• Category:
  • Document type:
  • Level:
  • Page:
  • Words:

Communication barriers affecting new nurses transition into professional nursing practice

Communication Barriers Affecting New Nurses Transition Into Professional Nursing Practice


Graduate nurses face many challenges during their integration process into the workplace environment that have negative influences to their successful integration, and future career directions. Many of them are not usually fully prepared to meet and sustain the challenges that they encounter in their first year of practice, and it is imperative to have an effective orientation program to help novice nurses assimilate into the new environment. Communication barriers are the main reason that reports the poor transition process among novice nurses. Communication refers to the transfer of knowledge, and information from one party to another. In the healthcare environment, communication is a fundamental element that characterizes the interaction process between senior nurses and newly registered nurses, and nurse to patient communication, forming the basis through which new nurses acquire practicing skills. It involves both verbal and non-verbal models, entailing observation, listening, and speaking. Communication barriers negatively affect new nurses, it increases their levels of stress, creates a negative attitude towards work, and poor socialization with other members and staff in the healthcare set up, leading to dissatisfaction, and at extreme levels the imminent risk of leaving the nursing profession altogether.


Communication barriers leading to graduate nurses turnover has a negative impact on the stability of healthcare systems. Statistically, international levels of attrition of new graduate nurses stand at the rate of 30% to 60%, this negatively influences the sustainability of the workforce [ CITATION Goo13 l 2057 ]. Both in Australia and globally, its cost estimates 40,000 dollars per year for each nurse who leaves in the first year at work (The Future of Nursing, 2010). This puts a strain in the healthcare industry that is already grappling with the shortage of nurses. It also compromises with the quality of healthcare delivery.

Communication barriers affect the ability of graduate nurses to learn from mentors allocated to them. It is a major problem cited to impede the integration of graduate nurses into the workforce, thus posing a demoralizing effect. With the lack of smooth communication in the mentorship, novice nurses always face the pressure of fitting in yet with little practical experience, and lack of a proper job description[ CITATION Azi14 l 1033 ]. Their confidence suffers a significant blow as they lack someone whom they have an open interpersonal relationship with, and to whom they seek clarifications on areas of uncertainty. Furthermore, they work with the fear of erring while administering medication, doing harm to patients, offering poor quality healthcare, and their practicing license canceled or suspended. All these hardships arising from lack of effective communication with their mentors create emotions of helplessness, frustration, and discontent, hence demoralization. It is, therefore, evident that good communication is essential towards a productive mentorship program. Mentorship involves two individuals, the mentor, and the mentee, with clearly defined objectives to achieve identified goals and outcomes [ CITATION Lev12 l 2057 ].

Language barrier is a major blocker to effective communication between new nurses and expert nurses. Although speaking in the same language, the use of workplace nursing terminology by expert nurses causes a communication breakdown in their interaction with newly registered nurses. The practicing nursing language in healthcare institutions is significantly different from nursing language used in the nursing school. It is scientifically complex and technical. Senior nurses fail to understand the existing mismatch in language and instead go forth to use medical terminologies that novice nurses fail to understand. In the process, the message passed across fails to elicit the appropriate response or purpose. It is misunderstood and sometimes causes new nurses to make errors as they deliver health services to patients. Identically, graduate nurses who get absorbed into healthcare organizations away from where they schooled face language barrier. The linguistic in language differs from one place to another. As such, a nurse posted in a distant region will experience language barrier problems before he/she comes to fully understand the new linguistic fully[ CITATION Nee15 l 1033 ].

Lack of proper training also acts as a significant communication barrier in the transition process. It is no longer a secret that effective communication requires proper training on communication skills. In Australia and across the world, the curriculum does not adequately cover topics to equip nursing students with effective communication skills. The curriculum mainly covers topics related to the scientific aspect of the medical field. The healthcare system is involving, complex, and challenging; many a new nurse get weighed down by pressure. With the lack of training on how to manage the demands, and workload, new nurses’ are unable to maintain an effective communication interaction with their seniors[ CITATION Tim09 l 1033 ].

