable to both people.

Covert elements – where the speaker is able to recognize their rights and the rights of the listener in the communication process. These include respect, expressing feelings, having your own priorities, being able to say ‘no’, being able to make mistakes and choosing to say nothing.

Process – concerned with how people express themselves assertively. Is their body language, intonation and choice of language reflective of a confident assertive person? Are the processes that make up communication congruent, in keeping with what is being said? The process also involves managing the setting so that people are not embarrassed, or the noise levels are kept to a minimum. Increasing the likelihood of assertive communication happening again involves feedback to the listener to show that their accomplishment is appreciated.

Non-verbal cues – gesture, touch, proxemics and posture – also need to reflect confidence, regard and respect for self and others.

12. Therapeutic interactions

Assess a patient : The nurse wants to know more about a patient to identify his/her problems. This type of conversation can be a structured interview using an interview schedule. The purpose of this conversation is always a better understanding of the patient.

Instruct a patient : Patient instruction may vary from an informal conversation during which few facts are conveyed to an elaborate instruction session.

Problem solving : If a patient discuss his/her problems with a nurse, the nurse helps the patient to analyze the problem, consider possible alternative ways of handling it and how to decide which way is the best. Problem solving is done with the patients and not for them.

Give emotional support : The presence of an empathetic nurse, that is, one who can enter into the patient’s shoes and understand the patient’s experience, is immensely supportive of the patient. Emotional support alleviates the loneliness of the patient’s experience of illness and increases his/her dignity [ 17 ].

13. Guidelines for successful therapeutic interactions

After the purpose of the therapeutic interaction has been established, the following guidelines assist in conducting a successful interaction:

13.1. Maintaining a low-authority profile

The nurse must strive to maintain a low-authority profile at the beginning of the conversation. As the conversation progresses, the nurse can use more directive techniques to find out specific information. There are usually differences in age, sex, occupation, cultural background, moral and religious convictions between the nurse and the patient. These differences make it impossible for the nurse to fully understand the patient’s behavior and reactions. It is therefore, important for the nurse to understand and accept differences in patients’ cultures and beliefs. When in doubt, check with the patient. If trust is established, patient will be willing to teach the nurse.

13.2. Use of understandable language

The nurse should determine the patient’s level of understanding and if necessary change the use of language, comments and questions. Using the terminology which the patient does not understand can also frighten the patient and make him/her think that he/she has a more serious problem than he/she originally wanted help for. At the same time, the patient could give incorrect information because due to confusion, he/she may give affirmative answers to questions about symptoms that he/she has not actually experienced [ 18 ]. Nurses should share their aims with patients before expecting them to participate in the interaction. They should understand that there is a mutual understanding of each other’s point of departure. In an assessment interview, the nurse can, for instance, say: “Mr Jones, I would like to give you information on how to lose weight so as to bring down you high blood pressure, but I first need to find out what you already know about the condition”. It is not only important that the patients understand what nurses expect from the conversation; it is also essential that nurses understand the patients and convey this understanding before they participate in the conversation. When providing emotional support, this understanding is often all that is necessary. For nurses to understand patients, they must encourage them to talk – not just about facts, but also about their feelings. The nurse must listen more than speak, both to what the patient is saying verbally and what is being said non-verbally. Having listened carefully, the nurse then concentrates and responds empathetically to the patients’ feelings. Only when the nurse has a reasonably complete understanding of the patient’s situation and has communicated this understanding, can she proceed to interventions, such as giving information or solving a problem.

13.3. Tailor the message to the totality of the person

Saying something does not necessary mean that the message has been received and understood. It is the responsibility of the nurse to ensure that the person with whom he/she is conversing understands the message. To ensure this, the message has to be adapted to the language, culture and socio-economic status of the patient. The emotional or physical condition of patients may also make it difficult for them to receive long of complicated messages or even any message. There may also be other disturbances in the immediate environment for example, noise that can make the patient not to hear or understand the message. The message must also be adapted to the age of the patient [ 10 ].

13.4. Validate the interpretation with the patient

Validation means that you ask the patient whether your interpretation is correct or not. You therefore, ask him/her to confirm your understanding of what he/she said. Many misunderstandings arise because people interpret other people’s words without checking their interpretation. The nurse should try to eliminate misunderstandings in the conversations by checking meaning with the patient.

