Assertiveness in Nurses: Case Study, Benefits, and Strategies

This essay delves into the crucial role of assertiveness in nursing, emphasizing its importance for effective communication, patient care, and professional practice. The essay defines assertiveness, differentiating it from aggression and non-assertive behaviors, and highlights its benefits, such as increased self-esteem, improved communication, and enhanced job satisfaction. A case study illustrates how a nurse can assertively handle a confrontational situation with a patient's family, offering practical strategies like direct communication, owning the message, and seeking feedback. The essay emphasizes that assertive behavior is vital for nurses in today's healthcare environment, enabling them to resolve conflicts, enhance leadership skills, and advocate for patients effectively. Educational methods like role-playing are suggested to cultivate assertive behaviors among nurses, ultimately leading to improved patient outcomes and a more empowered nursing workforce. The essay concludes by reiterating the necessity of assertiveness for nurses to navigate the complexities of the healthcare industry and to be active leaders in their field.

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Assertiveness in Nurses
Student’s name
Institution

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Assertiveness in Nurses
Introduction
Assertiveness is a healthy trait in almost everyone and it negates the personal powerlessness and
leads to personal empowerment. In nursing, assertive behavior is considered an invaluable trait
or behavior for the professional practice to be successful (Kilkus, 1993). In dealing with
challenging situations involving human resources, nurses need to be assertive in the current
healthcare environment. Sometimes, as in the given case study, nurses have to confront difficult
situations and adamant people. In these scenarios, it is imperative that the nurse uses her
assertive skills to sort out the complex human relations (Booyens, nd).
Assertiveness, as an attribute in nursing, is often misunderstood. According to some people,
being confident is being assertive. However, the authors put forth that being confident is not so
much a criteria in assertiveness as much as valuing one’ views and one’s profession. Being
assertive can lead to others valuing the nurse more and her principles and work in the
professional sphere. Respect and recognition are bound to follow the nurse who is assertive.
Assertiveness is a slow process and takes time to inculcate. However, assertiveness is an antidote
to fear, passivity, anger, and even shyness. To create win-win situations for both the nurse and
the clients they work for, nurses need to be assertive.
What is Assertiveness?
Assertiveness is the behavior that allows an individual to express one’s self and their rights fully
well without violating the rights of the other person. A win-win solution is achieved to problems
when assertiveness is employed. A win-win situation is one in which both the parties are left

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satisfied and have their needs met to the highest degree possible. An assertive person has to
negotiate, influence, or listen sometimes to gain control of the situation and create harmony.
According to Dorland’s medical dictionary, assertiveness is defined as the “form of behavior
characterized by a confident declaration or affirmation of a statement without need of proof; this
affirms the person’s rights or point of view without aggressively threatening the rights of another
or submissively allowing another ignore or deny one’s right or point of view.”
Assertiveness is the capability of an individual to express their views, opinions, beliefs,
feelings and judgments honesty without violating the other person’s rights. Assertive
nurses are able to provide suggestions directly and openly and can take and give criticism,
can guage the rights and responsibilities in an emergency situation, and work on
assessments effectively.
When assertiveness is missing in nurses, the communication she has is also impacted
negatively and, hence, the patient care is compromised. Patients may notice the lack of
confidence and assertiveness in a nurse and may be reluctant to trust her completely. To
build confidence in the patient and in the way he sees the treatment, nurses need to be
assertive.
Thus, assertiveness is a boon and not a bane in the nursing profession. Assertiveness on the
part of a nurse can instill confidence in the patient regarding her abilities to treat the
patient and nurse him/her back to health.
Assertiveness vs. Aggression

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Assertiveness is not the same as aggression. Aggressiveness results in the person expressing
one’s thoughts and beliefs in an inappropriate fashion by violating others’ rights. By being
aggressive, one is considering his own rights, views, and needs above others. This is faulty
behavior. It often results in a win-lose situation with the aggressive person pushing himself to
victory over the other.
Assertiveness is also quite differ from being nonassertive. Passive, indirect behavior is what one
would call nonassertive behavior. When one does not respect his/her own needs and points of
view, he may be dominated by another, resulting in violation of the person’s rights. A message
of inferiority is conveyed by nonassertive behavior. It results in a lose-win situation where the
nonassertive person allows him/herself be overridden and opts to become the victim.
Case Study
In this case study, the nurse’s shoulder is being poked by the patient s family. Here, the personal
space of the nurse is being intruded and she must take the call to be assertive while confronting
such rash and insensitive people. The nurse must firmly, but not rudely put things in the right
perspective by asking them to apologise politely for poking her shoulder. The nurse may then
begin to describe the events that lead to the delayed sharing of information with the family of the
patient that has made them so angry. An apology from the intruder’s side and a brief explanation
from the nurse’s side are needed to set things right and equal for both parties.
Here are some ways in which the nurse can behave in an assertive manner when confronted with
abusive people.
1. Being Direct. Confront the patient’s family directly in person and deliver the message to
them precisely and clearly.

