COMMUNICATION
SKILLS
ABHIJIT BHOYAR

At the end of the class, staff nurses will be
able to acquire more knowledge regarding
communication skill, develop a positive
attitude towards it and practice this
knowledge in clinical areas.

 define communication
 identify process of communication
 discuss about effective communication
 illustrate the types of communication
 enlist the principles of communication
 enumerate the barriers of communication
 describe importance of communication in nursing.

Communication is a process in which a message is
transferred from one person to other person through a
suitable media and the intended message is received
and understood by the receiver.

1. Sender
2. Encoding
3. Message
4. Channel or media
5. Decoding
6. Receiver
7. Feedback

IDEATION
ENCODING
TRANSMISSION
DECODING
RECEIVING
RESPONSE
“Transmission of a message from a sender to a receiver in an
understandable manner.”

Message
Media
Encoding
Sender Feedback
Decoding
Receiver
Response

 SENDER : Sender or communicator is the person who sends
the message or an idea. Sender is the source who initiates the
process of communication. The sender is also called the
encoder.
 ENCODING : Encoding is the process by which the sender's
ideas are converted into the message through the use of
suitable language. The process of transforming thoughts and
ideas into symbolsis called encoding. The symbols can be
verbal or non verbal

 MESSAGE : Message is a key idea that the sender want to
communicate. It is a sign that elicits the response of
recipient. Communication process begins with deciding about
the message to be conveyed. It must be ensured that the
main objectives of the message is clear.

o Media or channel of the communication is the mode that is
used for conveying the message from the sender to the
receiver.
o The sender must choose an appropriate media for
transmitting the message.
o The media could be a face to face, conversation or electronic
gadgets, letter, telephone or mass-media etc.
o Choice of medium depends on the nature, importance and
urgency of the message.
o The appropriate channel selection contributes to
effectiveness of communication.

o It means translating the message into words for the purpose
of understanding.
o The receiver interprets the message to derive its meaning.
 RECEIVER :
o Receiver is a person for whom the message is intended/
targeted.
o The receiver perceive what the sender intended through the
sensation of seeing, hearing and feeling and then analysis of
the information through interpretation of what is thought to
be seen, heard or felt.

o The degree to which the decoder or receiver understands the
message is dependent upon various factors such as
knowledge of recipient, their responsiveness to the message
and the reliance of sender on receiver.
 FEEDBACK :
o Feed back is the main component of communication process
as it permits the sender to analyze the efficiency of the
message.

o It helps the sender in confirming the correct
interpretation of message by the receiver.
o Feedback may be verbal (through words), non verbal
(in form of smiles, signs etc). It may take written
forms also, in the form of memos, reports etc.

 AMBIGUITY :- Using words in current use is important
and to avoid words which convey vague meaning , as
it can lead to confusion in communication.

The communicator should
know his / her audience or
listeners and accordingly ideas
have to be put across.

 It is desirable to avoid extremes in speaking as
some subject matters may be to good or to bad.

An ideal
infrastructure and
environment are to
be provided to both
speaker and

Listening and understanding require a lot of
reasoning and attitude. The reasons of non listening

 The communicator has
to clarify his /her ideas
him/herself before and
then think on the
message clearly and
clarify ideas to ensure
effective
communication.

 The subject matter and its theme should
be greatly emphasized to draw attention to
the listener.

 It is probably the most
significant method of
improving communication
Two way process ensure
feedback.

 The style in which message is
conveyed is equally important
as what is being said . There
must be integration between
facial expression, voice,
gestures, mood to the action of
what is said about.

 One must be clear
about the ideas,
opinions and facts to be
communicated to have a
clear communication.

A verbal
communication
should be short ,
clear ,and simple
to pass the
message.

 An atmosphere of mutual trust is to be
created in the process of communication . The
informal relations are the beast weapon to
promote physical and human setting in an
institution.

