Harry E M u m , Jr, PhD
Are you a skilled listener? Listening behavior as a communication skill has been neglected or ignored. It has been regarded as an action but not as a skill subject to development. Prior to 1930, it was common to find references in the literature to the “three communication skills of reading, writing, and speaking.” More recently, however, listening
Harry E Munn, Jr, PhD, is associate professor of speech communication at North Carolina State University, Raleigh. He received his BS degree from the University of Wisconsin, Eau Claire; a master’s degree from Bradley University, Peoria, Ill, and his PhD from the University of Kansas, Lawrence. This article represents one portion of a communication workshop Dr Munn conducted recently for AORN of Baltimore. 994
behavior has been studied as a communication skill.’ In general, most individuals spend 7096 of their working day communicating. Of this communication time, WOis spent writing; 16%, reading; 30%, talking; and 45%, listening. Communication is a two-way process involving the sending and receiving of messages. Recent research by Conboy indicates that people rated to be highly effective communicators consider communication an exchange or transfer or interaction. They said such things as, “Communication is when one person understands what someone else has said.”* This reflects a positive attitude and recognition of the importance of listening. To be effective the nurse in the operating room must listen, seeking feedback to what has been said. Because the spotlight is always on the person talking, there is a tendency to want to be the sender of messages. On closer examination, however, we discover i t is the listening side of the communicative act where we gather the necessary data to solve a problem, to settle a grievance, to become more efficient, to build a supportive climate, to make a person feel special. The health care professional must be able to listen to diagnose medical and nurs-
AORN Journal, April 1977, V o l 2 5 , No 5
Listening power quiz When speaking interpersonallyor in a small group, do you: 1. prepare yourself physically by sitting facing the speaker and making sure that you can hear?
someseldom
2. watch the speaker for the nonverbal as well as the verbal
messages? 3. decide from the speaker’sappearance and delivery whether
or not what she or he has to say is worthwhile? 4.
listen primarily for ideas and underlying feelings?
5. determine your own bias, if any, and try to allow for it?
6. keep your mind on what the speaker is saying? 7. interrupt immediately if you hear a statement you feel is
wrong? 8. try to see the situation from the other person’s point of view? 9. try to have the last word?
10. make a conscientious effort to evaluate the logic and
creditability of what you hear?
ing problems as well as personal problems. This checklist, though by no means complete, will help you gauge your listening habits. Try to answer each question objectively. Score yourself as follows: questions 1, 2, 4, 5 , 6, 8, 10-ten points for usually, five points for sometimes, and zero points for seldom. Questions 3 , 7, 9, zero for usually, five points for sometimes, and ten points for seldom. If you score below 70, you have no listening power and have developed some bad listening habits; 70 to 85, you listen well but can still improve; 90 or above, you have listening power and are an excellent listener. A recent survey at a large company indicated that when employees were asked why they liked their supervisor, they re-
996
sponded, “because my superviso listens to me.” One of the deceptive features of listening behavior tends to be our comparative lack of feedback in respect to how we are doing. Therefore, we have a responsibility t o exhibit listening responses as communication checks to let the other person know how they are doing. A listening response is a very brief comment or action made to another person conveying the idea that you are interested, attentive, and wish for her or him to continue. It is made quietly and briefly so as not to interfere with the speaker’s train of thought. It is usually used when the speaker pauses. There are five types of listening responses: nod-nodding the head slightly and waiting
AORN Journal, April 1977, Vol25, No 5
pause-looking at the speaker expectantly without doing or saying any thing casual remark--“I see.” “Uh-huh.” “Is that so?’ “That’s interesting.” echo-repeating back the last few words the speaker said mirror-reflecting back to the speaker your understanding of what was just said. (“You feel that . . . .”) Investigations by Nichols indicated that we retain only 50?6 of the main content items immediately after hearing them and eight hours later we can only retain 25% of the original message.3 Can our listening ability be improved? Conboy makes the point that physicians and biologists agree that breathing is one life process human beings tend to handle poorly. It has been estimated that most of us could add 10 to 15 years to our life span if we practiced better breathing habits from an early age. Yet breathing is one thing we all do throughout our lives. Listening habits, like breathing habits, improve only with systematic and evaluated practice. Real listening requires an expenditure of energy in obtaining and retaining the spoken discourse of others. Tests in the physiological psychology laboratory have shown that active listening demands as much energy (makes a person just as tired) as comparable efforts in speaking, reading, or ~ r i t i n g . ~ One of the main objectives of AORN is to promote and encourage effective communication and interpersonal relations. It should be obvious that our communication and interpersonal relations will only improve to the extent that our listening ability improves. Our mental attitudes toward listening reduce our listening effectiveness. Bad mental attitudes toward listening are: 1. Calling the subject uninteresting. 998
2. Criticizing the speaker’s delivery, appearance. We should be concentrating on the ideas being expressed. 3. Getting overstimulated. When we do this, we tune ourselves out as listeners. 4. Listening only for facts. The feelings being expressed are extremely important. This is where a nurse’s bedside manner comes into play. 5 . Trying to make an outline of everything. If you do this you are missing the facial expressions and gestures that convey the speaker’s attitude. 6. Faking attention to the speaker. Don’t just nod your head up and down like the dog in the back of a car window. 7. Tolerating or creating distraction. Stop telephone calls and other unnecessary interruptions. 8. Avoiding difficult material. Don’t allow yourself to mentally skip over something that’s difficult to understand. 9. Letting emotion-laden words throw us out of tune with the speaker. Sometimes we hear a word we don’t like and once again tune out as a listener. 10. Wasting differential between thought speed and speech speed (500 words per minute to 125 words per minute). This last item is extremely important because we are involved in two processes as we listen: the process of picking up information and the process of associating that information with something from our past. This association makes the intake information meaningful. However, one serious problem is we think five times faster than someone can speak. Therefore, we have a tendency to become bored or
AORN Journal, April 1977, Vol25, N o 5
to let our minds wander off the subject matter. To improve our listening ability we can learn to take advantage of this thought-speed versus speech-speed differential. We could use this time anticipating the speaker’s next point, identifying and evaluating supporting material, and mentally summarizing what the speaker has said thus far. These three techniques would keep us polarized on the subject matter at hand. As professionals we are paid to listen to people, and we can improve our listening ability. The first step is to become aware that listening is not a passive activity and that there is little correlation between intelligence and listening. We must learn to “want” to remember. One technique that can be employed to improve listening ability is to pretend there will be a quiz afterwards. Listening makes people feel special, and it’s the special OR nurse who can listen. 0 Notes 1. Bill Conboy, Working Together . . . Communication in a Healthy organization (Columbus, Ohio: Charles E Merrill Publishing Co, 1976) 73. 2. /bid, 11. 3. Ralph G Nichols, Leonard Stevens, Are You Listening? (New York: McGraw-Hill, 1957) 115. 4. Conboy, Working Together, 74.
1000
Smallpox outbreak reported in Somalia An outbreak of smallpox has been located in Mogadishu, Somalia, and is under strict surveillance according to a World Health Organization (WHO) report. The disease was brought into Somalia by nomads from neighboring Ethiopia, the last country in the world to have endemic smallpox. It was last reported there in August
1976. The Somalian strain is known as variola minor, a less virulent form of smallpox than variola major. No case of variola major has been reported since it was erradicated in Bangladesh 18 months ago. WHO stated vaccination policy must be decided by each government according to its needs and circumstances. In Africa, where the disease is still present, vaccination programs should continue for at least two years. WHO is building up a reserve of antismallpox vaccine sufficient to vaccinate between 200 and 300 million people. Vaccine is already available to protect 112 million people, and an appeal has been issued for further donations to build up the reserve.
Cardiac nurse session The American Heart Association Council on Cardiovascular Nursing will hold its annual scientific sessions in Miami Beach, Fla, Nov 29 to Nov 30.The sessions will feature reports on research findings in nursing that will assist in patient care. Deadline for nurses submitting abstracts of their studies is May 27.Studies should focus on individuals, laboratory animals, or patients, be related to aspects of the cardiac field, and contribute new scientific knowledge or theory. For guidelines on submission of abstracts, contact the American Heart Association, Scientific Programs, 7320 Greenville Ave, Dallas, Tex 75231.
