Aggressive Communication In Nursing

Effective communication skills are important to any profession, but in nursing, they can make the difference between life and death. Good communication skills are essential for good leadership and management (Catalano, 2015). Nurse leaders will set the tone for their entire department in regards to communicating with each other, with patients and families, and with physicians and any other members of the health care team. This includes everything from sharing progress updates on patients to resolving conflict between coworkers. When nurse managers recognize this, they can use their influence to improve communication throughout the unit. Nurses must be able to help patients understand their medical issues and provide them instructions about

how to care for themselves. They must also be able to clearly give details about the patient's condition to doctors and fellow nurses. If they are unable to, serious medical errors can occur.
Understanding Communication
Communication is a collaborative sharing of information that includes a sender, message, and a receiver. To communicate effectively, the sender needs to understand the factors which could influence how the message is interpreted. The sender must consider the setting in which the communication occurs, that will can include the past experiences and personal perceptions of both the sender and receiver, the timing of the message, etc (Anderson, 2012). “After the sender sends the message, the receiver has a responsibility to listen to, process, and understand (encode) the information and then to respond to the sender by giving feedback (decoding). The encoding process occurs when the receiver thinks about the information, understands it, and forms an idea based on the message” (Catalano, 2015). Use of effective interpersonal communication strategies by nurses in both personal and professional settings, may reduce stress, promote wellness, and therefore, improve overall quality of life.
“Effective communication requires understanding that the perceptions, emotions, and participation of both parties are interactive and have an effect on the transmission of the message. Nurses should recognize the many barriers to clear communication and the benefits of clear communication” (Catalano, 2010). Effective communication is a collaborative process that communicates the right message to other staff members who correctly receive said message and understand it. Communication is then effective when the audience understands the message the sender is trying to communicate.
Communication Styles
There are three main types of communication: assertive, nonassertive, and aggressive. Assertive communication is the ideal type of communication. It involves interpersonal behaviors that allow people to defend and uphold their legitimate rights in a respectful manner that does not violate the rights of others. Assertive communication is honest and direct and exactly expresses the person’s feelings, beliefs, ideas, and opinions. It promotes trust and teamwork by communicating to others that they have the right to and are encouraged to express their opinions in an honest and respectful atmosphere.
Use of assertive communication can be necessary during conflict negotiation. Assertive communication allows expression in direct, honest, and nonthreatening ways that do not infringe upon the rights of others (Sommer, 2013)
Nonassertive communication is also mentioned as submissive communication.

Since they have a great fear of displeasing others, personal rejection, or future retaliation, submissive communicators dismiss their own feelings as being unimportant. When people use submissive communication their rights become violated by others. “Many experts believe that submissive communication patterns are protective mechanisms that help insecure people maintain their self-esteem by avoiding negative criticism and disagreement from others” (Catalano, 2010).
Aggressive communication strongly states the speaker’s legitimate rights and opinions with little concern or respect for the rights and opinions of others. “Aggressive communication is viewed by some psychologist as a protective mechanism that compensates for a person’s own insecurities, and others view it as a form of bullying” (Catalano, 2010). Aggressive communication can be viewed as several different forms, including screaming, sarcasm, rudeness, belittling jokes, and even direct personal insults.
There are three key methods of communication: verbal, paraverbal, and nonverbal. Verbal is written or spoken. Paraverbal is the tone, pitch, volume, and diction used when conveying verbal message. Nonverbal consist of body language, facial expressions, gestures, physical appearance, touch, and personal

space.
Factors that Affect Communication
People are constantly communicating something, in either a verbal, paraverbal, or nonverbal manner.

There regularly is a degree of overlap between the three styles. Some things people do and say help build communication, but other behaviors or words break communication down. Anything done or stated that affects communication is called a communication blocker. Actions performed and speech that encourage and build communication are called communication builders and are often referred to as therapeutic communication techniques. Some nonverbal communication builders can include: maintaining eye contact, nodding the head, positive facial expressions, and listening empathically. Extremely effective nurse managers never underestimate the importance of listening with empathy and the goal of understanding another point of view. Silence and communicating in a calm soothing tone are paraverbal communication builders. Reflecting feelings and emotions, asking clarifying questions, and asking open-ended questions are examples of verbal communication builders. Charge nurses must overcome the many distractions which create barriers to communication that prevent them from advocating effectively on behalf of the patients and

staff.
Patient barriers include environmental items such as noise, lack of privacy and lack of control over who is present; fear and anxiety related to being judged, becoming emotional or being weak; and other barriers such as an inability in explaining feelings and attempting to appear strong for someone else’s benefit. Health care professional barriers include environmental items such as lack of time or support, staff conflict and high workload; fear and anxiety related to causing the patient to be distressed by talking or responding to questions; and other barriers such as a lack of skills or strategies for coping with difficult emotions, reactions or questions.
Conclusion
Nurse leaders through effective communication guide their staff in communicating patient care, handling misunderstandings, and move to a highly functioning team.