Communication is a critical component of medical care. Patients share symptoms, medical history and current medications, and nurses and physicians ask questions to help narrow the cause of a patient’s symptoms. In healthcare, it is better to over-communicate than not communicate enough. An omission can mean the difference between life and death.
A study titled 4000 Clicks found that physicians spend only 28 percent of their time with patients. The bulk of their time — at 44 percent — goes to data entry. How much time do nurses have for patients?, on the other hand, reports that nurses spend 37 percent of their time with patients.
Of all healthcare providers, nurses spend the most time with patients. A patient in a hospital is typically under a particular nurse’s care for 8 to 12 hours at a time. By interacting with the patient, the patient’s family and other nurses during these shifts, nurses can glean information that is useful to physicians and colleagues.
A Doctor’s Own Hospitalization Shows the Value of Nurses
A physician with more than six decades of experience did not appreciate the value of nurses until he nearly died, when he realized that nurses provide most of the personal care to hospitalized patients. “I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled,” writes Arnold Relman, M.D. “This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good.”
He explains that nurses and doctors kept his family updated on his condition. Nurses and his wife, who is also a doctor, joined the rounds. While on rounds, doctors often discuss the patient’s care and results outside of the patient’s room.
“Feeling no need to go to the bedside, [the doctors] do not [go],” writes Lawrence K. Altman, M.D. “Instead they rely on nurses, failing to recognize that such behavior omits crucial elements in patient care — the physical touch and the personal touch.”
The Difference Between Basic and Detailed Information
Successful communication takes more than simply sharing information. What nurses say, how they say it, and what they mean are equally important. For example, a nurse asks a patient for a list of current prescriptions. In one scenario, the patient may list daily prescriptions. In another scenario, a patient provides prescriptions as well as over-the-counter medications such as pseudoephedrine and acetaminophen, vitamins, minerals and supplements.
These two different responses can lead to different results. Imagine that a patient comes in complaining of stomach discomfort. The patient does not mention taking ibuprofen or another NSAID multiple times a day for back pain. Without information about the ibuprofen, the physician may overlook it as a potential cause.
How Nurses Can Improve Communication
Sometimes patients feel intimidated by physicians. This may be the result of medical jargon, the physician’s demeanor or the nature of a sensitive topic. As a result, patients may shy away from asking questions, revealing details or requesting clarification. Communication with a nurse may be easier.
Here are eight tips to improve communication with patients:
- Listen without interrupting. Carefully listen to the patient without thinking about what you are going to say next. Ask clarifying questions during pauses. Summarize what the patient said to confirm you understood.
- Look at the patient. Even if the patient has an interpreter, look at the patient as much as possible.
- Match the communication to the listener. Limiting jargon helps, but some patients are in the healthcare profession. In this case, jargon may be acceptable. Some patients need more help understanding than others. After explaining each key point, confirm that the patient understands.
- Be honest. Sometimes you will have to communicate difficult news. Be frank and sensitive.
- Ask if the patient understands. Ensure the patient understands the condition, treatment and next steps.
- Pay attention to non-verbal cues. Facial expressions, posture, gestures, and personal space can also change how the patient receives a message. Be aware of non-verbal communication.
- Speak kindly. Tone can affect how the patient responds. It can mean the difference between what sounds like an accusation and what sounds simply like a question.
- Make a checklist of questions to ask. A surgical patient may hear the same questions multiple times. While this may annoy the patient, it is better than not asking the question at all. Checklists of questions can help prevent oversight.
Talking to a patient’s family, asking probing questions, or holding a casual conversation could lead to information that saves the patient’s life. These tips provide you with a starting point to improve communication. Additional training and continuing education can help you better respond to the diverse needs and cultures of your patients.
The Need for Continuing Education
One of the reasons the healthcare industry is encouraging more registered nurses to earn a Bachelor of Science in Nursing is the communication skills these degree programs develop. These programs round out your RN education by focusing on leadership and communication. They also address the most pressing topics in healthcare, such as geriatric care in preparation for the influx of Baby Boomers.
RN to BSN online programs like the one available at Colorado Mesa University can offer flexibility that working nurses need. When searching for a RN to BSN program, be sure to verify the nursing program is accredited and approved by the state Board of Nursing.
Learn more about Colorado Mesa University online RN to BSN program.
Altman, L. (2014). A Patient’s-Eye-View of Nurses. The New York TImes
Hill, R. G., Jr., Sears, L. M. and Melanson, S. W. (2013). 4000 Clicks: a productivity analysis of electronic medical records in a community hospital ED. The American Journal of Emergency Medicine
Relman, A. (2014). On Breaking One’s neck. The New York Review of Books
Westbrook, J. I., Duffield, C. and Li, L. (2011). How much time do nurses have for patients? A longitudinal study quantifying hospital nurses’ patterns of task time distribution and interactions with health professionals. NCBI
Have a question or concern about this article? Please contact us.