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What two things can you achieve by directly facing the person you are speaking to?
1.

How might a staff member perceive you if you stand too close during a conversation?
If you stand too far away?

What three things should you consider when assessing a recording of your own voice?
1.

On the last track we discussed the six step process for getting follow-through. These six steps were Stating your Request, Get Support, Discharge Strong Emotions, Know What You Will Say, and Debrief.

On this track, we will discuss the components regarding visually how you are perceived by your administrator, director of nursing, charge nurse, dietary supervisor, PT, OT, speech, CNAs, etc.

These five ideas will help you communicate more effectively with your staff and other co-workers. You've heard the old saying, "It's not what you say, it's how you say it." Do you feel this is true? So, what does your administrator see when he or she looks at you in the meeting in his or her office? I feel an outline of what to do on the previous tracks would be incomplete if I did not provide you with information on how to conduct these meetings with your administrator, director of nursing, etc, in the most effective professional manner.

Let's break down what he or she sees into five categories. These categories are eye contact; body posture; physical contact; facial expressions; and voice tone, inflection, and volume. This is the kind of track that will be useless to you if you only play it once. You not only need to replay it several times, but create a strong visualization of yourself.

#1 Eye Contact
The first component of gaining staff support and cooperation we will discuss is eye contact. As you probably have been told, where and what you look at conveys to other people your level of confidence in yourself. When you look at the department member or administrator you are speaking to, eye contact helps to communicate your sincerity and increases the directness of your message. Envision yourself looking directly at your administrator across his or her desk, or director of nursing, as you speak. Not staring, however.

Now, if you look down at your lap or at other objects in their office for most of the conversation, you are probably conveying a lack of confidence or even disrespect for the other person. However, when you stare too attentively, you might make the other staff member feel uncomfortable. The best way to deal with eye contact, I find, is by becoming more conscious of where you look when you speak. If you are intimidated by the other person, and tend to lack eye contact with him or her, in little steps, make longer and longer eye contact during conversations while looking away when comfortable. By maintaining eye contact when talking with your administrator, for example, you communicate respect and interest in the person, respect and interest for your own message which you are conveying, and respect and interest for the ideas of the other person. Let me repeat that. By maintaining eye contact when talking with your administrator, for example, you communicate respect and interest in the other person, respect and interest for your own message which you are conveying, and respect and interest for the ideas of the other person.

Body posture is another component for gaining staff support and cooperation that is an indicator of your personal interest in the other person. How are you sitting in your administrator's or director of nursing's office? If you sit too erect, you look anxious, and if you slump, you may look bored. Now, visualize your ideal sitting position.

If you stop to talk with the charge nurse or CNA in the hall, you’ll be amazed how much more interesting and extended a conversation can be when you are facing the person you are speaking to; as opposed to talking to them sideways and turning your head only. Also, when you find yourself sitting while another is standing, in a conversation, stand up yourself. Or if the other person is sitting, like the charge nurse sitting and charting behind the nurse's station, you might sit yourself, if appropriate, to establish a more effective line of communication. You are also showing your interest in the other person which possibly makes them more receptive to your own needs. When you turn the CD player off, visualize your ideal standing or sitting position.

#3 Physical Distance
In addition to eye contact and body posture, the next component regarding increasing the effectiveness of your communication, we will discuss is distance. Visualize for a moment how far away you normally stand during a conversation with another activity staff member, the director of nursing, dietary supervisor, administrator, office manager, etc. Are you overly conscious of being too close or too far away from the other person? If so, it can be beneficial to assess your physical space, which might be perceived as threatening if too close, but if you stand too far away, the other person might see you as unsure, insecure, and threatened, which could create an atmosphere of distrust during the exchange. When you turn the CD player off, visualize an ideal distance when standing and communicating with specific staff members. MUSIC

The fourth component regarding increasing your communication effectiveness is facial expressions. Have you ever seen a person try to smile when they are obviously embarrassed or angry and clearly do not want to smile? It never looks quite the same as it does when they are actually happy, does it? While attempting to gain staff support and cooperation, it is important that your facial expressions match your mood. If you are angry, try keeping a straight, non-smiling face, but don't force a smile. It just won't work, and will send an insincere, phony message of your intention.