AORN Journal, April 1977, Vol25, No 5
Are you a skilled listener? Listening behavior as a communication skill has been neglected or ignored. It has been regarded as an action but not as a skill subject to development. Prior to 1930, it was common to find references in the literature to the “three communication skills of reading, writing, and speaking.” More recently, however, listening
Harry E Munn, Jr, PhD, is associate professor of speech communication at North Carolina State University, Raleigh. He received his BS degree from the University of Wisconsin, Eau Claire; a master’s degree from Bradley University, Peoria, Ill, and his PhD from the University of Kansas, Lawrence. This article represents one portion of a communication workshop Dr Munn conducted recently for AORN of Baltimore. 994
behavior has been studied as a communication skill.’ In general, most individuals spend 7096 of their working day communicating. Of this communication time, WOis spent writing; 16%, reading; 30%, talking; and 45%, listening. Communication is a two-way process involving the sending and receiving of messages. Recent research by Conboy indicates that people rated to be highly effective communicators consider communication an exchange or transfer or interaction. They said such things as, “Communication is when one person understands what someone else has said.”* This reflects a positive attitude and recognition of the importance of listening. To be effective the nurse in the operating room must listen, seeking feedback to what has been said. Because the spotlight is always on the person talking, there is a tendency to want to be the sender of messages. On closer examination, however, we discover i t is the listening side of the communicative act where we gather the necessary data to solve a problem, to settle a grievance, to become more efficient, to build a supportive climate, to make a person feel special. The health care professional must be able to listen to diagnose medical and nurs-
AORN Journal, April 1977, V o l 2 5 , No 5
Listening power quiz When speaking interpersonallyor in a small group, do you: 1. prepare yourself physically by sitting facing the speaker and making sure that you can hear?
someseldom
2. watch the speaker for the nonverbal as well as the verbal
messages? 3. decide from the speaker’sappearance and delivery whether
or not what she or he has to say is worthwhile? 4.
listen primarily for ideas and underlying feelings?
5. determine your own bias, if any, and try to allow for it?
6. keep your mind on what the speaker is saying? 7. interrupt immediately if you hear a statement you feel is
wrong? 8. try to see the situation from the other person’s point of view? 9. try to have the last word?
10. make a conscientious effort to evaluate the logic and
creditability of what you hear?
ing problems as well as personal problems. This checklist, though by no means complete, will help you gauge your listening habits. Try to answer each question objectively. Score yourself as follows: questions 1, 2, 4, 5 , 6, 8, 10-ten points for usually, five points for sometimes, and zero points for seldom. Questions 3 , 7, 9, zero for usually, five points for sometimes, and ten points for seldom. If you score below 70, you have no listening power and have developed some bad listening habits; 70 to 85, you listen well but can still improve; 90 or above, you have listening power and are an excellent listener. A recent survey at a large company indicated that when employees were asked why they liked their supervisor, they re-
996
sponded, “because my superviso listens to me.” One of the deceptive features of listening behavior tends to be our comparative lack of feedback in respect to how we are doing. Therefore, we have a responsibility t o exhibit listening responses as communication checks to let the other person know how they are doing. A listening response is a very brief comment or action made to another person conveying the idea that you are interested, attentive, and wish for her or him to continue. It is made quietly and briefly so as not to interfere with the speaker’s train of thought. It is usually used when the speaker pauses. There are five types of listening responses: nod-nodding the head slightly and waiting
AORN Journal, April 1977, Vol25, No 5
pause-looking at the speaker expectantly without doing or saying any thing casual remark--“I see.” “Uh-huh.” “Is that so?’ “That’s interesting.” echo-repeating back the last few words the speaker said mirror-reflecting back to the speaker your understanding of what was just said. (“You feel that . . . .”) Investigations by Nichols indicated that we retain only 50?6 of the main content items immediately after hearing them and eight hours later we can only retain 25% of the original message.3 Can our listening ability be improved? Conboy makes the point that physicians and biologists agree that breathing is one life process human beings tend to handle poorly. It has been estimated that most of us could add 10 to 15 years to our life span if we practiced better breathing habits from an early age. Yet breathing is one thing we all do throughout our lives. Listening habits, like breathing habits, improve only with systematic and evaluated practice. Real listening requires an expenditure of energy in obtaining and retaining the spoken discourse of others. Tests in the physiological psychology laboratory have shown that active listening demands as much energy (makes a person just as tired) as comparable efforts in speaking, reading, or ~ r i t i n g . ~ One of the main objectives of AORN is to promote and encourage effective communication and interpersonal relations. It should be obvious that our communication and interpersonal relations will only improve to the extent that our listening ability improves. Our mental attitudes toward listening reduce our listening effectiveness. Bad mental attitudes toward listening are: 1. Calling the subject uninteresting. 998
2. Criticizing the speaker’s delivery, appearance. We should be concentrating on the ideas being expressed. 3. Getting overstimulated. When we do this, we tune ourselves out as listeners. 4. Listening only for facts. The feelings being expressed are extremely important. This is where a nurse’s bedside manner comes into play. 5 . Trying to make an outline of everything. If you do this you are missing the facial expressions and gestures that convey the speaker’s attitude. 6. Faking attention to the speaker. Don’t just nod your head up and down like the dog in the back of a car window. 7. Tolerating or creating distraction. Stop telephone calls and other unnecessary interruptions. 8. Avoiding difficult material. Don’t allow yourself to mentally skip over something that’s difficult to understand. 9. Letting emotion-laden words throw us out of tune with the speaker. Sometimes we hear a word we don’t like and once again tune out as a listener. 10. Wasting differential between thought speed and speech speed (500 words per minute to 125 words per minute). This last item is extremely important because we are involved in two processes as we listen: the process of picking up information and the process of associating that information with something from our past. This association makes the intake information meaningful. However, one serious problem is we think five times faster than someone can speak. Therefore, we have a tendency to become bored or
AORN Journal, April 1977, Vol25, N o 5
to let our minds wander off the subject matter. To improve our listening ability we can learn to take advantage of this thought-speed versus speech-speed differential. We could use this time anticipating the speaker’s next point, identifying and evaluating supporting material, and mentally summarizing what the speaker has said thus far. These three techniques would keep us polarized on the subject matter at hand. As professionals we are paid to listen to people, and we can improve our listening ability. The first step is to become aware that listening is not a passive activity and that there is little correlation between intelligence and listening. We must learn to “want” to remember. One technique that can be employed to improve listening ability is to pretend there will be a quiz afterwards. Listening makes people feel special, and it’s the special OR nurse who can listen. 0 Notes 1. Bill Conboy, Working Together . . . Communication in a Healthy organization (Columbus, Ohio: Charles E Merrill Publishing Co, 1976) 73. 2. /bid, 11. 3. Ralph G Nichols, Leonard Stevens, Are You Listening? (New York: McGraw-Hill, 1957) 115. 4. Conboy, Working Together, 74.
1000
Smallpox outbreak reported in Somalia An outbreak of smallpox has been located in Mogadishu, Somalia, and is under strict surveillance according to a World Health Organization (WHO) report. The disease was brought into Somalia by nomads from neighboring Ethiopia, the last country in the world to have endemic smallpox. It was last reported there in August
1976. The Somalian strain is known as variola minor, a less virulent form of smallpox than variola major. No case of variola major has been reported since it was erradicated in Bangladesh 18 months ago. WHO stated vaccination policy must be decided by each government according to its needs and circumstances. In Africa, where the disease is still present, vaccination programs should continue for at least two years. WHO is building up a reserve of antismallpox vaccine sufficient to vaccinate between 200 and 300 million people. Vaccine is already available to protect 112 million people, and an appeal has been issued for further donations to build up the reserve.
Cardiac nurse session The American Heart Association Council on Cardiovascular Nursing will hold its annual scientific sessions in Miami Beach, Fla, Nov 29 to Nov 30.The sessions will feature reports on research findings in nursing that will assist in patient care. Deadline for nurses submitting abstracts of their studies is May 27.Studies should focus on individuals, laboratory animals, or patients, be related to aspects of the cardiac field, and contribute new scientific knowledge or theory. For guidelines on submission of abstracts, contact the American Heart Association, Scientific Programs, 7320 Greenville Ave, Dallas, Tex 75231.
AORN Journal, April 1977, Vol25, No 5
