PHILOSOPHY OF MEDICAL & NURSING MANAGEMENT
INTRODUCTION
The word communication has been derived from the Latin word ‘communis; which means common. Communication therefore refers to the sharing of ideas, facts, opinion, information and understanding. 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". This attitude is manifested in the striving for mutual understanding, coordination and co-action. Communication is commonly defined as the transmission of information. Its precise definition is disputed and there are disagreements about whether unintentional or failed transmissions are included and whether communication not only transmits meaning but also creates it. Models of communication are simplified overviews of its main components and their interactions. Many models include the idea that a source uses a coding system to express information in the form of a message. The message is sent through a channel to a receiver who has to decode it to understand it. The main field of inquiry investigating communication is called communication studies.
Human communication has a long history and how people exchange information has changed over time. These changes were usually triggered by the development of new communication technologies. Examples are the invention of writing systems, the development of mass printing, the use of radio and television, and the invention of the internet. The technological advances also led to new forms of communication, such as the exchange of data between computers.
COMMUNICATION
DEFINITIONS
1. According to Aristotle, communication is a means of persuasion to influence the other so that the desired effect is achieved.
2. Another definition by Paul Leagens, it is "a process by which two or more people exchange ideas, facts, feeling or impressions in ways that each gains a ‘common understanding of meaning, intent and use of a message.’
3. According to prof. Dasgupta, communication is the process of passing information and understanding from one person to another. It is essentially a bridge of meaning between people. By using this bridge of meaning a person can safely cross the river of misunderstanding that separates all people.
4. According to Webster, sending, giving or exchanging ideas and information, which it often expressed non-verbally or verbally.
TYPES OF COMMUNICATION
· One-way communication (Didactic Method)
· Two-way communication (Socratic Method)
· Verbal communication
· Non-verbal communication
· Written communication
· Meta communication
· Visual communication
· Tele communication
ONE-WAY COMMUNICATION:
Ø One-way communication is when a sender transmits a message to a receiver in a way that does not allow the receiver to respond. It is considered linear because the information being sent only travels in one direction.
Ø For example, a doctor providing detailed written instructions for medication usage to a patient without actively checking for understanding or allowing the patient to ask questions.
TWO-WAY COMMUNICATION:
Ø Two-way communication is the process of exchanging messages between two or more people, where both parties actively send and receive information. This lets the sender know the information was received.
Ø For example, nurse checking in with a patient about pain level and adjusting medication based on their response.
VERBAL COMMUNICATION:
Ø Verbal communication is the act of sharing information using spoken or written words. It's a fundamental part of human interaction and is used in many situations, including in person, on the phone, or online.
Ø For example, a doctor explaining a diagnosis and treatment plan to a patient during a face-to-face consultation or discussing a patient's medical history over the phone with another healthcare professional.
NON-VERBAL COMMUNICATION:
Ø Nonverbal communication is the transmission of information without using words. It can include facial expressions, gestures, body language, eye contact, touch, space, and voice.
Ø For example, a nodding head to acknowledge understanding.
WRITTEN COMMUNICATION:
Ø Written communication is the exchange of information using written words, such as emails, letters, or faxes. It can be used for many purposes, including business, personal, and academic communication. Written communication creates a lasting record of communication that can be referred to later.
Ø For example, a patient discharge summary, which details a patient's diagnosis, treatment plan, medications, and instructions upon leaving the hospital.
META COMMUNICATION:
Ø Metacommunication is a form of communication that conveys additional meaning beyond the literal content of what is said. It can be verbal or non-verbal, and can include gestures, facial expressions, and vocalizations. It is the process of communicating about communication. Meta-communication is a secondary communication about how a piece of information is meant to be interpreted. A broader definition would be that metacommunication involves how people perceive you, not just your words.
Ø For example, if you say “Glad to see you” to someone and roll your eyes at the same time, they will not feel that you are actually glad to see them.
VISUAL COMMUNICATION:
Ø Visual communication is the use of visual elements to convey ideas and information which include signs, animations, graphic designs, advertising and electronic resources. This style of communication relies on the way one's brain perceives the outside images. It has been proven to be unique when compared to other verbal or written languages because of its more abstract structure.
Ø For example, 3D anatomical models and detailed diagrams to help medical professionals understand body structures and functions.
TELE COMMUNICATION:
Ø Telecommunication, often used in its plural form or abbreviated as telecom, is the transmission of information over a distance using electronic means typically through cables, radio waves, or other communication technologies.
Ø For example, doctors and patients communicate remotely using technology like video conferencing to provide consultations, diagnose conditions, and monitor treatment progress. Cell phones, satellites, radio and television broadcasting, the internet and telegraphs.
MODELS OF COMMUNICATION
1.Shannon’s model of communication:- The Shannon-Weaver model is one of the first models of communication. Shannon's model of communication process is a general model of the process.
Ø Initially published in the 1948 paper "A Mathematical Theory of Communication", it explains communication in terms of five basic components: a source, a transmitter, a channel, a receiver, and a destination.
Ø The source produces the original message. The transmitter translates the message into a signal, which is sent using a channel.
Ø The receiver translates the signal back into the original message and makes it available to the destination.