Again, noise is one of the physical barriers to effective communication. Australian healthcare systems serve a large number of patients, and as a result, there are many activities taking place within their premises. The many activities create a noisy environment, where one can hardly correctly hear communication from the other party. Under these conditions, the interaction of graduate nurses with the expert nurses is significantly affected. Information from their seniors is distorted in the noise, and can hardly seek clarification in areas they do not understand, thus failing to acquire necessary practicing skills to aid their transition process. On the other hand, this also affects the patient to nurse communication. Moreover, the environment of noise significantly affects the hearing of nurses who have reduced hearing abilities[ CITATION Nun09 l 1033 ].

Aligned with this barrier is time, the high number of patients is so demanding creating a situation where graduate nurses have little or no time to interact effectively with their senior peers. The flow of information between them and expert nurses is curtailed, a times they seek questions yet they do not find anyone to ask, they are left helpless, with no guidance to perform a particular nursing-care duty. The lack of communication results to the high number of medical errors reported, some of them fatal. It is no wonder the deaths due to preventable medical errors are on the rise. Estimates indicate that between 18000 and 54000 deaths in Australia result from medical errors (Medical Error Action Group). It therefore confirms the negative effect lack of time has on communication between new nurses and senior nurses[ CITATION Nee15 l 1033 ].

Psychological barriers negatively affect the ability to communicate well in the healthcare environment. It has a great influence on the three elements of communication, which is sending, receiving, and interpretation. Fear and stress are the most common psychological barriers, it affects both new nurses, and experts, though it is mostly the latter are affected most as they are new in the work set up, and have no skills to sustain the demands of the nursing profession[ CITATION Har08 l 1033 ]. The fact that graduate nurses are in a new environment and therefore experiencing change acts as a barrier to effective communication, which happens in several ways. New graduate nurses sometimes fear to ask questions regarding the process of conducting a new procedure. The fear stems from the idea that their colleagues will view them as incompetent. This blocks the new nurse from gaining new ideas and skills from their seniors. In some instances, they are reluctant to share their knowledge fearing of backlash where they are viewed as confrontational in nature [ CITATION Cat15 l 1033 ].

Additionally, the new environment has expert nurses who are well trained and experienced, they seem to be competent, and in control, an issue that instills feelings of inadequacy among novice nurses. On the other hand, the fear in the new environment is a communication barrier on how they interact with patients within their care, thus compromising the quality of service delivery. As a communication barrier, fear prevents novice nurses from taking advantage of the expertise nurses, and learning from them, forgetting the fact that the senior nurses were once as inexperienced as them. In the new environment, graduate nurses are afraid of making mistakes, and failing to meet the high standards of expectation that the nursing profession calls for[ CITATION Cat15 l 1033 ].

Coupled with fear, stress adds up to the existing communication barrier, the healthcare environment is so demanding, complex medical conditions that patients suffer from, work overload, personal problems, and experiences may sometimes be too heavy a burden for new nurses to shoulder [ CITATION Rus13 l 2057 ]. Hospitals are registering many cases of cancer, heart diseases, diabetes, renal failure, and mental health problems. Complex conditions are because of the increase in the number of chronic diseases in the new age, and the lack of resources to seek medical attention in the early stages of diseases. In recent days, the access to services such as prevention care, primary care, and under-funding of hospitals have added to the strain of obtaining health services [ CITATION Hof16 l 2057 ]. In the backdrop of this complex background and medical conditions, the allocation of such patients to new graduate nurses has a degenerative influence on their transformation process. The healthcare requirements of this complex needs subject them to constant anxiety and stress, thus further demoralizing them [ CITATION Osl09 l 2057 ].The result is continuous stressful conditions that affect the nurses’ interaction and communication with others, thus failing to fit into the new environment.

Equally important, the attitude that new nurses and senior nurses have towards each other is unhealthy and detrimental to the effectiveness of their communication. The cold relationship that exists between them has created a negative perception towards each other, further straining their personal and professional relationship. A factor attributed to the lack of recognition and poor transition experience process. New graduate nurses expect to join health services where they are received warmly under a receptive environment. Conversely, in most cases the workplace environment is never welcoming, characterized by a cold reception, disrespectful feedback, and bullying in some instances [ CITATION Mal11 l 2057 ].

Previous research work indicates that nurses rarely received quality feedback, and in few cases that they received, they were not able to utilize it in a way that promotes their practicing competency. Orientation hurriedly done and in most cases, graduate nurses found themselves dealing with the continuous pressure to fit into the system [ CITATION Pel09 l 2057 ]. Bullying is a retrogressive act that dampens the possibility of effective socialization into the workplace. Senior nurses engage in bullying in their selfish attempt to protect their authority, and control. This is both unethical and unprofessional, going against the basic purpose of healthcare organizations of offering medical care to patients, its own staff community, and the society. Such environment stresses graduate nurses, and destabilizes the transformation process.

