The art of communication in nursing
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The Art of Communication in Nursing. Cathy Groggel Nursing 450. Objectives:. To understand the basic components and forms of communication. To understand the importance of effective communication in the healthcare environment.

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The Art of Communication in Nursing

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Art of Communication

in Nursing

Cathy Groggel

Nursing 450


  • To understand the basic components and forms of communication.

  • To understand the importance of effective communication in the healthcare environment.

  • Discuss what approaches and techniques are useful for nurses in communicating with their patients and families.

  • Understand the barriers in communication and how improvements can be made in nursing.


The Who?





  • How?


“Effective communication is the creation of meaning in communication in which patients and healthcare providers exchange information so that patients are able to actively participate in their care.”

Boykins, 2014, p. 40

Root Cause Analysis

MeasurementMaterials Method

Patient Satisfaction Written Verbal

NDNQI Content Non-Verbal

Training/Skills Medical Jargon Manner

Time Brochures Emotions

Safety Reports Cue-Cards Feelings

Errors Interpreters Task Approach

Medication Respect/Dignity


Lighting Physician Email

Home Unlicensed Personnel Telephone

Hospital Patient Texting

Privacy Family Members Social Media

Readiness Age Web

Distractions Socio-economic Status

Environment Manpower Machine

Communication Breakdowns

  • “Between 1995 and 2005, ineffective communication and breakdowns in working together was the root cause of 66% of healthcare errors (Hughes, 2008).”

Sherwood & Zomorodi, 2014, p. 17

“…suggest that an estimated ‘70-80% of healthcare errors are caused by human factors associated with poor team communication and understanding.’”

Bleakley& Marshall, 2013, p. 128

“The nurse should be able to build communication and leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality care.”

Boykins, 2014, p. 42



  • It’s the Right thing to do!

  • The Joint Commission includes Patient-Centered communication as a Standard for Hospitals.

  • ANA Standards of Professional Nursing Practice.

  • Quality and Safety Education for Nursing (QSEN).

  • AACN




Environmental Health

“The nurse caring for the acutely and critically ill patient uses skilled communication to collaborate withthe team of patient, family, and healthcare providers in providing patient care in a safe, healing, humane,and caring environment.”

AACN, p.16

Basic Components of Communication

“Human communication is a two-person process in which both individuals influence and are influenced by each other.”

Kearney-Nunnery, 2008, p. 124

SMRC Model by David Berlo in 1960

  • Source/Encoder

  • Message

  • Channel

  • Receiver

Kearney-Nunnery, 2008, p. 125

Source-Message-Channel-Receiver Model

Health Communications Model

Types of Relationships

Kearney-Nunnery, 2008, p. 125



Professional/Significant other

Client/Significant other

Health Communications Model

Transaction Types





One on one


Kearney-Nunnery, 2008, p. 127

Forms of Communication

  • Metacommunication

  • Verbal

    • Vocabulary

    • Meaning

    • Intonation

    • Pacing

    • Clarity/Timing

“Nurses should also demonstrate credibility, which is defined as a sense of trustworthiness, sincerity, reliability, and integrity. The nurse must be dependable and believable.”

Kearney-Nunnery, 2008, p.129

Non-Verbal Communication

  • Body Language

  • Cultural differences

    • Personal space

    • Gestures

    • Eye contact

    • Touch

  • Use of space

  • Appearance

    Kearney-Nunnery, 2008, p. 130-132

Approaches in Communication

  • Involvement of Patient

    • Patient-centeredness

  • Sensitivity in Providing Information and Explanations

    • Quality

    • Readiness

  • Task Approach

  • Manner of Approach

    • Rapport

    • Tone

    • Pleasant

  • “The words people say are important, but the way they are said is important too. When we talk to someone, we choose the words to use and modify the way they are used on the basis of an unconscious appraisal of that person.”

