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Fundamentals · chapter 2 · Communication

Effective Communication

The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.

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Key points

  1. Communication outcomes

    Effective communicators build empathy and trust among patients and the healthcare team. When patients and healthcare providers feel understood and heard, better healthcare outcomes occur, and job satisfaction among healthcare providers improves.

  2. Core communication elements

    Healthcare providers need to provide factual, practical, clear, concise, and persuasive communication to patients to deliver safe and effective health care.

  3. Factual communication

    Providing patients with communication that is anything other than factual erodes the patient-provider relationship and deems the provider as untrustworthy. Patients deserve factual communication about their bodies.

  4. Practical information

    This sharing of practical information builds trust—the patient recognizes the nurse understands their limitations.

  5. Clear message purpose

    Effective communication occurs when the nurse clearly thinks through the purpose of the message. The message should be clear so that feedback can be elicited.

  6. Recommendations and patient wishes

    Nurses should present facts and make recommendations but also listen to the wishes of the patient.

  7. Professional communication

    To communicate respectfully with different types of people, the nurse should use professional communication.

  8. Patient understanding

    Patients are more likely to follow directions provided during an educational session if the information is supplied in a way the patient readily understands.

  9. Names and titles

    Nurses should ask patients what they prefer to be called—their name, title, and pronouns; doing so helps establish a positive patient-provider relationship.

  10. Empathetic care

    Empathetic care often leads to better adherence to treatment plans and a more positive attitude toward recovery. Patients who feel supported and understood are more likely to actively engage in their care (Bas-Sarmiento et al., 2019).

  11. Patient advocacy

    An assertive nurse advocates for patients until their concern is addressed. Assertive nurses are a necessity for patients who are unconscious, nonverbal, or have no advocate at their side as they must speak up as the voice of the patient.

  12. Adverse event resolution

    Resolution includes healthcare providers discussing through clear and structured communication what went wrong and how to prevent adverse events from occurring again.

  13. Motivational interviewing use

    Motivational interviewing can be used as a clinical communication tool to better understand the motivation behind a patient’s desire to change their behavior (Droppa Lee, 2014).

  14. Motivational interviewing assessment

    When assessing a motivational problem, always consider the patient’s cultural values, their general and health literacy, and their psychosocial needs.

Terms to know

Courtesy
Courtesy refers to the practice of being polite, respectful, and considerate when interacting with patients, their families, and colleagues.
empathy
The term empathy can be defined as the ability for one person to understand and share the feelings of another person.
motivational interviewing (MI)
Nurses may use motivational interviewing (MI), an evidence-based counseling approach that involves discussing feelings and incentives with the patient.
Focusing
Focusing is finding a clear direction and a goal.
Evoking
Evoking is the part of the MI process that helps the patient make the change.
SMART goal
The nurse should discuss with the patient the development of SMART goal, an acronym for goals that are specific, measurable, attainable, relevant, and timely.

Practice questions

Stuck on select-all-that-apply? How to take them one option at a time.

The graded version needs JavaScript. Every question is below anyway, with the answer and why.

Every question here, with the answer

  1. A client who had surgery this morning is reluctant to get out of bed. Which statement by the nurse is an example of clear and concise communication?

    1. Walking is important for healing, but if you would rather rest and have a snack, that is fine too.
    2. Walking after surgery will not hurt at all, so let's get up now.
    3. Are you ready to walk out into the hallway and back?
    4. You should try to walk today to help reduce complications, right now or in an hour after your pain level has decreased.

    Answer: You should try to walk today to help reduce complications, right now or in an hour after your pain level has decreased.

    Clear, concise communication tells the client they should ambulate to reduce post-op complications and gives a specific time frame. Offering the option to skip walking makes the message unclear, promising it will not hurt is nonfactual, and a hallway walk right after surgery is not a practical goal.

  2. A nurse wants a client to walk for the first time after surgery. Which statement reflects practical communication?

    1. Are you ready to try walking around the room?
    2. Are you ready to walk into the hallway?
    3. You can walk whenever you feel like it.
    4. I really hope you feel like walking today.

    Answer: Are you ready to try walking around the room?

    Practical communication sets a goal that fits the client's limitations, such as walking around the room, which builds trust. A hallway walk is not a practical goal right after surgery, the nurse should not speak about their own hopes, and leaving the timing open is unclear.

  3. A client is unconscious and has no family at the bedside. The nurse is concerned that a problem with the client's care has not been addressed. Which element of professional communication is most needed?

    1. Assertiveness
    2. Resolution
    3. Courtesy
    4. Use of names and titles

    Answer: Assertiveness

    An assertive nurse advocates for the client until the concern is addressed and is a necessity for clients who are unconscious or have no advocate. Courtesy and names and titles support the relationship but do not speak up for the client, and resolution refers to communication after adverse events.

  4. A client who had surgery says she understands why pain medication matters but is unsure about taking it. Which approach should the nurse use?

    1. Tell the client she has no choice and give the medication.
    2. Tell the client how the nurse would feel in her place.
    3. Explore the client's ambivalence using motivational interviewing.
    4. Document the refusal and leave the room.

    Answer: Explore the client's ambivalence using motivational interviewing.

    When a client is unsure about pain medication, the nurse explores the ambivalence and can use motivational interviewing. Forcing the medication ignores the client's wishes, leaving does not address the concern, and nurses should refrain from speaking about their own feelings.

  5. A nurse is using motivational interviewing with a client after a heart attack. Which actions reflect this approach? Select all that apply.

    1. Help the client set small, achievable goals.
    2. Tell the client exactly which foods to stop eating, since telling is the best motivator.
    3. Ask open-ended questions about what the client would gain by changing the diet.
    4. Express empathy about the client's current point of view.
    5. Highlight discrepancies between the client's current behavior and goal behavior.

    Answer: Help the client set small, achievable goals., Ask open-ended questions about what the client would gain by changing the diet., Express empathy about the client's current point of view., Highlight discrepancies between the client's current behavior and goal behavior.

    Motivational interviewing uses open-ended questions, empathy, highlighting discrepancies, and small achievable goals during planning. Simply telling the client how to decrease saturated fat is not the best way to motivate them.

  6. A nurse is teaching a client how to take a new medication at home. Which actions will make it more likely that the client understands the directions? Select all that apply.

    1. Supply the information in a way the client readily understands.
    2. Consider the client's health literacy.
    3. Give the teaching only once, verbally, to avoid confusion.
    4. Give the information in several forms, such as verbal and written.
    5. Use technical terms so the teaching is accurate.

    Answer: Supply the information in a way the client readily understands., Consider the client's health literacy., Give the information in several forms, such as verbal and written.

    Clients understand better when the message comes in several forms and in a way they readily understand, and health literacy should be considered. Technical terms and a single verbal explanation make it less likely the client understands and follows the directions.

Where every quote comes from

Section 2.3 Effective Communication of Fundamentals of Nursing by Christy Bowen, Lindsay Draper, Heather Moore, OpenStax, 2024. Read the whole section free at openstax.org.

The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.