Correspondingly, the lack of effective organizational socialization program is a barrier to effective communication in the interaction of graduate nurses and their expert peers. These programs help in the integration process, and there lack strains the interaction process. In the health services set up new graduate nurses come from diverse backgrounds, their individual traits are broad and wide, ranging from spontaneous characters to introverts[ CITATION Has13 l 2057 ]. This variation in character is the lead influence to their ability to socialize in the new working environment. These programs can be either formal, or informal, but adequate in nature. Its absence places new nurses in a helpless situation; they lack a platform where they can seek clarification regarding to their roles, organizations values and culture, and at the same time feedback on their performance efficiency [ CITATION Phi151 l 2057 ]. As a result, there is no smooth flow of communication, further hampering the process of transition of new nurses into the practicing nursing environment.

Finally, systemic barriers affect the quality of communication between newly registered nurses and their expert nurses. Many healthcare systems in Australia have inadequate or inappropriate systems and channels of communication. In addition, there is a lack of a clear understanding of the roles and function of communication. Under this environment, novice nurses are not informed of what is their role in communication, and the expectations from them. This explains the lack of coordination between new and expert nurses because of breakdown in communication[ CITATION Coi15 l 1033 ].


In summary, communication barriers have a negative effect have a negative impact on the transition process of newly registered nursing into the practicing environment. It is the major cause of dissatisfaction, anxiety, stress, and attrition rates among new nurses. Further research on this topic should focus on finding ways to solve the effects of communication barrier.


Aziato, L., Kwashie, A., & Kwadwo, K. A. (2014). Footprints of the Nursing Profession: Current Trends and Emerging Issues in Ghana. Accra: Sub-Saharan Publishers.

Catalano, J. T. (2015). Nursing Now! Today’s Issues, Tomorrow’s Trends. Philadelphia: F.A. Davis.

Coiera, E. (2015). Guide to Health Informatics, Third Edition. Florida: CRC Press.

Goode, C., Lynn, M., McElroy, D., Bednash, G., & Murray, B. (2013). Lessons learned from 10 years of research on a post-baccalaureate nurse residency program. Journal of nursing Administration
, 43 (2), 73-79.

Harrington, N., & Terry, C. L. (2008). LPN to RN Transitions: Achieving Success in Your New Role. Philadelphia: Lippincott Williams & Wilkins.

Hasson, F., McKenna, H., & Keeney, S. (2013). A qualitative study exploring the impact of student nurses working part time as a health care assistant. Nurse Educ. Today
, 33, 873-879.

Hofler, L., & Thomas, K. (2016). Transition of New Graduate Nurses to the Workforce. North Carolina Medical Journal
, 77 (2), 133-136.

Levin, R. F. (2012). Teaching Evidence-Based Practice in Nursing. New York: Springer Publishing Company.

Malouf, M. S. (2011). Fitting in: a pervasive new graduate nurse need. Nurs. Educ. Today
, 31, 488–493.

Neese, B. (2015, May 11). Effective Communication in Nursing: Theory and Best Practices — See more at: Retrieved September 17, 2016, from Southeastern University:

Nunnery, R. K. (2009). Making the Transition from LPN to RN. Philadelphia: F.A. Davis.

Oslon, M. (2009). The ‘Millennials’: first year in practice. Nurses Outlook
, 57 (1), 10-17.

Pellico, L., Brewer, C., & Kovner, C. (2009). What newly licensed registered nurses have to say about their first experiences. . Nursing Outlook
, 57, 194-203.

Phillips, C., Esterman, A., & Amanda, K. (2015). The theory of organisational socialisation and its potential for improving. Nurse Education Today
, 35, 118-124.

Rush, K., Adamack, M., Gordon, J., Lilly, M., & Janke, R. (2013). Best practices of formal new graduate nurse transition programs: an integrative review. Int. J. Nurs. Stud. , 50, 345-356.

Timby, B. K. (2009). Fundamental Nursing Skills and Concepts. Philadelphia: Lippincott Williams & Wilkins.