Standard 11. Communication

1
Standard 11. Communication

• The registered nurse communicates effectively in
  a variety of formats in all areas of practice.

2
Communication A Feedback Loop

• Works well when there is no stress.
• When stress is added, perceptions get tangled.
• The only true communication is what is perceived.
  
• Both people are often under stress.

2
3
Styles of Communication

• Passive

• Peacemakers
• No winners
• Ignoring own rights
• Allow others to be first
• Apologetic
• Inhibited
• Avoiding eye contact
• Tending to let others make decisions
• Hard to say no
• Making excuses
• Soft, weak, wavering voice
• Rambling
• Vague
• Fidgety
• Making distracting gestures

Goal Avoiding conflict at all cost.
3
4
Styles of Communication

• Aggressive

• Competitive
• Winners-losers
• Expressing self at expense of others
• Dominating
• Controlling
• Manipulating
• Making choices for others
• Demanding
• In-your-face
• You language
• Blaming
• Sarcasm
• Put-downs
• Stirring up guilt and resentment.

Goal Winning regardless of price to others.
4
5
Styles of Communication

• Assertive

• Respecting self and others
• Expressing self and standing up for self without
  violating rights of others
• Showing calmness, confidence
• Having relaxed eye contact
• Taking responsibility for own behavior and
  feelings
• Seeing and making choices
• Being open to negotiation and compromise.

Goal Having open, honest communication and
respect for self and others.
5
6
Silence Kills

• A national study of 1,700 nurses, physicians,
  clinical staff, and administrators concluded that
  it is common for providers to say nothing when
  they observe troubling performance by
  colleagues.
• 62 of nurses see coworkers taking shortcuts that
  may endanger patient care, and 48 of nurses
  believe coworkers show poor clinical judgment.
  However, fewer than 10 of nurses, physicians,
  and other clinicians directly confront colleagues
  about performance concerns.
• AACN and VitalSmarts (2005). Silence Kills The
  Seven Crucial Conversations for Healthcare.

7
Silence Kills

• Disrespect
• 77 of nurses work with others who are
  condescending, insulting, or rude.
• 33 work with a few who are verbally abusive.
• Poor Teamwork
• 88 of nurses have one or more teammates who
  gossip or are part of a clique that divides the
  team.

8
Silence Kills Why dont we speak up?

• Were afraid.
• We dont know how.
• It takes time and energy.

9
AACN Standards for a Healthy Work Environment

• Nurses must be as proficient in communication
  skills as they are in clinical skills
• Focus on finding solutions and achieving
  desirable outcomes.
• Seek to protect and advance collaborative
  relationships among colleagues.
• ?

10
AACN Standards for a Healthy Work Environment

• Nurse communication skills (contd)
• Invite and hear all relevant perspectives.
• Demonstrate congruence between words and actions
  and hold others accountable for the same.
• Nurses must be relentless in pursuing and
  fostering true collaboration.