Nurses' and midwives' assertive behaviour in the workplace.
AIM: This paper reports a study describing the assertive behaviour of a group of professional nurses and midwives and exploring potential barriers and facilitators to the use of assertiveness skills in the workplace. BACKGROUND: As nurses and midwives move away from traditional roles, it is increasingly being recognized that they need to behave in an assertive manner. Much literature supports the use of assertive behaviour in clinical practice. Although specific individual assertive behaviours and skills have been examined in many settings, little empirical evidence exists about the frequency and use of assertiveness skills by nurses and midwives in the workplace. While there is evidence on barriers to the use of assertive skills, there is little information about factors that may facilitate their use. METHOD: A survey design was adopted, using a 44-item questionnaire to collect data from a 2.5% random sample of nurses/midwives registered with the National Nursing Board of Ireland. The data were collected in 2003. RESULTS: While respondents frequently complimented their colleagues and often allowed them to express opinions, they were less accomplished at expressing their own opinions or making requests. Assertive behaviours were used more frequently with nursing/midwifery colleagues than with management/medical colleagues. Most used assertiveness skills with other grades of staff in their own profession. Responsibility to patients/clients emerged as a supporting factor for using assertive behaviour. Managers, the work atmosphere and fear were viewed as obstacles. CONCLUSION: Nurses and midwives needs to learn how to behave assertively, and this should be included in both pre- and post-registration education programmes. As use of assertiveness skills was reported to be least frequent with nurse/midwife managers, local policies and guidelines may be needed to encourage clinical practitioners to act autonomously and as client advocates.