Nurses use basic principles of communication to facilitate communication with patients, family members, peers, superiors, and other disciplines. This chapter focuses upon the principles and methods of communication, while addressing specific skills and barriers.

Communication is a process in which information is exchanged. Communication skills enable nurses to engage in an interactive process using nonverbal and verbal modes. The author sites trends affecting communication such as diversity, which is influenced by different ethnic, racial, socioeconomic backgrounds. The aging population, with an estimated 20% predicted to be 65 or older by 2020, challenges a nurse’s ability to maintain effective communication. Electronic communication, which is increasingly popular option, requires different interpretive and written skills.

Communication is an interactive process that is a means to an end. Typically it involves a message that originates with a sender. The message is the what that is delivered to the receiver. Feedback is generated by the receiver in response to the message.

There are channels of communication that are a part of interactions including: visual, auditory, and kinesthetic input. Three levels of processing input define the simplest to the highest level of integrating stimuli.

There are three modes of communication exemplified: verbal, nonverbal, and electronic. Verbal communication relies on speaking words. Nonverbal consists of facial expressions, body movements, posture, gestures, etc. Electronic methods include e-mail, voice mail, and telephones.

Further, different levels of communication are identified that nurses participate in: intrapersonal, interpersonal, and public. Avenues of communication are often defined by an organization's formal structure. This structure may be downward, upward, lateral, or diagonal.

Nurses need to rely upon communication skills such as attending, responding, clarifying, and collaborating. Barriers of gender, culture, conflict, and anger often challenge the process.