Barriers to Verbal and Nonverbal Communication

Barriers to Verbal and Nonverbal Communication

This essay is about barriers to verbal and nonverbal communication in nursing practice. Study it to gain insights that you can use when creating essays on factors that hinder communication in practice settings.

Introduction to Barriers to Verbal and Nonverbal Communication Essay

What is communication?

Communication is a multifaceted process with many different parts. Individuals communicate information via communication, which is a dynamic process (Sheldon 2005). The sender, the receiver, and the message are all required in this process. (Alder 2003). If any of these elements are missing, communication will be impossible.

While Peate (2006) claims that communication occurs on a daily basis and follows a linear pattern, Spouse (2008) contends that it is not that simple and does not follow such a pattern. He says that since signals are conveyed simultaneously through verbal and nonverbal channels, the recipient is supposed to grasp how they are communicated.

Effective communication requires an understanding of effective verbal and nonverbal communication skills, as well as the potential hurdles to effective communication. Before a nurse may register, the Nursing and Midwifery Council (2008) specifies that they must have strong communication skills, since it is an important aspect of a nurse’s care delivery. 2003 (WAG)

Reflecting on communication in practice will reinforce communication theory and enable a nurse to examine problematic and effective communication in a variety of circumstances. As a result, excellent communication strategies will be enforced in a range of scenarios, allowing for a more interpersonal and therapeutic nurse-patient interaction.

This assignment explores the importance of health care communication in nursing by:

  • Examining the differences between verbal and nonverbal communication, as well as potential roadblocks
  • By exploring the fundamentals of care set out by the Welsh assembly and the nurse and midwifery council’s code of conduct a better understanding of the importance of communication is gained.
  • Using a situation from a community posting as a model for reflection in practice.

Verbal Communication

What is verbal communication?

Verbal communication takes the form of spoken language and may be delivered in a formal or casual manner. Verbal language is one of the most common ways humans communicate, and it’s a fantastic method to obtain information via a question and response process (an important aspect of communication) (Berry 2007; Hawkins and Power 1999). As a result, verbal communication in nursing should be seen as a fundamental procedure and a valuable tool in patient evaluation.

There are two sorts of questions: open-ended and closed-ended inquiries (Stevenson 2004). Open-ended inquiries usually need more than a single word answer and begin with the words what, who, where, when, why, and how. It encourages the patient to discuss more about their health and how they are feeling, leading to a more thorough examination (Stevenson 2004).

The use of open-ended inquiries gives the patient the impression that the nurse is paying attention to them and that they are being heard (Grover 2005). It enables a psychological emphasis to be offered, as well as a sense of involvement in all areas of the patient’s treatment, allowing for the development of a therapeutic connection (Dougherty 2008).

Closed inquiries are used to find out highly particular details about a patient (Dougherty 2008). They excel in obtaining accurate information in a short period of time (Baillie 2005). Closed questions are divided into two categories: concentrated and multiple-choice. Multiple choice questions are more likely to be based on the nurse’s knowledge of the illness being examined, while focused questions are more likely to get information on a specific clinical circumstance (e.g., asking a patient who has been given Ibuprofen, “Are you asthmatic?”). It may be used to assist the patient in describing their pain, such as if it is mild, acute, or throbbing (Stevenson 2004).

Good listening skills are required for efficient verbal communication. If the individual with whom you’re speaking doesn’t seem engaged, sharing information, worries, and emotions becomes tough (Andrews 2001). Active listening might help you get a better grasp of your patient’s most current health concerns (Sheldon 2005). Message overload, physical noise, insufficient effort, and psychological noise may all contribute to poor listening. As a result, in a nurse’s duty, being ready to listen and putting out the effort and time is critical (Grover 2005).

Non-verbal Communication

What is non-verbal communication?

This method of communication does not need the use of spoken language and may be more successful than using words. Nonverbal behaviour accounts for 60–65 percent of all communication between individuals, and these behaviours might reveal sentiments and emotions that the patient is experiencing (Foley 2010, p. 38).

