Guest Post: Communication in Healthcare, A Necessary Skill

When it comes to writing a cover letter, creating resumes and CVs, we often put down “Good Communication Skills” or something along the line. However, what exactly is a good communication skill? Is it being able to communicate using more than one language? Do you think you are a good communicator? Here is a real-life scenario emphasizing the need of clear communication in healthcare to save patients’ lives.

An internal medicine pharmacist received a call in the afternoon from a nurse seeking help with “Vancomycin dosing.” Upon further questioning, it was discovered that nurse wanted to see if a patient should get “additional dose” of Vancomycin. The pharmacist was not sure why we would just give an additional dose of Vancomycin. Upon few more questions, the nurse told pharmacist that Vancomycin had extravasated into the patient’s arm and the arm was described to be as big as a “football.” According to the nurse in charge of this patient’s care, neither the patient nor PT/OT personal reported this to nurse and nurse found out when she was doing routine check up on the patient. While nurses check routinely on their patients, it can sometimes be extremely challenging when they have to take care of six different patients requiring care at the same time. There was no apparent harm done to the patient’s arm, since this was Vancomycin. Some notorious medications can cause limb-threatening ischemia, leading to amputations and possible medical malpractice lawsuit. Some of these medications include Promethazine, Phenytoin, Chemotherapy medications, and Dopamine (and other medications with vasoconstricting effects like norepinephrine, epinephrine). Topical Nitroglycerin, Hyaluronidase, and Phentolamine are some of the primary treatment choices. (More information can be found at (Detail-Document; Pharmacist’s Letter 2011; 27(12):271212)

Situations like these CAN be prevented, or addressed much earlier with proper patient & staff education. Using open-ended questions, speaking clearly, and being approachable by anyone when they need your help are some of the qualities of a good communicator. In my dictionary, there is no dumb question. In fact, I love questions from my coworkers, they help me see the other side of my views and while we may not agree on all points, I surely treat them with the respect for bringing new ideas on the table. As a last note, whenever there is emergency, use the word EMERGENCY to seek help. It will not only alert everyone around you, but it will also help the patient get the right care in timely manner.

Kishan Patel, Pharm.D Candidate 2016

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  1. Fayez Nseir

    Very interesting question, that’s how to communicate, asking before giving ” wrong answer” or inapropiate one.

  2. koyakuttymeletath

    I have a doubt in this case.Vancomycin was ordered to give by infusion.When 500mg vancomycin is giving by iv infusion it should take at least 60 minutes to finish the administration.Another doubt the medicines was administering in to the vein or out side the vein

  3. Kishan Patel

    Good point @koyakuttymeletath.

    Vancomycin has a 1G/hr maximum infusion speed at this specific hospital. 500mg is typically given over 30minutes, unless patients experience Red Men Syndrome.

    Lastly, It sounded like the infusion was started correctly by the nurse and then it started leaking out in the vein due to patient moving around with physical therapy. It was little hard to point out when the patient’s IV started leaking, but the point is that, when they noticed it, the was described to be the “size of the football”!

    Thank you for your input,
    Kishan Patel


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Written By Eric Christianson

March 11, 2015

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