Communication Interview
1
Staff and Nurse Manager Interview/Communication Assignment
Student Name
Minnesota State University, Mankato
N402-8 Psychosocial/Interprofessional Communication
Dr. Ellen Vorbeck, DNP, ANP-BC, ARNP
Month/day/year
Professional Communication
I interviewed a staff nurse and a staff nurse manager about inter/intra-professional communication styles for this assignment. Understanding communication styles is essential for healthcare workers. Knowing how one communicates can help improve communication clarity with both colleagues and patients. Both nurses who were interviewed work at a large hospital in a busy emergency department.
Staff Nurse Interview
Perceived Barriers
The staff nurse, AR, identified a few barriers to communication within the work environment. The main obstacle that AR discussed was between physicians and nurses. Often, physicians do not clearly communicate with nurses or communicate in a very aggressive manner. AR talked about how this kind of communication is very frustrating, especially in an intense environment, like the emergency department. Those who communicate in an aggressive manner are often not good listeners and interrupt regularly (Baraldi, 2020). They adopt a commanding stance, speak loudly, and strive to control people (Baraldi, 2020). This makes it difficult for AR to care for patients properly, especially in a setting as intense as an emergency department.
Communication with Patients
AR talked about how important it is to read the situation and adjust your communication approach as needed when communicating with patients. AR tries to use patience, open-ended questions, active listening, and explains as much as possible while working with patients. By using an assertive style of communication, AR finds that she can communicate with patients best. Being assertive is vital to building successful relationships with coworkers, family members, and patients (Blazer, 2020). This style of communication helps minimize personal stress, improve patient safety, and improve nursing care (Blazer, 2020).
Communication with Colleagues
AR discussed how building relationships with your colleagues is critical. Using assertive communication has helped AR build better and more trusting relationships with coworkers. This style of communication helps this nurse work better with colleagues and find resolutions to problems faster. In a fast-paced work environment, positive working relationships are critical to success (Spence Laschinger, 2010). A group of healthcare workers that respect each other's efforts to the patient care process and work well together is required for high-quality patient care (Spence Laschinger, 2010). AR states that there are a few coworkers who use an aggressive style of communication. These coworkers are often tricky and draining to work with.
Communication with Leadership
AR feels that she and her coworkers can have good communication with those in leadership positions. They have opportunities each morning to ask questions and give any updates to leadership. Those in leadership make an effort to keep the lines of communication open and are highly respected on the unit because of this. Effective relationships between leadership and healthcare employees may lead to better strategic planning, more efficient use of limited resources, a shared sense of purpose, increased job satisfaction, higher staff retention rates, and improved patient outcomes (Center for Rural Health Policies Analysis, 2013). AR feels that because there is good communication between her and management, she feels supported and more comfortable doing her job.
Staff Nurse Manager Interview
Perceived Barriers
The nurse manager, NW, discussed that the most significant barrier for communication seems to be between floor nurses and doctors. Some of the physicians use a more aggressive style of communication which frustrates a lot of the nursing staff. Aggressive styles of communication can lead to feelings of distrust, increased stress and conflict, not feeling respected, and poor goal achievement (Scott, 2020). NW, at times, speaks with those physicians to try and discuss using a more assertive communication style rather than an aggressive style. NW feels that there is still work to be done to help improve the communication between the nurses and doctors.
Communication with Patients
NW said that communication with each patient is a little different depending on the situation. Explaining what is happening, being empathetic, using a calm and assertive tone, and utilizing therapeutic communication techniques is how NW usually communicates with patients. According to Balzer (2020), utilizing empathy helps a person feel more connected with another person. Empathy also helps decrease a patient’s feelings of isolation and loneliness (Balzer, 2020). NW discussed how, at times, a firmer approach is needed when interacting with patients to help maintain order during a chaotic or traumatic event but still tries to use a warm tone during these situations.
