At my college of nursing, we teach students the value of therapeutic communication and the techniques to achieve it. Unfortunately, some former students who visit me after graduation tell me that their facility's management emphasizes physical task completion and discourages therapeutic communication with patients and families.
Why is this? Because of cost containment, patients' stays are shorter, limiting the time available for nurse/patient interaction. High-technology physical interventions are considered more important than therapeutic communication, which has been devalued as an intervention strategy. As a result, much of our traditional commitment to learning and using good nurse/patient communication techniques has all but disappeared. Some schools of nursing have even stopped teaching these principles and techniques.
How could this have happened? Skilled, sensitive communication is a defining feature of the core nursing values of caring and compassion. Nurse/patient communication is crucial to helping people deal effectively with their health care needs, and it's essential for patient education. Good communication is the foundation that allows nurses to help patients, families, and other caregivers to manage emotional crises and the pain of physical and mental illness.
Good communication is also the key to effective collaboration with our colleagues, including physicians. But the evidence suggests that nurses and physicians don't always communicate well in the real world. Turn to page 28 for my analysis of a recent national survey on nurse/physician relationships conducted by Nursing2008. Although the results are encouraging in some respects, 43% of respondents report being dissatisfied with their professional relationships with physicians. That's a disturbingly large minority.
The Centers for Medicare and Medicaid Services, the Institute for Healthcare Improvement, and The Joint Commission all emphasize good staff communication as a critical element in good patient care.1-3
Nurses must take the lead in encouraging good communication, not only with our patients, but also with colleagues. We need to set up formal policies and procedures in our nursing units that encourage nurse/patient and interdisciplinary staff communication. Because patients move between facilities more often than before, we need to set up channels of interagency communication so that we can share information about patients' treatment plans. By practicing effective communication strategies, we can enhance patient safety, minimize errors, and improve clinical outcomes.
Theodora Sirota, APRN, BC, PhD
Associate Professor of Nursing, Seton Hall University College of Nursing, South Orange, N.J.
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