The exchange of thoughts, messages, or information, as by speech, visuals, signals, writing, or behavior.

Derived from the Latin word "communis", meaning to share and the Latin verb communicare that means to make common

The transfer or conveying of meaning (Oxford Dictionary) One mind affecting another (Claude Shannon) Transmission of stimuli (Colin Cherry) One system influences another (Charles E. Osgood) The mechanism through which human relations exist and develop (Wilbur Schramm)

Communication is the process of transmitting feelings, attitudes, facts, beliefs and ideas between living beings. (Birvenu) Communication is the exchange of meanings between individuals through a common system of symbols. (I.A.Richards) Communication is the sum of all the things one person does when he wants to create understanding in the mind of another. It is a bridge of meaning. It involves s systematic and continuous process of telling, listening and understanding. (Louis Allen)

Education and Instruction Information Entertainment Discussion Persuasion Cultural promotion Integration

Input Sender Channel Noise Receiver Output Code

Input. Sender has an intention to communicate with another person that makes up the content of the message. Sender. Sender encodes the message, e.g. the idea of "piece of furniture to sit on" Thus he gives expression to the content.

Channel. The message is sent via a channel, which can be made of a variety of materials. In acoustic communication it consists of air, in written communication of paper or other writing materials.

Noise The channel is subjected to various sources of noise. E.g. telephone communication, where numerous secondary sounds are audible. Receiver The receiver decodes the incoming message, or expression. He "translates" it and thus receives the message.

Output This is the content decoded by the receiver. Code The codes of the sender and receiver must have at least a certain set in common in order to make communication work.

encoder

decoder

sender
decoder

message

channel

receiver encoder

noise

feedback

 Communicator

(sender or encoder)

is the one who initiates the communication process by starting a dialogue.

is the formulation of messages in the communicators mind.

Encoding

A message is what a communicator actually produces for transmission using spoken or written words, photographs, paintings, films, posters, etc. A channel Is the vehicle through which a message is carried from the communicator to the receiver.

The Receiver the receiver should have the ability to listen, to read, to think, to be able to receive and decode the messages in the manner the communicator want him to. Decoding Is the interpretation of the message by the receiver.

 Feedback Is the response or acknowledgement of receiver to the communicators message. Exchange is possible only if the receiver responds.

Noise Is an interruption that can creep in at any point of the communication process and make it ineffective. Environment is one major cause that interferes with message reception For smooth and effective communication, it is necessary to eliminate or reduce noise as far as possible.

Visual channel receiver use sight to process information. Most effective and most frequently used Auditory channel receiver uses hearing. Includes not only word spoken but also how the words are spoken(tone, pitch) Kinesthetic channel uses touch and other physiological responses to convey meaning

 Intrapersonal

communication Interpersonal communication Group communication Mass communication Non-verbal communication

It occurs when an individual sends and receives messages internally. use of the central nervous system (CNS) and peripheral nervous system (PNS) for generation, transmission, and receiving of messages. involves understanding our intellect as well as our physical and emotional sensations.

Physical self - our bodily parts, the various systems that perform the bodily functions and the five senses that help us receive external stimuli. Emotional self - prompts our emotional responses to stimuli like fright, flight and fight, etc. Intellectual self - mental actions or behavior like word and sentence formation, use of comparison, use of logic and reasoning, problem solving, and decision making, etc.

there is more to the self-concept because we maintain separate private and public selves. Johari Window. Created by social scientists Joseph Luft and Harrington Ingham. This model compares various aspects of open (public) and closed (private) communication relationships.

Johari Window

The open section known to you and known to others. The hidden section - known to you but unknown to others. The blind section unknown to you but known to others. The unknown section - unknown both to you and others.

face-to-face interaction between two persons, both are sending and receiving messages. Ideal and effective communication situation because of immediate feedback. clarify and emphasize many points through your expressions, gestures, and voices.

