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SECTION 5: COMMUNICATION

 

This section continues from the early section on working with others. Often, we are not sure whether the issue is the other person or our communication with one another which is causing problems. This section looks at how we can use communication more effectively to manage difficult situations.

 

Scenario 4: Nasim “Lin was the kind of colleague that everyone hoped they would not be on shift with. Whilst much of the time the work was of a just about good enough standard, and whilst Lin could be nice and accommodating, when Lin made mistakes, they were far reaching ones. We had had several complaints, but when we had tried to sort these out, Lin became defensive, aggressive and psychologically erratic. I feared another error happening, not just because of the effect it could have, but also because I dreaded having to speak to Lin about it. As someone with an interest in education and development I usually was the one who had to deal with Lin, and I was starting to lose sleep over the next time this would be the case. I had already had a difficult situation when Lin claimed that I was acting in a bullying and undermining way. I also felt that I had been cowardly in not always facing up to doing what should have been done in terms of managing Lin. After all, if I had managed the situation better maybe I would not have been facing this now.”

 

As acknowledged above, communication is very often a feature of ineffective personal and professional practice. Poor or non-communication leads to misunderstanding, emotional negativity and inaccurate assumptions being made. Communication is cited as one of the main causes of medical error and can adversely affect working relationships and productivity (Starmer et al 2014) Effective communication means we can deliver difficult information without causing conflict or losing trust, but it is a skill that has to be developed and does not come easily to most of us.

Effective communication is not just about exchanging information but is about understanding the emotions and intentions behind that information. Good communication is a two-way street; we need to ensure that the person we have said something to has understood it as we intended it to be understood and that involves checking with them. Good communicators use their nonverbal communication skills, or body language to reinforce to what they are saying, not to contradict it, thus gaining trust from their listener, and they show when they are listening through their eye contact and body language. A feature of a highly effective communicator is that they are aware of their own and others’ emotions and how they might affect the conversation.

 

In Scenario 4 Nasim’s story is a familiar one for many of us. Nasim had perhaps avoided conversations with Lin for several reasons: wanting to give the benefit of the doubt, avoiding difficult communication, fear of repercussions. The situation had developed and Nasim felt that in fact the strategy of ‘going easy’ on Lin had failed.

 

The following clip talks about dealing with difficult people but also considers ways to communicate to minimise difficulties. It reflects some of the areas we looked at in the previous section and ends with strategies for enhancing our communication. https://www.youtube.com/watch?v=kARkOdRHaj8

 

Let’s look at communication and difficult conversations in some further detail.

Reflection 1: Think of two or three times you have been reluctant to have a conversation with someone either because you thought they were difficult to deal with, or there was a difficult situation that required addressing. How did you avoid the conversation? How did you feel about it? What triggered the conversation when it did happen? How well did it go? What helped – or hindered your ability to manage the conversation? This can be done individually or in small groups. If in small groups, please share thoughts.

 

Why do we avoid difficult conversations?

There are several barriers to effective communication:

 

1. Stress and negative emotion. When stressed or emotionally overwhelmed, we are more likely to misread other people, send confusing or off-putting nonverbal signals, and lapse into unhealthy knee-jerk patterns of behaviour. We worry that maybe it is just us who struggles with this person or that we do not have the skills to conduct the conversation that is needed.

2. Lack of focus. When emotions come into it, we find it difficult to focus on what the issues are, and what might be personal prejudice. Maybe we merely don’t like the other person. Maybe we do not have the evidence we need to conduct the conversation.

3. Inconsistent or negative body language. Non-verbal communication should reinforce what is being said, not contradict it. If we say one thing, but our body language says something else, our listener probably feels we’re being dishonest. We sometimes fear that we will let ourselves down in this way. Unless we are aware of our body language, we fear that we will contradict ourselves and send the wrong signals. It is important to avoid sending negative signals even if we are having a difficult conversation.

“It’s not what you say, but how you say it!” is a widely held belief. In truth both are important. Both what we say and how we say it have impact. Consider different ways of communicating for different purposes:

• An open team meeting is useful if you want to persuade and influence a team with a new idea. In person they can see your enthusiasm and passion, and you can clarify any questions they have. If you can do that spontaneously they are more likely to believe in the idea than if you prepared a paper and offered no discussion.
• Emails are essential in our workplace but try to confine them to giving information only. Where we run into problems with emails is usually when they can be misinterpreted, involve different opinions or possible conflict.
• One to one conversations are more appropriate for breaking bad news or for difficult conversations. Just as you would not email a patient with fatal test results, so you would not resort to email to manage a colleague or learner related issue. Whilst we have different relationships with colleagues, patients and learners, there are some core requirements for all, as all are human. Clarity, honesty, and a calm approach are all essential.
• Presentations are useful for large group, one-way communication, and can benefit from visual stimuli. They need to be entertaining, clear, and attractive to look at and listen to. Think of what makes a good film and avoid the kind of presentation where cramped text is read aloud monotonously.

The following link is a useful resource about different aspects of effective communication https://www.helpguide.org/articles/stress/stress-symptoms-signs-and-causes.htm

 

Transactional Analysis

Some forms of communication with colleagues are especially challenging and require advanced skills of understanding the patterns of behaviour that are identified in Transactional Analysis (TA).

