Develop Your Interpersonal and Self-Management Skills

A Practical Resource for Healthcare Administrative and Clerical Staff

Karen Stainsby, Hussain Gandhi

• Publisher: CRC Press
• Year: 2018
• eBook ISBN:
  9781315358130
• Topic: Medicina
• Subtopic: Teoria, pratica e riferimenti medici

This work contains forewords by Richard Mcdonough and Mari Robbins, respectively, a Member of Council, The Association of Medical Secretaries, Practice Managers, Administrators and Receptionists (AMSPAR); and, a former college lecturer in health studies, and a management and training consultant. "I wrote this book to help you in your work role, to provide information and practical suggestions. A large part of what you do involves communicating with other people: colleagues, patients, relatives, carers and the general public. Given the complexities, vulnerabilities and sometimes 'demanding behaviour' of other people, this may at times be an arduous task. Healthcare jobs take their toll on people, and being able to manage the various demands without being ground down is a great challenge. This book will help to affirm and build upon what you already know in a way that supports both you and your work." - Karen Stainsby, in the Preface.

Part I: Communication

Chapter 1

Good communication

What is ‘communication’?

You seldom listen to me, and when you do you don’t hear, and when you do hear you hear wrong, and even when you hear right you change it so fast that it’s never the same.

Marjorie Kellogg

The ability to communicate, to exchange information, ideas, feelings, hopes, dreams and fears, is perhaps the most influential factor in human development. Grunts and the use of basic body language were how humans began the process of giving each other information. Now, within a matter of seconds, we can talk and write to people on the other side of the world. Messages are sent into outer space with the hope that one day we might communicate with life from other planets and galaxies. People who have undergone massive injuries to their brains or bodies are taught other ways to communicate using, for example, tiny muscle movements. The need and drive to communicate seems paramount to us.

We can’t ‘not communicate’ with others; we do it every day in the way we dress, the use of wedding rings, bindis, tattoos, the car we drive, etc. Good poker players train themselves to keep to an absolute minimum those little tell-tale signs that say ‘I have a great hand’.

We are making marvellous advancements in the name of ‘communication’, and much of what we do is without conscious thought or effort. So why do so many of us find it difficult to communicate effectively? When communication ‘goes wrong’, so do relationships. ‘We don’t talk any more’ is a very common phrase said to me as a counsellor (most often about partners, but also about friends, relatives, work colleagues and bosses). Perhaps by looking at the mechanism behind communication, we can understand why communication breakdowns occur.

By getting your message across successfully, you accurately convey your thoughts, ideas, etc., to the listener, and they in turn perceive the message in the same way.

Effective communication involves six aspects:

1. the source, e.g. speaker, writer
2. the message, e.g. words, body language
3. the communication channel, e.g. conversation, letter
4. the receiver, e.g. listener, reader
5. the reply, e.g. spoken, non-verbal reply, written
6. the context, e.g. language, culture, occasion, type and history of relationship.

(Adapted from Shannon and Weaver, 1949.¹)

Figure 1.1 The communication process.

A communication breakdown can occur at any point in the communication process. If, for example, I am unaware that the person to whom I have sent a letter is unable to read, my message will not get across. Similarly, if the receiver does not nod their head, smile or even frown when I speak to them, I’m left wondering whether my message has got through at all. Let’s look at the sorts of things that can interfere with each part of the process.

1. The source: e.g. the person talks in a quiet voice or chews on a toffee while speaking.
2. The message: e.g. what is communicated and what is left out, what can be read ‘between the lines’. Sometimes the message is too lengthy, disorganised, or contains errors, jargon or slang.
3. The communication channel: e.g. bad phone lines, emails sent to the wrong address, talking quietly in a noisy office.
4. The receiver: e.g. ideas and feelings about the message and its source will undoubtedly influence the ability to receive and understand the message.
5. The reply: e.g. verbal acknowledgement, ‘I see’, nods, smiles or grimaces, email and letter replies, again the receiver’s ideas and feelings about the message and its source.
6. The context: e.g. cultural mismatch, failure to appreciate ‘newness’ of the relationship, wrong thing said for the occasion.

