Nursing the patient with severe communication impairment

Background. Effective communication with patients is critical to effective nursing practice. Surprisingly, there is little information on nurses' expe riences in caring for USA. patients who are unable to speak. Purpose and method. This study provides descriptive information from interv iews with 20 nurses who cared for patients with severe communication impair ment. The interview protocol explored positive and negative experiences of nursing patients with severe communication impairment. Frequency counts and descriptive analyses were conducted to identify the major themes emerging from the interviews. Results. The results suggest that nurse-patient communication is difficult when the patient has severe communication impairment, although some nurses discovered effective strategies to facilitate communication with such patie nts. Many of the difficulties could be viewed as a breakdown in understandi ng arising from the lack of a readily interpretable communication system th at could be used by nurse and patient. Conclusions. The results suggest a need for training nurses in the use of a lternative modes of communication. Nurses also need access to a variety of simple augmentative communication devices for use with patients who are una ble to speak. Finally, nurses should collaborate with speech pathologists o n the development of preadmission information and bedside training for peop le who are admitted to hospital with severe communication impairment.