TA is founded on the principles that:

• People can change
• People have a right to be in the world and to be accepted

Developed by Eric Berne (1964) TA analyses social transactions, or communication to identify the unconscious psychological patterns we bring to our communication with others. It may be that our psychology is adversely affecting our communication or that the psychology of others directs the kinds of conversations we have. Few of us can become trained TA analysts but these three clips explain in simple terms the basis for the difficulties we might have with some of our colleagues and in communicating with them. Especially useful is the middle clip which outlines the nature of games that are played out both consciously and unconsciously:

• Theramin Trees (2010) Transactional analysis 1: Ego states and basic transactions https://m.youtube.com/watch?v=nKNyFSLJy6o
• Theramin Trees (2010) Transactional Analysis 2: Games https://m.youtube.com/watch?v=YOqJ4sc9TAc
• Theramin Trees (2010) Transactional Analysis 3: Gimmicks https://m.youtube.com/watch?v=58F2qYyAzME

 

Some people repeat communication patterns from childhood which are destructive to them and those around them. Remember that you do not have to engage with such patterns, and if you are honest, respectful, consistent and clear, it is easier to avoid the kinds of conversations which we all dread.

 

Here is a simple set of suggestions for acting in a way that will limit the number of games you are drawn into: Ask open questions that put the responsibility back on the other person Stay calm Maintain eye contact Remember that you and the other person are equal, not inferior or superior Remember that we all have a right to an opinion, and a right to disagree with other’s opinions Try to remain in the here and now and not be influenced by previous information or encounters Ask for information if feeling unclear or afraid Avoid making assumptions – seek to clarify information Be flexible and prepared to act on new information Recognise that others are doing their best Avoid trying to take over or ‘fix’ things for people Be consistent Give compliments when you feel they are deserved but don't if they are not Accept compliments graciously

 

Negotiation Skills

So much of our communications at work are negotiations. From working with a patient to manage their health, to inter professional working and even with our own closest colleagues. Negotiation skills are part of life and most of us have learned them in the workplace and in other social contexts. However, our ability to negotiate can be compromised when we are stressed, or preoccupied. The following information offers a reminder as to how we can best organised and proceed with our everyday negotiations.

To help you get your preparation right, here are eight factors to consider in advance:

Step 1: Prepare to negotiate

1. Goals. What are you trying to achieve during the negotiation? And what do you think the other person's goals will be?
2. Trades. What might you be able to ask for, and what would you be prepared to give away?
3. Alternatives. If you really can't achieve your goals, what would be your "best alternative to a negotiated agreement" (BATNA)? Your position will be more secure if you have a number of options, so it's worth putting plenty of effort into addressing this point.
4. Relationships. How have negotiations gone with this person in the past? Just as importantly, what kind of relationship do you want with them in the future?
5. Expected outcomes. What precedents have been set? Based on those, and on any other evidence you have, what seems to be the most likely outcome of this negotiation?
6. Consequences. Is this a big, one-off deal, or one of many smaller negotiations? What do you and the other party stand to gain or lose?
7. Power. Who holds the power here? How might this affect the negotiation process?
8. Solutions. Taking all these points into account, what do you now consider to be a fair outcome – one that you can put forward with confidence?

 

Step 2: Think about the following inter relational principles:

1. Treat the other person with respect.
2. Separate the person from the problem.
3. Understand their point of view.
4. Listen first, talk second.
5. Stick to the facts.
6. Explore options together.

 

Step 3: Achieve a ‘win-win’

1. "Expand the pie," extending what's on offer to accommodate both parties.
2. Suggest alternative solutions, exploring various possibilities that might work for everyone.
3. Trade favours, each of you agreeing to honour priorities for the other side.
4. Offer compensation, recognizing where sacrifices have been made.

The information above came from the following website which offers further support and information.

https://www.mindtools.com/pages/article/essential-negotiation.htm

 

Scenario 4: Nasim’s outcome Nasim fell into a common pattern of hoping that Lin’s issues would either improve or go away. Assuming that avoiding facing up to the situation was kinder than tackling it, Nasim inadvertently allowed it to worsen. The first and only time that any communication about any difficulties had taken place, Lin had complained to other colleagues about Nasim, who then felt isolated, and that the communication had been poor. Communication is invested with emotion and assumption, and with difficult conversations it is often best to start as soon as you know there is an issue. Compassion can often mislead and being clear and supportive can often be more helpful than excessively explaining or making allowances. Lin had two issues – the errors that were made and the aggressive and accusatory behaviour when it was discussed. Professionals can often feel isolated by having to deal with difficult colleagues, and this is where communication with the other colleagues in the team or department can help. To minimise the concern that Nasim might be being personally and emotionally subjective, discussion with others would have confirmed the collective view of Lin’s behaviour, and given valuable evidence to help substantiate and illustrate the nature of the issues. Ways in which Nasim could have communicated more effectively here include: Asking the whole team for their views Talking to Lin early on in a clear, honest and dispassionate way Documenting the conversation Assisting in drawing up a plan of action Holding regular conversations to support the plan of action Making clear that aggressive and accusatory behaviour would not be tolerated This scenario has other issues apart from the communication related issues, as there are educational and occupational concerns too. However, focusing on the communication shows how often we can find that effective communication can improve our and others’ personal and professional effectiveness in the workplace.

 

What can we learn from this scenario?

In her book Shut up and say something: Communication Strategies to Overcome Challenges and Influence Listeners, Karen Friedman (2011), a communication coach, suggests we consider the following features of effective communication:

• Be direct, to the point and concise.
• Give a headline message first, avoid being long winded and offer the single most important point of your message at the start. After all, this is how newspapers communicate and gain attention.
• Match your nonverbal communication to your message, so ensure that voice tone, eye contact and body language are consistent
• Remember the world does not revolve around you, so spare a thought for your listener and make it easy for them
• Ask for specifics if you do not understand. If someone suggests a new way of doing things, ask them for an example of when it worked for them before
• Give bad news personally. It might be difficult, but it is so much better for the recipient. After all, you are not receiving the bad news so however challenging it is for you it cannot be as bad as it is for them.