Surviving the health care environment with assertiveness skills
Conflict is a constant feature of the health care environment, and the effective management of conflict is a skill that many people do not possess on a professional or personal level. Conflicted environments within health care impact on a variety of factors, but one issue of particular importance currently is the level of satisfaction and retention of staff. By providing beginning practitioners with the skills to improve their ability to effectively manage conflict, these issues may be addressed. Effective communication skills are an integral aspect of competence for all health professionals, and the development of the skill to a more advanced level is required for beginning practitioners to succeed. Clinical experiences for student nurses were evaluated, and conflict situations were seen to significantly impact on their ability to succeed on clinical placement. Their inability to express themselves assertively, particularly in the context of hierarchy, was identified by students as an issue of major concern. As a result of this recognition of the students' needs, an innovative approach to teaching communication in the undergraduate curriculum for health care professionals has been developed. A number of strategies were implemented to develop understanding and skills in assertiveness, but one particular innovation is the use of reflective writing in conjunction with an assertiveness diary. Assertiveness is defined, they are provided with resources of situations to practice being assertive, and implement this practice within their daily life. They then examine a chosen situation, reflect on the positive and negative aspects of their response, the impact of their response on others, and goals for improvement in the future. The transition from theoretical concepts, to application of skills, and appreciation of the usability and value of these skills has translated to significant practice development for the students. Additionally, the reflective component highlighted the importance of self awareness, and its link to the impact on others of their reflection, encouraging empathic awareness. This has been structured within a theoretical framework of Bar-On's emotional intelligence, that encompasses a number of these aspects.