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Ineffective Communication in Medical-Surgical Units Research Paper


Communication is a crucial component of organizational management and leadership. In healthcare settings, communication occurs on several different levels; for instance, patients communicate with doctors and nurses, nurses communicate with physicians and other medical personnel. According to Marquis and Huston (2015), communication consists of three components: the sender, the message, and the receiver. Both the sender and the receiver are affected by internal and external climate, and thus understanding the effect of climate on each individual is important to improve communication (Marquis & Huston, 2015).

Internal climate includes personal characteristics of the individual, such as stress levels, values, and feelings, whereas external climate refers to information such as the organizational climate, status, and manager-subordinate communication (Marquis & Huston, 2015). This essay aims to analyze an example of ineffective communication and to determine possible ways of addressing similar issues.

Barriers to Effective Communication

Barriers to communication may arise due to a variety of factors. For instance, according to Van Keer, Deschepper, Huyghens, Distelmans, and Bilsen (2014), increasing cultural diversity might lead to a higher incidence of conflicts and errors, as language and cultural differences become barriers to communication. Maintaining effective communication in hospital settings is essential, as it might help to improve patient health outcomes. For instance, Manojlovich et al. (2015) note that “Poor communication is the leading cause of preventable adverse events in hospitals, as well as a major root cause of sentinel events” (p. 61). Thus, leaders should work to establish efficient communication patterns and to promote positive communication practices to overcome possible challenges.

Example of Ineffective Communication

The following example of ineffective communication took place in one of the Medical-Surgical Units where a patient was scheduled to have a colonoscopy the next morning. The patient’s doctor and nurse informed her about the procedure and obtained informed consent before beginning bowel preparation for colonoscopy. The patient could not eat after midnight on the evening before her colonoscopy, as the procedure was scheduled at 9 am the next morning.

However, in the morning, it turned out that the doctor had canceled the procedure because of an emergency, but forgot to inform the patient and the nurse about the cancellation. Although the case did not have any significant health consequences for the patient, there was still a disruption to the normal communication pattern. As the sender of the message, the doctor was influenced by a variety of factors, which probably included his feelings about the emergency, causing him to forget about the need to inform the patient and the nurse. The nurse, on the other hand, was affected by a desire to help the patient by adhering to the prescribed diagnostic procedures, including colonoscopy.


One of the possible ways to prevent the event would be to introduce detailed communication protocols and schemes that employees would follow throughout their professional interactions. For example, Vardaman et al. (2012) found that the implementation of the situation-background-assessment-recommendation (SBAR) protocol results in enhanced communication and decision-making in hospital care settings.

However, changing the communication policy that is currently in place would require effective leadership. For instance, transformational leadership is considered to be among the most efficient practices in promoting organizational change (Seyranian, 2014), whereas communicative leadership could be used to set communication standards and enhance communication throughout the unit (Johansson, Miller, & Hamrin, 2014). Both options would help to prevent similar issues in the future.


Overall, the use of specific and detailed communication processes, as well as effective communication leadership would have helped to prevent the outlined case of ineffective communication, as well as other similar issues. Effective communication practices, on the other hand, would also have a positive impact on patient health outcomes, as they would improve the decision-making process and enhance collaboration between nurses, physicians, and other medical staff.


Johansson, C., Miller, V. D., Hamrin, S. (2014). Conceptualizing communicative leadership: A framework for analyzing and developing leaders’ communication competence. Corporate Communications: An International Journal, 19(2), 147–165.

Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Manojlovich, M., Harrod, M., Holtz, B., Hofer, T., Kuhn, L., & Krein, S. L. (2015). The use of multiple qualitative methods to characterize communication events between physicians and nurses. Health Communication, 30(1), 61–69.

Seyranian, V. (2014). Social identity framing communication strategies for mobilizing social change. The Leadership Quarterly, 25(3), 468-486.

Van Keer, R. V., Deschepper, R. D., Huyghens, L. H., Distelmans, W. D., & Bilsen, J. B. (2014). Dealing with cultural diversity during the process of communication and decision-making in the ICU: A literature review. Critical Care, 18(1), 24. Web.

Vardaman, J. M., Cornell, P., Gondo, M. B., Amis, J. M., Townsend-Gervis, M., & Thetford, C. (2012). Beyond communication: The role of standardized protocols in a changing health care environment. Health Care Management Review, 37(1), 88-97.

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