Communication with Colleagues
NW tries to communicate with coworkers in a respectful as assertive manner. Communicating in this way helps maintain order when things get chaotic in the emergency department. Assertive communication can help you express your point of view while simultaneously showing respect for others’ beliefs and rights (Mayo Clinic, 2020). NW discussed how it took some time to learn how to communicate assertively. As a new nurse, NW recalled how her communication style was probably seen as timid and unsure. Assessing your current communication style, practicing, and rehearsing what you want to say, and using “I” statements are ways that nurses can learn to be more assertive (Mayo Clinic, 2020). Learning how to be assertive is a lifelong process in which one continually learns (Balzer, 2020). Communication with Leadership
NW emphasized how important it is to keep an open line of communication with leadership, especially in the emergency department. NW tries to make sure all the nursing staff’s concerns are addressed, and any questions are answered as promptly as possible. NW feels that this is very important given the intense critical care that is provided in this environment. Strong communication from leadership in an emergency department is essential to promote and strengthen teamwork (Lateef, 2018). When leadership allows for staff to express their thoughts and ideas, communication can be improved, which helps make sure that staff’s concerns are heard and can help improve morale (Lang et al., 2020).
Analysis of Interviews
After interviewing AR and NW, I feel like they both have a good sense of the importance of communication within healthcare. It seems like the problems with communication that they identified are fixable with time and continued communication. It appears that the assertive communication style is the preference for both nurses interviewed. It seems to assist them the most in their work and allow for a better relationship with both patients and coworkers. Both nurses have a solid understanding of their styles of communication. This understanding will enable them to build healthy and trusting relationships with colleagues and patients. This understanding also allows the nurses to be able to reflect and improve upon their communication skills.
Communication Improvements
Communication is a skill that can be learned and improved upon. By understanding this, one can continue to strengthen relationships with colleagues and patients. One area for improvement could be learning how to better communicate with those who use an aggressive communication style. Aggressive communication can put patients’ safety at risk when it is used (Balzer, 2020). Before dealing with an aggressive colleague, taking a deep breath, remembering not to take their behavior personally, and distinguishing between the problem and person is important (Balzer, 2020). By asking questions to gather more information, one can create a conversation to help understand the source of the aggression (Balzer, 2020). To determine whether the aggressor is aware of their behavior and its effects, ask questions to better understand this (Balzer, 2020). Using the CARE (clarify, articulate, request, encourage) confrontation technique, one can clearly state how the aggressor’s behavior has affected them and what changes you would like to see in their behavior (Balzer, 2020). By utilizing these techniques AR and NW could minimize the amount of aggressive communication they experience while working.
Assertive communication is a skill that requires time to practice (Balzer, 2020). Participating in assertive communication training has been associated with improved assertiveness, enhanced self-esteem, and creating balanced connections with others (Omura et al., 2016). Training can take numerous forms, including demonstration, discussion groups, lecture, and role-playing using virtual or face-to-face scenarios (Omura et al., 2016). This training has also been shown to enhance the well-being of healthcare personnel by improving happiness, self-esteem, and reducing anxiety (Omura et al., 2016). Furthermore, it has been shown to help with conflict management and as a coping method for aggressive behavior (Omura et al., 2016). Both AR and NW could participate in this training to improve upon a skill they frequently use in their practice. By doing this, they can form better relationships with coworkers, patients, families, and improve and promote patient safety (Balzer, 2020).
