Comment by Jason Portell: Running heads should be excluded as part of APA 7th edition unless directed to use.



Verbal, Non-verbal and Written Communication for Practice Scholars Comment by Jason Portell: Bold Comment by Jason Portell: V

Carleen Noreus

Chamberlain University

NR714 Comment by Jason Portell: Wrong course number. This is NR703

November 23, 2020












Verbal, Non-verbal and Written Communication for Practice Scholars

Generally, it’s impossible for any human being to interact without sending and receiving information. Even the deaf including very silent interactions, messages still get transmitted accidentally or deliberately (Bramhall, 2014). As such, communication is very significant in all human activities and most critical for nurses whose services are irreplaceable. Nursing being a healthcare science is mainly oriented towards serving emotional and psychological needs of humans. Nurses are usually the first responders of any health crisis and are relied upon for effective treatment. In this regard, any clinical officer is required not only to possess scientific skills and knowledge but must also have interpersonal skills that are relevant for effective interactions (Bramhall, 2014). Communication is therefore very vital in medical practice including all medical activities mainly treatment, prevention, therapy, rehabilitation and health promotion among others. Effective communication in nursing practice is specifically most relevant given that almost all nursing activities are based on dialogue where an interpersonal environment must be created to ensure effective communication (Bramhall, 2014). Comment by Jason Portell: Even the Deaf include very silent interactions and messages still get transmitted accidentally or deliberately. Comment by Jason Portell: Nursing, being a healthcare science, is mainly…

Nursing unlike business oriented activities don’t just rely on effective communication but also interpersonal relation. In the corporate world, effective communication is simply the exchange of information mainly through thoughts/opinions or feelings among people using electronic means or speech. In contrast, therapeutic practice involves mainly oral exchange of personal information between nurses and patients including thirty parties like next-of-kin who depend on each other for effective services. As such, unlike corporate communication which may be top-down or bottom-up, therapeutic communication must be a two-way process (O’Hagan, et al., 2014). The patient must be able to convey their concerns to the nurse to ensure effective diagnosis and treatment and like-wise, the nurse must be able to decode the information and transmit it back to the patient or relevant authorities with utmost discretion depending on the patient’s condition. As such, without effective communication, treatment wouldn’t be possible (O’Hagan, et al., 2014). It’s therefore critical that nurses and medical personnel understand verbal, non-verbal and written communication in the context of healthcare. Comment by Jason Portell: Nursing, unlike business-oriented activities, relies on effective communication and interpersonal relations. Comment by Jason Portell: I’m not sure I agree with this statement. The business world needs this as well. Comment by Jason Portell: I see a lot statements in the paper like this… “unlike x” or “is not only this but also a,b,c…” these statements could very well just be be written without the comparison and extra wording. You want to get right to it. For instance, this sentence could be “As such, therapeutic communication must be a two-way process.” Think about this as you’re writing papers moving forward in the program.

Verbal Communication Comment by Jason Portell: This should be a level 1 header and centered.

In respect to medical practice, communication should be viewed as an intrinsic trait of all human nature. Anyone can communicate. Communication therefore has value, content and context. The content is action done or what was said, the importance of the message is its value and context is how it was communicated (Sibiya, 2018). In this regard, verbal communication can never be unidirectional; the sender becomes the receiver and vise-verse. As such, failure to provide feedback is often regarded ineffective communication as it creates negative attitudes and irrational conclusions (Sibiya, 2018). In this regard, it’s critical to note that during verbal communication, the message sent must be different to feedback given that decoding of information is based on individual factors, attitudes and subjective perceptions. As such, people often interpret what they heard and not necessarily what the sender actually intended. In this aspect, nurses must ensure particular focus on how they use medical terminologies and other technical terms while interacting with patients. It’s evident that most patients conclude different interpretations to what they heard during medical examinations while others cannot totally understand the caregiver thus they developing mental stress; a factor that discourages any communication process (Sibiya, 2018). Comment by Jason Portell: This sentence is very difficult to understand. Consider rephrasing. I remain unclear on what you’re saying here.

Success in verbal communication relies on interpersonal relationships. Creating good patient-doctor relationship ensures friendly environment that not only promote communication but also the healing process. The nurses should be as kind as possible to be able to ask follow-up questions (Bramhall, 2014). As such, interpersonal relationships promote verbal communication as it allows nurses to provide feedback in friendly and not scary manner and show interest. This will in turn make the patience harbor feelings of acceptance and trust which are most critical in any communication process especially in the modern multicultural society. As such, creating good interpersonal relationship is critical prerequisite to successful communication between patients and caregivers as it not only helps decode and transmit information but also helps manage mental stress due to communication (Sibiya, 2018). In this regard, verbal communication between health professionals and patients must be based on the nurses’ ability to show sincere sympathy for the care of the patients and the patient’s equal interest on the same. Comment by Jason Portell: Through all of this, I was unable to discern what you were saying were the components, comportment, and collaboration was in respect to a DNP nursing leader.

