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A nurse can be excellent with patients and still struggle during the first few months of working in a new healthcare system.

Not because their clinical knowledge is inadequate.

Not necessarily because their English is poor.

Sometimes, the difficulty begins when the audience changes.

Explaining a medication to a patient requires one kind of communication. Calling a doctor about a deteriorating patient requires another. Handing over to the incoming nurse, questioning an instruction that does not appear safe, disagreeing with a colleague, speaking during a multidisciplinary meeting or telling a senior that you need help all require different judgements about what to say, how much to say, when to say it and how directly to say it.

Why Healthcare Professionals Need to Communicate Well

For healthcare professionals planning to work abroad, particularly internationally qualified nurses, this deserves far more attention than it often receives.

Learning to communicate with patients is essential.

Learning to communicate with the people caring for those patients alongside you is equally part of professional practice.

Professional Healthcare Communication With Colleagues

Healthcare Communication Does Not Stop at the Bedside

When people hear the phrase healthcare communication skills, they often think first of patient interaction: active listening, empathy, explaining medical information clearly, checking understanding and responding sensitively to concerns.

All of that matters.

But consider an ordinary hospital shift.

A nurse may communicate with the patient, relatives, another nurse, a healthcare assistant, a doctor, a pharmacist, a physiotherapist, a bed manager and a member of the discharge team. Information may be exchanged face to face, over the telephone, through documentation or electronically.

The patient’s care moves through that network.

This means communication is doing more than building rapport. It is helping professionals coordinate what happens next.

A beautifully conducted patient conversation cannot compensate for a critical observation that was never handed over.

Good English and Good Clinical Communication Are Not the Same Thing

This distinction is particularly important for internationally qualified healthcare professionals.

A nurse may have strong conversational English and still find professional communication difficult after moving to another country.

Why?

Because workplace communication involves conventions that ordinary language proficiency does not automatically teach.

Imagine that a patient’s blood pressure has fallen considerably and they have become increasingly drowsy.

A nurse calls the doctor and says:

“Doctor, the patient is not looking good. His BP is low and he’s feeling weak. Could you please come and see him?”

The English is understandable. The concern is genuine.

But the communication could be much more clinically useful.

The receiving professional needs to establish quickly:

Who is the patient? What has changed? How significant is the change? What other observations are relevant? What has already been done? What does the nurse need now?

A clearer escalation might begin:

“I’m calling about Mr Harris in Bed 6. His blood pressure has fallen from 118/72 to 86/54 over the last hour, and he is now increasingly drowsy. His heart rate is 118…”

The difference is not “better vocabulary”.

It is better selection and organisation of clinical information.

That distinction matters enormously.

The Skill Is Knowing What the Other Professional Needs From You

One of the most useful principles in professional healthcare communication is also one of the simplest:

Communicate for the receiver, not merely from the sender.

Healthcare professionals often possess far more information than they need to communicate at any one moment.

The difficult part is selecting what matters.

During a routine handover, the incoming nurse needs enough information to continue care safely.

During an urgent escalation, the doctor needs information that helps them understand the patient’s present condition and determine the required response.

During a referral, another healthcare professional needs to know why their input is required.

During a multidisciplinary discussion, colleagues need information relevant to the decision being made.

The same patient may therefore be discussed very differently in each situation.

This is why effective communication between healthcare professionals cannot be reduced to memorised sentences.

It requires judgement.

Handover Is Not a Biography of the Patient

Consider this handover:

“Mrs Williams is 76 and came in three days ago. She lives with her daughter. She has diabetes and hypertension and had her gallbladder removed about ten years ago. She slept okay last night. Her daughter visited yesterday. She’s on several medications…”

Nothing here is necessarily incorrect.

That is precisely what makes poor handovers deceptive.

The problem is often not false information. It is undifferentiated information: everything is given similar weight, leaving the receiver to work out what actually matters.

Now imagine that Mrs Williams has developed new confusion overnight, has reduced urine output and has had a temperature of 38.7°C.

Those facts alter the handover considerably.

Good clinical communication requires the healthcare professional to distinguish background from change, and routine information from information requiring attention.

The question is not:

“What do I know about this patient?”

It is:

“What does the next professional need to know to care for this patient safely?”

That is a much harder question.

And a much more useful one.

Structured Communication Helps, but the Framework Is Not the Skill

Healthcare professionals working internationally are likely to encounter structured communication approaches such as SBAR: Situation, Background, Assessment and Recommendation.

These frameworks can be extremely useful because they provide a mental structure when information needs to be communicated efficiently.

But there is a danger in teaching the acronym without teaching the reasoning behind it.

A nurse can technically follow SBAR and still communicate poorly.

For example, the “Background” section does not mean recounting the patient’s entire medical history. The relevant background depends on the present situation.

