nursing essays on communication

Understanding Communication in Nursing (With Examples, Importance, & How to Improve)

Communication is one of the most powerful tools nurses use when providing patient care. Because communication can impact every aspect of work and nurse-patient relationships, nurses must learn how to improve communication in nursing and implement measures for effective communication. In this article, you will learn the importance of therapeutic communication and find 18 useful tips to improve communication in nursing.

Who Do Nurses Communicate With?

7 reasons why communication is so important in nursing, 1. effective communication in nursing is essential in assessing a patient’s response to treatment., 2. communication with patients and their loved ones helps relieve stress and improves patient outcomes., 3. effective communication among the healthcare team can help reduce the risk of errors in patient care., 4. effective communication in nursing care is necessary to advocate for patients., 5. communicating with patients and their families will help identify special needs., 6. communication with your patients will help you identify and understand the social determinants impacting their health., 7. effective communication in nursing is vital for understanding the status of your patient's emotional and physical well-being., what are the 8 essential components of good communication in nursing, 1. eye contact:, 2. an attentive listener:, 3. a clear message:, 4. patience:, 5. being receptive:, 6. body language:, 7. understanding:, 8. feedback:, examples of bad communication vs. good communication in nursing, 1. scenario:, bad communication:, good communication:, 2. scenario:, 3. scenario:, 4. scenario:, how to improve communication in nursing, 1. use the right tone when speaking to others., 2. be aware of others’ body language., 3. be mindful of your own body language., 4. show interest in what others say., 5. be patient., 6. demonstrate a positive attitude., 7. create an atmosphere conducive to effective communication., 8. practice active listening., 9. exercise emotional intelligence., 10. ask open-ended questions., 11. be attentive to your patient’s efforts at communicating with you., 12. practice cultural awareness., 13. ask for input from colleagues., 14. be mindful of your patient’s situation., 15. exercise diverse types of communication., 16. incorporate role-play when appropriate., 17. involve your patient’s friends and/or family., 18. show compassion., 7 consequences of bad communication in nursing, 1. miscommunication of vital patient information:, 2. poor communication skills in nursing can cause increased workload pressure., 3. patients may not understand important information such as when to take a medication or possible side effects to report., 4. when there is bad communication in nursing, there is an increased risk to the patient's safety., 5. when nurses communicate poorly with one another, there is an increased risk of malpractice suits., 6. poor patient satisfaction scores:, 7. increased chance of medication errors., useful resources to improve communication in nursing, • the importance of listening in healthcare, • empowering communication, • therapeutic communication, calming people down and dealing with patient complaints, • how can i improve my communication skills with my patients, • communication mishaps between patients and nurses, youtube videos, • nursing fundamentals: therapeutic communication & coping, • nurse to nurse communication skills, • therapeutic communication for nurses: avoid these 5 traps, • nursing standard: inclusive communication and how to avoid making assumptions, • stitcher: healthcare communication- effective techniques for clinicians, • audible: healthcare communication solutions, • therapeutic communication: knowing what to say when, • communication for nurses: how to prevent harmful events and promote patient safety, • 4 essential keys to effective communication, my final thoughts, frequently asked questions answered by our expert, 1. as a nurse, how do i know if i am a good communicator, 2. will lack of communication impact my nursing career, 3. usually, how long does it take for a nurse to improve the skill of therapeutic communication, 4. do all types of nurses require very good communication skills, 5. as a nurse, do i need to be good at all types of communication.

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Mater Sociomed
• v.26(1); 2014 Feb

Communication in Nursing Practice

Lambrini kourkouta.

1 Nursing Department, Technological Educational Institute of Thessaloniki, Greece

Ioanna V. Papathanasiou

2 Nursing Department, Technological Educational Institute of Larissa, Greece

Good communication between nurses and patients is essential for the successful outcome of individualized nursing care of each patient. To achieve this, however, nurses must understand and help their patients, demonstrating courtesy, kindness and sincerity. Also they should devote time to the patient to communicate with the necessary confidentiality, and must not forget that this communication includes persons who surround the sick person, which is why the language of communication should be understood by all those involved in it. Good communication also is not only based on the physical abilities of nurses, but also on education and experience.

1. INTRODUCTION

Nursing as a health care science, focuses on serving the needs of human as a biopsychosocial and spiritual being. Its practice requires not only scientific knowledge, but also interpersonal, intellectual and technical abilities and skills. This means a composition of knowledge, clinical work and interpersonal communication ( 1 ). Communication is a vital element in Nursing in all areas of activity and in all its interventions such as prevention, treatment, therapy, rehabilitation, education and health promotion ( 2 ). The nursing process moreover as a scientific method of exercise and implementation of Nursing, is achieved through dialogue, through interpersonal environment and with specific skills of verbal communication ( 3 ).

As communication we can define the exchange of information, thoughts and feelings among people using speech or other means. Therapeutic practice involves the oral communication of public health officials and nurses on the one hand and the patient or his relatives on the other. It is a two way process. The patient conveys their fears and concerns to their nurse and helps them make a correct nursing diagnosis. The nurse takes the information and in turn transmits other information to the patient with discretion and delicacy as to the nature of the disease and advises with treatment and a rehabilitation plan for health promotion ( 4 ).

Effective communication requires an understanding of the patient and the experiences they express. It requires skills and simultaneously the sincere intention of the nurse to understand what concerns the patient. To understand the patient only is not sufficient but the nurse must also convey the message that he/she is understandable and acceptable. It is a reflection of the knowledge of the participants, the way they think and feel and their capabilities ( 5 ).

In order for the nurses to be successful in their work they have to study communication and interpersonal relations in their education with special courses and internships. They need to learn the various aspects and applications of communication in various fields of nursing ( 6 ). In this context it is understood that emphasis must be placed on the importance of communication between nurse and patient and nursing education must focus on communication skills of nurses.

2. PRINCIPLES OF COMMUNICATION

Communication can be defined as a transaction and message creation. The entire process occurs in a context consisting of physical space, cultural and social values and psychological conditions ( 7 ). Communication assists in the performance of accurate, consistent and easy nursing work, ensuring both the satisfaction of the patient and the protection of the health professional. When health professionals are not trained in communication skills, they face more difficulties separating work from their personal life, tending to transfer problems from one side to the other ( 8 ).

Communication is an intrinsic characteristic of human nature. Nobody cannot communicate. Communication has content and value. The contents regards to what was said, whilst the relationship regards as to how it was said. The nature of the relationship depends on how the two parties understand the communication sequence ( 9 ). Communication is never unidirectional. It is an interaction in which each sender becomes receiver and vice versa. The failure to recognize the two-way communication capability, quite often leads to negative conclusions and attitudes ( 10 ).

Moreover, the message sent is not the same as the message received. The decoding of the messages is based on individual factors and subjective perceptions. This fact, in conjunction with the process of feedback makes communication. We interpret something that we heard not according to what the sender actually said but according to our own code ( 11 ). Particular attention should be given by the caregivers to use technical terms and medical terminology during their contact with the ill, because it is often found that the patient ascribes different interpretations to what he hears or even more cannot understand what is meant exactly, mainly by the therapist, thus increasing mental stress, a fact which makes it more difficult to communicate with the patient ( 12 ).

Communication happens without words. It is an ongoing process. This non-verbal communication is expressed by facial expressions, gestures, posture and physical barriers such as distance from the interlocutor ( 13 ). It is important that there is an agreement between verbal and nonverbal communication. Particularly under stressful conditions where it is difficult to see the changes in the non-verbal messages of the patients with whom we mostly communicate ( 14 ). Moreover, each patient has his own specific characteristics that influence not only behavior in the process of communication, but also if and how to cooperate with nursing services and how they will undertake self-management of health ( 15 ).

Listening is important in communication. It is responsible nursing practice and requires concentration of attention and mobilization of all the senses for the perception of verbal and non-verbal messages emitted by each patient. By listening, nurses assess the situation and the problems of the patient; they enhance his/her self-esteem and integrate both the nursing diagnosis and the process of care at all levels ( 5 ).

Good personal relationships are described as the ability of the nurse to ask questions with kindness and provide information in a way that does not scare, that demonstrates interest, creates feelings of acceptance, trust and a harmonious relationship, especially in modern multicultural society ( 16 ). The therapeutic relationship is an important prerequisite to effective communication between health professionals and patients in order not only to transmit information, but also to effectively address mental processes which are activated by it. The communication between health professionals and patients include the ability to express sincere concern for the care of the patient and the patient becomes a partaker of this interest ( 9 ).

3. SPEAKING WITH THE PATIENT

Communication between health officials-in this case nurses-and patient is a process that begins with the first contact of the two and lasts as long as the therapeutic relationship. The nurse, who wants to create the right relationship with the patient, must win him/her from the first moment. This will happen if the conversation is held in appropriate conditions. Even though it seems obvious, it should be noted that courtesy and kindness on part of the nurse is required ( 4 , 17 ).

