If you've been in your role for 60 days or 6 months, at some point you've probably found yourself thinking any or all of the following:
- I thought I covered that issue at the last staff meeting…
- I put the picture and instructions of the new equipment in the communication book, how can they say they weren't told about it?
- I can't believe the “rumor mill” has everything backward about what I told staff at shift change yesterday!
- I'm pretty sure the memo was in English—how can they not “get this?”
Just when you thought you were doing a good job with staff communication, reality strikes and you realize your efforts haven't been as effective as you hoped. Communication occurs in a variety of formats: face-to-face, e-mail, telephone, and social media, such as Facebook and Twitter. Verbal and written communication remain the most common for nurse managers. Consider these scenarios in the work setting that may contribute to your communication challenges:
- Multiple generations are now working together and each has their own preferred method of communication style.
- The concept that “one communication style” should fit all isn't valid.
- On a weekly basis, the average healthcare worker has to sort through a plethora of communication (e-mail, communication books, bulletin boards, and so on).
- Leadership isn't skilled in writing clear and effective communication.
- There's an unrealistic expectation that the original content of a message will stay intact when you filter it through multiple sources.
- The communication doesn't clearly define any actions the leader expects as a result of the information.
- The art of listening and paying attention has become diluted with multiple distractions (social media, smart phones, and other electronics).1
As a new nurse manager, think about methods you currently use to communicate with staff and respond to the following four questions:
- Do you express your thoughts clearly? In both your written and verbal communication, how do you know the message you hope to share is the same one staff members hear?
- Do you make eye contact when speaking with another person? Are you peeking at your smart phone or looking away from the person who's talking? If so, then you're not only being disrespectful, but you can't effectively listen to what the person is saying.
- Do you use effective body language to confirm that you're listening? Is your mind wandering off to the overdue budget report as the other person is speaking? Do you nod or present facial expressions or hand gestures that indicate you're listening?
- Do you pay attention to the body language of the person you're communicating with? Are you attentive to the facial and physical gestures staff members display when in communication with you? Are you able to recognize that although their words imply “they're ok,” they have tears welling in their eyes or they won't make eye contact with you?
If you were to ask a trusted colleague to answer these questions about you, what would he or she have to say? Would your colleague's responses match yours? Seek out someone you trust and present these four questions, bringing with you some examples of your written communication. It isn't unusual for a leader to make many assumptions about his or her own communication style. The thought prevails that if something were wrong, surely someone would say something. This is untrue—staff members won't typically provide feedback to their leader unless prompted or surveyed for their opinions.
Staff members will observe, scrutinize, and dissect your communication methods, so it's essential for nurse leaders to fully develop their communication skills. You want to be the person who role models effective and timely communication, providing staff members with an opportunity to learn how to improve their own communication skills. The following key communication concepts will help to redirect your efforts toward a more efficient and effective means of combating communication challenges and keeping staff informed, up to date, and engaged in their workplace.
Key communication concept 1: Determine staff preferences
Conduct a survey to determine staff members' preferred method(s) of communication. (See Table 1.) Synopsize the results and post them publicly for all to view. Use this feedback to develop a new approach toward connecting with all staff.
Key communication concept 2: Provide clarity in communication
Select three of your previous written communications and ask a staff member to share the perceived message. Let him or her know you're working on improving how you communicate with staff, but need feedback to do so. You don't have to agree with his or her comments, but you do need to listen and listen carefully.
You may also want to consider engaging a trusted staff member or two to act as your mouthpiece for select communication to ensure that your message is accurately understood. When certain messages come from a leader and go directly to staff, some staff members simply look at the source of the information, not the content. Liken this to your ability to hit the “delete” button on your e-mail without reading the message. Although staff may be responsible to read or listen to all communication, some staff members will relate their perception of the sender's credibility to their decision to review or not review the content. The accountability you place on staff to review all of your communication will come into play here because much of this information directly impacts patient care.
Key communication concept 3: Communication accountability
After you've developed a plan for improving your communication techniques, style, and content, be sure to clarify your expectations of staff members' accountability for the content of each communication. This can be accomplished through:
- automated e-mail programs that confirm message receipt
- sign-off sheets for communication notebooks
- attendance sign-in sheets for staff meetings
- informal notes for small group verbal communication
- huddle communication sign-off sheets
- communication expectations included in job descriptions.
Key communication concept 4: Be aware of information overload
Make sure that you have realistic expectations of staff members and understand the volume of information and communication they're responsible to review, recall, and intertwine with their other responsibilities. Repetition is valuable for key items such as patient safety and medication delivery changes. Consider interjecting some humor when appropriate or use clip art to really grab staff attention.
Decide on a central location for posting new, updated, and important information. The best example is using a bulletin board. Be sure to delegate to select staff the upkeep of any bulletin boards to ensure that information is current, appropriate, and still relevant. Walk through other departments for examples of how to make communication tools, such as a bulletin board, visually appealing.
Key communication concept 5: Walk the talk
Be aware of your own behaviors and how they may or may not support your communication. When you remind staff members in an e-mail that everyone is responsible to answer patient call lights, they need to see you comply with this when you walk through the department. When dress code issues erupt and you repost and communicate the dress code policy, be sure that your appearance is professional and meets all of the dress code criteria. You want to develop credibility and trust through communication, regardless of the medium.
Key communication concept 6: Listening skills
Staff meetings and conflict resolution are two key verbal methods of communication. Verbal communication requires that one person listens while the other verbalizes, and it's the listening aspect that proves to be the most difficult for many of us. It takes time to develop our listening skills, but when staff members feel that you truly listen to them, they're more likely to actively listen to you as well. Some key phrases you can use to let another person know you're listening include:
- Tell me more about what happened.
- So, what you're saying is __________________________?
- Is there anything else about the incident I should know?
- I hear you telling me that you're no longer upset, but your expression tells another story. Tell me more about how you really feel.
- It sounds like I forgot to include the PRN staff in this last communication, I'll be sure to add them to the text message list.
Say what you mean, mean what you say
Your ability to effectively communicate is integral to the success of your role as a nurse leader. Being open to feedback about your communication methods and style is important as you work to develop this skill. Listen to any feedback you receive and use it, along with the six key communication concepts, to develop resources and ideas for more commendable communication. As George Bernard Shaw once said, “The greatest problem of communication is the illusion that it has been accomplished