communication Archives

“All communication must lead to change”- Aristotle

In acting, we learn that words are useless. Words only become effective once humans add purpose to them. The greatest actors understand the power of each word and use that power effectively to change the person they are speaking to. The change can be a perspective of a topic or a perspective about themself. We sometimes use the same words with different meanings or inflections to mean different things. This is the beauty of language and communication.

We conducted a communication survey within our facility to evaluate our current communication methods, strategies, and opportunities. A majority of the respondents voiced that they were “not confident” or “fairly confident” about our internal communication, communication with hostile patients/ family members, and communication to different departments.

With Covid, we realized that nurses are out of practice with communicating with visitors and the routine communication with interdisciplinary staff, most of which was eliminated during Covid.

There are two main types of communication that can be evaluated here: assertive communication and aggressive communication. Assertive communication is standing up for your beliefs, voicing your concerns, and not being afraid to communicate different viewpoints. Assertive communication is essential for leaders as it does not just go with the flow, but uses words effectively to evoke a positive change. Aggressive communication is not normally effective because it downplays other views, does not accept criticism, and has the “I am always right” mentality. Rather than offering suggestion like assertive communication, aggressive communication demands a certain way.

Communication is essential for a healthy work environment and relationship with coworkers. Ensuring that all voices are heard, points are spoken clearly, and evaluating different approaches are all ways to improve current communication modalities. If people have the sense that they have a say, their motivation for change can be greatly improved.

The first time I ever got yelled at by a physician was my first month off of nursing orientation. The patient’s chart was “r/o stroke”. One of the core measures for stroke patients was to provide a handbook and educate them on stroke diagnosis, prevention, and treatment. Apparently, no one had told this patient that we were ruling out a stroke, and as I began my teaching, she got very upset. The physician walked into the room and was flooded with questions from the patient and family about her stroke. The patient was found not to have a stroke, but was not told of any of this. The physician found me in the hallway and immediately starting yelling at me and told me to not tell someone that they have had a stroke. I pointed out on the chart that it clearly stated that they were ruling out a stroke and to provide education. The physician was not even aware of this. I walked back into the patient room and they were appalled by how this doctor had treated me. They ended up leaving AMA because they didn’t want to be in a facility where the doctors treated their nurses like that..

The Chief Medical Officer found me later in the day and told me that the physician actually felt bad for yelling at me because he was having a hard day.

Communication is extremely important in healthcare, however patient surveys often rank this category as in need of improvement. Communicating with doctors can seem intimidating, especially as a new nurse or one who is new to the unit. The best doctors are those who are not only knowledgeable, but personable, make efforts to communicate with nursing staff, allow time for questions, and those who are patient. Unfortunately, many doctors do not act this way. Below are some tips to utilize when contacting the physician.

If you have even a slight feeling that something is wrong, contact the physician. You see them for 12 hours/day. They are only in the room for 20 minutes.
Use SBAR– provide the situation (why are you contacting?), background (labs, dx, hx), assessment (lungs, bowels, VS, etc.), recommendations (what does the patient need?).
Be confident in yourself.
Remember that you do not work for the physician. You work for the hospital.
You are the patient advocate.

Until next shift,

Shania

Communicating for Change

Nurse-physician communication

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