Nurse-Patient Communication Can Reduce Medical Errors

Do you feel like a child when you talk to your health care provider? Are you afraid to ask questions? Are you concerned that your health care provider may not like you if you ask too many questions or challenge their directives for you? Do you feel like you have to raise your voice or make aggressive demands to be heard?

Often, nurses and other healthcare providers are viewed as authorities, much like a parent. When patients feel like powerless children the primitive stress response of fight (aggression) or flight (non-communication) is often the result.

Nurses can fall into the same trap, thinking that they need to be the authority and that the patient must comply, like an obedient child, with their recommendations. Patients who do not do what they are told may be called “non-compliant”. Or, patients who asked too many questions can be viewed as being difficult. Providers may even “fire” patients who are too aggressively difficult, which can leave them high and dry without adequate care.

When communication breaks down due to the power struggle between patients and providers, the stage is set for an increase in medical errors and poor health outcomes.

It is important for both patients and providers to respect and value the authority and knowledge that each brings to the relationship. While providers have a unique body of knowledge regarding diagnosis and treatment, patients have a unique body of knowledge about their history, the way their body functions and how treatment recommendations will fit with their unique lifestyle and values.

Since the ultimate power for deciding which recommendations will be implemented rests with the patient, it is important for the provider to understand the patient’s history, lifestyle and values. It is also important for the patient to feel empowered to offer information and ask questions that will help them to make the best choices for their health.

The safest relationship between provider and patient is one that respects and values that both are adults in partnership toward achieving the best outcomes for the patient. This type of communication is one key to reducing medical errors.

The New England, Healthcare Institute (NEHI) found that from one third to one half of patients in the US do not take their medications, as instructed, leading to poorer health, more frequent hospitalization and a higher risk of death. This raises medical costs by as much as $290 billion annually. The Institute believes that if healthcare providers are reimbursed for health outcomes. They might spend more time and resources to help educate patients more effectively on proper treatment implementation. But this solution addresses only half the equation. It is also important for patients to recognize and assume responsibility for clarifying and implementing strategies to effectively achieve their own desired outcomes.

A nurse or provider can create the atmosphere for partnership by allowing enough time for conversation and consultation with the patient, and inviting an open dialogue. The patient contributes to the partnership by assertively communicating information, questions, concerns and a desire to make the best choices for their own health.

The increasing complexity and cost of healthcare, along with an increasing demand for better outcomes and accountability provides an incentive for better communication between patients and providers. Both must become more aware of changing old parent-child models of communication where the provider is the authority and the patient must either comply or oppose their directives, to an adult-adult relationship where both respect and value the contribution each makes toward the health outcomes both want.

When providers and patients communicate as partners toward better health, medical errors can be reduced and win-win health outcomes can be achieved.

© Aila Accad, RN

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