PrintArticle

Avoiding Nurses' Biggest Communication Mistakes

By Megan M. Krischke, contributor

Being able to communicate clearly with patients and other health care staff is a key component in nursing. Not only does clear communication ease relational interactions, it can impact patient outcomes by reducing medical errors and improving patients’ self care.

7 Tips to Improve Your Nursing Communication

Introduce yourself and explain actions to patients.
Take time to listen to each patient and ask questions.
Ask for feedback, confirm that the patient understands.
Assess each patient’s level of health care literacy and adjust explanations as needed.
Remember to listen well, ask questions and give feedback to medical colleagues.
Take the initiative to address communication breakdowns within health care team.
Follow standardized documentation and care procedures, both written and verbal.

“When I first began looking at effective therapeutic communication, it was in the light of patient satisfaction, from the standpoint of how our interactions with patients could be confusing, off-putting or dissatisfying,” said Gwen van Servellen, Ph.D., RN, FAAN, research professor and interim director for academic programs and outreach at the University of California, Irvine, and author of Communication Skills for the Health Care Professional: Concepts, Practice and Evidence. "Through that research I began to see the relationship between effective communication and quality care and reduction in errors.”

One of the main detriments to good communication in nursing is a harried pace, she discovered.

“When we feel the pressure of having more to do than time to do it, we aren’t listening well or explaining adequately,” van Servellen commented. “Without clear instructions, patients aren’t able to follow treatment plans. Poor communication can lead to more health problems down the road, which can lead to patient mortality.”
So what are the biggest communication mistakes that nurses can make?

“When it comes to communication mistakes that nurses make with patients,” she explained, “number one on my list is our not informing patients about who we are and what we are there to do, particularly in the hospital setting. If we aren’t introducing ourselves, it can create fear, anxiety and confusion for the patient."

“Second, is that we fail to listen because we feel we don’t have enough time to sit down, make eye contact, really hear what a patient is saying and ask questions.”

“Another mistake nurses make,” continued van Servellen, “is not confirming that a patient has understood what they were told. Getting feedback is an extremely important communication skill. After giving a patient instructions on self-care we need to say, ‘Now you tell me how to do it because maybe I wasn’t clear about certain things and then I can understand what gaps I need to fill.’”

Another common mistake for health care providers, across the board, is failing to assess a patient’s health care literacy and then speaking to them in terms they understand. For example, a nurse may explain to a patient how to take antibiotics, but if the patient does not understand that the antibiotics are the pills in the bottle, he is unlikely to self-medicate effectively.

“Heath care literacy is not just being able to understand the treatment that is prescribed, but also how to navigate the health care system,” explained van Servellen. “We have an obligation not only to assess patient literacy, but to intervene by helping them to know how to navigate the system. For instance, discussing with them the information they need to provide the physical therapist or pharmacist.”

Many of the skills that improve communication with patients can be applied to interactions with coworkers.

“If we listen well, ask questions and give feedback, then we can see that reciprocated by other members of the team,” van Servellen explained. “In a hospital setting it all begins with nursing administration. They set the standard for therapeutic communication. This kind of effective communication tends to reduce conflict and misunderstandings.”

Van Servellen also encourages nurses to take initiative when they see a communication breakdown.

“Take the responsibility to approach the other person and say ‘I think we misunderstood each other. Can we sit down and let me ask some questions about what you were trying to say?’” stated van Servellen.

Because documentation and records are key places where medical staff communicate, Sarah Sinclair, RN, BSN, MBA, FACHE, executive chief nursing officer for the Cleveland Clinic Health System, recommends implementing standardized documentation and care procedures, which creates more precise communication between units.

“At The Clinic, a tool we use when a patient is transferring units is SBAR. The nurse explains the current Situation, or diagnosis; what procedures have Been performed; Assesses the current state of the patient; and Recommends a for plan of care,” Sinclair explained.