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2. “Owning” the message. Ownership can be in the form of saying “I would require an
apology for poking on my shoulder”. The use of “I” is very effective in this context.
3. Asking of feedback. Correcting any misperceptions can be possible by asking for
feedback about whether the nurse has been clear about her viewpoint. This way, the nurse
can help the other party realize that she is expressing her opinion honestly and is not
making ruthless demands.
4. Stopping to be apologizing all the time. The healthcare team has been late in delivering
information to the patient’s family. But, they are their own reasons for it. Instead of the
nurse feeling terribly apologetic and assuming all the blame, she can make the other party
see why the information was delivered late.
5. Not being self-depreciating. Although being modest is an often desired trait in nurses, it
should not be taken in to an extreme.
6. Acting confident. The nurse while confronting the aggressive family of the patient must
make sure to sound confident. This can be done by making eye contact with all concerned
and not looking down or away, as if being ashamed and shaky. Standing erect and with
the head held upright while talking to them can create an air of confidence around the
nurse.
7. Clarifying things. The nurse, after having asked for an apology from the other person,
can now describe the events that led to the late delivery of information to the patient’s
family. This will clear up things and make both parties feel good after the confrontation.
Benefits Derived from Being Assertive
Being assertive offers one several benefits. By being assertive, one can (1) gain self-esteem and
self-confidence; (2) understand and recognize one’s feelings; (3) earn the respect from peers as

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well as competitors; (4) help enhance communication; (5) help in the creation of win-win
situations, (6) help in creating honest relationships; and (7) as a nurse, enjoy more job
satisfaction.
Assertive behavior is needed in today s nursing profession. Nurses are no longer regarded as
passive, but as active players providing vital healthcare to patients. Effective patient–nurse
communication can be enhanced with assertive behaviour. Educational methods and curricula
can be developed to promote assertive behaviors among nurses. It is preferable that this
educational method is incorporated into the undergraduate courses meant for nurses.
One of the most effective educational methods that foster assertive behavior in nurses is through
“role plays”. Role plays often mimic real-life situations. When confronting scenarios with
difficult people who have to be pacified and harmony set in, the nurses have to be assertive
(McCabe, 2003).
From literature, it can be learnt that the nursing profession needs assertiveness to be an important
part of conflict resolution.
Nursing in hospitals often requires the negotiation of complex interpersonal ties. Also, the nurses
work within economic constraints and balance multiple roles and responsibilities. Nursing
professionals are responsible individuals and need to be accountable to many in the hospital.
They are always busy and are equipped with a range of professional skills and knowledge.
Hospital nurses are often caught up in the busyness and complexities of everyday work.
In such a context, reflective practice can be encouraged among nurses such that they are not too
passive while meeting people and are able to voice their opinions and views assertively.

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Conclusion
It is currently widely recognized that the nurses need to be assertive in appropriate situations
while conforming issues to human resources in the healthcare industry. Yet, literature studies
point out that nurses tend to be demure and not assertive at all. With assertiveness, the nurse can
enjoy better job satisfaction, resolve conflicts effectively, enhance their leadership skills, avoid
compromises in patient care, reduce job stress, and effectively and actively bring in changes that
are desired. Hence, assertiveness as an attribute has been discussed in positive light in the above
essay along with description of how a nurse should handle a particular case scenario where she is
poked in the shoulder by the angry family of a patient.
Nurses need to be be direct, own their message, ask for feedback, stop apologising all the time,
not be self–depreciative, act confidently, meet people in the eye, stand erectly without looking
down in order to be assertive.
The healthcare industry is changing with time, and the current scenario asks nurses to be active
role leaders and negotiate confidently and assertively with the patient and their families. Nurses
can also take a strong role in resolving disputes or conflicts in the hospital area. These actions
will put the nurse in change of the situation and make her a clear leader and empower her
greatly.

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Bibliography
Booyens, S. W., (nd) Dimensions of nursing management, Kenwyn: Juta.
Kilkus, S. P. (1993). Assertiveness among professional nurses, J. Adv. Nurs., 18(8), 134-1330.
McCabe, C. (2003). Teaching assertiveness to undergraduate students. Nurse Education in
Practice Journal, 3(1), 30–42.