Lead and Staff Nurse Communication Interview

Introduction
Interpersonal communication focuses on the exchange of information through verbal and nonverbal communication. Effective interpersonal communication is important because it contributes to how we connect with others and develop relationships. This paper aims to explore the communication barriers and techniques utilized by two experienced nurses. TN is a registered nurse (RN) currently working on a Cardiac Telemetry unit (TN, personal communication, March 27th, 2023). JL is also an RN on the same Cardiac Telemetry Unit as TN but frequently works in the role of charge nurse. JL background includes experience as a Clinical Program Manager of Orthopedics, which she also reflected on during this interview (JL, personal communication, March 27th, 2023). Both TN and JL currently work at a large metropolitan hospital.
Staff Nurse Interview
Communication Barriers
When asked about communication barriers TN voiced the main barrier to be lack of communication between the variety of specialties that might be following one patient. For example, she stated how she has encountered contradicting orders from a patients primary service and the nephrology team that was consulted. This required her to communicate accordingly with both providers to clarify orders before initiating interventions or medications. In order for teamwork to be effective coordination, communication and collaboration must occur across multiple disciplinary’s (Rosen et al., 2018). Without proper teamwork mistakes can be made and patients do not receive the quality of care they deserve.
Communication Styles with Patients
TN describes communication with patients as being one of the most important roles as a nurse. When TN begins each shift she always starts by formally introducing herself to each patient and try’s to give them a generalized plan for the day to ensure they feel involved in the plan of care. According to Blazer Riley (2020), introducing yourself and your role is an important step to show respect for our patients. Since patients interact with many different professional roles daily it can be hard for them to remember each individual. TN emphasized that she feels when nurses are only task orientated it can take away from having effective communication with patients. One thing TN focuses on throughout her shifts, even when they get chaotic at times, is to slow down and meet the patient at eye level and discuss if their needs and questions are being met. The use of eye contact falls under the non-verbal communication strategy of kinesics, which refers to the use of body movement to assist in communicating messages (Wanko Keutchafo et al., 2020).
Communication Styles with Colleagues
TN’s communication with her colleagues can be described by using three words: assertive, respectful and direct. She explains that she is not afraid to ask for help when needed, delegates tasks accordingly and always advocates for her patients’ needs. Being an assertive nurse is a skill that takes time to learn and is demonstrated by an individual who is positive, clear in what they are asking for and nonjudgmental (Blazer Riley, 2020). An assertive nurse accomplishes this with respectful language and behaviors (Blazer Riley, 2020).
Communication with Leadership/Administration
When asked about communication with leadership roles such as charge nurse or nurse managers TN expressed how grateful she is that those individuals encourage all staff members to communicate concerns or issues directly. She describes her work environment to be open, honest and welcoming to all. TN feels as though her nurse manager appropriately advocates for the units needs. Individuals in leadership roles on her unit are always accessible to help when needed and offer support for both work related and personal problems that may arise. In a study that was completed on nurse burnout it states how having a positive, trusting, open relationship with leadership and mangers reduce the percentage of early nurse burnout (Dall’Ora et al., 2020).
Lead Nurse Interview
Communication Barriers
JL expressed that she has encountered a number of communication barriers within her leadership roles. One of the biggest communication barriers that she addressed was being short staffed and nurses being overworked. This has led to lack of communication between colleagues and patients, having more of a task orientated only mindset and medical errors occurring. JL explains how as nurses we are limited on time and when nurse patient ratios are high effective communication seems to be the first thing lost. According to Blazer Riley (2020), an important function of communication is to create meaning by transmitting a message directly from sender to receiver. With inappropriate nurse-patient ratios messages have a higher chance of getting lost in translation as they cannot always be directly communicated to the appropriate receiver. During her manager position, a communication barrier that JL commonly experienced was lack of follow up on issues that were brought forward by management. She expressed how management was not always kept in the loop as issues were being addressed by upper management or other leadership roles.
