MODES

OF COMMUNICATION 1

Modes of Communication

Elizabeth Bearden

Louisiana State University

Author Note

This paper is a written draft for English 2001, instructed by Ms. Jean Coco.
MODES OF COMMUNICATION 2

Abstract

This paper examines many modes of communication and explains their importance to those

working in the medical field. It also explains how much of an impact that written communication

has on patients when communication is used properly. Patient history is written and recorded

during each doctor visit and is passed around the hospital. Since written communication is a

traditional way to efficiently to share information, this paper focuses on why it is crucial that

information is accurate and recorded carefully.

Keywords: Written communication, lsu.library.edu

Preface:
My first source is a complete patient record. This record is designed to clearly show
what healthcare workers review when they first receive a patient. This record can help them
determine how to communicate with the patient and plan their treatment. Accurate and complete
records ensure that a patient if safe and well cared for during their hospital stay.
The next article focuses on the importance of clear written communication and in value in
responsible healthcare. I included a table from a study comparing two types of healthcare
workers complaining about unclear communication among co-workers. The specialists said
general practitioners often left out vital information on charts while the general practitioners
complained that the specialists were often not clear enough with their comments. It was a very
helpful website with useful information that made me more aware of the importance of proper
written communication.
In my third paragraph, I chose a common pitfall that showed how simple it is to make a
mistake by being distracted and not recognizing the patients needs.
I knew this was a credible source because its an article from CQ Researcher, and an
orthopedic surgeon was relaying a story that reflected just such a miscommunication issue.
In the midterm review, I really appreciated your advice regarding the need to focus on
just the one style of communication that I had been assigned- written communication. I also
needed the guidance regarding citations and took extra care to make sure that this was done
correctly in the final assignment. This is something that I struggled with and definitely needed
more direction.
I was confused by your questioning of some of my comments regarding the importance
of written communication in the hospital. I learned this by reading and actually working at the
hospital as a CNA. Other than that, I was not confused by any other comments and appreciated
your guidance as I wanted my writing to be clear and direct.
MODES OF COMMUNICATION 3

Modes of Communication

Efficient communication is an essential element in every career but it is crucial in jobs in

the medical field because there are situations that are truly life or death. Working in a medical

environment involves multiple modes of communication that are used in different ways. Those

who learn to use these different modes effectively are more successful in their careers and in

interactions with co-workers, patients, and families. Written communication is used when

recording patient history correctly, medical orders, prescriptions and laboratory test results.

Visual communication is used constantly as it is extremely important to look at a patient often to

clearly assess their physical condition. Pain charts are often used as non-verbal communication

so that the patient can easily point to their level of pain or discomfort. Also, oral communication

is used to speak over the phone or face-to-face with a patient or other healthcare professionals

about the patients condition. Having familiarity with the proper mechanics of these modes will

help lead to safe and clear communication in the work place. Failing to use these modes can

result in improper treatments, which can lead to injuries and death and may result in malpractice

suits or at the worst the loss of a medical license. Written, visual, oral, and non-verbal are the

most common communication modes that people in the medical field should master to be

successful and responsible professionals.

Examples of Written Communication in the Hospital

Patient Examination

Written communication in the larger interpretation remains the most usual, and

sometimes the only, means of communication between health care professionals. (Vermeir, P et

al., 2015, p. 1258). It is used to relay messages from each health care worker across the hospital
MODES OF COMMUNICATION 4

to inform patients condition so that further actions can be taken. Normally when a patient is

admitted to the hospital, a nurse will take over first to chart the patients identity, medical history

such as allergies, or specific protocol since each patient and their condition is unique. It is

important to be thorough and extremely cautious to ensure that the correct information is in the

chart. The patients chart is the Bible of their condition and it will be transferred to the next

professional involved in their care- nurse, doctor, technician, and dietician. The information

provided must be correct so that the next professional can do their job properly as well. It takes a

team to care for a patient and clear and accurate written communication is very critical.

Preparticipation Physical Evaluation

PHYSICAL EXAMINATION FORM
Name __________________________________________________________________________________ Date of birth __________________________
PHYSICIAN REMINDERS
1. Consider additional questions on more sensitive issues
Do you feel stressed out or under a lot of pressure?
Do you ever feel sad, hopeless, depressed, or anxious?
Do you feel safe at your home or residence?
Have you ever tried cigarettes, chewing tobacco, snuff, or dip?
During the past 30 days, did you use chewing tobacco, snuff, or dip?
Do you drink alcohol or use any other drugs?
Have you ever taken anabolic steroids or used any other performance supplement?
Have you ever taken any supplements to help you gain or lose weight or improve your performance?
Do you wear a seat belt, use a helmet, and use condoms?
2. Consider reviewing questions on cardiovascular symptoms (questions 514).

