COMMUNICATION IN

PHARMACY
ASSERTIVENESS…..1

Eva M A Ombaka
This session…
Understand the terms passive, passive
aggressive, aggressive and assertive and
know when to be which!
Understand the rights that govern the
behaviours
Understand and use the “I” statements
Use different assertive statements
Learnt some assertive techniques and skills
 Reading
Chapter 6 in “Communication skills in
pharmacy practice”
Chapter 7 in “Communication skills
for pharmacists”
Links:
https://youtu.be/9zbt_9R8GrM
https://youtu.be/F0A-cIZBKQ4
(4 styles)
 Reality check
Community asks you to give speech on
medication use. What is your first
reaction?
How would you react to a hostile patient?
When and how often would you talk and
counsel your patients?
What actions would you take on refill
visits?
How many patients and physicians know
 Human being Rights
Right to be treated fairly
Right to be treated with respect
Right to be separated from others
emotionally, psychologically and
physically
Not responsible how others feel
Not responsible for their action
Responsible for own thoughts, feelings and
actions
To be assertive

Say what you mean

Mean what you say
But don’t say it mean!
 Defining assertiveness
Non-assertive (Passive) behaviour: Response
designed to avoid conflict at all costs! Fear of
saying anything in case others don’t agree
Hide from people
Put others’ needs above own
Avoid expressing their feelings
Believe need and feelings are wrong or bad.
Allow other to use them and manipulate them
Poor posture, poor eye contact, apologetic
Non assertive people don’t respect themselves
 Passive aggressive
 Secretly angry or resentful,
Appear corporative and friendly but
consciously or unconsciously do things
to annoy, disrupt or sabotage others!
Mutter to themselves as refuse to
acknowledge their anger
Expressions don’t match their feelings
e.g. smile when angry
Sarcasm to put others down
 Defining assertiveness
Aggressive behavior: Seek to win conflict
situation by dominating or intimidating others.
Violate rights of others to meet their own-Indifferent or
hostile to feelings , thoughts or needs of others.
Promote own interests or point of view- They need to be
right and not accept validity of opinions, value of idea of
others
Loud, interrupt others, attempt to dominate conversation
Use blame, criticism, sarcasm, threat, name calling
Win in short term but have negative long term effects

Aggressive people don’t respect others

When might you be
Passive?
Passive aggressive?
Aggressive?
 Defining assertiveness

Assertive behaviour: Direct expression of ideas,

opinions and desires. Intention is to communicate in
atmosphere of trust.
Courageous-communicate when feel not respected or
boundaries are violated
Initiate communication- expressing their feelings, opinions
and needs while conveying concern and respect
Face conflicts and search mutual accord solutions.
Goal stand for self and solve interpersonal problems
without damaging relationships
Assertive people respect themselves and others
 Defining assertiveness
A critical aspect of assertiveness is the
ability to respect the rights of others, even if
we do not agree with them!
Ability to act in ways that are consistent
with the standards we have for our own
behavior
Only power we have to effect change in any
relationship is to change our own behaviour
Goal focus on what one will do.
 Theoretical basis
Why aggressive or passive? Hold irrational
beliefs
Fear of rejection or anger from others and have
need for approval (everyone should like me…)
Over-concern for needs and rights of others (I
should always help and be nice….)
Believe had unalterable personality characteristics
(this is how I am….)
 Have negative self evaluation combined with
perfectionist standards (I must be perfect, if not am
failure. Others too- if not criticize severely!)
As these are excessively perfectionist they are irrational.
 Assertive people…
Take responsibility for own thoughts, feelings
and action
Respect other’s rights
Respect for oneself and express one’s needs and
defend ones rights
Have clear boundaries
Clear about who they are and how they feel
Clear about when their rights are being violated
Learn to question
 Assertive pharmacist
Take active role on patient care
Initiate communication-don’t wait
for questions
Convey their views
Resolve conflict in direct manner
in way conveying respect for
others.
ACTIVITY

READ DIALOGUES 1-3 PAGES 81

TO 84 (In Communication skill for
pharmacists)
 Types of Assertive statements
Simple assertion
I will be unable to refund your money on
this item
I want you to take this four times a day
until it is finished.
Empathic assertion
I know that this came as a complete
surprise to you. There was no way to
prepare for it.
 Types of Assertive statements
Confrontative assertion
You say you are going to take your
medication as we have discussed, but I am
not sure you are taking this seriously.
Positive feeling assertion
I really like it that you come in on the
exact day you are scheduled for your refill.
I am glad to see you.
 Types of Assertive statements
Negative feeling assertion
I feel really frustrated when I have trouble
explaining to you how to properly take
your medicines. You seem to feel this is
wife’s responsibility more than your own.
I would like to try again. When you do this
I feel like I really don’t want you to leave
the pharmacy until I can hear some
personal commitment from you.
Assignment

