Assertiveness

A direct, honest expression of ideas, opinions, and desires.
The intent of assertive behaviour is to show an atmosphere of trust
Assertive individuals initiate communication in a way that shows respect toward others
You cannot simply force others to change you have to change yourself/ how you react
Skills needed in assertive communication
- Initiating and maintaining a conversation
- Responding appropriately to negative criticism
- Give negative feedback gracefully
- Express appreciation
- Make requests
- Refuse requests
- Convey confidence
- Express opinions appropriately

Avoiding conflict at all cost
Passive people may not share their opinions if they disagree with someone else
Are not the ones to initiate conversation
Passive-aggressive
- When they show a happy/ encouraging front but when they turn around are angry and resentful

Cognitive Theories show that people respond because they have irrational beliefs that interfere with assertiveness
- Fear of rejection or anger from others and need for approval (everyone should
and approve of what I do)
- Overconcern for the needs and rights of others (I should always try to help o
be nice to them)
- Beliefs that problems with assertiveness are due to unalterable personality chara and are, therefore, unchangeable (this is just who I am)
- Perfectionist standards (I must be perfectly competent. If I am not, then I am a failure)
These fears are irrational and lead to unnecessary conflicts and anxiety
Cognitive restructuring teaches people to identify self-defeating thoughts and change them to more reasonable thoughts

Feedback focuses on a person's behavior rather than personality.
- Focus on what the person can change
Feedback is descriptive rather than evaluative.
- Describing what was said or done is less threatening than judging why it was done.
Feedback focuses on your own reactions rather than the other person's intentions.
Assigning "blame" is not part of constructive feedback.
Feedback uses "I" statements to show how you feel instead of pointing out and making accusations
Feedback is specific rather than general.
- It focuses on behavior that has just occurred and avoids dragging in past behavior.
Feedback focuses on problem-solving.
The intent is to solve a problem in a relationship so that the relationship can be improved.
Feedback is provided in a private setting.

Be able to admit to your mistakes
Do not act negatively to feedback
Encourage constructive criticism
Two common beliefs
- Everyone has to like us
- We can never make mistakes
Since it is impossible not to make mistakes and for everyone not to like us we see ourselves as failures we get defensive and take it personally

Most important assertive skill in relating to patients is YOUR WILLINGESS TO INITIATE COMMUNICATION.
Encouraging patients to be more assertive is also important to improve your communication with them.
Responding to an angry or critical patient
- Keep in mind that their feelings of hostility may be greatly magnified by the life stressors they are experiencing.
- Try to understand what it is like for them and respond empathically.
Another skill useful in responding to patient criticism is to get the patient to turn criticism into useful feedback.
If a patient persists in aggressive behavior in spite of your efforts to focus on understanding and problem-solving, you will want to set limits without becoming aggressive.

If you determine you need to speak directly with a doctor, you will be most effective if you are persistent with the receptionist or nurse.
Need to show respect towards other healthcare professionals but you need to be persistent in stating your request.
When you are identifying potential problems, you should be prepared to identify alternatives to resolve the problem.
Your duty to the patients’ best interests always comes first

Sometimes you will need to be assertive with your supervisor/boss.
Sometimes your supervisor will not share the professional identity or ethical standards we hold for patient care.
For some of us the first response to criticism is to counterattack.
Neither a passive nor aggressive response is helpful in this situation.
- Assertiveness will allow for problem-solving.
- When you are being criticized, it is important to distinguish between:
The truths people tell you about your behavior,
- The judgment that they attach to your behavior.
When you are being criticized filter through the truth and the opinions
- Use the truth to improve yourself
How to respond to criticism
- Getting useful feedback,
- Find out exactly what lead to the criticism. This may be useful to you improving your performance.
- Agreeing with criticism: Acknowledge the mistake.
Disagreeing with criticism: If you consider the criticism unreasonable, it is important to state your disagreement and why.
Fogging: Acknowledging the truth or possible truth in what people tell you about yourself while ignoring completely any judgments they might have implied.
Delaying a response: If the criticism takes you by surprise and you are confused about how to respond, give yourself time to think about the problem before you respond.