Communication Styles with Patients
JL describes her communication with patients as direct and assertive. During the interview she discussed how most of the time her patients felt as if they were out of the loop. JL stressed the importance of determining the patients knowledge of the plan of care and filling in the gaps as needed. JL highlighted the importance of being compassionate and empathetic within her communication style. Empathy allows nurses to begin connecting with the patient and build a trusting relationship (Blazer Riley, 2020). Empathetic communication can be demonstrated by withholding judgment, verbally reflecting that you understand patients emotions and accompanied by warmth and genuineness (Blazer Riley, 2020)
Communication Styles with Colleagues
JL describes her communication with colleagues as assertive and supportive. In her current role as charge nurse JL juggles many responsibilities including scheduling, staffing, administrative tasks and overseeing patient care on the unit. JL explains how she makes her expectations clear and does what she can to create a positive work environment. One of her main roles is to be a resource to the floor nurses. She achieves this by being accessible throughout the shift and showing a sense of warmth. Warmth in communication with colleagues helps make an individual seem more approachable and give a sense of comfortability (Blazer Riley, 2020). JL states that she focuses on communicating with nursing staff in a way that promotes teamwork and that no one’s role is above the other.
Communication with Leadership/Administration
JL describes her communication with leadership and administration as clear and direct. She does her best to prevent wasting anyone’s time by avoiding long emails or unnecessary meetings. She prefers communicating face to face with other leadership roles. JL advocates strongly for her staff and voices concerns when appropriate. She communicates clear work boundaries and remains assertive in her communication style. Benefits to an assertive communication style include gaining respect from colleagues, shows independence, you become a decision maker and appear self-confident (Blazer Riley, 2020).
Analysis of Interviews
Both TN and JL are currently employed at a large metropolitan hospital working on cardiac unit. Assertiveness, direct and empathetic were common communication styles for both nurses in regards to communicating with patients and colleagues. JL communication with leadership was described as clear and direct. TN describes her communication with leadership as open and honest. Both nurses strive to keep the patients involved in all aspects of care. They incorporate therapeutic approaches to their dealings with patients and adjust this approach as appropriate (Balzer Riley, 2020). Both express the importance of interprofessional communication and collaboration to be successful in their efforts to care for patients and work with staff and providers.
Methods to Improve Communication
TN’s main communication disconnect focused on the overall interprofessional teams ability to communicate the plan of care. During the interview, TN discussed the use of secure chat as a route of communication that she commonly utilizes. One way to improve this communication barrier could be by creating a secure chat with all relevant members of the care team so orders can be clarified and the information is clearly stated for all team members involved. In a research review it discuss the importance of interprofessional collaboration on the quality and safety of care delivery. Effective communication is at the center of achieving successful team work because without it can lead to miscommunication of the plan of care causing delays in treatment or inappropriate therapies (Rosen et al., 2018).
JL expressed concerns with nurses being overworked leading to lack of communication and a more task orientated mindset. One way that this communication barrier could be addressed is utilizing and educating nurses on the importance of bedside handoff. Bedside handoff allows both nurses to lay eyes on the patient at shift change, clearly report the plan of care with no outside distractions from the unit and reduces chance of miscommunication. In an experimental trial it was found that implementing bedside handover improved communication and job satisfaction for nurses. It also revealed that patients and their families satisfaction increased as this allowed them to ask questions and stay informed with the plan of care (Ghosh et al., 2021).
Additionally, communication barriers can be improved by focusing on creating a positive work environment and encourage optimistic attitudes. A positive work environment focuses on eliminating work gossip, promoting team collaboration and creating a strong work culture. Certain negative environmental factors influence how messages are sent and received (Blazer Riley, 2020). Implementing these strategies will allow for more open and respectful communication to occur.
Conclusion
Interprofessional communication focuses on the use of non-verbal and verbal communication. Having effective communication with patients and colleagues helps create trusting relationships, forms respect and allows for thoughts and feelings to be expressed openly (Blazer Riley, 2020). Effective interpersonal communication ensures that patients are being provided quality and safe care.
The goal of this paper was to gain insight into communication styles of two experienced nurses. An analysis was completed on communication barriers and communication styles with patients, colleagues and leadership roles. Three actions were provided on ways to improve communication barriers within the work environment.

References
Balzer Riley, J. (2020). Communication in Nursing (9th ed.). Elsevier
Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: A theoretical review. Human Resources for Health, 18(1). https://doi.org/10.1186/s12960-020-00469-9
Ghosh, S., Ramamoorthy, L., & pottakat, B. (2021). Impact of structured clinical handover protocol on communication and patient satisfaction. Journal of Patient Experience, 8, 1-6. https://doi.org/10.1177/2374373521997733
Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433–450. https://doi.org/10.1037/amp0000298’
Wanko Keutchafo, E. L., Kerr, J., & Jarvis, M. A. (2020). Evidence of nonverbal communication between nurses and older adults: a scoping review. BMC Nursing, 19(1), 1–13.