Firstup research exposes how communication breakdowns impact nurse and patient experiences; 90 percent of hospital nurses have learned about new policies or procedures only after they went into effect
SAN FRANCISCO, January 8, 2026 – As hospitals nationwide face persistent staffing shortages and clinical burnout, new research released today from Firstup, the pioneer of intelligent communication and engagement platforms for the workforce, reveals a fundamental challenge at the root of the crisis: communication failures.
For its State of Nursing Communication Report, Firstup surveyed 1,000 U.S. hospital nurses to understand how workplace communication impacts everything from onboarding to compliance and patient care. The research shows that nurses are routinely missing key updates – from safety protocols to policy changes – not because their hospitals are not communicating, but because the delivery methods are ineffective, the content is often irrelevant, and nurses lack the bandwidth to consume the messages.
This reality is more than just an inconvenience for the nursing staff; it represents a major vulnerability with direct impact on nurse retention, stress, collaboration, patient safety, and, ultimately, the hospital’s reputation and bottom line.
Key findings include:
- Traditional and passive channels are failing nurses. Email remains the top communication method (86%) for hospitals, and 25% of nurses still receive paper notices, both of which are easily missed during busy or short-staffed shifts.
- Frequent communication is not translating into engagement. Nearly 70% of nurses receive workplace updates several times a week or more, but almost half (48%) find those communications only “somewhat” relevant to their jobs. Because these messages are not always perceived as useful, 67% of nurses skim or delete workplace messages at least sometimes without fully reading the content. One in four (25%) say they do it often.
- Nurses lack the bandwidth and energy to process important updates. One-third say they do not have time to read updates, 19% say they lack the motivation, and 13% report feeling disengaged from their hospital.
- Low confidence in hospitals’ communication approach. About half (48%) of nurses are only “somewhat confident” that their hospital’s communication efforts keep nurses compliant with required policies and procedures.
- Critical information is being overlooked due to ineffective communication. 16% of nurses have missed updates on safety protocols, and 10% have overlooked HIPAA or compliance information. Nine in 10 (90%) of nurses have learned about new policies or procedures only after they took effect at least once, with nearly half (46%) saying it’s happened several times or more.
“Nurses are doing everything they can to care for patients in incredibly demanding conditions, but they are being asked to navigate communication systems that were not designed for clinical environments,” said Bill Schuh, CEO of Firstup. “Hospitals depend on nurses to make rapid, informed decisions and deliver high-quality patient care. Nurses depend on timely, relevant information to do their jobs safely, effectively, and compassionately. When communication breaks down, the entire system breaks down – and any lapse can negatively impact patient care or lead to costly incidents.”
With 50% of nurses reporting that they receive important workplace updates directly from their managers and supervisors, the research reveals how ineffective top-down communication can lead to a wide range of operational and clinical issues:
- Communication gaps directly affect patient care. Eighty-one percent of nurses report experiencing patient care issues due to a miscommunication or lack of communication from a manager or senior leadership, including inefficient handoffs or transitions of care (33%), delays in patient care or treatment (31%), and increased patient complaints or dissatisfaction (30%).
- Current communication practices contribute to burnout and attrition. Eighty-eight percent of nurses say a miscommunication or lack of communication from a manager or senior leadership has caused workplace issues, including increased stress or burnout (52%), desire to leave their department or unit (32%), or desire to leave the profession altogether (21%).
- Miscommunication affects teamwork. Forty percent say miscommunication from a manager or senior leadership has decreased collaboration.
- Many hospital communication efforts are only “somewhat effective.” Roughly 38% of nurses say their hospital’s communication about staffing changes, new equipment or technology, safety protocols, and onboarding needs improvement or is only somewhat effective.
“No one wants to hear the words ‘somewhat effective’ or ‘somewhat confident’ in a hospital setting. Our findings serve as a wake-up call for hospital leadership that communication cannot be an administrative afterthought,” added Melissa Hensley, VP, Healthcare at Firstup.[1] “Modern, intelligent approaches, focused on personalized communication and engagement that reaches nurses where they are, when they need it, are a crucial business imperative for operational excellence, risk mitigation, retention of nursing staff, and, most importantly, patient care.”
To review the full survey results, visit:
To explore the findings and hear practical strategies for reaching and supporting nurses in 2026, join Firstup and experts from Indiana University Health and Mercer for a webinar on January 27: Four Steps to Modernize Hospital Communication Across Every Shift and Every Unit.
Methodology
Firstup surveyed 1,000 U.S.-based nurses working in hospital settings, including full-time, part-time, and travel nurse roles. The survey was conducted from September to November 2025 via Pollfish, an online survey platform.
About Firstup
Firstup is the leading platform for intelligent communication and engagement that power meaningful business outcomes. As a true “mission control” for workforce communications, Firstup is built for organizations with critically important frontline employees – delivering the right message to the right person at the right time. The platform enables hyper‑personalized, data-driven journeys across channels (email, mobile, intranet, digital signage and more), bringing alignment, clarity and engagement to every level of the organization.
With integrations to core HR, IT and business systems, Firstup reduces digital noise, surfaces actionable insights, strengthens employee experience and helps clients maximize productivity and retention. Trusted by large enterprises worldwide, Firstup transforms internal communication into measurable impact. Learn more at www.firstup.io.
Download PDF
English (United States) 
English (UK)