Collaboration

Nurse's Touch: Professional Communication -> Organizational Communication

Organizational structure

entails how a group is developed, how lines of communication are open, and methods for how authority is channeled and decisions are made within your organizational arena.

• organization have formal and informal structures

• structures are formed from a large number of workers needing a supervisor to oversee work efforts

• organizational size impacts communication, decision-making

  • larger organizational find difficulties with communication

• lines of authority

Formal Structures in an organization

visible and typically highly planned and developed

• these include: written policies & procedures

• communication at this level follows the chain of command of the organization when making decisions

Informal Structures in organizations

tend to be hidden and unplanned

• includes day to day interactions among peers and other professional staff

Organizational relationships

• peer/colleague

  • effective communication enhances healthy interaction

• superiors

  • channels may occur in many different directions

• subordinates

  • traditional forms of communication

Intraprofessional relationships

a group of health care workers who all are from the same profession

EX: 3 R.T.s, they all collaborate on the same client

Interprofessional relationships

also referred to as interdisciplinary groups

• from different professions

• they facilitate coordination of care, promote problem solving, and optimal health across the continuum for clients.

• EX: 1 RN, 1 R.T., 1 Pharmacist

Professional Communication Skills

• Effective

  • assertive - most effective, but difficult to master. Combines honesty, tact. Requires active listening and providing feedback

  • SBAR - improves communication of client information to provide quality client care (used to give verbal report to nurses changing shift and contacting providers)

    • Situation - ID yourself, unit & briefly discuss your problem

    • Background - state client diagnosis, admission date & code status, pertinent medical history then summarize the treatment plan

    • Assessment - list vital signs, pain scale and include any changes since the previous assessment

    • Recommendation - tell the provider what you want to see done, ask the provider if he wants to order any medications, tests, or needs further notification

      • I-SBAR

        • reminder to identify self

      • SBAR-R

        • receiver - respond to the info you provide

• Ineffective

  • passive

    • avoids making difficult decisions, confrontation

    • ppl fail to express opinions

    • ppl pleaser

  • aggressive

    • hostile

    • infringes on the rights of others

    • winning is sole goal

    • places blame

    • uses intimidation tactics

  • passive-aggressive

    • avoids honest confrontation

    • appears honest, but is manipulative

  • shaming & dismissive behavior

    • mistreats other individuals

Chain of Command

• Lines of authority

• Communication

• Greatest authority at top

Communication Channels

• Diagonal

  • Manager engages with managers of other departments or health care providers

• Continual

  • Occurs between superiors with subordinates

• Grapevine

  • Informal

  • Involves 3-4 people on any level

Case Study Question 1:

Lucy used the SBAR format while calling Dr. Higgins. Which of the following is the purpose of SBAR?

Improves communication among health care workers

• SBAR, which stands for Situation, Background, Assessment, and Recommendation, is used to decrease communication errors and improve client safety by standardizing how communication is exchanged between health care workers. SBAR is not a permanent part of the client record, nor is it an evaluation tool.

Francine asks Lucy to cover for her during her break. Which of the following communication styles did
Francine use?

Case Study Q2:

Aggressive

• Francine communicated in an aggressive manner. Aggressive communication is an ineffective style of communication because it uses intimidation and blaming statements, which are typically hostile and infringe on the rights of others. Passive communication is typically people-pleasing in nature and used to avoid conflict. The nurse did not display passive communication. Assertive communication is an effective interaction technique used to relay information, and it is displayed in a professional manner. Francine did not display assertive communication.

Lucy responds to Francine's request to cover for her during her break. Which of the following
communication styles did Lucy use?

CASE STUDY Q3

Passive

• Lucy used a passive communication style when responding to Francine. Passive or submissive communication is ineffective and inappropriate to use because the nurse avoids confrontation by permitting others to make decisions. Shaming and dismissive communication styles are ineffective forms of communication with negative consequences. The nurse did not respond using these styles.

