Assertiveness

1 | | What do I want to develop' | Assertiveness skill | How did I know this about myself' | I often find difficult to express my own opinions and say “no” to people even if the request is very inconvenient for me. | What resources do I need to help me do this' | Support from personal tutor, mentors in practice; short courses provided by university or college;Reflection techniques which help to see improvement in a particular area over a period of time; | How will I know if I have developed in this area' | Receive positive feedback from personal tutor, mentors in practice, senior colleagues at work place; annual appraisal, | By what date do I need to have achieved my objective' | I would like to see improvement in this area by the end of first year of my training, however I am aware that mastering assertiveness skill is a part of life learning process. | Why is this important for a professional practitioner'(Rationale & underpinning evidence). | Assertiveness is a ability to express yourself and your rights without violating the right of others. Being assertive means having respect for yourself and others. Due to this mutual respect assertiveness is an effective, diplomatic and direct communication style (Bishop, 2000).Throughout the years nurses were seen as “good Samaritans”, “angels”, more like sheep then sheppard. Studies provided by Timmins and McCobe (2005) show that nurses often do not view assertiveness as an appropriate behaviour and they prefer to take passive role in conflict situations. However modern nursing expects nurses to be professionals who are confident and competent enough to act as patients’ advocates, as links between service users and other health professionals, as well as a barrier between the client and an adverse event (Beyea, 2008). Because nurses are always on the front line they play crucial role in maintaining patients’ safety. Assertive communication is one of the tools which helps nurses to fulfil this new role. An assertive nurse is confident enough to make a request to a physician to review a patient he/she is concern about. An assertive nurse is able to say “no”, feels free to ask for an advice, listens to a constructive criticism, makes confident statements of fact, without being judgmental. Still becoming assertive is not something which happens overnight, it is a skill which need to be developed and encouraged through education methods. Assertiveness training program increases not only ability of the professionals to use this important tool but also helps nurses to build their self- esteem ( Yen-Ru, 2008) what in long term improve their ability to speak up for their rights as well as the rights of the service users in their care. McCobe and Timming (2003) suggest role playing with a support from appropriate literature as a method of choice to develop effective verbal and non-verbal communication, what in many aspect is what assertiveness is all about.Assertiveness does not show people the “right” way to behave, it helps to open up, increases communication possibilities. It allows professionals to altar their habitual behaviour and empower the role of patient advocates (Gaddis, 2008). Putting assertiveness skill into practice helps to fulfil Nursing and Midwifery Council (NMC) Code of Conduct standards which require professionals to put patient’s safety, dignity and well being first (NMC, 2008). Assertiveness in an important interpersonal skill which enable practitioners to develop and maintain caring, professional relationship with the service users. | NB: List the key piece of work that you want your NU 1072 supervisor to look at in your eportfolio | | REFERENCES Beyea, S. (2008) Are you “Just a Nurse”' [online] AORN Journal February Vol.87, No2, pp. 441-444, article from CINAHL, last accessed 23 November 2010. Bishop, S. (2000) Develop Your Assertiveness ( 2nd edition) London: Kogan Page . Gaddis, S. (2008) Positive, Assertive “Pushback” for Nurses [online] New Hampshire Nursing News July Vol.32, Iss. 3, p.17, article from CINAHL, last accessed 20 November 2010. McCabe C., Timmins, F. (2003) Teaching assertiveness to undergraduate nursing students [online] Nurse education in Practice Vol. 3, Iss. 1, pp. 30-42, article from CINAHL, last accessed 23 November 2010. Nursing and Midwifery Council (NMC) (2008) The NMC Code of Professional Conduct: Standards for Conduct, Performance and Ethics London: NMC. Timmins, F., McCabe C. (2005) How assertive are nurses in the workplace' A preliminary pilot study Journal of Nursing Management, January Vol. 13, Iss.1, pp. 61-67. Yen-Ru, L., I-Shin S., Yue-Cune C., Tzu-Ju L., Kwua-Yun W. & Kuei-Ru C. (2008) Evaluation of an assertiveness training program on nursing and medical students’ assertiveness, self-esteem, and interpersonal communication satisfaction [online] Nurse Education Today Vol. 24, Issue 8, pp. 656-665, article from ScienceDirect, last accessed 28 November 2010. Putting assertiveness skill into practice helps to fulfil NMC Code of Conduct standards which require professionals to put patient’s safety, dignity and well being first (NMC, 2008). However only effective communicators are able to altar their habitual behaviour and empower the role of patient advocates (Gaddis, 2008). as well as developing and maintain caring relationship with service users. Ideally appropriate techniques should be taught during pre- registration education. Effect of assertiveness training on assertiveness (yen ru article There were significant differences of assertiveness at post-test and follow-up measurements between the two groups after assertiveness training, which is in agreement with other studies (Baggs and Spence, 1990, Pfost et al., 1992, Lee and Crockett, 1994, Chen, 1995 and Weinhardt et al., 1998). Possible reasons for the increase in assertiveness might be that completing the assertiveness training program was helpful for nursing and medical students to understand the concept of assertive behavior and how to apply it practically. The contents of the program included proper assertive