Getting People to Work Together

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Getting People to WorkTogether

• N.V. PETRENKO

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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

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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

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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

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• ! 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

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• ! Message
• Has content, structure, and style
• ! Channel
• Limits or shapes message to one or more
• ! Feedback
• Causes speaker to modify message

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• ! 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

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Method of Communication

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

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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

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Paralanguage

• ! The nonverbal component of spoken language
• ! Affects the interpretation of the message

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Components of Paralanguage

• ! Paralanguage affects the following nonverbal
  components of speech
• Rhythm
• Pitch
• Stress
• Information
• Rate
• Volume

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Understanding the Message is Influenced by

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

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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

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Seven Priniciples of EffectiveCommunication

• ! 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

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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.

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Directions of Communication (2)

• 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

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• 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

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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

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• Some say Nurses lack assertiveness
• ! Had you rather work to maintain harmony than
  voice opinions that may result in confrontation?

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• ! Assertiveness does not force agreement between
  participants but permits them to disagree
• ! Promotes clarification of each position.

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• ! 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

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• ! 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

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• ! In being assertive, one has the right to speak
  up but should also be a listener
• ! Assertiveness does not force agreement

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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

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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

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

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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

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Cultural Background

• ! Women constitute 58 of the workforce
  minorities, 1/3
• ! Cultural attitudes, beliefs, and behaviors all
  affect communication

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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

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• ! 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)

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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

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• ! 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

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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

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• ! 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

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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

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Criteria for Delegation

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

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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

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Methods of Giving the Report

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

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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.

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Role of Communication in Leadership

• ! The managers 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

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• ! 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

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• ! 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 physicians
  instructions.
• ! Remember the clients and their families
• ! Ask for help when you need it

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Conclusion

• ! Delivering and coordinating patient care is the
  nurses role
• ! Nurses need good communication skills
• ! The basic listening sequence helps nurses
  develop communication skills.