Likewise, “Recommendation” is not simply a sentence added because the framework requires one. It asks the communicator to make the purpose of the interaction clear.

Compare:

“So I just wanted to inform you.”

with:

“I’d like you to review him urgently.”

Or:

“Could you advise whether you would like his antihypertensive medication withheld until he has been reviewed?”

The second versions tell the receiver what response is being sought.

A framework can organise communication.

It cannot replace clinical judgement.

Asking for Help Is a Professional Communication Skill

One of the more difficult adjustments in a new workplace can be learning when and how to say:

“I need help.”

Internationally qualified professionals may enter workplaces with unfamiliar hierarchies, roles, protocols and expectations. Some come from professional cultures in which questioning a senior is uncommon. Others may worry that asking for clarification will make them appear inexperienced.

So they try to manage alone.

That can be a mistake.

There is a considerable difference between:

“I don’t know what to do.”

and:

“I’ve assessed the patient and completed the initial observations, but I’m concerned about the continuing deterioration. I’d like your help with the next step.”

The second statement does not conceal uncertainty.

It communicates it professionally.

Knowing the limits of your competence, seeking assistance appropriately and escalating concerns are not signs that communication has failed. They are examples of communication doing exactly what it should.

Politeness Should Never Make the Clinical Message Disappear

International professionals sometimes face an interesting linguistic problem: they become so concerned about sounding respectful that their message loses urgency.

Consider:

“Sorry to disturb you, doctor. I know you’re probably very busy, but whenever you have some time, if possible, could you perhaps review this patient? His oxygen saturation has dropped quite a bit.”

The speaker is trying very hard to be polite.

Unfortunately, the clinical priority has become buried beneath the politeness.

Professional courtesy matters. Excessive linguistic softening can be counterproductive when the situation requires clarity.

Compare:

“I’m concerned about Mr Patel’s deterioration. His oxygen saturation has fallen to 84% despite supplemental oxygen. I need an urgent medical review.”

Respectful.

Professional.

Unambiguous.

Being assertive does not mean being rude.

In healthcare, assertive communication often means making important information difficult to misunderstand.

You Also Need to Know How to Disagree

Communication becomes more difficult when everybody does not agree.

Suppose a nurse believes that a patient’s condition has deteriorated significantly, but the initial response from another professional is:

“Just continue monitoring.”

What happens next?

Some healthcare professionals will repeat themselves more loudly.

Some will become defensive.

Others, particularly when speaking to someone senior, may say:

“Okay.”

And stop.

Effective professional communication requires another option: respectful persistence.

For example:

“I understand. I’m still concerned because this is a significant change from his previous observations, and his level of consciousness has also deteriorated. Could you please review him?”

The objective is not to win an argument.

It is to ensure that a clinically important concern has been communicated clearly enough to be considered.

This distinction becomes particularly important in healthcare environments where professionals are expected to raise concerns about patient safety regardless of hierarchy.

“I Told Them” Is Not Always the Same as “We Communicated”

There is a phrase worth being cautious about in clinical work:

“But I told them.”

Perhaps you did.

But was the message heard?

Was its significance understood?

Was responsibility for the next action clear?

Imagine:

“Can somebody repeat Mrs Jones’s blood pressure later?”

Who is somebody?

When is later?

What should happen if it remains low?

Compare:

“Anna, could you repeat Mrs Jones’s blood pressure in 15 minutes and let me know the result, please?”

And where the information is safety-critical, confirming that the message has been heard correctly can be valuable.

Professional communication is not complete merely because words left one person’s mouth.

The useful endpoint is shared understanding.

Feedback Is Part of Healthcare Communication Too

Not every difficult conversation is an emergency.

Healthcare professionals also need to communicate when a colleague has made an error, when standards have slipped, when behaviour has affected the team or when somebody needs constructive feedback.

Compare:

“You’re always careless with documentation.”

with:

“I noticed that the fluid-balance entries for the last two rounds haven’t been completed. We need those observations recorded so that the patient’s intake and output can be assessed accurately.”

The first attacks the person.

The second identifies the behaviour, explains why it matters and keeps the discussion connected to professional practice.

This distinction sounds straightforward on paper.

It becomes considerably harder at the end of a demanding shift when people are tired, frustrated or under pressure.

That is exactly why communication needs to be treated as a skill rather than something professionals are simply expected to “pick up”.

Cultural Differences Can Change How the Same Sentence Is Heard

International healthcare teams bring together professionals with different first languages, educational backgrounds and expectations about hierarchy, politeness, disagreement and authority.

A communication style considered appropriately direct in one setting may sound abrupt to someone accustomed to more indirect language.

Conversely, communication intended as respectful may be interpreted as hesitant or unclear.

Neither conclusion automatically means that one culture communicates “better”.

It means healthcare professionals working internationally need cultural awareness in healthcare communication alongside language proficiency.

