SEMINAR ON COMMUNICATION

Central objective: By the end of the class the group gain knowledge regarding communication appreciate its importance in nursing ,and effectively use this knowledge in future practice. Specific objectives: At the end of the class the group; defines communication recognizes the importance of communication in management lists the objectives of communication. explains theories of communication. describes elements of communication. lists principles of communication. describes forms of communication. explainsdimensions of communication. describesmethods of communication. analysesbarriers of communication. describe the methods to overcome barriers of communication. explain regarding communication and nursing management

INTRODUCTION:
When you know something, say what you know. When you do not know something, say that you do not know. That is knowledgeKung Fu Tzu. For gaining that knowledge we need to express ourself and understand others;ie communicate. Communication can be regarded as a two way process of exchanging or shaping ideas,feelings and information.Broadily it refers to the countless ways that humans have of keeping in touch with one another. Communication enables us to grow, to learn, to be aware of ourselves and to adjust to our environment. The word 'communication' is derived from Latin word 'communis', which means common.

DEFINITIONS OF COMMUNICATION:
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The interchange of thought or information to bring about mutual understanding and confidence or good human relation.American Society of Training Directors. Communication is a process of sharing experience till it becomes a common possession. It modifies the disposition of both parties who partakes it. John Dewey. Communication is the transmission and interchange of facts, ideas, feelings or course of action.LelancI Brown. Communication is sharing of ideas and feelings in a mood of mutuality. Edgar Dale. Communication is a means of persuasion to influence other so that desired effect is achieved.Aristotle. Communication is the process of passing information and understanding from one person to another. It is the process of imparting ideas and making oneself understood by others Theo Haiemann.

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IMPORTANCE OF COMMUNICATION IN MANAGEMENT:

The importance of communication in any managerial process can hardly be overemphasized. If an organisation is to operate as an integrated unit, it is necessary that the top management should keep the lower level supervisors and employees well informed of its ultimate objectives, and of what it wants each person to accomplish, towards their realization. By freely sharing information, the management takes employees into its confidence, prepares them for changes, avoids misunderstandings, and removes them, if at all they develop, and makes them more knowledgeable about the problems and policies of the enterprise.

OBJECTIVES OF COMMUNICATION ARE:

To develop information and understanding which are necessary for group effort. To foster an attitude which is necessary for motivation, co-operation and job satisfaction. To discourage the spread of misinformation, rumors, gossips, and to release the emotional tension of workers.

To prepare workers for a change, by giving them the necessary information in advance. To encourage ideas, suggestions from subordinates for an improvement in the product and work conditions, for a reduction in the time or cost involved and for avoidance of the waste of raw material. To improve labour management relations by keeping both in contact with each other. To ensure a free exchange of information and ideas which will assist all the employees in understanding and accepting the rationale of the status and authority of everyone in the organisation. To satisfy basic human needs such as the needs for recognition, self importance and a sense of belonging. To serve auxiliary functions such as entertainment and the maintenance of social relations among fellow beings.

THEORIES OF COMMUNICATION
Bull's Eye Theory

Action view is the basis for this theory of communication. The whole process of communication is based on one-way action doing something to someone. The sender plays an important role who encodes the message with the help of arbitrary symbols. The demonstration or doing skills of the sender is for the purpose to change the behavior of receiver. The action believes that words have a meaning and there would be no misunderstanding which is the core of effective communication, provided the right words are used to convey the right message. Misperceptions or misunderstandings are bound to occur but according to information theory, the sender has to play effectively and adequately.
Ping-Pong Theory

This theory is also called interaction or interpersonal view. This approach to the study of human communication is the ping-pong theory of communication. Ping-Pong the game of table tennis, represents the interaction theory of communication. It is compared with turns at a table tennis match. In communication process, the turns takeplace between the sender and receiver. It is a complex theory of communication than the Bull's theory which recognizes the concept of linear feedback. In this theory, there is linear cause and effect.

Spiral Theory

The Spiral theory of communication is also called as transactions view of communication. It recognizes more than one interaction between sender and the receiver. A transaction implies independence, mutual and reciprocal causality. Myers and Myers say that human communication is best understood as a system in which senders are simultaneously receivers and senders. Communication is not static but dynamic and life time experience.

