UNDERSTANDING THE NATURE OF COMMUNICATION IN THE NURSING

ORGANIZATION

I. Organizational Communication

Richmond & McCroskey, 2005, define organizational communication as the process

by which individuals stimulate meaning in the minds of other individuals by means of verbal or

nonverbal messages in the context of a formal organization.

The word process indicates that communication is dynamic and ever changing. The

words stimulate meaning are intended to suggest that it is through communication with others

that we develop, generate/ cultivate/ shape/ and reshape ideas.

II. Lines of Communication

Communication is described as a two – way process, however in an organization it is four

dimensional. It entails the formal lines of communication: the vertical and horizontal. Vertical

line of communication is subdivided as upward communication and downward communication,

while the other two are horizontal and outward communication.

UPWARD
To Superior

OUTWARD
HORIZONTAL To Patient, Family and Community; To Workers’
To Peers and Members of the Organization NURSE
Family and Friends
S

DOWNWARD
To Subordinates

Figure 1 Four – dimensional Flow of Communication

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III. Myths and Misconceptions of Communication in an Organization

In our everyday life we deal with various groups of people. As nurses, we deal with our

patients, fellow nurses, and the other members of the medical team. However, we can’t say, that

our daily communication with different individuals or with different people would mean that we

are able to communicate well.

In relation to this, it might be of great help to understand the myths and misconceptions

about communication in an organization. Here are the myths and misconceptions about

communication as identified by Richmond and McCroskey (2005):

Meanings are in
words.

Communication
is a natural Communication is
ability. a verbal process.

Communication
can breakdown.
Myths and Misconceptions Telling is
communicating.
in an Organization

The more
communication, Communication
the better. will solve all our
problems.

Communication
is a good thing.

Figure 2 Myths and Miscommunications in an Organization by Richmond & McCroskey,

2005.

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 III. Barriers to Communication

In every communication lies a question of having the clarity of understanding, therefore,

going away with miscommunication. However, as communication continues the possibility of

having miscommunication would never be missing. Barriers to communication are gender,

culture, anger, incongruent responses and conflict.

TOP LEVEL MANAGEMENT

(Deans & Chief Nurses)

The Way Minds

Work

MIDDLE LEVEL Gend MIDDLE LEVEL

er
MANAGEMENT MANAGEMENT
Co

(Supervisors, Head Nurses, (Supervisors, Head Nurses,

nfl

Academe Coordinators) Academe Coordinators)

ict

Respo
gruent

nses
Incon

An
ge
r ltu re
Cu

Sender’s Behavior
Receiver’s
Behavior

FIRST LEVEL MANAGEMENT

(Staff Nurses, Public Health Nurses, Clinical
Instructors)

Figure 3 Conceptualized Framework on Barriers to Communication

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 Gender, as cited on the published essay of Michael Erbschloe at EBSCO (Gender and

Management, 2008), presents at least two primary challenges to organization managers. First are

the impact of gender on management staffing and the composition of management team. This

has most often been discussed in terms of women moving into management position which had

been, and still is in parts of the world, positions traditionally held by men. The second area of

impact is in human resource management, which has changed how management deals with a

mixed gender non – management workforce who is now often spilt rather evenly men and

women

Gender as a barrier to communication interferes when men and women lack the

understanding that they may process information differently. At some point, some men are more

interested in using reason while some women want to be heard and validate through

communication (Gray, 1992).

Culture grown increasingly diverse, thus diversity reduces the likelihood that nurses

will share a common culture background. As identified by Jackson (1984), different subgroups

or subcultures within the organization have their own value systems and identities. Members

within that subgroup form an allegiance to their own members. This results in different

translations of messages from management, depending on the significance of the message to the

subgroup values and is striving to accomplish.

Anger is a universal, strong feeling of displeasure that is often precipitated by a situation

that frustrates or prevents a person from attaining a goal or getting what is wanted from life.

Anger is also influenced by one’s beliefs. Ellis (1997), describes anger as an irrational

response that arises from one of four irrational ideas: (1) that the treatment one received was

awful (awfullizing), (2) feeling that one can’t stand having been treated so irresponsible and

unfairly (cant – stand – it – it is), (3) believing that one should not, must not behave as he did

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(shoulding and musting), (4) because one acted in a terrible manner, he is a terrible person

(undeservingness and damnation).

Incongruent responses occur when words and actions in a communication do not match

the inner experience of self or are inappropriate to the context. As identified by Dr. Sharma S.

Mantha & Mr. M. Sivaramakrishna (Handbook on Communication Skills for Public Health

Workers, 2001) incongruent responses are characterized by being a (1) placater, (2) blamer, (3)

computer and (4) a distracter.

The placater always talks in an ingratiating way, trying to please, apologizing and never

disagreeing, no matter what. A blamer is a fault finder, a dictator, a boss and always acts

superior. Computer is very correct, very reasonable with no semblance of any feeling showing

and that s/he is calm, cool and collected, and is almost totally disinterested and tries to sound

intellectual. The distracter never makes a direct response to anything and anything s/he says is

totally irrelevant to what anyone else is saying or doing.

Conflict is generally defined as the internal or external discord that results from

differences in ideas, values, or feelings between two or more people (Huston & Marquis, 2003).

