Assertiveness can help healthcare professionals become better leaders, able to articulate exactly what it is they need to take care of their patients without being intimidated.

"Assertiveness does not mean aggressiveness," said Justine Huffaker, MS, APRN, RN, CNA, interim chief nurse executive, Montefiore Medical Center, Bronx, NY. "Assertiveness gets you to let people know what you want to say, but in a respectful way."

Keys to Success

Communication is an important component of assertiveness.

"To be assertive, you need to have better communication skills, and in order to have better communication skills, you first have to know yourself," said Ann L. O'Sullivan, PhD, FAAN, CRNP, professor of primary care nursing at the University of Pennsylvania School of Nursing, Philadelphia. "Then you have to know your colleagues, and then you have to know what it is you're trying to change."

One tool she recommends are self-scoring behavioral style quizzes. These quizzes are quick and can be fun to do as a group. They can also help you begin to understand your strengths and weaknesses, as well as the strengths and weaknesses of your team members.

"When you understand yourself first, and then other people's styles, you can do a much better job of understanding why people respond the way they do," O'Sullivan said. "Taking that first step helps you be more assertive and then (you can) try to figure out what it is you're trying to change."

Kathleen McCauley, PhD, FAAN, RN, CS, associate professor of cardiovascular nursing and associate dean for academic programs at Penn's School of Nursing, explained another important element is respect. "We've got to treat each other with dignity and respect. When we have a problem, we've got to talk about it; not store things up, not feel we don't have a voice; but then move on and be solution-focused."

Teamwork

Team-focused patient care is increasingly common, O'Sullivan said, which stresses the importance of good communication skills. Working in teams also promotes assertiveness because "no decision or action rises or falls based on just one of you."

Assertiveness is important when dealing with both co-workers and patients, she said. 

Nicole Benkert is on staff at ADVANCE. 

Communication: Things to Remember
Variables influencing communication:

• No two people see things the same way.
• Your image of yourself influences how you see the world.
• Your image of another colors your relationship.
• You see things in terms of your values.
• You see what you want to see.
• Your feelings color what you see.
• You tend to simplify or complicate those things you do not understand.
• You tend to remember the first and last in a series of things.
• Meanings are in people, not in words. You do not get meaning from words -- you give meaning to words.
• You speak and think from your own frame of reference, not another's frame of reference.
• Communication is a two-way process. Get feedback.
• Communication happens when the meaning intended is received.

Guidelines for Assertiveness

• Respect your feelings.
  • Understand the difference among thinking, feeling and communicating your feelings.
  • Learn to listen to your feelings.
  • Have the courage to act on your feelings.
  • Learn to express your feelings.
  • Learn to listen to others express their feelings.
• Know your rights as a human being.
  • To judge your own behavior, thoughts and emotions.
  • To offer no excuses for justifying your behavior.
  • To judge if you are responsible for finding solutions to other people's problems.
  • To change your mind.
  • To make mistakes -- and be responsible for them.
  • To say "I don't know."
  • To be independent of the goodwill of others before coping with them.
  • To say "I don't understand."
  • To say "I don't care."
  • To attempt to achieve objectives and feel good about doing so, so long as you don't hurt others in the process.
• Know your responsibilities to yourself.
  • Your actions.
  • Self-improvement.
  • Your state of mind.
• Look change in the eye.

Source: Donohue EM. Communicating like a manager. Baltimore: Williams & Wilkins. 1989.