13.5. Active listening

Is the eye contact maintained with the person who is speaking?

Are the body and face turned towards the speaker?

Are there regular verbal responses, even if these consist only of encouraging sounds?

Does the response indicate understanding, not only of the facts, but also of the feelings and the implications of the facts?

It is much easier to speak than to listen. Nurses are, in general, very active people, who want help b acting quickly. To ‘just listen’ without expressing opinions or offering advice is therefore, often not in their nature. Active listening is a valuable skill to acquire [ 10 , 17 , 18 ].

13.6. Evaluate own communication

Simplicity : Say what you want to say concisely and without using difficult or unfamiliar terms.

Clarity : Say precisely what you want to say without digressing, and support your verbal message with non-verbal indicators.

Relevance : Make sure that your message suits the situation, the time and the person you are speaking to.

Adaptability : Adapt your response to the clues the patient that the patient gives you.

Respect : Always show respect for the individuality and dignity of the person you are speaking to [ 17 ].

14. Therapeutic communication techniques

Table 1 gives an overview of therapeutic communication techniques and provides examples of each technique [ 10 , 13 ].

Therapeutic communication techniques.

15. Counter-productive communication techniques

There are certain counter-productive communication techniques that the nurse should avoid as they do not assist in the recovery of the patient and do not have any therapeutic value. Table 2 shows counter-productive communication techniques, explains why these should be avoided and gives examples [ 10 , 18 ].

Non-therapeutic communication techniques that should be avoided.

16. Conclusion

Promoting effective communication in health care is demanding and challenging because of the nature of the work environment. Nurses who have received training in communication skills communicate effectively and show increased confidence in communicating with patients. Many nurses choose to work in other countries, providing an opportunity to broaden their experience and knowledge. However, it is important that nurses who have the opportunity to work in other countries develop communication skills, cultural awareness and sensitivity before arriving. For example, in China talking about death is taboo [ 19 ]. In South Africa, maintaining eye during communication may be regarded as being disrespectful by Black people [ 11 ]. This article provides a reflective account of the experiences of one of the authors of working overseas. This chapter provides the effective communication and interpersonal skills that enhance professional nursing practice and nursing relationships by explaining principles of communication, communication process, purpose of communication, types of communication, barriers to effective communication, models of communication and strategies of improving communication and guidelines for successful therapeutic interactions.

Acknowledgments

The author wishes to acknowledge the Durban University of Technology for funding this book chapter.

Conflict of interest

The author declares that there is no conflict of interest in this chapter.

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© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution 3.0 License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Effective communication skills in nursing practice

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• 1 Effective Communication Matters, Manchester, England.
• PMID: 25467362
• DOI: 10.7748/ns.29.14.53.e9355

This article highlights the importance of effective communication skills for nurses. It focuses on core communication skills, their definitions and the positive outcomes that result when applied to practice. Effective communication is central to the provision of compassionate, high-quality nursing care. The article aims to refresh and develop existing knowledge and understanding of effective communication skills. Nurses reading this article will be encouraged to develop a more conscious style of communicating with patients and carers, with the aim of improving health outcomes and patient satisfaction.

Keywords: Active listening; communication skills; communication skills training; compassionate care; effective communication; empathy; interpersonal skills; nursing care; patient cues; patient safety.

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• Communication skills. King R. King R. Nurs Stand. 2015 Aug 12;29(50):61-2. doi: 10.7748/ns.29.50.61.s44. Nurs Stand. 2015. PMID: 26264338 No abstract available.

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Communication in Nursing Practice

Lambrini kourkouta.

1 Nursing Department, Technological Educational Institute of Thessaloniki, Greece

Ioanna V. Papathanasiou

2 Nursing Department, Technological Educational Institute of Larissa, Greece

Good communication between nurses and patients is essential for the successful outcome of individualized nursing care of each patient. To achieve this, however, nurses must understand and help their patients, demonstrating courtesy, kindness and sincerity. Also they should devote time to the patient to communicate with the necessary confidentiality, and must not forget that this communication includes persons who surround the sick person, which is why the language of communication should be understood by all those involved in it. Good communication also is not only based on the physical abilities of nurses, but also on education and experience.

