Nursing the patient with severe communication impairment

Bronwyn Hemsley, Jeff Sigafoos*, Susan Balandin, Ralph Forbes, Christine Taylor, Vanessa A. Green, Trevor Parmenter

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

97 Citations (Scopus)


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. Purpose and method. 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.

Original languageEnglish
Pages (from-to)827-835
Number of pages9
JournalJournal of Advanced Nursing
Issue number6
Publication statusPublished - Sept 2001
Externally publishedYes


  • Augmentative and alternative communication
  • Barriers to effective communication
  • Communication strategies
  • Developmental and acquired disability
  • Hospital care
  • Nurse-patient communication
  • Severe communication impairment
  • Structured interviews


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