VIVEKANANDA COLLEGE OF NURSING SEMINAR ON; PRESENTED BY- APURVA DWIVEDI [M.Sc. Nsg. 2 st Yr.]
COMMUNICATION
INTRODUCTION Nurse managers are required to be aware of the techniques that can help them ensure effective management of educational/ service unit. Communication is one of the most important activities in the nursing management. It is the foundation upon which the manager achieves organizational objectives.
MEANING OF COMMUNICATION Communication is a process of change. In order to achieve the desired result, the communication necessarily is effective and purposive.
DEFINITION Communication is a process in which a message is transferred from one person to other person through a suitable media and the intended message is received and understood by the receiver.
IMPORTANCE
Promotes Motivation Communication promotes motivation by informing and clarifying the employees about the task to be done, the manner they are performing the task, and how to improve their performance if it is not up to the mark.
Source Of Information Communication is a source of information to the organizational members for decision making process as it helps identifying and assessing alternative course of actions.
Altering individual’s attitudes Communication also plays a crucial role in altering individual‘s attitudes, i.e.; A well informed individual will have better attitude than a less-informed individual. Organizational magazines, journals, meetings and various other forms of oral and written communication help in molding employee‘s attitudes.
Helps In Socializing Communication also helps in socializing. In today‘s life the only presence of another individual fosters communication. It is also said that one cannot survive without communication.
Controlling Process Communication also assists in controlling process. It helps controlling organizational member‘s behavior in various ways. There are various levels of hierarchy and certain principles and guidelines that employees must follow in an organization. They must comply with organizational policies, perform their job role efficiently and communicate any work problem and grievance to their superiors. Thus, communication helps in controlling function of management.
ELEMENTS There Are Seven Elements Of Communication:- Source Idea Message Encoding Channel Receiver Decoding Feedback
Source Idea The source idea is the process by which one formulates an idea to communicate to another party. This process can be influenced by external stimuli such as books or radio, or it can come about internally by thinking about a particular subject. The source idea is the basis for the communication.
Message The message is what will be communicated to another party. It is based on the source idea, but the message is crafted to meet the needs of the audience. For example, if the message is between two friends, the message will take a different form than if communicating with a superior.
Encoding Encoding is how the message is transmitted to another party. The message is converted into a suitable form for transmission. The medium of transmission will determine the form of the communication. For example, the message will take a different form if the communication will be spoken or written.
Channel The channel is the medium of the communication. The channel must be able to transmit the message from one party to another without changing the content of the message. The channel can be a piece of paper, a communications medium such as radio, or it can be an email. The channel is the path of the communication from sender to receiver. An email can use the internet as a channel.
Receiver The receiver is the party receiving the communication. The party uses the channel to get the communication from the transmitter. A receiver can be a television set, a computer, or a piece of paper depending on the channel used for the communication.
Decoding Decoding is the process where the message is interpreted for its content. It also means the receiver thinks about the message's content and internalizes the message. This step of the process is where the receiver compares the message to prior experiences or external stimuli.
Feedback Feedback is the final step in the communications process. This step conveys to the transmitter that the message is understood by the receiver. The receiver formats an appropriate reply to the first communication based on the channel and sends it to the transmitter of the original message.
CHARACTERISTICS
Clarity One of the most essential characteristics of an impressive communication is "clarity". Use simple and sound words, so that listeners can grab it easily. Be clear in your thoughts, jumbled and confused mind cannot deliver a good and clear saying. Avoid using any technical terms, try to explain in laymen language. Use examples to explain & support complex scenarios. Work a little bit on your accent and pronunciation.
2. Aim or Goal At every stage of your talk/communication, don't forget your "aim or goal". Try to deduce an acceptable stuff by judging pros & cons impartially. Communicate with a broad and practical mind.
3. Precision Be precise & exact in your approach. Neither be too deep nor be too short. Include some good facts acknowledging your topic
4. Avoid Repeatability, unless required so
5. Linkage Try to maintain a logic link between your sayings. Don't put two opposite faces of coin at a same time. Deliver in a structured & planned way.
6. Globalization and Localization Try to explain the broader aspects but not on the cost of local values. Aggregation of local values should result into global and broader aspects.
7. Style of Expressing Control various speech parameters like pitch, tone, intensity etc. According to the environment. Don't be too fast or too slow. Light humor at the right time is always accepted. Look straight & forward. Keep a light smile on your face
CONTI. Avoid using words that show arrogance. Feel what you say. Avoid being too formal, be natural and practical.
8. Know and Analyze the audiences
9. Do a good Homework
10. Dress Properly 25% confidence and 25% respect from audiences comes automatically, if you have dressed up well. Be neat, clean, ironed and polished irrespective of the fact that you have dressed up formally or informally. Do a good hair styling; avoid any casual or unethical looks.
