How Masks are Impacting Communication

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

In thinking back over the past 20 months, I notice that staff communicate less with one another and less with me. Casual conversations that took place in hallways or on elevators don’t happen as often. Sometimes, to be honest with masks and other PPE, I don’t initiate conversations with staff myself because I am unsure who I am talking with. Some of my team speak softly, and I don’t hear half of what they say. The patients complain about this to me as well when I make rounds. It takes a lot more energy to have a conversation when everyone is wearing masks. I guess this is a ripple effect of COVID – communication has suffered.

When I question leaders about how wearing masks for the last 20 months has impacted communication on their units, most tell me that they had never stopped to think about it. But once they do, leaders see profound changes in their own environments around communication when everyone wears masks. Examples of the impact of mask-wearing on communication include the following:

Nonverbal facial cues are harder to read, so it is challenging to see emotional reactions.
Messages are harder to hear, and critical information could be missed.
Patients and families have more challenges understanding information and instructions.
Mask wearing has led to less engagement in casual conversations; therefore, the staff is not as connected.
Mask wearing has led to fewer conversations in enclosed spaces like elevators – now nobody talks, and things seem less friendly.
Some older nurses have retired because they have hearing loss, and work has become too complicated.

Effective communication on teams is an outcome of conversations that staff have or, more importantly, don’t have with one another. Prolonged mask-wearing in healthcare environments impacts not only communication but also teamwork. It is a contributing factor (albeit one we cannot control) to the lack of connection that new staff feels to their teams. One manager told me that she identified the challenge pretty early on in the pandemic and began to hold ZOOM meetups for staff to socialize and get to know one another a little better. It has helped, she said, but like all the other leaders I have spoken with – she anxiously awaits the end of the pandemic when she can tell staff to take their masks off.

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