Non-verbal communication Comment by Jason Portell: Level 1 headers need to be bold, centered, and title case

Communication can also occur without words. Non-verbal communication is mainly based on body language and is often expressed mainly through facial expressions, body-posture, gestures and physical barriers for instance distance between communicators. Over 60% of all communications are non-verbal (Tuohy, 2019). In most occurrences other than sign language, non-verbal communication is often used to emphasize verbal communication. In regard to healthcare, it’s critical to ensure maximum attention to ensure an agreement between verbal and non-verbal communication. Most patient-physician communication occurs under stressful moments making it very difficult to notice any changes that are communicated non-verbally (Tuohy, 2019). In addition, every patient has their unique traits that not only influence their actions during communication but also their ability to full cooperate with the caregiver including their capacity to self-manage their healthcare (Sibiya, 2018). As such, effective communication in medical practice involves attentive listening Attentive listening ensures decoding of both verbal and non-verbal communication as emitted by the patient to effectively assess the situation. Attentive listening promotes the patients’ self-esteem and thereby helps in integrating the healthcare process to nurses’ diagnosis (Sibiya, 2018). Comment by Jason Portell: Throughout the paper thus far, you really aren’t discussing the topic of this paper through the lens of the DNP nursing leader. Instead, we see a variety of different lenses (e.g. in regard to healthcare, nurse-patient communication, patient-physician communication, etc.). The purpose of this paper in the context of a DNP nursing leadership course is to truly laser in and focus on these traits within the scope of nursing leadership and why this is relevant. I think the paper would be much stronger if it had that focus. Comment by Jason Portell: Right, but we are looking for the DNP nurse leader not the patient. Comment by Jason Portell: Missing a period.

Non-verbal communication is also based on other factors other than body language. In medical context, non-verbal communication includes hospital layout, decorations, spacing, and may also include the physician’s clothing and general appearance; factors which all communicate different perceptions (Sibiya, 2018). For instance, a warmly decorated and colorful patient’s waiting bay may communicate value and sense of welcoming as opposed to untidy or uncomfortable waiting bay. As such, non-verbal communication includes physical position for instance nodding the head in agreement, facial expressions like frown or smile, eye contact for instance looking away or staring, and physical reactions such as breathing heavily all have unique impact on verbal communication. As such, non-verbal communication is critical for clinicians as it not only helps supplement and substitute verbal communication but may also undermine communication as they can contradict speech. In this regard, eye-contact, physical touch for instance hand-shake makes most patients feel the caregiver is empathetic thus is more encouraged to communication (Sibiya, 2018). Comment by Jason Portell: Personal appearance is a non-verbal communication, but the environmental discussion here is superfluous to the discussion.

Non-verbal communication therefore encompasses various aspects of communication. While most patients encourage eye contact as show of support, others also support colorful and well-decorated clinical environments as they are not only welcoming but also promote positive non-verbal interactions. Various patients also agree that body language helps decode the physician’s message while nurses harbor a common feeling in regards to patients (Tuohy, 2019). As such, it’s critical that clinicians marry both verbal and non-verbal communication for effective diagnosis. For instance, most patients may claim to be absolutely fine but their body languages are absolute opposite; suggesting pain or discomfort. As such, being critical about non-verbal communication especially body language helps nurses probe further rather than just accepting the verbal words. Clinicians should therefore ensure greater attention to ensure effective communication given that cultural differences among other factors influence non-verbal communication (Tuohy, 2019).

Written Communication Comment by Jason Portell: Center this level 1 header

A written communication is involving the sending of messages mainly instructions in writing via letter, memos, reports and electronic medium like email or telegram. In this regard, written communication is formal and is less flexible as it’s often applied for future referencing. In a hospital set-up, written communication is mainly used for instances such as diagnosis and drug-prescription which may be applied as legal evidence either by clinicians or patients during a lawsuit (Ferreiraª, et al., 2016). The most used forms of written communication include referral and discharge letters. Ian addition, referral letters may be categorized into request for treatment, request for mutual responsibility in regards to a patient’s’ care and request for a second opinion whereas discharge letters are simply legal authority allowing a patient to go home (Ferreiraª, et al., 2016). Comment by Jason Portell: Lacks the discussion of professional tone and style, use of standard English, and strategies for writing as a DNP leader in professional documents. Comment by Jason Portell: involves Comment by Jason Portell: omit Comment by Jason Portell: most-used Comment by Jason Portell: In addition

