COMMUNICATION

INTRODUCTION
Communication is sharing ideas, or opinions with others. It is an integral part of the
management process, which involves an exchange of facts, feelings and information by two
or more persons and provides the means of putting the personnel into action in an
organization.
Communication is the basic element of human interactions that allows people to
establish, maintain and improve contacts with others. It constitutes the foundation of
interaction among human beings. Nursing is a communicative intervention and the
foundation of nursing lies in the “communicative attitude”.
Communication in a job is every one’s job in the organization. Therefore, knowledge
of communication and critical thinking is essential if effective working relationships are to be
developed and maintained.
DEFINITION
Communication is a process in which a message is transferred from one person
(sender) to other person (receiver) through a suitable media and the intended message is
received and understood by the receiver.
PURPOSES OF COMMUNICATION
Proper communication is needed at every step and serves several purposes as follows.
It provides;
1. Information and understanding necessary for group work.
2. The attitudes necessary for motivation, co-operation, and job satisfaction.
3. Work satisfaction
4. Assistance in decision making because taking decision needs information.
5. Promotion of managerial efficiency.
6. Co- operation through understanding.
7. Basis for co- ordination.
8. Provision for job satisfaction.
Essentials of communication
According to Millet, there are some factors necessary to make communication
effective, namely – It should be clear, consistent with the expectation of the recipient,
adequate, timely uniform and acceptable.
Jerry recommends 8 practices to achieve the goal.
1. Inform yourself
2. Establish a mutual trust in each other,
3. Find a common ground of experience
4. Use mutually known words
5. Have regard for context
6. Secure and hold the receivers attention
7. Employ examples and visual aids, and
8. Practice delaying reactions.

LEVELS OF COMMUNICATION

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 Communication takes place in the management at various levels every day with
various levels of people every day.
Intra personal communication
It occurs when a person communicates with himself, i.e. when the individual looks
outside and sees that it is very hot to go out during mid-afternoon and thinks to carry an
umbrella with him.
Interpersonal Communication
Is referred to when a communication takes place between two people either face- to –
face, or telephone, or small groups, etc.
Small group Communication
It is referred to when a communication occurs between three or more people
interacting with each other.
Organizational communication
This refers to the communication takes place between members of an organization
during the performance of organizational tasks, i.e. hospital, or educational institution, etc
Public communication
It involves interaction with the large groups of people, i.e. when a speaker addresses
an audience.
Mass Communication
It occurs when a small number of people send messages to a large, anonymous
audience through the use of some specialized media. Media , e.g. films, television, radio,
news papers and books etc.
TYPES OF COMMUNICATION
Mainly there are two types of communication. i.e. verbal communication and non- verbal
communication.
Verbal Communication:
Verbal communication involves spoken or written words. Words are tools or symbols
used to express ideas or feelings arouse emotional responses, describe objects, observations,
memories or interferences. To make a message clear nurses use effective verbal
communication technique such as:
 Clarity and brevity
Clarity can be achieved by speaking slowly and clearly. Using examples can make
explanation easier to understand. Brevity is best achieved by using words that express
an idea simply, i.e. “Tell me what is your problem.”
 Vocabulary
Instead of using purely technical words use, local words synonyms to technical words
for better understanding.
 Denotative and connotative meaning
A denotative meaning is one shared by individuals who use a common language that
is used to define a word so that it means the same to everyone. The connotative
meaning of a word is the thoughts, feelings or ideals that people have about the word.
 Pacing
Verbal communication is successful when expressed at an appropriate speed or pace.

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  Timing and relevance
Timing is critical to reception. For example if the supervisor /manager is in bad mood,
the timing is wrong to ask for a raise. And relevance is also important, i.e. that
communication is most likely to have an impact when message pertain to an
individual interest and needs.
Humor
It can be a powerful tool in promoting all aspects in management and also for well-
being. Laughter is the best medicine. When it is used in good sense according to
circumstances and events.
The written communication must be based on four essential ‘C’s – clear, correct, complete,
and concise.
Non verbal Communication
Non- verbal communication is transmission of messages without the use of words. To
compensate for the inadequacy of verbal message information, people unconsciously use
facial expression, gesture, touch and vocal tone to amplify the meaning of spoken
communication. It is one of the powerful ways people conway messages to others.
1) Metacommunication
It is the message that conveys the sender’s attitudes, feelings, and intentions towards
listener. It may be verbal or non-verbal. Non –verbal shows genuine feelings or may
be an attempt to hide feeling, for example, smiling when angry.
2) Personal appearance
The general impression formed of another person influences the response to that
person. It is often leads to impressions about personality and self concept.
3) Intonation
The tone of the speaker’s voice can have a dramatic impact on a message’s meaning.
A person’s emotion can directly influence tone of voice.
4) Facial expression
The face is rich in communication potential. The fase and eyes send overt and subtle
clues that assist in interpretation of messages, e.g. surprise, fear, anger, disgust,
happiness and sadness.
5) Posture and gait
It reflect attitudes emotions, self- concept and physical wellness.
6) Gestures
It identifies 3 functions such as an illustrating an idea, expressing an emotional state
and signaling by use of sign.
7) Touch
It is a personal form of non- verbal communication. Persons engaged in
communication must be close to each other when touch is used.
FLOW OF COMMUNICATION PUT INTO CATEGORIES
1. General Communication
From one part of the organization to its other parts and man-to man. It is carried on
horizontally between chains of command for securing co- ordination in operation can be
upward, downward or a sidewise in the structure.
2. Personal Communication