Nonverbal communication provides dimension to speech; it may be used to reaffirm verbal communication; it can be used to manage the flow of communication; it can be used to express emotions; it can be used to help define relationships; and it can be used to give feedback. The combination of verbal and paralanguage (vocal) may have an impact on communication (Spouse 2008)

Due to the usage of paralinguistic language, Berry (2007, pg18) emphasizes the richness of verbal language. In nonverbal communication, the tone and pitch of our questions, as well as volume and pace, all play a role. Personality, he believes, can be seen in the way paralanguage is utilized, as well as in the way it adds depth of meaning to the presentation of the material being transmitted.

According to Foley (2010), research shows that language has no actual impact on communicating emotional sentiments and that most people comprehend the emotion even if they don’t understand what is being said. As a result, paralanguage is a vital tool for determining a patient’s emotional state.

Body language, touch, gestures, facial expressions, and eye contact are examples of nonverbal activities (kinesis) that may transmit messages. Our face may indicate numerous emotions without articulating how we feel by employing universal facial expressions of emotion (Foley 2010). When we are astonished, we lift our brows, and when we are horrified, we widen our eyes further.

First impressions are crucial for successful communication; remembering to grin with both your eyes and your lips may indicate an accessible and open person. This may assist a patient who is displaying indications of anxiousness to feel more at ease (Mason 2010).

Barriers to Communication

What are the barriers to communication?

It’s also crucial to have a good awareness of communication difficulties. Many of the difficulties related to health and social care were found to be attributable to communication inadequacies, according to the Welsh Assembly’s basics of care (2003). These hurdles might be the messenger’s judgemental or power-wielding attitude. According to Dickson (1999), socioeconomic status may be a barrier to communication, since feeling inferior to the nurse might distort the message and make communication harder to sustain.

Barriers in the environment, such as a crowded ward or a stressed nurse, might obstruct efficient communication. As Endacott suggests, this may significantly limit the degree of empathy and communication provided (2009). Due to their incapacity to speak vocally or their inability to comprehend complicated new information, people with learning impairments have challenges in conveying their needs. As a result, communication breaks down, and their health-care requirements are not satisfied (Turnbull 2010).

Timby (2005) emphasizes the need of following the legislation as well as the NMC (2008) rules for permission and confidentiality when engaging with patients. This includes the transfer of responsibility to other specialists. He proposes that, regardless of age, religion, gender, or ethnicity, a patient’s right to autonomy be protected and respected without undue persuasion or intimidation. Communication must be used in practice, and reflecting on previous experiences aids in a better understanding of both effective and poor communication.


Reflecting on my experience as a practising nurse at a G.P. in the Valleys of South Wales has helped me comprehend and obtain practical expertise in effective communication in nursing practice. The period was one week and included visits at numerous C.O.P.D. centres (Chronic obstructive pulmonary disease). Using Gibbs’ reflective cycle, I will reflect on one visit (1988).


The patient will be referred to as Mrs A.E. due to confidentiality (NMC, 2008). Mrs A.E was summoned to the appointment room by the nurse. I could see she was worried by her body language (palm trembling and sweaty, fidgety, calm and rapid speech). She was invited to take a seat by the nurse. I got permission from the nurse to observe her review (NMC, 2008).

The evaluation began with a simple questionnaire that the nurse had prepared ahead of time on the computer. It was a rather restricted survey on her breathing, including how it felt and when it was labored. Her medicine and how she used her pumps were also brought up as topics of discussion. Reflecting on these questions, I believe the questions did not provide much room for Mrs. A.E to discuss anything other than the response to that particular question.

The nurse was in charge of the flow of information. The nurse didn’t make much eye contact with the patient and was more focused on the computer than on the patient. I was curious whether the nurse had picked up on the nervous nonverbal communication signals.

I wasn’t sure whether this was anxiety, anguish from being sick, or she was upset about something else since the patient appeared on the edge of crying. I felt sad for her since her whole body language suggested that she was unhappy. She did not smile and had her arms crossed over her torso (indicating that she was consoling herself). She also seemed to be uptight and uneasy.

The Nurse continued with the general examination and performed the lung test, while I measured the blood pressure and pulse, as required by the NMC. When the Nurse turned to face Mrs A.E. after all the questions had been completed on the computer, I observed she made eye contact with her and her body was slightly leaned toward the patient (non-verbal communication).

