Running head: COMMUNICATION 1

Communication

Tiffany Miller

Baker College
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Communication

Good communication is key in health care. Good or bad communication skills could

either make or break a patient’s stay in a health care facility. First impressions are crucial, and

communication skills could really impact the patient’s first impression of the nurse. Nurses need

to communicate the plan of care to the patient, so the patient does not feel left out, especially

since the care is determined by what the patient wishes. Patients have the right to know all that is

happening with their care, so nurses need to try their best to discuss every aspect of the care plan

with the patient.

Excellent communication is critical in healthcare for many different reasons. In some

crucial situations, failure to communicate could mean death. Patients rely on good

communication with their nurses to keep updated with their health. Nurses need good

communication skills to explain different procedures, medications, and assessments to their

patients.

For example: if a patient is being discharged, the nurse must communicate with the

patient to explain, in full detail, what the discharge instructions mean. Many nurses assume that a

patient can just read the instructions to know what to do after leaving the healthcare facility, but

discharge instructions contain a lot of professional jargon that many patients will not fully

understand, or even understand at all. After going over discharge instructions, nurses should ask

the patient if they have any questions; this is good communication skills because some patients

may be too afraid to ask questions, if the nurse does not initiate question asking.

Communication is not just how you speak to a person, but how the person perceives the

information being given. If a person does not fully understand the conversation, they could relay

the wrong information to someone else. Good communication skills include knowing the
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different ways to communicate such as if a nurse has a deaf or hard of hearing patient, or even a

patient who does not speak English. Healthcare facilities have useful resources that can help the

nurses communicate with their patient, such as an interpreter.

According to Foden-Vencil, (2014) turning to a patient’s family member to translate for

you could cause emotional distress, depending on what you are having the family member

translate. The example Foden-Vencil (2014) used having a family member translate to the patient

that they have been diagnosed with cancer. Most family members would not be comfortable

telling their loved one that they have cancer, therefore a translator would be a better choice for

communication.

Communication is not just essential between the patient and the nurse, but also between

all of the health care staff. If a patient is seen by multiple health care staff, (such as a nurse, a

nursing assistant, a nurse practitioner, and a doctor) and is asked the same question multiple

times, the patient could get irritated and not want to answer anymore questions, due to the lack of

communication between health care personnel. Patients may feel that the health care workers are

not communicating with each other or even checking the chart before entering the patient’s

room.

Communication is not just verbalization, but it is also written communication.

Communication can also mean documenting information in the chart and relaying pertinent

information to other health care personnel to whom it relates. Sending patient information to a

facility that the patient is being transferred to is an example of this type of communication.

Good communication also relates to patient safety. If the nurse is not explaining to the

patients that they are required by the facility to wear sticky socks to prevent them from falling,
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the patient could assume that they can wear their own socks, which could result in the patient

slipping while ambulating.

Many elderly patients want to feel some sort of independence, so they do not always want

the nurses help with simple tasks such as walking to the bathroom. If the nurse does not tell the

patient that they need to have someone help them walk to the bathroom, they could assume that it

is okay to walk alone. Explaining simple tasks, such as using the call light, could result in a

safety issue, which is why good communication is key in healthcare. Some patients, especially

elderly patients or Alzheimer’s patients, have a hard time with their short-term memory, so

nurses need to understand that they may need to repeatedly explain the same concept to a patient,

to avoid safety issues.

While admitting a patient to the health care facility, it is important to explain how to use

the call light to the patient, even if they have been in the hospital previously. If a patient is in the

hospital with a wound on their foot, they most likely will need help walking to the bathroom so

that they do not fall. If the same patient was in the hospital recently for asthma, they could

assume that they still do not need help walking to the bathroom. Anytime a patient’s health status

changes, it is a nurse’s responsibility to communicate with the patient what needs to happen and

what needs to change.

Bad communication could also lead to giving the wrong medication to a patient. If a

doctor does not communicate the correct medicinal information to a nurse, the wrong medication

could be given. The nurse checking his/her two patient identifiers, before administering the

medication, could help avoid this.

I would describe therapeutic communication as using soft, gentle, reassuring words to

calm a patient. Some patients may think that therapeutic communication does not work, just from
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hearing those two words; they may think that we are just trying to trick them. According to

Montefiore (2017), it is proven that a soothing, quiet health care environment helps promote

healing, which I relate to a type of therapeutic communication. Everyone has their own definition

of therapeutic communication, but I think everyone’s overall definition is about the same and has

the same type of goals.

