Nurses are the backbone of health care and often face challenges at the bedside — many of which can be mitigated through effective communication.
Nurses are on the front line of care, and communication is one of the most essential skills they can bring to the bedside.
When executed well and grounded in empathy, communication becomes a therapeutic tool. It can help mitigate risks, reduce frustration, lessen nursing burnout and foster strong relationships among patients, caregivers and care teams.
However, communicating with patients who are frustrated, fearful or in pain can be challenging in inpatient rehabilitation. These challenges can add stress to an already demanding workload and lead to frustration on both sides.
Sam Gauvin, chief nursing officer at Fairlawn Rehabilitation Hospital, an affiliate of Encompass Health, said effective communication not only improves patient satisfaction but can also reduce the likelihood of errors.
Gauvin said having a solid line of communication with care teams and patients helps with reducing frustration and burnout.
“Nurses are effective communicators and often have to determine what the patient truly needs,” she said. “During challenging moments, pause, assess the situation and consider whether there is another way to approach the problem — or someone you can reach out to for guidance.”
How can nurses improve their communications?
Nursing communication is a technical skill developed through simulation, role-play, real-world experience and ongoing professional development. It's important to work with your supervisor and mentors to improve communication skills.
Having additional resources and team support can make a meaningful difference. Strong communication among staff members helps mitigate confrontations and reduce patient frustration.
Linking communication to conflict prevention and safety
Unaddressed patient frustration, fear or pain often escalate when communication is unclear, dismissive or misunderstood. These situations may also arise when a patient is experiencing behavioral challenges related to medications or other medically complex conditions.
To help mitigate the risks, Gauvin advises nurses to use the teach-back method.
“When nurses employ the teach-back method, they verify patient understanding of care, medications or complex medical terminology,” she said. “Nurses can ask patients to explain, in their own words, what they need to do for their care. This approach can help reduce challenges, including avoidable complications and hospital readmissions.”
How does active listening prevent and defuse conflicts?
Active listening enables nurses to identify and respond to early signs of patient frustration, anxiety or confusion before these feelings progress to open conflict.
Gauvin said that active listening is a powerful communication tool for nurses. Some of the cues patients provide come through small conversations. Those moments can lead to strong relationships and help better meet patients' needs.
By practicing active listening, nurses acknowledge both the verbal and nonverbal cues that signal a patient's distress or dissatisfaction. This validation helps de-escalate frustrations that, if overlooked, could develop into more challenging behaviors.
Ask open-ended questions
Open-ended questions encourage patients to share concerns that may be contributing to disruptive behavior. These responses can reveal potential sources of conflict that nurses can address proactively.
Examples of open-ended questions include:
- Tell me about the pain you're experiencing.
- What, if any, side effects are you experiencing with your medications?
- How can I help adjust your care to make you more comfortable?
These questions — rather than a closed question like “Are you having pain?” — invite patients to describe their experience in detail. This helps clarify expectations, reduces misunderstandings and strengthens the patient-nurse relationship.
Why is understanding a patient's body language a clinical skill?
Nurses observe patients' body language not only to detect unspoken needs but also to understand their behavior and emotions. For example, a patient who avoids eye contact, tenses their shoulders or clenches their fists may be signaling anxiety or fear, even if they say they feel fine. Others may guard an injured area, groan during movement or shift restlessly in bed, indicating pain or discomfort that has not been voiced.
Observing subtle cues such as guarding, agitation or discomfort allows nurses to intervene early and tailor care appropriately.
Gauvin advises that nurses should maintain an open posture and remain attentive to nonverbal cues. Sitting at eye level rather than standing over a patient conveys respect and reduces power imbalances. Avoid crossed arms, rushed movements or defensive gestures, which can make you appear unapproachable.
“Body language is as simple as eye contact,” she said. “Sitting down with a patient, using simple hand gestures or uncrossing your arms can make a difference. It's important to ensure the patient feels cared for and to keep your body language open and positive. You can also observe a patient's body language to recognize when they're frustrated or confused. Your goal is to figure out a safe plan to move forward.”
How to communicate with patients and their caregivers
Approach patients and families proactively by providing regular updates, setting transparent boundaries and ensuring consistent points of contact, which can reduce workplace violence and turn negative interactions into positive relationships.
Use these tips to de-escalate tension and build trust:
Start by listening: Allow patients and caregivers to share their concerns without interruption. Maintaining eye contact, nodding and using brief verbal cues such as “I understand” or “Tell me more” signals respect and attentiveness. Even when concerns cannot be immediately resolved, feeling heard can reduce frustration.
Acknowledge emotions before addressing facts: Statements such as, “I can see this is overwhelming,” or “It sounds like you're worried about what happens next,” validate feelings and create space for collaboration. Avoid dismissive language or rushing to solutions before emotions are recognized.
Use clear, simple language: Medical terminology can increase confusion and anxiety, especially during stressful situations. Break information into manageable steps, pause often and check for understanding. When caregivers are involved, address them directly while keeping the patient at the center of the conversation.
How can nurses promote patient safety with communication?
Being one-on-one with a patient places their health and safety at the forefront. Simply asking what you can do for them right now, or what they need moving forward, can make a meaningful difference in their care.
Gauvin said this approach helps nurses meet patients at their level and supports them more effectively.
“For a patient who has had a stroke and cannot communicate, it's important to use tools such as a pointing board, which gives them a way to express their thoughts,” she said. “You can also call a patient's family member to help settle the patient and get them back on track.”
For health care professionals, strong communication skills reduce patient conflict and promote collaboration among patients, families and care teams. Nurses should take advantage of available resources to strengthen communication skills and support career growth.
“It's important that nurses embrace the resources available to them so they can grow their communication skills, better protect their patients and themselves and continue building a fulfilling, sustainable career in nursing,” Gauvin said.
