Documente Academic
Documente Profesional
Documente Cultură
Communication in Nursing
Alexa M. Smiley
Abstract
This research paper will explore how technological advances have altered nursing
communication and the nurse-patient relationship. It will go in depth on three relevant forms of
devices, and video conferencing. There are varying opinions on the effects of technology in the
hospital setting. Some view the improvements as a way to boost efficiency and patient care,
while others see them as a barrier inhibiting direct communication. Communication is essential
in everything you do, especially in nursing because it facilitates the initial trust with the patient
and their family, and allows for any complications to be addressed effectively. This is why
nursing is known as not only a science, but an art as well, because both come into play to deliver
successful care. When technology prevents interpersonal communication, it takes away from the
art aspect of sympathizing for the patient on a human level. After considerable research, I found
that although these improvements have contributed to increased efficiency and patient care, it is
not to be forgotten that they too have also resulted in a separation between the nurse and patient.
Nursing is a field which is constantly improving and evolving to increase the standards of
healthcare around the world. With the workforce changing, it’s important to take note on what
exactly goes into the role of the nurse. By now, there have been many advancements in
technology that must be implemented into the hospital setting and can affect various aspects of
the patients’ recovery and nurse delivery. In order to truly understand the process, I found it of
particular interest to examine the ways in which advancements in technology have impacted
communication among nurses and ultimately the nurse-patient relationships. To gain a bigger
perspective, I went in depth on three current forms of technology that have revolutionized the
The purpose of this research is to not only shed light for the current nurses who can
improve patient care, but also the patients who will or have been affected. Most people have
taken a trip to the hospital at some point or know people who have, so in order to keep improving
the medical field we need to investigate all perspectives. This research will benefit the patients
and their families by putting them more at ease for what goes into their stay at the hospital and
how they are being treated. Current nurses can learn from the research as well as prospective
nursing students, who can better prepare for their role as a nurse by learning from the mistakes of
today’s nurses. The findings from the study can be implemented into teaching the nursing
curriculum and make for increased patient care in the future. On a global perspective it will
change nurses’ approach to technology around the world and on a more local perspective it will
The source in particular that stood out to me was the online article, "Communication and
Technology: Ida Orlando's Theory Applied", by Cynthia Gaudet and Maeve Howett. These
authors are both credible in the field of nursing, because they are both registered nurses. The
main argument of the article is to demonstrate that technology has led to improvement in patient
care but at the same time, it has hindered direct communication. Gaudet and Howett draw on
several studies which include the work of (Tejero's 2011), (Kharasch and Du's 2010),
(Kongsuwan and Locsin's 2011), as well as a (2010 study by Pillemer and colleagues).
Tejero's study described how nursing interventions don't necessarily affect patient outcomes but
the "interactions have a direct effect on patient satisfaction and learning" throughout their stay
(Gaudet and Howett, 2018, p. 370). For Kharasch and Du, their study showed that when nurses
were performing interviews in simulation, they ended up spending more time focused on
the computer screen than with forming actual face to face interactions. According to Kongsuwan
and Locsin's study they began by examining the perspectives of eight nurses. The result of this
being that "technology decreased the nurse's involvement with the patient and that there was a
reduction of the physical space as a result of the technology" (Gaudet and Howett, 2018, p. 371).
Another important study to highlight was with Pillemer and his colleagues in which they
observed the electronic health information system. The findings from this were that although
patients were satisfied, a quarter of them admitted that the electronic system significantly
lessened the amount of interpersonal communication they shared with the nurses. By referencing
these studies, it allows for Gaudet and Howett's theme to be evident in which although
technology increases efficiency in healthcare, "nursing must approach the use of technology
Information Technology
Information Technology is known as any forms of computer systems that help store or
send information, the most common being that of laptops, phones and tablets. This form of
technology is utilized immensely in the hospital setting, not to mention within nursing. It is
commonly relied on to store the health records of patients and to retrieve them when needed to
asses a patient’s medical history or current dosages of medicine. In the article, “Relationship
between smartphone addiction of nursing department students and their communication skills”,
the authors discuss how in a 2015 study conducted by Semerci and Akgun-Kostak, “56% of
students reported that using smartphones weakened individual relationships” (Cerit, B., Bilgin,
N.C., Ak, B., 2018). It is noted that because of the high need for communication skills as a nurse,
it was surprising to find that most nursing students in the study had a negative impact from the
information technology of cell phones. On an everyday basis cell phones are used and when they
aren’t abused they positively influence the clinical setting, but in some cases can lead to an
addictive level that causes the communication skills needed for nursing to suffer. In order to
effectively care for patients, there needs to be a balance between the use of information
technology like cell phones, and the communication towards the patients. Another instance of
complications with information technology was evident in my interview with registered nurse,
Johan Koutouby. After sitting down with her, I was enlightened to hear that in her experience
over the past five years she has found it crucial to implement her use of computer technology,
while also maintaining direct contact with the patient. Koutouby claimed that in the beginning,
she often would focus on either one or the other, but that the key was to ultimately combine the
two for the most successful patient outcomes. She made it clear that the patient is the most
COMMUNICATION IN NURSING 6
important aspect and for some of her cases it was the interpersonal communication and face to
face interaction that led to their recovery. Koutouby says, “everyone reacts differently to these
situations and what matters most is how you take into account each patient’s preferences to
deliver the uttermost care for recovery”. Not everyone will respond in the same manners like
with strictly technology use or strictly direct communication, so finding the blend of both is key.
