Prince Sultan College of Health Sciences

College of Nursing

Nursing management & Leadership

Unit II: Communication
 Objectives
At the end of the lecture you will be able to:
• Define communication.
• Describe the communication process.
• Define verbal and nonverbal communication, and explain why both are needed for effective
communication.
• Demonstrate strategies for effective communication.
• Choose appropriate communication modes for specific situations and messages diagram
upward, downward, horizontal, and diagonal communication.
• Explain the components necessary for effective interpersonal communication.
• Identify barriers to effective interpersonal communication.
• Demonstrate strategies taken by nurse leader for effective communication to advance patient
quality of care.
Outline:
• Introduction
• What is Communication?
• Elements of Communication Process
• Basics for Effective Communication
• Communication Channels
• Communication Modes ( Verbal & Non-verbal )
• Communication settings
• Tools of Communication
• Communication Barriers
• Communication with Patient & Families
 Introduction
• Communication is an essential tool for nursing practice because a critical
link exists between effective communication and positive patient
outcomes. Nurses must communicate effectively with all members of
the health-care team, including other nurses, the patient, and the
patient’s family (American Association of Colleges of Nursing [AACN],
2008).
• Communication is a complex ongoing dynamic process in which the
participants create shared meaning in an interaction.
 What is Communication?
Defining Communication
• The root of the word “communication” in Latin is communicare, which
means to share, or to make common. Weekley, E. (1967).
• Communication is defined as the process of understanding and sharing
meaning. Pearson, J., & Nelson, P. (2000).

• Communication process is the means by which ideas are transferred

through ideation, encoding, transmission, receiving, decoding and
response.
• It is the transfer of understanding from one person to another.
• It is the exchange of information or opinions and interactive.
 Elements of Communication Process
The following elements of the communication process are based on Laswell’s model and include:

1. Sender: the creator of the message. (A nurse who initiate a conversation acts as a
sender).

2. Message: the verbal and nonverbal stimuli relayed by the sender and processes it.

3. Receiver: the person who takes the message from the sender and processes it.

4. Feedback: the new message that is generated by the receiver in response to the
original message by the sender.
 The verbal and
The creator of the The person who takes the message
nonverbal stimuli
message. from the sender and processes it.
relayed by the sender
and processes it.

The new message that is generated by the receiver in response to the

original message by the sender.
 Basics for Effective Communication

 Clarify your ideas before communication

 Consider the physical settings
 Consider the psychological aspects/environment
 Consult with other when necessary, to be sure your
information is accurate.
 Be mindful of the tone as well as the words of the message.
 Follow up your communication
 Nonverbal behavior should support communication
 Be an active listener
 Be assertive when expressing your view.
Communication Channels
 Communication Channels
• It is the means by which a message is communicated.

• There are three main channels of communication:

 Visual: for visual communication channels receivers use sight to

process information.

Example: nurse observes that patient looks pale and thin.

 Communication Channels
 Auditory: the second most commonly used communication channel includes not
only the words are spoken.

• Tone and pitch of the voice or sound is important.

 Kinesthetic: this communication channel uses touch and physiological responses to

convey meaning.

Example: a nurse touched the shoulder of a patient who is upset to convey a

number of emotions such as empathy although it is important to remember that how
people interpret touch varies significantly from culture to culture.
 1- Verbal
Communication
Modes 2- Non-verbal
 A. Verbal Communication Modes

Components of verbal communication:

1. Word choice consists of selecting appropriate words and arranging them in

meaningful patterns. This includes using the language most familiar to the receiver.

 Accurate words indicate the meaning clearly without confusion. Generally

accurate words are concrete specific.

 Vocabulary level of the sender is also crucial. Using words that receiver do not
comprehend means they will not understand medical procedures. Thus, it is
necessary to make sure that receivers understand the vocabulary.
 A. Verbal Communication Modes

2. Tone is the overall impression that words give. Tone is conveyed verbally by
voice pitch (high or low) emphasis and volume.

3. Speed and timing or space: this means how rapidly or slowly a person talks.
 B. Non-verbal Communication
• This consists of body/ physical and facial expression that convey information.

• When the sender’s verbal information and nonverbal message differ the receiver
may become confused or may choose to believe the nonverbal message.

