Overview of Nurse Leadership Concept: Communication

“21st Century nursing is the glue that holds a patient’s health care journey together. Across the entire patient experience, and wherever there is someone in need of care, nurses work tirelessly to identify and protect the needs of the individual” (American Nurses Association, 2019). The American Nurses Association best describes the modern nursing field. Nurses are no longer looked upon as “pillow- fluffers” or expected to blindly follow physician’s orders. Nurses are highly skilled individuals that focus on the care and safety of their patients and the public.

The nursing field is constantly growing, evolving, and developing to meet the needs of the ever-changing society (American Nurses Association, 2019). The art of nursing is rooted in empathy, compassion, and respect, but nurses must also depend on their incredible skill set, both at the bed side and away from it. Nurses are leaders and influencers on a million different stages, whether it be as a staff nurse, chief nursing officer, or a member of congress.

Becoming influential and a leader requires a deep understanding of numerous concepts including but not limited to; power, image, networking, politics, and negotiation (Sullivan, 2013). This paper will go into detail explaining the concept of communication and how it relates to nursing influence and leadership.

Communication is an important aspect of everyday life and becomes even more essential in the nursing field when patient’s lives are at stake. Communication simply is the transfer of information from one individual to another. It is useless unless the communication is effective.

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Effective communication occurs when the message the sender intends and what the receiver comprehends are the same (Sullivan, 2013). Achieving effective communication is difficult because there are many opportunities for misinterpretations (Sullivan, 2013). For this reason, it is important to be aware of and consider all factors that may interfere with effectiveness.

Verbal communication goes beyond spoken words. As the saying goes it is not what you say, but how you say it. Verbal communication includes the enunciation, tone, and stress of voice (Sullivan, 2013.) Therefore, it is imperative to speak calmly and be aware of the volume and attitude in your voice when you speak. One must also be aware of their non-verbal communication which includes body language such as eye contact, facial expressions, and hand placement. Body language speaks volumes and is often more powerful then spoken words (Sullivan, 2013). Again, ensuring that both verbal and nonverbal communication are congruent helps decrease opportunities for misinterpretation.

Another important factor needed to achieve effective communication is active listening. It not only requires silence while others are talking but requires one to stay in the moment, avoid interruptions, ask clarifying questions, and of course one’s undivided attention (Sullivan, 2013). Being aware of both verbal and nonverbal communication as well as participating in active listening are only several ways to avoid miscommunication. The most effective way to avoid miscommunication is to be conscious of its barriers such as; preconceived beliefs, lack of self-confidence, and defensiveness (Sullivan, 2013.) Communication is a complicated yet important concept that once mastered will provide the potential to complete and achieve extraordinary things.

As mentioned earlier, communication is essential to all roles in the nursing field. Nurses communicate with patients, patient’s families, and other members of the interdisciplinary healthcare team. Communicating effectively is essential in providing quality care and meeting patient outcomes. It also is crucial in influencing patients, fellow nurses, and other healthcare providers. Effective and strong communication skills are needed to achieve goals, complete tasks, and advance the nursing profession. Powerful communication skills not only allows nurses to assist their patients clinically but also provides the influence needed to make drastic and needed changes in healthcare systems and healthcare policy.

The importance of effective communication has been a topic of study for decades. Researchers have focused on all aspects of communication in the healthcare field and have found the impact of effective communication on patients, and nurses. Several studies have also identified needs or lapse in research. A literature review was completed on the topic of communication in the healthcare field, below are the findings of eight peer reviewed journal articles.

Literature Review

The first article reviewed focused on non-verbal communication. The article titled “Body Language in Healthcare”, concentrates on the effect body language has on the nurse patient relationship. “Body Language in Healthcare” used quantitative research which involved the observation of care situations in two different hospitals (Guimarães, Felippe, Santo, & Porto, 2015). The research proved that using body language efficiently established rapport with patients, improved quality of care, and allowed nurses to interact and connect with patients on a more personal level (Guimarães, Felippe, Santo, & Porto, 2015). Research showed that this deeper connection allowed nurses to provide individualized care and gave patients the comfort to clarify their needs (Guimarães, Felippe, Santo, & Porto, 2015). As one can see, nonverbal communication is just as important as spoken words. Being conscious of body language can initiate or terminate a productive nurse patient relationship.