Prepare the Swahili of the different

assertive statements
Be ready to share
 Assertiveness techniques/skills
1. Providing feedback
Criteria for useful feedback….
– Focus on persons behavior, not
personality. (Directing at something that
can be changed).
– Descriptive not evaluative (not judging)
– Focus feedback on own reactions, rather
than other’s intentions (don’t blame,
don’t assume bad intent)
 Assertiveness techniques/skills
Criteria for useful feedback…ii
 Feedback uses “I” statements that take the
form “When you [do or say]_____, I feel
___.”
 Feedback is specific rather than general.
 Focus on present (just occurred not past)
 Does not over-generalise (you always do..…)
 Focus on problem solving, not letting off
steam!
 Provide feedback in private (-ve)!
 Assertiveness techniques/skills
2. Invite feedback from others.
-Hear criticism or suggestion without being
defensive or getting angry
-Admit when have made mistake
3. Setting limits
-Take responsibility for decision about how
spend personal resources (time/money)
-Decide how much want to do; delay if must
think; can be yes or no or partly
 Assertiveness techniques/skills
4. Making request
-Ask for what you want in direct manner
-Ask for help and expect assertive responses!
5. Being persistent
-Ensure your rights are respected e.g. when have
said no and others want to coax you to change.
-Repeat decision calmly –”broken record”
response
 Assertiveness techniques/skills
6. Ignore provocations
-Humiliation, intimidation, sarcasm,
aggressiveness, personal attacks, turf
battles-Focus on solving problem
Assertiveness techniques/skills
Broken record-
 https://youtu.be/Qx02oTgfxVU?list=RDQx02oTgfxVU

Calm repetition –saying what you want over

and over again
“In my professional opinion, it is not
advisable for you to drink alcohol while
taking this medication” (said repeatedly)
“I cannot in good conscience, fill this
prescription as it written” (again repeatedly)
 Assertiveness techniques/skills
Fogging-Accepting manipulative criticism
by calmly accepting to your critic that probably
there are some truth in what he says yet
remaining your own judge of what you do.
Patient: You are just a pharmacist. The doctor told
me everything I need to know.
Pharmacist: You are right I am a pharmacist. And I
work with the doctor to make sure you know how
to take your medicines properly.
Assertiveness techniques/skills
Negative inquiry-
Actively prompting criticism in order to
use the information (if helpful) or
exhaust ( if manipulative) while
prompting your critic to be more
assertive
Assertiveness techniques/skills
Patient: This is ridiculous. I can’t take this
four time a day.
Pharmacist: What is it about taking this
medicine four times a day that bothers
you?

“What is it you dislike about what I

have told you?”
Assertiveness techniques/skills
Workable compromise
-you can always bargain for your
material goals unless the compromise
affects your personal feelings of self
respect.
(Reframing page 79…pharm practice)
Assertiveness techniques/skills
Case: Patient wants medication now for
two weeks of painkiller and you feel
they will need to consult a doctor
eventually.
Pharmacist: Since this is a medicine
for pain, I would be able to dispense
only half your prescription.
Assertiveness techniques/skills
Sorting issues
-Sometimes issues can be sandwiched.
Need to sort them out separately to
avoid confusion, anxious and guilt.
Assertiveness techniques/skills
Patient: I thought you were my
friend! Why didn’t you tell me my
daughter was taking birth control
pills?
Pharmacist: I am your friend, but I am
also a pharmacist. I need to discus
the issue with you as a pharmacist.
And as a pharmacist, I owe your
daughter confidentiality.
 Assertiveness techniques/skills
Disarming anger
-honest contract offered to another
individual exhibiting a lot of anger or
bordering violence. Goal -agree to talk
once some anger dissipate.
 Assertiveness techniques/skills
Pharmacist: I am very interested in helping you
with this problem. However I get very
nervous when people yell at me and I am
going to need you to talk in normal voice to
me before I can do anything for you.
Pharmacist: Oh! I didn’t realize a mistake
could have been made. Let me get pen and
paper, I want to get all the details down about
this problem.
 Assertiveness techniques/skills
Selective ignoring
-discriminatory attending or non-attending to
specific content from another individual.
Patient: Hey honey, ya got my prescription
ready?
Pharmacist: (without response to sexist remark)
Let me check that Mr. Johnson.
Patient: These direction are confusing. Why don’t
you come over to my place and explain to me?
Pharmacist: I’ll be glad to explain them to you
Assertiveness summary

To be assertive, each person must be able to directly and

honestly convey;
“This is what I think……”
“This is how I feel about the situation…..”
“This is what I want to have happen…..”
“This is what I am wiling to do…..”

Focus on problem solving

ACTIVITY
REVIEW CASE 6.1
A patient who is obviously in a hurry brings in a
prescription to be filled. You are extremely busy and
there is a 30-minute wait. When she is told this, she
explodes “That is ridiculous. It can’t take that long to
pour pills from a big bottle into a little bottle.” When
you start to explain about patient counseling, she says
“I’ve never had anyone talk with me about the
prescriptions I get here. All you do is ask me to sign a
form.”
1. What special assertiveness skills might you use?
2. What is your role in this situation?
 Reality check
Community asks you to give speech on
medication use. What is your first
reaction?
How would you react to a hostile patient?
When and how often would you talk and
counsel your patients?
What actions would you take on refill
visits?
How many patients and physicians know
ASSERTIVENESS IN PRACTICE

DEALING WITH DIFFERENT PEOPLE

IN WORK SITUATION…..
ASSERTIVENESS SLIDES SET 2