ACJ Review: From Silence to Voice: What Nurses Know and Must Communicate to the Public

Volume 7, Issue 2004

From Silence to Voice: What Nurses Know and Must Communicate to the Public

Buresh, Bernice, and Gordon, Suzanne
Canadian Nurses Association, Ottawa, Canada (see also Silence to Voice)

Available from Cornell University Press, 2003
312 pages
ISBN 0-8014-8868-0

Reviewed by: Ann Marie Cianci (AuD), Iona College
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Reviewed by: Ann Marie Cianci (AuD), Iona College
The profession of nursing has evolved from simple care giving assistant to a range of responsibilities from basic care to case management to primary care, i.e., nurse practitioners, whose responsibilities approach the scope of practice of physicians. Nurses are responsible for communicating information: to patients and families; in health documentation; as intermediaries between patients and physicians, administrators and physicians or patients; etc. The responsibility for using appropriate language in different communication situations is staggering for nurses.
As a group, nurses represent the largest number of health professionals. According to Buresh and Gordon, however, nurses are the most under-represented profession in media coverage. The authors suggest that nurses themselves are responsible for the lack of public information and coverage in the media because of nurses’ refusal to speak (“silence”). The purpose of this publication is to empower nurses to learn appropriate methods of communication for various purposes (“voice”). The book has two sections: aspects of communicating with and educating their patients and colleagues about nursing, and aspects of communicating through the media to the public in order to promote the nursing profession.
The authors take a somewhat feminist stance, partly because the profession of nursing is traditionally a “woman’s profession”, although they clearly acknowledge that there are male nurses who should also communicate appropriately. The feminist point-of-view reflects the parallel history of the feminist movement and the emergence of the nursing profession as a visible, essential force in healthcare.
Buresh and Gordon address communication theory appropriately from presentation and non-verbal skills to oral and written communication, depending upon the purpose of the communication act (e.g., patient communication, medical information, media presentations). The authors indicate that basic communication theory and skills are required for all communication, whether oral, written, electronic or via mass media. The ultimate goal is to put theory into practice in order to publicize the contributions nurses make to the health and welfare of their public (their patients). The patient comes first, and the authors stress professional and ethical proscriptions, particularly confidentiality issues.
Buresh and Gordon practiced nursing and educated nursing students, clinicians and research-level nurses. They are now journalists who communicate with the public through mass media and political arenas. They discuss basic communication skills for nurses who wish to follow their example to raise the profession of nursing to a high level of public respect. The authors describe the mechanics of the media and how to educate the public by taking advantage of electronic and print news media. The book serves well as a textbook for nursing students and encourages veteran practitioners to communicate about the value of their profession. Effective written communication skills for the purpose of public relations are emphasized.
Communication skills addressed in this book include the need for nurses to seize every available opportunity to educate. The text provides scenarios with sample responses from nurses, especially in situations with negative connotations that could evoke undesirable defensive responses. Again, basic human communication skills are stressed to facilitate practical public relations.
The internet is mentioned briefly. However, considering the need for critically assessing the validity and reliability of information obtained online and the increasing numbers of people accessing information online, perhaps this should be addressed at greater length.
Buresh and Gordon stress the use of every type of media to assist in making the nursing profession visible. Major communication skills discussed include presentation, credibility, being prepared, expressing enthusiasm and having conviction. These essentials of public speaking are at the core of the book’s philosophy. This also appears to be the core of good nursing practice. Putting basic human communication skills into practice will result in good nursing and public image, according to the authors.
The contemporary profession of nursing continues to transition as nurses, collectively and individually, communicate more with their public. Proper communication strategy is imperative, and most (health care) service providers could utilize this publication generically. The information regarding the media is invaluable and facilitates patient relationships, public service campaigns and news coverage. As a core text, From Silence to Voice: What Nurses Know and Must Communicate to the Public is an easy-to-read practical reference.