Proximity between sender and receiver can motivate, encourage, and coordinate work more effectively than any other form of communication. in a crisis, through interpersonal channel, flow of information is tremendous e.g. news of violence, famine or disaster

Functions of interpersonal communication Linking function - connects a person with his or her environment. Mentation function - helps us conceptualize, remember, and plan Regulatory function- serves to regulate our own and others behavior.

an extension of interpersonal communication. Group is a number of people with a common goal who interact with one another to accomplish their goals, recognize one anothers existence and see themselves as part of the group. Groups provide an opportunity for people to come together to discuss and exchange views of common interest. A group needs to have at least 3 members to form a coalitions and some kind of organization is present.

communication with mass audiences channeled through mass media. Any mechanical device that multiplies messages and takes it to a large number of people simultaneously is called mass communication. The media through which messages are being transmitted include radio, TV, newspapers, magazines, films, records, tape recorders, video cassette recorders, etc and require large organizations and electronic devices to put across the message.

Functions of Mass Communication To inform To educate To entertain and To persuade

Information that is communicates without using words the total impact of oral message is only about 7% verbal, 38% vocal and 55% non verbal. (Albert Mehrabian, expert on body language and author of books like silent messages)

 Types

of non-verbal communication Facial behavior our faces reveal how we are feeling inside while we might be trying to present a different emotion

 Types

of non-verbal communication Kinesics or body movement Emblems Illustrators Regulators Affect display

 Types

of non-verbal communication

Posture and gestures the way stand or sit or the way we walk are strong indicators. Personal appearance Manipulate personal appearance to look good.

 Types

of non-verbal communication

Clothing Clothing and adornments can be sources of information about a person. It may convey social and financial status, culture, religion, group association, and self-concept

 Types

of non-verbal communication

Proxemics Study of distance between people in their interaction. Intimate: touching to 1 feet. Personal: 1 feet to 4 feet. Social: 4 to 12 feet. Public: 12 to 15 feet.

 Types

of non-verbal communication

Smell and taste Particular fragrance announces the arrival of a particular person. Body odors provide us clues about a persons hygienic state. Like smell, taste is also a silent sense that receives and sends messages

 Types

of non-verbal communication

Environmental factors Architectural arrangement of objects, interior decoration, colors, time, music, etc provide a lot of non verbal cues and clues. Dim lighting, quite atmosphere, and soft music leads to greater intimacy and has a soothing effect.

 Types

of non-verbal communication

Body language constitutes 55% of what we are communicating. If we wish to communicate well, we have to understand how you can (and cant) use your body to say what you mean.

1. 2. 3. 4. 5.

Upward communication Downward communication Horizontal/ Lateral communication Diagonal communication Grapevine communication

Upward communication Communication that flows to a higher level in an organization

1.

2. Downward communication

Communication that flows from a higher level in an organization to a lower level.

2. Downward communication

Strategies for successful downward communication (Sullivan and Decker, 1992) a. Know what needs to be done, who should do it, and steps needed to complete it. b. Eliminate as much interference as possible, allowing subordinates to listen effectively. c. Give information clearly and concisely, using appropriate vocabulary and non offensive voice tone, making sure that all needed information is included. d. Actively solicit feedback to ensure that subordinates have accurately and completely received the message. e. Follow up by answering questions and verifying that tasks are being performed according to the instructions given

2. Downward communication

Used by the managers for the following purposes: 1. Providing feedback on employees performance 2. Giving job instructions. 3. Providing a complete understanding of the employees job as well as to communicate them how their job is related to other jobs in the organization. 4. Communicating the organizations mission and vision to the employees. 5. Highlighting the areas of attention

2. Horizontal/ Lateral communication

Communication that takes place at same levels of hierarchy in an organization

3. Horizontal/ Lateral communication advantages: Time saving. Facilitates coordination of the task. Facilitates cooperation among team members. Provides emotional and social assistance to the organization members. Helps in solving various organizational problems. Means of information sharing. Can also be used for resolving conflicts of a department with other departments or conflicts within a department.

4. Diagonal communication Communication that takes place between a manager and employees of other workgroups.

5. Grapevine communication An informal communication network

5. Grapevine communication An informal communication network spreads rumors and gossips at all the levels of the organization. Neither pre-planned nor deliberately motivated by the management. Neither written or documented or recorded.

1. 2. 3. 4. 5. 6.

