Communication in Nursing: A Q&A on the Importance of Therapeutic Communication Techniques

There’s a firm and widely understood line that connects effective communication in nursing to improved patient outcomes.  

This is a point raised in a 2025 Teaching and Learning in Nursing article, which points out that nurses’ abilities to communicate in an agile and responsive manner has a direct bearing on safe and quality care.  

But, as with many topics in nursing education, the importance of communication in nursing doesn’t necessarily translate to an easy teaching and learning experience. That’s why we sat down with Hilary Gupte, RN, PGCE, a healthcare educator who has specialized in cardiac, critical care, and emergency settings, to discuss: 

• Why communication can be a challenging subject for student nurses unfamiliar with factors like non-verbal cues 

• The benefits of models and frameworks like SOLER and SBAR for introducing a standardized approach to unpredictable circumstances 

• Practical examples of where clarity, process, and therapeutic communication techniques have made a difference in practice 

• The importance of repetitive practice and how digital resources can help students gain exposure to a wide array of communication-driven scenarios 

When we talk about communication in nursing, what does that really encompass beyond just speaking to a patient? 

I like to break communication down into three key areas, really. 

In the first instance, you’ve got that all-important therapeutic nurse-patient communication, a core human-factor skill. This can be verbal or non-verbal, but in either case it’s an absolutely vital way to build that sense of trust with patients, which then can then translate into better emotional and psychological wellbeing. 

Secondly, there’s the patient safety aspect. This is a different use case for communication in nursing, but it’s every bit as important. And it’s more clinically focused that usually involves communicating across teams to make sure everyone’s updated on things like patient needs, findings, and referrals. It really boils down to safer care: good communication prevents errors, and there’s no question that many patient complaints are rooted in poor communication somewhere along the line. Effective communication relies heavily on shared mental models and situational awareness, both essential for coordinated care. 

And then you’ve got the third pillar of communication, which comes down to interprofessional team-based comms. This is centered more around professionalism, but there are still high stakes to bear in mind here: better staff satisfaction and retention can hinge on effective interprofessional interactions. Psychological safety within teams is a huge part of this, which in turn enables teams to provide better patient care. 

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Why do you think the importance of communication in nursing is so widely accepted, and yet still so difficult to teach well? 

The simple fact is that communication takes practice.  

You’re always going to encounter scenarios that you can’t plan for, and the nature of communication in nursing (or any other setting, really) is that it’s always going to take place in the moment. There’s an unpredictability there. 

That doesn’t mean it’s impossible to teach. But, in my experience, these factors do translate into a need for certain teaching approaches. As I say, I’m a big believer in repetitive practice as a means for nursing students to build confidence and overcome the unpredictable nature of patient communication, especially when it’s supported by realistic simulation scenarios. 

And there is a strong theoretical base to draw from in this space. Models like SBAR (Situation, Background, Assessment, Recommendation) to inform what you say and SOLER (Sit Squarely, Open Posture, Lean Forward, Eye Contact, Relax) to inform how you present yourself can make all the difference in the world for learners. 

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Do you see a difference between general interpersonal communication in nursing and therapeutic communication techniques, or are they essentially the same in practice? 

Well, the simple fact is that whether you’re communicating with a colleague or with a patient, the stakes are high.  

Wherever there’s a chance for harm, whether that’s through a failure to get across important referral information to a fellow nurse or through emotional distress or misunderstanding, you’re looking at a skill that needs to be thoroughly honed and practiced. 

And it’s worth remembering that communication is a skill that needs to be learned. I’ve known people who are naturally better at, or more comfortable with, communicating with patients than they are with teams, and for some people that’ll be the other way around.  

But no matter how naturally the skill may come to you, it is a skill. And as you imply in your question, therapeutic communication techniques are exactly that: they’re purposeful, evidence-based strategies designed to support interactions and understanding. They can absolutely be taught, rather than being an innate quality that you either have or don’t have. 

Can you recall an example from your professional nursing experience where body language or tone had more impact than words? 