PROCESS OF COMMUNICATION All of the manager‘s functions involve communication. The communication process involves six steps.
Ideation The first step, ideation, begins when the sender decides to share the content of her message with someone, senses a need to communicate, develops an idea or selects information to share. The purpose of communication may be inform, persuade, command, inquire or entertain.
Encoding Encoding is the second step, involves putting meaning into symbolic forms. Speaking, writing or non verbal behavior. One‘s personal, cultural and professional biases affect the goals and encoding process. Use of clearly understood symbols and communication of all the receiver needs to know are important.
Transmission The third step, transmission of the message, must overcome interference such as garbled speech, unintelligible use of words, long complex sentences, distortion from recording devices, noise and illegible handwriting.
Receiving The receiver‘s senses of seeing and hearing are activated as the transmitted message is received. People tend to have selective attention (hear the message of interest to them but not others) and selective perception (hear the parts of the message that conform with what they want to hear) that cause incomplete and distorted interpretation of the communication. Sometimes people tune out the message because they anticipate the content and think they know what is going to be said. The receiver may preoccupied with other activities and consequently not be ready to listen.
Decoding Decoding of the message by the receiver is the critical fifth step. Written messages allow more time for decoding, as the receiver assesses the explicit meaning and implications of the message based on what the symbols mean to her. The communication process is depend on the receiver‘s understanding of the information.
Response Or Feedback It is the final step. It is important for the manager or sender to know that the message has been received and accurately interpreted.
PRINCIPLES OF COMMUNICATION Communication should be conviction. Communication should be appropriate to situation. Communication should have objective and purposes. Communication should promote total achievement of purposes. Communication should represent the personality and individuality of the communication. Communication involves special preparation. Communication should be oriented to the interest and needs of the receiver. Communication through personal contact. Communication should seek attention. Communication should be familiar.
Techniques To Improve The Communication Listening Broad openings Restating Clarification Reflection Focusing Sharing perceptions Silence Humor Informing Suggesting
Listening An active process of receiving information. The complete attention of the nurse is required and there should be no preoccupation with oneself. Listening is a sign of respect for the person who is talking and a powerful reinforce of relationships. It allows the patients to talk more, without which the relationship cannot progress.
Broad Openings These encourage the patient to select topics for discussion, and indicate that nurse is there, listening to him and following him. For e.g.; Questions such as what shall we discuss today? ”Can you tell me more about that”? “And then what happened?” From the part of the nurse encourages the patient to talk.
Restating The nurse repeats to the patient the main thought he has expressed. It indicates that the nurses is listening. It also brings attention to something important.
Clarification The person‘s verbalization, especially when he is disturbed or feeling deeply, is not always clear. The patients remarks may be confused, incomplete or disordered due to their illness. So, the nurses need to clarify the feelings and ideas expressed by the patients. The nurses need to provide correlation between the patient‘s feeling and action. For example; “I am not sure what you mean “? “could you tell me once again?” Clarifies the unintelligible ideas of the patients.
Reflection This means directing back to the patient his ideas, feeling questions and content. Reflection of content is also called validation. Reflection of feeling consists of responses to the patient‘s feeling about the content.
Focusing It means expanding the discussion on a topic of importance. It helps the patient to become more specific, move from vagueness to clarity and focus on reality.
Sharing Perceptions These are the techniques of asking the patient to verify the nurse understands of what he is thinking or feeling. For e.g. The nurse could ask the patient, as “you are smiling, but I sense that you are really very angry with me”.
Theme Identification This involves identifying the underlying issues or problem experienced by the patient that emerges repeatedly during the course of the nurse-patient interaction. Once we identify the basis themes, it becomes easy to decide which of the patient‘s feeling and thoughts to respond to and pursue.
Silence This is lack of verbal communication for a therapeutic reason. Then the nurse‘s silence prompts patient to talk. For e.g.; Just sitting with a patient without talking, non verbally communicates our interest in the patient better.
Humor This is the discharge of energy through the comic enjoyment of the imperfect. It is a socially acceptable form of sublimation. It is a part of nurse client relationship. It is constructive coping behavior, and by learning to express humor, a patient learns to express how others feel.
Informing This is the skill of giving information. The nurse shares simple facts with the patient.
Suggesting This is the presentation of alternative ideas related to problem solving. It is the most useful communication technique when the patient has analyzed his problem area, and is ready to explore alternative coping mechanisms. At that time suggesting technique increase the patient‘s choices.
TYPES OF COMMUNICATION
On The Basis Of Relationship Expression
ONE-WAY V/S TWO WAY COMMUNICATION
One-way communication The flow of communication is one way from the communicator to the audience.
