What is a research synthesis? How does a research synthesis differ from a summary? Post your research syntheses of two journal articles(Good Communication at work can open the gateway to better relations) and (Nonverbal Behavior and Communication in workp

Good communication at woric can open the gateway to better relationships Taking a team approach can make real difference to your experience of work in the social care sector. By making use of good interpersonal communication skills you can achieve your best.

Pauline Newson on why it's good to listen... and then talk.

Pauline Newson is a senior lecturer in Nursing and Midwifery at Suffolk College, Ipswich Improving interpersonal communication in the workplace Unit: HSC45 Develop practices wiiicii promote ciioice, weiibeing, and tiie protection of aii individuáis Hsc45 (h) interpersonal communication P oor communication continues to be one of the major causes of complaints in the work environment. Interpersonal skills are sometime referred to as people skills because they are the skills used to interact with others. Communication may simply be the exchange of information between sender and receiver without the above considerations. Both forms of com- munication consist of two components: the spoken word (verbal), and non-verbal sig- nals e.g., body language, and eye contact.

Communication and interpersonal skills are frequently used interchangeably.

Interpersonal skills are differ to 'communica- tion' because the emphasis is on self-aware- ness, attentive listening, sensitivity to the feelings of others and observing reactions.

This article will discuss aspects of inter- personal communication and ways to facili- tate appraisal of your own strengths and weaknesses. There is great value to regu- larly reviewing the way you connect with colleagues and clients.

Effective team work All teams will be influenced by different personal philosophies. This in turn will be reflected in their style of communication.

Paying attention to how members of staff communicate with one another, as well as patients and residents, is key to achiev- ing the desired outcome of high quality effective care. As well as achieving high quality care, effective tise of interpersonal skills, has the potential to reduce conflict in the work environment, reduce sickness antl absence' rates, and lili niotixalion.

Staff absences from work will negatively impact on availability of resources in your home. By enhancing the environment at work there is the potential to not only improve care delivery, but to reduce costs as well. Sheehan et al (2007) demonstrated that patient satisfaction increased when communication betu'een team members is strong. Without these interpersonal skills to accompany understanding and respect, high quality care is difficult to achieve.

Self awareness One key aspect is the development of self- awareness. Burnard (2005) highlightetl tlie importance of being self-aware explaining that without it our view of others can be distorted. We may wn^ngly believe that ue share the share the same beliefs, values and attitudes our group. Yet, although we will may hold similar professional views to our colleagues, as indivitkials oLir foundations are set by our singular experience of family and community. We eacli pos.sess our own unic|ue culture.

Beliefs and values It is normal to work in environments where colleagues and residents hold diverse views about aspects of living, working, dying, and communication. Being respectful of differ- ence while maintaining our true identity is integral to successful team-working and com- iiiunicati(5n. According to Corey (2(X)9: 27) becoming comfortable with ilifferences is an ongoing process 366 Nursing & Residential Care, August 2010, Vol 12, No 8 Communication strategy for change One way of developing self-awareness is to recei\e feedback about yourself Given correctly, it is in the spirit of helpful encour- .igoiiicnt antl should britig about chatige •iticl dcNcloptiicnt. johari's window is ati a|iproat 11 used for this purpo.se.

i Johari's window: strategy for change I IK- mori.' .i\\;nv \\L' IMV OIOtir owti beha\- ii)ut\ lite more cotiilotiabk- it is to work with others. Kvans (2007) suggests .seeking out feedback as a positive way to increase N'our 'open area' and retlucc the size of the other three windows.' Learning more about ourselves am he tetnporarily painful, but ihe tnore at ease we are about receiving leedback, the happier we will be with our- selves and others, I .

Defence Mechanisms Defence tncchanistns were first described by Sigmund Fteud, He proposed that these behaviours help us to protect our- selves from anxiety and to maintain our self-esteetn.

We unconsciously bring our defence mechanisms in to play to shield us frotn anxious thoughts and actions (Corey 2009, Evans 2005, Hilton and Fallowfield, 1993).

Each person will use specific defence behaviours during conversations:

Examples of defence mechanisms • Denial:

a person shuts off from the reali- ty of what is happening, e.g. when a rela- tive is informed of their partners sudden death.

The news is too painful to cope with at the time so the response is no, tio, it can't be true'. Denial gives time for the news to sink and allows the mind to become accustomed to a traumatic event.

• Projection:

the use of defensive behav- iour to become distant from what you consider distasteful, e.g. someone who is often late for work may invoke negative feelings that are rooted in memories of when you were once late, and the fric- tion it created among colleagues.

