Chapter 19 - Effective Communication and Conflict Resolution

Describe the gender differences in communication.

Women: -generally work toward compromise -preserving relationships if of paramount importance -seek to communicate with sensitivity toward how the information is being received -value the process of communication itself as a significant part of relationships Men: -generally work toward winning -focus on goals and move aggressively toward accomplishment -communicate with a purpose to achieve an identified goal -typically use communication as a tool to deliver information

Define conflict.

an experience in which there is simultaneous arousal of two or more incompatible motives

Define negative communication.

behaviors that block or impair effective communication

Define positive communication.

behaviors that enhance effective communication

Define interpretation.

receiver's understanding of the meaning of the communication

Define information.

the data that are meaningful and alter the receiver's understanding

Define perception.

the manner in which one sees reality

Define active listening.

the process of hearing what other are saying with a sense of seriousness and discrimination

Define filtration.

unconscious exclusion of extraneous stimuli

A charge nurse has asked for the upcoming holiday off. The nurse manager calls her into the office and states, "The unit must be covered. Do you have any suggestions on how to cover it?" The charge nurse assumes her boss is upset with her for asking for the day off because she never asks her opinion on staffing. Which of the following elements most likely influenced the communication process?

Interpretation -interpretation of information can be influenced by such factors as context, precipitating events, preconceived ideas, personal perceptions, style of transmission, and past experiences that may cause the sender's message to mean to the receiver something that was entirely unplanned by the sender

Describe conflict resolution and its steps.

1. Conflict is seldom created intentionally 2. May occur because of lack of awareness of how our own behavior contributes to interpersonal problems 3. Steps to resolve conflict: -recognize one's own conflict resolution style -engage in active listening -all people involved must view their conflict as a problem to be solved mutually

Describe computer-based communication.

1. Email, text messages, attachments, and chatrooms 2. Lacks nonverbal cues to aid in communication 3. Beware: communication via computer can often be retrieved even after it has been deleted 4. Clarification - important to ensure that the correct message is received

Name and describe the characteristics of professional communication.

1. Empathy: -feeling what the other person is feeling and seeing the situation as they see it 2. Equality: -all participants in the process are equal 3. Openness: -feelings and thoughts stated directly and honestly 4. Positiveness: -conflict is viewed as positive 5. Supportiveness -requires flexibility and a willingness to change personal opinions/positions

Name the nonverbal factors that confirm/deny the spoken word.

1. Facial expression 2. Presence or absence of eye contact, posture, and body movement 3. Indirect nonverbal messages influence -dressing style -lifestyle -material possessions

Name distractions to good listening.

1. Framing an answer while the other person is still talking 2. Environmental disturbances that provide significant disruption 3. Preexisting concerns or worries that block absorption of conversation 4. Attempts to continue work in progress that leads to inattention 5. Ineffective engagement, peculiar mannerisms

Name good listening habits.

1. Give undivided attention to the sender. 2. Provide feedback by rephrasing the message in the receiver's own words 3. Give attention to positioning, so that the sender and receiver are facing each other and are able to make eye contact 4. Note nonverbal messages such as body language 5. Finish listening before you begin speaking 6. Active listening greatly improves the likelihood that the correct message will be received

Describe social media.

1. Heathcare-related sites, chat rooms, blogs, forums, and video sites provide an unparalleled opportunity to network, share and problem-solve healthcare issues 2. Patient retains right to confidentiality and privacy in every medium - nurses must be very careful in not using a patient's name or any other type of identifying information 3. Potential board of nursing actions for inappropriate use of social media: -unprofessional conduct -unethical conduct -moral turpitude -mismanagement of patient records -revealing a privileged communication -breach of confidentiality

Describe using touch.

1. Individuals generally have a well-defined sense of personal space 2. Nurse should be sensitive to each patient's preferences in terms of touch 3. A gentle touch for some can demonstrate genuine interest and concern

Name the subcomponents of communication.

1. Interpretation of information -sender's message may mean to the receiver something that was entirely unplanned or unexpected by the sender 2. Filtration 3. Feedback

Describe using open communication.

