Professional Communication

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Professional Communication

• At the core of
• professional nursing practice

• Building Capacity as a Team Member
• SOAR RN Nurse Residency Program

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You
Influence
Other party
Control
Environment
Impact
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Professional Nursing PracticeROLES

• Patient
• Others
• Self

Relationship-Based Care, Koloroutis, 2004.
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Presenting Yourself as a Nurse

• How do you address physicians, and how do they
  address you?
• Introducing yourself
• Entering a patients room?
• When you call a doctor?

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Looking Like a Nurse

• I Am a Professional Nurse
• How you appear, dress
• Way of being (carrying yourself)

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A Model of the Communication Process
FILTER
FILTER
Sends Message
Receiver
Sender
Acknowledges/Clarifies receipt of message
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• Patient
• Others
• Self

Behaviors
Emotions
Perceptions Assumptions Stories
Filters History Stimulus
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Skills Necessary for Reflection

• Self-Awareness
• Description
• Critical Analysis
• Synthesis
• Application

Marks-Maran, D. and Rose, P. (1997) Thinking and
Caring New Perspectives on Reflection in
Marks-Maran, D. and Rose, P. (eds) Reconstructing
Nursing Beyond Art and Science, London,
Bailliere Tindall. P.128
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Self-Awareness

• Foundation skill for Professional Practice
• Conscious of ones character
• Beliefs
• Values
• Qualities
• Strengths
• Limitations
• Requires courage, confidence, a certain degree of
  maturity
• Requires the support of others

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Nursing Behaviors
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Nursing Communications

• Conflict, Work Related Stress and Behaviors
• De Dreu, C.K.W., Beersma, B. (2005)
• Volkema, R., Bergmann, T. (1995)
• Hendel, T., Fish, M., Galon, V. (2005)
• Bell, C., Song, F. (2005)
• Dijkstra, M.T.M., van Dierendonck, D., Evers, A.
  (2005)
• Bosson, J., Johnson, A., Niederhoffer, K. (2006)
• Guerra, J.M., Martinez, I., Munduate, L.,
  Medina, F. (2005)
• Oztunc, G. (2006)
• Baltimore, J. (2006)

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Horizontal Violence Cutting to the Core

• Culture
• Oppressed group theory
• Nature of nurses and nursing (caretaking)
• Learning the hard way
• Expression
• Meeting personal need for control through
• Hazing
• Gossip
• Verbal abuse
• Abusing trust relationships
• Backstabbing
• Breaking Confidences

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Impact on the Individual

• Emotional
• Social
• Psychological
• Physical
• Other

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Horizontal Violence

• Containment
• Through Self Awareness
• Professional Behaviors
• DESC and Active Listening
• Heart to Heart talks
• Mutual Purpose
• Mutual Respect
• This is Crucial

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C
A
B

• Groups of three
• Two facing each other (A B)
• One with back to the others (C)
• C only may speak to B only and provide
  description to B of drawing
• A and B may not speak or use any non-verbal cues
• B draws what they are told to draw
• Dont look! C holds picture up so A can see it
  too. C continues and A may help B verbally only.
  No gestures.

WALL
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Conflict at Work the Recipe for Collaboration
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Style Under Stress

• Silence Any action taken to withhold information
  from the pool of shared meaning
• OR
• Violence Any action taken to compel others
  toward your point of view

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• Masking Understating or selectively showing your
  true opinion
• Avoiding Staying completely away from a
  sensitive subject
• Withdrawing Pulling out of the conversation
  altogether

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• Controlling Coercing others to share your view
• Labeling Putting a label on people or ideas
• Attacking Abusive tactics such as name-calling,
  belittling, and threatening

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• Procedural v. Psychological
• Task v. Relationship

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Cycle of Emotion
Escalate now or later
Explode dump
Suppress
Assert (release energy)
React
Accept
Clarify/ Verify
Incomplete Resolution
Deny
Collaborate
Recognize
Resolution
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What are my choices?
Suppression Explosion
Containment Expression
Important? NO then let it go
Assertive and Intentional
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Communications Behaviors