ELEMENTS OF COMMUNICATION:

Referent: The referent motivates one person to communicate with another. In health care setting, sight, sound,odor or any other cues initiate communication. Sender: The sender of message or communicator is a person who transmits the message. He/she conceive and initiate the message. He/she is the driving force to change the behavior of the receiver. Message: A piece of information, spoken or written, to be passed from one person to another. It is the subject matter of communication. It may involve any fact, idea, opinion, figure, attitude or course of action, including information. It exists in the mind of the communicator. Encoding (Communication symbol): The process of conversion of subject matter into symbols is called encoding. The message or subject matter of any communicationis always abstract and intangible. Transmission of message requires use of certain symbols. The communicator plans and organizes his/her ideas into a set of symbol- signs, etc. Encoding process translates ideas, facts, opinions into symbols, words- actions, pictures, etc. It is left to the sender in the selection of medium he/she suitable to communicate effectively to the intended receiver. Communication channel: Transmitter has to select the channel for sending information.Communication channel means the medium or media through which the message is sent. Media may be auditory (hearing, listening etc), visual (sight, observation,perception and so on), kinesthetic (procedural touch, caring touch and so on). Receiver: It is the person who receives the message. Effective communication proccss is not complete without the existence of a receiver of the message. It is the receiver who receives and attempts to interpret, perceive, understand and act upon the message Decoding: It is the process of translation of an encoded message into ordinal understandable language. Receiver converts the symbols, words or signs received from the sender to get the meaning of the message.

Feedback: It has been explained that communication is an exchange process. For t exchange to be complete the information must go back to the communicator, sending back of the knowledge about the message to the transmitter is known as feedback. It ensures that the receiver has received the message and understood in same sense as the sender meant. Feedback enables the communicator to execute corrections or change the message to be effective. Interpersonal variables: They are factors within both the sender and receiver that influence communication. They may be perceptions, sociocultural background,developmental levels and illness and so on. Environment: It is the setting for sender-receiver interaction. The shouldmeet the participant needs for physical and emotional comfort and safety.

PRINCIPLES OF COMMUNICATION

o Selection and determination of appropriate language and medium communication in accordance with the purpose of communication. . o Timing, physical setting, and the organization climate for communication need to be appropriated to convey the desired meaning of the communication conveyed by words. o Consultation with others for planning of communication. o The basic content and overtones of messages as well as the receptiveness to the view point of the receiver influences effectiveness of communication. o The messages should convey something of value to the receiver in the light of his/ her needs, interests, whenever possible. o Feedback from receivers, follow-up of communication through expression of the receivers, reactions and their performance review help in effective communication. o Communication while meeting the needs of immediate situations should be consistent with long-term goals and interest of the organization. o The communicator's action following communication is important in effective communication.

o The sender has to understand the receiver's attitude and reaction by careful, alert and proper listening to ensure that the desired meaning of the message has been comprehended by the receiver.

TYPES OF COMMUNICATIONS
Basically, the two most types of communication in an organisation are 'FORMAL' AND 'INFORMAL'communication.

Formal communications are "official", and are a part of the recognised communication system which is involved in the operation of the organisation. This communication can be from a superior or written. A formal communication can be from a superior to a subordinate, from a subordinate to a superior, intra administrative, or external.

Informal communications/grapewine communication are those that are "outside" the formal, and recognised communication system. Informal communications are not bound by any chart on the wall, but they are bound by conventions, customs, culture, etc. They include suppliers, clients, unions, government agencies and community groups. Informal communications originate spontaneously outside the formal channels and are the natural responses to the need for social interaction.