Overall, she stressed the importance of communication in nursing in order to establish a sense of
trust with her patients and to also get a better understanding of how they are progressing with
treatments. “There’s a type of connection you feel with direct communication, that forms of
technology fail to allow” she says. The take away from this is that although yes, these uses of
information technology are evident in the hospital setting, there needs to be a distinct separation
between how much is too much before the patients’ recovery starts to come into question.
Hands-Free Communication Devices like Vocera’s Badge are another form of technology
constantly seen used by nurses. Devices like this allow for the nurse to be at another end of the
hospital but still communicate with their patients if they ring for assistance. This can be seen as
very useful since the nurses don’t necessarily need to walk all the way back to patients’ rooms to
reach them. However, in times of urgency there may be complications if the nurse decides to rely
directly on the badge to do all the work if there happens to be an emergency. It can also prevent
the patient from receiving face to face contact from the nurse, because they may think this device
will relieve them of their duty to check in on patients. In the article, “Vocera Hands-Free
Communication Improves Satisfaction for Patients, Nurses, and Physicians at DMC Huron
Valley-Sinai Hospital”, they discuss how Vocera’s Badge has increased the productivity of the
COMMUNICATION IN NURSING 7
nurse and that the nurses employed there have realized they “no longer had to stop what they
were doing to reach each other or the patient and physician directly” (Vocera). The benefits are
definitely evident when nurses are calling on other health care providers, but when the patients
come in to play it can be more of a risk factor. To combat any criticism based on that theory,
Vocera makes a point to address the additions of the “stroke team” and “code blue team” buttons
on the device that allow for all members of the team to be alerted in case of an emergency. Their
main claim from the article was that “nurses can now spend more time at bedsides doing things
that directly improve patient care, without having to leave the current patient’s bedside to assist
perceptions and satisfaction”. This article contains a survey that illustrates that “50% reported
that the quality of their communication with patients had improved with the use of voice
communications technology, attributing this to the immediacy with which they were able to
respond to patients’ requests combined with fewer interruptions in direct care activities, and 71%
said that using this technology allowed them to communicate faster with their coworkers”
(Forrester, D., Fowler, S. & Gaidemak, H., 2011). These findings show the positive aspects of
hands-free communication devices and how when the device works, it is indeed beneficial for
the workplace in most circumstances. However, it was often found that this voice
communication device resulted in common malfunctions and misunderstood the staff and
patients with accents. Due to this, it shows that the technology won’t work for everyone and
therefore the communication between the nurse and patient isn’t always guaranteed when
needed. Both Vocera’s Badge and Voice Communications Devices can help facilitate patient
COMMUNICATION IN NURSING 8
assistance but once they create a barrier between the two people, it becomes an obstacle in the
way of patient care. In the graph below Joslin and Goldberger show how the response times of
Vocera’s Badge have changed as the device continued to be used in the workplace. At first the
nurse takes longer to respond to patients, but eventually becomes more and more efficient and is
able to respond faster. This shows how hands-free communication devices may take some time
to be effectively implemented into patient care but once done, they are proven to be effective as a
result.
COMMUNICATION IN NURSING 9
Video Conferencing
Video Conferencing is another major form of technology used nowadays when patients
are either in remote destinations, suffer from a chronic illness and must stay home, or are
immobile. This is a form of telenursing in which the patient and nurse do not have direct contact
with one another because of the distance between them. Although this may be helpful in those
situations, it may also be hinder patient recovery because there’s no physical touch or direct
communication that some patients rely on. In the article, “Video Conferencing in Nursing
Education Now Includes Telepresence Robots”, video conferencing is described as “the future of
emergency medicine, providing privacy for HIV patients through virtual clinics, and bringing
patients, caregivers, and families together in spite of distance” (T. Charlotte, 2017). This shows
that there are also positive sides to video conferencing and how it provides convenience within
the work place. Rygg, Brataas and Nordtug (2018) found that “technological challenges must be
solved at an organizational level, because they can affect the communication between patient and
COMMUNICATION IN NURSING 10
health personnel”. This appears to be a major issue with the technology of today because of the
unpredictability with how each device will operate and the network connections available.
