Communication Style Case Study
First Scenario
The first scenario is describing an aggressive behavior from a staff RN (Robin) towards an assistive personal (Rashad) who was just expressing his opinion during a team meeting. Robin intimidated Rashad with her aggressive comment to the point that made Rashad feel frustration, but Rashad did not respond her back; he stayed quietly. Instead, his response was passive-aggressive when he began to plan how to take revenge in future working situations. If I could improve this communication, I would do the following changes: Perhaps, she had a bad day that she explodes against Rashad, but she should not let her personal feelings to interfere with her interactions with others. Definitely, she needs to be more respectful. She needs to learn to calm down and relax before expressing her opinions. She should not raise her voice, neither to interrupt or made offensive comments about others responsibilities; she should not sub-estimate the role of others. In sum, she needs to understand the concept of effective communication within teamwork. In the other hand, Rashad was apparently passive, but very frustrated because he was afraid to respond to that comment. He should understand that he is an important part of the team, and his role is equally important than hers. He should tell her with normal tone of voice that this is not the appropriate way to talk to him; we all deserve respect, and state the purpose for being together in the meeting. For sure, he needs to be more self-confident and expressive. He needs to voice his concerns in that moment; otherwise, this unclear situation may create a hostile environment in which the ultimate victim would be the patient care.
Health care professions are based mainly in teamwork efforts and effective communication can be crucial when working in teams as it was demonstrated in the previous scenario. Neither Rashad nor Robin had the appropriate communication skills to keep an open and honest conversation to come up with new ideas to improve patient care.
Second scenario
In this scenario, the nurse, Pamela, and a volunteer, Brigite, are working together doing vision and hearing test in a rural community. When Pamela reviewed the test results done by the volunteer, she noticed a questionable difference compared with past results. She did not trust in the veracity and the way in which Brigite did the tests. So, instead of discuss it with Brigite, she decided to repeat and do the test again by herself.
It is clear in this situation that Pamela avoided any further discussion with Brigite due to lack of confidence in her communication skills. She thought she would not be capable to manage possible conflict when trying to solve this issue. Her attitude demonstrated that she was nonassertive in her initial communication. Therefore, Pamela is going to invest extra time and possible she may feel overworked and frustrated at the end.
My suggestion to improve and change this situation is that Pamela should give first clear and specific instructions in how the test had to be done, and then verify with the volunteer that the instructions were understood. In this way, Pamela would increase her confidence when delegating task because she would know that she expressed exactly what she wanted.
This type of nonassertive behavior is a passive response within the communication process that affects the relationships, especially within the healthcare profession. Nonassertive communication produces tense environments with feelings of frustration, and resentments. Like the previous example, Pamela may feel overwhelmed and frustrated with the extra task because she did not face the situation effectively. It is important to be aware that communicating assertively, with clear and direct statements especially when delegating task in the healthcare settings will increase the quality of the work resulting in a better use of the resources, and a better time dedicated to patient care.
Third Scenario
Third scenario is about Rosa, a nurse manager of an ambulatory surgical center, and Mabel, a surgical technician working with her in this center. Mabel told Rosa that she will not scrub any orthopedic case because this task was too heavy and demanded too much effort. Rosa explained in a clear and concise way that they all were working together as a team for the benefit of the patient and scrubbing patients was part of Mabel’s duties. Despite she used an effective communication with appropriate statements, Mabel responded aggressively and threated her by stated that she had family influences that would take action against Rosas’ position.
This is definitely a tense situation in which an assertive communication is responded aggressively. It is not an easy position for Rosa, who used effective communication techniques to motivate Mabel to reflect in her refusal. However, Mabel was so focused on her own feelings and frustrations that she did not listen to the reasons that Rosa explained her. Instead, Mabel responded aggressively. If I could improve this communication I would suggest Rosa to remain calm, and continue being clear and direct on her statements, she is doing great by focusing in the main goal, patient safety. However, she needs to set limits, and offer privacy to discuss; perhaps the tension will decrease. Then, she may encourage Mabel to express more details about her refusal to perform this task. By doing this, Rosa will explore what is behind Mabel’s excuses and at the same time, she would demonstrate that she cares about the teamwork.
In the other hand, Mabel should not use threating behavior; she should request to talk to Rosa about her duties before her frustrations escalated. Her communication should be objective, with substantial rationales, and mainly using respectfully manners.
The importance of patients’ safety makes effective communication skills a critical tool within health care professions. As it was seen in this scenario, Rosa was assertive, she stand up for the patient’s safety and demonstrated that she was concern about teamwork. This is a clear example of a healthy communication style.
Personal Scenario
At the beginning of my nursing career I learned that communication plays an important role in teamwork. I remember that one time, a CNA with more years working here, responded me back in the nurse station in front of other nurses. I asked her to check blood sugar to a patient because dinner trays were delivered at that moment and I needed to get ready his insulin before he started to eat. She walked away while she told me with a sarcastic tone of voice, “I’m sorry honey, but I am going to take my 10 minutes break now, I was so busy that I couldn’t get it before, so if you need it right now, you can do it”. I couldn’t react; I was in shock because I did not know what to say. I felt humiliated, I was a new nurse in the unit and I did not have enough experience to deal with this kind of situations. So, I did the task, and I cried later in the bathroom.
After I analyzed the situation, I recognize that I was uncomfortable being direct about my needs and feelings. Lack of confidence and being a new nurse were in my way to learn assertive skills and the CNA took advantage of that, her behavior was passive-aggressive when she responded sarcastically.
Now that I have more experience as a nurse I feel more confident when I have to delegate task. I have better teamwork relationships when I use assertive communication, and I know that I can use this skill to deal with different type of behaviors.
In conclusion, assertive communication skills can be learned and applied in all type of relationships, it offers many benefits to maintain and resolve conflict and within healthcare professions behaving assertively is crucial to protect the patient and advocate for them.