A selective review of the literature on nurse-patient communication: has the patient's contribution been neglected?

The literature on nurse-patient communication is selectively reviewed. Previous research has been critical of the quality and quantity of nurse-patient communication, describing it as brief and superficial. Nurses are depicted as controlling and restricting the course and topics of conversations with patients. Communication skills training for nurses has been advocated as a solution for this apparent deficit. In this paper it is argued that research has over-emphasized nurses' roles in nurse-patient communication, particularly their communication skills. The patients' contribution to the content and organization skills. The patients' contribution to the content and organization of nurse-patient communication has been largely ignored. Assumptions have been made about nurses' and patients' intentions and motives during nurse-patient conversations, but the participants, particularly patients, are rarely asked for their views. There has been a tendency to view nurse-patient communication in terms of isolated excerpts of conversation. When environmental and organizational factors are included, it is their effect on nurses' communication capability, not the patients', that are the interest. It is suggested that future research consider both patients' and nurses' contributions to nurse-patient communication.