Ø For example, for a landline phone call, the person calling is the source. They use the telephone as a transmitter, which produces an electric signal that is sent through the wire as a channel. The person receiving the call is the destination and their telephone is the receiver.
2.Aristotle’s triad model of communication: - Aristotle’s model of communication is also known as the “rhetorical triangle” or as the “speaker-audience-message” model. It consists of three main elements: the speaker, the audience, and the message.
· THE SPEAKER- The speaker is the person who is delivering the message. In this model, the speaker is responsible for creating and delivering the message effectively. This includes not only the words used but also the delivery style, tone, and body language.
· THE AUDIENCE- The audience is the group of people who receive the message. In this model, the audience is considered an essential part of the communication process. The speaker needs to understand the audience’s needs, interests, beliefs, and values to effectively communicate the message.
· THE MESSAGE- The message is the content of what is being communicated. In this model, the message should be clear, concise, and persuasive. The message should be crafted with the audience in mind to ensure that it is relevant and engaging.
Aristotle’s model of communication is important because it seems plausible and valid even in our modern lives. His model consists of three bullet points or three main important elements. That’s why we’ll explore each of them one by one.
ETHOS- The first element Aristotle comes up with is what he calls ethos. Ethos is essentially the speaker’s credibility to talk about the subject that he’s talking about and discuss it openly and with certainty. What this does to an audience is create an image of the speaker as someone who knows what they are talking about and as someone that they can easily rely on and trust.
PATHOS- The second most important element of communication is what Aristotle calls pathos. The literal translation of pathos is emotion. Pathos is essentially the speaker establishing an emotional connection with the audience he’s speaking to. The idea behind pathos is that the audience has to feel that they are being communicated with or that they are, in a way, interconnected. Pathos can be conveyed through various elements of communication, such as tone of voice, facial expressions, body languagIn order to effectively use pathos in communication, Aristotle suggested that speakers should have a deep understanding of their audience and their emotional state.
LOGOS-The third most important element of communication Aristotle points out is logos. Logos refers to the logical or rational appeal of a message. This element focuses on the substance of the message and how it is presented to the audience. Logos can be seen as the argument or reasoning behind a message, and it is often used to appeal to the audience’s sense of logic or reason. Logos focuses on the logical appeal and the argumentative structure of the message itself. In order to effectively use logos in communication, Aristotle suggested that speakers should use clear and logical arguments, present evidence or facts to support their claims, and use reasoning to connect their ideas and persuade their audience.
3.The linear model: -
In this model, communication is the transfer of information from one point to the next.
Ø Linear models of communication refer to one specific method that involves one-way communication.
Ø Linear communication is a simple communication model that's often used in sales and marketing activities, when sending engaging messages to customers, and in large-scale organisations, when sending communications to a group of people.
Ø This one-way communication style is particularly useful when communicating a message to a wide range of people simultaneously.
4.Interactional model: -
Ø This is a circular model of communication, in which the message is sent and received, encoded and decoded, and interpreted, by both the sender and receiver.
Ø he interactive model of communication is a method that involves exchanging ideas, information, or messages consistently. It's a nonlinear communication model that prioritizes message engagement.
Ø This refers to the back-and-forth communication process that is seen in basic conversations.
Ø For Example, the conversation that takes place between employees during a training session. As the trainee asks questions in regard to the job, the other worker replies with an answer. A worker in training is likely to continuously ask questions about the job, prompting responses from the other worker.
5.Smcr model: -
Ø In this Source Message-Channel-Receiver: (SMCR) model by Berlo, the linear telegraph model of communication becomes more complex.
Ø According to Berlo “The sender encodes the message through his speaking and writing skills. The receiver decodes the message through his listening and reading skills.”
Ø Both sending and receiving are influenced by knowledge, attitude, experience and skills and affected by the channel through which the message is sent.
Ø The sender encodes' the message through the use of symbols through a 'channel' such as speaking, writing, etc. The receiver receives the message through the channels of listening, reading, etc.
Ø Interpretation is the receiver's understanding of the message.
Ø According to Berlo, effective communication occurs when the sender of a message and its receiver are on the same level or are roughly similar. Furthermore, Berlo defines communication as any type of information that is being sent or transferred to a receiver. So, this can include casual conversations between friends or formal presentations given at a scientific conference.
6.Transactional model: -
Ø Transactional model is the process of continuous change and transformation where every component is changing such as the people, their environments and the medium used. Due to this, it assumes the communicators to be independent and act any way they want.
Ø Transactional model of communication is the exchange of messages between sender and receiver where each take turns to send or receive messages.
Ø Here, both sender and receiver are known as communicators and their role reverses each time in the communication process as both processes of sending and receiving occurs at the same time.
Ø This is also called circular model of communication.
ORGANIZATIONAL COMMUNICATIONS
Organizational communication refers to the communication that takes place between people who are working towards common goals within an organization. It consists of the interactions that take place for the purpose of working together towards these goals. Organizational communication has many purposes as it aims to convey what the organization stands for and why it exists. It is also used to communicate how the work is to be completed, the levels of authority within the organization, and how to identify the customers of the organization.
