1. Chapter 12 Communication, Negotiation, and Conflict Resolution
Joseph T. Catalano

2. The Need for Good Communication
The nursing profession recognizes communication as one of the cornerstones of its practice.
Nurses must be able to communicate with clients, family members, physicians, peers, and associates in an effective and constructive manner to achieve their goals of high-quality care.
Good communication is essential for good leadership and management.

3. Factors That Affect Communication
Change
Fear of the unknown
Anger
Positive or negative expression
Group dynamics
Unwritten rules

4. Factors That Affect Communication (cont’d)
Competition
Peer evaluation
Working environment
Coping with difficult behavior
Stress
A destructive circle

5. Understanding Communication
Encoding and decoding
Communication is interactive sharing of information.
It requires a sender, a message, and a receiver.
The receiver has the responsibility to listen to, process, and understand (encode) the information and then respond to the sender by giving feedback (decoding).

6. Understanding Communication (cont’d)
Factors that interfere with the encoding process
Sender factors
Unclear speech
Monotone voice
Poor sentence structure
Inappropriate use of terminology or jargon
Lack of knowledge about the topic

7. Understanding Communication (cont’d)
Factors that interfere with the encoding process (cont’d)
Receiver factors
Lack of attention
Prejudice and bias
Preoccupation with another problem
Physical factors such as pain, drowsiness, or impairment of the senses

8. Understanding Communication (cont’d)
Verbal communication: both the written and spoken word, constituting only about 7% of the communicated message.
Nonverbal communication: makes up 58% of communication and includes body language, facial expressions, gestures, physical appearance, touch, and spatial territory (personal space).
Paraverbal communication: makes up 35% of communication and includes vocal cues (tone, pauses), volume, and speed of speech.

9. Understanding Communication (cont’d)
When the verbal, nonverbal, and paraverbal messages are congruent (relay the same information), then the message is more easily encoded and clearly understood.

10. Communication Styles Nonassertive communication Submissive
Aggressive-hostile

11. Communication Styles (cont’d)
Assertive communication
Direct
Accurately expresses the person’s feelings, beliefs, ideas, and opinions
Respects self and others
Encourages trust and teamwork
Encourages others to express their opinions in an open and respectful atmosphere

12. Communication Styles (cont’d)
Rules for assertive communication
It takes practice.
It requires a willingness to take risks.
It requires a willingness to make mistakes and try again.
It requires an understanding that not every outcome sought will be obtained.
It requires strong self-esteem.
Constant re-examination of outcomes helps assess progress. 
Goals for assertiveness growth need to be established beforehand.
Others should be allowed to make mistakes.

13. Conflict Resolution Conflict on the job
A common situation that causes conflict is when nurses feel overworked or overwhelmed by their assignments.
“Why isn’t anyone helping me?”

14. Conflict Resolution (cont’d)
Reasons nurses are uncomfortable with conflict
 Fear of retaliation
 Fear of ridicule
 Fear of alienation of others
Mistaken belief that they are unable to handle the conflict situation
 Feeling like they do not have the right to speak up
 Past negative experiences with conflict situations
 Family background and experiences
 Lack of education and skills on conflict resolution

15. Conflict Resolution (cont’d)
Conflict resolution strategies
Strategy 1: Ignore the conflict
Strategy 2: Confront the conflict
Strategy 3: Postpone the conflict

16. Development of Conflict Resolution Skills
Build on existing skills.
Avoid personal attacks.
Listen actively.
Ignore trivia.
Set the stage.
Establish trust.

17. Negotiation
The process of give and take between individuals or groups with the goal of reaching an agreement acceptable to both sides.
A specialized two-way communication skill in which individuals or groups with differing needs or ideas settle on a middle ground result that may not completely please either party.
Negotiations may be formal or informal, hostile or friendly.

18. Negotiation (cont’d) Bargaining Collective bargaining
A special type of negotiation that is used when money-related issues are being discussed.
Collective bargaining
A formal type of negotiation.
Used by groups of workers represented by a union or a negotiating body to solve workplace issues.
Salaries, health-care benefits, safe work environment, hiring practices

19. Negotiation (cont’d) Conflicting powers
In formal contract negotiation, there is an obvious power control conflict.
Each side is reluctant to give up power or relinquish any control of key factors such as money or rights.
The employees’ group tries to gain some power from management and improve benefits for its members.

20. Negotiation (cont’d) Learn the skills
The purpose of all negotiation is to achieve a goal or objective.
It is a skill that nurse managers must learn.
All nurses should familiarize themselves with the skills.

21. Negotiation (cont’d) Keys to successful negotiation include
Do some research.
Clearly identify the objectives and goals.
Avoid taking criticism personally.
Avoid making personal attacks.
Negotiate in good faith.
Respect the other side’s goals and objectives.
Pre-plan the elements of the negotiation.
Attend workshops or seminars on negotiation and bargaining.

22. Negotiation (cont’d) Mediation or arbitration
Used when the sides are unable to reach a resolution to their differences.
Mediation is a form of alternative dispute resolution.
The appointed mediator works with both sides to reach an agreement.
The agreement is non-binding and either side can reject the settlement.

23. Negotiation (cont’d) Arbitration
Usually the last step before the dispute is taken to court for litigation
Can be either non-binding or binding
Both parties must agree ahead of time to comply with whatever decision is reached by the arbitrator.