1. Nurse Leader Skills: Communication and Team Building
Samuel Merritt University
Nurse Leader Skills: Communication and Team Building
NURS 560 Fall 2014
Dr. Mileva Saulo Lewis
Professor Emerita
N 560 Fa 2014 Dr. Lewis All rights reserved
Mileva S Lewis All rights reserved (c)

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3. At the completion of this session learners will be able to:
Apply principles of positive communication to the clinical setting
Identify obstacles/barriers to effective communication and strategies for improving
Discuss the implications of complexity, science, MBTI Types, leader & followership roles, and group roles for effective health care teams.
N 560 Fa 2014 Dr. Lewis All rights reserved

4. Communication – Two Views
George Bernard Shaw
White Water Rafting Director
The problem with communication is the illusion that it has taken place.
Communication is when you row in exactly the way that I’ve just yelled out.
Communication – Two Views
N 560 Fa 2014 Dr. Lewis All rights reserved

5. Communication Functions
Samuel Merritt University
Communication Functions
Control behavior
Fosters motivation
Emotional expression; social goals
Information transmission
Not a hierarchy – all are important
Robbins, S.P. (2014). Essentials of organizational behavior. (17th ed.). Upper Saddle River, NJ: Pearson
N 560 Fa 2014 Dr. Lewis All rights reserved
Mileva S Lewis All rights reserved (c)

6. What do you notice?
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8. Communication
Begins the moment two or more people become aware of each other’s presence
Most critical leadership skill
Impacts all management activities and cuts across all phases of the management process
The ability to communicate effectively often determines success as a leader-manager
Marquis & Huston 2015

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10. Communication Internal Factors External Factors Weather Temperature
Timing
Status, power, authority,
Organizational climate itself
Marquis & Huston, 2015
Values
Feelings
Temperament,
Stress levels of the sender and the receiver 
Communication
N 560 Fa 2014 Dr. Lewis All rights reserved

12. Exercise Draw what you hear I need two volunteers
One to give directions
One to draw what you hear (If you can draw a straight line – you are eligible to volunteer)
Debrief
N 560 Fa 2014 Dr. Lewis All rights reserved

13. Variables Affecting Organizational Communication
Number of levels that communicate
Gender
Power and status
Marquis & Huston, 2015

14. Organizational Communication Strategies Marquis & Huston, 2015
Leader-managers assess organizational communication
Leader-managers understand the organization’s structure and recognize who is affected by decisions
Communication is not a one-way channel;
Communication must be clear, simple, precise
Senders should seek feedback whether communication is received
Multiple communication methods should be used
Unnecessary information should not be disclosed

15. Channels of Communication
Upward
From subordinate to superior
Downward
From superior to subordinate
Horizontal
From peer to peer
Diagonal
Between individuals at differing hierarchy levels and job classifications
Grapevine
Informal, haphazard, and random, usually involving small groups
Marquis & Huston, 2015

16. Communication Modes Written Face-to-face
Telephone, Social Media, IPhone, etc.
Nonverbal

17. Elements of Nonverbal Communication
Space
Environment
Appearance
Eye contact
Posture
Facial expression and timing
Vocal expression
Marquis & Huston, 2015

18. Communication in Complex Situations
Veronica Chung reporting on:
Clancy, T.R. (2008). Managing organizational complexity. Directing a complex systems perspective. Journal of Nursing Administration, 38 (2),
Dr. Mileva Saulo Lewis, All rights reserved.

19. Types of Communication
Passive Aggressive
Indirectly aggressive (passive– aggressive)
Assertive
Marquis & Huston, 2015

20. Misconceptions and Myths about Assertiveness, cont.
To be assertive is to be aggressive
Assertiveness is unfeminine
Assertive communication is rude or insensitive
Marquis & Huston, 2015

21. Misconceptions and Myths about Assertiveness
All behavior is either assertive or passive
To get what you want, all you have to do is be assertive
Being assertive will:
Increase the odds of getting what you want
Increase your self-esteem
Marquis & Huston, 2015

23. Listening – The forgotten Skill (Burley-Allen, M. (1982)
Listening – The forgotten Skill (Burley-Allen, M. (1982). Listening: the forgotten skill. New York: John Wiley.
An Individual Exercise
Read three statements
Select your INITIAL response by checking a, b, c, or d.
You will have 3 minutes
Burley-Allen, 1982, p

