Running Head: MISCOMMUNICATION IN NURSING

Miscommunication in Nursing: A Review of Literature

Kelsey E. Anderson
University of Texas El Paso

Abstract

Running Head: MISCOMMUNICATION IN NURSING

Patients experience successful outcomes during their hospital stay when there is good
communication between the nursing staff, patients and all members of the interdisciplinary team.
There are many ways to ensure that patients understand the information and education that they
are receiving during hospitalization. Nurses demonstrating empathy, sincerity and kindness are
very important when helping and educating patients to ensure they understand the information
given to them for a successful recovery. Miscommunication of information, whether it is due to a
language barrier or poor communication skills by the medical professionals, can be detrimental
to the patients recovery and healing process. By addressing miscommunication in healthcare
settings, nurses will be able to effectively implement interventions such as prevention, treatment,
therapy, rehabilitation, education and health promotion. The purpose of this literary review is to
define the proper communication of information to patients, eliminating miscommunication in
the health care setting and potential consequences of healthcare miscommunication.

Nurses provide the glue escorting a patient into the consulting room; identifying with
challenges in adhering to lifestyle changes by reporting their own experience; allowing patients

Running Head: MISCOMMUNICATION IN NURSING

to disclose concerns not shared with doctors; being chatty; sharing a joke; and providing
explanations where doctors communication has failed (RNtoBSN, 2014).
The definition of communication is the act or process of using words, sounds, signs or
behaviors to express or exchange information or expresses ones ideas, thoughts and feelings to
another person. In the healthcare profession nurses use oral communication and demonstration to
convey the information to the patient. When the patient is unable to demonstrate back the
information or is non compliant this may be a cause of miscommunication on the nurses part
and patients part. There are four types of communication behaviors that are portrayed by nurses;
assertive, aggressive, passive and passive aggressive. The preferred style when communicating
with a patient is assertive. This behavior is straightforward and honest without being
inappropriate or belligerent (RNtoBSN, 2014). The other behaviors of communication can be the
cause of miscommunication by lacking sincerity or empathy and therefore decreasing the
patients trust in the nursing staff.
When it comes to miscommunication in the medical field, specifically nursing, four
questions need to be considered:
1.
2.
3.
4.

Are nurses communicating educational information properly to patients?

Are communication skills essential in the nursing profession?
Is there a way to eliminate miscommunication from health care?
What are the potential consequences of health care miscommunication?

The following review on literature will provide ways to improve communication skills, eliminate
miscommunication, it patients are retaining the education that is given and the consequences of
miscommunication in the medical field.
Are nurses communicating educational information properly to patients?

Running Head: MISCOMMUNICATION IN NURSING

The communication process starts between a nurse and a patient with the first contact of
the two and lasts as long as the therapeutic relationship (Kourkouta, 2014). The first impression
means a lot when starting that therapeutic relationship in nursing. When educating a patient, the
patient needs to feel comfortable, the nurse needs to set aside ample time for communicating and
the nurse needs to be honest. These things will promote adequate learning environment for the
patient. The efficient communication of education that patients need has gotten better on the
nurses part due to adequate interpersonal communication training given by the hospitals. From
my observations while working in a hospital setting are that the training that the nurses receive
covers common communication barriers which gives the nurses the tools to properly react to any
problems that may arise.
Nurses are taught about the therapeutic process of communication with patients. The four
phases consist of the orientation phase, identification phase, exploration phase and resolution
phase. The orientation phase is the trust development phase. The nurse explains treatment and
the patient is able to ask questions and received explanation (Neese, 2015). The identification
phase is where the nurse and patient start to work together. The patient becomes an active
participant in their own care and trust is built (Neese, 2015). The exploration phase consists of
uses all services offered. Lastly, the resolution phase, communication was successful and
patients needs were met. The patient will no longer need help from the nursing staff and the
relationship ends (Neese, 2015).

Running Head: MISCOMMUNICATION IN NURSING

Are communication skills essential in the nursing profession?

Outstanding communication skills are an essential attribute in nursing (Brown, 2014).
Nurses are advocates and the voice for the patients when it comes to their care. Communication
between the patient and nurse should be an honest, open line of communication so the patient
can be properly advocated for when in the hospital. The time spent in the hospital can be a
stressful time and patients can feel uncomfortable or angry if they feel they are not being heard
or understood. A high stress level can negatively effect a patients health, therefore slow down
the healing process and possible lengthen their hospital stay. It is part of the nurses job to clarify
any misunderstanding between the patient and the other members of the interdisciplinary team.
Discussions with other members of the interdisciplinary team help alleviate medical jargon from
being used when explaining diagnosis or treatment plans to patients. When observing medical
personnel, whether its a physician or nurse, explaining a procedure or diagnosis using medical
jargon the patient becomes flustered and a communication barrier is put up. When a nurse has

Running Head: MISCOMMUNICATION IN NURSING

good communication skills more information can be received from the patient that could produce
a more effective treatment plan which reduce stress, promote wellness and improve overall
quality of life (Vertino, 2014).
When talking about effective communication Maslows hierarchy of human needs can be
applied. The concept of communication can be most appropriately considered in the context of
three levels of hierarchy such as safety, love/belonging, and esteem (Vertino, 2014). When it
comes to safety, it is closest to a basic need then the other needs. If interpersonal communication
is not present when interacting with patients love/belonging and esteem will not be satisfied
which can affect the patients wellness.
Is there a way to eliminate miscommunication from health care?
Miscommunication can be very detrimental to patient safety and wellbeing, especially
when it involves the physician, nurses and patients. Ways to eliminate miscommunication
between interdisciplinary team members are confirming orders that a physicians given, writing
information down that either physicians say and asking questions if unclear about something.
This will ensure that everybody is on the same page when it comes to patient care. Ways to
improve communication with patients is speaking clearly and slowly, ensuring that the patient
speaks the same language as the medical professional, giving the patient the correct information
and teaching material, asking the patients questions to see what they have retained from the
teaching and ensuring medical jargon is not used to prevent confusion. Using body language as a
way of communicating can be beneficial as well. It can increase patient comfort level.
What are the potential consequences of health care miscommunication?

Running Head: MISCOMMUNICATION IN NURSING

There are many types of consequences that can be involved with miscommunication in
the health care setting such as compromised patient safety, negative affect on quality of care and
possible repercussions for the employee. Lack of communication creates situations where
medical error can occur. Patient safety is one of the biggest priorities when working in health
care setting. 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 Commissions 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 patients illness or condition that results in
death, permanent harm or another qualifying negative outcome (Neese, 2015).
Conclusion
In conclusion, this literary review has analyzed a large amount of data and has addressed
questions concerning miscommunication in the medical field such as ways to communicate
information to patients properly, ways to eliminate miscommunication and potential
consequences of miscommunication in nursing. Miscommunication can be potentially fatal if not
addressed in the medical field. It can happen between members of the interdisciplinary team or
medical staff and patients. There is a lot more research to be done on miscommunication and the
most effective communication styles when educating patients to ensure that the medical
information is being understood.

Running Head: MISCOMMUNICATION IN NURSING

Bibliography
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Neese, B. (2015, May 11). Effective Communication in Nursing: Theory & Best
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Retrieved from http://online.seu.edu/effective-communication-in-nursing/
Honeycutt, J. M., & Worobey, J. L. (1987). Impressions about communication styles and

Running Head: MISCOMMUNICATION IN NURSING

competence in nursing relationships. Communication Education, 36(3), 217-227.

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