Drawbacks Knowledge is imposed. Learning is authoritative. Little audience participation. No feedback. Does not influence human behavior
Two way communication In this both the communicators and the audience take place. The process of communication is active and democratic. It is more likely to influence behavior than one way communication.
FORMAL V/S INFORMAL COMMUNICATION Communication has been classified into formal (follows lines of authority) and informal (group line) communication.
Formal communication It is officially organized channels of communication and it is delayed communication. It is generally used for all practices purposes. This authoritative, specific, accurate and reaches everybody. The medium of formal communication may be department meeting, conferences, telephone calls, interviews, circular etc.
Informal network Gossip circles such as friends internet group, like minded people and casual groups. Communication is very faster here. The informal channels may be more active. It follows grape wine route. It may be a fact but more in native of rumor. It does not reach every one informal communications are quite fast and spontaneous.
Physiological Communication It is a stimulus received by the body immediately the brain receives the information and transmits to the respective organs through the nervous, where it has to be passed.
Psychic Communication Extra sensory perception occurs, i.e.; Something which will occur in future. The person pertains and predicts that in advance is called psychic communication.
Serial Communication Person to person the message will be passed line a chain. Sender passes the message to one person, then that receiver passes information to other and so on.
Symbolic Communication Good communication requires awareness of symbolic communication, the verbal and nonverbal symbolism used by others to convey meaning.
Visual Communication The visual forma of communication comprise charts and graphs, pictograms, tables, maps, posters etc.
VERBAL V/S NON-VERBAL COMMUNICATION The traditional way of communication has been by word of mouth language is the chief vehicle of communication. Through it, one can interact with other can be passes through. Direct verbal communication by word of mouth may be loaded with hidden meanings. The important aspects if verbal communications are as follows.
Vocabulary Communication is unsuccessful if senders and receivers cannot translate each others word and phrases when a nurses cases for a client who speaks another language an interpret may be necessary.
Denotative and connotative meaning A single word has several meaning. Individuals who use a common language share the denotative meaning, baseball has the same meaning for everyone who speaks English, but code denotes cardiac arrest primarily to health care providers. The connotative meaning is the shade or interpretation of a word‘s meaning influences by the thoughts, feelings or ideas people have about the word.
Pacing Conversation is more successful at an appropriate speed or pace nurse should speak slowly enough to enunciate clearly. Pacing is improved by thinking before.
Adoptability Spoken messages need to be altered a according with behavioral due from the receiver.
Intonation Tone of voice dramatically affects a meaning. The nurse must be aware of voice line to avoid sending unintended messages.
Clarity and brevity Effective communication is simple, brief and direct. Clarity is achieved by speaking slowly, enunciating clearly and using, repeating important parts of a message also clarifies communication. Brevity is achieved by using short sentences and words that expresses an idea simply and directly.
Credibility Credibility means worthiness of belief, trustworthiness and reliability.
Time and relevance Timing is critical in communication. Even though message is clear, poor timing can prevent it from being effective. Often the best time for interaction is when a client express an interest in communication. If message are relevant of important to the situation at hand, they are more effective.
Oral communication Oral communication is a transmitting message orally either by meeting the person through artificial media of communication such as telephone and intercom systems.
Written communication It is transmitting message in writing. Written communication can be followed when a record of communication is necessary.
NON VERBAL COMMUNICATION Communication can occur even without word. Non-verbal communication is message transmission through body language without using words. It includes bodily movements, positive, facial expression. Silence is non verbal communication. It can speak louder than words.
Personal Appearance Nurse learn to develop a general impression of clients health and emotion status through appearance and clients develop a general expression of the nurse‘s professionalism and caring in the same way personal appearance includes physical characteristics, facial expression, manner of dress and grooming first impressions are largely based on appearance.
Poster And Gait Poster and gait are forms of self expressions. The way people sit, stand and more reflect attitudes, emotion and self concept and health status.
Facial Expression The face is the most expressive part of the body. Facial expression convey emotion such as surprise, fear, anger, happiness and sadness. People can be unaware of the messages their expression convey doing procedure and the client may interpret. This is anger or disapproval.
Eye Contact Maintaining eye contact during conversation shows respect and willingness to listen, lack of eye contact may indicate anxiety, discomfort or lack of confidence in communicating.
Hand Movements And Gestures Hands also communicate by touch, slapping or caring another‘s head communicates obvious feelings.
MECHANICAL COMMUNICATION By using mechanical devices the communication will be sent. For e.g. Internet, radio, T.V. etc.
