Chapter 3 – Interprofessional Communication in Nursing
Interprofessional communication is a fundamental component of interprofessional collaboration. Effective interprofessional collaboration fosters effective teamwork among members of an interprofessional client care team to optimize client outcomes [Canadian Interprofessional Health Collaborative, 2010], ensuring that clients are safe throughout the healthcare system [Canadian Nurses Association, n.d.a.].
Because of the significance of interprofessional collaboration, the Canadian Interprofessional Health Collaborative has developed a National Interprofessional Competency Framework, as shown in Figure 3.3.
Figure 3.3: National Interprofessional Competency Framework
As shown in Figure 3.3, six interdependent competency domains have been identified to achieve the goal of interprofessional collaboration [Canadian Interprofessional Health Collaborative, 2010]. These are defined as the “knowledge, skills, attitudes, and values that shape the judgements essential for interprofessional practice” [Canadian Interprofessional Health Collaborative, 2010, pg. 9] and include:
- Interprofessional communication
- Patient/client/family/community-centred care
- Role clarification
- Team functioning
- Interprofessional conflict resolution
- Collaborative leadership
The first two competencies have a strong influencing role in all healthcare situations, so as shown in the figure, they encircle the other four competencies. This framework can assist you in contributing to effective healthcare team functioning with a focus on communication and working together collaboratively.
This chapter focuses specifically on the competency domain of interprofessional communication. This plays a central role in interprofessional collaboration because it supports the other five competency domains [Canadian Interprofessional Health Collaborative, 2010].
To fulfill the interprofessional communication competency, nurses and all healthcare professionals must develop the capacity to “communicate with each other in a collaborative, responsive and responsible manner” [Canadian Interprofessional Health Collaborative, 2010, p. 16]. This means that each healthcare professional is responsible for engaging in effective communication in the specific clinical and interprofessional context in respectful, explicit, and clear ways [Lyndon et al., 2011]. It is important to actively respond to the perspectives of everyone involved, including the client and other healthcare professionals. Table 3.2 presents strategies for effective interprofessional communication, adapted from the Canadian Interprofessional Health Collaborative.
Table 3.2: Strategies for effective interprofessional communication
Descriptors | Example and explanation |
“Establish teamwork communication principles” [p.16]. | Example: Each homecare agency has set procedures for homecare nurses to assess heart failure clients daily through remote monitoring of vital signs, weight, intake, and output. The client may tell the nurse that they have gained a couple of pounds this week. When significant changes like sudden weight gain arise, the nurse would submit a standardized electronic form to a clerk at a cardiac outpatient clinic. The cardiologist and nurse practitioner are then immediately alerted to the request for consultation and follow-up by phone with the client’s homecare agency nurse. This ensures that unforeseen changes in client status are managed appropriately and in a timely manner. Explanation: A clear set of communication principles and procedures is important for healthcare teams that work closely together and depend on each other. These types of principles and procedures can foster open and creative discussions, recognition and appreciation of each person’s role and contribution, as well as transparency in decision-making. |
“Actively listen to other team members” [p. 16]. | Example: A client is having trouble eating. The following conversation may occur. Dietician: “Let’s provide the client pureed foods to help with swallowing and reduce risks of choking.” Nurse: “I agree. I have noticed that the client needs to sit up straight and he takes a long time to chew. I will arrange for a pureed diet, should we also thicken any fluids?” Dietician: “Yes.” Nurse: “Okay, Mr. Rhoda, would you like to try some apple sauce to start?” Client: “Yes, please.” Explanation: Active listening involves closely attending to what another person is saying and responding to them based on what they said. |
“Communicate to ensure common understanding of care decisions” [p. 16]. | Example: When giving a sponge bath, a nursing student notes reddened skin at the lower back of the client. The nursing student discusses the finding with their preceptor and personal support worker. The preceptor informs the nursing student that the client likely has a stage 1 pressure ulcer and should be turned frequently according to institution policy. The nursing student confirms the need and reason for frequent turns and reiterates the need for good hydration/nutrition to reduce exacerbation of the pressure ulcer. The preceptor and personal support worker agree. Explanation: Each healthcare professional is responsible for communicating clearly as well as clarifying discussions or a written order or care plan when it is unclear. |
“Develop trusting relationships with clients/families and other team members” [p. 16]. | Example: A doctor writes down an order for pain medication for a client at an inpatient unit. The doctor knows that the nurse is trained to carry out the order. The doctor engages in a discussion with the nurse as follows. Physician: “I wrote an order for Tylenol III, that should help, any questions?” Nurse: “No, that sounds good. I will re-assess their pain after administration and will report any adverse effects of this medication.” Physician: “Great, thanks so much.” Explanation: Trust among the healthcare team [including clients/families] is integral to communication. Part of building trust begins with your interactions with each other. It is important to engage with others in respectful ways and provide time for discussion. Additionally, it is important to be honest in your communication. You should aim to be knowledgeable on the topic and if you are not, open up the discussion in a way that addresses this and allows for a learning opportunity. |
“Effectively use information and communication technology to improve interprofessional client/community-centred care” [p. 16]. | Example: The personal support worker routinely documents the amount of food that each client eats at each meal. The personal support worker understands that the healthcare team [dietitian, nurse, physician] will review this information regularly to update client care plans. The updated client care plans are easily accessible within each client’s electronic chart. Explanation: Information and communication technology involving telephone, computers, and software programs can facilitate communication. You will commonly use computer-based documentation systems to document your assessments and plans of care. It is vital that you document clearly and follow the College of Nurses of Ontario [2019] Documentation Standard of Practice. |
Consistent execution of successful communication requires attentive listening skills, administrative support, and collective commitment [Lyndon et al., 2011]. Other principles of interprofessional communication include:
- Speak clearly with appropriate vocal intonation and at a moderate pace.
- Use simple and clear language.
- Maintain eye contact and show confidence in what you are saying.
- Be efficient in your communication.
- Incorporate adequate, relevant, and timely information.
- Engage in active listening and ask questions for clarification.
- Speak up and seek clarification if needed until your concern regarding a client is addressed.
- Put clients first: always remember – and if appropriate, remind your interprofessional team members – that your decisions and actions affect the client and the client should be the focus of your discussions.
- Show respect in your communication patterns.