Barrier in Nurse Patient Communication Leading to Malpractice and Negligence in Nursing Home

This assignment discusses the barrier in nurse patient communication which leads to malpractice and negligence of residence in nursing home. It also provides recommendations to reduce malpractices and negligence in the nursing care facility.

Running head: NURSING COMMUNICATION AND MANAGEMENT
BARRIER IN NURSE PATIENT COMMUNICATION WHICH
LEADS TO MALPRACTICE AND NEGLIGENCE OF
RESIDENCE IN NURSING HOME
Name of the Student
Name of the University
Author Note

1NURSING COMMUNICATION AND MANAGEMENT
Executive Summary
The aim of this assignment is to develop the knowledge about the condition of the nursing g
facility and the communication skills of the nurses. The effect of the communication skill gaps
and also developing the recommendations in order to reduce the malpractices and negligence in
the nursing care facility would be the primary purpose of this following assignment. It has been
found that amount of the nursing workforce is high in the Australian context. However, the level
of the knowledge about the communication skills of the nurses is low. The literature review
process would help in obtaining the knowledge about the concept of the condition. The
recommended ways would be obtained based on this knowledge developed from the literature
review. Finally the conclusion developed which is the summary of the work in the following
section.

2NURSING COMMUNICATION AND MANAGEMENT
Table of Contents
Introduction......................................................................................................................................3
Search Strategy................................................................................................................................3
Literature Review............................................................................................................................3
Recommendation.............................................................................................................................7
Conclusion.......................................................................................................................................9
References......................................................................................................................................10

3NURSING COMMUNICATION AND MANAGEMENT
Introduction
Nursing care is the primary care in the health care system and it can be stated that
communication has a crucial role in the process of the patient care. However, it can be seen that
most of the nurses do not have the proper knowledge about the effective communication for
patient care. Hence, the lack of knowledge leads to negligence and malpractice in patient care. In
the following section literature review on barrier of nurse patient communication would be done.
Based on the obtained knowledge from the literature effective recommendations would be
provided to sustain against this issue.
Search Strategy
The literature search would focus on the electronic databases such as PubMed, CINAHL,
Google Scholar, Medline and PsycInfo. The articles would be chosen between the five year date
ranges. In order to search the specific articles on this topic of “barrier in nurse patient
communication which leads to malpractice and negligence of residence in nursing home” the
keyword search strategy would be implemented. The keywords will be ‘communication barriers
between nurse and patient’, ‘effects of communication in nursing care’, ‘malpractice and
negligence in nursing care procedure’, ‘communication’, ‘nursing care procedure’ and
‘communication barrier’. Other than all these the government reports on the health care facility
and knowledge of nurses would be considered for this topic as well.
Literature Review
According to Crawford, Candlin and Roger (2017), effective communication between the
patient and nurses would be helpful in providing improved care that includes patient assessment,
proper medication administration, counseling and other aspects of care. However, it has been

4NURSING COMMUNICATION AND MANAGEMENT
found that increasing cultural differences in Australian context language barrier of the nurse and
patient leads to miscommunication and misunderstanding. Misunderstanding between patient and
nurse refers to the arising issues such as attitude of negligence and patient feelings of neglect
form care professional. This issue can be reduced by implementing training plan for nurses in
order to decrease the linguistic barrier.
Philip, Woodward-Kron, Manias and Noronha (2019), highlighted that overseas qualified
nurses (OQN) face issues in communication with the patients and with colleagues due to the
language barrier (Hersh, Gorman, Biagioli, Mohan, Gold & Mejicano, 2014). It can be seen that
there are two possible factors present which are the language pre-existing attribute and language
barrier with interaction with colleagues and patients. Interaction here depends on adjustment and
career progress. Hence, it has been seen that although the knowledge of the care procedure is
adequate among the OQNs, but the communication and interaction skills with patients are
limited. Thus the care procedures lacks the effectiveness as expectations of patients is affected
by limited communication skills of OQN. Based on this assessment the authors concluded that
language adaptation and communication skills should be developed through adequate training
(Gonzalo, Thompson, Haidet, Mann & Wolpaw, 2017).
Watts et al. (2017), surveyed among 38 health care professionals including 21 oncology
nurses, 12 medical oncologists and 5 radiation oncologists. The survey was aimed to obtain the
knowledge about the communication between the minority group patients and the health care
professionals and the results highlighted that the factor of the emotional support to the minority
patients is less effective than the majority group patients. As per the participants discomfort
towards the minority patients and the lack of knowledge of communication skills for interacting
to the cancer patients are the causes of this lack of interaction as well (Morgan, Butow, Maddern