1. INTRODUCTION

Nursing as a health care science, focuses on serving the needs of human as a biopsychosocial and spiritual being. Its practice requires not only scientific knowledge, but also interpersonal, intellectual and technical abilities and skills. This means a composition of knowledge, clinical work and interpersonal communication ( 1 ). Communication 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 ( 2 ). The nursing process moreover as a scientific method of exercise and implementation of Nursing, is achieved through dialogue, through interpersonal environment and with specific skills of verbal communication ( 3 ).

As communication we can define the exchange of information, thoughts and feelings among people using speech or other means. Therapeutic practice involves the oral communication of public health officials and nurses on the one hand and the patient or his relatives on the other. It is a two way process. The patient conveys their fears and concerns to their nurse and helps them make a correct nursing diagnosis. The nurse takes the information and in turn transmits other information to the patient with discretion and delicacy as to the nature of the disease and advises with treatment and a rehabilitation plan for health promotion ( 4 ).

Effective communication requires an understanding of the patient and the experiences they express. It requires skills and simultaneously the sincere intention of the nurse to understand what concerns the patient. To understand the patient only is not sufficient but the nurse must also convey the message that he/she is understandable and acceptable. It is a reflection of the knowledge of the participants, the way they think and feel and their capabilities ( 5 ).

In order for the nurses to be successful in their work they have to study communication and interpersonal relations in their education with special courses and internships. They need to learn the various aspects and applications of communication in various fields of nursing ( 6 ). In this context it is understood that emphasis must be placed on the importance of communication between nurse and patient and nursing education must focus on communication skills of nurses.

2. PRINCIPLES OF COMMUNICATION

Communication can be defined as a transaction and message creation. The entire process occurs in a context consisting of physical space, cultural and social values and psychological conditions ( 7 ). Communication assists in the performance of accurate, consistent and easy nursing work, ensuring both the satisfaction of the patient and the protection of the health professional. When health professionals are not trained in communication skills, they face more difficulties separating work from their personal life, tending to transfer problems from one side to the other ( 8 ).

Communication is an intrinsic characteristic of human nature. Nobody cannot communicate. Communication has content and value. The contents regards to what was said, whilst the relationship regards as to how it was said. The nature of the relationship depends on how the two parties understand the communication sequence ( 9 ). Communication is never unidirectional. It is an interaction in which each sender becomes receiver and vice versa. The failure to recognize the two-way communication capability, quite often leads to negative conclusions and attitudes ( 10 ).

Moreover, the message sent is not the same as the message received. The decoding of the messages is based on individual factors and subjective perceptions. This fact, in conjunction with the process of feedback makes communication. We interpret something that we heard not according to what the sender actually said but according to our own code ( 11 ). Particular attention should be given by the caregivers to use technical terms and medical terminology during their contact with the ill, because it is often found that the patient ascribes different interpretations to what he hears or even more cannot understand what is meant exactly, mainly by the therapist, thus increasing mental stress, a fact which makes it more difficult to communicate with the patient ( 12 ).

Communication happens without words. It is an ongoing process. This non-verbal communication is expressed by facial expressions, gestures, posture and physical barriers such as distance from the interlocutor ( 13 ). It is important that there is an agreement between verbal and nonverbal communication. Particularly under stressful conditions where it is difficult to see the changes in the non-verbal messages of the patients with whom we mostly communicate ( 14 ). Moreover, each patient has his own specific characteristics that influence not only behavior in the process of communication, but also if and how to cooperate with nursing services and how they will undertake self-management of health ( 15 ).

Listening is important in communication. It is responsible nursing practice and requires concentration of attention and mobilization of all the senses for the perception of verbal and non-verbal messages emitted by each patient. By listening, nurses assess the situation and the problems of the patient; they enhance his/her self-esteem and integrate both the nursing diagnosis and the process of care at all levels ( 5 ).