1. Open-ended questions or statement that require more information than yes or no 2. Questions or statement that are phrased to require only one- or two-word responses may miss the mark entirely

Name positive communication techniques.

1. Openness 2. Empathy 3. Supportiveness 4. Positiveness 5. Equality 6. Developing trust - keeping promises 7. Using "I" messages 8. Expressing empathy

While making patient rounds, the charge nurse is told that a staff nurse sat in the room with the family and watched television, causing the patient's medications to be late. When communicating with the staff nurse, the charge nurse states, "I will not tolerate lazy disorganized nurses on my unit. Either join my team or leave, and I don't want to hear any of your excuses." Which type of communication did the manager use?

Aggressive: -conveys dominance and limits the focus on or understanding of the opinions, values, or beliefs of others

Describe online etiquette.

1. Be nice and ethical 2. Don't say anything to someone online that you wouldn't say in a face-to-face conversation 3. Remember the TMI (too much information) concept - do not give more personal information than others want to hear 4. Write with clarity, reread what you've written to determine whether it is clear or if it might be interpreted differently from what you intended 5. Respect other, including their privacy 6. Use discretion, posting online lives forever 7. Obey copyright laws

Describe negative communication techniques.

1. Blocking -making noncommital or generalized answers 2. False assurances -making statements that show a lack of concern or a lack of knowledge of the situation 3. Conflicting messages

Describe body language.

1. Body positioning and movement send loud messages to others 2. Communication is enriched through: -an open stance such as holding arms at the side or out toward the patient rather than crossed -leaning toward the patient as if to hear more clearly, rather than away from the patient

Describe confidentiality and privacy.

1. Breach of confidentiality and privacy through careless gossip has ethical and legal ramifications 2. Communication about confidential or personal patient issues must be controlled in all areas: nurses' station, utility rooms, etc

Name and describe the conflict resolution styles.

1. Avoidance: one person uses passive behaviors and withdraws from the conflict, neither person is able to pursue goals 2. Accommodation: one person puts aside their goals in order to satisfy the other person's desires 3. Force: one person achieve their own goals at the expense of the other person 4. Compromise: both people give up something to experience partial goal attainment 5. Collaboration: both people actively try to find solutions that will satisfy them both

Describe communication.

-complex process that can easily lead to misunderstandings -understanding communication is required for nurses to interact professionally with patients, families, peers, managers, student nurses, physicians, other members of the interdisciplinary team, and the public

Describe logical fallacies and name the different types.

-influential arguments based on flawed logic -understanding logical fallacies help the nurse to recognize the difference between legitimate and faulty reasoning and promote effective communication Types: -Ad hominem abusive: argument that attacks the person instead of the issue -Appeal to emotion: attempt to manipulate other people's emotions in order to avoid the real issue -Red herring: introduction of an irrelevant topic in order to divert attention away from the real issue

Describe written communication.

1. Absolute accuracy is paramount when one is recording in the legal document (medical record) 2. Every effort should be made to report concisely and truthfully 3. Thorough and concise

Describe closed communication styles.

1. Asking yes/no questions 2. Making inquiries or statement that require single-word answers and limit the response 3. Crossing arms, hands on the hips 4. Avoiding eye contact 5. Turning away or moving away from the individual

Name the communication styles.

1. Assertive: -pronounce their basic rights without violating the rights of others 2. Aggressive: -make decisions for themselves and others with the intent of winning 3. Passive -allow others to make decisions for them in the hope of avoiding confrontation or difficult situations 4. Passive-aggressive -avoid direct confrontation while manipulating others in order to achieve their personal goals

Name active listening techniques, why it is done, and how it is done.