Whenever considering the use of video conferencing it’s important to consider network access,
stability and patient relationships to ensure the conference will be successful on both ends.
However, putting aside these complications, conversations through video conferencing were
found to be “more targeted and thorough than face-to-face conversations” according to the
article, “The use of videoconferencing in nursing for people in their home” (Rygg, Brataas,
Nordtug, 2018). This is partially due to the fact that video calls are scheduled and set up for
specific times, allowing for the nurse to be fully focused on the individual patient at hand. In the
hospital setting, it would be different because the nurse would be visiting several patients at a
time and the dedication to a single patient may be compromised. Depending on the patient, there
were some cases that proved a need for direct contact and others where the use of video
conferencing allowed for the promotion of self-management among patients. Since there is no
physical nurse next to you, it let patients take the information gained through the call and apply it
to their treatment. This made them feel a sense of accomplishment and even encouraged
recovery because they didn’t feel as helpless and dependent on the nurse’s physical touch (Rygg,
Results
conferencing has allowed nurses and the medical field to become more advanced, accurate, and
efficient. Although they have contributed to efficiency in nursing, they have also decreased the
communication between patients and health care providers. A lack of face to face contact can
COMMUNICATION IN NURSING 11
affect each patient differently and alter the road to recovery, depending on their needs. In order
to combat the difficulties associated with advancements in technology, it’s important to assess
each patient’s situation and the resources available to facilitate recovery. These findings will in
turn help the nursing workforce of today and of the future to continue improving the field. Each
nurse utilizes technology at different levels and will adapt to each patient’s case differently
depending on how they take on their role as the nurse. The nurse-patient relationship plays a big
part in the communication involved because of the amount of trust established and how
comfortable the patient feels within the environment. Technology can either inhibit the
communication between the two by causing a barrier, or help facilitate it when either physical or
mental distance comes into play. Overall, the technological advances have revolutionized the
medical field and have allowed for improved treatment of patients. Not every innovation will
work perfectly, but in this case the productivity of technology outweighs the occasional obstacles
of communication.
COMMUNICATION IN NURSING 12
References
Cerit, B., Bilgin, N.C., Ak, B. (2018, March 14). Relationship between smartphone addiction of
Journal, Vol. 54, Issue 4-5. Retrieved February 12, 2019, from
https://www.tandfonline.com/doi/10.1080/10376178.2018.1448291
Forrester, D., Fowler, S. & Gaidemak, H. (2011, February). Voice communications technology:
healthcare provider perceptions and satisfaction. Official Journal of ANA, Vol.6, No.2.
communications-technology-healthcare-provider-perceptions-and-satisfaction/
Gaudet, C., Howett, M. (2018). Communication and Technology: Ida Orlando’s Theory Applied.
https://journals.sagepub.com/doi/pdf/10.1177/0894318418792891
Joslin, Jeremy, Goldberger, David. (2016). Use of the Vocera Communications Badge Improves
https://www.semanticscholar.org/paper/Use-of-the-Vocera-Communications-Badge-
Improves-Joslin-Goldberger/96dd27091932808ce900857a7f26246e8d6831d5
Rygg, Lisbeth O., Brataas, Hildfrid V., Nordtug, Bente. (2018, October 18). Introducing
https://resolver.ebscohost.com/openurl?sid=EBSCO%3aaph%3a132506341&ISSN=1687
6415&EISSN=&ISBN=&volume=&issue=&date=20181018&spage=1&pages=1-
6&title=International+Journal+of+Telemedicine+&atitle=Introducing+Videoconferencin
g+on+Tablet+Computers+in+Nurse–
Patient+Communication%3a+Technical+and+Training+Challenges.&aulast=Rygg%2c+
Lisbeth+O.&ID=pmid%3a%2cDOI%3a10.1155%2f2018%2f8943960&site=ftf-live
Rygg, Lisbeth O., Brataas, Hildfrid V., Nordtug, Bente. (2018, August 31). The use of
https://www.pagepressjournals.org/index.php/nursing/article/view/6761/7413
T. Charlotte. (2017, November 3). Video Conferencing in Nursing Education Now Includes
https://www.videoconferencingdaily.com/healthcare/video-conferencing-nursing-
education-now-includes-telepresence-robots/
Vocera. Vocera Hands-Free Communication Improves Satisfaction for Patients, Nurses, and
Physicians at DMC Huron Valley-Sinai Hospital. Retrieved February 15, 2019, from
https://www.vocera.com/resource/vocera-hands-free-communication-improves-
satisfaction-patients-nurses-and-physicians-dmc
COMMUNICATION IN NURSING 14