Helping Nurses with Communication Skills

By Rose O. Sherman, EdD, RN, NEA-BC

I had a mentor who often said that the “soft skills” are often the “hard skills” to master.  Communication is undoubtedly at the top of that hard skills list.  Poor communication skills in healthcare environments can lead to medical errors, fragmented care, poor team coordination, and incivility. They also lead to patient/family dissatisfaction and lower HCAHPS scores. Nurse communication is a critical driver in the patient experience, notes experts who study the data. Yet many health systems now struggle with their scores in nurse-patient communication amid skyrocketing nurse turnover and the decreasing tenure of acute care nurses.

In almost every leadership development session I do, nurse managers inevitably bring up the weak communication skills of newer nurses. Communication is incredibly challenging for Generation Z nurses raised with cell phones who use texting and social media as their primary communication channels. One nurse leader explained that she now sees new graduates enter rooms and fail to acknowledge patients and family members verbally. When she talks about conversations, some say they are uncomfortable knowing what to say. This situation has been complicated by the amount of remote learning and simulation during the pandemic. The lack of experienced preceptors and role models compounds the problem.

Challenges with communication can be expected for a generation that uses technology instead of face-to-face or phone conversations and whose patients are of different generations with different expectations. Other communication problems managers raise often center around talking too much at the wrong times, not maintaining eye contact while speaking, interrupting colleagues and their manager, failing to respond to administrative emails, poor conduct in team meetings, and sending inappropriate comments in text messages and emails.

Best Practices

To address these challenges, many health systems now have dedicated communication classes as part of orientation and annual competency reviews.  Some best practices in coaching younger staff about communication include:

1. Introduce yourself, look up, and acknowledge the presence of others as you enter patient rooms.
2. Have go-to questions for conversation starters, such as “Do you have a pet”?
3. Maintain eye contact even if it is uncomfortable.
4. Ask questions and then wait and listen for responses.
5. Don’t interrupt, check your phone, or let your mind wander when someone is speaking to you.
6. Empathize with others even if you disagree with their viewpoint.
7. Don’t become defensive when asked a question you can’t answer; instead, say – I will find out.
8. Exhibit respect, kindness, courtesy, and good manners.
9. Don’t make excuses when you make a mistake – apologize and try to fix it.
10. Watch what you say to patients and families – some conversations should be on stage, and some should be off-stage with colleagues.

The Leader as Coach

It goes without saying that managers with poor communication practices will have a challenging time coaching others.  Ensure your 1:1 communication skills and electronic messages are clear, concise, and high quality.  You can effectively role model communication in huddles and staff meetings by establishing ground rules around the best practices discussed above.

There is an art to good communication. Some nurses are naturally great communicators, but it can be a learned skill.  The good news is that our younger staff want to develop themselves professionally. Communication should be framed as a critical career development competency that will help them avoid derailment on their career journeys.

© emergingrnleader.com 2023

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