Effective communication in nursing means transferring accurate, timely information between nurses, patients and the wider care team, whether that exchange happens at the bedside or through a screen. Nurses spend a substantial share of every shift communicating: taking a history, explaining a treatment plan, updating a physician or documenting a patient’s condition for the next shift. When that exchange breaks down, patients face confusion, delayed treatment or a greater risk of a preventable error.
Communication skills used to mean voice, tone and body language in a hospital room. Today they also cover verbal clarity on a telehealth call, message tone in a patient portal and judgment about what an AI-generated note gets right or wrong. Registered nurses pursuing a bachelor’s degree through programs such as Fitchburg State University’s online Registered Nurse (RN) to Bachelor of Science in Nursing program, build these skills across both in-person and virtual settings.
Why Is Communication Important in Nursing Practice?
Clear communication reduces medical errors, speeds up care and helps patients trust the people treating them. The Joint Commission has long identified communication breakdowns, particularly during handoffs and shift changes, as one of the most common contributing factors in the sentinel events it reviews across U.S. hospitals. A single unclear handoff or an assumption left unspoken can carry into the next shift and affect a patient hours later.
During a single shift, a nurse communicates with a wide range of people, each with different needs and expectations. Recognizing who needs what kind of information, and when, is itself a communication skill. Key stakeholders and situations where clear communication matters include:
- Patients and their families, who need information explained in plain language
- Other nurses and healthcare professionals during handoffs and shift changes
- Physicians and specialists coordinating a treatment plan
- Nurse managers and administrators overseeing unit operations
Each of these relationships calls for a different register, from clinical shorthand with a physician to a slower, plainer explanation with a worried family member. Nurses who shift between these registers smoothly tend to catch errors earlier and build stronger trust with the people they treat.
How Do TeamSTEPPS 3.0 and SBAR Support Nursing Communication?
Structured communication tools give nurses a consistent framework for passing along critical information, instead of relying on memory or an unstructured verbal report. The Agency for Healthcare Research and Quality updated its flagship teamwork training program, AHRQ TeamSTEPPS, to version 3.0 in 2023 to reflect current healthcare delivery models, and to place more emphasis on active patient involvement. TeamSTEPPS 3.0 remains one of the most widely adopted frameworks for training healthcare teams in structured communication and teamwork.
One of the most widely used tools within TeamSTEPPS is SBAR: situation, background, assessment and recommendation. According to AHRQ’s SBAR tool guide, the framework gives nurses a structured way to organize a conversation about a patient’s condition, particularly when a situation is changing quickly and requires another provider’s immediate attention. A nurse using SBAR states the situation, summarizes relevant background, offers an assessment and then makes a specific recommendation, repeating back the response to confirm accuracy.
Beyond structured tools such as SBAR, nurses rely on a set of core techniques for every patient interaction. These habits build trust and reduce the chance that information gets lost or misunderstood.
- Use the patient’s name and make eye contact to build rapport.
- Avoid jargon and medical terminology the patient may not understand.
- Repeat or summarize what the patient said to confirm accuracy.
- Ask the patient to repeat back key information in their own words.
These techniques work together with structured frameworks such as SBAR rather than replacing them. A nurse who combines plain language with a consistent handoff structure communicates more reliably across every setting, from the bedside to a virtual visit.
How Should Nurses Communicate During Telehealth Visits?
Telehealth visits remove many of the nonverbal cues nurses rely on in person, which makes verbal clarity and tone carry more of the communication load. A patient cannot always see a reassuring hand gesture or read body language through a small video window, so word choice, pacing and vocal tone matter more than they do at the bedside. The American Academy of Ambulatory Care Nursing’s newly revised telehealth practice standards call for deliberate verbal techniques, such as narrating physical assessments aloud and checking in more frequently for understanding, to compensate for the loss of in-person cues.
Digital bedside manner also means managing the visit itself: confirming the patient can see and hear clearly, watching for signs of confusion on screen and staying calm when a connection drops or freezes. The Centers for Medicare & Medicaid Services has continued to expand which telehealth services Medicare covers, which means more nurses are involved in virtual visits across a wider range of care settings than a few years ago. A nurse who can troubleshoot a dropped call without losing the patient’s trust, by narrating what is happening and offering a clear next step, is practicing a communication skill as real as anything taught at the bedside.
A few habits consistently improve telehealth encounters for both the nurse and the patient. Building these into every virtual visit helps close the gap left by the absence of in-person cues.
- Speak slightly slower and more clearly than in person and pause for questions.
- State what you are doing before doing it, since the patient cannot see everything on screen.
- Confirm audio and video quality at the start of the visit rather than assuming it works.
- Have a backup plan, such as a phone number, ready before a technical issue occurs.
None of these habits require special equipment. They ask a nurse to be more explicit about things that would otherwise be communicated nonverbally in the same room as the patient.
How Do Nurses Communicate Through the EHR and Patient Portal?
Written communication now carries as much weight as verbal communication for many nurses, since most patient interactions eventually become an entry in the electronic health record (EHR) or a message in a patient portal. A handoff note that is vague or incomplete can mislead the next nurse just as easily as a garbled verbal report. Clear documentation also supports continuity of care when a patient moves between departments, providers or even health systems.
