Communication style can vary among individuals. Common communication types include assertive, passive, and aggressive. Assertive individuals communicate confidently and speak up for themselves. Aggressive individuals communicate with verbal attacks; they speak their feelings without regard to others, often in a condescending manner riddled with superiority tones. Passive individuals communicate out of fear of displeasing others; they avoid conflict often denying their own feelings or needs (Hansten, 2009). This paper will be discussing three case studies and a scenario from my own personal experience. In the first case study Rashad was passive and Robin was aggressive. Rashad an aide and Robin a RN attended a team meeting. Rashad spoke about role clarification during the meeting stating that he thought it was part of his role to anticipate some of the needs of the patients.
Robin was aggressive with her tone toward Rashad and disregarded his feelings and undermined his ability to do his job. Robin stated that he was only an aide and that he should only do what he is told. Rashad then planned on being passive-aggressive toward Robin in the future by not doing his job on his own, and only doing the things he was told to do. Robin’s condescending manner when speaking to Rashad did not take into account his feelings and she spoke with a sense of superiority. Rashad, fearing losing his job if he defended against her assault, was passive and quiet while devising a plan to make her pay for the way she treated him. This type of communication between Robin and Rashad is toxic and will lead to vengefulness and hostility among coworkers. Robin could have been assertive and clarified the role of RN and aide and the expectations of both parties. Rashad could have been assertive by being confident enough to stand up for his rights and expressing his feelings about how Robin treated him.
The second case study a school nurse named Pamela was passive or non-assertive when dealing with a volunteer Brigite who had administered some vision and hearing tests. Pamela noticed that the previous screens results and the results from the tests that Brigite administered differed. Pamela was concerned that they were not accurate. Instead of communicating to Brigite, and possible educating Brigite on proper technique for administering the tests, Pamela decided to redo all of the tests herself. This passive type of communication lead to a lot more work for Pamela and denied Brigite the opportunity to learn. If Pamela had communicated assertively with Brigite they could have retested the students together; with Brigite learning proper technique and building a trusting relationship between Brigite and Pamela. When dealing with delegated tasks, being assertive about how to do the task with clear expectations can build a trusting relationship among staff. Failure to be assertive leads to one party feeling like they need to do all the work; this can lead to overtime, burn out, and decreased job satisfaction.
The party who was denied the opportunity to learn because of the fear of the delegatee may feel underappreciated or not a part of the team. Feeling that you have to do it all for it to get done correctly can lead to multiple people being dissatisfied with their job. In case study three, Rosa is a surgical center manager and Mabel is a surgical technician. Mabel was aggressive to Rosa with regards to her job description by stating that her grandparent was the chairman on the board and that she would have Rosa’s head on a platter. Rosa was assertive in making sure that Mabel knew that what she was refusing to do was in her job description. Managers need to be assertive and treat everyone fairly regardless of who they know or are related to. Not being assertive with Mabel could have lead to hard feelings among other coworkers. Mabel’s aggressive behavior was threatening to Rosa; not only to Rosa’s authority but for her job in general. Mabel may feel entitled due to her grandparent’s role on the board, or she may just be a lazy employee, but whatever her motivation she has created a difficult situation for her manager.
Rosa needs to continue to have the confidence to remain assertive in order to maintain the respect she needs to do her managerial duties effectively. If Rosa becomes passive and lets Mabel manipulate her, she will lose the respect of the employees she manages. In my own personal scenario I was dealing with an aggressive family member whose mother was very ill and the prognosis was poor. I had to remain assertive and not let my feelings of anger get the best of me. This family member had been caring for her mother at home for about a year. When her mother was brought to the hospital she was emaciated, weighing only 70 pounds, she had 17 pressure sores, aspiration pneumonia, and was contracted into the fetal position. The patient flinched every time her daughter came near. Although Adult Protective Services had been notified, the daughter (family member in question) was allowed to stay with the patient. Any time a staff member would try to do any care for her mother the daughter would aggressively try to tell us how to do our jobs, and made accusations that we were the ones who created the sores.
She often sabotaged dressing changes but inserting herself into the process often contaminating the area. Despite her aggression the staff remained assertive that we were trained to do our jobs, and that we were following policy. I was the patient’s nurse on the day that she was rapidly declining after her lung collapsed and she was actively having a heart attack. The patient’s daughter became very aggressive with me and I had to be very assertive. The daughter wanted the patient deep suctioned; she was sure that would fix her. I had to continue to be assertive and explain that suctioning would not help in this case but could make her mother worse. I involved respiratory therapy and the doctor; we had a meeting before meeting with the patient’s daughter to explain the severity of the situation. We were able to medicate the patient and the patient calmed down with her breathing. At this point the daughter accepted what the situation was and thanked me for helping her mother. I saw an opportunity to sit down beside the daughter and discuss realistic expectations and set some boundaries.
By remaining confident and assertive and involving the team to join I gained the daughters trust, therefore decreasing her aggressive behavior. If I had been passive or avoidant the patient would have suffered. If I had gotten defensive and aggressive the patient would have suffered. By having good communication skills the situation was diffused and all parties came to an agreement. If I could do it over again I would have set boundaries earlier. I felt that the daughter was aggressive due to her stage in the grieving process or due to her guilt of her mother deteriorating while in her care. I was assertive when the patient’s daughter became aggressive toward me, but I was also avoidant of conflict by “choosing my battles.” Among the communication types assertive communication is the most productive. Passive or aggressive behavior can lead to difficulty managing others, hurt feelings, and stress. To effectively communicate in the healthcare setting, assertive communication is key for dealing with colleagues, patients, and their families.
Hansten, R. (2009). Clinical Delegation Skills: a handbook for professional practice. Retrieved from the University of Phoenix eBook collection database.