The patient should feel comfortable with the nurse, but the latter should protect his/her prestige and not give rise to misunderstandings. A key element is the need for a peaceful environment with no external distractions, which will ensure appropriate confidentiality of the dialogue. Frequently we see the phenomenon of serious discussions taking place in the middle of the corridor of the outpatient department or the nursing department, clinic, or in some office of the hospital, in which third parties unrelated to the care of the individual patient are coming in and out ( 18 ). In such an environment the patients are ashamed to express themselves freely ( 19 ).

Unfortunately, the concept of privacy is pretty much unknown to the Greek hospital system. Skilled nursing operations for the patients are made in chambers without screens or in hallways, in front of others. Patients and visitors of hospitals move without restriction in all the areas of the nursing and clinical departments. However, it is up to us to teach our colleagues and especially the new nurses and their patients setting the right example, in order for things to slowly change for the better ( 20 ).

Even more than the comfort of space, communication with the patient requires ample time. Each patient has his own way and pace to reveal his problem, but it takes some time to get to know the nurses and feel the confidence necessary to face them. The patient should have the feeling that the time-whether it is five minutes or an hour-is entirely his. The patient who has the undivided attention of the nurse reveals his problem sooner, with the satisfaction that the nurse has listened and observed him ( 21 ). After the nurse has listened to the ill, he/she should also talk to him. The language he uses for this purpose is very important. Often the patient is bombarded with big words with little or no significance for him ( 22 ). Once again the nurse may be directed to the ill in an incomprehensible way. Patients that are ashamed of their ignorance or are hesitant, avoid seeking an explanation, and as a result the consultation is inadequate and does not lead to the right outcome for the patient. The language of communication should therefore be at the level of the listener, who is not able to assess our scientific knowledge, but has to understand what we are telling him ( 23 ).

Another important requirement for proper and successful communication between nurses and patients is frankness and honesty. The discussion with the patient should leave no suspicions, doubts and misunderstandings. For example, if the patient suspects that while chatting with him we are making gestures to an escort, he/she will suspect that we are not telling him the whole truth ( 4 ). Where there is a need for a separate and private discussion with someone from the patient’s environment, we should be very careful of the place, manner and time of this communication, which should be independent of the discussion with the patient ( 24 , 25 ).

Communication as already stated is bidirectional, but the nurse or other health professional is responsibility for its proper conduct. The patient comes into the dialogue under stress and the emotional events he/she is facing. Moreover, depending on the psychosynthesis it can be more or less calm. Reactions such as anger, disbelief, moaning, aggression and denial of reality are known defence mechanisms, which are recruited to help him adjust to the new situation he is facing ( 8 , 26 ). The angry patient usually does not have any previous personal differences with health professionals, although they are the direct recipients of his anger. The latter should understand and accept these mechanisms which serve the underlying anxiety of the patient and to respond with information, awareness and readiness to provide all possible assistance ( 27 ).

Finally, people differ in their needs for communication. Some expect or require patient listening, without caring much about the answers. Others want a specific explanation for everything that happens to them. These different needs should be treated accordingly by the nurses, who should be able to detect what each patient wants ( 28 ). What of course in any case should be avoided by the caregivers is silence and indifference to the questions of the patient. In the best cases, the patient will leave disappointed and in the worst really indignant with nurses ( 9 ).

4.CONCLUSIONS

Communication with the patient is an individual part of the ‘long art’ of Hippocratic medicine ( 19 ). It is not only based on an innate ability that varies from person to person, but also on the necessary training and experience that one acquires during exercise ( 13 ). The need also for education in communication has been recognized worldwide ( 6 ). The results of this will be to demonstrate greater understanding among patients with greater benefit to patients and personal satisfaction to nurses in the performance of nursing ( 29 ).

Good communication also improves the quality of care provided to patients, which is observed in the results. Additionally, it is considered an inalienable right and a prerequisite for building a genuine and meaningful relationship between patients and nurses and other health professionals ( 30 ).

So in order for modern Nursing as a service to humans to realize the project, there is a need for dialogue and a good interpersonal climate that develops personally with each sick person, especially in our modern multicultural society. The best expertise training and continuing education of nurses in matters relating to the proper technique of communication will enable them to respond adequately and humanely to the expectations of patients.

CONFLICT OF INTEREST: NONE DECLARED

Effective communication between nurses and patients: an evolutionary concept analysis

Affiliation.

• 1 Student Nurse, University of West London, Brentford.
• PMID: 32881615
• DOI: 10.12968/bjcn.2020.25.9.438

Communication can be considered as the basis of the nurse-patient relationship and is an essential element in building trust and comfort in nursing care. Effective communication is a fundamental but complex concept in nursing practice. This concept analysis aims to clarify effective communication and its impact on patient care using Rodgers's (1989) evolutionary framework of concept analysis. Effective communication between nurses and patients is presented along with surrogate terms, attributes, antecedents, consequences, related concepts and a model case. Effective communication was identified to be a multifactorial concept and defines as a mutual agreement between nurses and patients. This influences the nursing process, clinical reasoning and decision-making. Consequently, promotes high-quality nursing care, positive patient outcome and patient's and nurse's satisfaction of care.

Keywords: Communication; Concept analysis; Nurse-patient relationship; Nursing traits; Trust.

• Communication*
• Models, Nursing
• Nurse's Role
• Nurse-Patient Relations*
• Nursing Process

Effective Communication in Nursing: Theory and Best Practices

According to a 2013 study published in the Journal of Patient Safety , as many as 440,000 people die each year from preventable medical errors, representing the third leading cause of death in the U.S. on the list from the Centers for Disease Control and Prevention (CDC). Of deaths due to medical errors, The Joint Commission estimates that 80 percent involve miscommunication. The Joint Commission’s analysis of 2012, 2013 and first-quarter 2014 data revealed that in all three time frames, communication was one of the top three leading causes of sentinel events, a patient safety event unrelated to the patient’s illness or condition that results in death, permanent harm or another qualifying negative outcome.

Increases in nursing communication can lessen medical errors and make a difference in positive patient outcomes. In a 2014 study published by the New England Journal of Medicine , medical error rates in nine children’s hospitals decreased by 23 percent after a handoff program was instituted to enhance and standardize communication. According to Ros Wright , the body of literature in nursing communication points to “increased recovery rates, a sense of safety and protection, improved levels of patient satisfaction and greater adherence to treatment options” as well-documented results of effective communication.

Communication Theories in Nursing

Multiple communication theories are used in nursing to help explain and guide interactions made between nurses and patients, as well as nurses and other health care professionals.

Peplau’s Interpersonal Relations Theory

This theory focuses on the nurse-client relationship and the therapeutic process that takes place. Communication that occurs in this context involves complex factors such as environment, in addition to attitudes, practices and beliefs in the dominant culture. Peplau’s interpersonal relations theory defines four stages of the relationship that achieve a common goal:

• Orientation Phase : The nurse engages the patient in treatment, and the patient is able to ask questions and receive explanations and information. This stage helps the patient develop trust and is where first impressions about the nurse and health care system begin to evolve.
• Identification Phase : The patient and nurse begin to work together. These interactions provide the basis for understanding, trust and acceptance as the patient becomes an active participant in treatment.
• Exploitation Phase : The patient takes advantage of all services offered, exploiting the nurse-patient relationship to address treatment goals.
• Resolution Phase : As a result of effective communication, the patient’s needs are met, and he or she moves toward full independence. The patient no longer needs help, and the relationship ends.

Dyadic Interpersonal Communication Model

The dyadic interpersonal communication model describes the dynamic interactive process that takes place between two people. Based on a sender and recipient — the encoder and decoder — and outside influences such as perception, attitude, content and the emotional and physical elements, the model points to the many factors that can alter the message or the message’s delivery.

As the sender or encoder provides a message, the recipient, or decoder, must process the information. The dyadic interpersonal communication model highlights the importance of clarity and awareness for the many factors that can affect verbal and nonverbal communication.

Other Theories

A number of other theories in communication and specifically in nursing communication have been used in health care. For instance, Jean Ann Seago notes that “Habermas’ critical theory has been used to identify successful nurse-physician collaborative strategies, including a willingness to move beyond basic information exchange and to challenge distortions and assumptions in the relationships.” Also, Seago mentions theories deriving from Foucault, feminism and the aviation industry to understand and enhance communication. In addition to these types of theories, several others could be named, such as those in experiential communication.

Best Practices in Nursing Communication

In order to help patients and work alongside peers, nurses must consider the skills and tools that are involved in effective communication. From being aware of potential barriers blocking effective communication to utilizing integral communication skills, nurses can take steps toward providing better care.

Barriers to Effective Communication

Nurses who are aware of the common barriers to effective communication will be able to anticipate and properly react to any roadblocks. With this focus, nurses can help ensure optimal communication and patient care.