The second article reviewed is titled “Nurse-Physician Communication in Long-Term Care: Literature Review”. This research focuses on 15 peer reviewed articles about nurse physician communication that were written between 2005 and 2015 (Renz., & Carrington, 2016). The article explains how miscommunications in health care has led to mistakes including medication errors, and patient falls, which is extremely dangerous in long term care facilities because the population is generally older with numerous comorbidities (Renz., & Carrington, 2016). The review of research proved that obstacles in achieving effective communication can be diminished with organized communication tools and educational programs (Renz, & Carrington, 2016). The most successful communication tool was the SBAR tool, or the situation, background, assessment, recommendation tool, while all educational programs improved communication according to post intervention assessment surveys completed by nurses (Renz, & Carrington, 2016). In conclusion, this literature review supported the fact that strong, active communication greatly affects clinical outcomes, patient safety, and job satisfaction of healthcare professionals (Renz, & Carrington, 2016).

The third article reviewed is titled “Communication in Nursing Practice”. This article goes into depth describing the principles of communication, and the positive effect of speaking frankly, openly, and honestly with patients (Kourkouta, & Papathanasiou, 2014). The article states that communicating efficiently and effectively not only requires education and involvement, but also an innate ability to connect and understand others (Kourkouta, & Papathanasiou, 2014). Forming a bond with patients and creating a productive atmosphere to communicate effectively leads to an increased understanding between nurses and patients (Kourkouta, & Papathanasiou, 2014). Once again, this journal article supports the fact that effective communication provides numerous benefits to the healthcare field including; improved quality care, enhanced nurse patient relationships, and increased job satisfaction.

Another article reviewed titled; “Effective Interpersonal Communication: A practical guide to improve your life” discusses how having strong interpersonal communication skills may enhance your life by decreasing stress therefore encouraging wellness (Vertino, 2014). The article connects interpersonal communication skills with Maslow’s hierarchy of needs and encourages readers to practice healthy communication skills and strategies, not only in their professional life, but also their personal lives (Vertino, 2014). In summary the article states that practicing effective interpersonal communication skills is essential in surviving and thriving in the nursing field (Vertino, 2014).

The next two articles focused on a specific patient population. The first article titled “Interventions to Improve Communication between People with Dementia and Nursing Staff during Daily Nursing Care: A Systematic Review” concentrated on demented patients. This systematic review focused on six studies and determined that quality care can only be achieved with good communication skills (Machiels, Metzelthin, Hamers & Zwakhalen, 2017). The article acknowledges that communicating and interacting with individuals with dementia can be difficult and frustrating and determined that more research is needed to develop and assess communication tools for individuals with dementia (Machiels, Metzelthin, Hamers & Zwakhalen, 2017).

The second article that focused on a specific patient population is titled “Effective Communication with Older Adults”. The article discusses the difficulties healthcare professionals may have when communicating with older adults due to their specific needs (Daly, 2017). The author encourages nurses to use a person-centered approach to best involve and interact successfully with older adults (Daly, 2017). The article also encourages nurses to be aware of their own communication styles, weakness, as well as strengths (Daly, 2017). Once more, the importance of communication is reiterated in the article stating that effective communication depends on competence and engagement (Daly, 2017).

The final two articles concentrate on the development of communication skills and the standardization of communication tools. “The Teaching Approach on Communicative Skills in Different Teaching Methodologies” is qualitative research which relied on 30 nursing professors from public universities and their students’ experiences (Oliveira et.al., 2018). The researchers exposed the students to various teaching, learning methods and then had the students participate in individual interviews with guiding questions (Oliveira et.al., 2018). The research showed that the development of communication skills is affected by numerous factors such as practical activities, individual traits, access to mass media, and the understanding of theoretical concepts related to the art of nursing (Oliveira et.al., 2018). Overall the consensus showed that real-life experience, and active learning is the best to enhance and support the development of communication skills (Oliveira et.al., 2018).

