Avoiding Liability Bulletin – December 1, 2016
What would nursing be without communication and communicating with patients, patient’s families, other staff members, and other team members? Indeed, communication in all its forms is essential to the practice of nursing.
However, not all nursing communication is effective. Nursing literature abounds with articles and research on tips for successful communication with patients, how not to speak to patients, and how best to share information with patients.
Obviously, what you say to a patient, how you say that something to a patient, or what your non-verbal communication conveys to a patient can result in a good outcome or a not-so-good outcome, including the potential for a lawsuit if the patient believes your statement or behavior is discriminatory, harassing, threatening, or non-caring.
A well-known, popular research project published in 20041 explored nurse-patient communications from patients’ perspectives. Eight patients in a general teaching hospital in Ireland were interviewed in an unstructured manner and the data obtained was analyzed. Findings were reported using themes and sub-themes.
Four themes were identified: lack of communication, attending, empathy, and friendly nurses and humor.2
The lack of communication category included examples of nurses not providing enough information to the patient and that nurses were more concerned with the tasks they had to complete than in talking with them.
The attending theme was seen by the patients as those nurses who gave of their time to the patient and was always “there” (e.g., coming back to the room after leaving to take care of other responsibilities); communication by the nurse was “open and honest”; the nurses were genuine, both in their verbal communication and their non-verbal communication which demonstrated “support, understanding, and respect for them as individuals”.3 Examples given included a nurse coming in to ask how the patient was or simply waving when going by the room.
The theme of empathy was described by patients’ feelings that the nurses were able to recognize and understand their situation.
The friendly nurses and humor theme was seen by the patients as helpful in increasing their self-esteem because they could make others laugh. Self-esteem was also increased when patients were included when nurses’ laughed.
Although the study is one with a small sample and was carried out in Ireland, its findings have relevance for your nursing practice. To begin with, a patient’s feeling of being ignored, not important, or treated in a perfunctory manner can further aggravate a patient’s disappointment in his care or, even worse, further aggravate a patient and/or his family when an injury occurs and a lawsuit is contemplated.
Utilizing empathetic and caring communication can be a major deterrent to exploring the possibility of a lawsuit. For example, studies involving malpractice claims and physicians indicated a link between poor communication and subsequent [filed] complaints.4
Empathetic and caring communication is something that you must constantly work on in order to ensure you use it daily with all patients. There are times when it is difficult to do so, to be sure, but you must strive to sincerely use this approach to communicating with patients.
As this study emphasizes, patient-centered communication does not require “additional resources”. Rather, it is the quality of an interaction with patients that is essential and it is you, as a nurse, who “has the greatest influence on whether patient interactions are ones of quality.5
- Catherine McCabe (2004), “Nurse-Patient Communication: An Exploration of Patients’ Experiences”, 13 Journal of Clinical Nursing, 41-49.
- Anna King and Ruth Happe (2013), “Best Practices” for Patient-Centered Communication: A Narrative Review”, 5(3) Journal of Graduate Medical Education, 385-393 (citations omitted).
- McCabe, supra note 1, at 47.
THIS BULLETIN IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT TO BE TAKEN AS SPECIFIC LEGAL OR ANY OTHER ADVICE BY THE READER. IF LEGAL OR OTHER ADVICE IS NEEDED, THE READER IS ENCOURAGED TO SEEK SUCH ADVICE FROM A COMPETENT PROFESSIONAL.