Overview of Communication

Communication is the process of using words, symbols, and behaviors to transmit information between two individuals. As the nurse, you will use effective communication to form patient-centered relationships, and to collaborate with patients and the health care team to achieve patient goals and outcomes.

Okay, let’s review the basic elements of communication. Communication involves six key elements: referent, sender, message, channel, receiver, and feedback.

First, the referent is the event that initiates communication, like the patient feeling the sensation of pain. Next, the sender is the person who has a message to deliver, like when your patient tells you about their pain.

Then, the channel is the way the message is conveyed and received through the five senses. For example, your patient may convey their message through the auditory channel by saying, “I have pain,” and through the visual channel by grimacing or wincing.

Now, the receiver is the person who interprets the message from the sender, like when you hear and see the message about your patient’s pain.

Lastly, the receiver provides feedback to the sender about the message and, if needed, asks for clarification about the message being sent.

For example, you might say, “I understand you’re in pain. Could you describe how it feels?” So, there are two types of communication, verbal and nonverbal.

Verbal communication uses words and can be transmitted by spoken, written, and electronic modes. On the other hand, nonverbal communication uses body language and cues, such as sighs, moans, and physical gestures.

Another nonverbal technique involves altering voice inflection by changing the tone, volume, or cadence of speech to convey the significance of a statement, like when a patient increases the volume of their voice out of frustration.

It’s important to note that nonverbal cues can enhance or inhibit communication. So, if your tone sounds condescending or rushed, your patient may feel offended or upset; whereas a compassionate tone can contribute to rapport and trust.

Alright, one communication strategy you can use is therapeutic communication, which is when information between health care team members and patients is exchanged in a way that enhances information sharing, while fostering respect and trust.

Therapeutic communication requires you to use assertiveness and advocacy; and to uphold professional boundaries. Examples of therapeutic communication include calling your patient by their preferred name, sharing observations, like, “You seem upset,” and seeking clarification by saying, “Please tell me more about what you mean.” On the other hand, nontherapeutic communication involves harmful interactions that can negatively impact the nurse-patient relationship.

Nontherapeutic communication is unprofessional, is not patient-focused, and has the potential to cross ethical and legal boundaries.

Examples include asking “why” questions, like, “Why aren't you taking your medication?”, giving premature advice, such as, "You should have the procedure,” or falsely reassuring the patient by saying, “Everything will be okay.” Now, some patients have conditions that can make communication difficult, including hearing, visual, cognitive, or physical impairments.

When communicating with patients who have a hearing impairment, useful strategies include minimizing outside noise, speaking slowly, using a sign language interpreter, and communicating in writing.

For patients with visual impairments, you may use assistive materials, such as large print or Braille. Also, during communication with patients who have cognitive or physical impairments, you can use nonverbal methods, like hand squeezing and eye blinking, or consult with the patient’s family members.

Importantly, all communication with patients and health care team members requires you to uphold confidentiality, as dictated by the Health Insurance Portability and Accountability Act, or HIPAA.

HIPAA requires that information not be shared with people outside the patient’s health care team unless the patient or guardian has given consent.

This applies to sharing information about the patient in public places, on social media, as well as speaking about the patient with friends or loved ones.

Failure to follow these requirements can result in legal and disciplinary action. Alright, as a quick recap....

Communication is the process of using words, symbols, and behaviors to transmit information between a sender and receiver.

As the nurse, you must use effective communication to form patient-centered relationships, and to collaborate with patients and the health care team to achieve patient goals and outcomes.

Communication can be verbal or nonverbal, and involves six key elements, including referent, sender, message, channel, receiver, and feedback.

Special communication considerations should be taken when working with patients with hearing, visual, cognitive, and physical impairments.

Lastly, all communication with patients requires the nurse to uphold