Case Studies

Case 4 Facing some difficult situations with colleagues

In each situation that follows, the dietitian is in a stronger position to communicate what she wants assertively by being aware of her own thoughts and feelings and knowing what outcome she would like. In each case, the dietitian uses active listening and reflecting skills, preparing what she wants to say to whom, and where and when to communicate. She thinks about the key points to include in order to convey a clear message and the precise words to use in order to convey it in a non-aggressive and non-accusing manner.

Situation 1

Nicky, a basic-grade dietitian working in a district hospital, has learned that an inpatient has not been receiving the food supplements she has arranged for him to have. He had seemed so ill and grateful for her interest in him. She went to a lot of trouble to ensure he would be given the supplements. She feels annoyed to learn he has not been getting them. She also feels afraid that she might be at fault, although she cannot understand how this could be, as she is sure she followed the correct procedure. However, she is nervous about tackling the situation effectively. She wants to appear professional and confident and to be able to sort the situation out satisfactorily so that her patient gets the supplements in future and that the system does not break down again. She visits the ward, thinking about what she wants to say.

What do you think Nicky might say to (i) the patient, (ii) the nursing staff or (iii) the doctor? Take time to construct a clear, concise message.

Situation 2

Tina, a community dietitian, is thinking about a situation with one of the doctors in the practice. It has come to her attention that he is handing out very low-calorie diet sheets to patients, which she considers inappropriate. She feels annoyed when she realises patients are getting conflicting advice. She feels anxious about speaking to him because he has been short-tempered with her in the past. She is also worried that somehow he will turn the tables and she will end up thinking of herself as being in the wrong. She would like to be able to express her concerns clearly and calmly, to feel at ease with him and to gain his cooperation.

What do you think Tina might say to the doctor when she has an opportunity? Take time to construct a clear, concise message.

Situation 3

Jo, another community dietitian, is concerned that a diabetic patient who told her that she had been advised not to eat bananas and grapes, has been given incorrect dietary advice by Fran, a practice nurse. She feels annoyed with Fran and wants to put her right, but is anxious that Fran will get defensive and aggressive towards her. She would like to be able to express her concerns clearly and calmly, to feel at ease with Fran and to gain her cooperation.

In Jo’s situation, would you speak to Fran or to one of the doctors in the practice? What would you say? Take time to construct a clear, concise message.

Although their situations are different, each dietitian has similar thoughts, feelings and desired outcomes. They all want their respective conversations to be a more rewarding experience than in the past.

For this to happen, each needs first to be clear about the outcome they want.

• • Nicky wants reassurance that she did her part, that her patient is not worse as a result of not getting the supplements and that he will be given the supplements in future.
• • Tina would like the doctor to agree to use the diet sheets she has available.
• • Jo would like Fran to give the same advice as she does.

You are recommended to use the book...

To read about how to convey a clear message (Chapter 9).