Communication, Confidentiality and Public Relations

COMMUNICATION,
CONFIDENTIALITY,
PUBLIC RELATIONS
PRESENTED BY,
SENJUTI BISWAS
M.SC NURSING 2ND YEAR
IOP-COE

Introduction: -
Communication is the life source for any organization.
Effective communication is essential to accomplish
all managerial functions. It is vital for directing and
controlling in the organization. It is through
communication, which provides an exchange of
information and sharing of ideas. Communication is
one of the most important activities in the nursing
management. It is the foundation upon which the
manager achieves organizational objectives.

The term ‘communication’ is a derivative of
the Latin word ‘communis’ means common.
In other words, it means if a person
communicates with another, it establishes a
collective group of understanding.
According to the dictionary, it is imparting
thoughts, opinions, or information by
speech, writing or signs.
Meaning of communication: -

Definition of communication: -
 According to Newman et al.- Communication
is an exchange of facts, ideas, opinions, or
emotions by two or more persons.
 According to Hoben- It is a verbal interchange
of thought or idea.
 According to Hudson- It is the means of
conveying information from one person to
another.

 It provides a channel to establish and
disseminate the goals.
 It facilitates the development of plans for
the achievement of goals.
 It aids in the management and utilization
of workforce.
 It helps manage, lead, direct and motivate
employees to contribute right things.
Purposes of communication: -

Importance of communication: -
Foundation of planning
Facilitation
Decision-making
Unity of direction
Basis of motivation, co-operation, and
improving morale

Importance of communication: -
Effective coordination
Congenial nurse manager-nurse
relation
Device for handling employees’
grievances
Modification of the behaviour of staff
Effective control

Elements of communication: -
1.Source
idea
7.Feedback
4.Channel 5.Receiver 6.Decoding
2.Message 3.Encoding

Characteristics of communication: -
 Clarity-
 One of the most essential characteristics of an impressive
communication is clarity.
 Use simple and sound words, so that listeners can grab it
easily.
 Be clear in your thoughts, jumbled and confused mind
cannot deliver a good and clear saying.

 Clarity-
 Avoid using any technical terms, try to
explain in laymen language.
 Use examples to explain and support
complex scenarios.
 Work a little bit on your accent and
pronunciation.

 Aim or goal-
 At every stage of talk/communication don’t forget the aim or goal.
 Try to deduce an acceptable stuff by judging pros and cons
impartially.
 Communicate with a broad and practical mind.
 Precision-
 Be precise and exact in your approach. Neither be too deep nor be
too short.
 Include some good facts acknowledging your topic.

 Avoid repeatability, unless required so.
 Linkage-
 Try to maintain a logic link between your sayings.
 Don’t put two opposite faces of coin at a same time.
 Deliver in a structured and planned way.
 Globalization and Localization-
 Try to explain the broader aspects but not on the cost of
local values.
 Aggregation of local values should result into global and
broader aspects.

 Style of expressing-
 Control various speech parameters like pitch, tone,
intensity etc. according to the environment.
 Don’t be too fast or too slow.
 Light humour at the right time is always accepted.
 Look straight and forward. Keep a light smile on your
face.
 Avoid using words that show arrogance.
 Feel what you say.
 Avoid using too formal. Be natural and practical.

 Know and analyze the audiences.
 Do a good homework.
 Dress properly-
 25% confidence and 25% respect from audiences comes
automatically, if you have dressed up well.
 Be neat, clean, ironed and polished irrespective of the fact
that you have dressed up formally or informally.
 Do a good hair styling, avoid any casual or unethical
looks.

Principles of communication: -
 Communication should be conviction.
 Communication should be appropriate to situation.
 Communication should have objective and purposes.
 Communication should promote total achievement of
purposes.
 Communication should represent the personality and
individuality of the communication.

Principles of communication: -
 Communication involves special
preparation.
 Communication should be oriented to
the interest and needs of the receiver.
 Communication through personal
contact.
 Communication should seek attention.
 Communication should be familiar.

Techniques to improve communication: -
 Listening
 Broad
openings
 Restating
 Clarification
 Reflection
 Focusing
 Sharing
perceptions
 Theme
identification
 Silence
 Humour
 Informing
 Suggesting

Types of communication: -
Communication
On the basis
of channel
On the basis
of direction
On the basis of
method of
expression
• Downward
• Upward
• Lateral
• Diagonal
• Verbal
• Written
• Non-
verbal
• Formal
• Informal

Types of communication according to the
direction: - A
Top level: Nurse
manager
Downward communication-
B
Middle level: Nurse supervisors
C
Operational level: Staff nurses

Cont.
A
Top level: Nurse
manager
Upward communication-
B
Middle level: Nurse supervisors
C
Operational level: Staff nurses

Cont.
Lateral communication-
It is a type of formal communication and takes place at the same levels
or with different departments in the organization.
Advantages-
• It facilitates the coordination of work and helps to check on the
power of the top managers
• It economizes time and helps in improving understanding.
• It promotes cooperation among team members and emotional
support to staff.
• It is a means of sharing information.
• It helps to resolve intra and interdepartmental conflicts.