In "Effective Communication Skills in Nursing Practice," Elain Bramhall highlights common barriers to effective communication for the patient and health care providers. Patient barriers include environmental items such as noise, lack of privacy and lack of control over who is present; fear and anxiety related to being judged, becoming emotional or being weak; and other barriers such as an inability in explaining feelings and attempting to appear strong for someone else’s benefit. Health care professional barriers include environmental items such as lack of time or support, staff conflict and high workload; fear and anxiety related to causing the patient to be distressed by talking or responding to questions; and other barriers such as a lack of skills or strategies for coping with difficult emotions, reactions or questions.

Effective Communication Skills

In the Journal of the Academy of Medical Sciences of Bosnia and Herzegovina , Lambrini Kourkouta and Ioanna Papathanasiou highlight three foundational skills in communication:

• Nonverbal Communication : An “ongoing process … characterized by facial expressions, gestures, posture and physical barriers such as distance from the interlocutor,” nonverbal communication must agree with verbal communication. In stressful moments, Kourkouta and Papathanasiou note, changes in these two communication types can be difficult to assess.
• Listening : An important part of communication, listening is a “responsible nursing practice and requires concentration of attention and mobilization of all the senses for the perception of verbal and nonverbal messages emitted by the patient.” By listening, nurses can be attentive to the patient and integrate care according to the patient’s evolving needs.
• Personal Relationships : Marked by kindness, compassion and care, nurses can develop good personal relationships with the ability to “ask questions with kindness and provide information that does not scare, that demonstrates interest, creates feelings of acceptance, trust and a harmonious relationship, especially in modern multicultural society.” This relationship is connected to not only the transmission of information but also the mental and emotional dynamics found in communication.

Further skills can promote effective communication practices in nurses. Bramhall points out that asking open questions, clarification and screening questions can help keep the focus on the patient. For information giving, providing small amounts of information at a time, checking what information the person knows already and pausing before continuing can help. And for listening, summarizing, paraphrasing, empathizing and making educated guesses can demonstrate that the nurse is listening and able to communicate effectively to patients and other health care professionals.

Developing Crucial Communication Skills

It is no secret that communication skills for nurses are essential and difficult to master — and they require proper attention. “Promoting effective communication in health care is demanding, complex and challenging because of the nature of the work environment, which is often stressful and pressurized, providing little time for communication,” Bramhall writes. “If nurses are to meet these challenges in the future, they need to be supported by high-quality, evidence-based training.”

Through education and employment-sponsored training, nurses can advance communication skills that are crucial to improving as effective health care professionals. At Southeastern University , current nursing professionals can enhance their communication skills with an online RN to BSN degree. The program expands on knowledge and skills nurses need to advance into leadership positions.

• communication

Recent Posts

The Power of Compassion: Building Therapeutic Relationships with Patients

FNU Receives Inclusive Excellence, Belonging, and Sustainability in Nursing Education Award

The Heartbeat of Healthcare: Embracing the Noble Journey of Nursing

Subscribe to email our newsletter.

Home — Essay Samples — Nursing & Health — Nursing — Nursing and Effective Communication

Nursing and Effective Communication

• Categories: Effective Communication Nursing

About this sample

Words: 514 |

Published: Jan 25, 2024

Words: 514 | Page: 1 | 3 min read

Benefits of Effective Communication in Nursing

Works cited.

• Barton, G., Bruce, A., & Schreiber, R. (2018). Teaching nurses teamwork: Integrative review of competency-based team training in nursing education. Nurse education in practice, 32, 129-137.
• Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Material socio-medica, 26(1), 65.
• The Importance of Effective Communication in Nursing (2022). The University Of St. Augustine for Health Sciences. Retrieved from, www.usa.edu/blog/communication-in-nursing/

Cite this Essay

Let us write you an essay from scratch

• 450+ experts on 30 subjects ready to help
• Custom essay delivered in as few as 3 hours

Get high-quality help

Prof. Kifaru

Verified writer

• Expert in: Sociology Nursing & Health

+ 120 experts online

By clicking “Check Writers’ Offers”, you agree to our terms of service and privacy policy . We’ll occasionally send you promo and account related email

No need to pay just yet!

Related Essays

2 pages / 872 words

1 pages / 599 words

2 pages / 988 words

4 pages / 2141 words

Remember! This is just a sample.

You can get your custom paper by one of our expert writers.

121 writers online

Still can’t find what you need?

Browse our vast selection of original essay samples, each expertly formatted and styled

Related Essays on Nursing

When driving around Miami, FL there are a copious number of billboards that I see advertising for people to become nurses throughout the city. When doing research, I’ve only come across a couple of news articles, advertising on [...]

In the ever-evolving landscape of healthcare, the resilient nurse stands as a beacon of unwavering dedication and adaptability. The key phrase, "pinnacle of nursing strength," captures the image of a nurse who has honed their [...]

Clinical learning experiences hold a paramount role in nursing education, serving as a bridge between theoretical knowledge and practical application. This essay explores the essential role of clinical placements in developing [...]

Gagnon, K., & Sabus, C. (2015). Professionalism in a Digital Age: Opportunities and Considerations for Using Social Media in Health Care. Physical Therapy, 95(3), 406–414.Nayak, S. G. (2018). Time Management in Nursing -- Hour [...]

Postpartum hemorrhage is a significant risk in the postpartum period, requiring prompt recognition, assessment, prevention, and management. Nursing care plays a pivotal role in ensuring the well-being of women experiencing [...]

Are you passionate about the field of nursing but have faced obstacles in your journey to becoming a nurse? In this appeal letter essay, we will explore the challenges and setbacks that aspiring nurses may encounter, and the [...]

Related Topics

By clicking “Send”, you agree to our Terms of service and Privacy statement . We will occasionally send you account related emails.

Where do you want us to send this sample?

By clicking “Continue”, you agree to our terms of service and privacy policy.

Be careful. This essay is not unique

This essay was donated by a student and is likely to have been used and submitted before

Download this Sample

Free samples may contain mistakes and not unique parts

Sorry, we could not paraphrase this essay. Our professional writers can rewrite it and get you a unique paper.

Please check your inbox.

We can write you a custom essay that will follow your exact instructions and meet the deadlines. Let's fix your grades together!

Get Your Personalized Essay in 3 Hours or Less!

We use cookies to personalyze your web-site experience. By continuing we’ll assume you board with our cookie policy .

• Instructions Followed To The Letter
• Deadlines Met At Every Stage
• Unique And Plagiarism Free

• Open access
• Published: 16 May 2024

Comparison of barriers to effective nurse-patient communication in COVID-19 and non-COVID-19 wards

• Hamed Bakhshi   ORCID: orcid.org/0009-0008-7865-0149 1 ,
• Mohammad Javad Shariati   ORCID: orcid.org/0009-0000-5518-698X 1 ,
• Mohammad Hasan Basirinezhad   ORCID: orcid.org/0000-0002-3672-556X 2 &
• Hossein Ebrahimi   ORCID: orcid.org/0000-0001-5731-7103 3  

BMC Nursing volume  23 , Article number:  328 ( 2024 ) Cite this article

97 Accesses

Metrics details

Communication is a basic need of humans. Identifying factors that prevent effective nurse-patient communication allows for the better implementation of necessary measures to modify barriers. This study aims to compare the barriers to effective nurse-patient communication from the perspectives of nurses and patients in COVID-19 and non-COVID-19 wards.

Materials and methods

This cross-sectional descriptive study was conducted in 2022. The participants included 200 nurses (by stratified sampling method) and 200 patients (by systematic random sampling) referred to two conveniently selected hospitals in Shahroud, Iran. The inclusion criteria for nurses were considered having at least a bachelor’s degree and a minimum literacy level for patients to complete the questionnaires. Data were collected by the demographic information form and questionnaire with 30 and 15 questions for nurses and patients, which contained similar questions to those for nurses, based on a 5-point Likert scale. Data were analysis using descriptive indices and inferential statistics (Linear regression) in SPSS software version 18.

The high workload of nursing, excessive expectations of patients, and the difficulty of nursing work were identified by nurses as the main communication barriers. From the patients’ viewpoints, the aggressiveness of nurses, the lack of facilities (welfare treatment), and the unsanitary conditions of their rooms were the main communication barriers. The regression model revealed that the mean score of barriers to communication among nurses would decrease to 0.48 for each unit of age increase. Additionally, the patient’s residence explained 2.3% of the nurses’ barriers to communication, meaning that native participants obtained a mean score of 2.83 units less than non-native nurses, and there was no statistically significant difference between the COVID and non-COVID wards.

In this study, the domain of job characteristics was identified by nurses as the major barrier, and patients emphasized factors that were in the domain of individual/social factors. There is a pressing need to pay attention to these barriers to eliminate them through necessary measures by nursing administrators.

Peer Review reports

First observed in Wuhan, China, the COVID-19 pandemic is an acute and very severe respiratory syndrome that the World Health Organization has raised as a health problem because of its high spread rate and consequences on an international scale. The number of COVID-19 patients is increasingly on the rise [ 1 , 2 ]. Illness and hospitalization are usually stressful and associated with bad experiences for patients and their family members [ 3 ].

