Effective Communication in the Nurse-Patient Relationship

Key points

1. Relationship roles

   For the patient, the relationship is a safe, supportive space for asking questions and expressing needs. For the nurse, it is an invaluable tool for providing compassionate care (ANA, 2023).

2. Professional boundaries protect trust

   Professional boundaries are a way to recenter the patient as the focus of care and prevent violations that could undermine trust and erode the therapeutic relationship (National Council of State Boards of Nursing, 2018).

3. Boundary responsibility

   Establishing and enforcing boundaries is the nurse’s responsibility, not the patient’s. At times, professional boundaries may blur or be challenging to maintain.

4. Therapeutic communication timing

   Effective, therapeutic communication begins as soon as nurses introduce themselves. Throughout the course of providing care, the nurse will evaluate and adjust their communication strategy to ensure that it is effective for the patient.

5. Health literacy and jargon

   All information and teaching provided to the patient must align with their health literacy level. This means not using medical jargon, including acronyms, that may confuse or intimidate a patient.

6. Open-ended assessment questions

   Effective, therapeutic communication also allows the nurse to gather data for clinical decision-making. For example, using open-ended rather than closed questioning helps the nurse gain valuable information from the patient and transition the assessment to the next phase of nursing care..

7. Nonjudgmental self-awareness

   To communicate nonjudgmentally and without bias, the nurse constantly needs to reflect on both their verbal and nonverbal communication with patients. Nurses need to be self-aware and willing to correct their behavior if it’s not contributing to open, effective, and compassionate communication.

8. Nonverbal communication impact

   Body language, facial expressions, eye contact, tone of voice, physical distance, and touch are all facets of nonverbal communication that can either enhance or hinder the nurse-patient relationship.

9. Cultural nonverbal meanings

   Cultural competence is critical to understanding nonverbal communication because different cultures ascribe different meanings to the same gestures, expressions, or social norms and concepts. What may be perceived as respectful in one cultural context could be seen as offensive or inappropriate in another.

10. Active listening focus

    To be an active listener, fully focus on the patient. One way to demonstrate openness to listening is simply looking at them or turning toward them.

11. Nonapproved translators

    The nurse should not use patient family members or nonapproved translators to communicate medical information. While a patient’s family may be trying to help, medical translation is more complex than translating everyday conversation; it requires expertise (Villanueva, 2023).

12. Auditory impairment support

    A patient with total or significant loss of hearing would need approved assistive technology or sign language interpretation to ensure that the questions the nurse needs to ask are heard and understood.

13. Teach-back strategy

    All patients, regardless of their communication needs, benefit from using the teach-back strategy to demonstrate their comprehension of the information the nurse has shared.

14. Team communication models

    Two models of communication health care professionals use with one another are Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) and ISBAR. These two models enhance teamwork, efficacy, and efficiency in communicating about patient care, and thus enhance quality of care.