The Nurse explained why her asthma may be worsening at the present, as well as how she can manage her COPD at this time of year, in a straightforward and suitable manner. The Nurse gave her detailed instructions on how to use her three separate pumps and had her repeat the instructions back to her to ensure she understood them.

As the discussion developed, I could sense the patient becoming more at ease, as well as proof that she comprehended the advice. The Nurse was familiar with this patient and spent the remainder of the time asking her about any other issues she had and how she was feeling in herself, using a more open questioning method.

The nurse utilized active listening skills to enable the patient to speak about her concerns while also showing empathy for her predicament and suggesting some possible remedies. She offered the patient information on a support group that helped patients with chronic illnesses gain confidence and cope with the emotional aspects of their illness.


My mentor said after the patient had left that the patient was a frequent visitor at the clinic and that she had a history of anxiety concerns that were exacerbated by her severe asthma. I felt really uneasy during the first part of the evaluation. Because I was there throughout the evaluation, I speculated that the lady’s failure to explain why she seemed frightened and disturbed may have been due to the fact that I was present. I also had the impression that the nurse was not responding to Mrs A.E’s anxiety indication, which made me uneasy.

I wanted to ask her if she was all right, but I didn’t want to disrupt the evaluation. However, towards the conclusion of the review, I was much more satisfied with how things had turned out. I believe that developing a connection with the patients helped the nurse to better understand the patient’s communication requirements and to make better use of the time she had.

She approached the woman with empathy and attentively listened to her. I understand that the first part of the review involved a lot of closed questions to get the facts about the condition, whereas the second part of the review involved more open questions and nonverbal communication, allowing the patient to express any concerns or feelings about the questions asked earlier.


Closed questions allow for a lot of information to be acquired in a short amount of time and may be tailored to the review requirements of the patient. These pre-generated questionnaires are effective at gathering information for the G.P. as well as maintaining accurate records, both of which are necessary for the patient’s care to be delivered in a consistent manner (NMC 2008). It may also shield the nurse from legal problems.

The use of open and closed questions enabled the review to go further into the patient’s thoughts and emotions, enabling the nurse to empathize with the patient, which is an important element of the counselling relationship (Chowdhry, 2010 pg. 22).

However, since the computer screen was faced away from the patient, excellent nonverbal communication skills were not possible. The patient’s nervousness may have been worsened by the nurse’s lack of eye contact. In study, Hayward (1975, p. 50) summarized that anxiety was associated with uncertainty about disease or potential issues. Anxiety has been related to an increase in pain.

As Nazarko (2009) points out, when a person is speaking with a nurse, it is critical that they have the nurse’s entire attention. He claims that being conscious of one’s own nonverbal behaviours, such as posture and eye contact, might influence how a patient receives messages.

The patient was apprehensive, concerned, and worried at the start of the review, as seen by the reflection. Her body language had drastically altered by the conclusion of the evaluation. The patient looked and felt much better, and she had a greater awareness of how her disease affected her and how to control it.

However, if this information was not conveyed clearly, the patient’s worry may have been exacerbated (Hayward, 1975). This also relates to the necessity to comprehend medical situations so that communication may be tailored to the requirements of the patients at the moment.

Communication is of utmost significance in the efficacy of care provided by nurses, according to the Welsh Assembly Government’s (2003) basics of care. We can comprehend and recognize that the communication in this reflection was excellent communication in practice by looking at all of the basics of communication and their impact on patient care.


Closed questions, which were employed at the start of the evaluation, had their benefits. They enabled the nurse to concentrate on the clinical facts that were required. The evaluation began with mostly closed questions to collect all of the clinical data required, such as personal information, spirometry findings, blood pressure, and COPD medicine management (Robinson, 2010).

The nurse may assess using quantifiable results and adapt treatments appropriately thanks to the organized method (Dougherty, 2008). If time is a concern, the closed question technique enables the consultation to be condensed. However, as Berry (2007) points out, this has the drawback of potentially missing critical information. Closed questions on a computer screen made it difficult to employ nonverbal communication. Eye contact, which is a key part of successful communication, is not allowed.

