Staff-patient communication in coronary care units.

It is now over 20 years since coronary care units (CCUs) began to be opened. The purpose of providing constant observation for patients with myocardial infarction, and immediate specialized treatment when necessary has been fulfilled. But there is increasing evidence that psychosocial aspects of care may be just as important to the patients' total well-being as physical care. Communication is a key factor, and since nurses are the staff members most constantly present in CCUs they can exert considerable influence on communication between patients and their visitors, nurses and perhaps other staff. But patients are all individuals who each have their own ways of reacting to illness. If their particular communication needs are to be met then this aspect of nursing care must be planned, based on careful preliminary assessment. There is some evidence that nurses' communication skills are not always well-developed. This is not surprising since there has been little structured and knowledge-based teaching of interpersonal skills in basic nurse education in the United Kingdom in the past, or in many other countries. Communication is a major component of care which merits more consideration, including the needs of patients, visitors and nurses; the aims of nurse-patient-visitor communication; and approaches to improving it.