Transcript Nurse Leader Skills: Delegation, Conflict Engagement and Ethics in

Nurse Leader Skills:
Communication and
Team Building
NURS 560 Fall 2014
Dr. Mileva Saulo Lewis
Professor Emerita
N 560 Fa 2014 Dr. Lewis All rights reserved
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N 560 Fa 2014 Dr. Lewis All rights reserved
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At the completion of this session
learners will be able to:

Apply principles of positive communication
to the clinical setting

Identify obstacles/barriers to effective
communication and strategies for improving

Discuss the implications of complexity,
science, MBTI Types, leader & followership
roles, and group roles for effective health
care teams.
N 560 Fa 2014 Dr. Lewis All rights reserved
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George Bernard Shaw

The problem with
communication is the
illusion that it has taken
place.
White Water Rafting Director

Communication is when
you row in exactly the
way that I’ve just
yelled out.
Communication – Two Views
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Communication Functions

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Control behavior
Fosters motivation
Emotional expression;
social goals
Information
transmission
Not a hierarchy – all
are important
 Robbins, S.P. (2014).
Essentials of organizational
behavior. (17th ed.). Upper
Saddle River, NJ: Pearson
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What do you notice?
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Communication

Begins the moment two or more
people become aware of each
other’s presence

Most critical leadership skill

Impacts all management activities
and cuts across all phases of the
management process

The ability to communicate
effectively often determines
success as a leader-manager
 Marquis & Huston 2015
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Internal Factors
External Factors
Weather
 Temperature
 Timing
 Status, power,
authority,
 Organizational climate
itself

Values
Feelings
Temperament,
Stress levels of the sender
and the receiver
◦ Marquis & Huston, 2015
Communication
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Exercise

Draw what you hear

I need two
volunteers
◦ One to give directions
◦ One to draw what you
hear (If you can draw a
straight line – you are
eligible to volunteer)
Debrief
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Variables Affecting
Organizational Communication

Number of levels that
communicate

Gender

Power and status
◦ Marquis & Huston, 2015
Organizational Communication Strategies
Marquis & Huston, 2015

Leader-managers assess organizational communication

Leader-managers understand the organization’s structure
and recognize who is affected by decisions

Communication is not a one-way channel;
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Communication must be clear, simple, precise

Senders should seek feedback whether communication is
received

Multiple communication methods should be used

Unnecessary information should not be disclosed
Channels of Communication
Upward

From subordinate to superior
Downward

From superior to subordinate
Horizontal

From peer to peer
Diagonal

Between individuals at differing hierarchy levels and job
classifications
Grapevine
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Informal, haphazard, and random, usually involving small
groups
◦ Marquis & Huston, 2015
Communication Modes

Written

Face-to-face
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Telephone, Social Media, IPhone,
etc.

Nonverbal
Elements of Nonverbal
Communication
Space
 Environment
 Appearance
 Eye contact
 Posture
 Facial expression and timing
 Vocal expression

 Marquis & Huston, 2015
Communication in Complex
Situations

Veronica Chung
reporting on:
 Clancy, T.R. (2008).
Managing
organizational
complexity. Directing
a complex systems
perspective. Journal
of Nursing
Administration, 38 (2),
61-3.
Dr. Mileva Saulo Lewis, All rights reserved.
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Types of Communication

Passive Aggressive
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Indirectly aggressive (passive–
aggressive)
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Assertive
 Marquis & Huston, 2015
Misconceptions and Myths about
Assertiveness, cont.

To be assertive is to be aggressive
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Assertiveness is unfeminine
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Assertive communication is rude
or insensitive
 Marquis & Huston, 2015
Misconceptions and Myths about
Assertiveness

All behavior is either assertive or
passive

To get what you want, all you
have to do is be assertive

Being assertive will:
◦ Increase the odds of getting what
you want
◦ Increase your self-esteem
 Marquis & Huston, 2015
Listening – The forgotten Skill
(Burley-Allen, M. (1982). Listening: the forgotten skill. New York: John
Wiley.