EXAMINATION
Height Weight Male Female
BP / ( / ) Pulse Vision R 20/ L 20/ Corrected Y N
MEDICAL NORMAL ABNORMAL FINDINGS
Appearance
Marfan stigmata (kyphoscoliosis, high-arched palate, pectus excavatum, arachnodactyly,
arm span > height, hyperlaxity, myopia, MVP, aortic insufficiency)
Eyes/ears/nose/throat
Pupils equal
Hearing
Lymph nodes
Heart a
Murmurs (auscultation standing, supine, +/- Valsalva)
Location of point of maximal impulse (PMI)
Pulses
Simultaneous femoral and radial pulses
Lungs
Abdomen
Genitourinary (males only)b
Skin
HSV, lesions suggestive of MRSA, tinea corporis
Neurologic c
MUSCULOSKELETAL
Neck
Back
Shoulder/arm
Elbow/forearm
Wrist/hand/fingers
Hip/thigh
Knee
Leg/ankle
Foot/toes
Functional
Duck-walk, single leg hop
Consider ECG, echocardiogram, and referral to cardiology for abnormal cardiac history or exam.
a

Consider GU exam if in private setting. Having third party present is recommended.

b

Consider cognitive evaluation or baseline neuropsychiatric testing if a history of significant concussion.

c

Cleared for all sports without restriction

Cleared for all sports without restriction with recommendations for further evaluation or treatment for _________________________________________________________________
____________________________________________________________________________________________________________________________________________
Not cleared
Pending further evaluation
For any sports
For certain sports _____________________________________________________________________________________________________________________
Reason ___________________________________________________________________________________________________________________________
Recommendations _________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________
I have examined the above-named student and completed the preparticipation physical evaluation. The athlete does not present apparent clinical contraindications to practice and
participate in the sport(s) as outlined above. A copy of the physical exam is on record in my office and can be made available to the school at the request of the parents. If condi-
tions arise after the athlete has been cleared for participation, the physician may rescind the clearance until the problem is resolved and the potential consequences are completely
explained to the athlete (and parents/guardians).

Name of physician (print/type) _____________________________________________________________________________________________________ Date ________________

Address ___________________________________________________________________________________________________________ Phone _________________________
Signature of physician _______________________________________________________________________________________________________________________, MD or DO

2010 American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic
Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment.
HE0503 9-2681/0410

Figure 1. Physical Examination Form

Source: How to Prepare for Your Appointment
MODES OF COMMUNICATION 5

Written Prescriptions

Figure 2. Prescription
Source: It isn't easy to take away a doctor's prescription pad.

When patients go to the doctor, it is usually for an illness or infection that needs to be

assessed. The doctor then diagnoses and treats the patients condition and sometimes prescribes

medication to cure their symptoms. The doctor writes the dosage and amount of refills for the

patient. They will also sign the prescription and then email, fax or have the patient deliver to the

pharmacist. This method of communication is used daily by doctors and professional nurses to

tend to patients needs.

MODES OF COMMUNICATION 6

Patient Assessment White Boards

Figure 3. White Boards

Source: Le Bonheur Children's Hospital.

Written communication keeps tasks for health care workers moving quickly during time-

consuming procedures. White boards are so efficient that they are now used in almost every

hospital. The records include the names of the patient, nurse, charge nurse, and doctor; contact

information for the patients family members as well as all of the daily tasks. The boards are

updated regularly and keep everyone on task. The doctor or nurse checks upon arriving to work
MODES OF COMMUNICATION 7

so they are immediately aware of their duties. If there is an emergency, it is assessed quickly

with all of the contact information available in big bold letters.

Pitfalls of Written Communication

Written communication pitfalls happen occasionally in the healthcare field. The nurse

first completes a physical examination of the patient and records the findings on to a form. The

nurse should carefully record this information. If the nurse is not paying attention to the

examination, and records information incorrectly then it is unlikely for co-workers down the line

to catch the mistake. The patient could be mistakenly diagnosed with a different condition after

the doctor receives the examination recording and could possibly prescribe the wrong type of

treatment.

