74 unit 2 | Working Within the Organization
Claude has been working on a busy oncology floor for
several years. He usually has a caseload of six to eight
patients on his shift, and he believes that he provides
safe, competent care. While Claude was on his way to
medicate a patient suffering from osteosarcoma, a
colleague called to him, “Claude, come with me,
please.” Claude responded, “I need to medicate Mr. J.
in Room 203. I will come right after that. Where
will you be?” “Never mind!” his colleague answered.
“I’ll f ind someone who’s more helpful. Don’t ask me
for help in the future.” This was not the response
Claude had expected. He thought he had expressed
both an interest in his patient and a willingness to
help his colleague. What was the problem?
After Claude gave Mr. Juniper his pain medica-
tion, he went back to his colleague. “Sonja, what’s
the matter?” he asked. Sonja replied, “Mrs. Vero fell
in the bathroom. I needed someone to stay with her
while I got her walker.” “Why didn’t you tell me it
was urgent?” asked Claude. “I was so upset that
I wasn’t thinking about what else you were doing,”
answered Sonja. Claude added, “And I didn’t ask
you why you needed me. I guess we need to work on
our communication, don’t we?”In the busy and sometimes chaotic world of nursing
practice, nurses work continuously with all sorts of
people. This variety makes the job dynamic and
challenging. Just when things appear to have settled
down, something happens that requires immediate
attention. Busy people need to communicate effec-
tively with each other. This chapter helps new nurses
communicate effectively with their colleagues and
work with people in all kinds of activities, even
those that are filled with multiple demands and
constant change.
Communication
People often assume that communication is
simply giving information to another person.
Communication involves the spoken word as well
as the nonverbal message, the emotional state of
people involved, and the cultural background that
affects their interpretation of the message
(Fontaine & Fletcher, 2002). Superficial listening
often results in misinterpretation of the message.
An individual’s attitude also influences what is
heard and how the message is interpreted. Active
listening is necessary to pick up all these levels of
meaning in a communication.
It is important for nurses to observe nonverbal
behavior when communicating with colleagues and
patients and to try to make their own nonverbal
behavior congruent with their verbal communica-
tions. Telling people you understand their problem
when you appear thoroughly confused or inatten-
tive is an example of incongruence between verbal
and nonverbal communication.The Basic Listening Sequence
Listeningis the most critical of all communication
skills. To be a good listener, one needs to listen
for both the information (content) and emotion
(feelings) conveyed. A good listener also shows
attentiveness through eye contact and body language
and gives the speaker some feedback to indicate that
what is being said is understood (Rees, 2005)
(Box 6-1). Contrast this to the poor listener who
interrupts, misinterprets what is said, or misses it
entirely due to inattention (Rees, 2005).Principles for Effective
CommunicationTo communicate effectively with others, consider
the following principles (Table 6-1).
1.Be sure that the message is understood. Ask for
feedback from the receiver to clarify any confu-
sion. Bring focus to the interaction. Repeating key
words or phrases as questions or using open-ended
questions can accomplish this. For example: “You
have been telling me that Susan is not providing
safe care to her patients. Can you tell me specifi-
cally what you have identified as unsafe care?”box 6-1
Basic Listening Sequence
Listen to the:- Information
- Emotion
Demonstrate attentiveness through: - Eye contact
- Body language
Verify understanding by: - Asking occasional questions
- Repeating important points
- Summarizing
Adapted from Rees, F. (2005). 25 Activities for Developing Team Leaders.
San Francisco: Pfeiffer.