What could be behind our poor communication in healthcare?

Apr 16, 2022 | Reflective practice

Looking at self-worth and the impact this has on our communication

In healthcare, one of the greatest reasons for complaints, issues and disturbances in all of our workplace relationships, is that of poor communication or miscommunication. No doubt, as nurses, we can all relate to situations and circumstances where things have not gone to plan because of these misunderstandings.

Recalling a personal experience where a colleague and I, both experienced nurses, received a patient back from theatre, who was not stable. For both of us, on separate occasions, we felt that something was not quite right. Neither of us at the time either questioned, raised concerns or followed up on what we were feeling. 

Why would two experienced nurses, who are confident in their practice, not question something that was clearly not sitting right?  And not even discuss it with each other, until the patient failed to improve and was sent to an appropriate clinical area to be stabilised?

Why the non-communication? 

As we reflected on this, we started with, ‘We should have done this and done that’, and while this form of self-criticism is used often to attempt to improve our practice, we both felt that we hadn’t addressed what was actually underneath this for each of us and that criticism was not the approach to bring understanding to our situation. 

While it is great to look at how a situation may have been dealt with, we both observed how this can slide into the very unhelpful practise of being critical of ourselves and running with, ‘must do better next time’.  This is an approach that is not supportive of any practitioner involved in a situation, especially when there has been an error in judgment. It also felt very important for us to unpack this together and support each other in this.

Both of us recognised that we did not want to rock the boat. We could see how both of us were being ‘nice’ because we knew that the theatre staff wanted to go home. We recognised that neither of us wanted to be judged by theatre staff, so we simply did not speak up. More broadly we realised that we did not trust our own feelings to speak up, just in case we were wrong. 

As a result of our discussion we could clearly see that no-one was to blame. We could see how one person’s non-communication lead to the next. It was like we got swept up in the wave of non-communication and what that moment needed was one person to say, ‘Stop, let’s look at this’, and this could have been anyone. This was great to feel, as it is often the case that we look for someone to blame, even if it is ourselves.  We could see how everyone had an equal part to play.

While we can work on our communication skills, the very basics of trusting and expressing what we feel in any situation will allow us to see things much more clearly and, importantly, see that blame plays no part. It’s never about being right or wrong, but about simply being honest with ourselves and each other. When we work together in unpacking situations such as this, it also supports the broader team to do exactly the same.  

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