Question

Mary Sue Timmons, RN, was working the 3 to 11 PM shift in the medical-surgical unit at Memorial Hospital when one of her patients began complaining of a headache. The patient also appeared to be very anxious and his blood pressure was 184/110. Mary Sue immediately called the physician and reported the patient's symptoms and vital signs. The physician ordered Valium 5 mg IV and said he would be there to see the patient very soon. Mary Sue repeated the verbal medication order and received confirmation from the physician before hanging up the phone. She then immediately wrote the verbal order in the chart and ordered the medication from the pharmacy. Mary Sue also requested a package insert for the Valium because she had never given that medication IV before. Just as Mary Sue received the medication from the pharmacy and began to read the package insert, the physician arrived and asked if the medication had been given. When Mary Sue began to explain that she had just received the medication and had to read the package insert, the physician exploded and said, "I am the doctor and I am the only one who needs to know anything about the medication. You are here to follow my orders!"

1. How should Mary Sue respond to this physician? Select all that apply.
   1. Maintain eye contact (conveys confidence)
   2. Refuse to give the medication
   3. State that the primary goal is the patient’s safety
   4. Tell him to give it himself

2. What positive, assertive communication techniques should Mary Sue use in responding to this physician?
   1. Be defensive
   2. Use “I” messages
   3. Maintain closed body stance
   4. Speak loudly so he can hear you

3. What negative techniques must Mary Sue avoid when responding to the physician? Select all that apply.
   1. Be assertive
   2. Apologize
   3. Give the medication
   4. Stay calm

Answer 1

1:-How should Mary Sue respond to this physician?
a)maintain eye contact

c)states that primary goal is patient safety

2:-What positive, assertive communication techniques should Mary Sue use in responding to this physician?

b.)use I messages

3:-What negative techniques must Mary Sue avoid when responding to the physician? Select all that apply.

b)Apologize

C)Give the medication

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ASSERTIVE COMMUNICATION SKILLS

1 USE “I” STATEMENTS:-By expressing yourself with“I want” or “I feel,” you let others know in a clear and non-threating way exactly how you feel about a situation. Rather than blaming others, simply state how you feel and own your feelings.

2. SAY NO:-It’s not easy to say no. But it’s important to know your limits and communicate when there’s a request to go beyond them. But when it becomes standard practice and you feel you’re being taken advantage of, speak up.

3. ASK FOR HELP.:-It’s okay to admit when you need help, and asking for assistance from others not only shows that you’re comfortable with doing so, but you also model for others that it’s okay to do so.

4SHOW EMPATHY. :-Consider how others may feel during certain situations. People experience the same situation in different ways, depending on their position or circumstance. Acknowledge their feelings and perspective, while still being clear on what you need from a situation

5 BE AWARE OF BODY LANGUAGE.

Remember that communication goes beyond words alone. Your body language conveys a lot, too.

>Stand or sit upright, hold your head even, and make regular eye contact.

>Be aware of your facial expression, keeping it neutral or positive.

>Don’t furrow your brow, purse your lips or slap your forehead.

>Maintain an open posture rather than crossing your arms or turning away.

6 BE AWARE OF YOUR EMOTIONS.

Emotions are normal. But letting your emotions get out of control can undermine assertive communication. Speaking impulsively out of anger may lead to saying something you regret and damaging a relationship – or worse

>Take a few deep breaths.

>Shift your attention elsewhere, such as to the bottom of your feet.

>Ask for a moment to consider the situation (while you secretly and quietly get your emotions under control).

>Use self-talk (mentally, of course) to counteract the escalating emotions you may feel.

7USE WORDS THAT CONVEY A CLEAR MESSAGE.

Use words that clearly convey what you want or need. Don’t soften your message so much that it’s diluted. Don’t waffle in your message. Avoid “should’ or “could.”

8 SPEAK CALMLY AND CLEARLY.

Be aware of not only the words you say but how you say them.

>During communication, maintain a calm and confident tone of voice.

>Use your voice in a way that conveys you have confidence in your message, yet you’re not bullying or arguing.

>Don’t upspeak (ending your sentence like a question) or you’ll come across as lacking confidence.

>Don’t raise your voice or you may sound angry or bullying.

9 ESCALATE IF APPROPRIATE.

If you’ve made repeated unsuccessful requests of a peer or subordinate, don’t let it go unresolved. If your requests aren’t met after several conversations, then escalating to the appropriate level may need necessary.

10 SET BOUNDARIES.know your limitations

11 ADMIT MISTAKES.

Be willing to admit it when you make mistakes, and apologize when needed. Everyone makes mistakes

12 UNDERSTAND YOUR VALUE.

It’s far easier to stand up for yourself when you understand the value you bring to the team. Even if your skills are different or you’re the newest team member, remember that you bring unique skills and experience to the organization

13 PRACTICE.

Don’t wait until you’re in a heated discussion or confronted with a challenging situation to try out these assertive communication skills. They’ll be much easier if you’ve run through them a few times in advance. If you need to initiate an uncomfortable conversation, practice how you’ll start it, including where it will happen and the words you’ll use

CHALLENGES TO ASSERTIVE COMMUNICATION SKILLS

You can’t control how others respond to you. If you find yourself in a situation in which someone is reacting aggressively, remain respectful in your approach. Stay calm. Stay focused on the message.