#46 Effective Communication in the ICU
It’s well known that many of the problems we encounter on a daily basis in medicine are related to ineffective communication. When caring for the critically ill, it’s vital that such lapses in communication are minimized. Join us along with Genae Christensen- a current MS-2, active critical care flight nurse and prior ECMO program coordinator as we delve into some important communication pitfalls and pearls. We will cover topics such as the authority gradient and how to navigate that, where misunderstandings may stem from, and how using structured communication systems may help you stay out of trouble. Give us a listen, let us know YOUR thoughts, share the show with your friends, and leave us a review!
Special Guests:
Genae Christensen – CCRN, Flight RN, ECMO coordinator, and Current MS2
Importance of Communication:
Effective communication between clinicians and nurses is essential in critical care.
Miscommunication is frequently identified in safety reports and risk management
meetings.Barriers to Effective Communication:
Authority Gradient:
Hierarchies in medicine (e.g., between nurses and physicians) can impede open
communication.Condescending behavior often masks underlying insecurity or imposter
syndrome.
Misunderstandings:
Lack of clarity in verbal exchanges and unclear expectations create friction.
Close-loop communication is critical to avoid confusion.
Effective Communication Strategies:
Prioritize Information:
Identify and communicate the most critical issue clearly and concisely.
Be prepared to justify why a specific concern is important.
Structured Communication Methods:
SBAR (Situation, Background, Assessment, Recommendation)
CUS (Concerned, Uncomfortable, Safety issue)
Crew Resource Management (CRM) inspired by aviation practices (e.g., "Sterile
cockpit" principle).
Respect and Inclusion:
Summarize patient situations to ensure all multidisciplinary team members
understand.Encourage active listening to foster mutual respect.
Managing High-Stress Situations:
Balance directive communication needed during crises with compassionate follow-up
and debriefing.Empower nurses by teaching and encouraging curiosity about clinical physiology.
Multidisciplinary Team Dynamics:Effective multidisciplinary rounds provide valuable institutional returns through improved
patient outcomes and team communication.Recognize each team member’s expertise and actively involve them in discussions.
Practical Tips for Providers and Nurses:Clearly differentiate between protocol-triggered communication and genuine medical
concerns.Validate concerns raised by nursing staff; ensure follow-up actions and timelines are
explicit.Real-Life Communication Example:
Effective communication during acute deterioration (e.g., lactic acidosis and respiratory failure in a patient with metastatic cancer) directly improved patient outcomes through timely intervention.
Recommended Communication Mindsets:
Assume good intent in interactions.
Always close the communication loop.
Reflect after high-pressure situations to continuously improve communication skills.