Assertiveness

Prepared By:
Shaier Khan
Sr. Nursing Instructor
SWCON
 Definitions & Introduction
 Assertiveness is the skill of standing up for yourself and
getting exactly what you want.
 It is the art of confident, clear, honest and direct
communication, while at all times retaining respect for
other people (Dainow & Bailey, 1988; Dickson, 1982).
 Assertiveness is non-aggressive, non-defensive and non-
manipulative & it does not interfere with other people’s
freedom to take an assertive stance.
 Cont…
 To be assertive is not always to get your own way, at
times though being assertive, we may compromise on
some issue without compromising our own self worth
(Lindenfield, 1986).

 The involved parties should feel acknowledged & not

feel being ‘put down’ or humiliated.
 If they feel humiliated, it is likely that the encounter will
have been handled aggressively rather than assertively.
 Assertiveness Myths

 It is uncaring to be assertive
 If someone says ‘no’ to my request, they
don’t like or love me
 I shouldn’t have to say what I need – people
close to me should know
 Advantages & Disadvantages
 Advantages
Assertiveness is viewed as:
 A valued behavior within nursing, resulting in positive
outcomes such as the enhancement of leadership skills
(Milstead, 1996)
 An increase in job satisfaction (Creech & Boyle, 1985)
 An avoidance of compromising patient care
(Poroch and McIntosh, 1995)
 Alleviation of job stress & anxiety (Bower, 1999)
 The heightening of nurses’ effectiveness in bringing
about change (Benton, 1999)
 A greater insight into the factors that influence the
responding style is necessary
 Advantages & Disadvantages
In addition,
 It increases self esteem, can lead to mutual respect,
keeps us from being taken advantage of by other
people.

 Disadvantages
 Can have negative consequences (others don’t like
what you’re saying), causes conflict that has to be
dealt with.
 Also, just because you’re assertive doesn’t mean
you always get what you want.
 Why is Assertiveness Important?

If you don’t know how to be assertive,

you might experience the following:
 Depression
This comes from anger turned
inward.
It can give you a sense of being
helpless and hopeless, with no
control over your life.
 Cont…
 Resentment
Anger at others for manipulating or taking advantage of
you.
 Frustration
Why did I let someone victimize me?
 Temper/Violence
If you can’t express anger appropriately, it builds up
until it blows.
 Anxiety
Which leads to avoidance. If you begin to avoid situations or
people that you know will make you uncomfortable, you may
miss out on fun activities, job opportunities etc.
 Cont…
 Poor relationships of all kinds
Non-assertive people are often unable to express emotions,
positive or negative. This results in poor relationships with
people around them.
 Physical complaints
Headaches, ulcers, high blood pressure. We all know what
stress does to our bodies.
 Assertiveness, when it becomes a habit, is a great stress
reliever.
 Assertiveness Rights
 You have the right to state your own needs & set your
own priorities as a person.
 You have the right to offer no reasons or excuses for
justifying your behavior.
 You have the right to decline responsibility for other
people’s problems.
 You have the right to change your mind.
 You have the right to make mistakes.
 You have the right to say’ I don’t know’.
 Assertiveness Rights Cont…
 You have the right to deal with others without being
depending on them for approval.
 You have the right to be illogical in making decisions.
 You have the right to say ‘I don’t understand’.
 You have the right to ask for what you want.
 You have the right to express your feelings, opinions
and values.
 You have the right to be treated with respect as an
intelligent, capable and equal human being.
(From Kagan, Evans & Kay, 1986, adapted from Smith, 1975)
 Assertiveness Rights Cont…
This is to remember that;
 One person’s rights are never at the expense of
another’s.
 What a person does should always be based on
his/her assessment & s/he should not be judged
by others.
‘Rights and responsibilities go side by side, so
always clarify the responsibilities that go along
with assertive rights.
 Components of Assertiveness Skill
Three components;
1) To be able to decide what it is you want or feel, and
say so specifically & directly.
2) To stick to your statement, repeating it, if
necessary, over and over again.
3) To deflect assertively any responses from the other
person which might determine your assertive
stance.
Different Behavior Types & Their
Consequences
 Helpful Hints in Applying
The Assertion Model
 Focus on the common goal: quality care, the welfare of
the patient, safety–it’s hard to disagree with safe, high
quality care.
 Avoid the issue of who’s right & who’s wrong. “Patient
Centered Care–concentrate on doing the right thing”.
 De-personalize the conversation
 Actively avoid being perceived as judgmental
 Be hard on the problem, not the people
 Verbal Tactics for achieving
Assertiveness
1) Use ‘I’ Statements:
It helps to assume responsibility for our own behavior
& lessen the likelihood that we blame others for what
we do.
2) Change Verbs:
Change ‘cant’ to ‘won’t’ & ‘have to’ to ‘choose to’ it
reminds us that we have choices & can change our
own circumstances if we want to.
3) Self Disclosure:
Say what you feel in order to help you relax & begin
to take charge of yourself. (Vaughan & Pillmoor, 1989)
 Non-verbal Tactics for achieving
Assertiveness
1) Voice & speech pattern:
A steady, medium volume, accompanied by deep
breaths in a difficult situation helps to be relaxed
and able to be heard clearly.
2) Calm facial expression:
Relaxed eye contact and relaxed body language
helps to convey sincerity and be taken seriously.
(Vaughan & Pillmoor, 1989)
 Techniques for Difficult Situations
• Broken record
– Keep repeating what you said in a low, pleasant voice.
• Fogging
– Way to deflect negative criticism & avoid a fight, agree
with part of the statement but retain your right to
chose your behavior and continue to support your
argument
• Defusing
– If someone is very angry, you let them cool down
before you talk about the issue
 Techniques for Difficult Situations
• Content to Process Shift
– Stop talking about the problem, and bring up what the
person is acting like right now
• Assertive inquiry/stop action
– Similar to above, say wait a minute (stop the action)
and then ask, Mr. X what is the real problem here?
• Summarization
– Summarizing what has been said. This helps to make
sure you’re understanding the other person.
 Negotiation & Compromise

 Assertiveness often requires some negotiation in order

to reach a compromise that is acceptable to both parties.

 Assertiveness requires exploration of the alternatives

with the responsibility to ensure the most progressive
compromise possible is achieved (Drucker, 1980).

Non-assertiveness may either involve;

 Manipulation or aggression in order to get own
way. OR
 Passivity in giving in and letting others to get
their own way.
 Assertiveness: Expected in
Nursing

 Helps nurse advocate for the patient

 Promotes honest, open communication and
behavior
 Considers others’ feelings and needs
 Benefits nurse, patient, and staff

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 References
1. Kagan C & Evans J. Professional interpersonal skills
for nurses; 2001. Nelson Thornes Ltd: Cheltnham; UK.

2. Marquis BL & Huston CJ. (2009). Leadership roles and

management functions in nursing: Theory and
application (6th ed.). Philadelphia: Lippincott, Williams,
and Wilkins.

3. McCartan PJ, Hargie OD. Assertiveness and caring: are

they compatible? J Clin Nurs. 2004;13(6):707-13.