5NURSING COMMUNICATION AND MANAGEMENT
& Shaw, 2015). Thus it has also been found that the aspect of the negligence and malpractice
such as miscommunication and misunderstanding occur in the care procedure. It has also been
seen that the participants implemented the strategies of speech modification, rapport building and
using non-verbal techniques. However, based on the survey it can be seen that the requirement of
the formal training for the communication skill build up should be prioritized in order to reduce
the challenges and malpractices in the nursing facility (Epner & Baile, 2014).
Hall, Brosnan, Frawley, Wardle, Collins and Leach (2018), opined that complementary
and alternative medicine (CAM) is one of the common health care aspect that many patient
perceive (Trail-Mahan, Mao & Bawel-Brinkley, 2013). It has been stated that the nurses play a
crucial role in the CAM communication. In order to obtain the proper knowledge about this
aspect the authors conducted a qualitative survey and based on the survey they found four
themes. The four themes include engaging with patients about CAM, communication with
doctors about patients’ use of CAM, connecting with CAM practitioners and barriers to CAM
communication. Based on the result the authors found that nurses felt discomfort in terms of
communicating with patients about CAM (Chang & Chang, 2015). It has also been found that
the process of the communication has several barriers and those barriers leads to the
miscommunication as well. The miscommunication and the negligence due to the personal
discomfort are the aspects that effectively harm the care quality as well. The authors also found
that the participants feel more comfortable during the CAM communication with colleagues than
with the patients as well. Hence, here the malpractice of the avoidance and also the negligence
are found.
Based on the government data it has been found that there are 273,404 registered nurse
and 60,000 enrolled nurses present in the country (health.gov.au, 2014). However, based on

6NURSING COMMUNICATION AND MANAGEMENT
different surveys it has been found that the factor of the interpersonal skill including
communication and interaction is lacking among majority of the nurses (Thomson, Outram,
Gilligan & Levett-Jones, 2015). The barriers include language and the attitude of the nurses in
the health care providence context. Hence, it can be stated that the process of the training for the
proper communication skill development is required along with the health policy development
regarding this issues (Lewis, Gaffney & Wilson, 2017).
According to Meuter, Gallois, Segalowitz, Ryder and Hocking (2015),
miscommunication can be able to lead the health care procedure to the life threatening direction.
It has been found that the amount of the foreign patients and overseas nurses can increase the
amount of the miscommunication among the health care system and also affect the process of the
health care facility. On this context the language can highlighted as the barrier for the proper
communication. The authors conducted a hospital based survey on eighty individual interactions
between the patients and nurses using English or Chinese as primary language. The aim of this
article was to determine the causes of the miscommunication among the nurses and patients.
Based on the collected data the authors concluded that linguistic and cultural diversities of nurse
and patients leads to this issue.
Based on the views of Adams, Mannix and Harrington (2017), effective communication
between the nurses and the family members of patient has a crucial role in decreasing the
psychological pressure and provide proper knowledge about the care process as well. Thus the
authors conducted a systematic review and find four themes about this context including nurses
as information and communication facilitators, nurses as family support providers, nurses’ non-
supportive behaviours’ and improving nurses’ communication skills. It has been found that most
of the cases nurses showed supportive behavior and tried to provide adequate information to the

7NURSING COMMUNICATION AND MANAGEMENT
family members of patients (Bloomer, Morphet, O’Connor, Lee and Griffiths, 2013). However, it
has been seen that the aspect of the nurses’ feelings on this context is negative as they thought
that the barriers such as communication skill and language leads to the providence of suboptimal
information and support to the family members of the patients (Berkenstadt, Perlson, Shalomson,
Tuval, Haviv-Yadid & Ziv, 2013). Thus the authors concluded that there are requirement of
proper leadership management and training to the nurses in order to reduce the aspect of the
malpractice in care facility.
Recommendation
Based on the obtained knowledge from the literature review it can be stated that the
factor of reduction of negligence and malpractice in health care facility would be dependent on
the communication skill development among nurses. One of the most needed aspects in this
process would be providing training to the nurses about the communication and also different
cultural and linguistic approaches as well. On this context it can also be stated that the
requirement of the leadership management, experience of the nurses and the collaboration skills
would help as well. Implementation of the management theories would also be helpful in
improvement of the nursing management and communication. The management model can be
implemented is Dyadic Interpersonal Communication Model which refers to the dynamic
concept of the interaction process between two person that is the sender and the recipient (Lu,
Kong, Ferrin & Dirks, 2017). The process of the interaction and communication can be improved
by the implementation of different interpersonal skills such as non-verbal communication for
showing empathy, listening to the patients and developing personal relation development (Lorié,
Reinero, Phillips, Zhang & Riess, 2017). The personal relation development here refers to the
therapeutic relation development between the nurse and the patient and nurse. Hence, the