Cont.
Diagonal communication-
It is a type of formal communication that takes place between the
managers of one department with the employees of another department.
It does not depict in the organization chart.
External interface-
A type of communication takes place between the manager of the
department with the outer group or outside the organization for an
official purpose is an external communication.

Types of communication according to
expression: -
Verbal Communication-
Verbal communication is oral communication that uses
spoken form. It may be face to face, telephonic, or using
other media. Speeches and discussion are examples of oral
communication. Verbal communication that helps in building
trust and rapport.

Cont.
Advantages-
Understanding and transparency- As oral communication
serves as interpersonal, it provides more understanding and
openness among managers, supervisors, and operational level
staff.
Scope for flexibility- Oral communication has no element of
rigidity and allows changes in the decision-making.
Instant feedback- The decision can be made quickly without
delay, as the feedback is an integral part of the communication
process.

Cont.
Advantages-
More effective- Oral communication is more effective because it is
easy to resolve the problems face to face or direct contact between staff.
A cost-effective way of communication- Oral communication saves
not only time but also the money and effort.
Encourage morale- Oral communication promotes receptive and
encouraging morale among nurses and essential for team building and
synergy.
More specific- It helps in conveying the message with the desired pitch
and tone.

Cont.
Disadvantages-
• It is less authentic unless the conversation is audio or
video recorder.
• Possibility of misunderstanding if words are not clear and
not understood.
• At times there can be arising conflict situation when there
is a slip of the tongue by a person.
• It may create confusion.

Cont.
Written communication-
It is a form of documented
communication. Formal notification is
usually in writing. The correspondence
takes place in downward and upward
direction. These are in the way of
letters, applications, memos, papers,
reports, orders, instructions, etc.

Cont.
Advantages-
Authenticity- It is very concrete form of documentary evidence.
Proof for future reference- It is useful for future reference purposes.
Bulk communication- It can be easily distributed to many employees,
thus making it a bulk communication method.
Cheaper means of communication- It is a more affordable means of
communication when used or sending and receiving messages to
distance places.
More transparent and specific- Written notes are written carefully,
and hence drafted more precise and accurate.

Cont.
Disadvantages-
 Very expensive for transmitting short
messages.
 It is generally formal
 If poorly drafted, it can create
misunderstanding and confusion.
 There is a lack of secrecy in written
communication.

Cont.
Nonverbal Communication-
Other than oral and written communication,
nonverbal communications are essential to
express emotions, attitudes, and reactions.
The person, if not able to express message
verbally or in writing, can communicate in
this form. Eye contact, gestures, movement,
and postures are types of nonverbal
communication.

Channels of communication: -
Formal Communication channels
These are ‘Through proper channel’, which means that the
path of communication flows through the line of authority
linking a position to its line superior, i.e. the range of
superior-subordinate authority relationships. There are five
types of a communication networks in an organization:
chain, circle, wheel, inverted V and free flow.

Cont.
Informal Communication Channels-

Strategies of communication: -
Strategies of
communication
Questioning
Directing Listening
Think before
you speak
Using
direction

Elements of effective communication: -
Clarity
Clarity of objectives of
communication
Use of two-way communication
Understanding receiver
Adequacy and completeness
Consistency

Timing
Appropriate language and symbols
Credibility
Excellent listener
Noise reduction
Control over emotions
Avoid overloading of messages
Constructive feedback
Select the appropriate channel

Flexibility in meeting the targets
Use of multiple channels of
communication
Use an informal channel of
communication
Maintain transparency with team
members and subordinates
Be confident

Features of a effective written communication: -
Clear Complete Coherence
Credibility
Continuity
Correctness
Concise

Barriers in communication: -
Semantic barrier- These are barriers
arising from the linguistic capacity of the
sender and the receiver. The difficulty
arises due to the same words or symbol
means the same meaning. The semantic
barriers can occur due to poorly expressed
messages, incorrect translations, distorted
perception, and use of technical language
that may not be understood by the receiver.

Psychological barrier- These are
barriers arising from the emotional or
mental status of the sender and
receiver. Stress, wrong assumptions,
passing remarks, attitude, poor
listener, defensiveness, and fear are
examples of psychological barriers.

Organizational barriers- These are
the barriers arising within
organizational structures due to no
supportive or no corporate policies,
rules and regulations, inadequate
facilities to the flow of
communication, status relationship,
and complexity in the organizational
structures.

