Effective Communication in Nursing Practice
Definition and history.
Communication forms an integral part of life. It involves the use of both verbal and non-verbal cues, begins at birth, and stops when someone dies. Nurses work in a busy and often chaotic setting, all this making the job challenging. There is a need for consistent, effective communication between colleagues on the clinical team, other support personnel as well as the patients themselves. Existing literature demonstrates a positive link between effective communication, improved worker morale, and increased patient safety in the care process. Through the communication process, nurses are able to establish the healthcare needs of the patients and, therefore, ensure excellent quality of nursing care. According to the United States Joint Commission, ineffective communication is the chief cause of adverse patient injuries. Therefore, a proper understanding of the principles of effective communication is key.
Abraham Maslow, in 1943, developed the hierarchy of human needs, defining human behavior as survival instincts. The basic needs range from physiological needs to self-actualization at the pinnacle of the hierarchy. Vertino (2014) linked interpersonal communication with Maslow’s hierarchy. She suggested that the quality of communication between people directly serves to improve job satisfaction, belonging, and safety. Ineffective communication causes confusion, chaos, inefficient operations, and, finally, wasted resources (Vertino, 2014).
According to Neese (2015), about 440,000 people die annually due to medical errors that can be prevented. According to the Centers for Disease Control and Prevention, this forms the leading cause of mortality in the United States. Improving nursing communication can lessen these errors and lead to an overall positive impact on patient outcomes. Different theories in nursing aid in explaining and guiding interactions between nurses, patients, and other healthcare professionals (Neese, 2015). Peplau’s Interpersonal Relations Theory focuses on the relationships between nurses and clients during the therapeutic process. According to Peplau, communication revolves around this relationship in four phases: orientation, identification, exploitation, and resolution. Effective communication is instrumental in every step during the patient’s contact with the healthcare system. The Dyadic Interpersonal communication model describes communication in terms of the sender and recipient and the different variables that may hinder the process. It highlights the need for awareness as well as clarity in the everyday use of verbal and nonverbal cues in effective communication (Neese, 2015).
Tappen et al. (2004) gave five principles of effective communication. The first principle is aiming for focus and clarity. This principle reiterates the need for the message to be understood. Tactics used to ensure this include seeking feedback, repetition of key phrases, and asking questions to ensure that the intended objective of the communication has been realized. Other principles include using direct language, encouraging feedback, acknowledging the contribution of other players in the communication channel or intended audience, and finally, using the most direct channels available.
Barriers to effective communication have been classified as either psychological, physical, semantic, or gender barriers. Physical barriers refer to the extraneous noises or activities in the area where communication occurs. They serve to distort the intended information or make it difficult for either party to receive it. Psychological barriers include anxiety, emotion, judgment, previous experience, personal bias, and cultural differences. Subsequently, semantic obstacles arise from differences in understanding the literal meaning of words that are different from the message’s intended. For example, the word ‘cool’ may mean exciting or clever, while it just means low temperature to others. Moreover, existing differences in how men and women are inclined to communicate may be a barrier to effective communication. Psychosocial development suggests that boys use communication to negotiate while girls use it to create and promote social relations and confirm and reduce disparities.
The role of effective communication in nursing
Communication forms the cornerstone of the diverse professional disciplines in nursing practice. In nursing practice, communication aims to inform, inquire, request, and investigate (James, 2013). Nursing practice is diverse as it involves roles as a bedside nurse, public health nurse, unit managers, and nurse leaders. At all these different roles, they require effective communication so as to execute their functions. Each role requires its own unique technique for effective communication in the three distinct roles mentioned above.
Bedside Nursing
Bedside nurses are charged with delivering immediate and direct medical care to the patients they are assigned to. Their scope of practice includes, but is not limited to, continuous assessment of the patient’s general status, identifying and satisfying the different needs of the patients, championing the rights of the patients, and interpreting clinical information to the patients and their families. Therefore, bedside nurses constantly report patient information. Nurse shift reports are essential communication tools as they make the transfer of critical patient information from one nurse to another. It is a widely accepted practice.
Ineffective communication during patient handovers creates grounds for gaps in the continuity of patient care. Medication errors falls, and other adverse events have been reported to be some of the more common breaches in patient safety during patient handovers. Bedside nurses receive or hand over patients every day when there is a change of nursing assignments. The total time for patient handovers is between 30 and 40 minutes, a time when the patient is mostly alone. According to Alforgue (2020), nurses have been reported to voice frustrations due to inconsistencies or poorly done handover reports. There is a need for accurate report compiling to ensure that the shared report is organized, concise, and includes all the essential details. Further, the tools employed in the change of shift reports need to be adapted to suit the different nursing care settings. Change of shift reports for the intensive care unit and larger general wards require different tactics in handing over that are most effective in communicating (Tappen et al., 2004).
Breakdown of communication, such as differences in communication styles, communication skills, and past experience, maybe a primary cause for inconsistencies. Different nurses may be inclined to make a detailed report about the patient’s situation, while others may focus on the critical patient data. Additionally, there may be differences in the type of information different nurses regard critical during handovers. All these constitute ineffective communication. Note-taking and the use of advanced and standardized worksheet tools promote effective communication and, therefore, a high quality of care. Practicing proper bedside shift reports improves with practice (Alforque, 2020).
Public Health Nurse
Public health nurses advocate for specific evidence-based changes in the population. They work as part of a multidisciplinary team to ensure that the most vulnerable patient groups achieve health preservation and promotion. They develop, implement, and manage health programs, collect and analyze medical data, provide patient education and monitoring, and are involved in overall community health and well-being. Health issues that a community faces are diverse and cannot be confined to a single system. Further, no one discipline is well suited with the requisite technical know-how to address these problems. Public health nurses undertake team conferences and communication with other disciplines as well as other communications with the community (Tappen et al., 2004).
