Memorandum

Charles Brian Kelly;

ENGL 7702; Final Report;
Date: 12/15/14
Introduction
A large amount of research has been conducted involving effective workplace
communication.1-13 Research of this type has been especially prevalent in the field of nursing.1,13-18
The bulk of effective nursing communication research is concentrated into three related and
overlapping areasnurse-nurse communication (communication between nurses of equal
standing)15, nurse-physician communication (communication between an nurse and a physician
with the ability to both hire and fire)16-17, and physician-physician communication
(communication between physicians of equal standing)18. However, in spite of all of this
research, each paper defines the term effective in its own way: leading to difficulty in
comparing research.
Since nurses face so many communication issues on a daily basisdifficulty
communicating with other nurses15,19, difficulty communicating with physicians17,
communicating emotionally charged news to patients and their families20, difficulties using
communication technology21being aware of the latest research on effective communication is
essential. However, because each research paper defines the term effective differently, it can be
difficult to quickly interpret how new research compares to previously published material. If all
nursing communication research papers were to use a common definition for the term effective
as applied to nursing communication, new research could be read and interpreted quicker and
thus be put into practice sooner. OHagan et al. (2013) proposed that best way to develop the
proper definition of effective nursing communication is to determine if there is a majority in
opinion of what the term effective means to those in the medical field. In the present study, two
private practice physician offices (for the purposes of this study, a private practice physician
office is one in which the physician is also the employer) in the coastal town of Wilmington, NC
were visited to determine if there were any commonalities between nurses and physicians on
what the term effective meant when applied to nurse-physician communication.
Methods
Two private practice physician offices in the city of Wilmington, NC were selected for
this study. Each office was visited and one-on-one personal structured interviews were conducted
with each nurse and physician(s). The structured interview included a brief description of nursephysician communication and the following questions:
1. How, in your own words, do you define the term effective when referring to nursephysician communication?
2. If the term effective is defined as when the listener (physician) clearly understands the
message that the speaker (nurse) intended to send, with a yes-or-no answer, do you
consider your office to have effective nurse-physician communication?

The results from these questions were then tabulated (See Table 1. below) and analyzed.

Physician Office 1

Physician Office 2

Question 1

Question
2

My boss knows what I mean

yes

My boss understands me

no

Everyone understands
everybody else
Employees understand the
boss and the boss
understands the employees
I don't know, I never
thought about it

no
no
yes

Gets the point across

no

Everyone feels heard

no

Compromization

no

The boss does what I want

no

Everybody understands
everybody

yes

My boss understands me

no

The boss understands the

employee's point of view

no

Achieves the desired effect

yes

My boss understands me

no

Gets the point across

no

Gets the point across

no

Question 1
The boss listens to what
employees have to say
Staff is thoroughly informed
about a patient
Everyone is on the same
page
Listening to each other
My boss understands what
we (employees) are saying
Brings about a desired
change
Staff is thoroughly informed
about a patient
Gets the point across
My boss understands what
we (employees) are saying
Everyone understands each
other
I understand what my
employees want
Everyone is on the same
page
Everyone understands each
other
My boss understands what
we (employees) are saying
Everyone understands each
other
Gets the point across
Gets the point across

Question
2
yes
yes
no
yes
yes
no
yes
yes
yes
yes
no
yes
yes
yes
yes
no
yes

Table 1. Answers to questions 1 and 2 from both physicians offices.

Findings
The first question all nurses and physicians at both offices were asked, How, in your
own words, do you define the term effective when referring to nurse-physician
communication? was easily understood and everyone gave several different definitions as

shown in Figures 1 and 2 below. This was expected because as explained above, research
publications also give differing definitions of the term effective and the last publication that a
nurse or physician read may well influence their interpretation of what the term effective means.

Figure 1. Answers to Question 1 from Physician Office 1.

Gets the point acros s
my bos s unders tands me
achieves the des ired effect
the bos s unders tands the employee's point of view
everybody unders tands everybody

Question
the bos 1
s does

what I want

comprimization
everyone feels heard
I don't know I never thought about it
employees unders tand the bos s and the bos s unders tands the employees
everyone unders tands everybody els e
my bos s knows
what
0
0.5 I mean1

1.5

2.5

3.5

Figure 2. Answers to Question 1 from Physician Office 2.

everyone unders tands each other
I unders tand what my employees want
gets the point acros s
brings about a des ired change

Question 1

my bos s unders tands what we (employees ) are s aying

lis tening to each other
everyone is on the s ame page
s taff is thoroughly informed about a patient
the bos s lis tens to what employees have to s ay

0.5

1.5

2.5

However, certain opinions are commonly shared amongst both physicians and nurses.
The first physicians office showed that the term effective, when applied to nurse-physician
communication carried the ideas of my boss understands me and gets the point across much
more often than other opinions. Likewise, at the second office the ideas of gets the point
across, everyone understands each other, and my boss understands what we (employees) are
saying were the more commonly held definitions about effective nurse-physician
communication, followed by staff is thoroughly informed about a patient and everyone is on
the same page. It can also clearly be seen from Figures 1 and 2 above that Physician Office 2 is
much more in agreement in terms of what efficient means than Physician Office 1.
The answers to the second question, If the term effective is defined as when the
listener (physician) clearly understands the message that the speaker (nurse) intended to send,
with a yes-or-no answer, do you consider your office to have effective nurse-physician
communication? were easily obtained and are shown in Figures 3 and 4 below.
Figure 3. Answers for Question 2 from Physician Office 1.

4
yes
no

12

Figure 4. Answers for Question 2 from Physician Office 2.

4
yes
no

13

As shown in Figure 3, the first physicians office had many nurses that rated the nurse-physician
communication at their office as not effective. At Physicians Office 2, more nurses rated the
nurse-physician communication as effective as shown in Figure 4.
Limitations
Readers may find it interesting that the office with more agreement about what the
definition of the term effective as applied to nurse-physician communication is (Physicians
Office 2) had more nurses that also agreed that their office demonstrated effective nursephysician communication when effective is given a standardized definition whereas the office
with many differing definitions of the term effective stated that their office did not demonstrate
effective communication when effective is given a standardized definition. Although it would be
tempting to link these responses, two examples on such a small study are not enough data to
indicate a correlation.
Steps for further research
The findings of this study indicate that, as suspected, there is substantial confusion about
what the term effective means when applied to nurse-physician communication (even among
those in the healthcare field), indicating the need for a cohesive definition of the term. The
multiple answers given for the first question, How, in your own words, do you define the term
effective when referring to nurse-physician communication? indicate that with a larger study,
data could become cumbersome and difficult to keep organized. Therefore, this question should
be adjusted so that the subject can select from a series of responses that which most closely
resembles their own opinion. Ideally, these choices would be similar to those most commonly
observed in this pilot study: my boss understands me; gets the point across; my boss
understands what we (employees) are saying; everyone understands each other; staff is
thoroughly informed about a patient; and everyone is on the same page. Though these
responses are very similar, the subject will be able to indicate which one most closely matches
what he/she would have said. This study also indicates that there may be a correlation between

lack of consensus about what the term effective means and whether or not a physicians office
workers view their nurse-physician communication as effective. Future research to determine the
validity of this observation could be interesting.

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