5 Ways to Improve Your Nurse Communication Skills
By Joan Fox Rose, MA, RN, contributor
Nurse communication is an essential element of patient safety and quality hospital care.
The Joint Commission Guide to Staff Communication, Second Edition, points out that the responsibility for effective communication in health care rests largely with the organization, but nurses and other clinicians can do a lot to ensure that vital information is gathered, shared and understood between all parties.
It affects all aspects of your nursing job and the patient experience. And it encompasses everyone you interact with, including:
- Communication with nurse managers and administrators
- Nurse-to-nurse communication
- Nurse-to-physician communication, plus interactions with other staff
- Nurse–patient communication, and communication with their family
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5 practices to make your nurse communication more effective:
1. Use proven communication tools and processes with your team
With patient safety and the patient experience at the forefront of their mission, NYU Winthrop Hospital, a 591-bed academic medical center based in Mineola, N.Y., uses tools designed to enhance communication among health team members from the TeamSTEPPS® curriculum.
TeamSTEPPS is an educational program sponsored by the Agency for Healthcare Research and Quality (AHRQ), and is designed to improve communication skills and performance.
Nurses can download the free TeamSTEPPS Pocket Guide App to support effective teamwork and communication on a daily basis.
2. Practice situational awareness and open communication
Situational awareness means being aware of what’s going on in your unit to assess if there are any issues or concerns that may impact care delivery.
“Healthcare is very complex and in its own nature, error-prone,” explained Monica Santoro, MS, BSN, RN, CPHQ, NYU Winthrop’s senior vice president and chief quality officer, adding that staff collaboration can go a long way toward supporting safe practices and preventing errors.
“It is also important to promote a culture that encourages open communication among the team where employees are comfortable sharing any questions or concerns that they may have,” she said
At NYU Winthrop, leaders and department managers confer each morning for a safety briefing. The hospital also uses multidisciplinary rounds as an opportunity to exchange information and ideas while enhancing communication among the care team and patients.
3. Focus on nurse-to-nurse communication, including patient handoffs
During nursing shift changes and other handoffs of care, clear and concise communication is required, Santoro advised. It is optimal to use a standardized process during handoffs to ensure key information is accurately transmitted and that there is an opportunity for the receiver to ask questions.
Two popular tools for patient handoff communications include SBAR and I-PASS. Each one is normally implemented with the help of unit- or facility-based training.
First developed by the military, SBAR has since been widely adopted as a communication tool in health care. The acronym stands for:
- S = Situation
- B = Background
- A = Assessment
- R = Recommendation
The I-PASS mnemonic has some similarities, providing the following framework for patient handoff communication:
- I = Illness severity
- P = Patient summary
- A = Action list
- S = Situation awareness and contingency planning
- S = Synthesis by receiver
4. Adjust to your audience, especially in nurse-to-patient communication
Each person a nurse interacts with has different communication needs.
Physicians primarily need the specifics about the patient’s condition and any changes that are taking place. Fellow nurses, technicians and assistants want this same information, plus what tasks are required, and any tips on dealing with a particular patient or situation.
Patients and their families often want to understand what their nurse is doing (or not doing) and why. A patient may be in pain, may feel worry or fear, and may need reassurance. Some will ask a lot of questions.
Each patient’s level of health literacy will also vary, so your nurse communication skills and style will need to adjust accordingly.
The following tips can enhance nurse–patient communication in most settings (emergency and critical care units may require some different methods).
- Introduce yourself and address your patient by name
- Stop and listen -- don’t let documentation or other duties distract you from important cues
- Look directly at your patient, smile, and be conscious of body language (yours and theirs)
- Ask for clarity or repeat back what you think you heard
- Give a brief explanation of what you are doing and why
- Speak clearly and slowly; share information in small bites so as not to overwhelm
- Use the teach-back method, asking patients to repeat information in their own words
- Assess each patient’s ability to understand and comply with instructions; pull in a family member, translator or other assistance if needed
RELATED: How to Communicate with Patients of All Generations
5. Engage patients and family members
Patients and family members who are engaged as partners in their care have improved outcomes, Santoro pointed out. At NYU Winthrop, nurse-to-patient communication starts when the patient enters the facility.
Nurses present patients and families with educational materials on admission, describing their role in promoting safety, including topics such as the ABCs of preventing blood clots and hand hygiene.
Key cards are another way in which the hospital partners with patients and families, according to Lee C. Moldowsky, MSN, RN-B, Winthrop’s director of nursing quality and performance improvement. These cards are used to educate patients and families on key patient care processes. For example, patients who have a central line will be given a key card describing necessary measures to prevent infection.
“Whenever we teach patients or family members about important issues in patient care, we engage them in a ‘teach-back method’ of validation to explain, in their own words, what was learned,” Moldowsky commented.
White boards in patient rooms are another communication tool utilized by the Winthrop care team to keep patients and families informed about care goals. The boards also enhance nurse-to-nurse communication and improve teamwork and communication with other staff.
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