As a result, overt interaction between people in conflict can range from relatively passive

actions such as avoiding each other (Pruit & Rubin, 1986, van de Vliert 1990) to venting

emotions (Thomas 1992) and confrontation (Morrill and Thomas 1992). It may also increase

communication with those not directly involved in the conflict as people discuss the situation

with co – workers (Wall & Callister 1995). And it also reduces coordination and collaboration

between people or teams, resulting in lower efficiency (Spector & Jex 1998, De Dreu et al. 1999)

and reduced productivity (Pondy 1967, Tjosvold 1991).

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 In its essence, these barriers to communication affect the entire workforce in terms of (1)

the way their minds work, (2) the sending behavior and (3) the receiving behavior (Dr. Sharma

S. Mantha & Mr. M. Sivaramakrishna, 2001).

The ways minds work are influenced by perceptions of the reality, stereotypes and

prejudices, perceptions of relationships and gender differences.

Sender’s behavior is influenced by different meaning of the words, hiding thoughts and

feelings, and that sender may be blind to other’s emotions or vice versa.

Receiver’s behavior are influenced by hearing through own filters, receivers are easily

distracted, reactions that block communication, sending solutions, and avoiding the others

concerns.

IV. The Impact of Technology on Organizational communication

Another issue which faces the nursing organization is the impact of telecommunication

technology. While it is true that this telecommunications enhances communication with in the

nursing organization, its utilization in healthcare delivery depends upon its availability and

acceptance by healthcare providers (Doebbeling et al., 2006).

Richards (2001) also argues that a massive communications revolution (paradigm shift) is

underway, one that will have profound effects on the art and science of nursing. However, new

generations of nurses, who have used technology to play, learn, communicate, and form

relationships since childhood, will be accustomed to the instantaneous and interactive flow of

information and dialogue (Richards, 2001). These nurses are known as “Net nurses” and that

they will view technology as in the same light as contemporary nurses do their stethoscopes and

will use this resource to continue to provide evidence – based, professional care.

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 However, as this generation of net nurses continues to rise and respond to

telecommunication technology, the generations of baby boomers might not be responsive of it

which may cause a profound effect to the organizational communication.

IV. Recommendations

Addressing Gender Issues

Traditional View Area of Communication Paradigm Shift

Nurse Managers instills an

Male are powerful than female Manger – understanding about their roles and
Subordinate responsibilities that is based on
established standard protocols of the
organization that is free from gender
Male are interested in using reason bias.

Female wanted to be heard and validate Subordinate-

through communication Subordinate

Men and women should understand

that they process information
differently and that they must realize
the other’s preference and make
accommodations of it.

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 Addressing Culture Issues

Traditional Culture Areas of Communication Paradigm Shift

Subgroups or subculture create their Manger –

Subordinate Managers assess their unit culture.
own value system and identities.

Managers build and promote a

constructive culture.

Subgroups and subcultures interact in

guarded and reactive ways and approach
tasks in forceful ways to protect their Subordinate
status and security. –
Subordinate Subordinates should interact in a
proactive way that will help them to
meet their satisfaction.

Addressing Anger Issues

Areas of Communication Irrational Ideas Paradigm Shift

Manger – Awfullizing Manager & subordinates responds

Subordinate in a calm manner.

Can’t – stand – it – it is Manager listens without bias and

without mentally preparing his/her
next response.
Shoulding & Musting

Subordinate Manager must be objective and

– work out a solution that is
Undeservingness and
Subordinate agreeable to both parties.
Damnation

Manager respond without anger

and work toward a resolution.

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 Addressing Incongruent Responses Issues

Areas of Communication Incongruent Responses Paradigm Shift

Manger – Placating
Subordinate Managers build and enhance
mutual trust and respect.

Blamer

Managers must be firm in giving

clear, simple precise information
Computer and is responsible for ensuring the
message is understood.
Subordinate
–
Subordinate Distracter
Subordinates should interact in a
proactive way that will help them to
meet their satisfaction.

Addressing Conflict Issues

Areas of Communication Effects Paradigm Shift

Manger – Avoidance Manager uses compromising in a

Subordinate way that there is a willingness to
give up something of equal value.
Venting Emotions

Subordinate Manager uses smoothing in order

– to get someone to accommodate or
Confrontation cooperate with another party.
Subordinate

Manager uses collaborating that

all parties accept mutual
responsibility for reaching the
supraordinate goal.

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V. References

Books & Journals Publications

1. Marquis, B. & Huston, C., Leadership Roles and Management Functions in Nursing, 4 th

Edition, 2003

2. Venson, L. & Nagtalon, J., Nursing Management Towards Quality Care, 3rd Edition,

2006

3. Heidenthal – Kelly, Patricia, Nursing Leadership and Management, 2003

4. Mantha, S. & Sivaramakrishna, M., Handbook on Communication Skills for Public

Managers, 2001

Electronic Publications

1. http//www.scribd.com//, Richmond & McCroskey, Understanding the Nature of

Communication, 2005

2. EBSCO Journals:

a. Almost, J., Conflict Within Nursing Work Environments: Concept Analysis, 2005

b. Doebbeling, B. et al., Communications Technology to Improve Evidence – Based

Practice, 2006

c. Preston, P. Teams as the Key to Organizational Communication, 2004

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