There are most important media of communication in an organizations are-
FORMAL COMMUNICATION- It is the easiest way to communicate in the workplace. Formal communication is an exchange of official information between people within the same organization who are often at different levels within the organizational hierarchy. A formal communication can be from a superior to a subordinate, from a subordinate to a superior, intra-administrative or external.
1.Vertical communication: It is also known as interscalar communication one in which communication flows from top to bottom as well as from the rank and file workers towards the management. There are two types-
Downward communication: It is the transmission of ideas or information from nurse leaders to the subordinates. It is generally directive in the sense that it causes action to be initiated by the subordinates.
Upward communication: Upward communication is getting messages from employees to management is difficult to achieve, especially in larger organization.
2.Horizontal communication: It is also known as lateral communication. This is the communication from persons at one level in an organization to others at the same level. It is frequently between the line and staff units.
INFORMAL COMMUNICATION- Informal communication is casual communication between coworkers in the workplace. It's unofficial in nature and is based on the informal, social relationships that are formed in a workplace outside the normal hierarchy of business structure.
a. STRAIGHT CHAIN PATTERNS:- It develops when the communicated messages are top secret . In this pattern rumours pass from A to B, B to C and so on.
b. STAR PATTERNS:- Where rumour is disclosed by one person to many others who come in contact with him.
c. PROBABILITY PATTERNS:- Wholesome messages may be accidentally communicated to B and C who in turn communicates it to others, while some members of the group may be left out either because of their absence, lack of opportunity.
d. LYSTER NET:- Where A says something to his three close friends and one of these passes on the information to another while a fourth one tells two more either in a straight chain pattern or in an informal star pattern.
COMMUNICATION NETWORK PATTERN
1. Type 1: All the four persons can communicate with one person, ‘A’ but can not communication themselves.
2. Type II: A is the boss, B and C are his senior assistants and D and E are their junior subordinates A can directly communicate with B and C but not with D and E.
3. Type III: By allowing direct communication between two seniors members B and C, A, B and C are reduced to a group of equal insofar as the level of communication is concerned.
4. Type IV: A can communicate with B but B has the facility to communicate with C, D, and E.
PRINCIPLES OF COMMUNICATION
Ø Know your audience.
Ø Knowledge about purpose of communication.
Ø Anticipate objections.
Ø Achieve credibility.
Ø Be clear and concise: The message should be clear and concise for effective communication. There should be no ambiguity in the message. The message must be a clear as possible.
Ø Objectivity: The communicator must know the purpose of communication before transmitting the message.
Ø Understanding: Understanding is the main aim of any communication. The communication must create proper understanding in the mind of receiver.
Ø Consistency: The message to be communicated should be consistent with plans, policies programs and goals of institute. It should not be conflicting with previous communication.
Ø Completeness: The message should be adequate and complete. Inadequate communication delayed action and affects the efficiency.
Ø Time: Information should be communicated at the right time.
Ø Simplicity: Message should in simple language.
Ø Avoids gender bias: Use words free from gender bias.
Ø Emphasize positive pleasant facts try to avoid these negative words, fear, mistake, wrong, damage, disagree.
Ø Feedback: Feedback is essential for effective communication without feedback communication process is not complete.
Ø Trust: Without a sense of trust it may be difficult to communicate effectively.
Ø Active listening: It means being focused entirely on the person speaking and not interrupting.
Ø No assumptions: It is important to clarify what someone means, rather than make assumptions that one have understood what someone are trying to convey.
Ø Authenticity: Be trustful in communication. The manner in which message said, tone, speed, body language are more important in conveying the message.
Ø A communication should not be disclose sensitive personal facts about an individual.
Ø A communication should not be threatening or managing.
Ø Select and determine appropriate language and medium of communication according to its purpose.
Ø Avoid being too formal or aloof.
Ø Avoid distraction.
Ø Avoid personal biases.
INTERPERSONAL RELATIONSHIP
DEFINITION
1. According to Imogene King "the interpersonal relationship is the process of interactions between two or more individuals represents a sequence of verbal and non-verbal behaviours that are goal directed."
2. Interpersonal relationships refer to reciprocal social & emotional interactions between two or more individuals in an environment.
3. Interpersonal relationship is defined as a close association between individuals who share common interests & goals.
DYNAMICS OF INTERPERSONAL RELATIONSHIP
Interpersonal relationship are dynamic system that keep changing during their existence. Like living organisms, relationships have a beginning, a lifespan and an end.
1.Dyad
Ø A dyad consists of two interacting people.
Ø It is the simplest of the three interpersonal dynamics.
Ø One person relays a message & the other listen.
Ø It is one of the most unstable interpersonal dynamic. The interaction ends when one constituent of the dyad refuses to listen or share his or her message.
Ø It is also one of the most intimate interpersonal dynamic as the focus of listening & communication is centred on only one person.
2. Triad
Ø A triad consists of three interaction people.
Ø The members engage in the relay & reception of thoughts & ideas.
Ø It is more stable than the dyad as the third members may act as a mediator when there is conflict between the other two.
Ø A group consists of more than three members & is a collection of triads & dyads.
Ø It is the most stable from of interpersonal relationship.
