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74 unit 2 | Working Within the Organization CikguOnline
Claude has been working on a busy oncology floor for It is important for nurses to observe nonverbal
several years. He usually has a caseload of six to eight behavior when communicating with colleagues and
patients on his shift, and he believes that he provides patients and to try to make their own nonverbal
safe, competent care.While Claude was on his way to behavior congruent with their verbal communica-
medicate a patient suffering from osteosarcoma, a tions. Telling people you understand their problem
colleague called to him, “Claude, come with me, when you appear thoroughly confused or inatten-
please.” Claude responded, “I need to medicate Mr. J. tive is an example of incongruence between verbal
in Room 203. I will come right after that. Where and nonverbal communication.
will you be?” “Never mind!” his colleague answered.
“I’ll find someone who’s more helpful. Don’t ask me The Basic Listening Sequence
for help in the future.” This was not the response
Claude had expected. He thought he had expressed Listening is the most critical of all communication
both an interest in his patient and a willingness to skills. To be a good listener, one needs to listen
help his colleague. What was the problem? for both the information (content) and emotion
After Claude gave Mr. Juniper his pain medica- (feelings) conveyed. A good listener also shows
tion, he went back to his colleague. “Sonja, what’s attentiveness through eye contact and body language
the matter?” he asked. Sonja replied, “Mrs. Vero fell and gives the speaker some feedback to indicate that
in the bathroom. I needed someone to stay with her what is being said is understood (Rees, 2005)
while I got her walker.” “Why didn’t you tell me it (Box 6-1). Contrast this to the poor listener who
was urgent?” asked Claude. “I was so upset that interrupts, misinterprets what is said, or misses it
I wasn’t thinking about what else you were doing,” entirely due to inattention (Rees, 2005).
answered Sonja. Claude added, “And I didn’t ask
you why you needed me. I guess we need to work on Principles for Effective
our communication, don’t we?” Communication
In the busy and sometimes chaotic world of nursing
To communicate effectively with others, consider
practice, nurses work continuously with all sorts of
the following principles (Table 6-1).
people. This variety makes the job dynamic and
challenging. Just when things appear to have settled 1. Be sure that the message is understood. Ask for
down, something happens that requires immediate feedback from the receiver to clarify any confu-
attention. Busy people need to communicate effec- sion. Bring focus to the interaction. Repeating key
tively with each other.This chapter helps new nurses words or phrases as questions or using open-ended
communicate effectively with their colleagues and questions can accomplish this. For example: “You
work with people in all kinds of activities, even have been telling me that Susan is not providing
those that are filled with multiple demands and safe care to her patients. Can you tell me specifi-
constant change. cally what you have identified as unsafe care?”

Communication box 6-1

People often assume that communication is Basic Listening Sequence
simply giving information to another person. Listen to the:
Communication involves the spoken word as well • Information
as the nonverbal message, the emotional state of • Emotion
people involved, and the cultural background that Demonstrate attentiveness through:
affects their interpretation of the message • Eye contact
• Body language
(Fontaine & Fletcher, 2002). Superficial listening
Verify understanding by:
often results in misinterpretation of the message.
• Asking occasional questions
An individual’s attitude also influences what is
• Repeating important points
heard and how the message is interpreted. Active • Summarizing
listening is necessary to pick up all these levels of
Adapted from Rees, F. (2005). 25 Activities for Developing Team Leaders.
meaning in a communication. San Francisco: Pfeiffer.