Communication Techniques
Introduction
Communication is crucial in every aspect of our life starting from relationships to business. Communication helps us make friendship, form camaraderie with colleagues and gain respect and love from people. Communication is very important for the success of a healthcare system. A good communication not only helps establish a good rapport between healthcare providers and patients, it also helps build a good interpersonal relationship among the healthcare staff which is crucial for the effective operation of a healthcare facility. Communication is broadly divided into three types - passive, aggressive and assertive. This paper will highlight how each communication style varies from each other and how developing an assertive communication style is crucial for nursing students to get their job done.
Communication Styles – Passive, Assertive and Aggressive
Passive communication refers to the style of communication which is self-effacing and maladaptive. People communicating in a passive manner are shy of confrontation and don't express their own desires in order to avoid hurting others. Their timidity in expression of their own thoughts and beliefs often lead them to a situation that makes them feel victimized, resentful and helpless. They suffer from a lack of self-esteem due to which they give more priority to other people's needs than their own and cherish this false notion that they will get rejected if they give their opinions. They often take help of 'you know,' 'may be' and 'I mean' sort of expressions in their interaction with someone (Dulwich College Suzhou). They avert eye contacts, look away or look down while talking, wring their hands, bite their lips or smile while expressing anger or when being criticized. Example of passive communication includes the following: "I wish my children would have listened to me."
Assertive communication is a direct and straightforward style of communication in which the speaker openly expresses his opinions, feelings, desires and thoughts. They respect the thoughts and feelings of others while advocating for their own needs. These people make requests directly and refuse directly. They consider negotiation and compromise without sacrificing their own dignity and rights. They can handle criticism effectively without being inimical or aggressive. Their voice remains firm and relaxed while communication and they show fewer hesitations in their talks. They use lot of 'I' sentences in their communication such as I like, I don't like, I want and so on (Hennessy). They make direct eye contact without staring and their posture remains balanced and open. They smile when they are happy and frown when they are angry. Example of assertive communication includes: "I don't like eating spaghetti but I don't expect you not to like it too."
Aggressive communication style refers to the method of openly expressing feelings, thoughts, and beliefs in a manner not respectful to others and reflective of the speaker's selfishness. Aggressive speaker intimidates and hurts others to put across their thoughts. This person acts in direct contrast with passive speaker by putting their own needs over others believing that with power and control they can have their needs met. Aggressive speakers use sarcastic, harsh and condescending tone in their communication and often brag of themselves. They throw questions in a threatening manner and stare rudely at the other person. They use gestures like finger-pointing and clenched fists during communication. They express themselves in way that implies that they are always right and superior to others. Example of aggressive communication includes: "I know better than you do."
People who communicate passively project such a selfless image about themselves that their friends tend to protect them. If things go wrong they are rarely blamed because of their helpless image. They manage to avoid conflict-inducing stress by avoiding confrontation. Passive people maintain a good friendly image and often are called as sporting and unselfish. Assertive people, on the other hand, by openly expressing their feelings and thoughts avoid internal conflicts and guilt. Their ability to voice their opinions clearly also shows their self-confidence and their consideration for others' feelings and thoughts shows their respect for others. Being able to communicate feelings frankly helps them avoid stress. Assertive communication also improves interpersonal relationship and reduces anxiety and conflicts. The frankness in communication of assertive speakers prevents others from taking advantage of them. When the needs arise, they can boldly stand up for their viewpoints and don't budge from their opinions easily. The advantage of aggressive style of communication is aggressive speakers with their intimidating ways manage to wield control over others and feel powerful. They are less vulnerable and people cannot take advantage of them. Since they are so outrightly forthright with their thoughts, they can easily release their tension off and in any situation of conflict they usually manage to win their way.
