title: Nursing the patient with severe communication impairment.
abstract: BACKGROUND
  Effective communication with patients is critical to effective nursing practice. Surprisingly, there is little information on nurses' experiences in caring for patients who are unable to speak.
  
  
  OBJECTIVE
  This study provides descriptive information from interviews with 20 nurses who cared for patients with severe communication impairment. The interview protocol explored positive and negative experiences of nursing patients with severe communication impairment. Frequency counts and descriptive analyses were conducted to identify the major themes emerging from the interviews.
  
  
  RESULTS
  The results suggest that nurse-patient communication is difficult when the patient has severe communication impairment, although some nurses discovered effective strategies to facilitate communication with such patients. Many of the difficulties could be viewed as a breakdown in understanding arising from the lack of a readily interpretable communication system that could be used by nurse and patient.
  
  
  CONCLUSIONS
  The results suggest a need for training nurses in the use of alternative modes of communication. Nurses also need access to a variety of simple augmentative communication devices for use with patients who are unable to speak. Finally, nurses should collaborate with speech pathologists on the development of preadmission information and bedside training for people who are admitted to hospital with severe communication impairment.
authors.affiliation: Centre for Developmental Disability Studies, Sydney, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Hemsley
authors.forename: J
authors.initials: J
authors.lastname: Sigafoos
authors.forename: S
authors.initials: S
authors.lastname: Balandin
authors.forename: R
authors.initials: R
authors.lastname: Forbes
authors.forename: C
authors.initials: C
authors.lastname: Taylor
authors.forename: V A
authors.initials: VA
authors.lastname: Green
authors.forename: T
authors.initials: T
authors.lastname: Parmenter
mesh_terms: D000328:Adult; D003142:Communication; D003147:Communication Disorders / Q000451:nursing*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009723:Nurse-Patient Relations; D015399:Nursing Research