The objective is not to erase your identity or imitate an accent.

It is to understand how communication functions in the healthcare environment in which you are practising.

That includes noticing how colleagues:

escalate concerns;

request assistance;

address senior professionals;

disagree;

clarify instructions;

give and receive feedback;

communicate urgency.

For internationally qualified nurses, observing these patterns deliberately can make workplace adaptation considerably easier.

Written Communication Is Communication With a Colleague You May Never Meet

Clinical communication does not happen only in conversation.

Notes, referrals, discharge documents, emails and electronic records also communicate.

The reader may not be present to ask:

“What exactly did you mean?”

That makes precision particularly important.

Compare:

“Patient doing better. Continue same.”

with documentation that identifies the relevant change, current status and ongoing plan.

The principle is similar to verbal communication: include information that helps the next professional understand the patient’s care.

This is also why skills developed during examinations such as OET Writing have relevance beyond the examination room. Selecting relevant information, organising it for a professional reader and making the purpose clear are genuine workplace communication skills.

The examination may assess them.

Clinical practice gives them a consequence.

Communication With Colleagues Is Also About Relationships

There is another aspect of teamwork that receives less attention because it is harder to measure.

People work differently with colleagues they trust.

A colleague who knows that you communicate concerns clearly, listen when challenged, acknowledge other professionals’ expertise and do not become defensive when questioned is easier to collaborate with.

This does not mean everybody in a healthcare team needs to become friends.

Professional trust is enough.

And professional trust is built partly through hundreds of small communication behaviours: acknowledging somebody’s contribution, answering a question properly, admitting when you are unsure, passing on information when you said you would, and disagreeing without humiliation.

These interactions may look small compared with the dramatic moments of clinical care.

Collectively, they influence how a team functions.

For International Healthcare Professionals, This Skill Deserves Deliberate Practice

Many healthcare professionals preparing to work abroad spend months learning regulatory requirements, preparing for English-language examinations and studying for clinical assessments.

That preparation is necessary.

But there is another question worth asking:

Can I communicate effectively once I am actually inside the healthcare team?

Can you hand over a patient without giving either too little information or everything you know?

Can you telephone a senior colleague and communicate urgency clearly?

Can you ask for clarification without sounding accusatory?

Can you say that you disagree?

Can you receive feedback without immediately defending yourself?

Can you explain your clinical reasoning concisely?

Can you raise a patient-safety concern when the person you are speaking to is more senior than you?

Those are not simply English-language questions.

They are questions of professional healthcare communication.

And like other clinical skills, they improve through deliberate practice, feedback and reflection.

Frequently Asked Questions

What are the most important communication skills for nurses working with colleagues?

Important skills include structured handover, clear escalation, active listening, clarification, concise information sharing, assertive communication, respectful disagreement, giving and receiving feedback, and communicating appropriately across professional roles.

Why is interprofessional communication important in healthcare?

Patient care is often delivered by several professionals rather than one person working independently. Effective interprofessional communication helps the team share relevant information, coordinate care, clarify responsibilities and respond appropriately when a patient’s condition changes.

What is SBAR in healthcare communication?

SBAR stands for Situation, Background, Assessment and Recommendation. It provides a structure for organising clinical information, particularly during handovers and escalation. Its effectiveness still depends on selecting relevant information and communicating it clearly.

How can internationally qualified nurses improve communication at work?

Alongside improving English proficiency, internationally qualified nurses can practise realistic workplace situations such as handovers, telephone escalation, requesting clarification, speaking to senior colleagues, multidisciplinary discussions and giving or receiving feedback. Observing the communication conventions of the healthcare system in which they work is also valuable.

Is assertive communication the same as being rude?

No. Assertive professional communication means expressing a concern, request or clinical judgement clearly while remaining respectful. In situations involving patient safety, excessive hesitation or indirectness can make an important message less clear.

The Patient Is Not the Only Person Who Needs You to Communicate Well

Patient-centred communication deserves the attention it receives.

But modern healthcare is rarely delivered by one professional in isolation.

Patients move between shifts, departments, disciplines and services. Their information moves with them. Decisions are discussed. Concerns are escalated. Instructions are clarified. Professionals disagree. Somebody notices a change and needs somebody else to understand why it matters.

That entire process depends on communication.

For healthcare professionals planning an international career, the goal therefore should not simply be to speak English well enough to work abroad.

Nor should communication training end with learning how to sound empathetic with patients.

The broader professional skill is learning how to communicate with purpose: changing what you say, how you structure it and how directly you say it according to the person, the clinical situation and the outcome required.

A good healthcare professional needs to know what is happening to the patient.

A good healthcare communicator also needs to make sure the right colleague understands what needs to happen next.

To learn more about how our structured courses prepare you for every OET sub-test, visit Khaira Education.