Nursing

From the staff development bookshelf: Communication strategies for nurse leaders

Staff Development Weekly: Insight on Evidence-Based Practice in Education, February 3, 2012

Communication is defined as act of communicating, or the exchange of information between individuals or groups. According to the Business Dictionary, another definition is a "Two-way process of reaching mutual understanding, in which participants not only exchange (encode-decode) information but also create and share meaning."  Communication is used to disseminate information to others. Communication can be written, verbal, or non-verbal. Communication can be largely affected (93%) by body language and tone of voice, leaving only 7% of the intent based on actual words (AHRQ).  It can also be affected by the style of delivery, such as how the speaker stands, sits, or engages the audience, such as by using direct eye contact. Ultimately, an effective communicator delivers a message so that the listener can hear the message.

Based on this information, there is an opportunity to assess your performance in the three key components of spoken face-to-face communication: words, tone, and body language. Words may not be as easy to adjust, as they are often driven by the message and, in the clinical world, common by profession. However, you can make sure that your speed and use of abbreviations are appropriate for the topic and audience. Tone is a little more challenging. You might not be aware of your tone, especially if the message is critical or emotional. You can record your voice; however, it can still be challenging to hear your own tone objectively. Awareness is the first step, and you can always ask a colleague or family member for his or her assessment of your tone. Once you are aware of issues, you can be more purposeful about your approach. The last of these components and probably the most critical is body language. Begin by paying attention to your audience - they are telling you something. Look carefully at the audience and how they are responding to your message. Be prepared to adjust your approach based on what you are seeing. In Leadership Simplified, Van Dyke noted the importance of managing the following non-verbal cues:

  • Good eye contact
  • Be conscious of where your hands and arms are (crossed arms represent disinterest)
  • Control facial expressions, especially scowls
  • Posture: leaning forward (interested) or leaning backward (disinterested)
  • Neck and forehead rubbing (stress)
  • Nodding "yes"  and "Um-hums" (represent listening)
  • Be mindful of gesturing (limit to emphasize key points) (Van Dyke, 2010)

The nurse leader is responsible for establishing the communication culture in the department. This may be fostered by being visible, having an open-door policy for accessibility, and creating a structure for communicating. This can include monthly staff meetings, weekly newsletters, notes on the bulletin board, and some of the more recent strategies developed by AHRQ in TEAMSTEPPS such as daily huddles, briefings, or debriefings. These brief meetings offer a structure for key messaging on an ongoing basis, or "just in time" manner that works well in busy healthcare departments. Each of the interactions should have an opportunity for dialogue in order to share concerns or ask questions of clarification. If this is impossible due to time constraints, it is critical to provide an avenue of follow-up for the audience. Key to successful communication includes consistency, regular frequency, and the opportunity to provide feedback or comment.

Source: Book excerpt adapted from The Nurse Leader's Guide to Business Skills: Strategies for Optimizing Financial Performance by Pamela Hunt, BS, MSN, RN and Deborah Laughon, RN, BSN, MS, DBA, CCRN.

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