Team Players: The RN’s Role in Communication and Collaboration
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Authored by Dr. Pam Vollmer, DNP, RN, AMB-BC, NPD-BC, CEO and Director of Content for CE Ready
Nursing is not a solo act. It’s a team effort. At the center of patient care, Registered Nurses (RNs) serve as the link between doctors, specialists, support staff, patients, and families. Communication and collaboration are essential to ensuring safe, coordinated, and effective care. Whether during hospital rounds, care transitions, or emergency interventions, RNs are the glue holding the care team together.
In this post, we’ll explore how RNs excel in communication, advocate for patients, and foster collaboration across disciplines.
What Nurses Need to Know
Communication failures contribute to more than 70 percent of serious medical errors, according to research analyzed through the Joint Commission’s sentinel event database. In 2024 alone, the Joint Commission received 1,575 sentinel event reports, a 12 percent increase from 2023. RNs sit at the center of every care team, serving as the primary communicators between patients, physicians, specialists, therapists, and families. That position carries enormous responsibility. Weak communication creates gaps that harm patients. Strong communication closes those gaps before they become crises. The American Nurses Association identifies communication and collaboration as foundational competencies in its Nursing Scope and Standards of Practice. CE Ready is a Florida-based ANCC-accredited continuing education provider (provider number P0986). It offers flexible, self-paced CE for LPNs, RNs, and APRNs across dozens of states at ceready.com.
Jerome has been an RN on a medical-surgical unit for six years. On a busy Thursday afternoon, he noticed a post-surgical patient’s blood pressure trending down across three readings over ninety minutes. The attending physician had not yet rounded. Jerome called using SBAR, presented the pattern clearly, and had a new order within four minutes. By the time the physician arrived, fluids were running and the patient was stabilizing. Nobody would ever call that moment dramatic. Jerome would tell you it was just good communication.
Why Communication Is the Core Clinical Skill
Effective communication is not a soft skill in nursing. It is a patient safety infrastructure. Research reviewed through the Agency for Healthcare Research and Quality shows that communication breakdowns contribute to the majority of preventable patient harm events. The Joint Commission identified communication failures at the root of more than 70 percent of sentinel events in its analysis of serious adverse outcomes.
For RNs, communication operates across multiple relationships simultaneously. You communicate patient status changes upward to physicians. You communicate care plan updates laterally to therapists, pharmacists, and case managers. Downward, you communicate expectations and observations to LPNs and nursing assistants. In every direction, accuracy and timeliness are non-negotiable.
The stakes are highest during transitions: shift handoffs, transfers between units, and discharge from hospital to home. Those moments concentrate the most opportunity for information to fall through the cracks. Strong handoff communication does not happen by chance. It requires deliberate structure, clear language, and a culture that treats speaking up as an expectation rather than an exception. CE in communication directly supports all of these skills.
SBAR: Structured Communication That Saves Time
SBAR stands for Situation, Background, Assessment, and Recommendation. It is the most widely used structured communication framework in nursing, and for good reason. When a nurse calls a physician about a patient concern, both parties benefit from a shared format. The physician gets the information in an organized sequence. The nurse can present her clinical reasoning clearly and confidently.
In practice, SBAR works because it mirrors how clinical decisions are actually made. You state what is happening now, provide the relevant history, share your assessment of what it means, and offer a specific recommendation. That last step is where many nurses hesitate. Recommending a course of action can feel presumptuous. Clinically, it is exactly what the physician needs to hear.
SBAR also supports documentation. When a concern is communicated verbally using a structured format, it is easier to document accurately afterward. That documentation protects both the patient and the nurse. Beyond SBAR, tools like I-PASS for handoffs and daily goals sheets for interdisciplinary rounds serve the same function: reducing reliance on memory and informal information transfer in environments where both are unreliable.
Communicating with Patients and Families
The most important communication an RN has each shift is not with the physician. It is with the patient. Patients who understand what is happening, what to expect, and who to call when something feels wrong are measurably safer than those who do not. That understanding does not happen automatically. It requires deliberate, skillful nursing communication.
Translating clinical information into plain language is one of the most undervalued technical skills in nursing. Telling a patient their troponin is elevated means nothing without context. Explaining what that means for their heart, what comes next, and why the physician was just called gives the patient the information they need to be a participant in their own care.
Family communication adds another dimension. Families often serve as the patient’s primary advocate and caregiver after discharge. Bringing them into conversations, answering their questions honestly, and preparing them for what caregiving will require at home all fall within the RN’s responsibility. Cultural factors shape how information is received and how decisions are made. The LGBTQ Considerations in Healthcare course and the Cultural Competence and Equity in Nursing Practice course both build the cross-cultural communication skills that patient-centered care demands.
Interdisciplinary Rounds and Team Collaboration
Interdisciplinary rounds are where collaboration becomes visible. Physicians, nurses, pharmacists, physical therapists, social workers, and case managers gather around the patient’s goals for the day. The RN is almost always the most consistently present member of that group, and often the one with the most current information about how the patient is actually doing.
Contributing meaningfully to rounds requires preparation. Before rounds begin, a skilled nurse has reviewed the latest vitals, knows what the patient is worried about, and has identified the barriers standing between this patient and safe discharge. That preparation transforms rounds from a reporting exercise into a problem-solving one.