24. Responses Question 1 Question 2 Question 3 a b c d a b c d
N 560 Fa 2014 Dr. Lewis All rights reserved

25. GRRR as a Listening Tool Marquis & Huston, 2015, p. 451

26. Communication Barriers
Samuel Merritt University
Communication Barriers
Filters
Selective perception
Gender styles
Emotions
Language
Non-verbal
Cross cultural factors
Assume differences
Emphasize description
Lack of empathy
Interpretation as working hypothesis
Robbins, 2014
N 560 Fa 2014 Dr. Lewis All rights reserved
Mileva S Lewis All rights reserved (c)

27. Gender Differences Academic Research Cautions
Women
Men
Enhance social connection
Create relationships by talking
Use more words, tentative, polite
Foster intimate bonds
Express concern for others
Use less powerful speech
Tag questions, Interrupt & swear less
Synergistic
Relationships established by doing things
Exert dominance
Value Independence
Maintain status
Offer solutions
Unemotional and independent
Merchant, 2012; Tannen,1990
Gender Differences Academic Research Cautions
N 560 Fa 2014 Dr. Lewis All rights reserved

28. Qualifiers Mitigating- tend to weaken comment
Perhaps…
I guess…
Well…
Inappropriate use of disclaimer; weakens one’s stand
I could be wrong but –
This may sound crazy but –
You may not like this but –
(Eakins, B.W. & Eakins, R.G. (1978). Sex differences in communication. Boston: Houghton Mifflin, p. 44.
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29. Viva La Difference!
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30. Men are from Mars; Women are from Venus Value Differences as Strengths
Difference needs, goals and values
Understanding is key
Men
Goal Oriented; sense of self through results;
Stress – go into the cave
Conflicts - Problems – offer solutions
Women
Relationship oriented; sense of self by feelings & quality of relationships
Stress – women talk
Conflicts - Problems – Seek empathy and understanding
Gray, 1992
N 560 Fa 2014 Dr. Lewis All rights reserved

31. Mindfulness – Relationship to Communication
Nicole Campion
Anthony, M., Vidal, K., (May 31, 2010) "Mindful Communication: A Novel Approach to Improving Delegation and Increasing Patient Safety" OJIN: The Online Journal of Issues in Nursing Vol. 15, No. 2, Manuscript 2.
N 560 Fa 2014 Dr. Lewis All rights reserved

32. How about a Break
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33. Putting it All Together Experiential Exercise
MBTI styles
Communication
Team Building
Group Roles
Constructive
Destructive

34. Team Building Exercise It’s a Surprise !
N 560 Fa 2014 Dr. Lewis All rights reserved

35. Team Task Analysis
Use the Problem-Solving Model (Z method – next slide) to answer some of the following questions:
Did you get the desired result? If not, what could you have done differently.
What did the team overlook?
If you did, what accounts for your success?
What did the team emphasize?
What did each member contribute to the problem-solving process?
What is the relevance of this to our work as nurse leaders and team members?
RM 4-23

36. Problem-Solving Model
Identify and clarify problem (who, what, when, where)
Gather relevant, specific data
Use facts verifiable by a reliable source (time cards, thermometer, etc.)
Intuit probable causes
Generate alternatives, interpretations of the factual data
Seek patterns relating this problem to others S N T F
Determine “fit” with personal and organizational values
Assess effects on stakeholders/ relationships/ organization
Determine how to win self and others to solution
Weigh practicality of alternatives
Examine consequences
Weigh gains/losses
Using the MBTI ® Tool in Organizations (3rd ed.) © 2001 by CPP, Inc. Permission is hereby granted to reproduce this overhead master for workshop use. .
Adapted from works by Gordon Lawrence and Eleanor Corlett.
RM 4-11

37. Leadership Roles Decision maker Communicator Evaluator Facilitator
Risk-taker
Energizer
Mentor
Critical thinker
Buffer
Advocate
Coach
Counselor
Teacher
Forecaster
Visionary
Influencer
Creative problem solver
Change agent
Diplomat
Role model
Marquis & Huston, 2015
Dr. Mileva Saulo Lewis, All rights reserved