I’ll give you a couple of examples from both the verbal and non-verbal side. 

In terms of verbal communication, I remember once asking a student to fetch GTN spray from a ward. That sounds like a simple enough request (and it is!), but in the moment I didn’t convey what GTN spray is or why I needed it urgently. And, as a result, the student took their time, whereas if I’d explained that I needed it in response to patient chest pain, the student may have acted quicker. That’s also a good reminder that tone, clarity, and behavior signalling can change how someone understands.  

On the non-verbal side, you really see the effects of perception and presentation when you’re in a healthcare setting. I’ve known some doctors who find themselves getting paged a lot more than others (regardless of whether or not it’s their role to be the first point of contact) purely based on how approachable they’re perceived to be by other members of the team. Even subtle cues like posture or eye contact can signal availability long before words are exchanged.  

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What are the most common barriers in nursing communication that educators need to be aware of, especially for first-year students or those on rotations? 

Whether the subject is interprofessional communication skills or therapeutic communication techniques, I’ve found that some students don’t necessarily realize how they’re perceived by others. It’s that blind area of the Johari window: the set of qualities that others can spot but which we’re not fully aware of ourselves. 

In my experience, encouraging nursing students to be genuinely open to feedback is really key here, and especially 360-degree feedback, which gives students the chance to understand how they’re performing and perceived by a variety of different people. Students may be more receptive to feedback when we teach them how a small shift in communication can have a real impact on patient experience and safety. 

Combined with roleplay simulation-based exercises, these approaches can help shed some light on those blind spots and give students the opportunity to ensure that those non-verbal cues line up intentionally with the openness, clarity, and approachability that we want nurses to convey. 

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What's the advantage of frameworks like SOLER when you’re teaching therapeutic communication techniques? 

I think the real advantages of these more codified techniques come to the fore when you’re communicating bad news. Even when nurses aren’t breaking the news themselves, we’re often the ones who stay behind to support the patient and families. It’s helpful if we can reiterate the information in a consistent and compassionate way.  

These situations are always going to be emotive, and it can be impossible to know how patients or families are going to respond. It could be the fourth family member’s cancer diagnosis, or their first ever encounter with it, and that individuality human experience makes reactions hard to predict. 

In the face of that uncertainty, models like SOLER are a great anchor for students to stay attached to as they navigate these nuances and unknowns. They help the learner remain grounded, present and intentional, especially when combined with the repetitive practice that turns communication techniques second nature.  

And there are also frameworks for inter-professional communications, too. I’m a big believer in the SBAR model (Situation, Background, Assessment, Recommendation). Standardizing the way you deliver important patient information to colleagues has a huge impact on the quality, safety, and clarity of your care. 

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Could you share a couple of therapeutic communication examples from practice: moments where communication clearly built trust, defused tension, or helped you deliver difficult news? 

I find myself putting these kinds of techniques into practice all the time. Mirroring patients’ words, for example, makes it easier for patients to feel heard and to process information at their own pace, and active listening is the absolute cornerstone of my patient interactions. Both essential behaviour markers of therapeutic communication.  

As someone who’s spent a lot of time working in Critical Care, I’ve found these techniques have been really useful in de-escalating tricky situations. Patients in intensive care often find themselves frightened or disoriented, and the ability to talk to them in calm, consistent ways, and to show you are truly listening, can make a huge difference in making them feel grounded, safe, and understood. 

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Traditionally, communication is taught using roleplay. How do you feel about digital simulation as a way to complement and maximize the value of these nurse-patient communication scenarios? 

At heart, teaching communication in nursing comes down to scenario-based learning. 

When situations vary so drastically from one patient encounter to the next, the best thing you can give learners is the opportunity to practice as much as possible, and that’s where digital resources can really shine: a variety of different scenarios that can be practiced as much as possible. 

The more techniques you have in your communications toolbox, the more natural your in-person interactions become. Digital exposure to a broad range of patient circumstances is just a fantastic way to keep that toolbox full and help students feel more prepared as they step into clinical practice.  

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