Communication Skills

Assertiveness By

Dr. Vian Ahmed

BSc. Pharmacy, MSc. & PhD. Clinical Pharmacy

Types of Behavior

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Passive Behavior

• Avoid conflict at all cost.

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Characteristics of Passive Person

• Passive persons will;

1. Not say what they really think out of fear that others

may not agree.

2. Hide from people & wait for others to initiate

conversation.

3. Put the needs of other people above their own.

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Characteristics of Passive Person

4. Have a great deal of anxiety in relationships.

5. Worry about how others will respond to them &

have a high need for approval.

6. See themselves as victims who are subject to

the manipulation of others. It is this view that

is damaging to their self-esteem.

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Features of Passive Pharmacists

1. Hide behind the counter,

2. Give prescriptions to staff to hand to patients,

3. Avoid interaction with patients unless asked specific

questions

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Aggressive behavior

• Win in conflict situations by dominating or

intimidating others.

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Characteristics of Aggressive Person;

• Aggressive person will;

1. Promote their own interests or points of view but are

hostile to the feelings, thoughts, or needs of others.

2. Think that aggression works as others back down in

order to avoid prolonging the conflict.

3. Easily be angered & have a low tolerance for

frustration.

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Aggressive behavior;

• Some times people may act in subtle

ways to get even with the aggressive person.

Example 1;

patients who do not feel they are treated with respect in

a community pharmacy may not return to that pharmacy

& may tell friends about their negative experiences.

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Aggressive behavior;

• Example 2;

Employees who feel helpless

& undervalued can sabotage the

goals of their employer in a variety of indirect ways.

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So

Aggressive individuals may “win” certain interpersonal

battles in the short term, but their behavior often leads

to negative long term consequences.

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Assertive behavior

• Is the direct expression of ideas, opinions & desires.

• The intent is to communicate in an atmosphere of trust.

• The goal is to stand up for oneself & to solve

interpersonal problems in ways that do not damage

relationships.

• Assertiveness requires that you respect others as well as

yourself.

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Assertiveness

• Confident & forceful

behavior.

• Being assertive; being able

to stand up for your own or other people's rights in

a calm and positive way, without being either

aggressive, or passively accepting wrong

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Features of Assertive Pharmacists

1. Come out from behind counters,

2. Introduce themselves to patients,

3. Provide information on medications,

4. Assess the patient’s use of medications & problems

with therapy.

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Differences between Types of Behavior

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Assertive techniques

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Assertive Techniques

• Start statements with “ I”

• Express your own beliefs & rights.

• Express your thoughts & Feelings directly to reinforce

your identity.

• Include positive & negative information in a statement.

• Assertive Statements; Simple, Soft, Empathic,

Confrontive, & Persuative.

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Empathic assertion

• Contains an element of recognition of the other

person’s feelings, needs or wants, as well as a

statement of your needs & wants.

• In this situation you want to indicate that you are

aware of & sensitive to their position.

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Empathic assertion

• Example 1;

I appreciate that you don’t like the new procedure,

however, until it’s changed , I'd like to keep working on

it.

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Empathic assertion

• Example 2;

I recognize that it's difficult to be precise on

costs, however, I need a rough estimate.

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Assertiveness & other health care

professionals

• When problems in patient therapies arise,

consultations with physicians/ nurses are required.

• If you needed to speak directly with the doctor, insist

on your request.

• Messages transmitted through third parties is not

effective mean of communication.

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Case Study

PHARMACIST CALLING A NURSE IN A

PHYSICIAN’S OFFICE

• Pharmacist: This is J. L., the pharmacist at Central

Pharmacy. I’d like to speak to Dr. S please.

• Nurse: He’s with a patient right now. What is it you

wish to speak to him about?

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Case Study Continued…..

• Pharmacist: I am concerned about Mrs. R’s

prescription for metformin. I will need to speak to Dr.

S about it. Please have him call me ASA he comes out

from the patient examination.

• Nurse: It might be quicker if you tell me what the

problem is. I could talk to Dr. S & get back to you.

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Case Study Continued…..

• Pharmacist: Thank you, but in this case I would like

to talk to Dr. S directly.

• Nurse: He’s very busy today & we’re running behind

schedule.

• Pharmacist: I know he has a busy schedule but I

must speak with him ASP. Please ask him to call.

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Case Study Continued…..

• The doctor calls back the pharmacist after 30

minutes;

• Outline the correct statement made by the

pharmacist?

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Case Study Continued…..

• A) Dr. S, this is the pharmacist at Main Street Pharmacy.

I’m sorry to bother you—I know you’re busy—but I think

there’s a problem with Mrs. R’s prescription for

metformin.

• B) Dr. S, this is J. L., the pharmacist at Main Street

Pharmacy. I’m calling about a problem Mrs. R is having

with her prescription for metformin.

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Case Study Continued…..

A) Did you know that Mrs. R is still having diarrhea from the

metformin? Do you want to change her prescription?

B) I spoke with Mrs. R today. She reports that she continues to

have diarrhea after 3 months on the medication. She has

stopped her walking program & is reluctant to leave the house

because of the diarrhea. The effect on her life is so serious

that you may want to consider switching her to a sulfonylurea

such as glyburide or one of the newer thiazolidenediones such

as Avandia® or Actos®, which are less likely to cause

diarrhea.

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