Active listening Responding. Clarifying. Dealing with conflict. Advanced communication skills Being appropriately assertive in communicating with others

1. Active listening attending requires the listener to pay more attention to taking in the message that preparing or forming a response (Sullivan and Decker,1992)

1. Active listening Eight key principles of active listening 1. Minimize distractions 2. Look directly at the other person 3. Pay attention to both verbal and nonverbal messages 4. Ask questions to clarify if needed 5. Use empathy 6. Get feedback about what you are hearing 7. Acknowledge the other persons message and feelings 8. Be patient; avoid finding instant solution

2. Responding The listener acknowledges in some way the he/ she has received the message. Includes actions like: 1. Nonverbal affirmation, like nodding the to indicate that message has been received. 2. Verbal affirmation like yes or I hear you 3. Questioning to clarify the message. So you mean that... 4. Rephrasing or restating the key point of the message, to affirm the message has been received accurately. What Im hearing is that

3. Clarifying. Allows listeners to accurately process information that may be disorganized or not clear. To clarify, listeners also uses restating and questioning to clear up any information that is confusing or contradictory

4.

Dealing with conflict. Essentials for dealing with conflict (Ruthman, 2003) 1. Identify the problem. 2. Delineate. 3. Resolve.

5. Advanced communication skills Appropriately assertive behavior plus consistent active listening allows the nurse leader to practice advanced communication skills

5. Advanced

communication skills Skills according to Ruthman (2003) include: 1. Focusing 2. Providing information 3. Reassuring

5. Advanced communication skills Skills according to Ruthman (2003) include:

4. Using appropriate humor. 5. Expressing acceptance or appreciation. 6. Asking questions to expand listeners understanding.

6. Being appropriately assertive in

communicating with others

Means the ability to stand up for ones rights and needs without violating the right of others.

Being appropriately assertive in communicating with others Behaviors appropriate to professionally assertive communication (Smith, 1975) 1. Do not apologize unless you are clearly at fault, or you know who is at fault and you are taking responsibility for what happened. 2. Avoid reaction such as tantrums, revenge, sarcasm, and threats, which increase listeners defensiveness and decrease speakers ability to communicate effectively.

Being appropriately assertive in communicating with others Behaviors appropriate to professionally assertive communication (Smith, 1975) 3. Make sure that nonverbal and verbal messages are consistent. 4. Avoid a knee-jerk reaction to negative responses or criticism from patients, staff or family. 5. Use I statements to convey feelings, and be honest about feelings, needs, or ideas. 6. Acknowledge faults but do not overly apologize for them.

1. Language barrier Lack of common language Semantic barrier Poor vocabulary Poor grammar and punctuation Roundabout verbiage

2. Physical barrier Noise Time Distance Age Sex

3. Socio-psychological barrier Status barrier Attitudes and values Different perception of reality Inference Abstracting Close-mindedness Distortion, filtering and editing Bad listening Emotions Resistance to change

A. Communicating with people inside the organization 1. Organizational roles 2. Hierarchies 3. Formal and Informal communication paths within the organization 4. Public communication

Communicating with people inside the organization 1. Organizational roles persons role in the organization affects how that person sends and receives information. These roles are usually categorized according to the organizations levels and hierarchies.

Communicating with people inside the organization 2. Hierarchies Upward communication with superiors. Downward communication with subordinates Lateral (or horizontal) communication with peers/ coworkers. Diagonal communication with people at different hierarchical level within the organization.

Communicating with people inside the organization 3. Formal and Informal communication paths within the organization Official (formal) paths that are clearly documented and spelled out. (official reporting mechanism like memos, emils, reports) Unofficial (informal) paths. Numerous ways that information makes its way through the organization.

Communicating with people inside the organization 4. Public communication (to small, medium, and large group) the size of the receiving group affects how the message is organized and delivered. The larger the group, the more difficult the task of ensuring that message is transmitted and received appropriately

B. Communicating with patients and families Points to keep in mind when dealing with patient and family issue (Sullivan and Decker,2001) 1. Patients are customers and should be communicated with honesty and treated with respect. 2. Nurse leaders need to find a balance between avoiding medical jargon that is too complex and using terms that are too simple and condescending.