The inclusion of open-ended questions in the evaluation enabled the patient to convey their feelings about their illness as well as any other concerns they had. The nurse communicated via her nonverbal behaviour and active listening abilities. It gives the patient the chance to seek guidance on any concerns they may have. Open-ended inquiries might elicit a lengthy and occasionally irrelevant answer, wasting crucial time (Baillie, 2005).

Barriers to Verbal and Nonverbal Communication
Eye Contact

In the reflecting situation, eye contact is another key aspect of communication. At the outset of the evaluation, there was very little eye contact. When the nurse asked the closed questions, she made minimal eye contact, but none when the answer was delivered. This might have exacerbated the patient’s anxiety. Eye contact was made during the open questions section, on the other hand. Eye contact at this point facilitated information comprehension. The importance of eye contact in communicating is immeasurable, and it has a significant impact on anxiety symptoms (Dougherty 2008).

Reflection conclusion

In this COPD review, communication was used in a fairly systematic way. Closed questions were used to assist in arranging the session and getting a large amount of information from the patient. The open-ended inquiries gave the patient the opportunity to voice any feelings or worries. The nurse utilized both verbal and nonverbal communication to gather information about the patient, identify any requirements, and interact with the patient within the time frame.

However, in my view, greater engagement might have been built from the start if the computer screen had been brought closer to the patient during the closed question part. It would also enable the nurse to gaze at the patient while asking questions, resulting in a more therapeutic interaction while still collecting and documenting a lot of data. As a result, the adoption of effective communication skills as shown in this research, along with a person-centred approach, may considerably improve the quality of therapy and care provided to patients (Spouse, 2008), indicating strong communication in practice.

Action Plan

Barriers to Verbal and Nonverbal Communication
Gibb’s Reflective Cycle: Action Plan

The plan’s purpose is to get more patients involved in using the computer as an interactive tool. By letting the patient see what is on the screen and being typed, the patient feels more engaged in the evaluation and any feelings of inferiority associated with social class differences are removed.

In an attempt to achieve these goals, the following steps would be taken:

  • Form a team to examine the problem, which may include nursing staff or other hospital personnel.
  • Create a feedback form to learn how patients feel about the computer’s closed questions, including a part regarding how they would feel if they were able to peek at the screen.
  • Gather feedback findings, analyze, and review them.
  • Identify any obstacles to the plan’s execution (e.g. willingness of nurses to this change).
  • Inform the NMC about the problems and the results of the feedback survey.
  • The plan’s implementation.
  • Establish a monitoring and assessment team to ensure that the strategy is being carried out properly.


The relevance of communication in nursing practice has been examined in this assignment. As a result, communication is a crucial activity that involves the interaction of one or more people utilizing both verbal and nonverbal ways. Understanding communication hurdles may make a big difference in how well a nurse communicates in the field. In nursing, inquiry has shown to be a useful strategy for evaluating a patient and gathering information.

However, how this is done may have an impact on the nurse-patient relationship’s growth of empathy, trust, authenticity, and respect. However, it is critical for nurses to reflect on their communication in the workplace in order to enhance the therapeutic connection between them and the patient, which has been highlighted as critical in the delivery of care (WAG 2003).

Frequently Asked Questions (FAQs)

1. What is the meaning of non-verbal communication?

This method of communication does not need the use of spoken language and may be more successful than using words. Nonverbal behaviour accounts for 60–65 percent of all communication between individuals, and these behaviours might reveal sentiments and emotions that the patient is experiencing (Foley 2010, p. 38).

Nonverbal communication provides dimension to speech; it may be used to reaffirm verbal communication; it can be used to manage the flow of communication; it can be used to express emotions; it can be used to help define relationships; and it can be used to give feedback.

2. What are the barriers to communication in health care?

Many of the difficulties related to health and social care were found to be attributable to communication inadequacies, according to the Welsh Assembly’s basics of care (2003). These hurdles might be the messenger’s judgemental or power-wielding attitude. According to Dickson (1999), socioeconomic status may be a barrier to communication, since feeling inferior to the nurse might distort the message and make communication harder to sustain.

3. What are the 6 stages of Gibbs reflective cycle?

  • Description
  • Feelings
  • Evaluation
  • Analysis
  • Reflection conclusion
  • Action Plan


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Barriers to Verbal and Nonverbal Communication


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