Both interviewed nurses seemed to feel that there was some breakdown in communication between physicians and nurses. Poor intra-professional communication can be associated with delayed diagnosis, adverse medication events, and inadequate patient monitoring (CMPA, n.d.). Poor intra-professional communication can also increase a patient’s length of hospital stay and increase the cost of healthcare (Wang et al., 2018). By understanding the detrimental effects poor intra-professional have on patients, one can take steps to improve communication. Communication can be enhanced by healthcare providers communicating effectively and being knowledgeable about their scope of practice, duties and responsibilities, and relevant policies and procedures (CMPA, n.d.). Similar mental models, shared objectives, and proper accountability also assist in effective communication and trust-building within care teams (CMPA, n.d.). The SBAR communication technique can assist in clarifying important information during patient transitions and handoffs (CMPA, n.d.). Structured communication tools, like SBAR, can aid in the simplification and organization of inter/intra-professional patient care planning and increase communication clarity and patient safety (CMPA, n.d.). The use of communication tools such as bedside whiteboards, daily goal sheet/form, and door communication cards are other ways that can improve communication between physicians and nurses (Wang et al., 2018). It was found that after the implementation and explaining of the use of daily goal forms, the percentage of nurses and doctors who understood the daily goals for patients increased (Wang et al., 2018). Additionally, patient length of stay decreased (Wang et al., 2018).
Conclusion
Understanding how intra/interpersonal communication influences all aspects of healthcare is essential. Interpersonal communication is critical not just for understanding the patient but also for treating them as a person with their own wants and challenges, instead of just a set of symptoms (Practo, 2015). Furthermore, it aids in the patient's understanding of their health condition and promotes active participation in self-care (Practo, 2015). Good communication can also help improve and strengthen the relationships between staff members (PCC Institute for Health Professionals, 2016). Good interpersonal communication in healthcare has been shown to reduce stress and burnout (Kognito, 2020). High turnover rates and low morale have been explicitly correlated with poor communication between team members (Kognito, 2020).
References
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Center for Rural Health Policies Analysis . (2013, July 15). How Hospital Leaders Can Build Good Working Relationships with Physicians. Rural Health Value. Retrieved November 3, 2021, from https://ruralhealthvalue.public-health.uiowa.edu/files/Physician%20Relationships.pdf.
Kognito. (2020, December 8). The importance of interpersonal communication in Healthcare. Kognito. Retrieved November 5, 2021, from https://kognito.com/blog/interpersonal-communication-in-healthcare.
Lang, E., Ovens, H., Schull, M. J., Rosenberg, H., & Snider, C. (2020). Authentic Emergency Department leadership during a pandemic. CJEM, 22(4), 400–403. https://doi.org/10.1017/cem.2020.360
Lateef, F. (2018). Grace under pressure: Leadership in emergency medicine. Journal of Emergencies, Trauma, and Shock, 11(2), 73. https://doi.org/10.4103/jets.jets_18_18
Mayo Clinic. (2020, May 29). Stressed out? be assertive. Mayo Clinic. Retrieved November 3, 2021, from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/assertive/art-20044644.
Mayo Clinic. (2020, May 29). Stressed out? be assertive. Mayo Clinic. Retrieved November 6, 2021, from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/assertive/art-20044644.
Omura, M., Maguire, J., Levett-Jones, T., & Stone, T. E. (2016). Effectiveness of assertive communication training programs for health professionals and students: a systematic review protocol. JBI Evidence Synthesis, 14(10), 64–71.
Practo. (2015, February 27). The importance of interpersonal communication in medical practices. The Practo Blog for Doctors. Retrieved November 5, 2021, from https://doctors.practo.com/the-importance-of-interpersonal-communication-in-medical-practices/.
Scott, E. (2020, October 14). How to deal with relationship aggression. Verywell Mind. Retrieved November 3, 2021, from https://www.verywellmind.com/what-is-aggressiveness-aggressiveness-in-communication-3145097.
Spence Laschinger, H. K. (2010). Positive working relationships matter for better nurse and patient outcomes. Journal of Nursing Management, 18(8), 875–877. https://doi.org/10.1111/j.1365-2834.2010.01206.x
Wang, Y.-Y., Wan, Q.-Q., Lin, F., Zhou, W.-J., & Shang, S.-M. (2018). Interventions to improve communication between nurses and physicians in the intensive care unit: An integrative literature review. International Journal of Nursing Sciences, 5(1), 81–88. https://doi.org/10.1016/j.ijnss.2017.09.007