In so far as the workplace is in most cases constituted by a diverse number of individuals, communication between colleagues is decisive so as to effectively execute tasks as well as to building relationships which enhance the work environment. From the perspective of my own experiences as a registered nurse (RN) for the past seven years, I have encountered many cases where effective communication was decisive, in many instances leading to life saving decisions with regards to patients at the hospital. One such example I still remember vividly. A patient who had gone for a routine colonoscopy in a clinic had a bowel accidentally punctured by the doctor. The surgeon communicated to me that he would perform the surgery the next morning. I was unsure of this decision, but accepted it, since in the hospital environment there is a clear hierarchy of communication. However, when I returned to the patient to complete my assessment, I observed that his bowel had tripled in size. I immediately contacted the surgeon so as to notify him of the development and surgery was performed immediately. Without this emergency surgery, the patient would have most likely expired.
In this incident, numerous forms of communication are present. In the first instance, the communication in the hospital environment is clearly defined by a hierarchy. Nurses are lower in rank than doctors. Whereas at first glance in terms of the case I have outlined, it may seem that hierarchical forms of communication are ineffective, since the surgeon ignored my initial recommendation. However, from my experiences, a hierarchical structure of communication is necessary to a work environment where crucial decisions are to be made. Hierarchy is established by qualification and experience. This means that communication is not essentially democratic, but possesses a vertical structure. This is necessary for the complexity and speciality of the hospital environment, but, moreover, it is also crucial for the decision making process. Namely, simplifying the decision making chain and giving responsibility to certain individuals within this chain on the basis of qualification and experience enables crucial decisions to be made and carried out without opposition. Such quick and efficient communication forms are necessary for the high pressure environment of the hospital, where decision making is often a decision which can directly impact life or death.

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At the same time, from another perspective, there is also a democratic and dialogue form of communication present in this incident. As the above example demonstrates, I was able to convey my thoughts to the surgeon regarding the decision making process. Even though the decision making structure is hierarchical, the example demonstrates that opinions are valued, regardless of where one is located in the hierarchy. The surgeon could have refused to consult others when making his assessment. This would have had disastrous results in this case, as a continued dialogue between surgeon and RN was necessary so as to accurately assess the patient and make note of any significant changes in the patient’s condition. Dialogue is a crucial part of communication, since communication by definition involves one individual communicating with another.

Lastly, a crucial aspect of effective communication is that of flexibility. When two people interact in dialogue, they often have contrasting opinions. If the respective parties are inflexible with regards to their position, then dialogue is, in a certain sense, senseless and communication impossible. In the above example, flexibility plays a key role. I gave my initial opinion to the surgeon, who then felt that this was not the right decision. Respecting the hierarchy, I accepted the decision, however, also continued my duties and performed my necessary assessments. Noting the change in the patient, I then decided that I should contact the surgeon immediately. The surgeon also remained flexible, ultimately accepting my observation and then ordering that the operation be performed immediately. Flexibility in communication allows for the parties involved to revise their opinions through dialogue and new information.

Communication is fundamental because we are constantly engaged with others in the medium of language, sharing opinions, thoughts and desires. At the same time, in certain specific contexts, such as the hospital environment, fundamental communication skills are clearly decisive. Without these skills it is not possible to share valid information, formulate and exchange opinions, and make decisions, which are often of a life and death nature.