Technique: Mirror, Mirror
I consulted with an activity director, Lucille, who was not receiving much follow-through from nursing, following her meeting with her administrator. I noticed that Lucille was a timid person, and became stressed when she had to make requests of others, similar to the ones proposed on the previous tracks. To cover up her nervousness, Lucille would smile with a Cheshire cat toothy, insincere, glaring smile. To help Lucille understand what her face said on her behalf, I suggested the following exercise I called the “Mirror, Mirror Exercise.” First, I asked Lucille to relax all the muscles of her face as much as she could. I told her to let go of her expression, relax the muscles around her mouth, and let her jaw go loose. I then asked her to pay careful attention to the relaxed, soft feelings she had when her face was relaxed. Next, I asked Lucille to smile, bringing her mouth up as widely as she possibly could, feeling the tightness in her cheeks, around her eyes, and all the way up to her ears. I told her to hold that smile, look at the expression in the mirror, and concentrate on the feelings of tightness. We discussed how this unnatural tight smile looked on her face. Then, Lucille would relax her face completely again.

To have a natural smile on your face where your smile matches the look in your eyes... Consider the inner smile technique. In this technique you recall a happy or pleasant memory. Perhaps you might recall the feeling you had just as you opened a gift or present you were especially happy with or perhaps recall a pleasant scene of a sunny hillside with flowers. These thoughts can serve to give you an inner smile that may give you a natural relaxed expression on your face as you speak to the charge nurse or CNA. So create a repertoire of pleasant events, and think of one just prior to these meetings and conversations suggested on the previous tracks.

#5 Vocal Changes
In addition to eyes, body posture, physical distance, and a natural smile, the last component for gaining staff support and cooperation is your voice tone, inflection, and volume. The way in which you use your voice can have a significant effect on those around you. Agreed? An extreme example is, as you know, the same words spoken through clenched teeth in anger offer an entirely different message than when they are said with the tone of a pleasant request. However, a soft monotone voice won’t convince anyone, let alone your administrator or director of nursing, that you are serious about your department's compliance with federal guidelines. On the other hand, a well-modulated, conversational statement is convincing without being intimidating. Greg, an activity director, had trouble getting his point across to his director of nursing regarding CNAs transporting residents. I noticed that Greg talked very very softly and rarely changed his tone. Clearly talking to his hard of hearing residents was a challenge for Greg. I suggested to Greg that because his voice sounded different to him than to other people, that it might be a good idea to become better acquainted with it.

Technique: Listen to Yourself
To do this, I suggested Greg try the “Listen to Yourself” exercise. I asked Greg to try tape recording different styles of his voice. In the privacy of his home, I told him to experiment with four different tones: conversational tones, an angry shout, a caring message, and a persuasive argument. I then asked him to play back his recordings and consider these three dimensions of his voice:

Greg was surprised to discover that his shout was not loud at all and that his inflection, though to him sounded humble, only expressed passiveness and lack of enthusiasm. By being able to understand what worked and what didn't work for him regarding tone, inflection, and volume, Greg could now learn how to express his ideas in a more effective way.

What is the idea that you have gotten from this track that you want to work on? Is it eye contact? body posture? distance/physical contact? facial expressions? Or voice tone, inflection, and volume?

This track is so content dense you might consider replaying it more that once to actively implement some of the specific techniques suggested. Remember just listening won't change any thing related to your goal of gaining cooperation from staff.

On this track, we discussed the components regarding visually how you are perceived by your administrator, director of nursing, charge nurse, dietary supervisor, PT, OT, speech, CNAs, etc.

On the next track, we will discuss strategies to get support from the Therapies regarding scheduling therapy sessions so that residents can attend an activity of choice.

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