According to Tabandeh Sadeghi et al. (2011) “Communication is a basic need of humans. Any interaction is an opportunity to achieve effective communication and participation in understanding the issue, which leads to the achievement of mutual goals by individuals.” [ 4 ]. The three important aspects of communication that are emphasized the most are the message’s sender, the receiver, and the environment. Communicating is an interaction between the sender and the receiver of the message, and the environment affects them [ 5 , 6 ]. In the context of a hospital, these three aspects of communication can be defined as nurse, patient, and hospital environment, and all three should be considered when examining the obstacles [ 7 ]. “According to Ali Fakhr Movahedi et al. (2012)” Communication is considered a central concept in nursing and an essential part of nursing work [ 8 ]. Patients perceive interaction with nurses as the basis of their treatment [ 9 ]. Nurse-patient communication is an interpersonal process that is created between these two groups during treatment. This process generally includes the start, work, and end stages. Effective communication is an essential aspect of patient care by nurses, and many nursing tasks cannot be performed without this activity [ 10 ]. Effective communication consists of explicit transmission and receipt of message content, in which information is consciously and unconsciously produced by a person and communicated to the recipient through verbal and non-verbal patterns [ 11 ]. The non-verbal aspect of communication plays an essential role and is more important than the verbal aspect of language in emergencies. The mandatory use of face masks during the COVID-19 pandemic negatively influenced nurse-patient communication, notably because this tool significantly reduced the messages arising from non-verbal communication channels [ 12 ]. In this regard, Vitale et al. investigated wearing face masks as a communication barrier between nurses and patients. The results showed no differences in the patients’ opinions before and during the COVID-19 pandemic; patients believed that the mask was not a communication barrier, while nurses thought that wearing masks was a communication barrier [ 12 ]. Unfavorable communication can hamper the patient’s recovery and may even permanently deprive the patient of health or life.

In comparison, good communication affects the patient’s recovery more than medication. In fact, nurses will succeed in their tasks when they can communicate well with their patients [ 13 ]. Effective communication can affect pain control, adherence to a treatment regimen, and the patient’s mental health and play an important role in reducing the patient’s anxiety and fear and faster recovery [ 14 ]. During good communication, patients can disclose and express sensitive and personal information. Consequently, nurses can also transfer necessary information, attitudes, or skills [ 4 ]. Identifying factors that prevent effective nurse-patient communication allows for the better implementation of measures required to adjust obstacles [ 15 ].

The first published reports of the deaths of coronavirus-infected doctors during caring for patients indicate that the virus transmission to healthcare workers in healthcare centers is a hazardous issue [ 16 , 17 ]. Under these stressful conditions, nurses must manage long shift hours and the fear of contagion and overcome communication difficulties through layers of personal protective equipment. These problems may disrupt communication with patients and cause less focus of health workers on the psychosocial well-being of patients [ 18 , 19 ]. Baillie states that the lack of time is a clear barrier to communication between emergency nurses and patients [ 20 ]. Meehan et al. also reported that nurses mentioned the lack of time, fatigue, and workload of personnel to be the factors preventing nurse-patient interaction. In the same research, patients cited the issue of gender as a factor preventing their interaction with nurses. However, male and female patients had difficulty communicating with male nurses [ 21 ].

Identifying factors that prevent effective nurse-patient communication makes it possible to elucidate the direction of necessary measures for the planners and executives of the health sector to eliminate or modify barriers. In particular, when these barriers are identified and expressed with a realistic approach, i.e., from nurses’ and patients’ perspectives [ 22 ]. Before this, no study compared barriers to nurse-patient communication in COVID and non-COVID wards. Therefore, this research aims to compare the barriers to effective nurse-patient communication from nurses’ and patients’ perspectives in COVID-19 and NON-COVID-19 wards. Hopefully, identifying these obstacles and planning to solve them as soon as possible will make us have nurses in the future who can communicate well with patients and improve service delivery.

Study design

This cross-sectional descriptive research was conducted on 200 nurses and 200 patients at hospitals affiliated with the Shahroud University of Medical Sciences. The participants included nurses and patients from different wards of two conveniently selected hospitals in Shahroud. To sample nurses by the stratified method, the sample size was first divided by the total number of nurses in the mentioned hospitals to obtain the sampling fraction. According to Mohammadi et al. study, standard deviations reported for all subscales for barrier’s to effective communication (individual/social factors = 6.22), job characteristics = 6.74, patient’s clinical conditions = 4.22), and environmental factors = 9.09) were utilized to estimate the sample size [ 23 ]. Estimation error was considered 0.15 of standard deviation values. The confidence levels and power were considered at 0.95 and 0.8 respectively with a 15% dropout probability. Also, another sample size was calculated similarly using the standard deviation reported in Norouzinia et al. study for patient’s questionnaire equal to 1.96 [ 24 ]. Finally, among the estimated values; the largest number (200) was considered as the sample size of the present study for nurses and patients.

Considering that the total number of nurses is around 700 and the sample size calculated by the statistics consultant is 200 nurses, our sampling fraction was calculated as \(\frac{2}{7}\) . Therefore, \(\frac{2}{7}\) personnel of each department were included in the study. The patients were sampled by a systematically random method using the hospital list, file number, and dates of admission and discharge. The inclusion criteria for nurses were a bachelor’s degree or higher and a minimum literacy level for patients to complete the questionnaire. Moreover, the questionnaire contained questions about the nurses’ work experience or no experience in COVID-19 wards. The duration of working in COVID-19 wards was included in the questionnaire questions, and the duration was considered in the analysis. Data were collected using a questionnaire provided to the nurses through daily visits to various wards of the mentioned hospitals, including emergency, surgery, special care, internal medicine, gastroenterology, cardiology, urology, orthopedics, ICU, CCU, and other wards. The questionnaire was also provided to the patients hospitalized in surgery, special care, internal medicine, gastroenterology, cardiology, urology, ICU, and CCU wards, among others. Due to the reduced coronavirus spread during that period, the information on COVID-19 patients was accessed using hospital information by obtaining permission, and the questionnaire was completed through phone calls.

Measurements

Demographic information form.

It contained questions about information related to age, gender, marital status, language, and residence.

Communication barrier questionnaire

The barriers to effective nurse-patient communication were investigated using the same questionnaire designed by Anoosheh et al. This questionnaire contains 30 items for nurses and aims to evaluate nurses’ views about the barriers to effective nurse-patient communication. The response of this questionnaire is in the Likert range (completely false = 1, false = 2, I have no opinion = 3, agree = 4, and completely agree = 5). The nurses’ questionnaire contains four dimensions, and the question numbers of each dimension include individual/social factors (1–8), occupational characteristics (9–17), patient’s clinical conditions (18–21), and environmental factors (22–30). The domain of individual/social factors includes questions such as the gender difference between the patient and the nurse, age difference, aggressiveness of nurses, etc. The domain of job characteristics includes questions about the high workload of nursing, the difficulty of nursing work, the low salaries of nurses, etc. The domain of the patient’s clinical condition also includes questions such as the severity of the disease, the presence of the patient’s companion, etc. The domain of environmental factors: where communication occurs is important. The nurse and the patient should feel calm and safe in the treatment environment. This domain also includes questions such as the Lack of facilities (welfare - treatment) for patients, the unsanitary condition of the patient’s room, the High cost of treating patients, etc. A pilot study was carried out to assess the face validity among nurses. In addition, the content validity was assessed by estimation of content validity ratio and content validity index among nursing educators. The internal consistency for the present questionnaire assessed by Cronbach’s alpha coefficient equal to 0.96 [ 25 ].

The patient questionnaire contains 15 questions and aims to evaluate the patients’ views about the barriers to effective nurse-patient communication. The response of this questionnaire is in the Likert range (completely false = 1, false = 2, I have no opinion = 3, agree = 4, and completely agree = 5). No separate dimension was considered for the patient questionnaire. The reliability based on internal consistency was reported using Cronbach’s alpha equal to 0.91 [ 25 ]. The total score of the questionnaire is obtained by summing up the total scores of all questions. The score of each dimension is obtained from the sum of scores for each question of that dimension. Higher scores in each dimension indicate the greater strength of that dimension as a barrier to effective nurse-patient communication and vice versa. After completing the communication barrier questionnaire, a separate question was asked from the patients and nurses about whether or not the face mask was a communication barrier. This question was scored with a Likert scale (completely false = 1, false = 2, I have no opinion = 3, agree = 4, and completely agree = 5). The score of this question was measured separately from the nurse-patient communication barrier questionnaire.

Ethical considerations

Initially, necessary permissions were obtained from the Vice Chancellor of Research and Technology and the Research Ethics Council (code of ethics: IR.SHMU.REC.1401.140) at the Shahroud University of Medical Sciences. Necessary coordination was also made with the administrators of two conveniently selected hospitals in Shahroud. After explaining the purpose of the research and answering the questions of nurses and patients regarding the questionnaire and how to complete them, enough time was given to answer them.