 The purpose of communication is to
make others understand the subject
matter.
 The communication is ineffective if the
purpose is not achieved.

I. According to the flow of
information in an organization
communication channels are
broadly classified into two
Formal
Communication
Informal
Communication
a) Downward
b) Upward
c) Lateral or horizontal
communication

 Formal Communication follows the router formally laid down
in the organization structure. Formal Communications are
generally in writing. The formal communication flow in three
directions.
a) Downward
b) Upward
c) Lateral or horizontal communication

 Communication that flows from a higher level in an
organization to a lower level is a downward communication.
 In other words communication from superiors to transmit
work related information to the employees at lower levels.
 Employees require this information for performing their jobs
and for meeting the expectations of their managers.

 Downward communication is used by the manager for the
following purposes.
Providing feedback on employee performance Giving
instructions related to job.
Providing a complete understanding of the employee job as
well as to communicate them how their job is related to other
jobs in the organization.
Communicating the organization mission and vision to the
employees.
Highlighting the areas of attention.

 Organizational circulars, publications, letters to employees,
group meetings, etc are examples of downward
communication
 In order to have effective and error free downward
communication the manager must Specify communication
objective
 Ensure that the message is accurate, specific and
unambiguous

 Utilize the best communication technique to convey the
message to the receiver, in a right form.
 E.g. of down ward communication (vertical communication)

 Communication that flows to a higher level from the
employees in an organization is called upward
communication.
 It provides feedback on how well the organization is
functioning.
 The subordinates use upward communication to convey their
problems and performances to their superiors.

 The subordinates also use upward communication to tell how
well they have understood the downward communication.
 It can also be used by the employee to share their views and
ideas and to participate in the decision making process.
 Grievance Redressal system, complaint and suggestion box,
job satisfaction surveys, etc all help in upward
communication.

 Other examples of upward communication are - performance
reports made by low level management for reviewing by
higher level management, employee attitude surveys, letters
from employees, employee-manager decisions, etc.

 It serves as a measurement of effectiveness of downward
communication.
 It provides management with necessary information for
decision-making.
 It relieves employees from stress and frustrations of work
situations.
 It gives the employees a sense of participation in
management.


 Communication that takes place at same level of hierarchy in
an organization is called latest or horizontal communication.
 communication between peers between managers at same
levels or between any horizontally equivalent organizational
members.

It is time saving
• It facilitates co-ordination of the task
It facilitate co-operation among team members.
• It provides emotional and social assistance to the organizational
members.
It helps in solving various organizational problems.
• It is a means of information sharing
It can also be used for resolving conflicts of a department with other
department or conflicts with in a department.

 E.g.: Communication between Chief Nursing Officer to
Incharge of stores. If the Chief Nursing Officer needs to
discuss a matter regarding purchase of materials with the
incharge of stores, it is much easier to contact this individual
through a lateral communication instead of contacting him
through administrator.

 Communication that takes place between a manager and
employees of other work groups is called diagonal
communication.
 It does not appear on organizational chart.
 E.g.: Ward Incharge directly communicate the information
regarding patient diet to the employee of dietician
department instead of communicating with Head of the
Dietician department

 This type of communication helps to save time and to
speed up action. But it may violate the principle of unity
of command.

 Formal communication may also take place between an
organization and the external environment.
 An organization may give the information to the external
agencies such as public, finances, institutions, customers etc.

 Informal Communication technically known as Grapevine
Communication.
 It has no definite channel of communication nor does it follow
any line of authority.
 Information flow socially among the employees, which has no
official control.
 The message or information spreads in all directions and to all
levels.

 Informal Communication is fast and spontaneous, but also
enjoys a high degree of credibility amongst the employees.
 Sometimes the messages communicated are so erratic that
any action based on these may lead to difficult situation in
the organization.
 It is multiple in nature, In this type of communication, it is
difficult to assign the responsibility to anyone for spreading
false informations.