Now we know why and how it breaks down, ways to improve communication include:

• becoming more aware of the communication process in daily life
• noticing the barriers and where and when they happen
• thinking about how to reduce the degree and frequency of these barriers
• using ‘listening skills’.

You can learn more about ‘listening skills’ in the next part of this chapter.

Did You Know?

We ‘get the message’ from only about 7% of words spoken to us. The rest comes from how we use our voice and body language.²

Points to Ponder

• Think of a time when you experienced a ‘communication breakdown’. Looking at Figure 1.1, at what part in the communication process did this happen? What might have helped to prevent it from happening?
• Where do you experience most barriers to communication?

Basic listening skills

Nature gave us one tongue and two ears so we could hear twice as much as we speak.

Epictetus

Listening skills are ‘advanced interpersonal skills’. They help a person relate more effectively to others, thus building better relationships. These skills can be used anywhere and in almost any situation: with patients, relatives, carers, colleagues, friends, people at home and elsewhere.

But what is the difference between ‘listening’ and ‘hearing’? ‘Hearing’ means ‘picking up sound with the ears’, while listening means ‘hearing’ plus ‘paying attention’. Listening is a much more complex and active process.

Points to Ponder

• Do you remember a time when someone really listened to you? What did they say/do (or not say/do) that helped this? How did you feel?
• Remember a time when you did not feel listened to. What did they say/do (or not say/do) that contributed to this? How did you feel?

There are a number of listening skills that you can choose to use in different situations or when you want to achieve certain aims. Sometimes, all you want to have is a short conversation as you make your way to another department, while at other times, a more in-depth discussion may be required, perhaps to explore poor performance or to support a person who is upset. You will already have and use (perhaps unconsciously) some of the necessary skills, while others can be developed. They include:

• reflecting
• paraphrasing
• clarifying
• summarising
• challenging
• immediacy
• self-disclosure
• asking effective questions.

This section will give you information about each skill, why good listeners use it, how it helps and, if misused, how it can hinder the process of listening.

Whatever context or situation, these skills will help you to build rapport and a sense of connection. However, we also know that these skills are more effective when underpinned by three attitudes³:

• empathy
• non-judgementalism
• genuineness.

Empathy is the ability to walk in another person’s shoes, to see the world how they (not we) see it and to be able to demonstrate this to them. Empathy is different from sympathy, which is more about imagining what it might be like for us to be in that situation. Sympathy includes ‘feeling sorry’ for and ‘pitying’ the other person. Being empathic requires us to be able to distinguish between what are our feelings and thoughts and what are theirs.

Non-judgmentalism is accepting the person as worthy of being listened to despite what they are telling you. It does not mean that we accept another person’s bad behaviour. We all make judgements – it’s part of being human – but to enable and facilitate others to talk, we must be prepared to hold our judgements in check.

Genuineness is not ‘acting a part’ or ‘hiding behind’ a role (even when you are in a role).

Table 1.1 lists some of the specific listening skills.

Three further (and more advanced) listening skills include the following.

Challenging– this does not mean having a fight with someone, but gently raising inconsistencies in what they say or do, e.g. ‘Tony, you tell me that you get on well with your colleague Sue, but as you talk about her you clench your fists really tightly.’ Challenging should be used only when the relationship is strong enough to take it and balanced with empathy.

Immediacy– again, a skill to be used when the relationship has developed. Immediacy requires the listener to use their own responses to give information to the talker. For example, ‘Milly, you tell me that Mike has called you a bully and you say that this is not true. I’m not in your office and so I have not seen how you and ...

Table of contents

• Cover
• Title Page
• Copyright Page
• Contents
• Dedication Page
• Foreword
• Preface
• About the author
• Acknowledgements
• Getting the most from this book
• Part I: Communication
• Part II: Managing Yourself
• Part III: Working Together
• Part IV: Taking Care of Yourself
• Final thoughts
• Resources
• Answers to ‘Who Said This?’
• Index