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.”