Assertiveness Training Seminars
The goal of our Assertiveness Training seminar is to enable participants to learn to express their rights, requests, opinions, and feelings honestly, directly, and appropriately without violating the rights and self-esteem of others.
Each
Assertiveness Training Institute training
seminar begins with a self-assessment that
enables individuals to understand their personality.
We delve into each person’s strengths,
weaknesses and stress areas to help people understand
what makes them “tick.” We then
begin the process of enabling participants to
understand how to
communicate
more effectively with others. Through various
activities and assertiveness training exercises, participants
then begin to recognize other communication
styles and the best way to communicate to them.
Here is when the process of becoming more assertive
truly takes shape – by understanding the
needs of other communication styles, participants
learn how to express their opinion and stand
up for their interests regardless of who they
are dealing with.
For more information on our
assertiveness training seminars
contact us
here.
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* THE HIGH INCIDENCE OF VERBAL ABUSE directed toward
perioperative nurses by surgeons has been the subject
of recent research studies.
* REPEATED INCIDENTS of verbal abuse in the OR
contribute to increased incidence of errors, low
morale, and high turnover among nursing staff members.
* ASSERTIVENESS TRAINING that focuses on conflict
resolution and communication skills is an effective
method of coping with verbal abuse.
* EACH MEMBER is a vital part of the perioperative
team. Any disruption to the team, including verbal
abuse, can compromise patient safety. Collaboration
among team members is critical to ensure safe patient
outcomes. AORN J 79 (January 2004) 148-164.
**********
The article "Assertiveness training to prevent verbal
abuse in the OR" is the basis for this AORN Journal
independent study. The behavioral objectives and
examination for this program were prepared by Rebecca
Holm, RN, MSN, CNOR, clinical editor, with
consultation from Susan Bakewell, RN, MS, education
program professional, Center for Perioperative
Education.
Participants receive feedback on incorrect answers.
Each applicant who successfully completes this study
will receive a certificate of completion. The deadline
for submitting this study is Jan 31, 2007.
Complete the examination answer sheet and learner
evaluation found on pages 169-170 and mail with
appropriate fee to
AORN Customer Service c/o Home Study Program 2170 S
Parker Rd, Suite 300 Denver, CO 80231-5711
or fax the information with a credit card number to
(303) 750-3212.
You also may access this Home Study via AORN Online at
www.aorn.org/journal/homestudy/default.htm.
BEHAVIORAL OBJECTIVES
After reading and studying the article on
assertiveness training to prevent verbal abuse in the
OR, the nurse will be able to
1. identify the dimensions of verbal abuse,
2. explain how episodes of abuse have evolved
historically in the perioperative setting,
3. describe the effects of verbal abuse, and
4. discuss interventions that can be used to prevent
and manage verbal abuse.
Verbal abuse is a common form of workplace violence in
today's health care environment. Of 461 nurses
surveyed in 1999, 94% had experienced some form of
verbal abuse. (1)
DIMENSIONS OF VERBAL ABUSE
The term verbal abuse frequently is defined as
communication perceived by a person to be a harsh,
condemnatory attack, either professional or personal
(Table 1). It may be conveyed with tone, manner, or
nonverbal cues. (2) Abuse in the health care arena
consists of two dimensions, horizontal and vertical
abuse. Horizontal abuse is abuse directed between two
equally ranked coworkers, such as between two nurses.
Vertical abuse is use of inappropriate power toward an
actual or perceived subordinate. Vertical abuse occurs
when a surgeon directs abuse toward a nurse. A nurse
directing abuse toward a subordinate nurse or coworker
(eg, scrub technician) or directing inappropriate
behavior toward a patient also are examples of
vertical abuse. Vertical abuse directed from the
surgeon toward a nurse usually is done in the presence
of others. Vertical abuse between two nurses, on the
other hand, usually occurs in a private area.
A recent study conducted in Veteran's Health
Administration hospitals noted that more than 50% of
the physicians were unaware of the effects verbal
abuse had on nurses. (3) Other recent studies have
shown a high incidence of verbal abuse directed at
perioperative nurses by surgeons. (4-7)
HISTORICAL PERSPECTIVE
The perioperative setting can be very stressful. A
surgical team consists of the anesthesia care
provider, the surgeon, an RN first assistant (RNFA) or
a resident physician, a scrub person, and a
circulating nurse. With the exception of the
anesthesia care provider and the circulating nurse,
team members must remain within the sterile area and,
therefore, are unable to leave when verbal abuse
occurs. The anesthesia care provider continuously
monitors the patient during the procedure and is
required to be in the OR during the entire procedure.
Although the circulating nurse may leave the OR to
retrieve supplies or medications, he or she must
return quickly, and therefore, is almost as vulnerable
to abuse as team members confined to the sterile area.
The victims of abuse must stay and listen to the
abusive comments until someone can provide relief. If
relief can be obtained at all, it may be a matter of
minutes or hours, particularly if the individual is
part of an on-call team.
In the past, the perioperative setting allowed for
some laxity with jokes, remarks, or pranks. This was
accepted in the perioperative cul0are as a method of
stress reduction. Problems occurred, however, when the
behavior was unwelcome by staff members or if the
behaviors included lewd remarks or sexual innuendos.
These remarks could spread through gossip to other
staff members and could create an environment of
unrest and decreased trust. (1) This laxity has become
increasingly less acceptable in the current health
care environment.
EFFECTS OF ABUSE
Negative effects on patient care, work satisfaction,
and turnover rates have been reported after episodes
of verbal abuse. (6) One group of researchers
identified decreased morale, decreased productivity,
and increased errors related to verbal abuse) Verbal
abuse frequently is unprovoked and unexpected, and
victims of the attack often internalize the event. The
initial reaction to the event may be anger,
humiliation, shock, or surprise. The individual may
think, "How could Dr Smith say something like that to
me?" or "I didn't do anything to deserve that!"
Repeated events involving the same surgeon may lead to
feelings of inadequacy, disgust, or frustration. The
victim may begin to feel responsible for the event
having occurred. The surgeon may enjoy the feeling of
power he or she has over the victim. Common thoughts
perioperative nurses may have after experiencing abuse
include the following.
* "Why can I never do anything right when I work with
Dr Smith?"
* "I never have problems with other surgeons."
* "I must be doing something wrong to cause this
reaction."
* "Why is it always me she is upset with?"
* "She never yells at the other nurses."
* "I hate working in this room!"
* "Why am I so stupid when I work with Dr Smith?"
* "Why do I let her upset me so much that I start
crying?"
The consequences of verbal abuse can have long-term
effects on the working relationship of the OR team and
on patient care.
Source: no author
attributed
link
Related: Assertiveness Training
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