B. Communicating with patients and families Points to keep in mind when dealing with patient and family issue (Sullivan and Decker,2001) 3. Provide angry and upset customers a private, neutral place for communicating their needs. 4. When possible, if customers are not a native speakers and /or not fluent in English, try to provide an interpreter. 5. Learn about different cultures in order to be able to recognize communication issues that are culturally based

C. Communicating with difficult people 1. Hostile and aggressive People who blame other people for their situation and for triggering their angry, demeaning reaction. Coping mechanism: stand up for yourself and not to engage in an argument. Remove from public view if possible e.g. I dont agree or I see things differently. Lets discuss this further

C. Communicating with difficult people 2. Complainers and negativists Are Individuals who criticize or unsatisfied with given situations or decisions. Coping mechanism: not agreeing with them and asking for their view on how to: structure the problem, analyze the negative consequences of the final decision, and help them solve or accept the negative aspects of the best solution while reminding them of their role in constructing the solution.

C. Communicating with difficult people 3. Silent, unresponsive people Have learned that by simply never speaking, they dont have to participate in problem solving. They dont take responsibility for decisions. Coping mechanism: keeping silent after posing your concern, until the person speaks. If he refuses to speak, repeat your concern and remain silent. No response, you will make the final decision.

C. Communicating with difficult people 4. Superagreeable people Those who want to please everyone even if they cant. Are highly stressed to explain that they are unable to do something because it might displease the leader. Coping mechanism: assure the affected person that it is all right to say if they are currently unable to complete their work.

C. Communicating with difficult people 5. Knows-it-all People who are only impressed with their own views and facts even if they are not always correct. Coping mechanism: suggest that they review the facts of the situation, and point out the discrepancies of those facts to convince themselves of their errors.

C. Communicating with difficult people 6. Indecisive People who have difficulty in making decisions because they see impediments to any given course of action. Coping mechanism: leader should assure that what they tell will not be insignificant.

Diversity Aging population Ongoing and rapid changes in technology

A. Diversity 1. Cultural diversity. Different ethnic and cultural communities, each with its own practices about communication, food, medical practices, hygiene, etc.

A. Diversity 2. Religious diversity Different religious practices affect peoples willingness to undergo treatment, how they view different parts of the body, their perspective on different medications and treatment they are willing to undergo.

A. Diversity 3. Familial diversity. The traditional nuclear family of one male parent, one female parent (married to each other), and two children is no longer a norm. Families today may consist of unmarried opposite sex partners, an array of closelyrelated or loosely knit kin, neighbors, same-sex partners, intergenerational groups, multicultural or multiracial groups(Caroll,2004).

B. Aging population As people grow older, they have more illnesses, and may be more limited in their ability to hear and speak that changes they ability to communicate effectively. Nurse leaders need to be aware of this trend and adapt their communication skills accordingly.

C. Ongoing and rapid changes in technology The trend is toward electronic communication, including e-mail, voice mail, cell phones and hand held devices that make communication more and less effective. People with less education, those in rural areas, and people with low incomes have less access to technology-assisted communication

We

have two ears and one mouth so that we can listen as much as we speak ~ Epictus
Greek philosopher associated with Stoic, AD 55-c.135

He

who knows, does not speak. He who speak, does not know ~ Lao Tzu
(Chinese Taoist Philosopher, founder of Taoism, wrote Tao Te Ching (also the Book of the Way). 600 BC - 531 BC

Kind words can be short and easy

to speak, but their echoes are truly endless ~ Mother Teresa of Calcutta
Albanian born Indian Missionary and

Founder of the Order of the Missionaries of Charity. Nobel Prize for Peace in 1979. (1910-1997)

To

effectively communicate, we must realize that we are all different in the way we perceive the world and use this understanding as a guide to our communication with others

~ Anthony Robbins

(American advisor to leaders)

The most basic of all human needs

is the need to understand and be understood. The best way to understand people is to listen to them."

~ Ralph G. Nichols
Author of Harvard Business Review on Effective Communication

Caroll, Patricia L. (2006) Nursing Leadership and Management: A Practical Guide, Thomson Delmar Learning Tomey, Ann Mariner (2004) Guide to Nursing Management and Leadership. 7th Edition. Mosby Marquis, Bessie L. and Huston, Carol J. (2009) Leadership Roles and Management Functions in Nursing: Theory and Application. 6th Edition. Lippincott Williams and Wilkins. Tan, Crestita B., Beltran, Eden I., (2009) Leadership and Management in Nursing: A Transformative and Reflective Patient Care. 1st Edition. EPH

THANK YOU