Barriers to Effective Communication in Nursing

Nurses are the frontline force in most healthcare scenarios. Their ability to communicate clearly and effectively with patients impacts patient care and the patient’s perception of care. Communication is so important that some schools offer minors in health communication. While barriers exist, nurses can overcome many of them with a little thought and planning.

The possibility of miscommunication increases when the nurse and patient speak different first languages. Idioms and frames of reference can carry shades of meaning in one language that may not exist in another. Mispronunciation or incorrect signing can mislead the provider or patient. A translator can improve the situation when a nurse who speaks the language is unavailable.

Differences in ethnic background and mores can create communication problems. Societal expectations about the human body and its exposure to others can interfere with a nurse performing her duties and explaining follow-up care for a patient. What one culture considers a normal condition may camouflage illness. Learning about cultural differences can reduce many of these barriers.

Effective communication takes time: time to determine the patient’s condition, time to explain and educate, time to confirm that the patient understands. The shortage of nurses in many medical settings can lead to lack of time. Without enough nurses on staff, the amount of time available for each patient declines.

A nurse who makes assumptions about a patient based on a case diagnosis risks missing important cues. Open-minded communication between patient and nurse permits better assessment and more accurate care plans.

Nurses in a medical facility care for multiple patients at a time, creating a situation ripe for distractions and interruptions. Situations outside the workplace also can create distractions. Effective communication requires committed attention, something nurses may find more difficult to give with the increasing demands on them.

Nurses can intimidate or confuse patients with the use of medical jargon. Use common terms with a patient to simplify the conversation. The chart entry may read “singultus"; the patient will understand “hiccups” more readily. Adding a simple “which is” explanation after a medical term can improve the patient’s understanding: “I’m giving you an injection of hydromorphone hydrochloride, which is a medication the doctor ordered for your pain.”

Also, a nurse’s use of plural pronouns can create unintended barriers. “How are we feeling today?” “Did we eat our breakfast?” Phrases such as these can alienate a patient rather than connecting with him. Save the plural pronouns for when they apply: “When you get back from therapy, we’ll talk about your progress.”

The temptation to address the caregiver of a juvenile or uncommunicative patient may result in the patient feeling slighted. Include the patient as well as the caregiver in oral communication if the patient is present. Sometimes a patient chooses not to communicate because she feels ignored while her caregiver talks about her with medical personnel.