An Individual Exercise

Read three statements

Select your INITIAL response by checking
a, b, c, or d.

You will have 3 minutes
 Burley-Allen, 1982, p. 85-89
Responses

Question 1
◦
◦
◦
◦

a
b
c
d
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Question 3
◦
◦
◦
◦
a
b
c
d
Question 2
◦
◦
◦
◦
a
c
b
d
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GRRR as a Listening Tool
Marquis & Huston, 2015, p. 451
Communication Barriers
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Filters
Selective perception
Gender styles
Emotions
Language
Non-verbal
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Cross cultural factors
Assume differences
Emphasize description
Lack of empathy
Interpretation as working
hypothesis
 Robbins, 2014
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Women

Enhance social connection

Create relationships by talking

Use more words, tentative,
polite
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Foster intimate bonds

Express concern for others

Use less powerful speech

Tag questions, Interrupt &
swear less

Synergistic
Men
Relationships established by
doing things
 Exert dominance
 Value Independence
 Maintain status
 Offer solutions
 Unemotional and
independent

◦ Merchant, 2012; Tannen,1990
Gender Differences Academic Research
Cautions
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Qualifiers

Mitigating- tend to weaken comment
◦ Perhaps…
◦ I guess…
◦ Well…

Inappropriate use of disclaimer; weakens
one’s stand
◦ I could be wrong but –
◦ This may sound crazy but –
◦ You may not like this but –
 (Eakins, B.W. & Eakins, R.G. (1978). Sex differences in
communication. Boston: Houghton Mifflin, p. 44.
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Viva La Difference!
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Men are from Mars; Women are from Venus
Value Differences as Strengths



Difference needs, goals and values
Understanding is key
Men
◦ Goal Oriented; sense of self through results;
◦ Stress – go into the cave
◦ Conflicts - Problems – offer solutions

Women
◦ Relationship oriented; sense of self by feelings &
quality of relationships
◦ Stress – women talk
◦ Conflicts - Problems – Seek empathy and
understanding
 Gray, 1992
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Mindfulness – Relationship to
Communication

Nicole Campion

Anthony, M.,Vidal, K.,
(May 31, 2010) "Mindful
Communication: A Novel
Approach to Improving
Delegation and
Increasing Patient Safety"
OJIN:The Online Journal of
Issues in Nursing Vol. 15,
No. 2, Manuscript 2.

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How about a Break
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Putting it All Together
Experiential Exercise

MBTI styles

Communication

Team Building

Group Roles
◦ Constructive
◦ Destructive
Team Building Exercise
It’s a Surprise !
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Team Task Analysis
 Use
the Problem-Solving Model (Z method – next
slide) to answer some of the following questions:
 Did
you get the desired result? If not, what could
you have done differently.
What did the team overlook?
 If
you did, what accounts for your success?
What did the team emphasize?
 What
did each member contribute to the
problem-solving process?
 What is the relevance of this to our work as nurse
leaders and team members?
RM 4-23
Problem-Solving Model
Identify and clarify problem
(who, what, when, where)
 Gather relevant, specific data
 Use facts verifiable by a reliable
source (time cards, thermometer,
etc.)



Weigh practicality
of alternatives
Examine consequences
Weigh gains/losses



S
N
T
F

Using the MBTI ® Tool in Organizations (3rd ed.) © 2001 by
CPP, Inc. Permission is hereby granted to reproduce this
overhead master for workshop use. .