The final article reviewed entitled “Clinical Chatter: Every nurse Informed” aims to determine the adequacy and usability of a standardized communication tool (Talbott, Watson, Tariman & Sorenson, 2017). The researchers created Clinical Chatter, a computer-based program designed by nursing leaders to offer new tools, provide updates, and other information to all members in the healthcare system (Talbott, Watson, Tariman & Sorenson, 2017). Clinical Chatter proved to be an adequate source of communication between nurses of the organization (Talbott, Watson, Tariman & Sorenson, 2017). Surprisingly age, gender, and years of being a nurse did not affect the efficacy (Talbott, Watson, Tariman & Sorenson, 2017). The research concluded that a program such as Clinical Chatter can be used to promote effective communication in a healthcare system (Talbott, Watson, Tariman & Sorenson, 2017). A standardized communication tool will not be successful unless the leaders in the organization fully support and encourage the use of such a tool (Talbott, Watson, Tariman & Sorenson, 2017).

The literature review supported the fact that communication and its effectiveness is imperative to provide safe, competent, care as well as improve and encourage staff satisfaction. Although more research is needed to enhance communication between nurses and individuals with communication disorders, great progresses have been made. As healthcare professionals we must all take what the research has presented and put it into practice.

Influencing Health Care and Advocating for Patients

Communication is an integral part of the nursing profession. Without strong speaking, and listening skills, the responsibilities of a registered nurse will be left unmet. As a registered nurse with an MSN I will utilize the concept of communication to improve patients understanding of their situation and current care plan. This increased understanding will improve patient compliance, healing, and overall satisfaction. I will also communicate effectively with other members of the inter-professional healthcare team to provide competence and quality care.

Not only will practicing effective communication allow me to advocate for patients, but also other members of the healthcare team. I hope to use my advanced education and skill to collaborate with nurses and gain a better understanding of their needs. I will use my leadership skills to communicate requests to the appropriate personnel and help create changes to help make nurse’s jobs easier, and more satisfying. I will also show appreciation for all that nurses do which in turn will increase nurse satisfaction, improve morale, and decrease turnover rate (Graber et al., 2008). Obtaining effective communication skills allow me to be more than an advocate. It also allows me to influence healthcare. I will influence healthcare by becoming more involved in professional nursing organizations, writing to my congressman, and educating the public.

Future Goals

My goals for the immediate future once I earn my advanced degree is focus on resolving issues on my current unit, as well as taking on more leadership roles. My first goal is to decrease staff turnover and improve nurse satisfaction on the telemetry unit I am currently working on. Since I have been hired in April 2018, 10 registered nurses have left the unit with the same complaints of being over worked, and underappreciated. I hope to interview the nurses on my unit and identify the faults in the system that have caused so many nurses to accept other nursing positions. I plan on creating an evidence-based project and implementing what the research has shown to combat staff turnover. Hopefully implementing this project will be successful and lead to a decrease in staff turnover.

My second goal is to take on a leadership role. To begin I’d like to become a relief charge nurse in order to gain a better understanding of the basics of staffing, admissions, and to build my confidence. Once I am comfortable as relief charge, I’d like to apply to become a clinical shift supervisor, and eventually a nursing manager, or nursing supervisor of the entire hospital. I am confident that the completion of this degree will prepare me adequately to obtain and be successful in these leadership positions.

Some other goals I have include, making numerous positive changes for both the patients and nurses. I will use my advanced communication skills and collaborative efforts to make the hospital experience more pleasant. I also am preparing to become an active member on nursing committees, lending my voice and expertise to help make positive changes in the hospital.

Although I am still new to the nursing profession, only graduating in 2016, I am hopeful to be a changemaker and influencer for all my years remaining in this wonderful challenging field.