 Each person involved in conveying the message may added,
subtract or change the original message.
 Therefore the rumors or gossips result more often then it
then does the truth.


 It spreads fastly.
 The manager gets to know the reactions of their subordinates
on their policies. Thus, the feedback obtained is quick
compared to formal channel of communication
 The Grapevine creates a sense of unity among the employees
who share and discuss their views with each other. Thus
Grapevine helps in developing group cohesiveness

 The Grapevine serves as an emotional supportive value
 The Grapevine is a supplement in those cases where formal
communication does not work.

 The Grapevine carries partial information at times as it is
more based on rumours. Thus, it does not clearly depicts the
complete state of affairs.
 The Grapevine is not trustworthy always as it does not follows
official path of communication and it spread more gossips and
unconfirmed report.

 The productivity of employees may be hampered as they
spend more time talking rather than working.
 The Grapevine leads to making hostility against the
executives.
 The Grapevine may hamper the good will of the organization
as it may carry false negative information about the high level
people of the organization.

TYPES
VERBAL
NON
VERBAL

The verbal means of
communication includes the use
of language. Language is the chief
vehicle of communication.
A communication in which words are
used can be called verbal
communication.

ORAL COMMUNICATION :
 Oral communication involves communication through
spoken words.
 It includes by direct or face to face conversation,
telephonic conversation.
 Oral communication is generally recommended when
the communication matter is of temporary kind or where
a direct interaction is required. (Meeting, lectures,
interviews etc.)

The feedback is spontaneous in case of oral
communication. Thus decisions can be
made quickly without any delay.
Oral communication saves time and money,
because it is very quick and simple.
On the spot clarification of any doubt is
possible with oral communication.

Oral communication promotes a receptive
and encouraging morale among employees.
Oral communication can be best used to
transfer private and confidential
informations
There is high level of understanding and
transparency in oral communication as it is
interpersonal..

Oral communication is more likely to be
forgotten or distorted.
There may be misunderstandings as the
information is not complete and may lack
essentials.
It requires attentiveness and great
receptivity on part of the receiver.

Oral communication (such as
speeches) is not frequently used as
records except in investigation
work.
Oral communication is not suitable
for lengthy messages

 Written communication involves transmission of
messages in the form of letters, reports, circulars,
memos and manuals etc.

It is permanent record of communication,
So, it is useful for future reference,
Written communication is suitable for
lengthy messages
Written communication is more precise
and explicit

Legal defenses can depend upon written
communication as it provides valid records
It assists in proper delegation of
responsibilities
It is suitable for sending messages to
distant places

Written Communication is time
consuming and expensive
Receivers feedback and
response is not spontaneous
It is difficult to keep the
communication secret.

It is difficult to keep the communication
secret.
It is not clear (such as language or words
used), it may lead to confusion and
misunderstanding
It is less effective as face-to-face contact is
not involved.

 CLARITY AND BREVITY- Clarity can be achieved
by speaking slowly and clearly. Brevity is best
achieved by using words that express an idea
simply .e.g. “ tell me what is your problem”.
Clarity
Integrity Timing
Adequacy

 VOCABULARY – instead of using purely technical
words use local words for better understanding
 PACING- verbal communication is successful when
expressed at an appropriate speed or space.

 TIMING AND RELEVANCE- timing is critical to perception. For
example if the supervisor/manager is in bad mood, the time is wrong
to ask for a raise. And relevance is also important , i.e. messages have
to be of receiver’s interest and needs.
 Humour – It can be a powerful tool in promoting all aspects in
communicating anything when it is used in good sense according to
circumstances and events.

 Communication can occur even without words.
 To compensate for the inadequacy of verbal message information.
 People unconsciously use facial expression, gesture, touch and vocal
tone to amplify the meaning of spoken communication.
 It is one of the powerful ways people convey message to others.
 Facial expression-

 One –way communication
(Didactic Method)
 The flow of communication
is “one –way” from the
communicator to the receiver.
Eg. Lecture method.