behavior and clarification and confirmation of the individual’s fundamental rights. As a result of the encouragement by the leaders through role-plays (which included confronting criticism and expressing dissatisfaction, refusals, and requests), group members could also properly express their internal thoughts and feelings that they dared not express in the past. The group provided opportunities for students to interact with each other, providing them more opportunity to explore relationships with others, promote assertive behaviors, and identify with others. Additionally, when a student behaved assertively, the leader and other students provided positive feedback (during the activity and 10 min before the end of the activity). The atmosphere for the activity was ideal. The confidence and security of the group and the leader contributed to learning assertive behavior. At the end of the eight training sessions, the leader encouraged students to review the teaching materials and homework by telephone in order to increase their understanding of assertiveness and to help them apply it in the future. Effect of assertiveness training on self-esteem There were significant differences in self-esteem at the post-test and follow-up measurements between the two groups after assertiveness training, which agrees with other studies (Morgan and Leung, 1980, Temple and Robson, 1991, Brown and Carmichael, 1992 and Montgomery, 1993). Possible reasons for the increase in self-esteem might be that completion of the training program increased students’ assertiveness, which led to a simultaneous increase in self-esteem and self-identity. Moreover, students could express their opinion on a variety of topics (including confronting criticism; expressing dissatisfaction, refusals, and requests; and giving and accepting praise) and share their experiences with each other. Introductions of the group members allowed the other students to realize that the other group members had similar bad experiences in the past, which allowed them to integrate their concept of ego and improve their self-esteem. Additionally, participation in role-plays (which included confronting criticism and expressing dissatisfaction, refusals, and requests) improved the organizing capacity of the students so that they could more easily understand and accept their thoughts, which further improved their self-esteem. Each activity had a theme, and the leader always played a warm-up game to relieve pressure and enhance the members’ ability to participate in the activity. Students in the experimental group more easily avoided embarrassing situations, interacted effectively with each other so that they overcame their inferiority, and improved their self-esteem. Feedback and encouragement from other students also increased students’ self-esteem. Finally, the leader provided written feedback to students after the training to help students understand themselves, to increase understanding of the leader and group, and to increase their self-esteem. Summary In summary, this study found that nursing and medical students’ assertiveness and self-esteem at post-test and one-month follow-up measurements of the experimental group after training was significantly increased compared to the pre-test measurement. However, interpersonal communication satisfaction at post-test and one-month follow-up measurements of the experimental group was not significantly different from that at the pre-test measurements. Our study found that the assertiveness training program significantly increased the assertiveness and self-esteem of our nursing and medical students, especially among individuals with low assertiveness and self-esteem, which could be provided as a reference to future scholars and teacher in demand. McCabe C; Timmins F Teaching assertiveness to undergraduate nursing students Nurse Education In Practice 2003 Volume: 3 Issue: 1p. 30-42. Abstract Assertiveness is an important behaviour for today’s professional nurse. As nurses move away from traditional subservient roles and perceived stereotypes it is increasingly being recognised that a nurse needs to behave in an assertive manner. Assertiveness is necessary for effective nurse/patient communication, and it is suggested that its development may also aid the confidence of the profession as it develops. Assertive behaviour may be encouraged through educational methods. It is preferable that nurses receive this educational preparation during undergraduate programmes. Nurse educators have an important role in the development and implementation of assertiveness training/education programmes for undergraduate nursing students. Little empirical evidence exists to support teaching in this area, however role-play is a concept that is suggested for the experiential teaching of communication/interpersonal skills in general. Using role-play as a central focus, and available literature on the topic, a 3-hour assertiveness workshop is devised for undergraduate nursing students. This paper describes this workshop from the teacher’s perspective and outlines student responses. The experience is both positive and enlightening. Nurse educators have an important role to play in the development of education programmes of this kind. The sharing of this experience allows educators to examine current practice and presents pathways for future empirical studies in this area. Nurses play a vital communication role in the healthcare system. Advocacy and empowerment are central to this. O’Mara (1995) suggested that to empower their patients nurses need to be assertive Promoting assertive behaviour aims to improve nurse/patient communication, interprofessional communication, and personal confidence. Castledine G., Nurses must stop themselves being used by doctors. British Journal of Nursing 6 4 (1997), p. 234. Castledine (1997, p. 234) has anecdotally expressed concern about the position of nursing within society. “It is ambiguous, precarious and transitional and, in relation to medicine, it remains very much the underdog”.