Passive communicators due to their piling up of pent up emotions and anger sometimes erupt in an aggressive manner. People often take advantage of them by asking unreasonable favors. Assertive communication too has its weakness. Just because assertive person shows respects to the rights of other person doesn’t mean that he will get what he wants always. Assertive people don't budge from their own viewpoints easily but sometimes they might find out that the views they held on to were wrong. The problem with aggressive communication is that aggressive speakers might create enemies through their forbidding manner. People might feel resentful towards aggressive speakers and try to avoid them. Aggressive speakers might jeopardize their relationship with others due to their domineering nature.
Communication Style in a Clinical Setting
Nurses are instrumental in the treatment of patients. Right from administering medication to pushing injections and checking vital signs, nurses take care of the daily needs of the patients. Patients can often refuse to listen to the nurse and this can result in serious consequences for the patients whose health might deteriorate if they refuse to eat or take medicines. Therefore, out of all the communication styles, incorporating assertiveness in the communication style is very important for the student nurses to get the patients do what is told in a persistent manner. Passive communication and aggressive communication in a clinical setting are not at all beneficial for the health of the patients. Passive communication builds a very poor interpersonal relationship between patients and nurses leading to helplessness, depression, resentment and undue stress and aggressive communication, on the other hand, humiliates, embarrasses and undermines the interpersonal relationship leading to decreased productivity and unexpected clinical outcome.
Since nurses are the ones patients depend on for smallest of needs, development of a good interpersonal relationship between nurses and patients is crucial. Nurses need to ensure that through an assertive communication style they develop a good rapport with the patients so that patients can rely on them and feel safe in their company. The quality of communication between nurses and patients can improve healthcare and help patients adapt to illness and follow interventions. Patients will trust nurses only if they show concerns and understanding about the problems of the patients. Nurses need to exhibit frankness in their interaction with patients so that patients feel relaxed. They need to make eye contacts and keep an open body posture so that patients receive a positive vibe (Benton, 1999). If a patient is non-compliant and irritable, instead of losing cool the nurse should tackle the situation effectively by showing confidence in her body posture making direct eye contact with the patient while listening to him carefully and then explain the situation to the patient who might be acting unreasonably because of his concern for his failing health. Nurses need to show a modicum of genuine interest and empathy in the patient's suffering so that patients can comfortably open up their feelings. Assertiveness helps nurses develop a control over the patients. For example, one of the duties of the nurses is to ensure that the patients are complying with the treatment plan. If a patient suffering from serious diabetes is put on a restricted diet, nurses need to make sure that the patient is following the diet plan or else his life might be in danger. An assertive nurse will be able to convey to the patient the importance of following the diet plan as prescribed by the doctor and the patient will dutifully listen to the nurse’s advice if he trusts her.
Conclusion
Communication is critical for the successful operation of a healthcare system. There are three communication styles - assertive, aggressive and passive. Aggressive communication is a very intimidating style of communication which though manages to gain control over people creates enemies. On the other hand, passive communication style makes the speaker seem less important and helpless. Assertive communication which is a balanced way of communication without being aggressive and passive is the right way to put across one's thoughts persistently and therefore, for nursing students aspiring to tackle patients effectively, learning assertive style of communication would be right way to go about their profession.
References
Hennessy, Kit. Assertive Communication, Faculty and Employee Assistance Program, Retrieved on 16th July 2013 from <http://www.healthsystem.virginia.edu/pub/feap/work-life/newsletters/assertive-communication.pdf>
Therapeutic Communication Techniques, Jones and Bartlett Publishers, Retrieved on 16th July 2013 from <http://www.jblearning.com/samples/0763735884/Antai-Otong%20Chapter%20Two.pdf>
Benton, D (1999). Assertiveness, power and influence, Royal College of Nursing, Retrieved on 16th July 2013 from <http://nursingstandard.rcnpublishing.co.uk/archive/article-assertiveness-power-and-influence-2679>
The Characteristics of Passive, Aggressive and Assertive Communication, Dulwich College Suzhou, Retrieved on 16th July 2013 from <http://www.dulwich-suzhou.cn/uploaded/DCSZ_meet_the_counselor/The_Characteristics_of_Passive,_Aggressive_and_Assertive_Communication.pdf>
