“Confident Voices”-Book Review

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Book Review by Kathleen Ashton, PHD, ARPN, BC:  “Confident Voices:  The Nurses’ Guide to Improving Communication & Creating Positive Workplaces”

Reprinted from Journal of Legal Nurse Consulting • Summer 2011 • Volume 22, Number 3. page 30

Beth Boynton has teamed up with Bonnie Kerrick to remind us all of the basics of communication. Many of us believe we are communicating just fine, but the rates of errors and other communication-related incidents in today’s healthcare environment tell a different story. The effect of poor communication is being recognized as a contributing factor in many adverse events in the hospital and other healthcare settings. In any field communication is usually pivotally important and the field of Legal Nurse Consulting is no exception.

The first 4 chapters of the book set the stage with theories, research, and actual stories concerning current conditions. The scope of the problem is delineated through examples of toxic workplaces and a look at workplace violence. Boynton contends that nurses who “eat their young”, abusive physicians, and toxic workplaces are evidence of dysfunctional conflicts that permeate our healthcare culture. She takes us back to Maslow and that Hierarchy of Needs we all learned in our basic programs while interspersing quotes from well- known leaders and great thinkers. Included is a look at the types of organizational cultures and relationships. Some very foundational ideas such as how dress affects the culture of an organization are explored in detail.

Three foundational principles of communication are presented in Part II as a means of changing the status quo. These include respectful listening, being responsive by speaking up assertively, and effectiveness in creating a safe environment. Boynton’s examples and discussion of these principles serve as a guide for effecting change. Every chapter includes discussion and reflection questions at the end, making the book quite useful in a variety of settings with all levels of professionals.

Part II is focused on change and presents some very real solutions to the problem of workplace dysfunction. One section discusses the benefits of using “I” statements and offers some practice exercises. Chapter 6 reviews the components of respectful listening and describes true curiosity as one of the important components. Chapter 7 is aimed at all levels of professionals but points especially to those in leadership positions and exhorts the leaders to look closely at the dynamics of communication. Boynton states that, “Disrespectful behavior cannot be excused at any level”. She then offers steps to create a better environment.

Part III is intended to move the reader from toxic to positive workplaces with an eye towards integration of the concepts discussed earlier into the context of real nursing experiences. Two very interesting stories are detailed in chapters 8 and 9 and when used with the discussion and reflection questions at the end of each chapter could serve as great scenarios for a leadership and management class setting. Chapter 10 gives the reader a glimpse of some real champions and provides guidance for those who truly wish to improve their skills.

As an example of the change sought throughout the book, the epilogue is titled, “Where Nurses Nurture Their Young”. It is the author’s challenge to all nurses to use good communication principles to combat the increased workplace violence and incivility seen in our profession and to start the change process using the guidance offered by this very informative book.

Dr. Kathleen Ashton is a Professor of Nursing in the Jefferson School of Nursing at Thomas Jefferson University in Philadelphia, PA and a Professor Emeritus at Rutgers University in Camden, NJ where she taught for 16 years. She has conducted numerous funded research studies on women and heart disease and has published her work in leading medical and nursing journals.

She obtained her basic nursing education at Mercer Medical Center in Trenton, NJ, her BSN from Coe College in Iowa, her MS in nursing from the University of Maryland, and her PhD from Temple University in Philadelphia. As a Legal Nurse Consultant for over 15 years she reviews cases for plaintiff and defense firms and serves as an expert witness at trial. She also serves on various boards for community and professional organizations and volunteers for medical missions to Lima, Peru where she practices as an Advanced Practice Nurse. She has received awards for her research, teaching, and service, including the New Jersey Governor’s Merit Award for Advanced Practice Nursing.

ConfConfident Voices: The Nurses' Guide to Improving Communication & Creating Positive Workplacesident Voices: The Nurses’ Guide to Improving Communication and Creating Positive Workplaces by Beth Boynton, RN, MS Edited by Bonnie Kerrick, RN, BSN

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