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Communication skills (Essence of Care benchmark)

One of the basics of good nursing is good communication with patients. Failure to communicate well with a patient right away will destroy the delicate nurse/patient relationship and mean the patient does not trust the nurse.

Poor communication can even be dangerous as misunderstandings and people getting their wires crossed can lead to misdiagnosis and even medication errors.

But this area is one of the main sources of complaints made to the health service ombudsman every year and some believe training in communication should be a separate module in nurse training instead of being subsumed into the general curriculum.

The barriers to good communication skills are many and include time pressures so busy nurses may not be able to get time to sit and talk with patients; lack of privacy; skills mix on the wards can mean there is a shortage of qualified nurses who are available to talk to patients; lack of training; and different languages.

Useful things to remember in having good communication include being prepared to know what you are going to say; having the right information to hand for when patients ask questions; maintaining eye contact and observing the patient’s body language; listening properly; picking up on the non-verbal signs as well as the verbal ones; avoiding the use of medical jargon; and in cases of breaking bad news, being prepared emotionally, trying to find the right environment, and being sensitive, honest and compassionate.

Essence of Care – the government’s strategy to improve the quality of the fundamental aspects of nursing care – has communication as one of its 10 key benchmark areas.

The initiative provides a process for sharing and comparing practices and enables nurses to identify best practice or develop action plans to remedy practice that is identified as needing improvement

For the benchmark on communications, many factors are included. These include inter-personal skills; opportunity for communication; assessment of communication needs; information sharing; resources to aid communication and understanding; coordination of care; empowerment to communicate needs; valuing the patients and/or carers’ expertise and contribution; and training needs

By using the communication benchmark, some trusts have identified gaps and rectified those by introducing dedicated rooms for patients and relatives to talk privately, making communication skills part of nurses’ appraisals and producing patient information leaflets on specific topics such as stroke.

Good communication skills can also be particularly helpful when patients complain. Patients usually see nurses as more approachable than doctors if they have a problem they want to discuss.

Nurses can often deal with complaints quickly and effectively before they are taken further and prevent what was initially a minor problem from becoming a long, drawn-out formal complaint.

Updated: September 2006

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