Nurses are not the only ones who must pay attention to and double check their

recordings. It is equally, if not more important, for doctors to do so. Doctors have the

responsibility to write needed prescriptions. If the patients physical examination is not accurate,

then the wrong medicine or an incorrect dosage could be written. Also if the doctor talking to the

patient is distracted or thinking about something else the doctor is more likely to make a mistake

writing the prescription. According to an article called, Patient Safety on CQ Researcher, an

orthopedic surgeon was supposed to perform a simple procedure on a womans left wrist. While

everything seemed to go well, the doctor realized he performed the wrong procedure and she

needed surgery on her finger instead. The doctor then wanted to know what went wrong that led

to his mistake. In his article in The New England Journal of Medicine about the incident, Ring
 MODES OF COMMUNICATION 8

had become distracted by an emotional encounter with an earlier patient; a nurse marked the

patients hand at the wrist and not at the surgical site.. (Mantel, 2012. Para. 2-7).

Pitfalls can also occur in written communication on a patients white board chart. The

nurse has to pay close attention to the name of each patient when entering each room on the

floor. The nurse in charge will write what medicine the patient needs to receive at what time,

also if the patient can only eat food in liquid form, and many more important information. If the

nurse fails to record a patients peanut allergy, then a meal could mistakenly be served to the

patient with nuts because the nurse forgot to include that small detail. The white board has all of

the important details, as well as certain duties to be followed for the day. If the board is not

complete than dangerous consequences might occur.

Table 1: GPs and specialists perceptions on aspects of communication

GPs Specialists agree (%) p-
agree value
GPs telephone accessibility is good 85.3 32.8 < 0.00
1
Referral letter of GP is of good quality 29.1
Questions are addressed by the specialist 50.0 87.5 < 0.00
1
GPs follow the advice given by the specialist 92.2 49.5 < 0.00
1
Specialist letter is sent back in a timely manner 22.5 61.8 < 0.00
1
Figure 4. Table 1.
Source: Vermeir, P., et al.

It is also important for the information to be written clearly and concisely to decrease

confusion as different team members care for the patient. One should learn to state the

communication with sufficient detail but keep it concise and clear so that the next caregiver will

actually read it thoroughly. According to Vermeir et al., poor communication causes more work

for the next health care worker because they have to duplicate work by asking the patient
MODES OF COMMUNICATION 9

questions to repeat their scenarios, treatments, and tests which fatigues the patient and can lead

to misunderstandings (2015, p. 1262). Misunderstandings result in unnecessary stress for the

patients and family members. As recorded in table one, general practitioners and specialists

revealed their opinions on how well they receive written communication from other co-workers.

The general practitioners and specialists in the study disagreed with the quality of

communication between the groups. The specialists felt that the general practitioners left out

valuable information needed while general practitioners also said that the specialists did not

clearly answer all of their questions concerning the next steps. The chart also shows how the

specialists opinions do not match up in a cross-sectional study among a random sample of 550

general practitioners and 533 specialists selected from the Netherlands Medical Address Book

(Vermeir, P et al., 2015, p. 1259). It is incredibly important to have a detailed recording of the

patients clinical signs, medication, activities of daily living, social network, need of home are

and the benefit of general hospital care (Vermeir, P et al., 2015, p. 1260). The data shows how

professionals in the health care field in the primary and secondary levels have

miscommunication issues that are categorized as health hazards. According to the results of the

data, Overall, 20% of the discharge letters were missing vital medical information and less than

half of the letters contained high quality information of ADL, social network, or need for

homecare. (Vermeir, P et al., 2015, p. 1260).

Written communication is an essential source of communication used in almost every

work setting. Mistakes and misunderstandings can occur when details are not written or recorded

correctly. It is necessary for healthcare workers to always use written communication precisely.

Patient examinations, reports, written prescriptions, and daily patient assessment white boards

are common written communications used daily. It is important that the modes of
MODES OF COMMUNICATION 10

communication are clear and concise so all health care workers involved with a specific patient

has all of the information necessary for thorough care.

References

How to Prepare for Your Appointment. (n.d.). Retrieved April 27, 2017, from

https://www.universityorthopedics.com/patientcenter/patient_forms.html

Le Bonheur Children's Hospital. (n.d.). Improved communication boosts experience scores.

Retrieved April 27, 2017, from http://www.lebonheur.org/for-providers/physician-

publications/delivering-on-a-promise/fall-2014/improved-communication-boosts-

experience-scores.dot

Letitia Stein and Susan Taylor Martin, Times staff writers. (2010,

September 24). It isn't easy to take away a doctor's prescription

pad. Retrieved April 27, 2017, from

http://www.tampabay.com/news/health/medicine/it-isnt-easy-to-take-away-a-doctors-

prescription-pad/1123881

Mantel, B. (2012, February 10). Patient safety. CQ Researcher, 22, 125-152.

Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., . . . Vogelaers,
MODES OF COMMUNICATION 11

D. (2015). Communication in healthcare: A narrative review of the literature and

practical recommendations. International Journal of Clinical Practice, 69(11), 1257-

1267.