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    Jenny Haines

    For communication to be effective, there needs to be listening on both sides. Health system staff need to speak in English, that is a basic requirement, now recognised by the registering authorities. Health system staff and patients and their families talk all the time, and listen, hopefully, to what is said. But there may be many reasons that the message sent, is not the message received eg, information given in a rush by a time pressured health care professional and not fully or properly explained; information given in medicalese and not understood by the recipient; information given that the recipient does not want to hear and so does not hear in the way intended; information given that is innocently wrong by an inexperienced practitioner or a practitioner being asked to take greater responsiblity that what they are educated for; information being rejected by the recipient because that is not what they want to hear; information given to an aggressive recipient who does not listen. I could go on and on. Communication in the health system has been identified by numerous researchers as the number one issue affecting outcomes in the health system. There are patients who speak up about their own care. Some do it calmly and assertively, and that is often welcomed by health system staff as it clarifies for the staff what concerns the patient and their family. But there are the aggressive patients and families who make health system staff defensive and cautious. These patients spoil it for everyone because staff become wary in dealing with them, and then wary in dealing with others in case they encounter such nasty aggression again. And then there are the patients and families who need advocates, because they would never dream of being assertive. Nurses are certainly educated to be patient advocates.

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