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#WENURSES

#WeNurses - Are you up to the communication challenge?

Did you miss the latest #WeNurses chat discussing communication? Let us sum it up for you…

Communication is a fundamental nursing skill that is often taken for granted. It is something that we do every moment of every working day, with patients, with relatives, with colleagues and carers. CNO Jane Cummings has included communication in her 6 C’s (care, compassion, commitment, communication, courage and competence) as part of her vision, clarifying that there can be no doubt that communication is an integral part of nursing.

As a nurse who works primarily in long term elderly care settings I see the value of good communication constantly. I often work with patients who are hearing impaired, have poor eyesight or who have lost the ability to talk and express themselves. This makes my working day challenging but no more so than an anaesthetic room nurse, who only sees their anxious patient briefly, or a A&E nurse who has to deal with frightened relatives or drunken patients or even a community nurse who has the challenges of being in a patient’s home for only brief periods at a time. As nurses we all face communication challenges and this #WeNurses chat set out to explore some of them.

This chat started by asking: what are the barriers to effective communication?

@michellemellor3 tweeted “The use of terminology, jargon & abbreviations that are not always understood by patients!”

@englishfornurse added “Barriers to good comunication can be simple as having too much to do and forgetting that talking to the patient is good for them”

@essyjar said “Not ensuring pt fully understands”

@WeNurses then asked if chatters felt that the vocabulary nurses use is a barrier?

@cuteasbuttonz stated “I find a lot of pts get confused with all the ‘jargon’ & want plain eng. spec in MFOP. Far too many acronyms in the NHS”

@englishfornurse said “Absolutely agree, jargon is great with colleagues but not when patients are listening”

@michellemellor3 agreed “Yes nurses do use unfamiliar terminology sometimes unknowingly”

@Ldstudentnurse tweeted “Yes match your vocabulary to the person you are speaking with”

@cuteasbuttonz said “This is a good point as a 1st year student a lot of language used confused me on my 1st placement”

@cherylwilson2 raised the issue of non verbal communication “Communication can be verbal AND non verbal…watch as well as listen !”

@LDstudentnurse added “Listening is most important if your not really hearing whats being communicated u are missing the opportunity to engage”

@Michellemellor3 tweeted “Sit at the same level as your patient, don’t stand over them this can be intimidating to some”

@essjayarr stated “Open body language, friendly manner and eye contact! Basics for verbal and non-verbal comms”

@lindahosie agreed by saying “Non verbal often speaks much louder than words! Not going to comm with a nurse obvious in a bad mood”

@VivJBennett tweeted “For people with LTC often are the experts in their illness course and management … listening and respecting so impt”

@LeggeAngie added “Communication could be letting the patient know you are there to listen when they are ready”

Throughout the course of the discussion many participants tweeted important tips to aid effective communication in nursing:

@CherylWilson2 tweeted “Communication must happen throughout the day not just at key times”

@MichelleMellor3 tweeted “Need to communicate to patients in a clear, concise and welcoming manner”

@JaneMCummings raised an important point “- also need to communicate with relatives, carers and others in meaningful way”

@Ramck001 tweeted “Sometimes the patient might want to chat or just be in silent reflection, gotta take your cue from them really :)”

@WeNurses then asked “What are everyone’s thoughts on when communication fails? What do we do then ?”

@LeggeAngie advised “Be honest. Ask for help”

@LDstudentnurse tweeted “Try again and if it really is not happening accept that you may not be the right person at this point in time”

@cherylWilson2 said “Find out why by more effective communication”

@essjayarrr added “Be honest, find other ways to ensure communication is effective”

The issue of whether technology is a help or a barrier to communication was then discussed:

@VivJBennett tweeted “.. very interesting re technology … help or barrier? GPs use as part of clinical interaction”

@michellemellor3 said “Patients like face to face contact - see the person”

@cherylWilson2 stated “Depends on how its used ! Hearing aids essential and written word for me and hearing impaired. Frustrating as unseen”

@DGFoord added “Useful technologies, like skype, webchat & clinical decision-support systems for remote assessment gives good results”

@LDstudentnurse said “Its a major help for some people, same as before match you communication style/aid to client”

@VivJBennett reflected “Sometimes I need face to face … sometimes I would like to communicate by phone or email ..are we ready for this change?”

@CherylWilson2 added “Clinics here use texts to contact young people if they state that’s their preference”

Complaints and how they are often caused by poor communication was discussed:

@LeggeAngie said “Complaints and claims often stem from poor communication when a problem first arises”

@Michellemellor3 tweeted “Complaints and anxiety that could have been avoided with effective engagement with patient”

@flutterraevyn added “Or the problem is escalated due to poor communication issue when raised”

@DgFoord said “Ultimately communications is probably one of the most common root causes of complaints; so easily avoided”

Towards the end of the chat WeNurses asked “How can we ensure good communication with our patients?”

@LDstudentnurse replied “Always be real, honest, open and LISTEN”

@CherylWilson2 responded by saying “Lead by example ensure excellent comms between team”

@Salsa442 said “Time, positioning and posture, active listening, no jargon and comm at pts level of understanding, reflect with them”

In the final minutes of the chat WeNurses asked chatters to reflect by asking “What will you take away from this chat to improve your practice?”

@englishfornurse stated “We will take away a real pride. Nurses really want to talk to their patients and help them understand what is happening”

@cuteasbuttonz said “I will take time to consider understanding of pt and how I deliver info”

@michellemellor3 said “Communication is not one way, consider the person you are chatting with and let them make their point also”

For me, in my role, communication is often as little as holding a hand, giving a smile or just taking time to stop, listen and care. Nursing is a diverse profession and the communication needs and challenges in each speciality are as diverse - but there is no doubt that there are challenges.

Our role as nurses is to rise to those challenges, enabling effective communication that enhances patient care. One of the fabulous things about nurse Twitter chats is that they are full of great nurse communicators, and with communicators like #WeNurses nurses we are surely able to rise to the challenge! During the chat @studentnurdse tweeted “Communication is more than just talking, it’s listening, looking and understanding what’s being said but also what’s not”. She is right; whatever your speciality of nursing - whether you are a student nurse or a director of nursing, we all need to remember communication is not just about talking.

Teresa Chinn is a nurse, a blogger and social media specialist and leads the #WeNurses discussions for WeNurses. Follow @WeNurses on Twitter.

Readers' comments (2)

  • tinkerbell

    sender - message - receiver

    I notice that a majority of NHS staff are hopeless at taking a message. It is suggested that 97% of communication is non-verbal, but it would be a start if people were able to receive a message by 'listening' in the first place to what is being said.

    e.g. 'Send reinforcements we're going to advance'
    changes to
    'send three and fourpence we're going to a dance'.

    Unsuitable or offensive?

  • michael stone

    It is very easy to be holding two different conversations without knowing this is happening - you and the person you are talking to can sometimes both be saying 'yes', when actually the 'yes' is to a different question.

    That gets worse as a problem when people are using 'jargon' or are from different professions - I think one of the great communication skills, especially when reading stuff like e-mails, is to think 'Am I understanding this properly - did she mean what I think she meant, or have I imposed what I think she meant onto this ?'.

    I don't think guidance is really the communication this piece is about, but if you show people anything at all that is lengthy and potentially complex (guidance or 'an incident report' for example) what individuals see, is very influenced by who/what they are - everyone pays greater attention to different bits, and everone tends to ignore the bits that don't fit in with what they expected to find.

    I could get very 'philosophical' on this, so I'm stopping here.

    With the comment, that it is necessary to make the attempt to communicate !

    Unsuitable or offensive?

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