Personal barriers- Unfavourable attitude
of managers/supervisors toward
subordinates, fear of challenge to authority,
lack of confidence in subordinates, lack of
subject knowledge, perceptual variations,
disorders of sense organs, ignoring a
communication, lack of time are examples
of personal barriers causing inefficient
communication process.

Environmental barriers- One of
the significant hurdles of
communication in a workplace is the
ecological and physical barrier. High
intensity of light for visual
communication, high temperature,
humidity, bad ventilation contribute
distortion in sending and receiving a
message are examples of the
physical obstacles.

Mechanical barriers- Mechanical barriers
include any disturbances, which interfere
with the fidelity of the physical
transmission of the message. A telephone in
poor working condition creates a
mechanical barrier. In mass communication,
automatic barriers include smeared ink in
the printed matter, a rolling screen on TV, a
type too small to be read in the newspaper.

Theories of communication: -
The decibel theory-
It argues that the best way to get the
message across is to state one’s point
loudly and frequently. Its effectiveness
over a period of time is nil, but many
of us still need to be reminded that
shouting only makes poor
communication louder.

The sell theory-
It lays down that the total burden of
communication is on the communicator
while the receiver is passive and
pliable. One of the problems created by
this approach is that it tends to increase
the barriers between the individuals
and thus reduces the chances of hearing
each other.

The minimet theory-
It assumes that the receiver
probably is not much interested in
what is being communicated. By
telling an individual what he needs
to know, he will have little to
object and little to question.

Interpersonal communication: -
It is the interaction occurs
between two people or in a
small group. Healthy
interpersonal communication
allows problem solving,
sharing of ideas, decision
making, and personal growth.
It is the heart of nursing
practice.

Advantages: -
o There is an opportunity to ask questions, exchange
ideas and clarify meaning.
o It can develop a friendly and co-operative spirit.
o It is easy and quick.
o It is flexible and hence effective.
o Helps to understand each other
o Avoid duplication of work
o Shares ideas, knowledge, and views on various
prospective.

Channels of managerial communication: -

Confidentiality: -
Introduction-
Confidentiality is mainly about
your privacy, meaning that any
information you write down or
tell someone about will be kept
between you and that person. It is
both a legal duty as well as an
ethical duty.

Medical Confidentiality: -
 Foundation of trust in doctor
patient relationship.
 Privileged communication
intended only for the
knowledge of a particular
person.
 The act to keep private
information secret or
undisclosed.

HIPAA: -
In 1996 Congress enacted the HEALTH
INSURANCE PORTABILITY AND
ACCOUNTABILITY ACT or H.I.P.A.A.
 The primary purpose of this act was to
ensure the continuity of health
insurance when one changes the jobs.
But later it also provided standards for
health information transactions and
confidentiality and security of patient
data.

Purpose of confidentiality: -
Allows the patient to feel free to make a full
and frank disclosure of information to the
physician.
Full disclosure enables the physician to
diagnose conditions properly and to treat the
patient appropriately.
In return for the patient’s honesty, the
physician generally should not reveal
confidential communications or information.
There are exceptions to the rule.

Importance of confidentiality: -
 Natural human desire for privacy.
 Fear of social embarrassment or disapproval.
 Fear of discrimination, stigmatization.
 Information misused against patient.
 Builds confidence and open communication.
 Demonstrates doctor’s fidelity to the patient.
 Respects patient’s privacy, dignity and individuality.
 Encourages free exchange of information
 Medical confidentiality respects patient autonomy.
 Right to determine with whom, when and how much of personal
medical information is shared.

Disclosure of information: -
Medical confidentiality is not
absolute. Disclosure of the
information should be done-
 With patient’s consent
 For benefit of patient
 Prevent harm to others
 When required by law
 Medical research or audit

Principles for disclosure: -
 The disclosure of information
should be done to proper
authorities.
 Information disclosed should not
be beyond what is required or
relevant.
 Reason for disclosure
documented in the medical
records.

Breach of confidentiality: -
 A breach of confidentiality is a disclosure to a third party,
without patient consent or court order, of private
information that the physician has learned within the
patient-physician relationship.
 The most benign breach of confidentiality takes place
when clinicians share medical information as case
studies.
 The greatest threat to medical privacy occurs because
most of the times the bills are paid by some form of
health insurance, either private or public.

