Effective Communication in Nursing: A Core Principle of the NMC Code

Introduction

In the healthcare profession, communication is not just about exchanging information—it’s about building trust, ensuring safety, and fostering empathy. For nurses and midwives, the Nursing and Midwifery Council (NMC) places paramount importance on effective communication as a core component of professional practice. The NMC Code, formally known as “The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates,” outlines communication as a fundamental duty and ethical obligation. This article explores the significance of communication in the context of the NMC Code, its impact on patient care, and how nurses can improve their communication skills.

The NMC Code and Communication

The NMC Code, updated most recently in 2018, comprises four themes:

Prioritise people
Practise effectively
Preserve safety
Promote professionalism and trust

Communication is embedded throughout the Code but is explicitly highlighted under the section “Practise effectively.” According to the Code, nurses and midwives must:

Use a range of communication methods to meet the needs of those in their care.
Communicate clearly and effectively in spoken, written, and digital form.
Check understanding and involve people in decisions about their care.

The emphasis is on person-centred communication—where the needs, preferences, and values of individuals are respected and considered during all interactions.

Why Effective Communication Matters in Nursing

Effective communication in nursing is vital for several reasons:

1. Ensures Patient Safety

Poor communication can result in medical errors, incorrect treatment, and adverse outcomes. For example, failing to accurately document a patient’s allergy can lead to life-threatening consequences. The NMC requires accurate record-keeping and timely handovers to maintain safety and continuity of care.

2. Promotes Trust and Therapeutic Relationships

Trust is the foundation of the nurse-patient relationship. Open, honest, and compassionate communication helps patients feel safe, understood, and valued. According to the NMC, professionals must listen carefully, avoid assumptions, and explain information in a way the person can understand.

3. Supports Shared Decision-Making

The NMC Code requires nurses to involve patients in decisions about their care. This can only be achieved through dialogue that is respectful, non-judgmental, and responsive to the patient’s level of understanding. Informed consent is a key legal and ethical principle directly linked to communication.

4. Encourages Team Collaboration

Nurses rarely work in isolation. Communication with colleagues, including doctors, physiotherapists, and healthcare assistants, is essential for coordinated care. The NMC expects nurses to share relevant information clearly and in a timely manner while respecting confidentiality.

Core Communication Skills for Nurses

To meet the expectations of the NMC, nurses must develop and demonstrate several core communication skills:

1. Active Listening

Listening is more than just hearing words—it involves paying full attention, observing body language, and responding appropriately. It includes techniques such as summarising and clarifying to confirm understanding.

2. Empathy and Emotional Intelligence

Empathetic communication helps patients feel respected and cared for, particularly in sensitive situations such as terminal diagnoses, bereavement, or chronic illness. Emotional intelligence allows nurses to manage their own emotions while responding sensitively to others.

3. Clarity and Simplicity

Healthcare jargon can confuse or intimidate patients. Nurses must explain medical terms in simple language and tailor their communication style to the individual’s needs, whether that means using visual aids, interpreters, or written materials.

4. Non-Verbal Communication

Body language, eye contact, facial expressions, and tone of voice all contribute to how a message is received. Being aware of these cues is critical, especially when working with patients who have cognitive or speech impairments.

Communication in Special Circumstances

1. Communicating with Children and Vulnerable Adults

When dealing with children or vulnerable adults, communication must be adapted to their developmental level and emotional state. The NMC advises using age-appropriate language and engaging with carers or guardians as necessary.

2. Cultural and Linguistic Diversity

In today’s multicultural society, cultural sensitivity is essential. Nurses must be aware of cultural norms, use interpreters when needed, and avoid assumptions based on ethnicity, religion, or language.

3. Digital Communication and Documentation

The digital age has introduced new forms of communication, including emails, electronic health records, and telehealth consultations. The NMC Code mandates accuracy, security, and confidentiality when using digital platforms to communicate or record information.

Communication During Handover and Documentation

Effective communication during shift handovers and in clinical documentation is critical for continuity and patient safety. The NMC requires records to be:

Accurate and up-to-date
Legible and clear
Objective and fact-based
Completed in a timely manner

The SBAR (Situation, Background, Assessment, Recommendation) framework is often used during handovers to structure communication in a concise and effective way.

Breaches of the Code: Consequences of Poor Communication

Failure to communicate effectively can have serious repercussions. Complaints against nurses often involve issues such as:

Inadequate documentation
Informed consent violations
Poor attitude or tone
Breaches of confidentiality

Such breaches can lead to investigations by the NMC, warnings, suspension, or removal from the professional register.

Improving Communication: Education and Reflection

The NMC encourages lifelong learning and reflective practice. Nurses should:

Seek feedback from colleagues and patients
Attend communication skills workshops
Engage in role-play or simulation training
Reflect on difficult conversations and learn from them

Revalidation, which is required every three years, also emphasises communication. Nurses must provide examples of how they meet the NMC’s communication standards through reflective accounts.

Conclusion

Communication is more than a skill—it is a professional responsibility that lies at the heart of ethical and safe nursing practice. The NMC Code recognises this and sets clear expectations for how nurses and midwives should communicate with patients, families, and colleagues. By listening actively, speaking clearly, documenting accurately, and showing empathy, nurses not only comply with the Code but also enhance the quality of care and build trust within the healthcare system. As healthcare evolves, so too must communication practices, ensuring that every interaction remains respectful, effective, and patient-centred.

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