Therapeutic communication is different from other types of communication based on the

condition of the patient. Some patients that are nervous for surgery want to know more detail on

the procedure they are having done; while communicating with this patient, it is important to use

therapeutic communication to help ease the patient’s mind rather than frighten the patient even

more. Other times, therapeutic communication is not as crucial; such as describing the use of a

medication the nurse is administering to the patient. Therapeutic communication could also be

used to help a person who has a headache; the nurse would not want to be loud to make the

patient’s headache worse. If a nurse has to immediate questions to ask to a patient with a

headache, it would be better to use a soft voice, if the questions do not need to be asked

immediately, the nurse could wait until a more appropriate time.

The goal of therapeutic communication is to calm a patient who is nervous or frightened.

Reassurance is another goal of therapeutic communication, even though nurses to avoid giving

false reassurance to their patients. Therapeutic communication could help the patient heal

quicker; if a patient is tense because of their situation, it could prevent healing, therefore

therapeutic communication would be the best way to converse with the patient.

Therapeutic communication is great for any age. With younger patients, therapeutic

communication is the main type of communication to use while speaking with the patient;

children are usually frightened by loud or harsh sounds. Therapeutic communication is also great
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to use for patients who are on hospice care. Hospice is a calming form of nursing care, so

therapeutic communication could help keep the environment more serene.

Not all communication is therapeutic; with some patients, nurses need to be more stern

and serious. Therapeutic communication would not be effective in a situation that involved a

combative patient. Nurses do need to understand when their communication is becoming

inappropriate, but with some patients, being stern is the only answer. Confused patients also do

not react to therapeutic communication because they are not 100% sure what is happening.

Therapeutic communication is also hard to use when patients are hard of hearing; with these

patients, the nurse has to speak loud enough for the patient to hear them, which eliminates the

idea of therapeutic communication. Deciding what type of communication to use with each

patient is hard to decipher because each patient is different.

According to Engard, (2017, p.1), some key components of therapeutic communication

are “using silence, accepting, giving recognition, active listening, and reflecting”. Therapeutic

communication does not necessarily mean that the health care worker is speaking; it could be

that the health care worker is listening to the patient’s thoughts. For some patients, all they want

is someone to hear their side of the story to make him/her feel better; not all patients feel the

need to take pain medications to alleviate pain, it may be an emotional pain they are feeling. The

first step is for the patient to accept everything that is happening to their health, reflecting back

on the problem could help relieve the patient of some worry.

While communicating in the healthcare environment, nurses need to consider the

patient’s rights. If a doctor wants to discuss a care plan with the patient, it is important to

recognize if that patient does not want anyone else to hear the conversation. If the patient does

not have a private room, the doctor should always ask if the patient would rather discuss the
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situation in a more private area. Speaking quietly, but loud enough for the patient to hear might

be okay with the patient if they do not have a private room. If the patient has family in the room,

the doctor should ask if it is okay to discuss their care in front of the family members.

There are some obvious and less obvious reasons to not discuss information with a

patient at certain times. If the patient is aggravated and does not want to listen, discussing care

could be put off until the patient is calm and can comprehend what is happening. If a patient is

confused, or not in their right mind, the nurse could wait for the family to get there before

discussing important information.

Another way that communication could be blocked is if other care personnel come to take

the patient, let’s say to take an X-ray. If the X-ray is stat, the nurse must pause and wait until the

patient gets back from the test. During this time, the nurse could forget the information they need

to discuss with the patient; to avoid this, the nurse should write down the important information

that needs to be discussed immediately.

In conclusion, every aspect of a patient’s care should be relayed to the patient. Nurses try

their best to discuss every part of a care plan to the patient. It is okay to forget a small part of

information, as long as the nurses still remember later on to discuss the left out piece of

information with the patient. Patient care is based off of what the patient wants to happen, nurses

should never encourage a patient to do what they think is right, they can only give the patient all

of their options. The patient may think that the nurse is talking too much, but the nurses need to

protect themselves and make sure that they discussed everything possible with the patient.

Therapeutic communication is not the only type of communication used in a healthcare

setting, but it still is one of the most important ones. Documentation is another great part of
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communication. Nurses have so much going on, they are forgetful sometimes; the best way to

remember everything necessary is to take notes and chart it.

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References

Engard, B., (2017-03-2017). 17 therapeutic communication techniques. River University Online.

Retrieved from: https://online.rivier.edu/therapeutic-communication-techniques/

Foden-Vencil, K. (2014-10-27). In the hospital, a bad translation can destroy a life. Health News

from NPR. Retrieved from: http://www.npr.org/sections/health-

shots/2014/10/27/358055673/in-the-hospital-a-bad-translation-can-destroy-a-life

Montefiore, (2017). Silent hospitals help healing (SHHH) program. Healing Arts. Retrieved

from: http://www.montefiore.org/healingarts-silent-hospitals-help-healing