PURPOSES OF INTERPERSONAL RELATIONSHIP
1. Interpersonal relationship for an individual
Ø Personal growth & development
Ø Source of enjoyment
Ø Sense of security
Ø Context of understanding
Ø Interpersonal needs
Ø Establishing personal identity
2. Interpersonal relationship for nurses
Ø Building a positive functional multidisciplinary team
Ø Improving intra-and /or inter-team communication, coordination & cooperation
Ø Building mutual understanding & cooperation
Ø Understanding self
Ø Improved decision making & problem solving
3. Interpersonal relationship for patients
Ø Developing a sense of security & comfort
Ø Fostering trust & cooperation
Ø Facilitating communication
Ø Improving socialization
Ø Developing & maintaining positive feelings
TYPES OF INTERPERSONAL RELATIONSHIP
LOVE
Ø A informalized intimate relationship characterized by passion, intimacy, trust & respect is called love.
Ø Individuals in a romantic relationship are deeply attached to each other & share a special bond.
CASUAL RELATIONSHIPS
Ø In these relationships, the individuals usually develop a relationship that exclusively lacks mutual love & consists of sexual behavior only that does not extend beyond one night.
Ø These individuals may be known as sexual partners in a wider sense of friends with benefits who consider sexual intercourse only in their relationship.
FRIENDSHIP
Ø Theories of friendship emphasize the concept as a freely chosen association where individuals develop a common ground of thinking & behaving when they enter into the relationship by including mutual love, trust, respect & unconditional acceptance for each other.
Ø Friendship is a relationship with no formalities & the individuals enjoy each other's presence.
PROFESSIONAL RELATIONSHIP
Ø Individual working for the same organization are said to share a professional relationship & are called colleagues.
Ø Colleagues may or may not like each other.
MARRIAGE
Ø Marriage is a formalize intimate relationship or a long-term relationship where two individuals decide to enter into wedlock & stay together life-long after knowing each other well.
BROTHERHOOD AND SISTERHOOD
Ø Individuals united for a common cause or a common interest (may involve formal membership in clubs, organization, associations, societies, etc.) may be termed as a brotherhood or a sisterhood.
Ø In this relationship, individuals are committed to doing good deeds for fellow members & people.
FAMILY AND KINSHIP
Ø Family communication patterns establish roles & identify & enable personal & social growth of individuals.
Ø Family relationships can get distorted if there is an unresolved conflict between members.
Ø Most of the time, a significant family member senses other family members have significant emotional difficulties but fails to bring them out unless the physician or nurse enquires.
PLATONIC RELATIONSHIP
Ø A relationship between two individuals without feelings of sexual desire for each other is called a platonic relationship.
Ø In such a relationship, a man & a woman are just friends & do not mix love with friendship.
Ø Platonic relationships might end in a romantic relationship with partners developing feelings of love for each other.
ACQUAINTANCES
Ø An acquaintance is a relationship where someone is simply known to someone by introduction or by a few interaction.
Ø There is an absence of close relationship and the individuals lack in depth personal information about other.
Ø This could also be a beginning of a future close relationship.
PHASES OF INTERPERSONAL RELATIONSHIP
Hildegard Peplau(1952) gave the interpersonal relationship model. Four sequential phases
a. Orientation
b. Identification
c. Exploitation
d. Resolution
Orientation Phase
Ø Problem defining phase.
Ø Starts when client meets the nurse as stranger.
Ø Defining problem and deciding the type of service needed.
Ø Client seeks assistance, conveys needs, asks questions, shares preconceptions and expectations of past experiences.
Ø Nurse responds, explains roles to client, helps to identify problems and to use available resources and services.
Identification Phase
Ø Selection of appropriate professional assistance.
Ø Patient begins to have a feeling of belonging and a capability of dealing with the problem which decreases the feeling of helplessness and hopelessness.
Exploitation Phase
Ø Use of professional assistance for problem solving alternatives.
Ø Advantages of services are used based on the needs and interests of the patients.
Ø Individual feels as an integral part of the helping environment.
Ø They may make minor requests or attention getting techniques.
Ø The principles of interview techniques must be used in order to explore, understand and adequately deal with the underlying problem.
Ø Patient may fluctuate on independence.
Ø Nurse must be aware about the various phases of communication.
Ø Nurse aids the patient in exploiting all avenues of help and progress is made towards the final step.
Resolution Phase
Ø Termination of professional relationship.
Ø The patient needs have already been met by the collaborative effect of patient and nurse.
Ø Now they need to terminate their therapeutic relationship and dissolve the links between them Sometimes may be difficult for both as psychological dependence persists.
Ø Patient drifts away and breaks bond with nurse and healthier emotional balance is demonstrated and both becomes mature individual.
PRINCIPLES OF IPR
Ø Learn everyone's name and never address anyone by a nickname.
Ø Respect everyone's individuality. Each member of a team is as important as the other.
Ø Do not impose anything on anybody.
Ø Keep emotion under control.
Ø Do not be afraid to admit ignorance.
Ø Do not give and take any personal favour.
Ø The team leader should not make any excuse regarding his or her responsibility.
Ø Develop habits of listening and focus attention on the problems.
Ø Do not do or say anything that will disturb another's faith.