Intuit probable causes
Generate alternatives,
interpretations of the
factual data
Seek patterns relating this
problem to others
Determine “fit” with personal
and organizational values
Assess effects on
stakeholders/ relationships/
organization
Determine how to win self
and others to solution
Adapted from works by Gordon Lawrence and Eleanor Corlett.
RM 4-11
Leadership Roles
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Decision maker
Communicator
Evaluator
Facilitator
Risk-taker
Energizer
Mentor
Critical thinker
Buffer
Advocate
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Coach
Counselor
Teacher
Forecaster
Visionary
Influencer
Creative problem
solver
Change agent
Diplomat
Role model
◦ Marquis & Huston,
2015
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Types of Followers
Effective or
exemplary
• Alienated
followers
• “Yes” people
• “Sheep”
•
• Finkelman, 2014
•
Partner
•
Contributor
•
Politician
•
Subordinate
• Finkelman, 2014
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rights reserved
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Follower Characteristics
• Strength & independence
• Critical thinking
• Ability, willingness to think
independently
• Ability to give timely, honest
feedback, constructive criticism
• Be one’s own person
• Innovative, creative
• Cooperative, collaborative
• Grossman& Viliaga, 2000 in Finkelman,
2014
Dr. Mileva Saulo Lewis, All
rights reserved
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Follower Characteristics,
 Innovative, creative
 Cooperative,
collaborative
 Self-starter
 Go above and
beyond
 Willing to assume
leadership
Grossman& Viliaga, 2000
in Finkelman, 2014, p.
333-34
cont.
 Take
the
initiative
 Attentive to
what’s
happening
 “Hold up
your end of
the bargain”
 Energized by
work &
environment
Dr. Mileva Saulo Lewis, All
rights reserved
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“SYNERGY”
Optimal
contributions
of all
individual
team
members
There is no
“I in team!
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Communication
in a Digital World
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ANA/NCSBN Principles for Social
Networking

ANA Code of Ethics for Nurses

ANA Standards of Practice

ANA Social Policy Statement
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Take Home Messages
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Preparation for 20 October
First Hour –Delegation

READ: TEXT: Chp. 20

NCSBN/ANA Delegation Guidelines

Review: Whitlock, J. (2013). The value
of active followership. Nursing
Management, 20(2), 20-23

Complete Learning Exercise 13.3


Supplemental Readings
Report due no later than 5
pm on Saturday 18
October

CAMPION: Anthony, M.,Vidal, K.,
(May 31, 2010) "Mindful
Communication: A Novel Approach to
Improving Delegation and Increasing
Patient Safety" OJIN: The Online Journal
of Issues in Nursing Vol. 15, No. 2,
Manuscript 2.

COOLEY Weydt, A. (2010).
Developing delegation skills. OJIN: The
Online Journal of Issues in Nursing,
15(2), Manuscript 1.
During the week: Observe what is
delegated to LPNs and PCAs and how


Complete Learning Exercise 20.9
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Three Realms of Nurses
Responsibility
Potter; Glaser
Individual
Organization
Society
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Learner Choices

Chapter Four – Ethical Issues
◦ Types of ethical issues
◦ Ethical Frameworks and Principles of ethical
reasoning, decision making

Chapter Six – Patient, Subordinate & Professional
Advocacy
◦ Becoming an advocate: patient advocacy; patient’s
rights;
◦ Workplace advocacy; whistleblowing;
◦ Professional advocacy
 For Patients
 The Workplace
 Associations: Professional Political Activity and/or Labor
Unions
N 560 Fa 2014 Dr. Lewis All rights reserved
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Preparation for 20 October Second Hour
Power, Authority and Influence
Read Text: Chapters
4&6
 Supplemental
Readings – Readings
as assigned for class
on 10/20
 Please send
summaries no
later 5 pm on 20
October
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
Correa
Flores
Flowers
Frangadakis
Fregoso
Garcia
Bumatay-Galvez
Garcia-Yepez
Gomez
N 560 Fa 2014 Dr. Lewis All rights reserved
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Dr. Mileva’s Schedule Next Week
I am attending the
American Society for
Bioethics and
Humanities national
conference
Wednesday through
Sunday at 4 pm.
 Will answer e-mail as
I am able

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Please complete the midcourse evaluation
Thank you
Dr. Mileva
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Thank you for your hard work!
Dr. Mileva Saulo Lewis, All rights reserved.
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