Communication Style Case Study
University of Phoenix
HCS/350

Communication Style Case Study In communicating, “The words you choose and the way in which they are delivered to the delegate make the difference between a successful and a frustrating episode in delegation” (Hansten & Jackson, 2009). The three communication styles in the case studies are passive, aggressive, and assertive. An analysis of the first scenario reveals that Robin, RN, used aggressive communication while Rashad, the assistive staff used passive aggressive communication style. In order to accommodate therapeutic communication that would improve the outcome, the scenario would change as follows:
Robin, RN sends out an announcement of a staff meeting to discuss roles, responsibilities and expectations of the assistive staff. Robin, RN opens the meeting by stating, “The purpose of the meeting is to review roles, responsibilities and expectations of our assistive staff, please take a copy of the job description so that I am circulating so that we can review together.” Rashad, Assistive personnel stated, “My role is to anticipate the needs of the patients for toileting and personal hygiene right?” Robin, RN, in a inquiring voice, restated, “Rashad, do I hear you asking if your role is just to anticipate the needs of the patients for toileting and personal hygiene?” Rashad, acknowledged “Yes, I need to know what else I may have to do.” Robin, RN, in a calm, but professional and assertive tone stated, “I am going to review all responsibilities and expectations for the role of the assistive staff and I would be more than happy to discuss further with you if you have questions or need clarity.” Rashad, Assistive staff, “Thanks Robin, I will listen to the requirements and talk with you later if I have questions or need clarity.” In this scenario, Robin, RN set the tone for the meeting, by sending out the announcement regarding the meeting. She immediately acknowledged Rashad and responded appropriately in a non-threatening tone. The interchange of communication was respectful and nonthreatening for both. This was great communication and dialogue between Rashad and Robin. An analysis of the second scenario reveals that Pamela, school nurse, behavior category is nonaggressive. In order to accommodate therapeutic communication to improve the outcome, the scenario would change as follows: Pamela, a local school nurse was following up on a recent vision and hearing test performed by a volunteer Brigite. Pamela, the Nurse, was concerned because of the accuracy of the test results and how they did not compare to previous readings. Pamela to Brigette, ‘I am here to review the results of the vision and hearing test you performed. First, let me thank-you for volunteering, we really appreciate your assistance.” Brigite, “You are welcome, I am more than happy to help.” Pamela reviews the readings of the test with Brigite stating “the numbers are not comparing to previous readings, can you show me how you performed the test?” Brigite, stated, “Sure, I was not given any direction; I read and followed the instructions.” Brigite demonstrated the test accurately. Pamela, stated “that is the correct way to perform procedure the test, let’s review the documentation.” Upon reviewing the documentation the results together, Brigite noted she had documented the values under the wrong heading; “I documented the vision results under hearing results,” in an apologetic tone, “I guess I was not paying attention, I will correct that right now.” Pamela, the nurse, stated, “I understand mistakes can happen, I am glad that the test was performed correctly.” Brigite openly admitted she had limited training on how to perform the procedure. They talked to each other with respect and in a nonthreatening manner. The outcome was very good, Pamela, the school nurse, did not have to repeat the procedures and Brigite understands how to correctly document the results. There was excellent collaboration between the two as well as a great learning experience.

An analysis of the last scenario reveals that Rosa, the manager of the ambulatory surgical unit used assertive communication and Mabel, a surgical technician used aggressive communication. The assertive behavior in the book scenario was used appropriately. Rosa informed the technician that she is considered a member of the team and is expected to perform the same work as the rest of the team. Mabel, the surgical technician used the assertive style by saying she was the granddaughter of the chairman of the board. Rosa, the manager, stood her ground and used her assertiveness, and role as manager to encourage Mabel to comply. “Assertive communicators are confident and positive and lay claim to their own right to speak up for themselves” (Hansten & Jackson, 2009). Apparently Mabel using her aggressive communication thought that she could cause fear or intimidation since she was related to the chairman of the board. “Aggressive behavior is an encroachment or attack upon another and is almost always hostile in intent” (Hansten & Jackson, 2009). In order to accommodate therapeutic communication that would improve the outcome, the scenario would change as follows: Rosa, manager of the ambulatory care surgical unit was making rounds on her unit. She spoke with Mabel a surgical technician and also the granddaughter of the chairman of the board. Mabel was preparing to assist with an orthopedic case, when Rosa, asked “Mabel are you assisting with that case?”Rosa, replied, “Yes, I am, I did not scrub because when I went through training the other technicians were to physically stressed to train me properly.” Rosa, replied, My expectation for the entire staff is you all work together as a team. Everyone has different strengths and I would like to maximize all of them. Scrubbing to assist with a case is part of your job description as well as an expectation. I will partner you with a technician at the beginning of the shift so that you can observe the correct technique. Mabel, replied, “Thank-you, I want to learn and be able to share the responsibilities of the team.” Mabel realized that her stating that she was related to the chairman of the board did not change the expectation of the manager. “Because the assertive person communicates directly when there is a problem, others can trust problems will be shared with them and not inappropriately with other” (Hansten & Jackson, 2009). The revision of the scenario revealed a very good outcome. The collaboration and dialogue between the two was effective. Trust was established and expectations were discussed between the staff. A personal situation when I had to use assertive communication to get a point across and establish ground rules was at the work-up station where vital signs are taken. A member came to an appointment and was having her vital signs taken. The nurse, Kala taking her vital signs put the blood pressure cuff on incorrectly and the members crossed her legs during the procedure as well as dangle her arm toward the floor. As the manager of the department, I intervened saying, “excuse me” to the patient and “Kala, please excuse me, can I see you for a moment?” The nurse, Kala, excused herself from the member and came into my office. I questioned her regarding taking blood pressures accurately. She became defensive stating, “I have been taking blood pressures for years and I know what I am doing.” I replied, “Kala what I just witnessed was incorrect, the expectation is that you are competent with the care that you provide and I did not see that. I am going to assign another nurse to continue with the care of that member, asking that nurse to retake the vital signs.” I want you to review the correct procedure for taking vital signs. I will need to recheck or have someone monitor your vital signs until you are competent.” Kala embarrassed, stated sometimes I get in a hurry. I do know how to the correct procedure for taking vital signs and I understand the importance of taking them correctly.” I replied, “Kala it is vital that you perform your work in the proper way, you cannot hurry when providing care.” Kala, replied, “I was wrong and I apologize for yelling, but I was embarrassed that you saw me. I was hurrying because it is time for my lunch break.” The communication was effective, I was not trying to embarrass Kala, However, I was concerned about the way she was taking vital signs and also questioned was this a habit. I assigned her to back office work and signed her up for a remedial class on proper techniques when taking vital signs. As the manager, my concern was the patient and the accuracy of their vital signs. Since this incident, the nurses on the ambulatory unit are required to take yearly competency testing and one of the competencies is all persons working directly with members must passed vital signs competency 100%. All the nurses in the ambulatory medicine department passed the competency at 100% accuracy. This signifies great outcomes for patients and staff, as well as positive, helpful communication between me and the staff.

References

Hansten, R.I. & Jackson, M. (2009) Clinical Delegation Skills: A Handbook for professional practice (4th ed).Sandbury, MA:Jones and Bartlett.