LEARNING KEY SKILLS IN NURSING MANAGEMENT

E-mail is particularly fraught with opportunities for misunderstanding. From the greeting (e.g., dear, hi, hello, or no salutation) to the sign-off (e.g., warm regards, best wishes, best, or no sign-off), the sender conveys more than the choice of words. A speedy reply is expected and en- courages a response, sometimes without adequate thought. Finally, the possibility of sending the message to the wrong person, especially the dreaded “reply to all,” is another chance for your message to be misinterpreted. Texting shares many of the same dangers as e-mail and has added pressure for a faster response.

Directions of Communication Formal or informal communication may be downward, upward, lateral, or diagonal. Downward communication (manager to staff) is often directive. The staff is told what needs to be done or given information to facilitate the job to be done. Upward communication occurs from staff to management or from lower management to middle or upper management. Upward commu- nication often involves reporting pertinent information to facilitate problem solving and deci- sion making. Lateral communication occurs between individuals or departments at the same hierarchical level (e.g., nurse managers, department heads). Diagonal communication involves individuals or departments at different hierarchical levels (e.g., staff nurse to chief of the medi- cal staff). Both lateral and diagonal communication involve information sharing, discussion, and negotiation.

An informal channel commonly seen in organizations is the grapevine (e.g., rumors and gossip). Grapevine communication is usually rapid, haphazard, and prone to distortion. It can also be useful. Sometimes the only way to learn about a pending change is through the grape- vine. One problem with grapevine communication, however, is that no one is accountable for any misinformation that is relayed. Keep in mind, too, that information gathered this way is a slightly altered version of the truth, changing as the message passes from person to person.

Effective Listening Most nurses believe they are good listeners. Observing and listening to patients are skills nurses learn early in their careers and use every day. Being a good listener, however, involves more than just hearing words and watching body language (Sullivan, 2013). Maintaining eye contact is misleading; it may or may not signal that a person is listening. Barriers to effective listening include preconceived beliefs, lack of self-confidence, flagging energy, defensiveness, and habit (Donaldson, 2007).

Preconceived Beliefs The longer your relationship with someone is, the more apt you are to think you know what the person says or means and, thus, the more likely you are to not listen. This holds true in personal as well as professional relationships and applies to groups of people (known as stereotyping). Not expecting others to have anything worthwhile to say also is an example of preconceptions about them.

Lack of Self-Confidence Listening is difficult if you are nervous, and weak self-confidence frequently is the cause. People tend to talk too much or think about what they’re planning to say next to pay attention to the per- son speaking. Often their mind is racing and they may not be listening even when they’re talking themselves.

Flagging Energy Listening takes energy and sometimes we simply don’t have enough energy to listen carefully. Too many people speaking at once, having too much to do, being worried, or being too tired can all interfere with our ability to listen.