INTERPERSONAL NEEDS
The basis for evolving this theory of interpersonal behaviour is the individual fundamental relations orientation. The basic assumption of this approach is that people needs in people. Although each individual has different intensities of need and different mechanisms for handling them, people have three basic interpersonal needs in common.
· The need for inclusion
· The need for control
· The need for affection
The need for inclusion: It is to maintain a satisfactory relation between the self and other people with the respect to interaction or belongingness. Some people like to be in groups, to interact and to mingle. Other people seek much less contact, they prefer to be alone, and to interact minimally.
The need to control: This is the need to maintain a satisfactory relation between oneself and other people with regard to power and influence. In other word, every individual has a need to control his situation to some degree, so that his environment can be predictable for him. It means that from whom one wants to be completely controlled and is dependent on others for making decisions for them.
The need for affections: This is the need to maintain a satisfactory relation between the self and other people with regards to love and affection.
DEVELOPING HELPING RELATIONSHIP
Whatever are the practice settings, the nurse establishes some sort of helping relationships in which mutual goals are set with the client, or with the support persons if the client is unable to participate. It includes the following ways:
Ø Listen actively
Ø Help to identify what the person is feeling
Ø Put yourself in the other person's shoes
Ø Be honest
Ø Do not tell the person not to feel-like if the client is crying. Don’t say "don't worry about it, everything will be fine". This will inhibit the person to ventilate the feelings
Ø Do not tell a person what to feel
Ø Do not make excuses for the other person
Ø Be genuine
Ø Whatever course is chosen it needs for further achievement of the clients' goals, be compatible with the clients' value system, and offer the probability of success. The client needs to choose the ways to achieve the goals, however the nurse can assist in identifying the options.
Ø Know your role and limitations.
INTERPERSONAL RELATIONSHIP IN NURSING
The patient in a hospital experiences new and unfamiliar surroundings. It is up to the nurse to see that the patient feels at ease and adjusts to the hospital routine and the new environment, to cooperate and accept treatment necessary for regaining health.
The patient is an important person in the hospital. Treat him as an individual, call him by his name help him to overcome fear and anxiety. The nurse should be dignified, cheerful and courteous. Be pleasant with patients but not too familiar.
Treat patients with sympathy and firmness to gain respect and admiration. Personal appearance a very important in establishing a good nurse-patient relationship. The nurse should not talk or discuss personal affairs or other patients or hospitals. The nurse-patient relationship must be professional and one of absolute trust, irrespective of caste, creed, or social status. She should not accept any personal gifts from patients.
The nurse is an important member of a team that must work in cooperation and harmony for the care of patients. She should be familiar with the organization of the hospital and the nursing department.
The nurse must feel accountable to the organization, should be honest, dependable and willing to carry out the prescribed treatment and care for the patient. She should maintain her position and dignity. She should not accept verbal orders from the physician (medical personnel). There should be a team spirit.
The nurse should have respect for seniors and concern and caring towards fellow nurses, juniors and other supporting staff. She should maintain a healthy and good relationship with various departments.
INDIVIDUAL AND GROUP
INDIVIDUAL
Individual is defined as a single human being as contrasted with a social group or institution. An individual is a person or a specific object.
GROUP
Group is defined as a number of persons or things gathered closely together and forming a recognizable unit; share similar characteristics, and collectively have a sense of unity.
CLASSIFICATION OF GROUP
Primary Group- It's a small, intimate group in which relationship among members are personal, spontaneous, sentimental, cooperative and inclusive, e.g. family, play group of children.
Secondary Group- It is generally larger, more impersonal and less sentiments than a primary group. Its social group whose members pursue specific interests or activities, e.g. professional associations, task groups, business groups.
Formal Group- People become familiar with many different work groups during their facilities and spend a major part of working hours in such group. Formal groups usually exist to carry out task goal rather than to meet the needs of group members. Some examples of semiformal groups are churches, lodges and social clubs.
Informal Groups- These are groups which provide person's education and develop most cultural values. Numerous informal groups are Friendship groups, hobby groups, child care centre, work group, labours union.
CHARACTERISTICS OF A GROUP
Size: Groups can range in size from small to large.
Goals: Groups have a common purpose or goal that guides their actions.
Structure: Groups have roles and positions that define how the group is organized.
Norms: Groups have shared rules and expectations for how members behave.
Roles: Groups have specific functions or responsibilities assigned to individual members.
Interaction: Group members communicate and collaborate with each other.
Interdependence: Group members depend on each other to achieve the group's goals.
Identity and cohesion: Group members feel like part of a unified entity.
CHARACTERISTICS OF A INDIVIDUAL
Ø Own Personality
Ø Real Nature
Ø Set of persistent qualities
Ø Engagement and use of right behaviours and words
Ø Inward desire to do right at any cost
Ø Morality
GROUP DYNAMICS
The word 'dynamics' means force. The word group dynamics refers to the forces, operating in groups. Group dynamics refers to the attitudinal and behavioural characteristics of a group. The social process by which people interact in a group environment. The influences of personality, power and behaviour on the group process. Group dynamics concern how groups form, their structure and process, and how they function. Group dynamics are relevant in both formal and informal groups of all types.