• Aggressive I Win, You Lose
• Passive I Lose, you Win
• Passive/Aggressive Everybody loses
• Assertive More Winners than Losers

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Principles of Assertiveness

• Assertion does not mean aggression.
• When you decide to be assertive, be aware of the
  consequences.
• You cannot make others happy.
• In any relationship, you will incur some
  disapproval.
• Adopt the attitude that you will do the best you
  can.
• You cannot change other peoples behavior, only
  your own.
• Habit is no reason for doing anything.
• Worrying about something will not change it.
• People are not mind readers.
• Dont be victimized.
• LISTEN, LISTEN, LISTEN!

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DESC Script

• Step 1 Describe
• Step 2 Express
• (Explain)
• Step 3 Specify
• Step 4 Consequences (Caring for
  ourselves)

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The Heart of the MatterCollaboration and Mutual
Purpose

• What does my behavior tell me about what my
  motives are?
• Clarify what you REALLY want (AND)
• For myself
• For others (patients, families, physicians,
  co-workers)
• For the relationships
• How will I behave if this is what I want?

Modified from Patterson, Kerry, et al. Crucial
Conversations Tools for talking when the stakes
are high. McGraw-Hill, San Francisco, 2002.
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• Feedback is always meant to be positive.
• Its goal is to improve the
• current situation or performance its goal is
  never to criticize or
• offend.
• The structure of giving feedback is a reflection
  of this
• positive intent.

Ingrid Bens of Participative Dynamics, Toronto.
Facilitating with Ease.
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You
Influence
Other party
Control
Environment
Impact
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• The courage to change requires openness, insight,
  
• and a commitment to self-responsibility.
• To look deeply into oneself can be painful, and
  eliminating dysfunctional coping mechanisms
• even more so.
• Marion Conti-OHare RN PhD CS HNC

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Myers/Briggs Overview

• Introvert
• Prefer privacy
• Energize alone with time for thought and
  reflection
• Often seen as superior thinkers
• Asked often if they are angry
• Sensate
• Think, plan and write in paragraphs
• Look to past history for help in making decisions
• Enjoy attending to details and making sure all
  bases are covered in all matters.
• Feel short changed and uneasy with lack of
  details.
• Feeler
• Makes decisions based on their personal
  convictions.
• Feels justified ignoring analytical data if
  someones feelings are hurt
• May sabotage a process if they feel excluded

• Extravert
• Prefer to be with other people
• Energize with others, like to bounce ideas
• Often seen as socially adapt
• Feel often as if they have said too much.
• iNtuitive
• Think, plan and write in bullets
• Look to future possibilities in making decisions
• Enjoy brain storming and coming up with new
  innovative ways to do things.
• Feel bored and irritable with too many details.
• Thinker
• Makes decisions based on subjective analytical
  data
• Feels justified ignoring someones feelings if
  analytical data supports their contention
• May go on a tirade of opposition if they sense a
  lack of fairness.

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Typology

• An assessment of thinking style
• and the value of Diversity
• in Collaboration and on Teams

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Preferences are Innate

• How you gather data/take in information
• How you make decisions
• What energizes you
• How you approve life

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Preferences are Measured onFour Preference Scales

• Extraversion (E) or Introversion (I)
• Sensing (S) or Intuition (N)
• Thinking (T) or Feeling (F)
• Judgment (J) or Perceiving (P)

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Ways of Gathering Information

• Sensing (S) and Intuition (N)

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Sensate (S) Intuition (N)

• Take in information by way of their 5 senses
  sight, sound, feel, taste and smell..
• Present focus
• Here and now
• Accuracy and Detail
• Literal and Sequential
• Trust only black and white facts.

