Patient-Centric Communication in Nursing Practice
This paper reviews peer-reviewed literature on nurse-patient communication, exploring how communication skills affect patient outcomes, safety, and care quality. Drawing on studies spanning from 1991 to 2006, the review examines patterns of interaction between nurses and patients, the role of nurses as patient advocates, and the influence of institutional communication structures on care quality. Key themes include asymmetrical power dynamics in nurse-patient dialogue, the often-overlooked contribution of patients to communication, the comparative communication styles of nurses and physicians, and the impact of communication skills training. The paper concludes that nurse-patient communication has been underexplored and that standardized communication training is essential for improving patient care.
- Introduction: Framing nurse-patient communication as a critical skill
- Review of the Literature: Survey of studies on nurse-patient communication patterns
- Summary and Recommendations: Call for more research and communication standards
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What makes this paper effective
- The paper synthesizes a range of peer-reviewed studies spanning multiple decades, giving the reader a chronological sense of how nurse-patient communication research has evolved.
- It balances negative and positive examples of nursing communication, opening with a study on power imbalances before moving toward constructive findings, which gives the argument structural credibility.
- The paper consistently anchors claims in specific study findings and direct quotations, maintaining academic rigor throughout the review.
Key academic technique demonstrated
The paper demonstrates effective use of the literature review format by organizing multiple independent studies around a unifying theme — the quality and impact of nurse-patient communication — and drawing a synthesized conclusion from disparate sources. Rather than summarizing studies in isolation, the author uses each source to build a cumulative argument that nurse communication has real consequences for patient health outcomes.
Structure breakdown
The paper opens with an introduction that frames the significance of the topic and justifies the scope of the literature search. The central section, "Review of the Literature," works through approximately ten peer-reviewed studies, arranged thematically to move from problems (control, asymmetry) toward solutions (training, open communication). A brief summary closes with a call for further research and standardized communication guidelines. This three-part structure — introduction, evidence review, conclusion — is a reliable model for nursing literature reviews at the undergraduate level.
Introduction
There are probably no skills as critical in nursing as communication skills. The nurse is generally responsible for giving the patient instructions on medications, follow-up care, and other vitally important health information. Ineffective communication may result in poor outcomes for patients and, in the most severe cases, even death. This paper examines peer-reviewed literature on nurse-patient communication in order to support the development of effective communication skills in nursing practice.
To understand the relative scarcity of literature on nurse-patient communication, one need only perform a simple search on the PubMed website using the keywords "nurse-patient communication." The first study reviewed here is an example of negative communication skills among nursing staff; it is followed by studies that identify positive interactions in communication between nursing staff and patients.
Review of the Literature
Tfouni, de Carvalho, and Scochi (1991) conducted a study analyzing nurse-patient interaction through approximately 20 dialogues among five nurses and twenty patients, in which the mechanics of conversation were analyzed. The results showed "an asymmetry in the interaction, a fact that qualifies the nurse-patient interaction as one of control, domination and effacement of individuality. These factors show that the ideology of the hospital institution with respect to the patient is characterized by imposition of authority and alienation."
Williams and Gossett (2001), in their work entitled "Nursing Communication: Advocacy for the Patient or Physician," state that "communication among nurses, patients, and physicians is a key component of effective health care. In addition to communication with patients, nurses directly or indirectly influence physician-patient communications." Their study was a secondary analysis examining the interactions of registered nurses with "simulated patients regarding what the physician had told the patient about the reason for hospitalization." The findings concluded that "nurses mediate and clarify communications between the patient and physician."
Mendes, Trevizan, Noqueira, and Hayashida (2000) assert that "nursing is a profession committed to the promotion of human beings" and hold that "communication plays an important role within the nursing process and its results, and it is also a fundamental component of the treatment."
Colon-Emeric (2006), in the work entitled "Patterns of Medical and Nursing Staff Communication in Nursing Homes: Implications and Insights From Complexity Science," notes that "complexity science teaches that relationships among health care providers are key to our understanding of how quality care emerges." This six-month study compared patterns of medicine-nursing communication in two facilities, focusing on information flow, cognitive diversity, self-organization, and innovation. Data were gathered through field observations, shadowing, and in-depth interviews. In the first facility, a dominant "vertical chain of command between care providers characterized by thin connections and limited information exchange" was found, which "limited cognitive diversity and innovation in clinical problem solving." The second facility was characterized by "open communication patterns between medical and frontline staff," resulting in higher levels of "information flow, cognitive diversity, innovation and self-organization" — although these gains were tempered by staff turnover. The study concludes that "the patterns of communication between care providers in nursing facilities have an important impact on their ability to provide quality, innovative care."
Vaartio (2006), in "Nursing Advocacy: How is it Defined by Patients and Nurses, What Does it Involve and How is it Experienced?", observes that "advocacy is an integral part of nursing. However, there is a scarcity of empirical evidence on nursing advocacy process and most of that evidence concerns nurses' views on the care of certain vulnerable patient groups in acute care settings. Before nursing practice can truly adopt advocacy as an inherent and natural part of nursing, a clearer understanding is needed of how it is defined and what activities are needed to accomplish advocacy." The study further states that in nursing practice "the abstract concept of nursing advocacy finds expression in voice responsiveness, which integrates and acknowledges professional responsibility for and active involvement in supporting patients' needs and wishes."
Jarrett and Payne (1995), in "A Selective Review of the Literature on Nurse-Patient Communication: Has the Patient's Contribution Been Neglected?", state that "previous research has been critical of the quality and quantity of nurse-patient communication, describing it as brief and superficial. Nurses are depicted as controlling and restricting the course and topics of conversations with patients. Communication skills training for nurses has been advocated as a solution for this apparent deficit." Jarrett and Payne further contend that earlier research overemphasizes the communication of the nurse while minimizing the patient's contribution to the content of the interaction.
Collins (2005), in "Explanation in Consultations: The Combined Effectiveness of Doctor's and Nurses' Communication with Patients," reports on a comparative study of "doctors' and nurses' communication with patients in multidisciplinary health care." Sessions were videotaped and qualitatively analyzed, with findings stating: "Distinctive features of explanations in nurses' and doctors' consultations with patients were identified. These can be understood by reference to patterns of communication. Nurses' communication was mediated by patients' contributions; doctors' communication gave an overarching direction to the consultation as a whole. While nurses' explanations began from the viewpoint of a patient's responsibility and behavior, doctors' explanations began from the viewpoint of biomedical intervention. Their consultations lent different opportunities for patients' involvement." The communications of doctors and nurses were found to have their own individual and unique features, allowing "distinct contributions" of each — findings that have "implications for policy, for practice and for interprofessional education."
Poggenpoel (1997), in "Nurses' Responses to Patient's Communication," presents the results of research "undertaken to explore and describe nurses' responses to patients' communication as a factor in health promotion, maintenance and restoration." The study was exploratory, qualitative, descriptive, and contextual in design. Five categories of nurse responses to patient communication were identified: (1) reassuring; (2) giving advice or dictating from one's own frame of reference; (3) explaining; (4) moralizing; and (5) first-level empathy. Findings state that "the first four categories of communication patterns are detrimental to the promotion, maintenance and restoration of the patient's health."
Jones (2003) states that the inclusion of patients in healthcare consultations has been long ignored by mainstream nursing, but argues that "there is a pressing need for a research approach that accurately captures the contribution of both participants within nurse-patient interaction." Burgio et al. (2001) examined the effects of communication skills training and found that "nursing staff can be trained to improve and maintain communication skills during care without increasing the amount of time delivering care."
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