Types of Communication

Core Concepts

Verbal communication: spoken and written words

Verbal communication includes both speaking and writing. Words carry two kinds of meaning: denotative (the dictionary meaning) and connotative (the emotional or cultural associations a word carries — compare "slim" and "skinny"). Effective verbal communication uses vocabulary the other person understands, a calm pace, a clear tone, and messages that are concise and timely. Written verbal communication — charting, care plans, teaching materials, messages to colleagues — must be legible (or typed), objective, and free of vague words.

Nonverbal communication: the message behind the words

Nonverbal communication is everything communicated without words: facial expression, posture, gestures, eye contact, touch, use of silence, personal space, appearance, and paralinguistics (tone, pitch, volume, and rate of speech). Communication scholars have long noted that a large share of meaning is carried nonverbally, and when words and body language disagree, people tend to believe the body language. Nurses both send and read nonverbal cues — a patient who says "I'm fine" but avoids eye contact and holds the body stiffly may be telling a different story. Caution: nonverbal cues are culturally influenced, not universal.

Communication by number of participants

• Intrapersonal: self-talk and reflection — the internal conversation nurses use to plan and evaluate ("Did I explain that clearly? What should I ask next?").
• Interpersonal: between two people — the classic nurse–patient conversation.
• Small-group: three or more people, such as shift report, team rounds, family conferences, and care-planning meetings.
• Public/organizational: one person to many, such as patient-education classes, community health presentations, and staff in-services.

Electronic and written communication

Electronic channels — the electronic health record (EHR), secure messaging, telephone, and telehealth visits — are now central to nursing communication. The rules that matter: protect privacy and confidentiality (access and share only what is needed for care), follow facility policy on approved abbreviations and security, never document for another person, and keep personal opinions out of the record. A telephone or video visit still requires the same listening and confirming skills as a face-to-face conversation, with extra attention to what you cannot see on screen.

Matching the type to the situation

Effective nurses match the channel to the purpose: spoken words for urgent matters and sensitive conversations; written or electronic documentation for anything that must be remembered or verified later; simple written instructions plus demonstration for discharge teaching; and a trained medical interpreter (per facility policy) when language barriers exist — family members, especially children, should not be used as interpreters.

How It Works / Step-by-Step Process

1. Determine the purpose of the message and who needs to receive it.
2. Choose the channel(s) — spoken, written/electronic, nonverbal — that fit the purpose, urgency, and the patient's situation.
3. Encode the message in plain language, keeping your verbal and nonverbal cues congruent.
4. Confirm the message was received and understood, then document what matters for the record.

Common Confusions