• Take in information by way of a sixth
  sense..
• Instant understanding
• Gut feeling and hunch
• Patterns
• Awareness of possibilities
• Random

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Sensate (S) Intuitive (N)

• Look at specific parts and pieces

• Look at patterns
• correlations and associations

• Live in the present and take the time to
  smell the roses

• Lives for the future, always wondering what
  could be

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Sensates (S) Intuitives(N)

• Always start at the beginning and take one
  deliberate step at a time

• Jump in anywhere skipping steps whenever
  possible

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Sensates (S) Intuitives (N)

• Like set procedures and established routines

• Like frequent change and variety

• An intuitive may seem like a flighty dreamer
  to the sensate

• Sensates may seem black and white and
  ritualistic to the intuitive

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S KEY WORDS N

• Details
• Present
• Practical
• Facts
• Sequential
• Repetition
• Perspiration
• Conserve

• Patterns
• Future
• Imagination
• Innovation
• Random
• Variety
• Inspiration
• Change

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WAYS OF MAKING DECISIONS

• THINKING (T) AND FEELING (F)

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WAYS OF MAKING DECISIONS?

• THINKING
• Based on Objectivity and logic
• Good at analyzing plans
• May seem cold and condescending to the feeling
  persuasion
• Concerned with truth justice and equality

• FEELING
• Based on personal subjective values
• Good at understanding people
• Concerned with compassion and harmony
• May seem emotional and sentimental to the
  thinking persuasion

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Key Words

• T
• Head
• Justice
• Impersonal
• Analyze
• Principles
• Logic

• F
• Heart
• Harmony
• Personal
• Empathize
• Values
• Emotion

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How do extraverts and introverts energize?...

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Extraversion Introversion

• get their energy by quiet thoughtfulness and
  reflection
• External activities and intrusions pull the
  extraverts out
• Talk things out
• Act then maybe reflect

• get their energy from being with other people
  and generating ideas
• External activities and intrusions push
  introverts inward
• Think things through.
• Reflect then maybe act

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KEY WORDS

• E
• Outwardly directed
• Action
• Breadth
• Expressive
• Speak to Think
• Publicly disclosing
• Gregarious

• I
• Inwardly directed
• Reflection
• Depth
• Contained
• Think to Speak
• Publicly guarded
• Reserved

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Extravert Introvert

• Like variety and action
• Often inpatient with long, slow jobs
• Do-think-do
• When working on a task, welcome interruptions
• Develop ideas by discussion

• Like quiet for concentration
• Prefers working on one project for a long time
  uninterrupted
• Think-do think
• Find interruptions intrusive
• Develop ideas by reflection, thinking

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The question for you is

• Extrovert
• What do you envy about the introvert?

• Intovert
• What do you envy about the extrovert?

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How you live your life

• JUDGING (J) OR PERCEIVING (P)

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How do you like to live?

• J
• A decisive, orderly and planned life?

• P
• A spontaneous, flexible and adaptable life?

• A life full of structure, order and
  organization?

• A life full of open options and last minute
  decisions?

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Judging Perceiving

• Handle deadlines by planning in advance
• Like clear limits and directions
• Like to have life under control
• May seem rigid demanding and uptight to the Ps

• Meet deadlines by last minute rush
• Has difficulty with limitations likes to explore
  options
• Prefer to experience life as it happens
• May seem messy disorganized and irresponsible to
  the Js

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Judgers Like Closure!

• Do you make lists?
• Do you work on your lists?
• If you do something that is not on your list do
  you add it and then cross it off?
• Do you become stressed if you have to address
  something that is not on your list?
• Do you become frustrated if you are interrupted?

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Perceivers Like To Have Open Options!

• 
  
• Do you prefer to wait until the last minute to
  decide something?
• Can you change direction with little internal
  stress?
• If something is cancelled at the last minute do
  you feel like you were given a gift?
• Do you welcome change?
• Do you like to be asked to do something new?

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Key Words

• J
• Organization
• Structure
• Control
• Completion
• Decisive
• Deadlines
• Plans

• P
• Spontaneous
• Flexibility
• Go with the Flow
• Experience as it happens
• Open Options
• Exploratory
• Ideas

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