Speaking up during rounds also requires professional confidence. Hierarchical dynamics in healthcare can make it genuinely difficult to raise a concern in front of a senior physician. Research consistently shows that nurses who feel psychologically safe speaking up provide better patient care. Building that confidence is partly a cultural responsibility for organizations, and partly an individual skill that develops over time. The Communication in Healthcare course covers evidence-based strategies for assertive communication, conflict navigation, and structured team interaction.
Shift Handoffs: Where Errors Begin and End
Incomplete shift handoffs are one of the most documented sources of preventable patient harm. When a nurse leaves for the day without conveying a pending lab result, a medication concern, or a family’s unresolved question, the next nurse inherits a gap she does not know exists. Patients fall through those gaps.
Bedside handoffs, where the outgoing and incoming nurse exchange information directly in front of the patient, address this problem at its source. The patient hears what is being communicated, can correct inaccuracies, and enters the new shift already feeling informed. Studies consistently link bedside handoffs to higher patient satisfaction and fewer post-handoff errors.
Standardized handoff tools serve the same function. Whether a unit uses I-PASS, a structured electronic report, or a checklist built into the electronic health record, the goal is identical: make sure nothing important depends on memory or assumption. Strong handoff communication is also closely tied to error prevention. The Prevention of Medical Errors course builds a systems-level understanding of how communication breakdowns contribute to patient harm and how nurses can interrupt those patterns.
Overcoming Communication Barriers
Even skilled communicators face barriers in clinical settings. Time pressure is the most common. When five things are competing for your attention, the temptation is to communicate quickly and move on. That speed creates the very gaps that produce errors. Developing the habit of structured communication, even under pressure, is what separates experienced nurses from novice ones.
Emotional situations create a different kind of barrier. During a family crisis, a code, or a difficult conversation about prognosis, communication requires both clinical clarity and genuine human presence. Staying calm, choosing words carefully, and reading the room are skills that develop with experience but also benefit from deliberate reflection and education.
Language differences and sensory impairments are barriers that require proactive solutions. Qualified interpreters, translated written materials, and alternative communication tools are all within the RN’s scope to identify and request. Using a patient’s family member as an interpreter is common but introduces real risks around accuracy and confidentiality. Knowing when to request a professional interpreter is itself a clinical decision. The CE Ready course catalog covers communication, cultural competence, and equity topics that directly address the full range of barriers nurses encounter.
Communication Tools at a Glance
Strong RN communication depends on consistent use of the right tools in the right situations. Here is a quick reference for the most commonly used frameworks and where each one applies.
| Communication Tool | Purpose | When to Use It |
| SBAR | Structured clinical updates to physicians and providers | Condition changes, abnormal results, urgent concerns |
| I-PASS | Standardized shift handoffs | Beginning and end of every shift |
| Daily goals sheet | Interdisciplinary alignment on patient priorities | Morning rounds, care conferences |
| Bedside reporting | Patient-centered shift handoff | Any transition between nursing shifts |
| Teach-back | Confirm patient and family understanding | Patient education, discharge preparation |
| Interpreter services | Language-concordant communication | Any encounter with a language barrier |
Frequently Asked Questions
Q: Why is communication considered a patient safety issue in nursing?
A: Research reviewed through the Agency for Healthcare Research and Quality and the Joint Commission’s sentinel event database shows that communication failures contribute to more than 70 percent of serious adverse patient events. When information is lost, delayed, or misunderstood during handoffs, rounds, or urgent escalations, patients are harmed. Strong nursing communication directly reduces that risk by ensuring the right information reaches the right person at the right time.
Q: What is SBAR and why do nurses use it?
A: SBAR stands for Situation, Background, Assessment, and Recommendation. It is a structured communication framework that organizes clinical information into a predictable format, making it easier for nurses to communicate concerns clearly and for physicians to respond efficiently. Using SBAR reduces the likelihood that critical information is omitted during urgent conversations and supports clearer documentation afterward.
Q: How do nurses communicate effectively with patients from different cultural backgrounds?
A: Effective cross-cultural communication starts with self-awareness about assumptions that might shape how a nurse interprets a patient’s behavior or responses. Beyond awareness, practical skills include using qualified interpreters rather than family members when accuracy and confidentiality matter, adapting communication style to the patient’s preferences, and recognizing how cultural values influence health decisions. CE in cultural competence builds these skills systematically.
Q: What makes a good shift handoff in nursing?
A: A good shift handoff is structured, complete, and patient-centered. Bedside handoffs that include the patient directly in the exchange improve accuracy and patient satisfaction. Standardized tools like I-PASS reduce reliance on memory and ensure nothing important is omitted. A good handoff covers the patient’s current status, pending results and orders, outstanding family concerns, and any anticipated changes in the coming shift.
Q: How does CE support communication skills in nursing?
A: CE in healthcare communication builds both the technical frameworks and the interpersonal skills that effective nursing communication requires. Courses cover structured tools like SBAR, strategies for assertive communication in hierarchical settings, cross-cultural communication, patient and family education techniques, and conflict navigation. CE Ready offers ANCC-accredited CE in communication and related topics for LPNs, RNs, and APRNs.
References
Agency for Healthcare Research and Quality. (2024). TeamSTEPPS fundamentals. https://www.ahrq.gov/
American Nurses Association. (2023). Nursing: Scope and standards of practice. https://www.nursingworld.org/
Joint Commission. (2024). Sentinel event data: 2024 annual review. https://www.jointcommission.org/