Finkelman, Leadership and Management for Nurses: Core Competencies for Quality
Care, 3rd edition.
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Chapter 14: Effective Staff Communication and Working Relationships
LEARNING OUTCOMES AND SUGGESTED CLASSROOM AND CLINICAL
ACTIVITIES
LEARNING OUTCOME 1
Describe the critical elements of communication; lines of communication,
communication process, and verbal and nonverbal communication
Suggestions and Strategies for Classroom Experience
• Students can be asked to identify an example for each of the communication lines.
Suggestions and Strategies for Clinical Experience
• After identifying the examples in class, students can be asked to identify
LEARNING OUTCOME 2
Assess a team’s communication.
Suggestions and Strategies for Classroom Experience
• Ask students in small groups to reflect on the following questions: (1) How do
you describe effective communication? (2) What do you think an individual can
do to improve her communication? This could also be done as a written
Suggestions and Strategies for Clinical Experience
• Assign students to attend a team meeting and then critique the team’s
communication in a one- to two-page written assignment. This assignment also
LEARNING OUTCOME 3
Compare the four communication methods, including the most effective use of the
method.
Suggestions and Strategies for Classroom Experience
• Ask students in small groups to use storytelling as a method of communication.
Discuss the pros and cons of this method.
Suggestions and Strategies for Clinical Experience
• Discuss with students how the clinical site is using information technology. What
is its effectiveness? If the site is not using it, how could it be used?
LEARNING OUTCOME 4
Apply two strategies for resolving communication problems.
Suggestions and Strategies for Classroom Experience
• Discuss the results from the interviews done in the clinical setting (described
below).
Suggestions and Strategies for Clinical Experience
• Students can interview a staff member, team leader, or nurse manager to learn
more about how she resolves communication problems at work. Does she apply
any of the strategies mentioned in the chapter?
LEARNING OUTCOME 5
Assess your own communication style.
Suggestions and Strategies for Classroom Experience
• Ask each student to self-assess his own communication and then discuss the
assessment with a classmate. How does the classmate view the student’s self–
assessment?
Suggestions and Strategies for Clinical Experience
• Each student can be asked to identify one aspect of communication that needs
KEY CHAPTER CONCEPTS
2. Communication can be verbal or nonverbal. Individuals are vastly dependent on verbal
communication and are often less aware of metacommunication and nonverbal
3. The communication process is made up of five elements: the sender; the message,
which includes both verbal and nonverbal information, as well as the sender’s attitude
4. Problems with communication typically have a negative impact on organization’s
culture, level of effectiveness, staff’s morale, and the quality of patient care.
6. Downward communications go from superior to subordinate. Communication is
downward when a team leader tells a team member that a specific task must be
7. Upward communication (from subordinates to superiors) provides management with
insights into the company and its employees and competitors. Examples of upward
8. Lateral (or horizontal) communication is mostly used to coordinate activities. This type
of communication takes place between staff members that are in the same or similar
9. Diagonal communication usually occurs when staff members who are from different
hierarchical levels are working on a project together, as equals. This form of
10. Each level of the communication process is composed of encoding (translation by
sender to change ideas into language), the message (content), the medium (carrier of the
11. The communication process can be used to better understand and evaluate ongoing
communication. There are many factors that affect the sender and the message, such as
12. The five elements of the communication process are the sender, the message, the
13. Communication effectiveness means the communication is productive, with the goal
being message sent, received, and understood as sent. There are many considerations in
14. Questions that should be considered when a work group’s communication is assessed
15. Other critical issues related to communication are information overload, which is
growing with the increase of information technology (makes it difficult to decide what
16. Communication is not always easy to accomplish; there are many barriers. Some
examples of barriers include failing to listen to others and not recognizing them; using
17. Leaders and managers can resolve/address the barriers above by encouraging active
listening and seeking more understanding of others’ expectations and viewpoints; using
18. Leaders and managers should advocate that each staff member has a responsibility to
contribute ideas and opinions as well.
19. There are many communication methods; however, four that have relevance to
20. Written communication is best used when there needs to be documentation of the
communication, the message needs to be given to multiple persons, or it is difficult or
21. Face-to-face communication is particularly important when personal sensitive
information needs to be discussed. It allows for greater give-and-take. Active listening
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22. Storytelling can be helpful when clarifying a confusing message, inspiring others, or
making communication more interesting; particularly effective during times of change
23. Information technology has changed communication, making it more rapid and
24. The nurse manager plays an important role in setting the tone for communication in
25. There are a variety of strategies that can be used to resolve communication problems.
Some of the strategies include asking for feedback, paraphrasing, reflecting,
26. Paraphrasing is when a person restates what another person has said and asks for
confirmation of what was stated. The focus is on facts and the statement should be
27. Assessing one’s style of communication is an important part of being a professional
APPLYING LEADERSHIP AND MANAGEMENT
BSN and Master’s Essentials: Application to Content
Chapter identifies which Essentials apply to the chapter content. This information is
primarily for the instructor, but students should understand the how these nursing
education standards apply to the chapter content and the nursing profession.
My Hospital Unit: An Evolving Case Experience
See the overview of the My Hospital Unit feature found in the front of the textbook.
Refer students to the specific My Hospital Unit scenario found in the chapter.
Applying AONE Competencies
The AONE competencies for nurse leaders are found in Appendix A. Ask students to
identify which of the AONE competencies apply to the content in the chapter.
Engaging in the Content: Critical Thinking and Clinical Reasoning and Judgment
See Discussion Questions and Application Exercises at the end of the chapter. Online
options are noted.
Chapter Features: Case Study and Applying Evidence-Based Practice
The Chapter Features: Case Study and Applying Evidence-Based Practice features may
ADDITIONAL CASE
This case is not found in the textbook. It may be used for individual or team assignments:
written assignment and classroom or online team discussions. It may also be used as an
essay question for exams.
Case:
A medical unit has moved to using interprofessional care teams. A team is composed of a
physician, several nurses, pharmacist, respiratory therapist, and when needed physical
therapist. The team meets routinely to review patients and rounds on patients as a team.
The idea of an interprofessional team model was accepted when it was started; however,
the nurse manager has noticed some negative communication trends. During meetings the
two nurses say little and rarely speak up during rounds. They tend to speak to team
members individually but not to the team as whole. The other team members vary in their
participation depending on the patient.
Questions:
1. What might be reasons for these communication patterns?
2. How might the nurse manager approach the communication issues with the team?
3. How might communication be improved?