Developing Leadership Skills for Health and Social Care Professionals

Annie Phillips

• Publisher: Routledge
• Year: 2021
• eBook ISBN: 9781000552584
• Edition: 1
• Topic: Medicina
• Subtopic: Atención sanitaria

Do you want to develop effective supervisory, people and management skills? If you work in health or social care as a manager or clinician, deal with people on a daily basis, and need these dealings to be thoughtful, effective and stress free, this is the book for you. It teaches you how to understand and alleviate barriers to effective communication, manage the stresses and conflicts, and develop the effective clinical, people and management skills you need to navigate successfully through a career in healthcare. It challenges the reader to re-construct their approach to leadership and encourages the development of interpersonal, observational and caring skills. This highly practical guide, and its companion volume Developing Assertiveness Skills for Health and Social Care Professionals are essential tools for all health and social care professionals, particularly those in acute medicine, primary care and the community. It is also highly recommended to those without a management role wanting to understand how to develop their relationships with their colleagues and managers.

Section 1

Assertiveness skills

CHAPTER 1

Why is assertiveness important?

All of us have the right to be treated with respect, to be listened to and taken seriously. We have the rights to set our own priorities and to choose for ourselves. We have the right to express our own feelings and opinions without fear. We have the right to make mistakes.

These rights are important at a personal and professional level, but crucial to anyone developing leadership skills, when the expectations are higher and our need to communicate well in a highly complex and demanding work context such as health and social care is even more important. Behaving assertively helps us to take charge and acts in ways that invite respect, accepting our own limitations and strengths, leading to clearer communication.

Assertive skills alone enable us to fulfil our clinical or management roles in any integrated health or social care setting more effectively, and to cope more readily with feelings of frustration or inadequacy. This book takes us one step beyond, taking a broad look at the range of interpersonal communication skills required to communicate at a higher level, developing the reader’s professional or leadership qualities. Anyone who works in either the public or private sector as clinician or manager, anyone who deals with people – colleagues, senior staff, the public – on a daily basis, and needs these dealings to be thoughtful, effective and stress free, will benefit.

To be assertive does not mean you will always get what you want, or that all your problems will be solved. It is one tool among many. Assertive techniques help us to communicate in constructive and satisfying ways, to achieve workable results in difficult situations, and can assist in resolving conflicts without aggression. These are essential techniques to understand and use in all our work roles.

Assertiveness is a skill that is particularly important for women. Women make up the majority of workers in the caring professions; and they are much more likely than men to put themselves last, and can therefore find it harder to communicate their own needs or to develop themselves or their career. There are some noticeable gender differences. Both sexes draw constantly on their emotional and intellectual resources when dealing with clinical and managerial conflicts, and struggle to provide a good service with limited resources and sometimes little peer group support. Women, however, are more likely to feel guilty when they do not, or are unable to, live up to the caring image. Women are socialised to want to be thought of as indispensable: the work can involve sacrifice; we find it hard to delegate and certainly do not want to offend. Although men generally find it easier to be assertive, some find it harder to develop the fine-tuned and complex verbal and non-verbal skills needed to listen and communicate with empathy, sympathy and focus. They sometimes tend towards aggression rather than passivity, and may struggle to rein in or understand their own emotional responses if they have not been socialised to do so. Thus, generally, more women than men seek ways to become more assertive.

In teaching assertiveness, I like to think we are looking at behaving with good intent, and integrity, with the motivation to care for others and ourselves, being kind and thoughtful in the ways we conduct ourselves at work, paying attention to ourselves and others in a focused, compassionate way. It is important that we are motivated to behave with understanding and tolerance, and this in turn helps to generate and feed our own, and other people’s, good feelings. Compassion requires thoughtfulness, curiosity and openness, and it also at times requires courage – and these are qualities that we all at times struggle with. We have to be brave to be assertive.

Thus, used well, assertiveness is not about behaving selfishly, but rather about using our skills of attention, reasoning, awareness of feeling and behaviour to build the attributes of sensitivity, sympathy, empathy, non-judgement, care, and compassion for others and ourselves. The assertive person recognises their own limits and is able to call a halt before they burn out. They give themselves time to rest and replenish their energies, and recognise that their needs are no more or no less than others, but equal.

