And Your Communication Style is....

Excellent communication skills are critical to the nursing profession. Yet, there are times I become frustrated when a nurse is giving a marathon report full of unnecessary information. I am guilty of “internal eye rolling” when communicating with someone full of energy and less focus. My muscles tighten when my manager sits on both sides of the fence on an important issue and has difficulty making decisions. The truth is…. I am really good at identifying communication styles that I prefer or dislike. Unfortunately, I have little self-awareness of my own communication style and how others receive my message. Are you ready to increase your self-awareness by exploring your communication style? Nurses General Nursing Article

And Your Communication Style is....

And Your Communication Style is.....In healthcare, good communication skills are needed to build relationships and for positive outcomes. Nurses communicate with many healthcare disciplines and with patients of varying backgrounds (cultural, educational and others). Is your message clear or are the disadvantages in your communication style distorting the intended message? Let's explore four styles (aggressive, passive-aggressive, passive and assertive) and the advantages and disadvantages of each style.

Aggressive Communication Style (The Winner)

An aggressive communicator will put their needs and ideas first. This style can come across as demanding and abrasive. The intended message will often be lost as the recipient is reacting to the harsh delivery. The winner often comes across hostile and confrontational. Non-verbal communication may include invading others' personal space, big dramatic gestures and harsh facial expressions. The Winner does not listen very well, interrupts frequently and has a know-it-all attitude.

Examples of aggressive communication

  • After receiving a patient assignment from the charge nurse, the winner states "no one cares how hard my workload is". The winner then slams the door to the medication room
  • "I don't know why you keep asking how to enter a lab order. I have told you ten times"
  • "I don't care that Jim has to work every weekend. It's not my problem our weekend nurse is on medical leave"

The person on the receiving end of the winner often feels defensive, resentful, hurt afraid and reluctant to report mistakes and problems.

Take-away: aggressive communication is usually ineffective.

Passive-Aggressive (The Sabotager)

A passive-aggressive communicator appears genuine and agreeable, but anger and resentment is present under the surface. The Sabotager is not truthful and forthcoming with their thoughts and feelings. Instead, they are indirectly aggressive - unreliable, patronizing, sarcastic, devious and often gossips. Non-verbal communication may include invading personal space and speech that is often dramatically sweet.

Examples of passive-aggressive communication

  • "I was only joking". Expresses hostility openly, but in a socially acceptable way.
  • "No one ever told me". Used to justify work that is late or not completed
  • "I was sick". Consistently calls out sick to avoid working (i.e. on a Monday or Friday, understaffed for day, expecting snow/ice)
  • "That's not my job". Excuse used when asked to complete a task that the sabotage results or feels is beneath them
  • "Go ahead and decide without me. No one listens to me anyway"

The person on the receiving end of the sabotager often feels hurt, confused, angry and resentful. People who communicate passive-aggressively appear passive on the surface, but are acting out resentments and anger indirectly to undermine.

Passive Communication Style (The Avoider)

The avoider is often seen as patient, easygoing and always concerned with the needs of others. Passive communicators also avoid conflict and are reluctant to express their own thoughts, concerns and feelings. It is common practice for the avoider to accept additional work and responsibilities and give in to the ideas of others. Unfortunately, the avoider is often burdened with resentments and frustrations.

Examples of passive communication

  • "I don't mind working through lunch again today"
  • "You can make the schedule, anything is fine with me"
  • "I am so sorry for asking, but could you help me pull a patient up in bed?"
  • "I will let the group make the decision" when asked to provide input on patient assignments

The person on the receiving end of the avoider often feels frustrated, like they can take advantage, confused as to what the avoider needs and/or wants and resentment. The passive communication style is about people pleasing while avoiding conflict.

Assertive Communication Style

This is the opposite of passive and is confident, self-aware, honest and direct. Assertive communicators are typically active listeners and are considerate of others' feelings. Common nonverbal communication includes direct eye contact, attentiveness, relaxed posture, and appropriate speech volume. The assertive style is known for compromising and confronts problems as they occur.

Examples of assertive communication

  • "I will not be able to stay late today; I have a doctor's appointment"
  • "You appear overwhelmed"
  • "What alternatives do we have"?
  • "My child has a fever and I need to be off tonight"

The person on the receiving in of an assertive communicator often feels the person is honest, knows where they stand and respected.

Take-away: The assertive communication style is the most effective and a balance between aggressive and passive. Keep in mind that we all fluctuate between communication styles in different situations. It is a good starting place to be aware of your preferred style in order to improve your communication and message. What changes can you make in your communication style to improve your message?

For additional information, visit the following:

Four Basic Communication Styles

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J.Adderton

About J.Adderton, BSN, MSN

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Nurse with over 20 years experience and diverse career path- community health, management, education and end of life care.

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I think I'm a combination of all of the above. I try to be assertive most the time but sometimes am passive and sometimes my bluntness comes off as abrasive. Imagine that? I usually regret when that happens.

I can't stand, and am occasionally guilty of, the passive-aggressive style, e.g. "I was only joking." If you have to say that afterward it's probably not really that funny after all. I hate when I do that because I know it's probably a lie and hurt someone. :facepalm:

Specializes in Psych (25 years), Medical (15 years).

People use passive-aggressive communication because it works. There's always an underlying message that the receiver is expected to find. Once the receiver starts to guess the underlying message, the passive aggressive-communicator has some control and power over the situation.

Being direct or, in this case, playing the role of an assertive communicator with a passive-aggressive communicator usually puts them on the defense. A defensive reaction with an assertive communicator gives them the upper hand, as the assertive communicator will challenge exactly what is said.

I think I see myself as an factually assertive passive-aggressive communicator.

One situation which comes to mind is that of a 12 hour nurse who wanted to take a smoke break an hour after my 8 hour shift began.

I said, "I saw you smoking when I came in at 2300 and you want to take another break?"

Her reply, probably due to taking my statement of fact as being passive-aggressive, was, "Do you think I take too many breaks?"

No- I was merely relating facts. You were on break at 2300. It's now 2400 and you want to take another break, correct?"

"Well, fine then! I won't take another break now!"

As previously stated, people use passive-aggressive communication because it works. The nurse took my statement of facts as being passive-aggressive with the underlying message being that I thought she should not take another break when in reality, I just wanted to mess with her by being a factually assertive passive-aggressive communicator!

Specializes in Psych (25 years), Medical (15 years).
I can't stand, and am occasionally guilty of, the passive-aggressive style, e.g. "I was only joking." If you have to say that afterward it's probably not really that funny after all.

I will relate facts and often get the response of "You're kidding?!"

"No", I reply, "I'm funnier than that."

I cannot stand passive aggressive or passive communicators. We're adults and I feel people should be able to say what they need to say in a professional/respectful way and people should be able to receive it. Aggressive communicators are nothing more than "bullies" who are fear-based and when challenged most of the time they will back down. We all have bad days and fall back on bad behaviors, but we should all use professional communication 90% of the time. Great article and great reminder for us all.

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