In short
Communication concerns are common in notifications about nurses because so much of safe care depends on it. The NMBA Code of conduct expects communication that is respectful, kind, compassionate and honest, and treats accurate, timely communication as essential to informed consent. Concerns arise in three directions: with the person in your care, within the team, and in the record. If a communication notification is made, map it to the code, reflect honestly on the impact, and evidence a concrete change to how you communicate.
What are communication concerns for nurses?
They are concerns about how you communicated with a person, a family, or your team, judged against the NMBA Code of conduct.
The NMBA Code of conduct for nurses builds effective communication into safe, person-centred practice. It states that positive professional relationships are built on communication that is respectful, kind, compassionate and honest, and that accurate, relevant and timely communication is essential to obtaining informed consent. Because communication underpins consent, handover and shared decision-making, it appears in many notifications, often alongside a clinical concern. For the wider process, see our guide to what happens after a notification to the NMBA.
It is worth being clear that a communication concern is not only about words. It covers what you explained, how you listened, the tone and manner you used, whether you checked understanding, and whether the right information reached the right colleague in time. Two nurses can deliver the same clinical care, yet one leaves the person feeling informed and respected while the other leaves them feeling unheard. That difference is exactly what a communication notification is about, and it is why reflecting on the person's experience is central to a good response.
What are the three directions a nurse is judged on?
Communication concerns arise in three directions, and it helps to see your practice through all three.
With the person
- Explaining care clearly
- Obtaining informed consent
- Respectful, kind manner
- Shared decision-making
With the team
- Clear handover
- Timely escalation
- Reporting to the RN and team
- Safe delegation
In the record
- Accurate documentation
- Timely entries
- Reporting status as practicable
- A reliable account of care
Why is communication a consent issue?
Because informed consent depends on accurate, relevant and timely communication, a communication failure is often a consent failure.
The code is explicit that effective communication is essential to obtaining informed consent. A person can only make an informed decision if they understand the nature and purpose of their care, in a way that fits their values and preferences. Proceeding with a procedure or medication without adequately explaining it, or without checking understanding, is one of the more serious communication concerns, because it goes to the person's right to decide about their own care. Person-centred communication and consent are, in practice, the same skill.
What does respectful, person-centred communication mean?
Communication that is respectful, kind, compassionate and honest, and never dismissive or judgemental.
The code asks nurses to be non-judgemental and not to refer to people in a non-professional manner, including in ways that could be negatively interpreted. Concerns here often arise from tone and attitude rather than clinical error: a person who felt dismissed, spoken over, or not listened to. Because these concerns are about how care felt to the person, the response benefits from genuine reflection on their experience, not just the facts of what was said.
How does communication within the team feature?
Handover, escalation and reporting to the right person at the right time are core communication expectations.
Nursing and midwifery care is collaborative, and the standards for practice expect you to report a person's status to the registered nurse and the wider team as soon as practicable, and to use clear methods to hand over and escalate. Communication breakdowns in the team, such as an unclear handover or a delayed report, can contribute to a poor outcome and feature in performance notifications. Using a structured handover approach helps ensure the right information reaches the right person in time.
Why does cultural safety matter in communication?
The NMBA Code makes culturally safe, respectful communication a core expectation, so a lack of it can itself be a concern.
Under the domain of practising safely, effectively and collaboratively, the code asks nurses to engage with people as individuals in a culturally safe and respectful way, and to foster open and honest professional relationships. Cultural safety is defined by the person receiving care, not by the nurse, which means it is their experience of feeling safe, respected and understood that matters. Communication that ignores a person's cultural needs, uses no interpreter where one is needed, or dismisses their preferences can breach this expectation. For Aboriginal and Torres Strait Islander peoples in particular, culturally safe communication is central to equitable care. Showing that you understand cultural safety, and have reflected on it, strengthens a response to any communication concern.
How should you respond to a communication notification?
Map the concern to the code, reflect honestly on the person's experience, and evidence a concrete change to how you communicate.
Identify which part of the code the concern touches, whether consent, respectful communication or team handover. Then, in a reflective account, show that you understand the impact on the person, and back it with remediation such as communication CPD and a specific change to your practice. Because communication concerns are often about experience, a defensive response tends to work against you.
