How to Improve Nurse Communication Scores Without Teaching to the Test

Nurse communication is one of the most watched measures in patient experience, and it is easy to see why. Nurses spend more time with patients than almost anyone else on the care team, and patients tend to describe their whole stay through the lens of how those conversations felt. When units try to improve the score, the tempting approach is a script: say this phrase, mention this word. Patients can usually tell the difference between a script and someone who is actually paying attention.

The better approach is to build a few small habits that make patients feel listened to, informed and respected, and to support the nurses who have to practice them on a busy shift.

Know what patients are actually rating

Patient surveys generally ask three things about nurses: whether they listened carefully, whether they explained things in a way the patient could understand, and whether they treated the patient with courtesy and respect. Each of those is a feeling the patient carries away from many small moments. A great clinical day with rushed conversations can still leave a patient feeling unheard.

Listen in a way patients can see

Listening is not only about hearing the words. It is about showing the person you heard them. Sitting down for important conversations, even for a minute, changes how long the patient thinks you stayed. Making eye contact, letting them finish and repeating back what they said all signal that you are paying attention.

Most people do not listen to understand, they listen to reload, waiting for their turn to talk. Patients notice when someone is already halfway to the door. I wrote about the power of being seen in People Remember When You See Them.

Explain what happens next

A lot of patient anxiety comes from not knowing what is coming. When a nurse explains what the next medication is for, when the doctor is likely to round and what the test will feel like, patients feel informed and calmer. Plain words matter here. Clinical language is efficient between colleagues, but to a frightened patient it can sound like a wall.

Teach-back is one of the simplest tools for checking understanding. Asking a patient to explain in their own words when to take the new medication, framed as checking how well you explained it rather than testing them, catches confusion before discharge.

Show courtesy in the small things

Courtesy and respect show up in small moments: knocking before entering, introducing yourself and your role, using the name the patient prefers, apologizing for a wait, and closing each visit by asking whether there is anything else you can do. One habit I love is asking patients to tell you one thing about themselves that is not in their file. It turns a patient into a person, and it gives the whole team something human to connect over. I wrote about it in Tell Me One Thing That Is Not in This File.

Support the nurses who make it happen

Communication is the first thing to suffer when nurses are exhausted, short-staffed or feeling unsupported. Press Ganey found that hospitals in the top quartile for employee engagement are 4.2 times more likely to achieve top patient experience scores. Improving nurse communication is therefore partly a leadership job: protecting time, recognizing nurses who communicate well, and sharing the patient comments that mention them by name.

When nurses hear that a patient remembered how they explained something or how they made them feel, that recognition fuels the next shift. This connection between staff and patient experience is the heart of my healthcare keynote, The Power of Small Moments. See also Why Employee Engagement Drives Patient Experience and The Four Questions Every Patient Is Silently Asking.