In a hospital set-up, written communication is most vital for future references especially among patients with chronic conditions. Written communication can be reproduced. It therefore makes it easier to share information in instances requiring patients to shift from one system to another including those requiring numerous caregivers; for instance, drug rehabilitation programs. Moreover, with the increasing technological advancements promoting a shift towards digital technology, written communication is highly favored given that is used more immediate mediums which also provide evidence of communication (O’Hagan, et al., 2014). As such, written communication ensures medico-legal value. Most importantly, written communication allows clinicians to record any care offered to a patient, thus promoting safe and continuous treatment regardless of shifts while these records may also be applied in court of law as legal evidence when patients file legal suite regarding care offered to them (O’Hagan, et al., 2014).

All clinicians must have skills in written communication. Most nurses are mandated to offer assistance to registration and records staffs where that may be required to update, produce or prepare patients’ health records (Sibiya, 2018). In this perspective, clinicians must document every care delivered, provide specific such as time and date when and if significant events such as death occurs, ensure data has no error and is bias-free. As such, as part of the healthcare team, any medical personnel must ensure any written communication about a patient’s condition is only accessed by authorized people. This is as such, because unauthorized third-party access to medical records is breach of patients’ right to privacy as therefore a criminal offense (Sibiya, 2018). As such, it’s often encouraged to promote verbal communication between nurse-patient and written communication mainly between clinicians. Verbal communication should not only have used in those instances requiring patients to have written communication (Sibiya, 2018).

Misinterpretation of Communication

In most occasions, verbal communication go hand-in-hand with non-verbal communication especially body language. As such, specifically relying on body language without integrating it to speech will lead to misinterpretation of the message. Clinicians must therefore focus on any disparities between their observations and what the patient says (Haghighi, & Rooeintan, 2018). This will help in triangulating messages from various sources to create a holistic view by listening to and integrating the patient’s both verbal and non-verbal messages. In this regard, nurses must be aware of all messages by considering various behaviors (Haghighi, & Rooeintan, 2018). For instance, sweating among female patients may be due to nervousness or other symptoms and as such, nervousness must be only concluded if sweating is also combined with poor eye contact.

Cultural differences also influence decoding of messages. Based on proxemics, most people would only allow very close proximity during communication and will feel discomfort when any unknown parties invade their personal space or if the distance expands further. It’s therefore critical that clinicians know when and if to enter a patient’s personal space (Ferreiraª, et al., 2016). Based on cultural differences, eye contact may be considered rude by some patients, and averting the same could be considered respect or dishonesty by others. Clinicians must therefore be aware of their patients’ conditions and communication preferences. For instance, people with Asperger’s find eye contact uncomfortable. Despite various variations due to culture and gender, it’s natural that human being share common emotions through facial expression regardless of age, gender, or social class (Ferreiraª, et al., 2016).

In conclusion, all types of communication are important however, non-verbal messages tend to be more impactful than either written or verbal messages. As such, to ensure effective communication, medical professionals must learn how to manage their own body language while using verbal-communication to avoid sending mixed signals and focus more on decoding the patient’s unspoken message for accurate diagnosis and treatment. Written communication should only be applied to specific events requiring recording of communication.



Bramhall, E. (2014). Effective communication skills in nursing practice. Nursing Standard (2014+), 29(14), 53.

Ferreiraª, M., Silvaᵃ, D., Piresᵃ, A., Sousaᵃ, M., Nascimentoᵃ, M., & Calheirosᵃ, N. (2016). Clinical skills and communication in nursing students. In 2nd International Conference on Health and Health Psychology.

Haghighi, S., & Rooeintan, M. (2018). Effective Communication Barriers between Nursing Students and Patients from Nursing students’ Point of View in Ahvaz in 2013-14.

O’Hagan, S., Manias, E., Elder, C., Pill, J., Woodward‐Kron, R., McNamara, T., … & McColl, G. (2014). What counts as effective communication in nursing? Evidence from nurse educators’ and clinicians’ feedback on nurse interactions with simulated patients. Journal of advanced nursing, 70(6), 1344-1355.

Sibiya, M. N. (2018). Effective Communication in Nursing. Nursing 19.

Tuohy, D. (2019). Effective intercultural communication in nursing. Nursing Standard, 34(2).