Jane and Lucy discuss the verbal exchange that occured between Lucy and Francine. Which of the following communication styles did Jane use?

Passive-aggressive

• Jane used a passive-aggressive communication style. Passive-aggressive communication is ineffective and inappropriate to use because it uses manipulative behaviors to create conflict in an effort to make other individuals appear wrong or incompetent. Passive or submissive communication is ineffective and inappropriate to use because the nurse avoids confrontation by permitting others to make decisions. Assertive communication is an effective interaction technique used to relay information, and it is displayed in a professional manner

Lucy responds to Jane regarding her recommendation for discussing the incident with the
unit manager. Which of the following communication styles did Lucy use?

Assertive

• Lucy used an assertive communication style. Assertive communication is an effective style of interpersonal communication to use because it uses active listening and "I" statements, and it combines honesty and tactfulness to ensure the rights of self and others. Dismissive and passive aggressive communication styles are ineffective forms of communication with negative consequences.

A nurse manager is conducting an in-service on ineffective communication patterns. Which of the following should she include when discussing components of passive communication? (Select all that apply.)

• Puts others' needs and wants ahead of self is correct. This is a component of passive communication.

• Avoids conflicts is correct. This is a component of passive communication.

• Difficult time saying "no" is correct. This is a component of passive communication.

A nurse is reviewing professional communication skills with a newly licensed nurse. Which of the following is a form of effective communication?

Assertive

• Assertive communication is the most effective communication technique that is used to convey information in an informative and professional manner.

A nurse manager is discussing formal and informal structures or processes with a newly licensed nurse. Which of the following statements made by the newly licensed nurse requires further teaching?

"Informal structures are visible."

• Informal structures or processes tend to be hidden and unplanned. Informal processes are not usually discussed or written.

Which of the following should be included in an interprofessional or interdisciplinary team? (Select all that apply.)

Respiratory therapist is correct. Interprofessional relationships are a group of various disciplines who utilize their own individual professional theories to promote health care.

Provider is correct. The provider should be included in the interprofessional or interdiscipilinary team.

Nurses is correct. The nurse should be included in the interprofessional or interdisciplinary team.

Dietitian is correct. The dietitian should be included in the interprofessional or interdiscpilinary team.

Which of the following should a nurse include in the verbal SBAR report to a provider? (Select all that apply.)

Background is correct. Background is the second component of Situation, Background, Assessment, Recommendation.

Assessment is correct. Assessment is the third component of Situation, Background, Assessment, Recommendation.

Situation is correct. Situation is the first component of Situation, Background, Assessment, Recommendation.

Recommendation is correct. Recommendation is the last component of Situation, Background, Assessment, Recommendation.

A charge nurse is reviewing organizational structure with a group of newly licensed nurses. Which of the following should she include in her discussion? (Select all that apply.)

Lines of authority is correct. Organizational structure involves lines of authority.

Organizational size is correct. Organizational structure involves organizational size.

Formal structures is correct. Formal structures are a part of organizational structure.

Informal structures is correct. Informal structures are a part of organizational structure.

A nurse manager is discussing aggressive communication with a nurse who is having conflicts with peers due to her ineffective communication patterns. Which of the following should the nurse manager identify as a characteristic of aggressive communication?

Infringes on the rights of others

• Individuals who infringe on the rights of others are using aggressive communication patterns.

A nurse manager is discussing organizational concepts in a charge nurse meeting. Which of the following statements by a charge nurse indicates a need for further teaching?

"Smaller organizations find communication more difficult due to size and complex processes."

• Larger organizations, not smaller ones, find communication difficult due to size and complex processes.

Which of the following types of communication is informal, becomes distorted, and typically involves three or four individuals?

Grapevine

• Grapevine communication is informal and generally involves three or four people at one time. The message often contains errors as it is communicated because the sender bears little accountability for the message.

A nurse manager is reviewing concepts related to organizational communication with a group of charge nurses. Which of the following statements made by a charge nurse requires additional teaching?

"Information should be informally distributed."

• Information should be distributed formally.