    Draper, 2014, p. 276

    Communication Techniques

    • Tools

      • Question types

  • Active listening

    • Interest

    • Attention

    • Restatement/Reflection

  • Questioning

    • Open-ended

    • Close-ended

    • Circular

    • Goal oriented

  • Understanding

    • Elaboration

    • Alternatives

  • Non-Verbal

  • Silence

    • Distractions

      • Nurse

      • Sensory

  • Knowledge Level

    • Deficits

  • Interpretation

    • Language

    • Cultural

    • Literacy level

  • Communication Barriers

    • Training

      • Inadequate Nurse Training

      • Poor planning

  • Emotions

    • Regulate

  • Time

  • Communication Barriers

    Yoder-Wise, 2014, p. 350-351

    “...pitfalls in communication comprise actions, behaviors, and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for patients.”

    Yoder-Wise, 2014, p. 351

    Communication Pitfalls

    Improving Communication

    • Speak-Up


    Improving Communication

    • Share stories

      • Near-misses

      • Simulated learning

  • Change Behavior

    • Classes

    • Scripting

    • Emotions

    • Be accountable

  • Improving Communication

    • Use Standard Methods of Communication

      • Bedside Handovers

      • SBAR

      • Read-Backs

      • Briefings/Huddles

      • Huddles

      • Interdisciplinary Rounds

      • Nurse Liaison

  • Research in Nursing

  • Types of Communication

    • Face to face

    Types of Communication


    Types of Communication


    Types of Communication

    Electronic Health/Medical Records

    Types of Communication


    Types of Communication

    Text Messaging

    Types of Communication

    Social Media

    Future Communications

    Nursing Impact

    Improving patient outcomes

    Enhancing patient connection

    Improving efficiencies

    Decreasing costs

    Strengthen communication

    Informed decision making

    Standardizing report

    Engaging patients


    American Association of Critical-Care Nurses. (n.d.). Standards. In American Association of Critical-Care Nurses. Retrieved June 22, 2014, from

    American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.)

    Silver Spring, MD:

    Bleakley, A., & Marshall, R. (2013). Can the science of communication inform the art of the medical humanities?. Medical Education, 47(2), 126-133. doi:10.1111/medu.12056

    Boykins, D. (2014). Core Communication Competencies in Patient-Centered Care. ABNF Journal, 25(2), 40-45.

    Davies, N. (2014). Empathic nursing: going the extra mile. Practice Nursing, 25(4), 198-202.

    Draper, P. (2014). Words, words, words: conversation as a tool to promote wellbeing. Nursing & Residential Care, 16(5), 275-277.

    Kearney-Nunnery, R. (2008). Advancing your career: Concepts of professional nursing (4th ed.). Philadelphia, PA: F. A. Davis Company.


    • Leef, B. L., & Hallas, D. (2013). The Sensitivity Training Clown Workshop: Enhancing Therapeutic Communication Skills in Nursing Students. Nursing Education Perspectives, 34(4), 260-264.

    • McGilton, K., Boscart, V., Fox, M., Sidani, S., Rochon, E., & Sorin-Peters, R. (2009). A systematic review of the effectiveness of communication interventions for health care providers caring for patients in residential care settings. Worldviews On Evidence-Based Nursing, 6(3), 149-159. doi:10.1111/j.1741-6787.2009.00155.x

    • O'Hagan, S., Manias, E., Elder, C., Pill, J., Woodward-Kron, R., McNamara, T., & Webb, G., & McColl, G. (2013, October). What counts as effective communication in nursing? Evidence from a nurse educators' view and clinicians' feedback on nurse interactions with simulated patients. Journal of Advanced Nursing, 70(6), 1344-1356.

    • Sherwood, G., & Zomorodi, M. (2014). A New Mindset for Quality and Safety: The QSEN Competencies Redefine

    • Nurses' Roles in Practice. Nephrology Nursing Journal, 41(1), 15-72.

    • Spruce, L. (2014). Back to Basics: Speak Up. AORN Journal, 99(3), 407-415. doi:10.1016/j.aorn.2013.10.020

    • Tremayne, P. (2014). Using humour to enhance the nurse-patient relationship. Nursing Standard, 28(30), 37-40.

    • Yoder-Wise, P. S. (2014). Leading and managing in nursing: Revised reprint (5th ed.). St. Louis,

    • MO: Elsevier Inc.

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