Statistical analysis

Data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential tests (Linear regression) in SPSS software version 18. All variables with a significance level of less than 0.2 are included in the final regression model. A significance level of 0.05 was considered. Considering that one of the purposes of this study is to determine the barriers to effective nurse-patient communication based on demographic information, three participants were excluded from the data analysis due to a lack of demographic information completion.

The average ages of nurses and patients were respectively 33.28 and 38.57 years, and most nurses (85.3%) and patients (61.5%) were females and males, respectively. Other demographic characteristics are listed in Table  1 .

In this study, the mean score obtained for each domain of the barriers to nurse-patient communication was determined from the nurses’ point of view. According to these results, the highest score with an average of 32.41 ± 6.75 related to the domain of job characteristics, and the lowest score with an average of 11.76 ± 3.17 related to the domain of Patient’s Clinical Conditions. Additional information is presented in Table  2 .

The excessive patients’ expectations in the domain of individual/social factors, the high workload of nursing in the domain of job characteristics, the severity of the disease in the domain of the patient’s clinical conditions, and no appreciation for nurses by authorities in the domain of environmental factors were the major communication barriers. The patient-nurse age difference from the domain of individual/social factors, the patient’s contact with multiple nurses with different attitudes from the domain of job characteristics, previous hospitalization history from the domain of the patient’s clinical conditions, and the high cost of patient treatment from the domain of environmental factors were the least important barriers to communication from the nurses’ viewpoints. From the patients’ views, the aggressiveness of nurses and the patient-nurse age difference were the major and the minor barriers to communication, respectively. Face masks were among the minor barriers to nurse-patient communication from the viewpoints of both groups (Table  3 ); this table is placed at the end of the article.

The relationship between nurses’ age and communication barriers was investigated using a regression model. This model was first run as a univariate type, and variables with a significance of < 0.2 were introduced into a multivariate model using the backward method. Finally, the model showed that the nurses’ age variable explained 3.8% of the score variance. In other words, the regression model revealed that the mean score of nurses would decrease to 0.486 for each year of age increase, and there is no statistically significant difference between the COVID and non-COVID wards (Table  4 ).

Additionally, the patient’s residence variable explained 2.3% of the score variance, meaning that native people obtained a mean score of 2.813 units less than non-native people, and there is no statistically significant difference between the COVID and non-COVID wards (Table  5 ).

The present study aimed to determine the barriers to effective nurse-patient communication from the viewpoints of nurses and patients in COVID-19 and non-COVID-19 wards in hospitals affiliated with the Shahroud University of Medical Sciences. The results of this study showed that in the domains of barriers to effective communication, nurses reported the highest score in job characteristics and the lowest score in the patient’s clinical conditions. In a study on nursing students at Urmia Midwifery School of Nursing, Habibzadeh et al. (2017) reported the highest and the lowest mean scores for questions related to occupational characteristics and the patient’s clinical conditions [ 26 ], which corresponds to our results. Work congestion conditions increase the work pressure of nurses, leading to fatigue, a situation in which nurses lack enough time to discover the patient’s concerns [ 27 ]. Stress and pressure caused by time constraints often result in miscommunication and reduce the satisfaction of nurses and patients [ 28 ].

The results of this study showed that the high workload of nursing and excessive expectations of patients are mentioned as two major obstacles to effective communication with patients from the point of view of nurses. Anoushe et al. (2015) and Baraz Pordanjani et al. (2016) investigated barriers to effective nurse-patient communication. They reported that nurses identify their workload as a major barrier to effective patient communication [ 15 , 22 ]. However, Habibzadeh et al. (2017) claimed that nurses’ lack of information and skills in patient communication was identified as the main communication barrier [ 26 ]. A possible reason for this discrepancy might be that the current study was conducted during the COVID-19 pandemic, concurrent with the increased workload of nurses compared to the pre-pandemic period.

The difficulty of nursing work, the psychophysical fatigue of nurses, the lack of comfort facilities for nurses, and no appreciation for nurses by administrators are in the next ranks of importance. Similarly, Anoushe et al. (2005) reported the difficulty of nursing work, the lack of comfort facilities for nurses, and psychophysical fatigue among the barriers with more emphasis by nurses [ 22 ]. The notable point is that nurses do not have the opportunity to establish effective communication with patients due to their workload. Furthermore, their work type is hard and tiring, and they do not receive proper benefits or appreciation. In such a situation, one cannot expect good nurse-patient communication, and the conditions affect patients’ moods. As expressed by the patients, this issue also negatively affects the quality of their relationships with patients [ 15 ].

The aggressiveness of nurses mentioned as the main obstacle to effective communication with patients from the patients’ point of view. Likewise, Baraz Pordanjani et al. (2009) found a statistically significant difference between the aggressiveness of nurses from the perspectives of nurses and patients [ 15 ].

Regarding the communication barriers from the patient’s perspective, the lack of facilities (welfare treatment) for them and the unsanitary condition of their rooms were among the factors more emphasized by patients than by the nurses. Interestingly, Baraz Pordanjani et al. observed that nurses believed more than patients that the lack of comfort facilities for patients and the unsanitary condition of their rooms would hinder effective communication [ 15 ]. This contradictory result can result from the difference in facilities and health/treatment conditions of the studied hospitals.

The viewpoints of both nurse and patient groups show that age and class differences do not negatively influence their relationships. Since nurses are responsible for initiating and maintaining communication with patients, it can be claimed that they perform their professional tasks, including communication establishment, regardless of the social class and age of patients, who also acknowledge this issue.

The face mask also obtained a low score from the viewpoints of patients and nurses. Vitale et al. investigated the use of face masks as a communication barrier between nurses and patients. The results indicated no difference in the patients’ opinions before and during the COVID-19 pandemic; that is, patients did not consider the mask a communication barrier, which is consistent with the present study. However, nurses thought that using a mask would be a communication barrier [ 12 ].

The present results revealed a significant relationship between the age of nurses and the barriers to effective nurse-patient communication; as such, the total score of nurses decreased for each year of age increase; However, no statistically significant difference was observed in the comparison of COVID and non-COVID wards. In this regard, Gopichandran et al. (2021) aimed to determine communication barriers between doctors and patients during the COVID-19 pandemic in India. They claimed that communication barriers decreased with age [ 29 ]. Nurses gain more experience and skills with rising age. Enough experience is also a characteristic that patients consider necessary for nursing work [ 30 ]. “According to Aram Feizi et al. (2006)” Mark (2001) concluded that the experience of the nursing unit could create satisfaction in both nurses and patients [ 30 ]. The possible reason for obtaining different results could be that the COVID-19 vaccination process was carried out slowly in Iran. For this reason, the nurses, both in the COVID and non-COVID wards, considered all patients with unique viewpoints (all of the patients considered potential cases of COVID-19). For this reason, there was no statistical difference between the communication barriers of the COVID and non-COVID departments.

No statistically significant difference was observed between the scores of male and female nurses and the barriers to effective nurse-patient communication. Unlike this result, Mohammadi et al. (2013) reported a significant difference between job characteristics, patients’ clinical conditions, environmental factors, and the gender of nurses [ 23 ]. The discrepant results might be caused by the heterogeneous distribution of participants in terms of gender, as 56% of the nurses were male in the study of Mohammadi et al. In comparison, less than 20% of the participants were male nurses in the present study.

The present results showed that the patients’ residence was significantly related to the barriers to effective nurse-patient communication, and native people obtained a lower mean score than non-native people: However, there was no any no significant difference between COVID and NON-COVID wards This result might be because nurses are more informed of the accents and dialects of native patients. Caring for patients speaking different languages and accents can lead to problems in the quantity and quality of nurse-patient communication. When patients and caregivers have different cultural values and languages, communication can cause the inability to exchange information [ 27 ]. Tilki and Okoughan presented evidence that differences in spoken language could hinder effective communication [ 31 ]. On the other hand, the results of the study by Vitale et al. showed that there was no difference between the patients before and during the covid-19 pandemic, which is consistent with the results of the present study [ 12 ].

Limitations

Among the limitations of this study, we can mention the low response rate by nurses and patients, which was completed with the continuous presence of the researcher. Since this research is conducted only in public medical centers affiliated to Shahroud University of Medical Sciences, the results may not be generalizable to centers affiliated with other universities of medical sciences in Iran and non-academic centers such as private medical centers. It is recommended that future research be conducted in larger settings.

This study demonstrated that nurses identified the domain of job characteristics as the most critical barrier among the four domains of barriers to effective nurse-patient communication. Patients more emphasized factors that were in the domain of individual/social factors. There is a pressing need to pay attention to these barriers to eliminate them through necessary measures by nursing officials. Hopefully, the elimination of these barriers in the future will lead to nurses who can communicate well with patients and improve service delivery.

Implications

This research helps to identify barriers to effective communication between nurses and patients. In the field of policy and management, the results of this research can help to plan for effective nurse-patient communication. In the field of education, according to the results of this article, necessary training should be given to nurses and patients regarding communication barriers to help improve communication. There will be a basis for further, more comprehensive research in the field of research. Hopefully, these results can help nursing officials and nurses remove communication barriers and improve service delivery.

Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, et al. Cardiovascular considerations for patients, Health Care Workers, and Health systems during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75(18):2352–71.

Article   CAS   PubMed   PubMed Central   Google Scholar  

WHO. Coronavirus disease (COVID-19). Situation Report– 161. 2020.[cited 2020 June 29] https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200629-covid-19-sitrep-161.pdf?sfvrsn=74fde64e_2 .

Sheldon LK, Barrett R, Ellington L. Difficult communication in nursing. J Nurs Scholarsh. 2006;38(2):141–7.

Article   PubMed   Google Scholar  

Sadeghi T, Dehghan Nayyeri N, Karimi R. Nursing-patient relationship: a comparison between nurses and adolescents perceptions. Iran J Med Ethics History Med. 2011;4(3):69–78.

Google Scholar  

Caris-Verhallen WM, De Gruijter IM, Kerkstra A, Bensing JM. Factors related to nurse communication with elderly people. J Adv Nurs. 1999;30(5):1106–17.

Article   CAS   PubMed   Google Scholar  

Kopp P. Better communication with older patients. Professional nurse (London, England). 2001;16(8):1296-9.

Aghamolaei T, Hasani L. Communication barriers among nurses and elderly patients. Hormozgan Med J. 2011;14(4):312–8.

Fakhr-Movahedi A, Negarandeh R, Salsali M. Exploring nurse-patient communication strategies. J Hayat. 2013;18(4):28–46.

Kettunen T, Poskiparta M, Gerlander M. Nurse-patient power relationship: preliminary evidence of patients’ power messages. Patient Educ Couns. 2002;47(2):101–13.

Hagerty BM, Patusky KL. Reconceptualizing the nurse-patient relationship. J Nurs Scholarsh. 2003;35(2):145–50.

Clancy CM, Farquhar MB, Sharp BA. Patient safety in nursing practice. J Nurs Care Qual. 2005;20(3):193–7.

Vitale E, Giammarinaro MP, Lupo R, Archetta V, Fortunato RS, Caldararo C, et al. The quality of patient-nurse communication perceived before and during the COVID-19 pandemic: an Italian pilot study. Acta Biomed. 2021;92(S2):e2021035.

CAS   PubMed   PubMed Central   Google Scholar  

Jan Mohamady S, Salami S, Abasi Marei F, Masror D, Nazary Jobrany M. F J. Civilization and Nursing.Tehran: Publication Salemi2002. 107-9 p.

Maskor NA, Krauss SE, Muhamad M, Nik Mahmood NH. Communication competencies of oncology nurses in Malaysia. Asian Pac J Cancer Prev. 2013;14(1):153–8.

Baraz Pordanjani S, Shariati A, Alijani H, Moein Mosavi B. Assessing barriers of nurse-patient’s effective communication in educational hospitals of Ahwaz. Iran J Nurs Res. 2010;5(16):45–52.

Bowdle A, Munoz-Price LS. Preventing infection of patients and Healthcare workers should be the New Normal in the era of Novel Coronavirus Epidemics. Anesthesiology. 2020;132(6):1292–5.

Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth. 2020;67(5):568–76.

Fritzsche K, Scheib P, Ko N, Wirsching M, Kuhnert A, Hick J, et al. Results of a psychosomatic training program in China, Vietnam and Laos: successful cross-cultural transfer of a postgraduate training program for medical doctors. Biopsychosoc Med. 2012;6(1):17.

Article   PubMed   PubMed Central   Google Scholar  

Eltaybani S, Igarashi A, Cal A, Lai CK, Carrasco C, Sari DW et al. Long-term care facilities’ response to the COVID‐19 pandemic: An international, cross‐sectional survey. J Adv Nurs. 2023.

Baillie L. An exploration of nurse-patient relationships in accident and emergency. Accid Emerg Nurs. 2005;13(1):9–14.

Cleary M, Edwards C, Meehan T. Factors influencing nurse–patient interaction in the acute psychiatric setting: an exploratory investigation. Aust N Z J Mental Health Nurs. 1999;8(3):109–16.

Article   CAS   Google Scholar  

Anoosheh M, Zarkhah S. Investigating barriers to effective nurse-patient communication. Teb Tazkie. 2006;15(2):49–57.

Mohammadi I, Mozafari M, Beigi EJ, Kaikhavani S. Barriers to effective nurse- patient communication from perspective of nurses employed in Educational hospitals of Ilam. J Neyshabur Univ Med Sci. 2015;2(3):20–7.

Norouzinia R, Aghabarari M, Shiri M, Karimi M, Samami E. Communication barriers perceived by nurses and patients. Glob J Health Sci. 2015;8(6):65–74.

Anoosheh M, Zarkhah S, Faghihzadeh S, Vaismoradi M. Nurse-patient communication barriers in Iranian nursing. Int Nurs Rev. 2009;56(2):243–9.

Habibzadeh H, Dehgannejad J, Hoseinzadeghan F, Bafandehzendeh M. Barriers to establishing Effective Communication between Nurse and Patient according to nursing students’ viewpoints Urmia nursing and midwifery Faculty. Nurs Midwifery J. 2019;17(9):696–704.

Mazhariazad F, Taghadosi M, Erami E. Challenges of nurse-patient communication in Iran: a review study. Sci J Nurs Midwifery Paramedical Fac. 2019;4(4):15–29.

Jahromi MK, Ramezanli S. Evaluation of barriers contributing in the demonstration of an effective nurse-patient communication in educational hospitals of Jahrom, 2014. Global J Health Sci. 2014;6(6):54.

Gopichandran V, Sakthivel K. Doctor-patient communication and trust in doctors during COVID 19 times-A cross sectional study in Chennai, India. PLoS ONE. 2021;16(6):e0253497.

Feizi A, Mohammadi R, Nikravesh M. Factors causing patient’s Trust in Nurse from patients’ perspective. Razi J Med Sci. 2006;13(52):177–87.

Okougha M, Tilki M. Experience of overseas nurses: the potential for misunderstanding. Br J Nurs. 2010;19(2):102–6.

Download references

Acknowledgements

The present study is a research project approved under the number 14010048 at Shahroud University of Medical Sciences. The researchers are grateful to the Vice Chancellor of Research and Technology at Shahroud University of Medical Sciences for the necessary financial support of the present study and the participating nurses and patients.

No funding.

Author information

Authors and affiliations.

Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran

Hamed Bakhshi & Mohammad Javad Shariati

Department of Epidemiology and Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Mohammad Hasan Basirinezhad

Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran

Hossein Ebrahimi

You can also search for this author in PubMed   Google Scholar

Contributions

All authors contributed to the writing of the article: design and writing of the article (HB, HE), data collection (HB, MS), analysis and interpretation of data (HB, MB), final approval of the submitted version (HE, HB).

Corresponding author

Correspondence to Hossein Ebrahimi .

Ethics declarations

Ethics approval and consent to participate.

In order to observe ethical considerations, after explaining the study objectives and method to nurses and patients, written informed consent was obtained from them. It should be noted that the principles of the Helsinki Declaration, including the right to enter the research freely, no harm or loss to participants, maintaining the right to withdraw from the study, and confidentiality of information, were observed in this study. Besides, the researchers committed themselves to adhering to the principles of the Committee on Publication Ethics (COPE) set out for the publication of the results. This cross-sectional study was approved by the ethics committee of Shahroud University of Medical Sciences with the registration number: IR.SHMU.REC.1401.140.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Bakhshi, H., Shariati, M., Basirinezhad, M. et al. Comparison of barriers to effective nurse-patient communication in COVID-19 and non-COVID-19 wards. BMC Nurs 23 , 328 (2024). https://doi.org/10.1186/s12912-024-01947-4

Download citation

Received : 05 August 2023

Accepted : 18 April 2024

Published : 16 May 2024

DOI : https://doi.org/10.1186/s12912-024-01947-4

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Communication barriers
• Communication
• Nurse–patient communication

BMC Nursing

ISSN: 1472-6955

• General enquiries: [email protected]

Advocacy and Communication Strategies in Nursing Essay

Introduction, communication strategies, nmc safeguarding film, reference list.

Among nurses and midwives’ duties, there is one that relates to the responsibility of speaking on behalf of patients. The NMC has created a set of videos intending to promote advocacy for patient’s health, specifically to ensure that healthcare professionals report abuse and other types of mistreatment of vulnerable patients. These films support the standards that NMC outlines in its Code of Conduct for Nurses ( The code of conduct, no date; NMC, 2015). This paper will review healthcare advocacy using relevant theories and address potential communication strategies.

NMC’s code of ethics outlines the standards of work that each nurse or midwife practising in the United Kingdom must adhere to daily. The NMC’s (2015, p. 6) first standard is as follows: nurses must ‘treat people as individuals and uphold their dignity. In the NMC’s first scenario, the man’s dignity is compromised since he continuously asks to give him glasses, and all nurses ignore his requests. Hence, the first scene shows that the standards set out by NMC are not met in some care facilities.

