By Christina Orlovsky, contributor
Communication is critical to success in many industries, and
nursing is no exception. In fact, nurse communication is often the very glue
that holds the profession—and the safety of the patients cared for by nursing
“It is very important to stress how important nurse
communication is to patient safety,” said June Fabre, MBA, RN, author of Smart Nursing: How to Create a Positive Work Environment that Empowers and Retains Nurses, and the founder of Smart Heathcare LLC. “If nurse communication and patient safety aren’t there for new nurses, they can lose their jobs right away—it’s critical for their success.”
Fabre pointed to the Joint Commission’s 2008 National Patient
Safety Goals, which list “Improve the effectiveness of communication among
caregivers” as the second goal—for good reason.
“According to the Joint Commission, poor communication is the
number one cause of serious medical errors,” Fabre continued.
Consequently, the Joint Commission also highlights several
particular areas where effective communication must be stressed, offering the
- For verbal or telephone orders or for telephonic reporting
of critical test results, verify the complete order or test result by having
the person receiving the information record and “read-back” the complete order
or test result.
- Standardize a list of abbreviations, acronyms, symbols, and
dose designations that are not to be used throughout the organization.
- Measure and assess, and if appropriate, take action to
improve the timeliness of reporting, and the timeliness of receipt by the
responsible licensed caregiver, of critical test results and values.
- Implement a standardized approach to “hand off”
communications, including an opportunity to ask and respond to questions.
In addition to the Joint Commission’s communication goals and
action steps, Fabre offered other methods to improve nurse communication in the
“There are two ways for nurses to address issues: One is
assertively, with ‘I’ statements, as in ‘I see this as a problem’,” she
explained. “The other is to use ‘You’ statements, phrasing your request in a way
that’s important to the other person. For example, instead of saying, ‘I need
another nurse,’ you could say to a manager, ‘You will find there are many errors
if we don’t have enough nurses.’ A new nurse can try to think about what’s
important to the other person they’re communicating with and put the request in
Let it out
Anyone who has ever worked in a group of any kind knows that
personalities and work styles often differ. In this case, it’s easy to let
little problems build up into one major blowout. Fabre warned against this
“It’s important for new nurses to address little irritants or
problems immediately,” she said. “You want to avoid saving up so you don’t blow
up. Address things as you go along.”
Your grandmother’s old advice to avoid saying anything unless
you have something nice to say still holds water—even in a tense work
“It’s not just what you say, it’s how you say it,” Fabre
added. “We have to use respectful communication even if there’s a big issue. Say
what you have to say in a way that shows you’re a professional.”
Also remember that a large percentage of communication is
actually nonverbal. Listening skills and body language also play an important
part in demonstrating respect.
Master the art of small talk
Never underestimate the power of easygoing conversation.
“Small talk an important skill to have because it builds the
kind of relationships that help you not only be successful in your first job but
also go up to higher levels. It helps you collaborate with other people,” Fabre
continued. “Collaboration is really important in nursing. No one is ever as
smart on their own as a group is when you can get a good group together.”
Fabre added that making good small talk is a skill that can be
“Make a list of questions you can ask other people—questions
that aren’t too personal and that, chances are, the other person will want to
talk about,” she said. Fabre’s favorite question: Have you had a favorite
vacation in the past few years? “It’s an open-ended question that people will
talk about for a half hour and that will give you clues as to what they’re
Another way to improve small talk is to keep up on current
events, movies and other things people have in common.
Workplace conflict, though never pleasant, is manageable—if
you know the proper way to negotiate with your colleagues. Fabre listed three
steps to resolving conflict: diffusing the situation, building a relationship
and then negotiating a resolution.
“One way to diffuse a conflict is to actually find a grain of
truth in what the other person is saying and agree with it—even if you disagree
entirely,” she said. “For example, you can say, ‘I see that you spent a lot of
time thinking about it.’ If someone wants to have a conflict and you don’t push
back, it sort of takes the wind out of their sails.”
To build a relationship with someone, offer to assist them in
a sincere way. And, finally, to negotiate a resolution, make a statement that
nobody can disagree with, such as, “Getting upset doesn’t help anything,” Fabre
“Instead of a disagreement cycle, get an agreement cycle
Know the end result
The final key to effective communication is to understand the
power of nurse communication with regard to the patient.
“When people collaborate, you hear everyone’s concerns,” Fabre
concluded. “The final result is patient safety.”
Check out June Fabre’s book, “Smart Nursing: How to Create a
Positive Work Environment that Empowers and Retains Nurses,” to learn how nurse communication and patient safety are essential for the success of new grads. For
more information on the National Patient Safety Goals, visit the Joint Commission Web site.
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