8NURSING COMMUNICATION AND MANAGEMENT
interpersonal relationship development would need the skill development through proper
channeled training of the nurses which includes the language, culture and attitude development
of the nurses. The factor of the nursing skill development would require the proper development
of the communication skill as well as the communication play a crucial role in the understanding
and trust development between the nurse and the patient. The process of the communication
should be considered by the health educators in order to improve the health care facility and
reducing the negligence aspect as well as the malpractice in the care facility. Dyadic
Interpersonal Communication Model would be implemented in order to reduce the gap in the
communication between the nurse and the patients. In this model the sender and the recipient
relation can be encoded by the several factors such as the perception, attitude, and concept and
emotional and physical attribute as well. The model helps in the proper alteration and relating all
the factors of the communication and relationship development processes (Lu, Kong, Ferrin &
Dirks, 2017). Hence, it can be stated that the implementation of these processes would be
effective for the improvement of the communication skills of the nurses. Other than these the
implementation of the different communication and relationship development skills as mentioned
before would also be required. Thus the improvement of the issue is clearly dependent on the
proper training and also effectively demonstrating the need of these factors in the nursing care
providence. Moreover, the concept and attitude for the effective communication with the nurses
would be developed by the self management and self developmental abilities by the experience
obtained by the nurses (Zhu, Chen, Shi, Liang & Liu, 2016). Nurses should focus on the
development of the knowledge and skills for the communication and interaction with the patients
in order to provide improved care and obtain customer satisfaction as well. The satisfaction of
the patients is the most crucial factor as well in the nursing care facility providence.

9NURSING COMMUNICATION AND MANAGEMENT
Conclusion
Based on the above discussion it can be concluded that the communication between the
nurses and patients play a crucial role in the development of the therapeutic relationship and
obtaining customer satisfaction. Thus the development of the language and cultural competence
is required among the nurses for the improvement of the communication and interpersonal skills.
The communication and also the interpersonal skills are lacking among majority of the nurses.
Thus providing support to the patients and family members are difficult. Thus the improvement
of care among the nursing facility should consider the training of the nurses in the effective
communication skill development. The factor of the implementation of the Dyadic Interpersonal
Communication Model in this context would also be helpful in the reduction of the negligence
factor and malpractices of nursing care facility.

10NURSING COMMUNICATION AND MANAGEMENT
References
Adams, A. M. N., Mannix, T., & Harrington, A. (2017). Nurses' communication with families in
the intensive care unit–a literature review. Nursing in critical care, 22(2), 70-80. DOI:
10.1111/nicc.12141
Berkenstadt, H., Perlson, D., Shalomson, O., Tuval, A., Haviv-Yadid, Y., & Ziv, A. (2013).
Simulation-based intervention to improve anesthesiology residents communication with
families of critically ill patients--preliminary prospective evaluation. Harefuah, 152(8),
453-6. Retrieved from https://europepmc.org/abstract/med/24167928
Bloomer, M.J., Morphet, J., O’Connor, M., Lee, S., & Griffiths, D. (2013).Nursing care of the
family before and after a death in theICU – an exploratory pilot study. Australian
Critical26:23–28. DOI: 10.1016/j.aucc.2012.01.001
Chang, H.-Y., & Chang, H.-L. (2015). A review of nurses’ knowledge, attitudes, and ability to
communicate the risks and benefits of complementary and alternative medicine. Journal
of Clinical Nursing, 24(11-12), 1466–1478. DOI:10.1111/jocn.12790
Crawford, T., Candlin, S., & Roger, P. (2017). New perspectives on understanding cultural
diversity in nurse–patient communication. Collegian, 24(1), 63-69. Retrieved from
https://doi.org/10.1016/j.colegn.2015.09.001
Epner, D. E., & Baile, W. F. (2014). Difficult conversations: teaching medical oncology trainees
communication skills one hour at a time. Academic Medicine, 89(4), 578. DOI:
10.1097/ACM.0000000000000177
Gonzalo, J. D., Thompson, B. M., Haidet, P., Mann, K., & Wolpaw, D. R. (2017). A
Constructive Reframing of Student Roles and Systems Learning in Medical Education

