Communication Process in Nursing and Patient Safety

Introduction

Communication is vital in any industry, but it is especially important in nursing because miscommunication can lead to medical errors. This paper addresses four key areas: (1) identifying the components of the communication process, (2) evaluating conflicting verbal and nonverbal communication cues, (3) evaluating the potential effectiveness of various communication strategies and styles used to deal with conflict, and (4) discussing the effects of communication on patient safety.

Components of the Communication Process

The components of the communication process include the sender, the receiver, and the message that passes between them (Cherry & Jacob, 2019). One crucial aspect of this process, however, is feedback — the response given by the receiver of the original message. Feedback is what transforms the receiver into the sender and the original sender into the receiver. It is what enables communication to function as a true two-way flow.

The message travels from the sender to the receiver, who interprets it and provides that interpretation back to the sender, demonstrating how well the message was understood. This is a vital aspect of communication that is often overlooked. It is not enough for communication to flow only in one direction. The sender may believe the message was received, but without the message being confirmed back in a way that expressly demonstrates reception, the sender cannot be certain that delivery occurred. Feedback is like the signature required when a delivery service brings a package to one's door — the package is important, and the signature is necessary. That is how one should think of feedback.

Evaluating Conflicting Verbal and Nonverbal Cues

Conflicting verbal and nonverbal communication cues can significantly influence how a receiver interprets a message. Interpretation depends on preconceptions, perception, context, precipitating events, past experiences, environment, and the modes of transmission used. Verbal and nonverbal communications are two such modes of transmission. They are received differently in part because of filtration — the natural process by which a receiver screens out noise when receiving a message. For instance, a nurse who sees a message on a whiteboard may filter out more than is appropriate because that same board or wall is already cluttered with other messages. Similarly, a crucial element of a verbal message might be filtered out if the tone of voice is unsympathetic, if the message is surrounded by an unsatisfying exchange, or if environmental distractions are present.

For these reasons, and to ensure that messages are effectively interpreted, both verbal and nonverbal communications should be as direct and to the point as possible. This is reflected in the communication standards known as the 3 B's: Be Brief, Be Clear, and Be Timely. A useful addition to these standards is: Be Complete — ensuring the message is not only partially given or received. Requiring feedback from the receiver remains one of the most effective ways to confirm that a message was received in full.

Nonverbal communication can confirm or contradict the spoken word, so it is important that a sender use nonverbal signals — such as hand gestures, spatial distancing, tone of voice, touch, facial expressions, eye contact, posture, and body language — to support the message being conveyed (Cherry & Jacob, 2019). When verbal and nonverbal communications conflict, the receiver tends to disregard the verbal message and act on the nonverbal one instead. Poor posture or lack of eye contact, for example, sends an unintended alternate message that the receiver subconsciously registers. To prevent this kind of conflict, nurses should employ positive communication techniques such as establishing eye contact, keeping promises, expressing empathy, developing trust, clarifying information, using open communication, and using appropriate touch.

By contrast, some nurses may rely on negative communication techniques — such as blocking, which involves responding with vague or noncommittal answers. False assurances, logical fallacies (such as ad hominem attacks or red herrings), distractions from the real topic, and contradictory messages are all examples of negative communication techniques. These approaches should be avoided, as they only serve to generate conflict and erode trust.