Breaching of confidentiality: -
Medical confidentiality
becomes critical in certain
conditions like-
- Sexual history and STD
- Adolescent sexuality
- Alcohol and drug
dependence
- Psychiatric Conditions

Exceptions: -
Treatment of minors
HIV+ patients
Abuse of a child or adult
Transportation safety
Reporting of wounds and
threats

Public Relations: -
Definition-
 Public relation means the development of cordial,
equitable and therefore mutually profitable relations
between a business industry organization and the public it
serves. – W.T. Parry
 Public relations are the process whereby an organization
analyses the needs and desires of all interested parties in
order to conduct itself more responsively towards them. –
Rex Harlow

Aims of Public Relations: -
 To enhance the image of excellence,
quality, reliability, and respectability of
an organization
 To eliminate misunderstandings and
misgivings
 To promote a healthy relationship
between the public and administration
 To have public support.

Need of Public Relations: -
 Increased governmental
activities.
 Population explosion creating
communication problems.
 Increased educational standards
resulting in rise in expectations.
 Progress in communication
techniques.

Well executed Public Relations: -
Increase visibility for the hospital, employees.
 Position the hospital as a health care leader and authority within the
community or region.
 Expand awareness of the hospital’s entire range of programs and
services.
 Enhance the hospital’s image.
 Aid in recruitment and retention of employees.
Support efforts to raise funds for new programs.
 Act as a foundation when negative news about the hospital occurs.
 Boost employee morale.

Forms of Public Relations: -
Employee
relations
Community
relations
Government
relations
Media
relations
Employee
education,
award
programs
Community
events,
volunteer
activities
Policies,
programs
Positive
publicity

Types of Public Relations: -
Advertising
Publicity- It is the spreading of information to gain public
awareness for a product, person, service.
Propaganda- It is a form of communication that is aimed
at influencing the attitude of a community toward some
cause or position.
Public diplomacy- Public diplomacy, broadly speaking, is
the communication with foreign publics to establish a
dialogue designed to inform and influence.

Types of Public Relations: -
Campaign- Effective public relations require a
knowledge, based on analysis and understanding, of all
factors that influence public attitudes toward the
organization.
Promotion- Commercialization of publicity.
Annual reports
Collaboration or strategic restructuring
Presentations

General consideration: -
Mostly the hospital administrator acts as the public relations in
charge. He or she may employ some assistant who should be a
skilled person in the public relations process.
Some hospitals appoint public relations officer (PRO)/welfare
officer to manage the public relations department.
Public relations refer to building, bridging, and establishing
understanding and rapport with the general public.
The person responsible for public relations must plan, organize,
and evaluate the function of public relations programs.

General consideration: -
It is a two-way process between hospital and public
that needs effective communication and understanding.
Formal and informal contacts should be established
between employees and the public.
The public needs proper information and facts
regarding hospital services through publicity,
propaganda, advertising, and education.

Functions of Public Relations: -
 To establish the relationship between organization
and society
 To develop reciprocal understanding and goodwill
 To analyze the public perception and attitude
toward the organization
 To identify the organization policy with the public
interest
 To execute the programs for communication with
the public.

Elements of Public Relations: -
 A planned effort or management function
 The relationship between an organization and its public
 Evaluation of public attitudes and opinions
 An organization’s policies, procedures, and actions
 Steps were taken to ensure that said policies, procedures,
and activities are in the public interest and socially
responsible
 Execution of action and/or communication program
 Rapport, understanding, and acceptance.

Factors affecting hospital public image: -
1. Services
2. Health providers
3. Means of publicity and
public education

Organizing public relations program: -

Advantages of public relations: -
o Help the hospitals to secure and maintain the goodwill of the
community to accomplish the purpose up to their satisfaction.
o Public can fully utilize the services rendered by the hospital.
o Helps to orient the staff working in the hospital about the public
programs.
o It reflects the reputation of the hospitals.
o It will help them to visualize the extent and type of services
rendered by the hospital and the attitude of staff members.
o The staff learns adjustment, patience, and understanding of the sick
and their families to meet the patient’s need, in spite of technical
perfection.

Disadvantages of public relations: -
 It is difficult to measure.
 Public relations is highly dependable on the willingness of
third-party endorsers to publish the content. This means
that you have less direct influence over the success.
 Due to turbulent industry the market is continuously
shifting. So, it is important to be updated with the current
events.
 The marketing campaign does not guarantee successful
results.

Communication pattern in Nursing: -
Communication of nurse
administrator with medical
administrators
Communication of nurse
administrator with subordinates
Communication pattern of nurse
supervisors
Communication pattern of bedside
nurses

Conclusion: -
Having good communication skills is
essential to collaborating on teams with
your fellow nurses and colleagues from
other disciplines. It’s also important to
patient-centred care. Nurses who take the
time to listen and understand the concerns
of each of their patients are better
prepared to address issues as they arise,
resulting in better patient outcomes.

Communication, Confidentiality and Public Relations

Communication, Confidentiality and Public Relations

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