Chief Nurse Officer
Chief Nursing Officers have complex, demanding, and dynamic roles in the present-day healthcare world. They are tasked with leading teams of professional nurses to achieve high-quality, consistent healthcare delivery. The success of CNOs is dependent on information flow. They have to be informed on all things that occur in the workplace and collect opinions and ideas to further improve care delivery. A high-level communication system is needed to achieve these goals. Highlighting inadequacies in the organization and advocating for change requires the competent and tactical leadership of the CNO as they are the decision-makers, lead communicators, and collaborators.
CNOs communicate with the external organizational environment, including stakeholders such as sponsors, donors, government, family, and players in the internal environment. As highlighted above, they apply the tools and techniques of proper communication as other nursing officers in different specialties. Another technique they employ to ensure optimum operations, quality, and morale is encouraging and giving positive feedback. Giving and receiving feedback from staff ensures that CNO understands their strengths, weaknesses, and challenges. This is a fundamental leadership responsibility and promotes organizational well-being in terms of employee satisfaction and growth. It encourages constructive behavior, provides recognition, and improves employee skills. Other channels that provide effective communication include appraisal and peer reviews.
Application in Practice
Effective communication is a fundamental aspect of my nursing career. As a nurse, I have immense medical knowledge and clinical expertise. However, without effective communication skills, practicing nursing in a way that brings job satisfaction and high-quality care is impossible. Additionally, working as part of a multidisciplinary team and dealing with patients, their families, and other colleagues requires good communication skills. As a nurse, I will apply effective communication as a leadership skill to collect, relay, and interpret information between physicians and other caregivers, family members, and patients. It is an indispensable skill in nursing practice if the best care is suitable.
Personal Growth
Not all people are naturally good communicators. Additional training, self-awareness, and insights serve to improve our communication skills. Early in my training and clinical experience, I understood that miscommunication in healthcare carries with it high stakes. I actively worked to improve my communication skills as they are highly demanded. I adopted active listening by paying attention, using non-verbal cues to show that I am listening, and ensuring that I always give feedback.
Additionally, I have adopted different tools to improve communication between colleagues and other healthcare professionals at the bedside. There is a patient handover report tool at work that we use. I undertook online courses on Udemy to improve my writing. Alternating between oral and written communication has also helped me improve my communication skills. Improving communication is all about making an effort and further undertaking personal research recognizing opportunities so as to improve my nursing communication skills consistently.
Personal SWOT analysis
My SWOT analysis refers to a plan aimed at identifying personal factors that are either strengths, weaknesses, opportunities, or threats. These factors determine whether I will be successful in achieving my career goals. It is beneficial to identify areas whereby a person needs to improve and how to improve them. I have shown good communication skills during the different deployments, which I accumulated while working as a student and in volunteer experience over the years. I am able to effectively communicate with colleagues, fellow students, and other members of the healthcare team. Communication is a pillar in providing high-quality nursing care, and therefore, I always work towards improving it. Additionally, I am highly motivated and passionate about having a successful career as a nurse, working as part of a team, and having risk identification and resolving capabilities. These strengths have been very instrumental so far, and I know that they will be fundamental for my career as we advance.
My current weaknesses are mainly that I am not very confident in holding managerial experience. I do not think that I have enough training and capabilities on the matter. In addition, I have not improved my leadership skills very much either. Finally, I have not developed enough field experience and narrowed the knowledge gap. Opportunities that I can explore in the future include diversifying in nursing practice moving forward. This will ensure that I accumulate knowledge and experience in different practical fields, primarily managerial, public health, and critical care nursing. The nursing career is a noble career with relative job security, and all these factors provide an opportunity for me in the foreseeable future. The main threats include burnout and stress from long working hours and an unsupportive workplace. Finally, professional competition arising from other qualified and registered nurses is another threat.
References
Alforque, C. C. (2020). Standardizing the Bedside Shift Report: Improving Communications and Promoting Patient Safety.
James, J. T. (2013). A new, evidence-based estimate of patient harms associated with hospital care. Journal of Patient Safety, 9(3), 122-128.
Neese, B. (2015). Effective communication in nursing: Theory and best practices. The document was posted in Southeastern University and archived at http://online. Seu. Edu/effective-communication-in-nursing.
Tappen, R. M., Weiss, S. A., Whitehead, D. K., & Fletcher, M. (2004). Essentials of nursing leadership and management. The Canadian Nurse, 100(1), 14.
Vertino, K. A. (2014). Effective interpersonal communication: A practical guide to improve your life. The Online Journal of Issues in Nursing, 19(3).
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Question 
Choose one or more leadership topic(s) from your textbook or a scholarly source from a previous discussion or assignment from this course and write about its application to nursing practice. Provide definitions, history/background, and significant concepts of the chosen topic. Describe the topic’s function in nursing practice by examining at least three nursing roles (bedside nurse, public health nurse, CNO, unit manager, etc.). Discuss how the leadership topic can be used in your practice (nursing). Discuss your personal growth regarding your chosen leadership topic. Evaluate personal strengths, weaknesses, opportunities, and threats to your career advancement.
Effective Communication in Nursing Practice
Then, discuss the top three traits that make a good nurse leader. Support your statements with examples from your practice experience and scholarly sources.
Assignment Expectations:
Length: 1750 to 2000 words in length
Structure: Your essay must include an introduction and a conclusion, but it must also include a title page and reference page in APA format. These do not count toward the minimum word count for this assignment.
References: To answer the questions, use appropriate APA style in-text citations and references for all resources. A minimum of three scholarly sources plus the textbook are required.