Some nurses are so lacking in communication skills that they unsettle patients by speaking over them and giving conflicting advice, research has found.
The annual Inpatient Survey urged such health professionals to take a "long hard look" at how they related to people under their care, after 22% said nurses spoke in front of them as if they did not exist.
The research, carried out by the Care Quality Commission, also found that more than a third (35%) had been given contradictory advice - up from 31% in 2002.
Other problems included a general lack of staff and a feeling that patients were unable to talk to anyone about their worries and fears.
Sarah Kraszewski, principal lecturer in nursing at Anglia Ruskin University, said there was "never any excuse for talking over patients".
"You can never assume that because someone's grown-up they know how to communicate effectively," she explained.
"It's good for us all to stand back and take a long hard look at ourselves."