DIMENSIONS OF COMMUNICATION
Communication flows in various directions. Generally, it is transmitted down or flows across an organisation. VERTICAL COMMUNICATION is one in which communication flows from top to bottom as well as from the rank and file workers towards the management. Thus, it consists of Downward communication Upward communication
DOWNWARD COMMUNICATION:

It flows superior to subordinates. It is generally directive in the sense that it causes action to be initiated by subordinates. Instructions, directions, clarifications, interpretations, orders, policies, rules and regulations, procedures, a specific conduct of jobs, changes in work rules, time schedules, safety and welfare measures, orders for transfers, promotions, information on working conditions, leave, etc; have to flow downwards from those at the top of the pyramid to the rank

and file workers at lower levels who form the base; and this flow may be in the form of an oral or written communication. Organisation charts show the flow of authority and the channel through which this downward communication flows.
UPWARD COMMUNICATION:

It is the other side of the downward communication, namely, information flowing from subordinates to superior. Upward communication includes Personal contacts by each member of the management with his immediate subordinates in the management with a view to answering questions or complaints immediately - Fact finding surveys of supervisors' opinions and attitudes - Giving information to management - Shaping a pattern for improved management policy and practices - Holding conferences with supervisors in the form of such devices as round table conferences, open forums, panel discussions, topical outlines of discussions and periodic weekend meetings; and - Issuing supervisors' manuals and handbooks.
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HORIZONTAL, INTRA ADMINISTRATIVE, OR LATERAL COMMUNICATION

This is communication from persons at one level in an organisation to others at the same level. It is particularly frequent between the line and staff units. It provides a means by which managers at the same level of an organisation co-ordinate their activities without referring all the matters to their superior. Many matters can be handled at the same level of an organisation. In this way one acts speedily and, at the same time, relieves superiors of unnecessary problems. For example, multiple copies of memorandum that flow to all the positions needing the information increase the co-ordination of efforts. Communications at the horizontal level is also important at the executive level. EXTRA ORGANISATIONAL COMMUNICATION This type of communication takes place between agencies outside an organisation and the people within it. Communication is generally effected through letters and the passing of annual reports to the creditors, bankers, the government and trade organisations.

METHODS OF COMMUNICATION
All methods of communication in an organisation may be grouped under the following heads The chain of command Mass methods The representative system

CHAIN OF COMMAND

Information from top level management to the operational level or vice versa flows following the organisation's hierarchical order. This method has its own strengths and weaknesses. Strengths At each level, the official is fully informed about the organisational matters. He or she can make attempts to ensure that intended purpose of information is achieved. Weaknesses Too many levels may cause distortions in information. Moreover, unless planned, it can be expensive in terms of management time. MASS METHODS Information is disseminated through notice boards, circulars, news letters, magazines and booklets. Strengths Mass methods offer cheapest as well as adequate way of giving particular information to large number of persons. It is possible to ensure that the information transmitted is accurate. They are necessary aid for management in support of their managerial function. Weaknesses Mass methods are not good for transmitting proper understanding. You cannot ask question to ensure understanding. Although information transmitted is accurate, there is no insurance that it is correctly understood.

THE REPRESENTATIVE SYSTEM In this system information flows through staff representatives. This method provides an opportunity for management to explain the communication and repeat it at different levels. Strengths It is a necessity for adequate upward communication and invaluable in bringing home to senior management the vividness of feeling in the office at lower levels. Weaknesses

It is not suitable; for downward communication; Representatives while trying to explain departmental policies appear to be representatives of management, or otherwise, their personal prejudices and bias distort the communication. Representatives become almost the boss of the working group.

BARRIERS OF COMMUNICATION
Barriers in communication imply hurdles or problems on the way which adversely affect the transmission of information from sender to receiver. The important barriers in communication are: 1.Organizational 2.Semantic 3.Personal 4.Psychological 5.Physical 6.Mechanical 7.Cross cultural 8.Perceptional 9.Interpersonal 10.Gender

