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How to Communicate Effectively


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What About Nurse/Physician Communication?

Since the dawn of professional care-giving, nurses have watched as a small number of physicians behaved badly—yelling, swearing, throwing things.

But with the knowledge that unsettling outbursts can negatively affect patient care and staff morale, some enlightened hospitals no longer tolerate disruptive tantrums.

To read more about this topic, click here.

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 professionals—together.

“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 following guidelines:

  • 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 workplace.

Be assertive

“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 those terms.”

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 situation.

“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.”

Be respectful

Your grandmother’s old advice to avoid saying anything unless you have something nice to say still holds water—even in a tense work environment.

“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 learned.

“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 interested in.”

Another way to improve small talk is to keep up on current events, movies and other things people have in common.

Overcome conflict

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 said.

“Instead of a disagreement cycle, get an agreement cycle going.”

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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