Patient portals add another layer: nurses and care teams now respond to patient messages in writing, often without the tone cues a phone call or in-person conversation provides. A message that reads as short or clinical in an email can come across as cold, even when that is not the intent, so nurses learn to write portal responses that are accurate and warm at the same time. Programs such as Fitchburg State’s online RN to BS in Nursing program build this kind of written communication practice into coursework on health information technology, alongside the verbal and telehealth skills nurses use every shift.
Time pressure remains the biggest threat to documentation quality. Rushed notes are more likely to contain vague language, missing details or a copy-forward error that repeats an old assessment instead of a current one. Nurses who build a habit of documenting in real time, rather than catching up at the end of a shift, produce records the rest of the care team can actually trust.
What Are Common Barriers to Communication in Nursing?
Every patient brings a different set of communication needs, and recognizing those differences is itself a clinical skill. Some patients want every detail explained; others feel overwhelmed by too much information at once and prefer a simpler summary with room to ask follow-up questions. Nurses learn to read these preferences quickly, often within the first few minutes of an interaction.
A number of factors can interfere with communication regardless of a nurse’s skill level. Recognizing these barriers early allows a nurse to adjust their approach before a misunderstanding affects care.
- A patient’s distressed emotional state or high anxiety
- Inability to respond due to sedation, intubation or unconsciousness
- Language barriers or limited English proficiency
- Hearing or vision impairment
- Cultural beliefs and values that shape how a patient wants to receive information
None of these barriers are a reason to stop communicating. They are a signal to adjust the method. A nurse might bring in a medical interpreter, involve a family member or simply slow down and check for understanding more often, practices that align closely with the ethical standards that guide nursing practice.
How Is AI-Assisted Documentation Changing Nursing Communication?
Ambient AI tools are beginning to change how nurses document patient encounters, though they are changing the paperwork, not the underlying communication skill. In October 2025, Microsoft announced an expansion of its Dragon Copilot AI clinical assistant, building what the company describes as the first commercially available ambient documentation tool designed specifically for nursing workflows. The tool listens to a nurse-patient conversation and drafts flowsheet documentation for the nurse to review, edit and approve before it enters the electronic health record.
Tools like this can reduce the hours nurses spend charting, but they do not remove the nurse’s responsibility for what ends up in the chart. A nurse still has to confirm that an AI-generated note accurately reflects what was said and observed, catch anything the software misheard or missed and add the clinical judgment the software cannot supply on its own. Verbal communication skills matter more, not less, once part of the visit is being transcribed in the background.
For a nurse in training, this means learning to hold a clear, well-organized conversation with a patient, since that same conversation now doubles as source material for documentation. A rambling or disorganized patient interview produces a rambling, disorganized AI-generated note just as easily as it produces a rambling handwritten one.
How Do RN to BSN Programs Build These Communication Skills?
Communication runs through nearly every course in a bachelor’s-level nursing curriculum, not just a single class dedicated to the topic. Coursework in health assessment, evidence-based practice and community-based nursing all require students to practice explaining clinical information clearly, whether to a patient, a classmate or an instructor. Fitchburg State University’s RN to BS in Nursing program builds these skills through nursing core courses and two clinical practicum experiences, giving students a chance to apply them in a live care setting.
Because virtual care and health information technology are now standard parts of nursing practice, this focus connects closely to evidence-based nursing practice, where students learn to evaluate current research rather than lean on outdated habits. Understanding how health policy shapes nursing practice rounds out this picture, since rules such as Medicare’s telehealth coverage requirements directly affect how and when nurses use these communication skills.
Strengthening Communication Across Every Care Setting
Nursing communication has expanded well beyond the bedside conversation it used to be. A nurse today needs the same clarity and empathy that have always mattered in person, plus the added skills to communicate clearly on a telehealth call, in a patient portal message and alongside AI documentation tools that are only going to become more common.
Structured frameworks such as TeamSTEPPS 3.0 and SBAR give nurses a consistent foundation to build on, no matter which setting they are working in. Nurses who invest in these skills, whether through experience or through a formal degree program, tend to make fewer errors, build stronger patient trust and adapt more easily as care continues to move toward hybrid in-person and virtual models.
Learn more about Fitchburg State University’s online Registered Nurse to Bachelor of Science in Nursing program.
About Fitchburg State University online RN to BS in Nursing program
Fitchburg State University’s online RN to BS in Nursing program is designed for registered nurses with a diploma or associate degree who want to build stronger clinical reasoning, leadership and analytical skills. The curriculum includes 32 nursing-specific credit hours across 10 courses, delivered in an accelerated, 7-week online format built for working nurses, plus two clinical practicum experiences. Coursework spans health assessment, evidence-based practice, community-based nursing, health policy and a dedicated course on caring for forensic populations, giving graduates a broad foundation beyond communication skills alone.
Fitchburg State University traces its roots to 1894, when it was established as a state normal school, and it has since grown into a public university within the Massachusetts state university system. The university, based in Fitchburg, Massachusetts, holds accreditation from the Commission on Collegiate Nursing Education for its baccalaureate nursing program. Fitchburg State’s nursing programs have been recognized among the top online nursing options in Massachusetts, reflecting a long-standing commitment to preparing nurses for evolving healthcare roles.
