Communication Barriers and the CNA’s Voice


Article Categories: Environment & Legal and Ethics



In a single journey within the healthcare system, a patient receives care from different workers across many disciplines. Many teams work together. To reach optimal patient experience, communication among healthcare workers is vital.

Communication failure is one of the leading causes of accidents, errors, and other untoward events that usually lead to patient harm, according to the Joint Commission for Hospital Accreditation. Other than that, it also leads to conflicts, stress, and low morale among staff.

Have you witnessed any untoward events such as patient harm because of miscommunication among healthcare team members? How did it go? What happened to the patient?

As a CNA, you can help avoid mistakes caused by poor communication by first knowing what causes it and then doing your part to prevent it.

Barriers to effective communication and what the nursing assistant can do:

1. Culture of accepting faulty communication.

Let’s try to recall your days as a newbie when you were introduced to terms that were not in your nursing books. These terms make sense to only a few people who understand their hidden meaning. Like codes, you’re supposed to know what they mean.

You probably just got used to it without attempting to correct that practice. An example is saying, "We have a hit" to mean 'a newly admitted patient'. A study says healthcare workers tend to accept this culture, which makes them ignore red flags.

What you should do: Avoid using slang terms that are only known to a certain number of people. Be precise to avoid confusion.

2. Personality differences.

Some personality types tend to keep to themselves and leave their observations unsaid, assuming that other members of the healthcare team who are 'more knowledgeable' and in authority would notice anyway. Also, staff with low self-esteem may find it difficult to approach a supervisor to express their thoughts.

What you should do: If you are the shy and introvert type of person, it helps to remember that you are obliged to report any observations that concern the patient. If you know someone in your team who is always reluctant to speak up, encourage them to express their thoughts, and provide reassurance.

3. Fear.

Many nursing assistants are hesitant to speak their mind mainly because they believe that they don’t have the voice to do so and that their opinions don't matter. They fear being ridiculed and judged for saying what’s on their mind. It’s an instinct of self-preservation that tries to protect oneself, of avoiding trouble, but at the expense of the patient.

What you should do: The best approach to this dilemma is to not be a part of a bullying culture. Be on the side that truly cares for what others have to say. Help them overcome their fear by engaging them in conversations and regularly asking for their feedback.

4. Cultural differences.

With the US' growing ethnic and cultural diversity, miscommunication becomes more common as the healthcare sector employs people from different cultural backgrounds. Some may not have a firm grasp of the English language, which could be a huge barrier to effective communication.

Assertive co-workers may give constructive criticisms, and staff from a more conservative culture may view this as too bold and rude. So instead of accepting the feedback, they tend to ignore it.

On the other hand, being timid may be regarded as incompetence. Conflicts and misunderstandings arise because of these differences, and patient care suffers.

What you can do: Acknowledge that cultural differences exist. Always seek clarification when their message is not precise. Ensure that you and your co-workers are on the same page.

5. Vague Requests.

In a very busy shift, the staff are usually in a hurry to get things done, and they unintentionally cut short their requests, too. And this habit is dangerous because the message they send across becomes confusing and vague.

What you can do: Use the check-back technique where you repeat what they had just said in a question form and then wait for their confirmation. If the nurse says, "I and O every 4” you may say, “I need to measure their intake and output every 4 hours, right?”. When the nurse confirms the request, then you know exactly that the needed action is clear and correctly understood.

The CNA’s voice is powerful and significant, just like that of any other staff. Be committed to ensuring that proper communication becomes the norm in your workplace.

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