Organizational Barriers These barriers arise when duties and line of authority are not clearly defined. They arise on the account of distance communication, more layers of communication, heavy communication load etc. Various types of organizational barriers are: Policy: Broad objectives and policies of the organization are laid down by the top management. They change the behavior of the receiver. If the policy is not supporting in the

free flow of communication vertically and horizontally, it acts as a hurdle in the smooth flow of communication. Rules and regulations: Formal communication should follow the path of flow. Organizational rules and regulations sometimes work as obstacles in transmitting a message when they are rigid resulting in delay in decision making process and action. Facilities: Organizational facilities are indispensable for the smooth, proper and timely flow of communication. The purpose of communication is defeated if minimum facilities for transmitting message are not provided. Complex organization: Complexity in organization structure is a common feature in most of the big enterprises. Complexity involves many layers of supervision, long distance, more lines, communication gaps, organizational distance between lines of authorities from top to bottom in the health team. Status and position: In two-way communication, status and position impede the flow of communication particularly in upward direction. The reasons are non- listening attitude of the superior, non-answering and interpreting as well as withholding information, etc. Semantic Barriers
Problems of language are called 'semantic barriers'. They arise on account of linguistic background and ability of the communicator. Linguistic barriers occur in both oral and written communication. Common types of semantic barriers are:

Badly expressed message: The absence of clarity and precision in the subject matter of communication results in badly expressed message. The common causes for clarity and precision are using unfamiliar words, jargon, using superfluous words, lack of unity and coherence, use of unnecessary prepositions, adjectives and adverbs, lack of simplicity, longer sentences, poor language, poor construction of sentences and so on.

Jargon language: Jargon is the language which is special to science, technology, law, commerce etc. Special and technical personnel often use technical language of their own. This leads to isolation and limited communication and acts as a barrier.

Unclarified assumptions: Often over looked but critically important are the uncommunicated assumption which underline practically all messages. Certain implied things cannot be interpreted by the receiver correctly.

Faulty translations: Encoding process translates symbols, ideas, facts, opinions, and feeling into words, action, pictures and audio visual media. This translation should be understood by the receiver. When there is a fault in translation it remains as barrier in effective communication. Personal Barriers a. Barriers to superiors: Superiors may be reluctant to listen to their subordinates as they may reflect adversely on their ability and intelligence. Their hierarchical status and position and relationship with subordinates act as barriers of communication. b. Barriers to subordinates: Subordinates are also equally responsible for restricting communication flow particularly in upward direction. They act as barriers in number of ways as indicated below: People generally resist new ideas They dislike showing mistakes Lack of incentives and encouragement Unwillingness to communicate upward message on personal grounds They slant information relating to their failures

Psychological Barriers

Poor pronunciation Confused thinking Communication overload Attitude Fear and anxiety Suspicious, jealousy, anger Resentment, antagonism and prejudices Lack of interest and lack of listening

Physical Barriers Environmental disturbances: Lack of privacy, traffic nuisances, loud speakers, unwanted noise, bright light, unusual sight or any other stimulus providing a potential distraction. Physical health: Inability to receive when ill. Poor hearing: Born deaf. Loss of hearing due to accident, excess use of ear phone

Distance: Four distinct zones may greatly vary in different cultures. 18" intimate; 4' personal; 12'social; 20'public. MechanicalBarriers Non-availability of proper machines Presence of defective machines Interruption Power failure Cross Cultural Barriers Culturalethnic, religious and social difference Economic position Traditions barring people of different culture from mingling together. Political beliefs Ethics and values Rules and regulations Barriers to membership of a group as detached,devious,impersonal,condescending, hypocritical, avoiding eyecontact, too silent,aggressive,over- emotional,angry, confrontational Perceptional barriers Lack of common experience LinguisticDifferent languages and vocabulary Lack of knowledge of any language Low IQ From receiver's side: Interrupting the speaker; asking too many questions for the sake of probing From sender's side: Unclear messages; incomplete sentences; no clarification Interpersonal Barriers Withdrawal: absence of interpersonal contact Rituals: meaningless, repetitive routines devoid of real contact Pastimes: activities that entertain and keep individuals engaged in free times Gender Barriers Women: Prefer conversation for rapport building Want empathy, not solutions Are more likely to compliment Emphasize politeness More conciliatory Men:

Talks as a means to preserve independence and status by displaying knowledge and skill Work out problems on an individualized basis Are more directive in conversation Are more intimidating Call attention to their accomplishments Tend to dominate discussions during meetings

