EDITOR IAL Elevate l Inspire l Innovate l Energize Founding Editors Eugene W. Jackson

Communication: The good, the bad, and the ugly Pardon me while I climb on my soapbox. The topic? Communication. It should be easy, right? Communication simply involves giving and receiving information. It’s the foundation of patient safety and it’s crucial in transitions between caregivers and healthcare settings. We know communication breakdown is often the root of poor patient outcomes. Myriad good tools such as SBAR, electronic devices, and training programs are widely available to facilitate communication. So, what’s the problem? It boils down to the quality of the human interaction...how information is given and how it’s received. Personality, stress, knowledge, biases, and past experiences influence both the delivery and the receipt of the message. Here’s an example: A nurse communicates that a patient may be exhibiting early signs of X (insert a complication). However, that information didn’t fit the provider’s perspective. Pick a reason: The provider didn’t expect the patient’s condition to change, the provider questions the nurse’s competence, the provider’s interpretation differs from the nurse’s, the provider is busy and downplays the concern, the condition change doesn’t fit neatly into the provider’s preordained plan, ego or anger impede an effective response. The nurse could react in several ways: second-guess the concern and feel foolish, be (perhaps falsely) reassured, or pursue the issue up the chain of command—and then prepare to deal with the backlash. Rather than focus on whether the nurse is right or wrong, what matters most is that a concern about a patient’s welfare exists—a warning of a possible problem that should prompt timely reevaluation by the provider or qualified designee without the unnecessary drama of a bad interaction. In reality, a “thank you” is in order for the opportunity to address the concern and intervene early. It’s also a good time for a collaborative conversation to acquire a shared mental model of the situation. The patient’s outcome can hang on the perils and pitfalls of communication. Being a patient advocate takes courage and knowledge, including knowing when to get help from experienced colleagues and how to invoke the chain of command to activate needed resources. Don’t let patients fall victim to poor communication. Embrace a culture that adamantly supports patient safety and accepts nothing less. Until next time—

Daniel L. Cheney

EDITORIAL STAFF Editor-in-Chief: Linda Laskowski-Jones, MS, RN, ACNS-BC, CEN, FAWM Editorial Director: Kimberly A. Gasda Executive Editor: Katherine W. Carey Senior Clinical Editor: Denise D. Hayes, MSN, RN, CRNP Managing Editor: Cynthia A. Laufenberg Senior Editor: Betsy Pitner Lowe Assistant Editor: Danielle Westermann King Publishing Assistant: Andrei Greska Managing Editor, Production: Erika Fedell Senior Production Editor: Stephanie Grant Contributing Editors: Rose G. Foltz, Nanci Kulig Design Director: Edward W. Rosanio Art Director: Lisa A. Dischert Executive Director, Continuing Education and Conferences: Karen E. Innocent, DNP, MS, RN, CRNP, ANP-BC, CMSRN Continuing Education Manager: Janet S. Thomas, MS, RN-BC Print Production Coordinator: Pat Lankford BUSINESS AND ADVERTISING STAFF Director, Publishing: Theresa M. Steltzer Advertising Sales Director, Career, Events and Education: Ben Crowe Advertising Sales Director, Products and Services: Peter Bless Executive Director of Marketing: Keith Follweiler Manager of Circulation: Deb Benward Associate Director of Marketing: Lisa Whelan Associate Marketing Manager: Danielle Beren Associate Marketing Manager: Marie Bartos Products & Services National Account Manager Sue Ryan, RN 1-800-457-9076 Career, Education and Events Advertising Eastern US Regional Sales Manager: Linda Barta 1-800-237-1342 Western US Advertising Sales Representative: Michaela Taylor 415-603-9197 Advertising Coordinator: Valerie McCarthy 215-521-8961, fax 215-754-4921 Customer Service: To subscribe or renew, resolve billing questions, or submit an address change, call 1-800-879-0498.


Linda Laskowski-Jones, MS, RN, ACNS-BC, CEN, FAWM Editor-in-Chief, Nursing2014 Vice President: Emergency & Trauma Services Christiana Care Health System, Wilmington, Del.

Cathy Wolfe CEO and President Jayne Marks Vice President of Publishing Jennifer E. Brogan Vice President, Nursing, Health, and Wellness Publishing Anne Dabrow Woods, DNP, MSN, RN, CRNP, ANP-BC Chief Nurse

Contact Linda Laskowski-Jones at [email protected] DOI-10.1097/01.NURSE.0000446648.18242.e4

6 l Nursing2014 l June

Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.



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