OC‘I‘OBER 1999. VOL 70. N O 3

P H E s I I) I!: N *r 9 s M b: s s A G L

Communication-speaking, surfing, and smiling

A word is not a crystal, trans- parent arid unchanged; it is the skin of a living thought.

and may vary greatly in color and content according to the circuni- stances and the time in which it is used.”’

readers of this column (except maybe the Past Presidents) that the President’s Messages do not automatically roll off the brain of the writer. Authors are painfully aware how difficult i t is at times to put their thoughts down in ii meaningful way. (Attention! Aspiring authors: Do NOT let this deter you. Fortunately for all of us. there are editors who are will- ing to and capable of nudging us along toward our goal; believe me. they are all too familiar with the symptoms of “cantus writus.”)

I have been (impatiently) waiting for tlie Muse, the mythical patron of writers, to return from her summer vacation to help me meet the JorrrwI deadline. (Another factoid: President’s Messages are written two months before publication. Thus, while I’m writing this, the leaves are green-r brown--crops are ripening, and the weather is hot and inuggy. While you are I-catl- ing this, you are admiring the red and yellow leaves, preparing for Oktoberfest, or grateful that cool- er weather has finally returned.) It is not without irony that the sub- ject of this Presidenl’s Message is communication.

When writer’s block occurs, I usually re-read my mail, looking

for the undiscovered postcard from the Muse. (Okay, so some- times I go to the movies.) What I found on the back page of the recently arrived Nurses i n Business, Industry & Consulting (BlC) Specialty Assembly Newsletter was the Oliver Wendell Holmes quotation at the beginning of this column. Sue Taylor, RN, BA, BIC newsletter editor, used the quote to introduce her request for articles on topics of interest to BIC members. In this short quotation, Holnies suc- cinctly captures one of the princi- ples that both fotms the founda- tion for successful communication and identifies some of its niost persistent stumbling blocks.

WORDS AS VEHICLES Words-written or spoken-

convey thoughts. They are the vehicle for communicating ideas from one person to another. Holmes’ reference to circumstan- tial and temporal factors that can vary the meaning of words is par- ticularly relevant in this era of communication technology. Consider the many methods of communication at our disposal: voice mail, e-mail, faxes, cellular telephones, web sites, and chat rooms. Circitnistantial factors related to these technologies include rules of etiquette associat- ed with each technology. For example, e-mail writers should avoid the use of ALL CAPITAL LETTERS WHEN SENDING MESSAGES because it implies “shouting.”’ Fax scnders and

receivers need to respect con- fidentiality; and chat room par- ticipants are requested to limit their questions and pATRlclA c. SE,FERT responses to the designated topic.

Another consideration may be the reading level of patients who are encouraged to surf the Internet LO find information, or patients’ ability to gain access to this elec- tronic infomiation source. There also may be differences in patients’ technical skills or con- fort with the use of these coniniu- nication tools. At this time, the computer chip is rapidly beconi- iiig tlie printing press of the future,’ and we need to become familiar, and comfortable. with this technology if we arc to serve our patients.

In addition to the staggering number of available communica- tion mechanisms, we also need to be sensitive to the increasing number of diversity categories in today’s society: gender (eg, “he said, she said”), generational (eg, one group loves technology, another fears it), cultural (eg, dif- ferent perceptions o f pain), and language (eg, Spanish, Victnamese, Hindi). All these f lu- tors are reflective of the time in which we live and can be the source of anguish, emotional pain, or worse to patients and col- leagues if they arc not respcctcd.

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COMMUNICA TlNG WITH MACHINES

In addition to communicating with people, we also must learn to interact with things: robots, infor- mation systems, and computer programs. Talking to machines requires a new skill set; how many of you have tried to tell a listserver that you want to “unsub- scribe”-and you succeeded on the first attempt? Our ability to interact with these machines, devices, and electronic systems has become a necessary compo- nent of clinical competency, and our patient’s safety may depend on our ability to engage in this form of “communication.” Imagine the not-too-distant future, when telesurgery becomes more prevalent; surely our ability to talk to robots will make the difference between life and death.

NONVER5AL C O ~ ~ U ~ l C A T l ~ N Many of our communication

patterns involve nonverbal or body language. We employ non- verbal communication when we smile, frown, or embrace some- one. Therapeutic touch not only promotes relaxation, but also communicates concern. Art and music communicate ideas as well as emotion, and music therapy is commonly used to reduce anxiety in the perioperative setting. When language is a barrier, nonverbal communication often can help patients cope until a translator arrives.

BENEFITS OF COMMUNICATION There are two key benefits to

fostering good (and frequent) communication with animate and inanimate beings. The fist is bet- ter patient care; the second is a stronger AORN. Communication with our patients is one of the

most therapeutic interventions at our disposal. Our failure to com- municate necessary information to patients for achieving identified outcomes can mean the difference between success and failure. Part of our responsibility is to familiar- ize ourselves with computer tech- nology so that we not only can open doors to the vast information available online, but also can direct our patients to the most appropriate and accurate web sites. Patient education is a critical nursing function in this era of shortened lengths of stay because it provides patients with the knowledge to make informed decisions and thereby increase control over their own lives. The importance of good communica- tion is underscored by patient sat- isfaction surveys illustrating that a cause for criticism is more likely to be our failure to communicate our interest or compassion to patients rather than our lack of technical skill.

