Challenging situations often arise when we feel poorly equipped to deliver nursing care. Sometimes in nursing it can be difficult to know what to say or what to do, and this can be particularly challenging for us. As we develop our skills and knowledge and gain more experience and confidence, we begin to feel better equipped to deal with the personal challenges associated with providing nursing care.

Common barriers in our communication with each other include:

• Language (not being able to understand another person because they speak (and perhaps can only speak) a different language
• Culture (different cultures are likely to have different expectations about social interaction and conduct)
• Consciousness (people who have fluctuating level of consciousness, or who are unresponsive, pose considerable communication challenges for the nurse)
• Sensory Impairments (such as people who are deaf, blind or cannot speak)
• Mental health problems

It is important to ensure that information is readily available to all patients and service users. Key written information should be available in different formats (in writing, braille and so forth) and in all common languages and interpreters should be accessible to explain healthcare interventions.

Aural refers to hearing or relating to the ear while oral refers to the mouth or that which is spoken rather than written. One of the key problems here is that the terms sound very alike. While the term oral is in common usage, aural is not commonly used.