 Both sender and receiver take part. Receiver may raise
questions and add their own information, ideas and opinions
to the subject .
 The process of learning is active and democratic .

It comprises charts, graphs, tables, maps,
posters etc.

It is the process of
communication over distance
Using electromagnetic
instruments designed for this
purposes.
Radio , internet etc.

It is the exchange of
ideas between two
persons

Person to person the message will be passed liked a
chain, sender passes the message to one person,
receiver passes information to other & so on.

 If a stimuli received by the body, immediate the brain
receives the information and transmits to the respective
organs through the neurons where it has to be passed.
Hearing
Smell
Taste
Touch
Seeing

 The word ‘barriers’ means hindrances or hurdles or
difficulties or problems. Any difficulty which partly or
fully prevents any activity is called a barrier.
BARRIERS OF COMMUNICATION

1. Organizational barriers
2. Semantic barriers
3. Personal barriers
4. Psychological barriers
5. Physical barriers
6. Mechanical barriers
7. Cross- cultural barriers
8. Perceptional barriers
9. Interpersonal barriers
10. Gender barriers

1. Unclarified
assumptions
2. Badly expressed message

4. Jargon Language
3. Faulty
translations
Cont…

a. Barriers to superiors
 Regard and attitude
 To maintain authority
 Prejudice
 Complex
 Self satisfaction
 Distrust
 Message overload

 People generally resist new ideas
 They dislike showing mistakes
 Lack of incentives and
encouragement
 Unwillingness to communicate
upward message on personal
grounds
 They slant information relating to
their failures.

 Poor pronunciation
 Confused thinking
 Communication overload
 Attitude
 Resentment, antagonism
and prejudices
 Lack of interest and lack
of listening

 Environmental
disturbances
 Physical health
 Poor hearing
 Distance
Hearing

 Non – availability of proper
machines
 Presence of defective machines
 Interruption
 Power failure

 Cultural – ethnic ,religious and social difference
 Economic position
 Traditions barring people of different culture
from mingling together.
 Political beliefs
 Ethics and values
 Rules and regulations
 Barriers to membership of a group as
detached, devious, impersonal,
condescending, hypocritical, avoiding eye
contact, too silent, aggressive, over-emotional,
angry, confrontational.

 Lack of common
experience
 Linguistic- different
languages and vocabulary
 Lack of knowledge of any
language
 Low IQ

 From receiver’s side:
interrupting the speaker;
asking too many questions
for the sake of probing
 From sender’s side : unclear
messages; incomplete
sentences; no clarification

 withdrawal: absence of
interpersonal contact
 Rituals: meaningless, repetitive
routines devoid of real contact
 Pastimes: activities that entertain and
keep individuals engaged in free
times

Women:
 Prefer conversation for rapport
building
 Want empathy, not solutions
 Are more likely to compliment
 Emphasize politeness
 More conciliatory

MEN:
 Talks as a means to preserve
independence and status by
displaying knowledge and skill
 Work out problems on an
individualized basis
 Are more directive in conversation
 Are more intimidating
 Call attention to their
accomplishments
 Tend to dominate discussions
during meetings

 Suitable Language

Active Listening

 Actions and deeds
 Clarity
 Knowing the receiver
 Interpersonal relationships

 TRANSFER OF INFORMATION:

TRUST

 HONESTY

 PREVENTING CONFLICT

 EMPATHY:

 To protect the patient rights, ethical principles
and legal status
 To understand Cultural diversity:
 Active and accurate listening habits

 Better understanding behaviour and other
problems
 Improved interviewing and consulting
techniques
 Helps to promote managerial efficiency

 Provides basis for leadership action
 Provides coordination
 Provides professional satisfaction

 Enthusiasm to create team
spirit
 Enhanced the power of
interpersonal motivation

 Describe the situation and how it affects you.
Give just the facts.
 Say how you feel.
 Say what you need.