Vol. 2, Issue 2, Part A (2025)

Effective nurse-patient communication is a critical element of safe, patient-centered care, yet it remains one of the most frequent challenges in busy general wards where high patient loads, time constraints, and environmental pressures directly influence clinical interactions. This observational research assesses key communication barriers experienced by nurses working in overcrowded general wards and examines how organizational, interpersonal, and situational factors shape the quality of nurse-patient exchanges. A structured, non-participant practical observation method was adopted to capture real-time communication scenarios between nurses and adult inpatients during routine clinical duties. Data were recorded using a standardized communication assessment checklist focusing on clarity of dialogue, emotional responsiveness, task explanations, patient engagement, and environmental influences. The findings indicate that noise, multitasking, heavy workload, limited time per patient, and the use of medical jargon significantly obstruct effective communication. In several cases, nurses relied heavily on directive and task-oriented styles, while patients demonstrated hesitation in seeking clarification, often due to perceived nurse busyness or fear of being ignored. Environmental disruptions, competing clinical priorities, and inadequate privacy further contributed to compromised rapport building. Practical observations also revealed discrepancies between perceived and actual communication; nurses believed they were communicating adequately, but observational data showed gaps in patient understanding, emotional support, and shared decision-making. This research highlights the need for targeted communication training, workload redistribution, and structural adjustments to reduce noise and interruptions in general wards. Strengthening communication protocols and creating protected interaction time could enhance patient satisfaction, safety, and trust. The research recommends integrating communication-focused audits and simulation-based education into routine nursing practice to promote sustained improvements. By understanding specific barriers within real ward environments, healthcare institutions can develop context-appropriate strategies that support nurses and empower patients, ultimately improving the overall quality of care.