However much management knowledge you accumulate, it will count for naught if you do not have the confidence to put the theory you learn into practice. Doing that relies to a large extent on your ability to communicate effectively with your team. Handling and nurturing work relationships is one of your key skills, and an ability to think, speak and act assertively will enhance your reputation and success as a manager. If you want to motivate staff, earn their loyalty and respect and enable them to achieve the best possible results for your practice, then developing confidence in communication and your own ability to deal effectively and calmly with situations needs to be high up on your priority list. It all sounds so simple. So why do we not choose to act assertively and why do we find this so difficult?
In any situation where two people are trying to communicate they both have certain needs and wants and in many cases these needs and wants may be in conflict (for example the receptionist cannot ensure every task is completed the moment the dentist requires it). Assertiveness is all about being able to express yourself in an open, non-confrontational way and get the best out of your work relationships. It is about the proper use of power, and being able to stand up for your own opinions, rights and requirements whilst respecting those of others. Yet assertiveness does not come naturally to many of us because we can confuse addressing issues directly with being aggressive, or because we have in the past turned to passive behaviour in such situations to avoid confrontation.
It's natural to fear conflict and for this reason we can shy away from dealing with issues in the practice in the hope that they will sort themselves or just go away. They rarely do. The receptionist who consistently turns up late with the excuse about the bus being delayed, the associate none of the nurses wants to work with because they are abrupt in their dealings, the patient who has always forgotten their debit card when it comes to payment time – it's highly unlikely that they will suddenly change their behaviour just because we silently want them to.
Of course, it is even easier these days to avoid dealing directly with people with the plethora of communications methods available to us. More and more we hide behind email and texts and even posts on Facebook pages rather than speak to someone in person. Yet talking with someone face to face is the simplest and most effective way of finding an acceptable outcome to whatever the issue is because it allows for discussion and agreement in a way that no other communication medium does. However some of us find it difficult to find the right words at the right time, whether in giving feedback or dealing with a difficult situation. Assertive communication is a skill and as a skill it can be learned and will improve with practice but here are a few principles to get you started.
Dos
- Before initiating a discussion, consider the outcome you want and practise how you are going to ask for it – "I'd like you to come in on time in the mornings." Consider how you will open up the discussion – "I'd like to talk to you about the way you and your nurse are communicating in the surgery."
- Be prepared to listen and acknowledge what the other person has said, perhaps by paraphrasing – "From what you have said you are having difficulties getting on the first bus as it is full by the time it reaches your stop." Acknowledge your feelings and the other person's – "I recognise that this is very disappointing for you."
- Propose an acceptable outcome – "I suggest that we look at a way of your directing the nurses that they perceive as less aggressive."
- When giving negative feedback explain the impact of the other's actions on the rest of the team – "When you arrive late it puts an unacceptable pressure on the other nurses to prepare your surgery in time for the first patient." Use positive language, for example say "I'd like to discuss with you how we can resolve this issue speedily" rather than "You've got to sort this problem out now."
- Concentrate on behaviour not personality. "You've got to be less shy when you are covering reception" is likely to be less effective than "I'd like to you to say good morning to every patient when they arrive."
- Don'ts
- Do not ignore or discount what the other person has said. Assertive communication is a two way exchange in which good listening is paramount. At all costs avoid "I hear what you are saying but..."
- Do not be afraid to disclose how you feel about things – "I feel very frustrated when you say you know what to do but then ignore the protocol we all agreed on." It can help to open up discussion.
- Do not go in unprepared if you need to give negative feedback. Practise what you are going to say and how you are going to say it.
- Do not be afraid if someone disagrees with you; it is OK for them not to agree with you. Acknowledge the area of disagreement, look for areas where you can agree and focus on the outcome that you are seeking – "I know from what you have said that you don't agree with the procedure and I am happy to review it with you to see if it can be improved; in the meantime we do need to follow it."
- Do not be afraid to say "I don't know". Dentists and managers are not omniscient gods and you may earn more respect by saying you need to think about something before giving a decision, rather than making up a policy 'on the hoof' in order to look decisive and then living to regret it.
Assertiveness is not what you know but the way that you conduct yourself. It's characterised by openness, directness and honesty - values that most practices would like to feel that they espouse and demonstrate to their patients, so isn't it worth developing them in our communication with each other in practice? After all, the aim of assertive behaviour is to communicate productively. By remaining calm, being honest, sticking to the facts of the situation, and listening carefully to and respecting other people, you will ensure a more fruitful relationship with your colleagues, staff and indeed your patients.