The Power of Positive Communication: A 21st Century Imperative
When you meet your friend on the roadside or in the market place, let the spirit in you move your lips and direct your tongue. Let the voice within your voice speak to the ear of his ear; For his soul will keep the truth of your heart as the taste of the wine is remembered.
When the colour is forgotten and the vessel is no more. 1
The power of positive communication may be the single most critical element in the role that each of us will play in this new century as nursing leaders, clinical practice nurses, members of local communities, and members of the global humanity. Through our actions and what we say and sometimes fail to say, we convey love, approval, satisfaction, happiness, joy, and sometimes despair.
As nurse executive leaders, we have the unique opportunity of serving as role models and building the nursing culture. Our behavior sets the standards for others. This leadership position places us in a role that is distinct and powerful, a role that when effectively communicated has the ability to bring about the achievement of organizational and professional goals for the leader and those led.
Twenty-first century clinical practice nurses are also leaders. Each brings a body of nursing knowledge meant to deliver care and enhance the health of society. Each nurse is a unique individual, with values, standards, strategic and critical thinking abilities, and the drive for success and approval. Creating an environment of inclusion and trust encourages clinical nurses to behave as leaders, solve difficult and complex problems, and buy into the organizational vision.
Nurses come from diverse backgrounds; increasingly, nurses, like many of their patients, speak a second language. With diversity as a driving force for the nursing profession in this new century, the demands for communication that is effective, caring, and sensitive will require executive leaders to acknowledge that nurses and their patients are forever linked together.
The ability to meet the combined nurse/consumer needs will become equally vital to the marketplace as cost and quality. Often, those needs have been cited as "soft" and not worthy of the executive leaders' time and effort. They include respect regardless of job title, active listening, and willingness to accept the diversity of thinking that results from a concept like circle communication. In this form of group exchange, a network of relationships is built, and a sense of community develops.
In this issue of Nursing Administration Quarterly, Cathleen Michaels describes circle communication as emphasizing individual contribution and yet building group consensus. Such an inclusive technique may be useful for developing organizational/clinical goals and to strengthen colleague relationships among clinical nurses. In a consumer-driven world, Lucille Joel describes an environment that is multicultural and multigenerational: a world in which consumers expect information, make their own decisions, and increasingly manage both their own health and disease. Bonnie Wesorick addresses the call to "create healthy, healing work cultures[horizontal ellipsis]integrated at the point of service." She believes that regardless of location (hospital, community, school, parish) the environment will significantly affect practice and outcomes, provider, and recipient of care.
Bonnie Hillegass et al. offer a unique perspective as a managed care organization strives to change managed care to care management in "Changing Managed Care to Care Management: Innovations in Nursing Practice." The corporate philosophy reflects the goal of moving the client along the care continuum "toward the least restrictive, safe, cost-effective, environment possible."
In "21st Century Rural Nursing: Navajo Traditional and Western Medicine," Barbara O'Brien et al. introduce many of us to the harsh realities of rural living, health, and nursing on the Navajo reservation of New Mexico. Within the borders of the United States in the 21st century may be found a culture of people in poverty, isolation, and social exclusion because of the lack of basic communication means like telephones and mail delivery. The need for nurses in advanced and specialized roles like case management will be especially significant for these underserved communities. Critical to their success will be the ability to sensitively communicate Western medicine techniques with native beliefs and culture. Karen Zander believes that nurses need to acknowledge case management as a specialty with a select body of knowledge that will need to "move beyond access and medical necessity functions to those functions that demand advanced nursing experience and skills" in the 21st century. Furthermore, combining multiple knowledge bases will be cost-effective for the payer and career enhancing for the nurse in this information-driven era. Jo Manion predicts the emergence of the free agent nurse workforce. This arrangement requires that employers communicate with and welcome nurses as copartners in care delivery and design. Generation X is familiar with this approach and will serve as mentors for their more senior nurse colleagues in achieving the mind-set that reflects this approach to employer/employee relationships.
Patricia Alpert et al. reflect on the future role of the nurse practitioner in practice, education, and research. This evolving role may be described in the advice given by Dr. Loretta Ford, "my final word to current NP's[horizontal ellipsis]is to take risks, chart new directions, study the results, learn from your mistakes, and enjoy change." 2
Every article in this issue presents unique insights into nursing practice and health care in our emerging century. I sincerely appreciate all the authors who took the time to offer their diverse perspectives of our practice future. I feel the need to end with the prayer that nurses and others will communicate to a troubled world a possible and more positive future for mankind that results when all people can speak, "I love you, my Brother, wherever you are, whether you kneel in your church, worship in your synagogue or pray in your mosque." 3 Perhaps this more than anything else will be the most important message for all of us to communicate in the 21st century.
REFERENCES