Good personal relationships are described as the ability of the nurse to ask questions with kindness and provide information in a way that does not scare, that demonstrates interest, creates feelings of acceptance, trust and a harmonious relationship, especially in modern multicultural society ( 16 ). The therapeutic relationship is an important prerequisite to effective communication between health professionals and patients in order not only to transmit information, but also to effectively address mental processes which are activated by it. The communication between health professionals and patients include the ability to express sincere concern for the care of the patient and the patient becomes a partaker of this interest ( 9 ).

3. SPEAKING WITH THE PATIENT

Communication between health officials-in this case nurses-and patient is a process that begins with the first contact of the two and lasts as long as the therapeutic relationship. The nurse, who wants to create the right relationship with the patient, must win him/her from the first moment. This will happen if the conversation is held in appropriate conditions. Even though it seems obvious, it should be noted that courtesy and kindness on part of the nurse is required ( 4 , 17 ).

The patient should feel comfortable with the nurse, but the latter should protect his/her prestige and not give rise to misunderstandings. A key element is the need for a peaceful environment with no external distractions, which will ensure appropriate confidentiality of the dialogue. Frequently we see the phenomenon of serious discussions taking place in the middle of the corridor of the outpatient department or the nursing department, clinic, or in some office of the hospital, in which third parties unrelated to the care of the individual patient are coming in and out ( 18 ). In such an environment the patients are ashamed to express themselves freely ( 19 ).

Unfortunately, the concept of privacy is pretty much unknown to the Greek hospital system. Skilled nursing operations for the patients are made in chambers without screens or in hallways, in front of others. Patients and visitors of hospitals move without restriction in all the areas of the nursing and clinical departments. However, it is up to us to teach our colleagues and especially the new nurses and their patients setting the right example, in order for things to slowly change for the better ( 20 ).

Even more than the comfort of space, communication with the patient requires ample time. Each patient has his own way and pace to reveal his problem, but it takes some time to get to know the nurses and feel the confidence necessary to face them. The patient should have the feeling that the time-whether it is five minutes or an hour-is entirely his. 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 ( 21 ). After the nurse has listened to the ill, he/she should also talk to him. The language he uses for this purpose is very important. Often the patient is bombarded with big words with little or no significance for him ( 22 ). Once again the nurse may be directed to the ill in an incomprehensible way. Patients that are ashamed of their ignorance or are hesitant, avoid seeking an explanation, and as a result the consultation is inadequate and does not lead to the right outcome for the patient. The language of communication should therefore be at the level of the listener, who is not able to assess our scientific knowledge, but has to understand what we are telling him ( 23 ).

Another important requirement for proper and successful communication between nurses and patients is frankness and honesty. The discussion with the patient should leave no suspicions, doubts and misunderstandings. For example, if the patient suspects that while chatting with him we are making gestures to an escort, he/she will suspect that we are not telling him the whole truth ( 4 ). Where there is a need for a separate and private discussion with someone from the patient’s environment, we should be very careful of the place, manner and time of this communication, which should be independent of the discussion with the patient ( 24 , 25 ).

Communication as already stated is bidirectional, but the nurse or other health professional is responsibility for its proper conduct. The patient comes into the dialogue under stress and the emotional events he/she is facing. Moreover, depending on the psychosynthesis it can be more or less calm. Reactions such as anger, disbelief, moaning, aggression and denial of reality are known defence mechanisms, which are recruited to help him adjust to the new situation he is facing ( 8 , 26 ). The angry patient usually does not have any previous personal differences with health professionals, although they are the direct recipients of his anger. The latter should understand and accept these mechanisms which serve the underlying anxiety of the patient and to respond with information, awareness and readiness to provide all possible assistance ( 27 ).

Finally, people differ in their needs for communication. Some expect or require patient listening, without caring much about the answers. Others want a specific explanation for everything that happens to them. These different needs should be treated accordingly by the nurses, who should be able to detect what each patient wants ( 28 ). What of course in any case should be avoided by the caregivers is silence and indifference to the questions of the patient. In the best cases, the patient will leave disappointed and in the worst really indignant with nurses ( 9 ).