DEFINITION
According to Keith Davis, “Group-dynamics is concerned with the formation and structure of groups and the way they affect individual members, other groups and the organisation.
It may be defined as the social process by which people interact face-to-face in the small groups. Thus, it is concerned with a dynamic interaction of individual in face-to-face relationships. Group dynamics focuses a team work, wherein, a small members groups are constantly in touch with each other and affectively contribute their ideas to accomplish tasks.
ASSESSING GROUP DYNAMICS
Group dynamics are forces in the group situation that determine the behaviour of the group and its members. To study the dynamics of the group, structure and organization may be analyzed-Commitment, leadership style, decision making methods, interaction patterns, cohesiveness, power.
Commitment
Ø The members of effective groups have a commitment (agreement, pledge, or obligation to do something) to the goals and output of the group.
Ø There are some indications of group commitment.
Ø Members feel a strong sense of belonging.
Ø Members enjoy each other.
Ø Members seek each other for counsel and support.
Ø Members support each other in times of difficulty.
Ø Members value the contributions of other members.
Ø Members are motivated by working in the group and want to do their task well.
Leadership Style
Ø To determine which group members carry out leadership functions, the following questions may be asked:
Ø Who starts the meeting or the work?
Ø Who contributes additional information to help the group carry out its function?
Ø Who represents the group with other groups?
Ø Who keeps the discussions relevant?
Decisions making Methods
Five methods have been identified:
Ø Individual or authority rule decisions. The designated leader makes the decision and the group members abide by it. Authority rule decisions may be made without discussion or consultation with the group or may be after discussing the issue and eliciting the group ideas and views.
Ø Minority decision: A few group members meet to discuss an issue and make the decision that is binding for all.
Ø Majority decisions: More than half of those involved make the decisions.
Ø Consensus decisions: Each group member expresses an opinion, and the decision is made by which members can abide, if not in all, at least in part.
Ø Unanimous decisions. Every group member agrees on the decision and can support the action to be taken.
Interaction Patterns
Ø It can be observed and ascertained by a sociogram, a diagram of the flow of verbal communication within a group during a specified period, eg. 5 or 15 min. Ideally, the interaction patterns of small group would indicate verbal interaction from all members of the group to all members of the group.
Cohesiveness
Cohesive groups possess certain group spirit, a sense of being "we" and a common purpose. The characteristics a cohesive group should have, are as follows:
Ø Members like one another, are friendly and enjoy interacting with one another.
Ø Members receive support on issues from one another.
Ø Members praise each other.
Ø They influence one another and are willing to influence one another.
Ø They share similar opinions.
Ø They accept assigned tasks and roles readily.
Ø Members trust each other.
Ø They defend each other against external criticism and attack.
Ø They are loyal to one another.
Ø Attendance, risk taking, participation and communication are high.
Ø "We" is frequently heard in discussions, and group output is high.
Power
Ø It is viewed as positive force that moves people toward attainment of individual or group goals. It is impossible to interact with others without influencing and being influenced by them, hence, group members are constantly adjusting to one another and modifying their behaviour.
Ø Members who believe they have little influence in the group are less likely to feel committed to group goals and to participate in decision-making. Dissatisfaction with group decreases its attractiveness and reduces its cohesion.
STAGES OF GROUP DYNAMICS
Tuckman described the four distinct stages that a group can as it comes together and starts to operate. This process can be subconscious, although an understanding of the stages can help group reach effectiveness more quickly and less painfully.
Stage 1: Forming
Individual behaviour is driven by a desire to be accepted by the others, and avoid controversy or conflict. Serious issues and feelings are avoided, and people focus on being busy with routines, such as team organization, who does what, when to meet, etc. But individuals are also gathering information and impressions about each other, and about the scope of the task and how to approach it. This is a comfortable stage to be in, but the avoidance of conflict and threat means that not much actually gets done.
Stage 2: Storming
Individuals in the group can only remain nice to each other for so long as important issues begin to be addressed. Some people's patience will break early, and minor confrontations will arise that are quickly dealt with or glossed over. These may relate to the work of the group itself, or to roles and responsibilities within the group. Some will observe that it's good to be getting into the real issues, while others will wish to remain in the comfort and security of stage 1. Depending on the culture of the organization and individuals, the conflict will be more or less suppressed, but it'll be there, under the surface. To deal with the conflict, individuals may feel they are winning or losing battles, and will look for structural clarity and rules to prevent the conflict persisting.
Stage 3: Norming
As Stage 2 evolves, the "rules of engagement" for the group become established, and the scope of the group's tasks or responsibilities are clear and agreed. Having had their arguments, they now understand each other better, and can appreciate each other's skills and experience. Individuals listen to each other, appreciate and support each other, and are prepared to change pre-conceived views: they feel they're part of a cohesive, effective group. However, individuals have had to work hard to attain this stage, and may resist any pressure to change especially from the outside for fear that the group will break up, or revert to a storm.
Stage 4: Performing
Not all groups reach this stage, characterized by a state of interdependence and flexibility. Everyone knows each other well enough to be able to work together, and trusts each other enough to allow independent activity. Roles and responsibilities change according to need in an almost seamless way. Group identity, loyalty and morale are all high, and everyone is equally task-orientated and people-orientated. This high degree of comfort means that all the energy of the group can be directed towards the tasks in hand. Ten years after first describing the four stages, Bruce Tuckman revisited his original work and described another final stage.
