Communication is central to an oncology nurse’s role—with patients and families, within the unit, and across interprofessional teams. The Joint Commission identified poor communication as a causative factor in 80% of medical errors, particularly during caregiving handoffs. Effective communication skills are both a science and an art, but oncology professionals can use a variety of tools and techniques to enhance their practice.
The Science and Art of Communication
Communication involves several components:
- A sender forms a message and delivers it to a receiver or decoder.
- How the message is delivered (e.g., verbally, in print, digital media) defines the channel.
- Context references the surroundings.
- Noise signifies anything that interferes with the receiver’s interpretation and understanding of the message.
Using multiple channels to deliver a message is a good strategy. For example, explain the side effects of a medication and provide a written copy of the information. Nurses can also assess the environment and remove as many distractions as possible.
Understanding the science of communication is important, but exemplifying the artistry of communication is a skill. Just like an artist uses tools, an effective communicator uses words, symbols, gestures, or media to compose a message. The art of communication begins with the intention to hear another person’s concerns, experience, opinions, and goals. Listening to hear, rather than respond, can help you recognize what isn’t being said and ask appropriate questions.
Health Literacy Universal Precautions and Open-Ended Questions
The Healthy People 2030 initiative identified improving healthcare communications as a high-priority issue. Using health literacy universal precautions is an important starting point: most healthcare professionals overestimate patients’ ability to understand and use the health information they are given.
Open-ended questions stimulate conversation, whereas closed-ended questions restrain communication to single-word answers like “fine” and “good” or “yes” and “no.” Think of closed-ended questions like a form where the answers are limited to a small selection and open-ended questions like free-text fields. Closed-ended questions are appropriate in research and have their place in conversation; however, deeper communication of thoughts and feelings can result by asking open-ended questions.
Apply It to Your Practice
Review the two scenarios in the sidebar. Can you identify how a conversation flows when using open-ended questions? In scenario I, the nurse is rushed and uses more medical jargon (peripheral neuropathy) and vague terms (skin conditions). As scenario II illustrates, seeking to understand Ron’s concerns and prior knowledge of the therapy helps the nurse build on what Ron already knows and address any pressing concerns at the onset. This is one way to reduce mental and emotional noise, especially when the teaching environment is not ideal.
The take-home points in these examples are to assess patients’ greatest concerns first to reduce mental and emotional noise. And ask what the patient already understands so you can build on that knowledge or clarify any misunderstandings.