11NURSING COMMUNICATION AND MANAGEMENT
Using a Communities of Practice Lens. Academic Medicine, 92(12), 1687–1694.
DOI:10.1097/acm.0000000000001778
Hall, H., Brosnan, C., Frawley, J., Wardle, J., Collins, M., & Leach, M. (2018). Nurses’
communication regarding patients’ use of complementary and alternative medicine.
Collegian, 25(3), 285-291. DOI: https://doi.org/10.1016/j.colegn.2017.09.001
health.gov.au. (2014). AUSTRALIA’S FUTURE HEALTH WORKFORCE –Nurses. Retrieved
13 September 2019, from
https://www1.health.gov.au/internet/main/publishing.nsf/Content/34AA7E6FDB8C16AA
CA257D9500112F25/$File/AFHW%20-%20Nurses%20detailed%20report.pdf
Hersh, W. R., Gorman, P. N., Biagioli, F. E., Mohan, V., Gold, J. A., & Mejicano, G. C. (2014).
Beyond information retrieval and electronic health record use: competencies in clinical
informatics for medical education. Advances in medical education and practice, 5, 205.
DOI: 10.2147/AMEP.S63903
Lewis, P., Gaffney, R. J., & Wilson, N. J. (2017). A narrative review of acute care nurses’
experiences nursing patients with intellectual disability: Underprepared, communication
barriers and ambiguity about the role of caregivers. Journal of Clinical Nursing, 26(11-
12), 1473-1484. DOI: 10.1111/jocn.13512
Lorié, Á., Reinero, D. A., Phillips, M., Zhang, L., & Riess, H. (2017). Culture and nonverbal
expressions of empathy in clinical settings: A systematic review. Patient Education and
Counseling, 100(3), 411-424. Retrieved from http://dx.doi.org/10.1016/j.pec.2016.09.018
Lu, S. C., Kong, D. T., Ferrin, D. L., & Dirks, K. T. (2017). What are the determinants of
interpersonal trust in dyadic negotiations? Meta-analytic evidence and implications for

12NURSING COMMUNICATION AND MANAGEMENT
future research. Journal of Trust Research, 7(1), 22-50. Retrieved from
https://doi.org/10.1080/21515581.2017.1285241
Meuter, R. F., Gallois, C., Segalowitz, N. S., Ryder, A. G., & Hocking, J. (2015). Overcoming
language barriers in healthcare: a protocol for investigating safe and effective
communication when patients or clinicians use a second language. BMC health services
research, 15(1), 371. Retrieved from https://doi.org/10.1186/s12913-015-1024-8
Morgan, M., Butow, P., Maddern, R., & Shaw, J. (2015). The role of the prostate cancer nurse
co‐ordinator: nurses' perspectives of barriers and challenges. International Journal of
Urological Nursing, 9(1), 22-28. Retrieved from https://doi.org/10.1111/ijun.12043
Philip, S., Woodward-Kron, R., Manias, E., & Noronha, M. (2019). Overseas Qualified
Nurses’(OQNs) perspectives and experiences of intraprofessional and nurse-patient
communication through a Community of Practice lens. Collegian, 26(1), 86-94.
Retrieved from https://doi.org/10.1016/j.colegn.2018.04.002
Thomson, K., Outram, S., Gilligan, C., & Levett-Jones, T. (2015). Interprofessional experiences
of recent healthcare graduates: A social psychology perspective on the barriers to
effective communication, teamwork, and patient-centred care. Journal of
interprofessional care, 29(6), 634-640. Retrieved from
http://dx.doi.org/10.3109/13561820.2015.1040873
Trail-Mahan, T., Mao, C. L., & Bawel-Brinkley, K. (2013). Complementary and alternative
medicine: nurses’ attitudes and knowledge. Pain Management Nursing, 14(4), 277-286.
DOI:10.1016/j.pmn.2011.06.001

13NURSING COMMUNICATION AND MANAGEMENT
Watts, K. J., Meiser, B., Zilliacus, E., Kaur, R., Taouk, M., Girgis, A., ... & Aranda, S. K. (2017).
Communicating with patients from minority backgrounds: Individual challenges
experienced by oncology health professionals. European Journal of Oncology Nursing,
26, 83-90. Retrieved from
https://www.researchgate.net/profile/Bettina_Meiser/publication/311897619_Communica
ting_with_patients_from_minority_backgrounds_Individual_challenges_experienced_by
_oncology_health_professionals/links/5a9753eb45851535bcdeb2db/Communicating-
with-patients-from-minority-backgrounds-Individual-challenges-experienced-by-
oncology-health-professionals.pdf
Zhu, B., Chen, C. R., Shi, Z. Y., Liang, H. X., & Liu, B. (2016). Mediating effect of self-efficacy
in relationship between emotional intelligence and clinical communication competency
of nurses. International Journal of Nursing Sciences, 3(2), 162-168. Retrieved from
https://doi.org/10.1016/j.ijnss.2016.04.003