Stage 5: Adjourning
This is about completion and disengagement, both from the tasks and the group members. Once the project is complete or the team disbands, group members may experience a sense of loss, as they’ve developed strong group dynamics. This is the time to celebrate the team’s accomplishments, reflect on what was achieved, and acknowledge the contributions of each member. It’s important to provide closure and recognition as the team moves on.
ORGANIZATIONAL BEHAVIOUR
DEFINITION
Ø Stephen R Robbins defined organizational behaviour as "a field of study that investigates the impact of individuals, groups, and structures on behaviour within the organization for the purpose of applying such knowledge towards improving an organizations effectiveness”.
Ø Another definition provided by Joe Kelly states, ‘Organisational behaviour is the systematic study of the nature of organisations, how they begin, grow, develop, and their effect on individual members, constituent groups, other organisations and larger institutions’.
Ø LM Prasad defined as the study and application of knowledge about human behaviour related to other elements of an organization such as structure, technology and social systems.
Ø Fred Luthans defined as organizational behaviour is directly concerned with the understanding, prediction and control of human behaviour.
NATURE OF ORGANISATIONAL BEHAVIOUR
1. Diversity: Organizational behaviour recognizes the unique differences among individuals, valuing diversity in backgrounds, skills, and perspectives as a source of strength and innovation within a company.
2. Adaptability: It emphasizes the need for organizations to be adaptable, allowing them to respond effectively to changes in the market, technology, and workforce dynamics.
3. Motivation: Understanding what motivates employees is crucial in Organisational Behaviour, as it directly influences productivity, job satisfaction, and retention rates within an organization.
4. Leadership: Effective leadership is a cornerstone of organisational behaviour, as leaders shape the culture, set the vision, and guide employees towards achieving organizational goals.
5. Communication: Clear and open communication channels are vital for the smooth operation of an organization, facilitating collaboration and minimizing misunderstandings.
6. Productivity: Organisational Behaviour aims to enhance productivity by optimizing the work environment, ensuring that employees have the resources and support they need to perform at their best.
7. Well-being: Employee well-being is a focus area in Organizational Behaviour, with the understanding that a healthy work-life balance contributes to better performance and lower turnover.
8. Innovation: Encouraging innovation is part of Organizational Behaviour, as it drives growth and keeps organizations competitive in their respective industries.
9. Ethics: Organizational Behaviour upholds ethical standards and practices, ensuring that organizations operate with integrity and respect for all stakeholders.
THEORIES OF ORGANIZATIONAL BEHAVIOUR
To understand the organization of a health care agency (e.g. a hospital, nursing home, health care agency or public health department) or any such institution, one must be familiar with organizational theory. Organizational theories are classified into three categories:
1. Classical doctrine
2. Humanistic school
3. Modern organization theory
1. Classical Doctrine
Classical doctrine is the oldest theory in the study of organizations. It emphasizes rigid, centralized control of workers to promote high production. An institution organized under the classical theory tends to treat workers in a mechanical yet objective way. Such an institution is very efficient in accomplishing its goals.
1. Frederick Taylor: Frederick Taylor is considered the father of classical theory and the father of scientific management. High production was his primary concern in developing this theory. He believed that high production could be achieved by paying high wages. In his opinion, it was possible to pay high wages and still have an overall low labour cost. Taylor's scientific management approach involves timing various work activities with a stopwatch. The purpose is to determine the exact time in which a worker should be able to accomplish a task. Workers can be given a large task, but one they are able to accomplish. Further, in the classical approach, strict obedience to authority is expected. Workers must do the handwork exactly as they are told by their superiors. Only top-level managers may do brain work because this type of work is not directly related to increasing production. The worker's job is to keep production going.
2. Henry Fayol: Fayol identified 14 principles of management and further developed Taylor's ideas (1949). His principles made it clear that production, efficiency, and profit were of prime importance, while individuals or workers were of comparatively less importance. His principles include:
a. Division of work: Work is broken down into specialized tasks.
b. Authority: Employers have the right to give orders and expect them to be obeyed.
c. Discipline: The employee is expected to be obedient to the institution.
d. Unity of command: An employee should receive orders from only one superior.
e. Unity of direction. There is only one person at the top of the institution and he or she has only one plan for the institution.
f. Subordination of individual interest to general interest: Institutional goal and activities always come first.
g. Remuneration of personnel: Salary should be fair and as far as possible, satisfactory to both employer and employee.
h. Centralization: All communication comes from and goes to the person at the top of the institution.
i. Scalar chain: There is a chain of superiors, ranging from the person at the top to the employee at the bottom of the institution.
j. Order: There is a place for everyone.
k. Equity: All persons in the institution will be treated alike.
l. Stability of tenure for personnel: A prosperous institution has stable workers.
m. Initiative: Within the limits of respect for authority and discipline, the employee has the freedom to propose and execute a plan.
n. Esprit de corps: In unity there is strength.
