Based on assigned readings please answer the following questions.  
1 a. Why should we study communication?
   b. Why is it important to be an assertive nurse?
2. Would you see yourself an assertive nurse?  If No, what are some barriers ? if Yes, where did you learn this skill ?
3. Describe and give an example from your practice of the following:
a)    Assertive communication
b)    Nonassertive communication
c)     and aggressive communication
4.  How do you currently manage your reactions to patient behaviors currently?
Postings should be a minimum of  250 words, spellchecked, and succinct in grammar and completed by Wednesday 11:59pm with response to two peers by Sunday 11:59pm.  Discussions require a APA reference at the end of your posting unless stated in the discussion instructions for the week.How We Can Enhance Nurses’ Assertiveness: A Literature Review
Ayako Okuyama1* Cordula Wagner2,3 and Bart Bijnen4,5

1Department of Total Health Promotion Science, Graduate School of Medicine, Osaka University, Osaka, Japan
2EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
3NIVEL Netherlands Institute for Health Services Research, Utrecht, The Netherlands
4Institute for Education and Training, VU University Medical Centre, Amsterdam, The Netherlands
5Foreest Medical School, Medical Centre Alkmaar, Alkmaar, The Netherlands
*Corresponding author: Ayako Okuyama, Department of Total Health Promotion Science, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita,
Osaka, 565-0871, Japan, Tel : +81-6-6879-2555; E-mail: [email protected]

Received date: June 10, 2014, Accepted date: August 25, 2014, Published date: August 28, 2014

Copyright: © 2014 Okuyama A et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objective : Assertiveness is important for effective team building in nursing. This article aims at evaluating the
results of the previous studies on nurses’ assertiveness in each decade in order to discuss the possible ways for
enhancing nurses’ assertiveness.

Methods : Five databases (PubMed, MEDLINE, CINAHL, Web of Science, and the Cochrane Library) were
searched for English-language articles published from 1946 to December 2012. Article which described the
assertiveness of nurses and relevant factors related to assertiveness in a clinical setting or evaluated assertiveness
training.

Results : Twenty-five studies in 26 articles were identified. In the 1970s and 1980s, research demonstrated that
nurses perceived they are submissive helper and were less assertive. These studies indicated that educational
achievement was regarded as a key factor in nurses’ assertiveness. The study in 1990s demonstrated that at least
one population of nurses was assertive. The studies after 2000 suggested that nurses behave in a passive way,
conforming to the stereotype of a ‘nice’ nurse, and were less likely to disagree with others. A sense of responsibility
for patients, managers’ leadership, organisational culture, and relationship between colleagues were reported as
influencing factors of nurses’ assertiveness.

Conclusion : Recently, the number of nurses who are trained in higher educational institutions has increased.
Despite this, nurses still experience some difficulties assessing themselves. Nurses should understand their role at
the recent health care environment as a professional. Nurse managers should take a leadership to avoid nurses’
concerns of voicing their opinions in order to improve nurses’ assertiveness.

Keywords: Assertiveness; Interdisciplinary communication; Quality
of health c




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