4.CONCLUSIONS

Communication with the patient is an individual part of the ‘long art’ of Hippocratic medicine ( 19 ). It is not only based on an innate ability that varies from person to person, but also on the necessary training and experience that one acquires during exercise ( 13 ). The need also for education in communication has been recognized worldwide ( 6 ). The results of this will be to demonstrate greater understanding among patients with greater benefit to patients and personal satisfaction to nurses in the performance of nursing ( 29 ).

Good communication also improves the quality of care provided to patients, which is observed in the results. Additionally, it is considered an inalienable right and a prerequisite for building a genuine and meaningful relationship between patients and nurses and other health professionals ( 30 ).

So in order for modern Nursing as a service to humans to realize the project, there is a need for dialogue and a good interpersonal climate that develops personally with each sick person, especially in our modern multicultural society. The best expertise training and continuing education of nurses in matters relating to the proper technique of communication will enable them to respond adequately and humanely to the expectations of patients.

CONFLICT OF INTEREST: NONE DECLARED

Nursing Leadership Style and Talents Required Report (Assessment)

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Introduction

Leadership characteristics and skills assessment, jung typology, reflection on professional leadership role.

Coordination of worker duties in a high-stakes situation is complex. Because of this, nurses are required to demonstrate leadership abilities that assure competency and safety. These characteristics stem from the nurse’s personality and directly impact their conduct, abilities, and relationships with patients and colleagues. As a result, a thorough understanding of one’s personality type can give vital hints about the strengths and defects that help and impede a nurse’s leadership position. This reflective essay critically examines the notion of nursing leadership, the ideal leadership style, and the most considerable talents required to become influential nurse leaders.

The fundamental qualities of healthcare companies that succeed in displaying sound business practices and maintaining healthy and happy organizational cultures include solid and effective nursing leadership built on trust, respect, and fairness. According to Cummings et al. (2021), successful nurse leadership practices significantly improve healthcare quality and patient outcomes. When nurse leadership substantially impacts both nursing and patient outcomes, it is critical to identify ideal nursing leader characteristics and understand how effective leadership practices may be implemented. A respected leader is well-qualified for their position and honorable in their judgments and actions. They attempt to create precise outcomes by assisting followers in achieving their goals and guiding them even when no authority is bestowed (Grossman & Valiga, 2017). They also understand each interprofessional team member’s tasks and scope of practice, including patients, to collaborate successfully to offer the quality of care possible (Quality and Safety Education in Nursing, 2012). Furthermore, my capacity to lead effectively depends on evidence-based practice, experience, and perseverance.

In this sense, a good leader should know health research methodologies and processes. Bianchi et al. (2018) suggest that crucial leadership skills such as developing a clear vision, using practical interpersonal skills, and providing continuing education to nurses are critical components of maintaining a commitment to evidence-based practice. In addition, using health research methodologies and procedures to develop new information for preparation and clinical decision-making based on evidence, clinical skill, and patient desires are other skills required for implementing evidence-based practice (Quality and Safety Education in Nursing, 2012). Academic nursing is evolving toward a new model and paradigm for nursing curriculum employing a competency-based strategy with the support of the new AACN Essentials (American Association of Colleges of Nursing, 2021). Furthermore, they also use their creativity to devise a strategy tailored to their work environment to settle problems and empower their subjects successfully.

People can be classified using the three criteria: extraversion or introversion, sensing or intuition, and thinking or feeling based on Jung’s theory of psychological type. The personality type can be identified by taking a test based on Carl Jung’s typological approach (HumanMetrics, n.d.). In this context, my personality type specified by the test was Introverted Sensing Feeling Judging (ISFJ). They are reliable workers, typically with perfect memory and remarkable analytic talents (HumanMetrics, n.d.). They are also adept with people in small groups or one-on-one scenarios due to their patient and genuinely empathetic attitude to dealing with others (HumanMetrics, n.d.). It is stated that traditional ISFJ occupations include teaching, nursing, religious work, medical work, and management (HumanMetrics, n.d.). In this sense, ISFJs are friendly and dependable coworkers and great employees, but they can be rushed and uneasy in managerial situations.