Illustrative example
The concern: A nurse gave a medication without adequately explaining it or checking the person understood, and the person felt they had not consented.
Mapping to the code: The nurse identifies the effective-communication and informed-consent expectations in the Code of conduct that the interaction touched.
Reflection: They acknowledge honestly how the person could have felt their right to decide was bypassed, without minimising or defending their intent.
Remediation: They complete CPD on effective communication, and adopt a routine of explaining, checking understanding, and confirming consent before care.
How can CPD help with a communication concern?
Targeted CPD on effective communication gives dated evidence that you understand the standard and have changed how you communicate.
Communication is a skill that improves with deliberate practice, so evidence of structured learning is particularly relevant. CPD on effective communication, aligned with your CPD registration standard, lets you show you have addressed the exact concern, whether consent, respectful communication or handover. Paired with a reflective account that centres the person's experience, it directly answers whether the risk has been addressed. Browse the full range of CPD for nurses and midwives.
Matched to communication concerns
Courses for a communication notification
Structured CPD chosen for communication and consent concerns, to help you evidence remediation. Independent CPD you can use as evidence of remediation.
Ensuring Effective Communication as Healthcare Professionals
- Directly targets the communication concern
- Improve consent, handover and rapport
- Evidence safer communication practice
Ethics and Ethical Standards for Nurses and Midwives
- Ground consent and honesty in ethics
- Support shared decision-making
- Show the reasoning a Board looks for
Ensuring Dignity and Non-Discrimination as Healthcare Professionals
- Address respectful, non-judgemental care
- Centre the person's experience
- Evidence respectful communication
How to Deal With a Notification or Investigation
- Understand each stage of the NMBA process
- Know what to do, and what to avoid, early
- Respond calmly and well prepared
Official sources
Frequently asked questions
Can a nurse be reported for poor communication?
Yes. The NMBA Code of conduct treats effective, respectful communication as part of safe, person-centred care. Concerns about consent, tone, or handover can all form the basis of a notification, often alongside a clinical concern.
How is communication linked to consent?
The code states that accurate, relevant and timely communication is essential to obtaining informed consent. If a person did not understand their care, or was not given the chance to decide, a communication failure becomes a consent concern.
What does respectful communication mean under the code?
Communication that is respectful, kind, compassionate and honest, and never judgemental or dismissive. The code asks nurses not to refer to people in a non-professional manner, including in ways that could be negatively interpreted.
Can a handover or escalation problem be a notification?
Yes. Communication within the team is a core expectation, and an unclear handover or delayed report can contribute to a poor outcome. These team-communication breakdowns commonly feature in performance notifications about nurses.
The person misunderstood me. Is that my fault?
A communication concern is about the person's experience, so acknowledging honestly how they may have felt is more persuasive than defending your intent. Showing you understand the impact, and have changed your approach, demonstrates genuine insight.
Can I keep working during a communication notification?
Usually yes. Most nurses keep working while a communication matter is assessed. Your registration is only restricted if the Board takes immediate action, used in a small number of higher risk matters after a show cause process.
How should I respond to a communication notification?
Map the concern to the code, reflect honestly on the person's experience, and evidence a concrete change, such as communication CPD and a routine of explaining, checking understanding and confirming consent. Avoid a defensive response.
Does CPD help with a communication notification?
Yes. CPD on effective communication, aligned with your CPD registration standard, gives dated evidence that you understand the standard and have changed your practice. It never guarantees an outcome, but it directly addresses the concern.
Dr Richard
Course Facilitator
A practising clinician with over 21 years of experience and postgraduate training in healthcare law and ethics, so every course reflects both clinical reality and Australian regulatory standards.
Written and reviewed by Dr Richard. Last reviewed . Read full profile
AHPRA Courses is an independent training provider. Our courses are structured CPD that practitioners can use as evidence of remediation. We are not affiliated with, endorsed by, or acting on behalf of Ahpra, the Nursing and Midwifery Board of Australia, or any other regulator. Courses provide evidence of remediation and do not determine the outcome of any matter. This article is general information, not legal advice. If you have received a notification, seek advice from your professional indemnity insurer or a health law solicitor.