Getting People to Work

TogetherN.V. PETRENKON.V. PETRENKO

Objectives

! Define the basic listening sequence ! Discuss the importance of effective

communication ! Make appropriates assignments to

team members ! Develop a system for organizing

and delivering client care

Communication

! Is a complex, ongoing dynamic process in which the participants simultaneously create shared meaning in an interaction

! Goal is to approach, as closely as possible, a common understanding of the message sent and the one received

Process of Communication has been viewed as

consisting of five elements – Encoder or sender – Message or information to be

conveyed – Sensory channel or method of

sending – Decoder receives the message – Feedback or return to the sender

indicates the degree of understanding of the message

! Speaker – Influenced by past conditioning,

present situation, communicative purpose, level of knowledge, speaking skill, attitudes toward self, subject, and listener

! Feedback – Causes speaker to alter his or her

verbal or nonverbal behavior

! Message – Has content, structure, and style

! Channel – Limits or shapes message to one or

more

! Feedback – Causes speaker to modify message

! Listener – Influenced by conditioning,

purpose, situation, and attitudes toward self, subject, and speaker

! Response – Feedback to the speaker in the

form of visual or verbal signals

Method of Communication

! Written Communication ! Verbal Communication ! Nonverbal Communication ! Visual ! Kinesthetic ! Mechanical

Channels of Communication

! Verbal – Employs words – Written – Spoken – Language

ismutually understood

– Communication is easy to control

Nonverbal – Employs behaviors – Conveys messages

that are not written or spoken

– Unconscious – More difficult to

control than verbal communication

Paralanguage

! The nonverbal component of spoken language

! Affects the interpretation of the message

Components of Paralanguage

! Paralanguage affects the following nonverbal components of speech:

– Rhythm – Pitch – Stress – Information – Rate – Volume

Understanding the Message is Influenced by

! Culture ! Knowledge ! Needs ! Goals ! Previous experiences ! Values ! Roles ! Abilities

Components of the Basic Listening Sequence

! Listening is the most critical of all communication skills

! Eye contact requires the listener to look at the speaker

! Attentive body language conveys interest and openness

! Vocal qualities include pitch, volume, and rapidity of speech

! Verbal tracking is paying attention to what is being said-paraphrasing

Seven Priniciples of Effective

Communication

! Information giving is not communication

! The sender is responsible for clarity ! Use simple and exact language ! Feedback should be encouraged ! The sender must have credibility ! Acknowledgment of others is essential ! Direct channels are best

Directions of Communication (1)

! Formal or informal communication may be downward, upward, lateral, or diagonal

– Downward (manager to staff) is often directive

– Upward (staff to management or lower management to middle or upper management) involves reporting pertinent information to facilitate problem solving and decision making.

Lateral communication occurs between individuals at the same hierarchical level (nurse managers, department heads)- involves information sharing, discussion and negotiation

– Diagonal communication involves individuals or departments at different hierarchical levels (staff nurse to chief of medical staff)-involves information sharing, discussion and negotiation

Directions of Communication (2)

Calmly repeat a negative reply without justifying it

– Be honest about feelings, needs, ideas, use “I”

– Accept and or acknowledge your faults calmly and without apology

Assertiveness in Communication

! Assertiveness describes behaviors that people can use to stand up for themselves and their rights without violating the rights of others

! Assertiveness helps to identify problems and facilitate problem solving and decision making

Some say Nurses lack assertiveness

! Had you rather work to maintain harmony than voice opinions that may result in confrontation?

! Assertiveness does not force agreement between participants but permits them to disagree

! Promotes clarification of each position.

! Communication may be passive, aggressive, passive-aggressive, or assertive

– Passive does not voice opinions

– Aggressive expresses their opinions in a hostile way infringing on others

– Passive aggressive is aggressive communication in a passive manner

! Aggressiveness describes behaviors that people use to force their wishes or ideas on others

! In assertiveness, use “I” rather than “you” ! The nonassertive person often attempts to

avoid problems by remaining silent when he or she is angry

! The aggressive person responds to the emotional aspect of the situation, alienating others

! The assertive person responds appropriately at the appropriate time

! In being assertive, one has the right to speak up but should also be a listener

! Assertiveness does not force agreement

Effective Communication in the Workplace

! Many do not accept responsibility or perform a task because they do not fully understand what is expected of them.