• Rationalization:

a person justifies a disap- pointtiient by using a logical explanatiotT to softeti the blow.

• (Jther examples include repression atici t'ontpen.sation.

^ Setting boundaries We all have b(5undaries which should not Ix- cro.ssed.

I tefer to situations where you are expected to change shift without the tiian- ager considering your own needs, be avail- able at all titiles to li.sten to other people's problems, or to suppon colleagues without teceiving the satne care and attention.

This Vver open door' approach cati inctease pressute on you duritig the wotk- itig day, culminating in a failure to achieve your .set tasks.

1 often refer to this as 'having leaky boundaries'. Imagine a bucket witli a hole in the bottom; as .soon as water enters the bucket it runs out!

Settitig boundaries will reduce your pet- .sonal stress and allow you accomplish your tasks for the day. It is u.seful to .set titne limits:

e.g., imagine Jane has asked to discuss an issue with you right this very tiiinute, instead of ambling along, you could reply: 'Yes Jane.

I will be free at 10am for 15 tninutes.' In that short sentetice you have shown Jatie that you are available at a set time for a specified time. You have set your boundaties and reduced the potential for this tneeting to meander on for an hour, jane has been given the message that the- tneeting needs to be concise.

This is a useful strategy' and should not lie considered as bjeing inflexible.

It is a method to conserve energy and time in order to allow for more meaningfitl engage- ment when appropriate.

Skiiis for improving interpersonai communication We should listen 80% of the time and speak for 20% of the tirne.

In 1984 Frankl identi- fied that on average, patients were inter- titpted within 18 seconds of starting to tell their story.

A large body of evidence shows that many p>eople profess to being good listeners but that their method of listening is superficial. Listening is not just about heat- ing, it is about being attentive.

Attentive listening Burnard (2005) explains attentive listening in the following way:

'listening involves givitlg ourselves up cotnpletely to the other person in order to hilly ittidetsiand him or her.' Giving ourselves up cotnpletel>' requires attention to the words being spoken, the pace antl emphasis placed on the words .said, and even the .selectioti of words itsed.

For example, a manager asks a metnlx'r of staff, 'How are you?' She replies, 'OK.' It is a ver>' short respon.se but the speak- er is telling you much more than 'OK', She could be shuttitig down the conwtsation for fear of di.sclosing .sotiie personal information The .speaker may al.so be uncotnlotiable with your cjitestion or be sitspicious of your interest.

To fully appreciate what is really being said, you tieed to be aware ol facial e.xpression, eye cotitact, body latigtiage, use of hatuls, what the feet are doitig etc.

These are things which can be observed very quickly, but tell you so much alxutt what the pet\son is really feeling.

To be a truly effective listener it is importatit lo become aware of the blocks to listetiing.

To become properly aware of personal lilocks to listening requires attention to your own .style of listening. Surprisingly, once atten- tion focuses on these blocks it is almost embarrassing to realize that their use is far more regular and automatic than one wouki wish to adrnit.

Biocks to listening itTiagine yotir child teturns home frotn school, you are preparing supper '^our child is trying to tell you .somethitig itiipor- tant that has happened. You are not paying full attention to his conversation and so he says: 'Mummy are you listening?' This can also happen at work when you do not listen to residents and .staff Nursing & Residential Care, August 2010, Vol 12, No 8 367 We often display blocks to listening without even realizing what we are doing.

The following list gives examples of blocks to listening.

• Derailing: you are more concerned with your own comfort during the conversa- tion. The speaker may be telling you something unpleasant, or something you would rather not hear and your response is to change the subject or use humour inappropriately. You have taken the spotlight way from the speaker, you have not listened attentively.

• Advising: before the person has finished speaking you are formulating a plan of action that will solve the issue. Your head is elsewhere so your ability to really listen is greatly reduced.

• Placating: a common example is a situa- tion where a colleague has experienced a break-up or the loss of a pregnancy.

Common platitudes include, 'there are plenty more fish in the sea' or 'you are young, you can try again.' You are hearing the person's pain and you are simply trying to make it better. When someone shares painful feelings he/ she needs their present emotion to be understood. In some ways the act of placating will disregard the present-day experience.

• Rehearsing: instead of paying attention to what is being said, the listener is planning what to say next. By doing this you will miss vital elements of what the speaker is trying to convey.

• Judging: as the story is being told you can hear a voice in your head admon- ishing, 'I can't believe you did that or I would have dealt with that differently' • Filtering: this is common when listen- ing to residents and patients. You have heard the story a himdred times before so you pick up only t)n the bits that you consider to be relevant. Unfortunately, you miss out on that person's unique experience.