1. Paraphrasing the context of the message Why: shows that you are listening, checking meaning, and interpreting the content How: restate the basic ideas and facts in your own words 2. Reflecting the emotion of the message Why: shows understanding of how the person feels, reflects what is observed rather than what is heard, helps the other person evaluate his or her own feelings after hearing them expressed by someone else How: listen to voice tone, and watch for nonverbal cues that indicate feelings, listen to what the person tells you they are feeling, state back how you perceive the feeling 3. Open questioning Why: obtains more information and avoids any assumptions about what the other person is thinking, encourages the other person to talk How: Ask questions that begin with "what," "how," "when," and "where," use questions that begin with "why" cautiously 4. Acknowledging Why: conveys that you appreciate the other person's perspective, recognized their worth and actions How: acknowledge the value of the person's issues and feelings (shows appreciation for his/her efforts and actions) 5. Summarizing Why: reviews progress, pulls together important idea and information, established a foundation for further discussion How: restate the central ideas and feelings you have heard 6. Framing Why: communicates your message in a way the other person will be more open to hearing, increases the opportunity of meeting their goal How: present your message in a hopeful, nonjudgmental, and open-ended way, point to common ground and away from differences 7. Reframing Why: helps others see their concerns in a new light, broadens the meaning of an issue to identify needs or interests, diffuses negative feelings, establishes a focus for resolution How: recognize underlying needs, reword concerns from negative to neutral or positive, past to future, problem to opportunity

Name factors influencing interpretation of messages.

1. Perception 2. Preconceptions 3. Precipitating events 4. Context 5. Past experiences 6. Environment 7. Transmission

Name the three primary components of communication.

1. Sender 2. Receiver 3. Message -dynamic, cyclic process whereby the receiver becomes the sender on responding to the message -this is followed by repeated alternating of roles

Describe clarifying information.

1. Sender should ask for feedback to be certain the receiver is correctly interpreting what is being said 2. Receiver should stop the sender any time the message become unclear and provide feedback regularly -"what I hear you saying is..." -" I understand you to mean..."

Describe cultural diversity.

1. Sensitivity to cultural differences is an integral part of the nurse's responsibility 2. Obvious difficulty is potential language barrier -preponderance of slang terms and colloquialisms can confound a literal translation -stress associated with illness and/or hospitalization adds to the potential for misunderstanding 3. Many communication components do not carry the same meaning in various cultures -direct eye contact -touch -gestures

Name and describe the elements of verbal communication.

1. The spoken word 2. Factors influence meaning of speech -same words can have several meanings -tone of inflection affects meaning -true meaning of a statement may be contained in the emphasis placed on a specific word 3. Attitude -involves a predisposition or tendency to respond in one way or another -attitude that accompanies a verbal interaction is more meaningful than the actual words spoken

Describe the generational differences in communication.

1. Traditionalists -follow the rules, valuing authority, formality, and the chain-of-command 2. Baby boomers: -embraced work as a definition of self-worth, adopting a strong work ethic, becoming goal-directed, and experiencing the accompanying struggle with work-personal life balance 3. Generation X: -value autonomy in their work, decision making, and life choices, but at the same time value the team and teamwork 4. Millenial: -value inclusion, team effort, and collective action, and they are quite adaptive to rapid change 5. Homelanders: -comfortable with multitasking, diversity, and technology

Describe methods to promoting a professional nursing image.

1. Use positive communication techniques 2. Provide a "safe" environment in which patients and coworkers can ask questions and learn 3. Focus energy toward solving conflict 4. Maintain clear, open, and sensitive communication

Describe interprofessional team communication.

1. Variety of disciplines approaching health care from the unique perspective of the theories and therapies of the varied professions 2. Listening essential for identifying the intended message of other disciplines 3. Frequent clarification and a sense of "safety" are paramount 4. Fundamental goal of all healthcare professionals: provide quality patient care

Describe professional responses to verbal conflict.

1. When conversation is escalating, try to move to private location 2. Speak in a normal tone of voice 3. Use "I" messages 4. Maintain eye contact throughout 5. Maintain an open body stance with your hands at your side or open toward the individual (but not invading the other person's space) 6. Do not physically back away unless you perceive you are actually in physical danger 7. Offer explanations but do not make excuses 8. If you say you will take care of something, or report something, or change something, do it

Name the five elements of communication.

1. Who relays the message 2. What is the message 3. In what way is the message relayed 4. To whom is the message relayed 5. With what effect is the message relayed