38. Types of Followers Effective or exemplary Alienated followers
“Yes” people
“Sheep”
Finkelman, 2014
Partner
Contributor
Politician
Subordinate
Finkelman, 2014
Dr. Mileva Saulo Lewis, All rights reserved

39. Follower Characteristics
Strength & independence
Critical thinking
Ability, willingness to think independently
Ability to give timely, honest feedback, constructive criticism
Be one’s own person
Innovative, creative
Cooperative, collaborative
Grossman& Viliaga, 2000 in Finkelman, 2014
Dr. Mileva Saulo Lewis, All rights reserved

40. Follower Characteristics, cont.
Samuel Merritt University
Follower Characteristics, cont.
Innovative, creative
Cooperative, collaborative
Self-starter
Go above and beyond
Willing to assume leadership
Grossman& Viliaga, 2000 in Finkelman, 2014, p
Take the initiative
Attentive to what’s happening
“Hold up your end of the bargain”
Energized by work & environment
Dr. Mileva Saulo Lewis, All rights reserved
Dr. Mileva Saulo Lewis, N 560, FA 2014, All rights reserved

41. “SYNERGY” Optimal contributions of all individual team members
There is no “I in team!
Dr. Mileva Saulo Lewis, All rights reserved

42. Communication in a Digital World
N 560 Fa 2014 Dr. Lewis All rights reserved

43. ANA/NCSBN Principles for Social Networking
ANA Code of Ethics for Nurses
ANA Standards of Practice
ANA Social Policy Statement
N 560 Fa 2014 Dr. Lewis All rights reserved

44. Take Home Messages ELOC Health Policy
Dr. Mileva Saulo Lewis, All rights reserved
Spring 2008

45. Preparation for 20 October First Hour –Delegation
READ: TEXT: Chp. 20
NCSBN/ANA Delegation Guidelines
Review: Whitlock, J. (2013). The value of active followership. Nursing Management, 20(2), 20-23
Complete Learning Exercise 13.3
During the week: Observe what is delegated to LPNs and PCAs and how
Complete Learning Exercise 20.9
Supplemental Readings Report due no later than 5 pm on Saturday 18 October
CAMPION: Anthony, M., Vidal, K., (May 31, 2010) "Mindful Communication: A Novel Approach to Improving Delegation and Increasing Patient Safety" OJIN: The Online Journal of Issues in Nursing Vol. 15, No. 2, Manuscript 2.
COOLEY Weydt, A. (2010). Developing delegation skills. OJIN: The Online Journal of Issues in Nursing, 15(2), Manuscript 1.
Dr. Mileva Saulo Lewis, All rights reserved.

46. Three Realms of Nurses Responsibility Potter; Glaser
Individual
Society
Organization
Dr. Mileva Saulo Lewis, All rights reserved

47. Learner Choices Chapter Four – Ethical Issues
Types of ethical issues
Ethical Frameworks and Principles of ethical reasoning, decision making
Chapter Six – Patient, Subordinate & Professional Advocacy
Becoming an advocate: patient advocacy; patient’s rights;
Workplace advocacy; whistleblowing;
Professional advocacy
For Patients
The Workplace
Associations: Professional Political Activity and/or Labor Unions
N 560 Fa 2014 Dr. Lewis All rights reserved

48. Preparation for 20 October Second Hour Power, Authority and Influence
Read Text: Chapters 4 & 6
Supplemental Readings – Readings as assigned for class on 10/20
Please send summaries no later 5 pm on 20 October
Correa
Flores
Flowers
Frangadakis
Fregoso
Garcia
Bumatay-Galvez
Garcia-Yepez
Gomez
N 560 Fa 2014 Dr. Lewis All rights reserved

49. Dr. Mileva’s Schedule Next Week
I am attending the American Society for Bioethics and Humanities national conference Wednesday through Sunday at 4 pm.
Will answer as I am able
N 560 Fa 2014 Dr. Lewis All rights reserved

50. Please complete the mid-course evaluation Thank you Dr. Mileva
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51. Thank you for your hard work!
Dr. Mileva Saulo Lewis, All rights reserved.