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It is between the superior and subordinate. It provides the basis for action and co-operation in
the enterprise.
3. One- way communication
One way communication goes only from the sender to the receiver. Here speaker believes
what he says is right. One – way communication usually used by the authoritative supervisor,
sometimes leads to confusion and misunderstanding.
4. Two- way communication
Two way communication goes back and froth between the sender and receiver. Here both
work together to understand. It means the active role of the receiver, who has the
responsibility to provide feedback to the sender.
Direction of communication
Communication can be in the following direction
1. Downward
2. Upward
3. Horizontal
4. Diagonal Communication
Downward communication
This is the traditional and most commonly used communication, where the management
gives orders to the subordinates at the bottom level to carry out the orders as per the
organizational hierarchy. e.g. Individual and group instructions, handbooks, interviews,
employee counseling, a loudspeaker, letters, posters, bulletin boards, annual reports.
Upward communication
It means the passing on information from the employee level to administration. This conveys
attitudes and feelings of the employees towards management. e.g. Face –to –face discussion,
open- door policies, staff meetings, written reports .
Horizontal (lateral) communication
Lateral or horizontal communication is referred to the communication which takes place
between the departments or personnel on the same level of the hierarchy. E.g. committees,
conferences, and meetings with the purpose of sharing information and solving the problem.
Diagonal communication
Diagonal communication occurs between two individuals or departments that are not on the
same level of the hierarchy.
Common means are: Unit in –charge ordering diet for the patient, X-ray department informs
appointments given to patients in a particular unit, etc.
FACTORS INFLUENCING COMMUNICATION
The factors influencing communication are:
1) Perception
It is the personal view of events, i.e. each persons senses, interprets , and
understands the events differently.
2) Values
These are standards that influence behavior. They are what person considers
important in life and thus influence expression of thoughts and ideas.
3) Emotions
These are person’s subjective feelings about events.

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 4) Socio- cultural background
Culture is the sum total of the learned ways of doing, feeling, and thinking. It is a
form of conditioning that shows itself through behavior. Language, gestures,
values, attitudes reflect cultural origin.
5) Gender
Some studies have shown certain speaker and listeners behaviors support sex-
linked difference and dominance patterns.
6) Knowledge
Knowledge of handling different level persons is essential for communication.
7) Role and relationships
Communication is more effective when the participants remain aware of their
roles in a relationship.
8) Environment
Warm and comfortable environment facilitates good communication.
9) Space and territoriality
Territoriality is the drive to gain, maintain and defend an exclusive right to an area
of space. It provides people with a sense of identity, security and control.
FACTORS IMPAIR COMMUNICATION
The following psycho- social factors block or impair communication
1. Homophiles
It refers to communicate most with persons similar to self, i.e. age, race, social
status.
2. Chain of command
In this the message is altered with each interchange, e.g. formal and informal
sanctions for circumventing the official chain of command leads to subordinate’s
to discuss problems with high level administrator.
3. Frame of reference: Means perceive some messages and ignore others.
4. Self- preservation: Refers to distort information for self protection.
5. Crisis: Means that confusion, excitement and conflict increase the likelihood of
message distortion because of employees stress and fatigue.
COMMUNICATION MODEL
The goal of effective communication is understanding, not agreement or persuasion.
Understanding builds productive relationships and opens the door for agreement or
persuasion, eg. The first line nurse manager can send a message to the blood bank for a unit
of packed cells, but if it is not received or understood by someone which means no
communication has occurred.
Or
If an HOD has given the message to the class representative regarding the change of
time table for the class and no student turns up as per the change suggested then it means the
message is not understood clearly by the student representative or the message is not reached
respective class.
An effective communication model consists of 6 steps for effective communication
process.
1. The message

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 2. Encoding
3. Transmitting
4. Decoding action
5. Continuous feedback
Senders must have something to say before they send a message. Message is the content of
intended communication.
 The sender
The sender chooses concept, idea or feeling to communicate. This is the content of
communication. It is the basis of a message. e.g. the first line manager (sender)
communicates information about patients, without a reason or goal, there is no need for
him to begin the communication process.
 Encoding
Encoding is translating the message into verbal (words) or non- verbal means
(expressions and gestures) that will communicate the intended message to the receiver.
 Transmitting
Transmitting is the channel used to communicate the message. The message can be in
any form that can be understood by receiver’s senses. For example, speech can be
heard; can be written word (read) electronic media (slides, projectors T V) gestures
facial expressions(seen or felt), a touch (comfort) .
 Decoding
The receiver perceives and interprets or decodes the sender’s message into information
that has meaning.
 Action
It is the behavior adopted by the receiver as a result of the message sent received and
perceived. It is the process of doing or performing something.
 Communication
It is not successful until the message received has been understood and acted upon
appropriately.
 Feedback
It is a continuous two way process in which senders receiver exchange information and
clarify meaning if the message sent. The communication process is not complete until
the feedback occurs.
IMPORTANCE OF COMMUNICATION
 It is the means through which nursing management achieves organizational goals.
 Nursing managers in carrying out their management functions, spend most of the time
communicating. i.e. with the nursing personnel, physicians, staff in supportive
services, patients/ clients, etc.
 Communication motivates staff members. i.e. sharing information of mutual interests,
explaining plans, etc.
 Communication leads to influence and power. i.e. the first line nurse manager can
improve quality patient care.
 It reduces anxiety, misunderstanding prejudices and enhances better interpersonal
relationships.

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STEPS IN PLANNING COMMUNICATION
1. Know your objective
2. Identify your guidance
3. Determine your medium
4. Tailor the communication to fit the relationship between sender and receiver.
5. Establish mutual interest- empathy
6. Watch your timings
7. Measure your results.
MODES OF COMMUNICATION
 Notice boards
 House magazine
 Suggestion scheme
 Meeting and conference
 Hospital and departmental letters
 Personnel policy manuals.