Bleeding Hearts, Shark Infested Waters Meet the Relativity and Complexity of Assertiveness

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Assertiveness is way more complicated than being firm or just speaking up for yourself and fascinating, (for me) to think about.  Perhaps even more important than an intellectual quest to understand it is there are vital links to patient safety and healthcare professional job satisfaction.

For the purposes of this post, we’ll use a psychological definition where assertiveness in it’s most simplest form is a respect for one’s own needs/wants/ideas AND those of others.

What Makes it so Complicated?

  • It involves individual developmental qualities such as self-esteem, self-awareness, and self-efficacy.
  • It must take place in the context of relationship or relationships.  Therefore, the individual developmental qualities such as self-esteem, self-awareness, and self-efficacy of others becomes part of the mix.
  • There is also an interrelatedness to skills and experiences in communication such as;  ownership language and respectful listening.
  •  Gender, age, ethnic, personality differences add more variables.
  •  People who are aggressive or passive or passive-aggressive have different learning needs to become assertive, i.e. an aggressive doctor needs to learn to listen and value others whereas a passive or passive-aggressive nurse needs to learn ownership language and develop respect for his or her self.
  • The culture that relationships exist in plays an important role in supporting assertiveness or not.  What happens when an assertive person works in an aggressive or passive-aggressive culture?  In my own experience as an evolving assertive woman, I know it is extremely hard to care for myself and others in an environment where the practice of BOTH is not respected, cultivated and supported.  It seems as though there are limitations as to how long such a system can last!

This is why it is so important for individuals to do their own personal work and for organizational leaders to look for ways to build assertive cultures where mutual respect is the norm.  In the  Joint Commission Guide to Staff Communication and my own, Confident Voices:  The Nurses’ Guide to Improving Communication and Creating Positive Workplaces are important resources to understand and address BOTH the individual and organizational behaviors that contribute to workplace violence, poor communication, medical errors and staff burnout.

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