• Dreaming: my personal favourite! You are being given a day-by-day accoimt of a friend's holiday but you only pick up on the bits that intere.st you. Then your mind wanders to the next task, or a voice complains that the story took over an hoLir! Sometimes you can negotiate this dream-time successfully and rejoin the conversation showing that you are interested. The problem is if you are later asked for an opinion, you may be clueless.

Using silence Effective interpersonal commimication is not always aboLit the words you use. Being silent is as important as your verbal contri- bution. Silence can be uncomfcjrtable but with practice it can quickly become possible not to feel the urge to fill every gap in the conversation.

Practice sitting in a room without a radio or television and listen to the sounds around you. Suddenly you will become aware of creaking floorboards, clocks ticking, air condition unit purring. Transfer this practice to listening within a conversation and you will often hear what is truly being said and, surprisingly, what is not being said.

Silence is a usefi.il tool because it allows the speaker time to think, how the words have made them feel, or even how he/she may .start to solve the issue. Silence makes space for reflection and in some instances allows time to come to terms witli grief Imagine a relative has been told the news that his wife has only days, rather than years, to live. The nurse who sits with him offers him a drink and holds his hand. She may think that she has done little, but as he leaves for home, he turns to the nurse and says, 'Thank you, it was what I needed. Just some space to think, it helped.' Empathy In the above example, the nurse is an effective listener because she demonstrates empathy. To demonstrate empathy you must walk alongside the person and be in his/her world, feeling as he/she might. By doing this you will gain an understanding of hi.s/her circum.stances. This differs from sympathy which Davis (2009) defines as 'an emotional response to... .suffering.' Teams that have empathy for one anoth- er and bring understanding to their working patterns can have a significant influence on the c|uality of care in the home. Regardless of the way teams are organized, or the resources available, good interpersonal communication remains a key strategy toi' effective team connection.

Team members can develop the ([uality of their interpersonal skills by establishing self-awareness, enhancing attentive listen- ing, and recognizing the blocks lo giving complete attention to others (.luring con- versation. Good quality communication can potentially reduce complaints and stress factors, whilst heightening motiva- tion in the workplace. MM Burnard. I'. (iOOT) Ckmn.sclliiig Skills iiir llc:illh Prott's.si<)nal.s. 4lh edition. Ncl.son 'I'liorncs.

Chettenliam.

Corey, G. (2009) Ttieory and Practice of Coiin.seling and Psychotherapy. Kigtit edition.

Thom.son, Brooks /Cole. United Kingdom Davis, M.A. (2009) A perspective on cultivating empathy.

Conipk'mentaiy Vn'mpics in CliiiiCiil Practice. 15, Pages76-79.

Evans, G. (2007) Counsetting for Dummies. John Wiley and Sons Ltd. Cliictiester Engtantt.

Erankel (1984) cited in Hilton D. and Fallowfield L.

Editors (1993) Counselling and communication in Health Care.

John Wiley and Sons .Ctiiche.ster.

Hilton, D. And Fallowfield, L. 0 editors (1993) Coun.selling and Communication in I leattli Carejohn Wiley and Sons, Chichester.

Sheehan, I). Kotier.st.son. I, and Ormond, T (2007) Comparison of language u.sed and patterns of communication in interprofe.ssionat and niultidisciptinary teams ¡aiinia/ (if Interprofessional Care Key points Effective interpersonal st

368 Nursing & Residential Care, August 2010, Vol 12, No 8 Communication QUESTIONS Are you a good listener or do you use 'blocks' to filter information?

Why is silence a useful tool?

Why should you be aovare of your listening skills?

How can teams develop the quality of their interpersonal skills?

ANSWERS 11 Remind yourself of how it felt when a lis- tener was not paying attention to you. You may recall feeling annoyed, disrespected, and unimportant to that person 2) Being aware of your blocks to listening will enable you to give your complete atten- tion to the speaker.

Pay attention to how you listen and change poor listening habits.

3) Silence is a u.selul tool becau.se it allows the speaker time to think about what has been said and how the words made them feel. Silence makes space for reflection and in some instances coming to term with a problem, or finding a solution.

In times of grief simply sitting with the resident or family member can be more supportive than offering advice.

4) leam members can develop the quality of their interpersonal skills by e.stablishing self-awareness, enhancing attentive listen- ing, and recognizing the blocks to giving complete attention to others during con- versations. Good quality communication can potentially reduce complaints and stress factors, while heightening motiva- tion in the workplace.

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