Nurse managers must provide leadership to sustain quality medical service by becoming aware of areas that need improvement, collaboratively selecting areas for intervention, and using communication skills to assess performance. Bianchi et al. (2018) state that patient communication and education are critical nursing skills when providing medical care. Cummings et al. (2021) support this idea and suggest communication as a leadership style needed for nursing leadership. Communication skill is also addressed in Teamwork and Collaboration QSEN competency. It is stated that a nurse should be able to examine the communication styles and preferences of patients and families, and other medical workers and use different communication techniques (Quality and Safety Education in Nursing, 2012). In addition, nurses must use communication techniques that reduce the risks connected with provider handoffs and care transitions and select communication styles that reduce the risks associated with authority gradients among team members.

I have learned much about leadership and management in nursing practice through course readings and discussion threads. In terms of my leadership abilities, I have acquired a diverse set of skills and knowledge in the field of nursing throughout the years. I am outgoing and versatile and have strong communication skills that allow me to interact with coworkers, patients, and their families. I understand the importance of choosing the right communication strategy and intention. One of the strengths of the ISFJ personality type is good communication skills. In this context, Wei et al. (2018) state that strengths-based leadership, or concentrating on employees’ strengths, is an effective strategy for increasing employee engagement and happiness. Thus, using my strength in communication, I would identify the strengths of other medical staff to engage them in work activities that capitalize on their finest qualities, resulting in positive organizational transformation.

To conclude, the significance of leadership in the nursing setting cannot be overstated. Leaders must have a high degree of leadership knowledge while also using the appropriate leadership style and abilities in all parts of work in the healthcare context. A good leader demonstrates honesty and trustworthiness while adopting a style appropriate for directing people and solving difficulties. In this sense, the course materials taught me the importance of equipping people with new skills to work together to create better and more positive patient-centered results.

American Association of Colleges of Nursing. (2021). AACN essentials . Web.

Bianchi, M., Bagnasco, A., Bressan, V., Barisone, M., Timmins, F., Rossi, S., Pellegrini, R., Aleo, G., & Sasso, L. (2018). A review of the role of nurse leadership in promoting and sustaining evidence-based practice . Journal of Nursing Management, 26 (8), 918-932. Web.

Cummings, G. G., Lee, S., Tate, K., Penconek, T., Micaroni, S. P. M., Paananen, T., & Chatterjee, G. E. (2021). The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership . International Journal of Nursing Studies, 115. Web.

Grossman, S.C. & Valiga, T.M. (2017). Grossman and Valiga leadership characteristics and skills assessment. In the new leadership challenge; Creating the future of nursing (5 th ed.). F.A. Davis Company. Used with permission.

HumanMetrics. (n.d.). Discover your personality type . Web.

Quality and Safety Education in Nursing. (2012). Graduate-level QSEN competencies: Knowledge, skills, and attitudes . Web.

Wei, H., Roberts, P., Strickler, J., & Corbett, R. W. (2018). Nurse leaders’ strategies to foster nurse resilience . Journal of Nursing Management, 27 (4), 681-687. Web.

• The Individuation Concept According to Carl Jung
• Jung’s spiritual realm theories
• Carl Jung's Analytical Theory of Personality
• The American Association of Critical Care Nurses' Role
• Neuman Systems Model in Nursing
• The Importance of a Nursing Home
• Virginia Henderson: Nursing Theory
• Nursing Practice in Adult Daycare
• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2024, June 25). Nursing Leadership Style and Talents Required. https://ivypanda.com/essays/nursing-leadership-style-and-talents-required/

"Nursing Leadership Style and Talents Required." IvyPanda , 25 June 2024, ivypanda.com/essays/nursing-leadership-style-and-talents-required/.

IvyPanda . (2024) 'Nursing Leadership Style and Talents Required'. 25 June.

IvyPanda . 2024. "Nursing Leadership Style and Talents Required." June 25, 2024. https://ivypanda.com/essays/nursing-leadership-style-and-talents-required/.

1. IvyPanda . "Nursing Leadership Style and Talents Required." June 25, 2024. https://ivypanda.com/essays/nursing-leadership-style-and-talents-required/.

Bibliography

IvyPanda . "Nursing Leadership Style and Talents Required." June 25, 2024. https://ivypanda.com/essays/nursing-leadership-style-and-talents-required/.

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