A worker who does only one task becomes highly skilled and efficient and he or she will be able to do the task faster and faster, therefore production will increase. If he or she is replaced, it is cheaper and faster to train someone else to perform one small task than to do a more complex combination of tasks.
2. Humanistic School
It was the demonstrated lack of concern for workers that led to the formulation of a new theory of organization in the 1930s. The humanistic theory, also called behavioural or neoclassical theory, identifies two major functions of organizations: one maintaining the external balance, that is the economics (the focus of classical theory), and the other maintaining the internal balance, that is the social organization of the workers through which they stratify their own desires and needs. Together, these functions have equal importance in the humanistic theory. The humanistic theory recognizes that workers have a collective of their own simply because they are in contact with and interact with each other. This collective is called the informal organization or workers as a unity within the total organization. Through it has a neo-formal structure, the informal organization has specific three functions:
1. Communication among workers.
2. Maintenance of cohesiveness among workers through a willingness to serve and accept authority.
3.Maintenance of feelings of personal integrity, self-respect and independent choice.
3. Modern Organization Theory
The modern organization theory began in the late 1950s as researchers recognized that in the humanistic as well as in the classical approach something was missing. The modern organization theory consists of two main approaches: system and contingency. The theory comes from the fields of sociology, economics, mathematics, engineering and administration, but its unifying strand is human systems in their totality. However, the modern organization theory is still evolving. Its basic assumption lies in a system framework-that the organization is an open system, consisting of input, throughput, output and feedback.
ROLE OF ORGANIZATIONAL BEHAVIOUR
The Role of organizational behaviour is multifaceted and crucial for the success of any organization. Here are some key points highlighting its importance:
1. Performance Improvement: Organizational Behaviour helps in identifying ways to increase productivity and efficiency, leading to better performance outcomes for both individuals and the organization.
2. Employee Satisfaction: By understanding the needs and motivations of employees, Organizational Behaviour contributes to creating a work environment that enhances job satisfaction and employee retention.
3. Leadership Development: Organizational Behaviour provides insights into effective leadership styles and practices, enabling the development of leaders who can inspire and guide their teams.
4. Change Management: It equips organizations with the tools to manage and adapt to change, ensuring resilience and flexibility in a dynamic business landscape.
5. Conflict Resolution: It offers strategies for resolving interpersonal and group conflicts, fostering a harmonious workplace.
6. Organizational Culture: It plays a significant role in shaping and maintaining a positive organizational culture, which is essential for long-term success.
7. Team Dynamics: Organizational Behaviour studies how teams work and interact, which is vital for building strong, collaborative teams that can achieve collective goals.
8. Communication Enhancement: It improves communication within an organization, ensuring that information flows effectively between different levels and departments.
9. Decision-Making: OB aids in the decision-making process by providing a better understanding of human behaviour and organizational dynamics.
10.Innovation Encouragement: It encourages innovation by creating an environment where new ideas are valued and employees feel empowered to share their creativity.
LEVELS OF ORGANIZATIONAL BEHAVIOUR
The three levels of organizational behaviour are individual, group, and organizational. These levels are interrelated and are used to study how people behave in organizations.
Individual level
Ø Also known as the micro level, this level focuses on understanding human behavior, incentives, and perception.
Ø Includes organizational psychology
Group level
Ø Also known as the meso level, this level focuses on group dynamics, leadership, and collaboration
Ø Includes social psychology
Organizational level
Ø Also known as the macro level, this level focuses on how organizations behave and interact with each other
Ø Includes organization theory and sociology
ORGANIZATIONAL BEHAVIOUR AND NURSING
Organizational behaviour in nursing" refers to the study of how nurses interact and behave within a healthcare setting, anlayzing factors like team dynamics, leadership styles, communication patterns, and organizational culture to optimize patient care by promoting a positive work environment and enhancing efficiency within the nursing unit; essentially, it's about understanding how the structure and dynamics of a healthcare organization influence nurses' actions and overall performance, impacting patient outcomes. It is an emerging field of knowledge which helps in practising nurse mangers to understand the dynamics of individual, groups and nursing organization in order to realize the nursing goals, suggest certain prescriptions for improving organizational effectiveness. The effect of any organization depends upon efficient use of human resources in persuit of organizational goals. However, use of these resources is not at easy task as individual behaviour is complex and less amenable for predicting and control. Hence, understanding of individual behaviour is important for nurse manager to design strategies for driving nurses to work.
SUMMARY
I summarized my topic by definition, types of communication, models and levels of communication, principles of communication, definition of IPR, purpose and types of IPR, group and individuals, definition of group dynamics, how to assess group dynamics, stages of group dynamics, definition and levels of organizational behaviour models of organizational behaviour, nature and role of organizational behaviour and relation with nursing.
CONCLUSION
I conclude my topic that effective communication is a critical cornerstone of successful organizational behaviour, as it fosters collaboration, transparency, employee engagement, and overall productivity by ensuring clear information flow, facilitating understanding between individuals and teams, and enabling positive relationships within an organization. organizational behaviour is that it's a key factor in an organization's success. By studying how people behave in an organization, managers can create a positive work environment. This can lead to better decision-making, conflict resolution, and adaptation to change.
