Chapter 24: Communication in Professional Nursing

Communication in Professional Nursing begins by deconstructing the communication process through the circular transactional model, which identifies key elements such as the referent, sender, receiver, message, channel, feedback, and the interpersonal variables and environmental contexts that shape interactions. The text distinguishes between different levels of communication, including intrapersonal (self-talk), interpersonal, small-group, public, and electronic communication, explaining how each functions within the healthcare setting. Significant attention is given to the nuances of verbal communication—such as vocabulary, pacing, intonation, and timing—and the critical impact of nonverbal communication, including personal appearance, posture, facial expressions, eye contact, and the specific zones of personal space (intimate, personal, social, and public). The chapter outlines the progression of the professional nurse-patient relationship through four distinct phases: preinteraction, orientation, working, and termination, while also addressing the principles of motivational interviewing to support behavioral change. To promote safety and reduce medical errors, the summary details standardized interprofessional communication tools like SBAR (Situation, Background, Assessment, Recommendation) and SACCIA, and addresses the negative impact of lateral violence in the workplace. A major portion of the chapter is dedicated to the implementation of therapeutic communication techniques, such as active listening using the SURETY model, sharing empathy, validation, paraphrasing, and silence, which are contrasted with nontherapeutic or blocking behaviors like false reassurance, asking personal questions, and defensive responses. Finally, the chapter applies the nursing process to communication, offering specific assessment and intervention strategies for patients with special needs, including those with aphasia, dysarthria, cognitive impairments, sensory deficits like hearing or vision loss, and those with limited English proficiency.