The importance of being aware of the need for advocacy within relationships in health care is linked to the patients not always communicating their needs clearly and effectively (Barr and Gates, 2029; Jackson, Gettings and Metcalfe, 2018). Hence, nurses have to recognise these issues and address them since they spend a lot of time caring for patients and communicating with them, which allows them to assess the latter’s needs (Nsiah, Siakwa and Ninnoni, 2019; Prestia and Dyess, 2020).

Regis College ( no date ) defines an advocate as an individual who speaks on behalf of the vulnerable people, whose voices and opinions may be lost due to bureaucracy or other issues. Consequently, a nurse advocate is a professional who observes and listens to ensure that all patients’ needs are met, including psychological. Nursing advocacy is not a novel concept, and it is integral to the job position. As part of the third principle by NMC (2015, p. 7), nurses have to assess patients’ physiological and psychological needs and ‘act as an advocate for the vulnerable, challenging poor practise and discriminatory attitudes and behaviour relating to their care’.

As becomes evident from the NMC film, there is still an issue with nurses failing to fulfil their advocacy role. In a discussion article by Nursing Times, Smith and Lee (2017) argue that nurses are often afraid to advocate for their patients since it requires them to challenge others. For example, in the NMC’s first scenario, one of the nurses would have to confront the others about ignoring his request to ensure that he receives his glasses now and will be heard in the future. This confrontation can lead to conflict and stress, which humans naturally tend to avoid. As a result, nurses, who often work with and support vulnerable populations, such as older adults or disabled individuals, often fail to fulfil their role as advocates.

Evidently, to be advocates, nurses have to possess not only excellent knowledge of medicine but also leadership qualities. Regis College ( no date ) outlines leadership, communication, decision-making skills and negotiation capabilities as a necessity to support nurse advocacy. These skills are necessary because they allow nurses to follow through with identifying the problem, voicing it and collaborating with other teams to resolve it.

Advocacy may relate to the day to day work of nurses, such as helping an elderly patient find his glasses, or it may concern systematic problems within the healthcare continuum. According to Regis College ( no date ), nurses can advocate within their medical facility, legal system or families. Hence, a nurse can raise the question of understaffing the elderly care facilities, which leads to neglect and improper care to advocate for policy changes to ensure that the issue faced by the older man can be avoided in the future.

Communication and advocacy are linked since without being able to listen and voice the advocacy issue effectively, and a nurse will be unable to resolve a problem (Abbasinia, Ahmadi and Kazemnejad, 2020). A range of communication strategies can enable the development of therapeutic relationships and help support the values and attitudes of patients. Active negation and advocacy on behalf of people to ensure equal access to care and support are possible if a nurse can effectively understand how the environment and the sender-receiver relationship affects the therapeutic relationship ( Communication theory and its applications in nursing and healthcare, no date ).

There are several theories of communication applicable to the nursing profession. One of them is Peplau’s Interpersonal Relationships Theory, which takes into account the environment, attitudes and beliefs shaped by a person’s culture as the factors that influence the nurse-client relationship (Blaszko Helming et al., 2021; Thomas, 2019). Hence, according to this approach, nurses should understand the complex factors that impact their communication with a patient. For example, in the NMC film, the patient is an older man who states that he does not want to burden anyone ( If you don’t do something… NMC, 2017). However, his basic needs are overlooked since he repeatedly asks for glasses and does not receive them.

Following Peplau’s theory, one can assume that nurses in this care facility overlook the fact that older adults are burdened by negative feelings and do not want to trouble others, which may prompt them to overlook some of their needs or not state them clearly. Peplau developed three nurse-client communication stages: orientation, identification, exploitation and resolution (Brown et al. ; Thomas, 2019; Sundqvist, 2018). If the nurses assessed the man’s needs during the orientation phase, mainly because he has bad eyesight and needs glasses to perform his daily activities, it would be easier for them to understand his needs during the identification and subsequent phases. Therefore, Peplau’s theory is one example of how communication and advocacy are linked because, without adequate identification of needs, nurses may fail to advocate for their patients.

NMC’s film under review is about using three scenarios that healthcare professionals may face in their practice. The first scenario is about an older adult placed in a care facility who faces neglect from the staff ( If you don’t do something… NMC, 2017). The communication strategy used by NMC in its Safeguarding film is negative because this approach helps support the urgency of the advocacy problem and show the distress the patient feels if his needs are unmet (Bola-Arotiowa, 2020; Peate, 2019). The main messaged is ‘If you don’t do something, who will?’, which aims to encouraged people to report cases of abuse and mistreatment.

The NMC’s film is an example of a negative communication strategy, and it shows the negative effect that neglect and mistreatment have on an elderly patient. This video shows a patient in distress, and the goal is to show the nurses, who are the target audience, the negative effect that neglect has on the individuals in care facilities. Hence, the negative communication strategy is justified here because the mental health consequences of neglect are severe, and it is vital for NMC to highlight this problem. If a positive communication strategy was chosen, the NMC could show a happy elderly patient in a care facility, who communicates with the staff and receives adequate care, but the message of this campaign ‘If you don’t do something, who will?’ would be perceived as less serious ( If you don’t do something… NMC, 2017).

In summary, this paper assesses the importance of nurse advocacy and communication strategies using a case study scenario by NMC. In the first part of the video by NMC, a man in an elderly care facility asks for glasses, but nurses ignore his needs. From an advocacy viewpoint, this is a severe violation of the NMC’s standards of practice, which require nurses to assess and advocate for their patient’s needs, both physiological and psychological. This video is an example of a negative communication strategy, which is used to emphasise the message of the campaign. Hence, the NMC’s scenario supports advocacy by showing a common issue in an elderly care facility and emphasising the distress that the patient feels. Moreover, this film shows the importance of the potential need to be aware of advocacy issues as patients do not always explain or justify their needs. Peplau’s theory of communication offers four steps of communication and can be used to develop a therapeutic relationship, values and attitudes.

Abbasinia, M., Ahmadi, F. and Kazemnejad, A. (2020) ‘Patient advocacy in nursing: concept analysis’, Nursing Ethics , 27(1), pp. 141–151.

Bola-Arotiowa, O. (2021) ‘Patient advocacy: a skill students can learn and practise before qualification’, British Journal of Nursing, 28(12), pp. 20-23.

Barr, O. and Gates, B. (eds.) (2018) Oxford handbook of learning and intellectual disability nursing. 2nd edn. Oxford: Oxford University Press.

Blaszko Helming, M. A., et al. (eds.) (2021) Dossey & Keegan’s holistic nursing: a handbook for practice . (8th edn.). Burlington, Massachusetts: Jones & Bartlett Learning.

Brown, D. et al . (eds.) (2021) Lewis’s medical-surgical nursing eBook . Chatswood, Australia: Elsevier.

The code of conduct ( no date ) Web.

Communication theory and its applications in nursing and healthcare ( no date) Web.

If you don’t do something… NMC (2017) Web.

Jackson, J., Gettings, S. and Metcalfe, A. (2018) ‘“The power of Twitter”: using social media at a conference with nursing students’, Nurse Education Today , 68, pp. 188-191.

Myers, C. (2020) ‘Promoting Population Health’, Nursing Clinics of North America, 55(1), pp. 11-20.

Nsiah, C., Siakwa, M. and Ninnoni, J. (2019) Registered Nurses’ description of patient advocacy in the clinical setting’, Nursing Open, 6(3), pp. 1124-1132.

Nursing & Midwifery Council (NMC) (2015) The Code . Web.

Peate, I. (2019) Fundamentals of assessment and care planning for nurses . New Jersey, USA: John Wiley & Sons.

Prestia, A. and Dyess, S. (2020) ‘Losing sight: the importance of nurse leaders’ maintaining patient and staff advocacy’, Nurse Leader, 18(4), pp. 329-332.

Regis College ( no date ) ‘Helping hands, helping voices: examples of patient advocacy in nursing.’ Regis College Blog . Web.

Smith, L. and Lee. M. (2017) ‘Patient advocacy: breaking down barriers and challenging decisions’ . Nursing Times , Web.

Sundqvist, A. et al. (2018) ‘Protective nursing advocacy: translation and psychometric evaluation of an instrument and a descriptive study of Swedish registered nurse anesthetists’ beliefs and actions’, Journal of PeriAnesthesia Nursing , 33(1), pp. 58-68.

Thomas, A. (2019) Communicate. Care. Cure. (3rd edn.). Gurgaon, India: Walters Kluwer Health.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2022, August 14). Advocacy and Communication Strategies in Nursing. https://ivypanda.com/essays/advocacy-and-communication-strategies-in-nursing/

"Advocacy and Communication Strategies in Nursing." IvyPanda , 14 Aug. 2022, ivypanda.com/essays/advocacy-and-communication-strategies-in-nursing/.

IvyPanda . (2022) 'Advocacy and Communication Strategies in Nursing'. 14 August.