Fifty-one years after Holmes’ comment, Strother Martin, in the movie “Cool Hand Luke” uttered the immortal words, “What we’ve got here is a failure to communi- cate.’” Do we employ “Latinate terms and six-syllable words”5 when talking to patients or their loved ones? We might not even be aware of what we are doing except for that blank stare on the patient’s face. It is normal to use clinical lingo in our communica- tion patterns, but as nurses we are also taught to empathize, or walk in someone else’s shoes.

Clinical lingo can even create communication problems between nurses, as demonstrated by research showing that the nurse expert’s situational, intuitive judg- ment is at times incomprehensible to the novice, who must rely on

rule-based practice and linear thinking.“ How do we orient, mentor, educate, and train novices to gain insight, skill, and experi- ence if their clinical guides cannot communicate in ways understood by the novice?

There is also evidence that clinical errors are not infrequently related to ineffective communica- tion patterns between members of the health care team.7 An institu- tional culture that does not value constructive criticism or one member’s pointing out the clinical errors of a member of another profession can have disastrous consequences.

BENEFIT TO AORN Second, the benefit of com-

munication to AORN is related to accepting and welcoming not only convergent, but also diverse, viewpoints. Although we may be uncomfortable with differing opinions, there is per- sonal and organizational benefit when we can use these situations to clarify viewpoints, address fears, reach consensus, and/or resolve underlying issues. Part of our responsibility as AORN members is to communicate our ideas, share our knowledge, and participate in deliberations on issues facing our organization. It is important to express your opinions-pro and con-because that is one of the most valuable contributions you can make to AORN. We are all leaders. Good leaders are able to see many sides of an issue, and it is a leader’s duty to actively seek alternate opinions and communi- cate a vision that embraces diversity as well as focused objectives.

often receives communication via The AORN Board of Directors

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telephone, e-mail, or “snail mail” from constituents with differing viewpoints. Rather than seeing this as a “challenge,” I view this as an “opportunity” for AORN to consider alternate views, to grow, and to identify new ideas. Sometimes there is an opportunity to educate one another; at other times it is a chance to learn from our members. It may even be an opportunity to clarify previous communications. (See Jan Olmstead’s Letter to the Editor and my response on page 569.) It

NOTES

always facilitates growth. This is the critical point: open discussion, candid communication, and joint problem solving strengthen our organization. Our organization consists of volunteers who pro- vide their time and expertise to promote the organization. Respecting different viewpoints is one of the highest compliments that can be given, and our AORN members deserve no less. When we have the courage to speak up and focus on what is best for AORN, we will surely succeed in

our efforts to advance this premier organization.

Postscript: I just received a postcard with a beautiful beach scene from the Muse. She writes, “Having a good time, wish you were here.”

PATRICIA C. SEIFERT RN, MSN, CNOR, CRNFA

PRESIDENT

President Seijert can be contacted by telephone at (800) 755-2676 x 311, by e-mail at SeijertPC@aol.com, or by fax at (703) 237-1259.

4. S Rosenberg, Cool Hand Luke (Hollywood, Calif 1. S Taylor, “Attention: Aspiring authors! We need your Warner Brothers, 1967) Videotape.

Journal 42 (MarcWApd 1999) 8-11.

Ca l i Addison-Wesley Publishing Co, 1984).

human factors affecting anesthetic vigilance and monitor- ing performance in the operating room environment,” Anesthesiology 73 (November 1990) 995.

talent and experience,” Nurses in Business, Industry & Consulting Specialty Assembly Newsletter 6 (Fall 1999) 4.

Magazine (Association of Operating Room Nurses, Inc, 1997).

3. C K Wilson, T Porter-O’Grady, Leading the Revolution in Health Care (Gaithersburg, Md: Aspen Publishers, Inc, 1999).

5. E Friedman, ‘‘Making choices,” Health Forum

6. P Benner, From Novice to Expert (Menlo Park,

7. M B Weinger, C E Englund, “Ergonomic and

2. B Marousky, “Do’s and don’ts of e-mail,” NetCafe

President Seifert Creates Perioperative Nursing Endowment AORN President Patricia C. Seifert, RN, MSN, CNOR, CRNFA, has established an endowment that will provide scholarships for individuals to attend perioperative nursing education courses. Currently, a decreasing number of nurses are prac- ticing in the perioperative setting. With a general lack of a perioperative component in general nurs- ing education, there is a great need to develop this type of scholarship fund. The endowment will allow the Foundation to provide ongoing funds to support the education of nurses wishing to enter perioperative practice.

This fund will be directed toward subsidizing

expenses associated with completing the didactic and clinical components of academically based perioperative nursing courses. Guidelines for appli- cant eligibility and the criteria for the education courses are currently under review.

Gifts or pledges for the Patricia C. Seifert Perioperative Nursing Internship Endowment may be mailed to the AORN Foundation, Patricia C. Seifert Perioperative Internship Endowment, 2 170 S Parker Rd, Suite 300, Denver, CO 80231-5711. Please call the AORN Foundation with any ques- tions at (800) 755-2676 x 366 or send an e-mail to sstokes@aorn.org.

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