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Effective Leadership and
Management in Nursing
EIGHTH EDITION
CHAPTER
9
Communicating
Effectively
Learning Outcomes
1. Identify the factors that influence
communication.
2. Discuss how communication can be
distorted and misunderstood.
3. Choose which communication mode to
use depending on the message and
the relationship.
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Learning Outcomes
4. Explain how communication strategies
vary according to the situation and
those involved.
5. Improve your collaborative
communication skills.
6. Develop a plan to enhance your
communication skills.
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Factors that Influence
Communication
• Participant's past conditioning
• The situation
• Each person's purpose in the
communication
• Attitudes toward self, the topic, and
one another
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Successful Communication
•
•
•
•
Clear message
Careful listening
Monitoring responses
Providing feedback
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Causes of Distorted
Communication
• Metacommunications
– Oral messages accompanied by
nonverbal messages
• Intrasender conflict
– Nonverbal communication can distort
the meaning of the spoken words
• Intersender conflict
– Person gets conflicting messages from
different sources
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Other Causes of Distorted
Communication
•
•
•
•
Using inadequate reasoning
Using strong, judgmental words
Speaking too fast or too slowly
Using unfamiliar words
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Other Causes of Distorted
Communication
• Spending too much time on details
• Busy or distracted recipient
• Previous negative experience with
sender
• Biased perception of message or sender
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Causes of Email and Texting
Miscommunications
• Speedy replies
• Sending message to wrong person
• Reply to all
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Gender Differences in
Communication
• Men and women communicate
differently
• Using gender-neutral language helps
bridge the gap between men's and
women's ways of communicating
• Men and women can improve their
ability to communicate with one
another
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Generational and Cultural
Differences in Communication
• Generational differences affect
communication styles
• Cultural attitudes, beliefs, and
behaviors also affect communication
• Misunderstanding results from people's
lack of understanding of one another's
cultural expectations
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Generational and Cultural
Differences in Communication
• Personal and professional cultural
enrichment training is recommended
• What applies to one individual will not
be true for everyone else in that culture
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Organizational Culture
• Customs, norms, and expectations
within an organization shape behavior
• Poor communication can be a source of
job dissatisfaction
• Violating the organization's
communication rules can result in
repercussions
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Modes of Communication
• Messages may be oral or written and
sent by mail, email, or fax
• Purpose of the message determines the
best mode to use
• The more important or delicate the
issue, the more intimate the mode
should be
• Conflict or confrontation is also usually
best handled in person
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Levels of Intimacy in Descending
Order
•
•
•
•
•
•
In person
On the telephone
Voicemail
Email, instant messaging, and texting
Memos, faxes, and written mail
Posting on social media, including blogs
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Different Levels of Formality
• Applying for a job
• Conveying the time and place of an
upcoming meeting
• Nominating a coworker for an award
• Communicating with a family member
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Directions of Communication
• Downward
– Manager to staff
• Upward
– Staff to management, or lower to
middle or upper management
• Lateral
– Between individuals or departments at
same level
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Directions of Communication
• Diagonal
– Individuals or departments at different
levels
• Grapevine
– Rumors and gossip
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
The Role of Communication in
Leadership
• Leaders who engage in frank, open,
two-way communication are seen as
informative
• Communication is enhanced when the
manager listens carefully and is
sensitive to others
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
The Role of Communication in
Leadership
• A major underlying factor is an ongoing
relationship between manager and
employees
• Successful leaders are able to persuade
others and enlist their support
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Communicating with Employees
• Good communication is the adhesive
that builds and maintains an effective
work group
• Giving direction
– Know the context of the instruction
– Get positive attention
– Give clear, concise instructions
– Verify through feedback
– Provide follow-up communication
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Communicating with
Administrators
• Working effectively with an
administrator is important because this
person directly influences personal
success in a career and within the
organization
• Managing a supervisor is a crucial skill
for nurses
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Communicating with
Administrators
• Managing upward is successful when
power and influence move in both
directions
• Understand the superior's position from
her or his frame of reference
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Influencing Your Supervisor
• Nurses need to approach their
supervisor to exert their influence on a
variety of issues and problems
• Timing is critical; consider the impact of
your ideas on other events occurring at
that time
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Communicating with Your
Supervisor
• Taking a problem to your supervisor
– Go with a goal to problem-solve
together
– Have some ideas about solving the
problem
– Keep an open mind
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Communicating with Your
Supervisor
• Negative inquiry
– "I don't understand"
• Fogging
– Agreeing with part of what was said
• Negative assertion
– Accepting some blame
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Communicating with Coworkers
and Medical Staff
• Coworkers
– Can provide support; there may also be
competition or conflicts
– Should interact on a professional level
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Communicating with Coworkers
and Medical Staff
• Medical staff
– Relationship of physician and nurse has
been that of superior and subordinate
– Have considerable power because of
their ability to attract patients to the
organization
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Communicating with Patients and
Families
• The patient (and family) are the
principal customers of the organization
• Handle complaints and concerns
tactfully and expeditiously
• Lawsuits can be avoided if the patient
or family feels that someone has taken
the time to listen to their complaints
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Communicating with Patients and
Families
• Most individuals are unfamiliar with
medical jargon
• Maintain privacy and identify a neutral
location for dealing with difficult
interactions
• Make a special effort to find an
interpreter if a patient or family does
not speak English
• Recognize cultural differences
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Supporting Collaboration with
Medical Staff for Patient Care
• Respect physicians as persons, and
expect them to respect you
• Consider yourself and your staff equal
partners with physicians in health care
• Build the staff's clinical competence and
credibility
• Actively listen and respond to physician
complaints as customer complaints
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Supporting Collaboration with
Medical Staff for Patient Care
• Use every opportunity to increase your
staff's contact with physicians
• Establish a collaborative practice
committee on your unit
• Serve as a role model to your staff in
nurse-physician communication
• Support your staff in participating in
collaborative efforts by your words and
actions
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Four Ways that Generate Power
• With words
– Use the other person's name frequently
– Use strong statements
– Avoid discounters, clichés, and fillers
• Through delivery
– Be enthusiastic
– Speak clearly and forcefully
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Four Ways that Generate Power
• Through delivery
– Make one point at a time
– Do not tolerate interruptions
• By listening
– For facts, emotions, and what is not
being said
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Four Ways that Generate Power
• Through body posture and language
– Sit next to antagonist; turn 30 degrees
to address that person and lean forward
– Expand your personal space
– Use gestures; smile when pleased, not
to please
– Maintain eye contact, but do not stare
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Improving Communication Skills
• Consider your relationship to the
receiver
• Craft your message
• Be clear about your goal
• Think about how the receiver might
respond
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Improving Communication Skills
• Decide on the medium to use
• Check your timing
• Be prepared when you deliver your
message
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Improving Communication Skills
• Attend to responses
• Reply appropriately
• Conclude when messages are
understood
• Evaluate the process
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan