They can hear the silence: Nursing practices on communication with patients

Background: Communication between the nurse and the patient is recognized as an important component of care that fosters the creation of therapeutic relationships, yet it is seen as a major shortcoming in intensive care units (ICUs). In this paper the authors explore the diverse factors that affect nursing practices with regard to nurse-patient communication. Purpose: l)To encourage nurses to reflect on how they communicate with patients in their current practice. 2) To contribute to an ongoing, open discussion regarding nurse-to-patient communication within the critical care setting. 3) To increase awareness and understanding of Gottlieb's (2013) Strengths-Based strategies for nurse-to-patient communication. Methods: Subjective information about nursing perspectives on communication practices were obtained through informal discussions with critical care nurses in Montreal, Canada and were then compared to the existing literature. Results: Data was gathered from nineteen ICU nurses; 63% of the participants stated that they believed nurse-to-patient communication was inadequate on their units. Through analysis of the data, challenges to communication were identified as well as suggestions to overcome these barriers. Factors affecting communication were found to exist in four domains: the system, the team, the nurse and the patient. Conclusion: Communication plays an integral role in nursing care but is often neglected in lieu of more technical and medical care. In response to the findings, strengths-based approaches to communicate vital information to patients are proposed. In response to this paper, further evaluation and implementation of communication strategies to improve nurse-to-patient communication within the ICU setting may be practised. Key words: nurse-patient communication, strengths-based nursing, critical care, nurse perspectives, patient-centred care