Communication skills - with patients

Nurses in every setting frequently communicate in a variety of ways with various individuals. Communication is clearly an important part of the role of the nurse. The Nursing and Midwifery Council’s Code (2018) recommends that, when communicating, nurses should: 

• use terms that people can understand
• take reasonable steps to meet people’s language and communication needs
• use a range of verbal and non-verbal communication methods
• check people’s understanding from time to time
• be able to communicate clearly and effectively in the English language

While communication is often verbal and non-verbal (ie body language) the nurse's role also involves written communication (eg record keeping). 

Effective communication is the transfer of messages between people. When planning to communicate with patients, nurses should consider the information that they are conveying and the aims of the conversation. Given that people have different styles of communication and the special communication needs of some groups, nurses should assess their approach to communication prior to initiating a conversation (Grayer et al, 2021).

As well as considering people’s abilities and communication needs, nurses must consider the message they want to get across, how it may be received and understood. The nurse should:

• consider the information and nature of the message being communicated
• think about how to make the information understandable to the other person
• communicate the message in a way the other person can understand (eg speaking, writing, video)
• consider how to check that the message has been understood

In preparation for having a conversation, the nurse should think about:

• making

There is usually little need for equipment when nurses communicate with patients. Depending on the nature of the conversation, nurses may need to consider having access to:

• a private room
• visual aids (eg videos and images)
• a person to support the patient (usually family or friends)
• an interpreter
• additional written material
• items for comfort (eg a drink and tissues) (Tehrani et al, 2018)

When the nurse is going to initiate a conversation, they must ensure that they:

• make time to focus on the person/people being communicated with
• find the right space to have the conversation - this may mean moving to a more private setting
• give the conversation their full attention - this may mean asking colleagues to cover for and not disturb them

The nurse should think about how they present themselves to the patient and their loved ones. The nurse can consider the SOLER acronym:

• • Sit squarely - the nurse should ensure the patient can always see their face and that they are paying attention
  • Open posture - a good way to show the nurse is being receptive
  • Lean forwards - this shows attentiveness and allows intimacy
  • Eye contact - key to showing someone’s full attention is on the conversation
  • Relaxed body language - says the nurse has the time to

Not adequately preparing for a conversation or communicating ineffectively may mean that the nurse might:

• fail to convey the information clearly
• present the information in the wrong way (eg with a lack cultural or age sensitivities)
• be unprepared for the needs of the recipient (eg language barrier because a translation service was not arranged)
• breach confidentiality, in choosing to have a conversation in the wrong place
• be interrupted (Wanko Keutchafo et al, 2020)

The biggest risk of ineffective communication could be a poor experience of care, which contributes to complaints that the NHS receive from patients (NHS Digital, 2021).

Nurses should develop their communication skills throughout their career by:

• observing colleagues when they communicate with patients
• reflecting on communication
• attending training and continuing professional development activities that cover communication
• inviting feedback on their communication skills

Nursing and Midwifery Council: standards of proficiency for registered nurses

Part 2: Procedures for the planning, provision and management of person-centred nursing care

3. Use evidence-based, best practice approaches for meeting needs for care and support with rest, sleep, comfort and the maintenance of dignity, accurately assessing the person’s capacity for independence and self-care and initiating appropriate interventions

3.4 take appropriate action to ensure privacy and dignity at all times

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NHS Digital. Data on written complaints in the NHS - 2020-21 Quarter 1 and Quarter 2 [NS]. 2021. https://digital.nhs.uk/data-and-information/publications/statistical/data-on-written-complaints-in-the-nhs/2020-21-quarter-1-and-quarter-2 (accessed 25 October 2023)

Nursing and Midwifery Council. The Code. 2018. https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf (accessed 25 October 2023)

Tehrani TH, Maddah SSB, Fallahi-Khoshknab M et al. Respecting the privacy of hospitalized patients: An integrative review. Nursing Ethics. 2018;1:969733018759832 https://doi.org/10.1177/0969733018759832.

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