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chapter 6 | Getting People to Work Together 75 CikguOnline
table 6-1 is stated clearly and firmly, using “I” statements.
For example:
Principles for Effective Communication
Principle One Aim for clarity and focus. The nurse manager noticed that Steve’s charting has
Principle Two Use direct and exact language. been of lower quality than expected during the past
Principle Three Encourage feedback. few weeks. She approached Steve and said,
Principle Four Acknowledge the contributions of “JCAHO surveyors are coming in several months.
others. I have been reviewing records and noticed that on
Principle Five Use the most direct channels of several of your charts some pertinent information is
communication available.
missing. I have scheduled time today and tomorrow
Tappen, R.M. (2001). Nursing Leadership and Management: Concepts
from 1:00 to 2:00 in the afternoon for us to review
and Practice (4th ed.). Philadelphia: FA Davis, with permission.
the charts. This allows you time to make the neces-
sary corrections and return the charts to me.”
By using “I” statements, the nurse manager is con-
2. Use direct and exact language. In both written fronting the issue without being accusatory.Assertive
and spoken messages, use language that is easily communication always requires congruence between
understood by all involved. verbal and nonverbal messages. Had she shaken her
3. Encourage feedback. This is the best way to finger close to Steve’s face or used a loud voice, the
help people understand each other and work nurse manager might think she was being assertive
together better. Remember, though, that feed- when in fact her manner would have been aggressive.
back may not be complimentary. This is dis- There is a misconception that people who com-
cussed later in the chapter. municate assertively always get what they want.
4. Acknowledge the contributions of others. Being assertive involves both rights and responsi-
Everyone wants to feel that he or she has worth. bilities. Assertive communicators have the right to
5. Use the most direct channel of communica- speak up, but they must also be prepared to listen to
tion available. The greater the number of indi- the response.
viduals involved in filtering a message, the less
likely the message will be received correctly. Barriers to Effective
Just as in an old children’s game, messages Communication in the Workplace
sent through a number of senders become
more and more distorted. Information that is People are often unwilling or unable to accept
controversial or distressing should definitely responsibility or to perform a specific task because
be delivered in person so that the receiver can they do not fully understand what is expected of
ask questions or receive further clarification. A them. Professional nurses are required to commu-
memo delivered “To all nursing staff ” in nicate patient information to other members of the
which cutbacks in staffing are announced nursing team. Although this may sound easy, there
would deliver a message very different from are many potential barriers to communication.
that in a meeting in which staff are allowed to These barriers may be physical, psychological,
talk and ask questions. semantic, or even gender-related.

Assertiveness in Communication Physical Barriers
Physical barriers to communication include extra-
Assertive behaviors allow people to stand up for neous noise, too much activity in the area where the
themselves and their rights without violating the communication is taking place, and physical sepa-
rights of others. Several authors have stated that ration of the people trying to engage in verbal
nurses lack assertiveness, claiming that nurses would interaction.
rather be silent than voice opinions that may result
in confrontation (Tappen, 2001). Assertiveness is Psychological Barriers
different from aggressiveness. People use aggressive Psychological “noise,”such as increased anxiety, may
behaviors to force their wishes or ideas on others. In interfere with the ability to pay attention to the
assertive communication, an individual’s position other speaker. Social values, emotions, judgments,