CHANNELS OF MANAGERIAL COMMUNICATION
Four Levels Of Managerial Communication
Downward Communication This is the traditional and most used communication, where the management gives orders to The subordinates at the bottom level to carry out the orders as per the organizational hierarchy. All the written and oral communication which are carried out from the top management to the employees by various means in order that the employees carry out their duties in the organization in achieving its goals.
Upward Communication Upward communication in the management levels from staff, lower and middle management personnel and continuous up to the organizational hierarchy. It provides a means for motivating satisfying personnel by encouraging employees input.
Lateral Communication Lateral or horizontal communication is referred to the communication which takes place between the departments or personnel on the same level of the hierarchy.
SUBORDINATES SUBORDINATES MANAGEMENT
Diagonal Communication Diagonal communication occurs between two individuals or departments that are not on the same level of the hierarchy.
BARRIERS OF COMMUNICATION Communication barriers create problem of misunderstanding and conflict between men who live together in the same community, who work together on the same job and even between men living in the distinct parts of the world who have never seen one another.
1. Due to organization structure The breakdown or distribution in communication sometimes arises due to: 1. Several layers of management; 2. Long lines of communication; 3. Special distance of subordinates from top management; 4. Lack of instructions for passing information to the subordinates; 5. Heavy pressures of work at certain levels of authority.
2. Due to status and position 1 . The attitude exhibited by the supervisor are sometimes a hurdle in two way Communication. One common illustration is non listening habit. A supervisor may guard information for: Consideration of prestige, ego and strategy. Underrating the understanding and intelligence of subordinates. 2. Prejudice among the supervisors and subordinates may stand in the way of a free flow of information and understanding. 3. The supervisors particularly at the middle level may sometimes like to be in good books of top management by: Not seeking clarification on instructions which are subject to different interpretations; and Acting as screen for passing only such information which may please the boss.
3. Semantic Barriers Semantic is the science of meaning. Words seldom mean same thing to two person Symbols. Or Words usually have a variety of meaning arid the sender and the receiver have to choose one meaning from among many. If both of them choose the same meaning, communication will be perfect. But this is not so always because of differences in formal education and specific situations of the people.
CONTI. Strictly one cannot convey meaning, only one can do it to convey words. But the same words may suggest quite different meaning to different people, e.g. Profits‘ may mean to management efficiency and growth, whereas to employees it may suggest excess funds piled up through paying inadequate wages
4. Tendency to evaluate A major barrier to the communication is the natural tendency to judge the statement of the person or other group. Every one tries to evaluate others from his own point of view or experience. Communication requires an open mind and willingness to see things through the eyes of others. Some intelligent brains even complimented him on his excellent style of imagination.
Heightened emotions Barriers may also arise but in specific situations, e.g. Emotional reactions, physical conditions like noise or insufficient light, past experience, etc. When emotions are strong, it is most difficult to know the frame of mind of the other person or group.
Lack Of Ability To Communicate All persons do not have the skill to communicate. Skill in communication may come naturally to some, but an average man may need some sort of training and practice by way of interviewing and public speaking, etc.
Inattention The simple failure to read bulletins, notices, minutes and reports is a common feature. With regard to failure to listen to oral communications, it has been seen that non listeners are often turned off while they are preoccupied with other affairs, like their family problems.
Unclarified Assumptions This can be clarified by an illustration. A customer send a message that he will visit a vendor‘s plant at particular time on some particular date. Then he may assume that vendor will receive him and arrange for his lunch, etc. Whereas vendor may assume that the customer was arriving in the city to attend some personal work and would make a routine call at the plant. This is an unclarified assumption with possible loss of goodwill.
Resistance To Change It is the general tendency of human-being to maintain status quo. When new ideas are being communicated, the listening apparatus may act as a filter in rejecting new ideas. Thus, resistance to change is an important obstacle to effective communication. Sometimes, organizations announce changes which seriously affect the employees, e.g. Shifts in timings, place and order of work, installation of new plant, etc. Changes affect people in different ways and it may take sometime to think through the full meaning of the message. Hence, it is important for the management not to force changes before people are in a position to adjust to their implications.
Closed Minds Certain people who think that they know everything about a particular subject also create obstacles in the way of effective communication.
THEORIES OF COMMUNICATION
The Decibel Theory It argues that the best way to get the message across is to state one‘s point loudly and frequently. Its effectiveness over a period of time is nil, but many of us still need to be reminded that shouting only makes poor communication louder.
The Sell Theory It lays down that the total burden of communication is on the communicator while the receiver is passive and pliable. One of the problem created by this approach is that it tends to increase the barriers between the individuals and thus reduces the chances of hearing each other.
The Minimet Theory It assumes that the receiver probably is not much interested in what is being communicated. By telling an individual what he needs to know, he will have little to object and little to question.