Components of nonverbal communication:

1.Body language

o Gestures: can be purposeful (such as waving hello) or inadvertent such as

putting hands in pocket or crossing one’s arm. This can be interpreted
differently according to situation, culture and people involved.
 B. Non-verbal Communication

1. Body language

o Posture: how a person stands sits or moves. An erect posture can convey the message of
assertiveness or confidence while a slumped posture could mean fatigue, disinterest or
lack of confidence.

o Facial expressions can include smiling and whether the person maintains eye contact
when speaking.

o Somebody positions postures or gestures may be affected by physical conditions such

as pain, neurological impairment or orthopedic conditions.
 B. Non-verbal Communication

2. Issues of personal space: this means the amount of space that people need to feel
comfortable. A lot of cultural differences exist in how much space people wish to
maintain while talking to others as well as appropriateness of touching another
person.

Nurse leaders need to establish clear limits as to what body language and touching
be acceptable and unacceptable communication in the workplace, and nursing staff
should be aware as well.
Personal Space
Communication occur in a variety of
settings:

1. Upward communication with

superiors.
2. Downward communication with
staff/subordinates.
3. Lateral communication with peers
and co-workers i.e people at the
same hierarchical levels within the
organization but no direct
supervisor.
Communication occur in a variety of
settings:
1. Formal (official) through emails reports.

2. Informal (unofficial) grapevine.

3. Public communication (to small, medium and large groups).

The size of the receiving group affects how the message is organized and delivered. Generally the
larger the group the more difficult the task of ensuring that the message is transmitted and
received appropriately.
 Tools of
Communication

A. Written Communication
B. Electronic Communication
C. Information Systems
A. Written
Communication
1. A memo is usually a one-page communication targeted
within an organization. It is meant to be brief and
focused covering one topic.
2. Letters are one or more-page communications
addressed to leaders outside or inside the organization.
Letters can perform a variety of functions including
transmitting health information, fund raising or public
relations.
3. Brochures, patient information: much patient education
information continues to be in print form such as
brochures or patient information booklets.
B. Electronic
Communication
• Traditionally all communication was either verbal or paper.
Electronic personal media device are found virtually
everywhere and in some cases have replaced paper.
• The most frequently used electronic media include:
 E-mail: for some time e-mails were considered strictly
informal communication with little professional use,
but now many organizations use e-mail for all internal
and much of their external communications.
B. Electronic
Communication
 Voice mail- voice mail boxes that hold phone messages
and allow retrieval are valuable ways of enhancing
communication in organization.
 Web based information- can include intranet that is
usually password protected for the members of the
organization only.
 C. Information Systems
Computerized information systems provide patient monitoring and
patient care tasks as well as communication of data within the
institution. Computerized systems include:

1. Nursing information systems which contain nursing and health

data that can be collected, stored, processed, retrieved and
communicated. These systems include:

Patient classification Discharge plan

Care plan and documentation Performance measurement
Quality improvement Point of care systems.
Inventory
 C. Information Systems
2. Hospital information systems: which manage information from
clinical and administrative such as patient accounting, financial
management, patient care, pharmacy, radiology and laboratories.
3. Decision support systems which help leaders make informed
operating decisions based on predicative data. These systems can
include:
 Cost accounting.
 Case mix information and acuity measurements to guide staffing
requirements.
 Department and organization: wide budget and forecasting.
 Marketing. And employee system
C. Information Systems

4. Executive information systems which allow leaders to explore key

indicators such as performance, cash flow, capital expenditure, patient
acuity, staffing levels and patient and staff satisfaction.
Communication
Barriers
 Communication Barriers:

1. Culture:
• Language
• Space and relationship
• Time.
• Environmental control
• Biological variations-
ethnic and cultural
groups.
Communication Barriers:

2. Emotions:
 Anger.
 Blaming- finding fault with
another’s action.
3. Gender: speaking style, spoken message,
relating to others.
4. Conflict.
5. Stress- a state of tension.
6. Interrupting.
7. Not paying attention.
Communication with Patient & Families
 Communication with Patient & Families
• Nurse leaders must often deal with difficult situations that involve patients and
their families and disagreements or complaints about delivery of care.

• Nurse leaders should keep the following in mind when dealing with patient and
family issues:

 Patients are customers and should be communicated with honesty and

treated with respect.

 Nurse leaders need to find a balance between avoiding medical terminology

that is too complex and using terms that are too simple.
Sullivan & Decker (2001)
 Communication with Patient & Families

 Provide angry patient a private, neutral place to communicate their needs.

 If patients are not native speakers and/ or not fluent in English/ Arabic try to
provide interpreter service.

 Learn about different cultures in order to be able to recognize communication

issues that are culturally based.
Any ?
Reference:
Marquis, Bessie L., Huston, Carol Jorgense.n, Leadership roles and management functions in nursing : theory and application / Bessie L.
Marquis, Carol J., Ninth edition (2017).
Murry E., Nursing leadership and manamgement safeaty and quality care. (2017).