SOME OF THE SITUATIONS THAT ASSERTIVE BEHAVIOUR CAN HELP WITH

• ➤ Complex communication: conflict, manipulation, aggression.
• ➤ Time management.
• ➤ Identification of obstacles to career or personal development.
• ➤ Overcoming work and people demands.
• ➤ Making and refusing requests.
• ➤ Handling criticism and compliments.
• ➤ Coping with rejection, building self-esteem.
• ➤ Giving constructive criticism.
• ➤ Staff appraisals and disciplinary procedures.
• ➤ Negotiating.
• ➤ Goal setting.

Behaving assertively helps us to communicate directly and powerfully at work; and can also defend against aggression or defensive behaviour when hopes and plans are thwarted. Negotiation and compromise form the lynchpin in assertiveness training. The assertive person takes charge and acts in ways that invite respect. This in turn leads to clearer communication, and any potential confusion or discord is alleviated.

There are many unusual management situations in the private and statutory healthcare sector: senior practitioners and clinical managers who are torn in many ways, balancing the demands of their staff with those of clients/patients and managers, needing to uphold professional standards while acknowledging financial pressures and the needs of the service overall; GPs, who now have to balance their professional and commissioning role; practice managers, unique in their role as representatives of general practice, acting as advocates for the staff and patients, leading and yet in turn ‘managed’ by their employers, the GPs, clinicians and the practitioners, all of whom have to find the very best for those they help while working to the management and government agenda, balancing personal and professional needs, and managing tensions – what is best for the client within the resources available? These unusual and diverse relationships can cause conflict. Assertiveness skills enable us to see our role more clearly and cope more readily with feelings of frustration or inadequacy. We need to be able, too, to express anger, frustrations and anxiety constructively in order to prevent further stress, improve management and improve services.

Eric Berne¹ was one of the first psychologists to identify behavioural traits in communicating which impacted on the success of the communication. His term for what we would now call assertiveness was ‘adult’: the assertive response is ‘in adult’: a neutral and fair communication style.

A quick checklist may show you what your most usual behavioural traits are, and therefore give you some indication of your need to learn some assertiveness skills.

• ➤ Do you see yourself as someone who is passive? Avoiding conflict, a victim?
• ➤ Or aggressive, angry, defensive, and competitive?
• ➤ Manipulative? Someone who behaves in devious ways, appearing to think highly of others but with an undercurrent of disapproval.
• ➤ The assertive person, however, says what they want, respectfully, without resorting to anger or manipulation; they take responsibility for themselves, their needs, feelings and reactions.

We are all a mix of behavioural styles, and our history and genes dictate our personality traits to some extent, but it is possible to communicate more honestly, openly and directly, and avoid the manipulation, anger and passivity that may be a more habitual stance.

Assertiveness is especially relevant for us as workers in the caring sector, because we do care: we care inherently for the people we work with and for, and our organisation. We can therefore feel very guilty when we do not, or are unable to, live up to the caring image. We often think of ourselves as indispensable: our work can involve sacrifice; we often find it hard to delegate. We do not want to offend. It is extremely easy for us to feel guilty. Consider the following scenarios:

• ➤ you feel guilty about keeping to time boundaries – you need to be available to your patients/clients and colleagues at all times
• ➤ you do not move to a more stimulating or rewarding job because you know there will be difficulties recruiting your replacement
• ➤ you do not push your staff as hard as you should because you can empathise with their difficulties around increasing public demands
• ➤ you reluctantly accept a new system of working that you have reservations about because you do not want to offend the colleagues/your manager, who are enthusiastic about it.

Anyone who consistently behaves in this way will overstretch and exhaust themselves. They are taking care of everyone else but themselves, at huge cost to their own physical and mental well-being. They think themselves indispensible, and soon ‘burn out’.

Here is a useful exercise to do with a friend or sympathetic colleague.

EXERCISE 1

The compassion trap

Using the columns below, list those things that you do for other people because they ask you, not because you want to do them or accept that they are part of your role.

Work	Friendships	Home

For example:

Work	Friendships	Home
Always make the tea Work overtime almost every day, unpaid Take the on call every Christmas	Always arrange family gatherings Talk with X for hours on end even through I have other family demands	Do majority of the housework Go to parent’s evening every time

• ➤ Swap lists.
• ➤ Role play the situation. Your part is to say ‘no’,...

Table of contents

• Cover
• Title Page
• Copyright Page
• Table of Contents
• Foreword
• About the author
• Acknowledgements
• Introduction
• Section 1 Assertiveness skills
• Section 2 Assertiveness and leadership in the workplace
• Section 3 Personal management skills
• Section 4 Applying leadership skills
• Index