METHODS TO OVERCOME BARRIERS OF COMMUNICATION

The aforementioned barriers can be thought of a filter, that is, message leaves the sender, goes through the aforementioned filters and is then received by the receiver which may muffle the message. The following strategies can be adopted to overcome such filters. Suitable language: The appropriate language and tone definitely minimizes linguistic barriers to communication. Use of technical terms should be avoided as far as possible and the message should be direct, simple and meaningfullanguage. Different people perceive the message differently. The team should use a common language to avoid semantic distortions. Active listening: Hearing and listening is not the same. Hearing is the act of perceiving sound. It is involuntary and simply refers to the reception of aural stimuli. Listening is a selective activity which involves the reception and the interpretation of aural stimuli. It involves decoding the sound into meaning. Listening is divided into two main categories: passive and active. Passive listening is little more than hearing. It happens when the receiver of the message has little motivation to listen carefully such as when listening to music or when being polite. People speak at 100 to 175 words per minute (WPM) but they can listen intelligently at 600 to 800 WPM. Since only a part of mind is paying attention, it is easy to go for mind drift thinking about other things while listening to someone. The cure for this act is active listening which involves listening with a purpose.

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Table 1.1: Ten rules for good listening with rationale Rule Rationale Stop talking You cannot listen if you are talking Helps a person feel free to talk, create a Put the person at permissive environment ease Show the person Look and act interested, listen to understand you want to listen and not to oppose tap or shuffle papers, Remove distractions Do not doodle, quiet aids in listening close the door to remain Empathize Be patient Hold your temper Go easy on argument and criticism Ask questions Try to see the other's point of view Allow plenty of time, do not interrupt, do not walk away Any angry person takes wrong meaning from words Do not put people on the defensive and cause them to 'clam up' or become angry, do not argue even if you lose or win This encourages a person and shows that you are listening, it helps to develop points further This is first and last because all other guides depend on it, you cannot listen effectively while you are talking

10. Stop talking

COMMUNICATION AND NURSING MANAGEMENT:

In the functioning of nursing service organization eacg task of the nurses at all levels involves communication.Nursing involves the sharing of information as well as understanding and interpreting the information transmitted and received. The three main communication approaches used in nursing are (1) Organizational approach (2) Interpersonal approach (3) Technological and scientific(information) approach Organizational approach In dynamic nursing service organization the decision making process consists of many interrelated messages between superiors and subordinates.Efeective communication between varied nursing units and departments can produce a coherent ,dynamic organization for improving nursing and other patient care services. Interpersonal approach In health care organization there are different professional and technical groups with different interests ,goals attitudes,abilities and expertise.Administrative and departmental heads are challenged to use techniques that keep status and power difference between groups to minimum and they also have channels open and unrestricted between individuals and groups. Technological and scientific(information) approach Information technology is widely used in the management of control systems and continuing training and educational programmes.Communication between nurses and various departments is enhanced.This helps in conservation of resources and maintaining accurate records for matters communicated.
INTERPERSONAL SKILLS FOR NURSE MANAGERS:

a.Showing respect Showing respect means conveying the attitude that people have importance, dignity, and worth e.g. using the title of Mr or Mrs

b. Empathizing Empathy is the ability to communicate understanding and experience of feelings and reduces their anxiety and defensiveness. It focuses attention on receivers and their feelings and reduces their anxiety and defensiveness. It show that the sender shares peoples concerns, and make them feel that their contributions are valued. c. Developing trust Trust developed through an open, honest and patient approach with others: As trust develops, communication becomes more free flowing and productive. Receivers will not express their true feelings if they do not fully trust the sender. Health care providers develop trust in communication process by showing that they truly accept others, that they believe in them as people. Trust generates trust e.g. if you show confidence in people you communicate with, they will respond the same way. Treating people as fully participating partners in the communication process, and demonstrating that they are trustworthy and responsible

CONCLUSION
Communication is the meaningful exchange and understanding of

ideas,statisticaldata,opinions or emotions from a source to a receiver. Nowadays professional nurses are involved in human and labourrelations,the development of quality and quantity nursing service standards,the assessment of nursing care ,and a whole list of other aspects of health care operations.Effective communication is an art and skill which needs to be learned and practiced.Remember,He/she who effectively communicates leads.