IvyPanda . 2022. "Advocacy and Communication Strategies in Nursing." August 14, 2022. https://ivypanda.com/essays/advocacy-and-communication-strategies-in-nursing/.

1. IvyPanda . "Advocacy and Communication Strategies in Nursing." August 14, 2022. https://ivypanda.com/essays/advocacy-and-communication-strategies-in-nursing/.

Bibliography

IvyPanda . "Advocacy and Communication Strategies in Nursing." August 14, 2022. https://ivypanda.com/essays/advocacy-and-communication-strategies-in-nursing/.

• ProVita Acquisition by New Medical Centre
• Peplau’s Interpersonal Relations Theory Use in Nursing Practice
• Peplau’s Interpersonal Relations Theory
• The Role of Quantitative and Qualitative Research in Nursing
• Evidence-Based Practice and RN Case Management
• Resolving Nursing Commitment Issues With Six Sigma
• Nursing Doctoral Education: Research and Practice-Focused
• The Belmont Report in Nursing Industry

Nursing Essay Examples

Nursing Essay Examples That Will Help You Write a Stellar Paper

Published on: May 6, 2023

Last updated on: Jan 29, 2024

Share this article

Many nursing students struggle with writing effective nursing essays, which are an essential part of their education and professional development.

Poor essay writing skills can lead to low grades and an inability to effectively communicate important information.

This blog provides a comprehensive guide to writing nursing essays with examples and tips for effective writing. Whether you are a nursing student or a professional looking to improve your writing skills, this blog has something for you. 

By following the tips and examples provided, you can write compelling nursing essays that showcase your dedication to the field.

Let’s get started.

On This Page On This Page -->

What is a Nursing Essay?

A nursing essay is a type of academic writing that aims to explore a particular topic related to nursing. It also presents a clear and concise argument or viewpoint supported by evidence. 

Nursing essays can take many forms, including:

• Descriptive essays
• Reflective essays
• Analytical essays
• Persuasive essays

What is the Importance of the Nursing Essay?

Nursing essays are important for several reasons. First, they help nursing students develop critical thinking skills by requiring them to analyze and evaluate information.

Second, they help students develop research skills by requiring them to locate and use credible sources to support their arguments. 

Third, nursing essays help students develop communication skills by requiring them to present their ideas clearly and concisely in writing. Finally, nursing essays are important for nursing education because they prepare students for the types of writing.

Paper Due? Why Suffer? That's our Job!

To help students better understand how to write nursing essays, it can be helpful to review examples.

Below are some examples of nursing essays.

Nursing School Essay Examples

College Nursing Essay Examples

Graduate Nursing Essay Examples

Nursing Scholarship Essay Examples

Nursing Essay Conclusion Examples

Nursing Essay Examples of Different Fields

Nursing is a diverse field with many different specialties and areas of focus. As a result, nursing essays can take many different forms and cover a wide range of topics. 

Given below are some examples of different types of nursing essays:

Personal Philosophy Of Nursing - Essay Examples

Cal State Fullerton Nursing Essay Examples

Evidence Based Practice Nursing In Medical Field - Essay Examples

Leadership In Nursing And Healthcare Professionals - Essay Examples

Principles Of Professional Practice Of Nursing Professionals And Pharmacists

If you're seeking additional examples of nursing essays, you're in luck! 

Below are some more examples that can help you gain a better understanding of nursing essays:

Health Care And Reflective Models For Nursing - Essay Examples

History Of Nursing Essay Examples

Ethical Dilemma In Nurses Work - Essay Examples

Mental Health Nursing Essay Examples

Why I Want To Be A Nurse Essay

Working In A Team And Collaboration In Nursing

How to Write a Nursing Essay

Writing a nursing essay can seem daunting, but with the right approach, it can be a rewarding experience.

Here are the key steps involved in writing a nursing essay:

Understanding the Topic and Question

The first step in writing a nursing essay is to carefully read and understand the topic and question. 

This will help you determine what information you need to research and include in your essay. Make sure you understand any key terms or concepts related to the topic. Consider different perspectives or viewpoints that may be relevant.

Researching the Topic

Once you have a clear understanding of the topic and question, it's time to research. 

Start by gathering information from credible sources such as academic journals, textbooks, and government websites. 

Consider both primary and secondary sources, and make sure to take detailed notes as you read.

Organizing and Outlining the Essay

Once you have completed your research, it's time to organize your ideas and create an outline for your essay. 

Start by identifying the main points or arguments you want to make, and then organize them into a logical order that flows well. 

Your outline should include an introduction, body paragraphs, and a conclusion.

Writing the Essay

With your outline in place, it's time to start writing your essay. Make sure to follow your outline closely, and use clear and concise language that effectively communicates your ideas. 

Use evidence from your research to support your arguments, and cite your sources appropriately.

Editing and Revising the Essay

Once you have completed a first draft of your essay, take some time to edit and revise it. Look for any errors in grammar, spelling, or punctuation, and make sure your essay is well-organized and flows well. 

Consider asking a peer or instructor to review your essay and provide feedback.

What To Include In Your Nursing Essay

When writing a nursing essay, there are several key elements that you should include. Here are some important things to keep in mind:

• Introduction

Your introduction should provide a brief overview of the topic and purpose of your essay. It should also include a clear thesis statement that presents your main argument or point of view.

• Background Information

Provide some background information on the topic to help the reader better understand the context of your essay. This can include relevant statistics, historical information, or other contextual details.

• Evidence and Examples

Use evidence and examples from your research to support your arguments and demonstrate your knowledge of the topic. Make sure to cite your sources appropriately and use a variety of sources to strengthen your argument.

• Analysis and Evaluation

Provide analysis and evaluation of the evidence and examples you've presented. This can include discussing strengths and weaknesses, comparing and contrasting different viewpoints, or offering your own perspective on the topic.

Your conclusion should summarize the main points of your essay and restate your thesis statement. It should also offer some final thoughts or suggestions for further research or action.

Nursing Essay Topic Ideas

Choosing a topic for your nursing essay can be challenging, but there are many areas in the field that you can explore. Here are some nursing essay topic ideas to consider:

• The role of technology in nursing practice
• The impact of cultural diversity on healthcare delivery
• Nursing leadership and management in healthcare organizations
• Ethical issues in nursing practice
• The importance of patient-centered care in nursing practice
• The impact of evidence-based practice on nursing care
• The role of nursing in promoting public health
• Nursing education and the importance of lifelong learning
• The impact of nursing shortages on healthcare delivery
• The importance of communication in nursing practice

These are just a few ideas to get you started. You can also explore other topics related to nursing that interest you or align with your academic or professional goals. 

Remember to choose a topic that is relevant, interesting, and feasible to research and write about.

Tips for Writing an Effective Nursing Essay

Writing a successful nursing essay requires careful planning, research, and attention to detail. Here are some tips to help you write an effective nursing essay:

• Writing Concisely and Clearly

Nursing essays should be written in clear and concise language, avoiding unnecessary jargon or technical terms. Use simple language and short sentences to help ensure that your ideas are communicated clearly and effectively.

• Stating a Clear Thesis Statement

Your thesis statement should clearly state your main argument and provide a roadmap for the rest of your essay. It should be clear, concise, and located at the end of your introduction.

• Using Proper Citation and Referencing

Citing and referencing your sources is crucial in any academic writing, including nursing essays. Make sure to use proper citation and referencing styles, such as APA or MLA. Include a reference list or bibliography at the end of your essay.

• Seeking Feedback and Revising

Before submitting your nursing essay, seek feedback from peers, professors, or writing tutors. Use their feedback to revise and improve your essay. Make sure that it is well-structured, coherent, and effectively communicates your point of view.

By following these tips, you can write a nursing essay that demonstrates your knowledge and skills in the field.

In conclusion, writing a successful nursing essay requires careful planning, research, and attention to detail. 

To showcase your knowledge in the field of nursing, it is important to have a clear understanding of the topic at hand. When writing your nursing essay, be sure to include relevant examples, incorporate current research, and use proper citation and referencing. 

And remember , seeking feedback and revising your essay is key to ensuring that it effectively communicates your ideas and arguments.

If you need help with your nursing essay or any other type of academic writing, consider using our AI essay writer . 

Our nursing essay writing service can provide personalized support to help you succeed in your academic goals.

So, why wait? Contact us to get college essay writing help today! 

Cathy A. (Literature)

For more than five years now, Cathy has been one of our most hardworking authors on the platform. With a Masters degree in mass communication, she knows the ins and outs of professional writing. Clients often leave her glowing reviews for being an amazing writer who takes her work very seriously.

Paper Due? Why Suffer? That’s our Job!

Legal & Policies

• Privacy Policy
• Cookies Policy
• Terms of Use
• Refunds & Cancellations
• Our Writers
• Success Stories
• Our Guarantees
• Affiliate Program
• Referral Program
• AI Essay Writer

Disclaimer: All client orders are completed by our team of highly qualified human writers. The essays and papers provided by us are not to be used for submission but rather as learning models only.