! Barriers to communication may be – Physical – Psychological – Semantic and – Gender

Factors Influencing Communication

! Psychological “noise’ such as increased anxiety may interfere with the ability to pay attention to the other speaker.

– Social values, emotions, judgments, and cultural influences also impede communication.

! Gender Barriers – Boys learn to use communication as a

way to negotiate and to develop independence

Girls use communication to confirm, minimize disparities, and create or strengthen closeness

Gender

! Men concentrate on individual performance

! Talk more, longer, and faster

! Focus on content ! Are more responsive

to superiors ! Express views more ! Disagree more ! Withdraw when

stressed

Women use descriptive Language ! Relate personal

experience ! Use open

communication techniques to seek and clarify

! More responsive to subordinates

! Perceive verbal and nonverbal messages

! Withdraw from conflict ! Seeks to be heard ! Requires validation

Cultural Background

! Women constitute 58 % of the workforce; minorities, 1/3

! Cultural attitudes, beliefs, and behaviors all affect communication

Organizational Policies, Norms

! Face to face verbal communication is considered the most effective method of communication, followed, in diminishing order, by the telephone, voice mail, electronic mail, and finally written

! Difficult communication should be relayed face to face

! Open, direct, and timely interactions between employees uncover problems and facilitate problem solving and decision making

– Avoid over apologizing – Avoid defensive, adverse reactions, such

as aggression, temper tantrums, backbiting, revenge, slander, sarcasm, and threats

– Use body language that is appropriate and matches the verbal message (eye contact, posture, gesture, facial expression)

Facilitating Good Communication

! Practice active listening ! Communicate genuine interest and

concern ! Provide the employee with

adequate information ! Use the team members’ ideas in

the plan of action ! Maximize feelings of self-respect

! Focus on the team members’ abilities ! Do not minimize the value of time

allowed to learn ! Praise competent performance ! State expectations clearly ! Be willing to look at alternatives that

others may feel important ! Demonstrate respect for others

Communication with Colleagues

! Promote trust and sincerity ! Keep lines of communication open on all

levels ! Use active listening skills and assertive

behavior ! Provide adequate information ! Maximize feeling of self-respect ! Focus on the abilities of your team ! Praise ! State your expectations clearly ! Look at alternatives ! Demonstrate respect

! Use telephone etiquette – Identify yourself – Speak clearly – Be courteous – Indicate your reason for calling – Indicate a willingness to be of assistance – Clarify instructions or directions ! Be careful with E-mails – Professional e-mail may remain

informal; message must be clear, concise, and courteous

Delegation of Client Care

! Safe delegation-ANA has defined unlicensed assistive personnel

– Potential for harm to the patient – Complexity of nursing activity – Problem solving required – Predictability of the outcome – Extent of interaction

Criteria for Delegation

! Task Related concerns ! Ability ! Priorities ! Efficiency ! Appropriateness ! Relationship oriented concerns ! Fairness ! Learning Opportunities ! Health ! Compatibility ! Preferences

Communicating Client Needs Change of Shift

Report

! Identify the client ! Include the diagnosis ! Presence on unit ! Provide the treatment plan ! Document client responses to

current treatments ! Omit personal opinions and value

judgments

Methods of Giving the Report

! Fact to Face ! Use of computer printouts ! Taped report ! Give report while walking rounds

Team Conferences

! Interdisciplinary team conferences involve each individual who cares for a specific patient

! Information about the patient is shared among team members

! The key to a successful team conference is to present the information in a clear and concise manner.

Role of Communication in Leadership

! The manager’s ability to communicate often determines his or her success as a leader

! Managers need to be good listeners – Give positive attention ! Managers need to give clear, concise

instructions ! Verify through feedback ! Give follow-up

! Change of shift report – Review page 27 – Identify the client, the room and

bed no. – Include the diagnosis – Is the client on the unit at present – Document the client responses to

current treatments – Omit personal information

! Be careful communicating with other disciplines

– In calling a physician, make sure that all of the needed information is available

– Document the call and the physician’s instructions.

! Remember the clients and their families

! Ask for help when you need it

Conclusion

! Delivering and coordinating patient care is the nurse’s role

! Nurses need good communication skills

! The basic listening sequence helps nurses develop communication skills.