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Lecture to 4th year medical students at the Kulliyah of Medicine, International Islamic University, Malaysia 14th October 2000 by Professor Omar Hasan Kasule Sr.
OUTLINE
ETIQUETTE WITH PATIENTS and THEIR FAMILIES
A. Bed-side etiquette
B. Dealing with the family
C. Informed consent
D. Confidentiality
E. Giving bad news
18.2.2 ETIQUETTE WITH THE DYING
A. Making the dying patient comfortable:
B. Ibadat:
C. Spiritual preparation.
D. The last stages
E. Death and burial
18.2.3 THE HEALTH CARE TEAM
A. General concepts and principles of group work
B. Etiquette of teaching, learning in the health care team
C. Etiquette of care delivery in the health care team
D. The health care team: general group dynamics
E. The health care team: special group dynamics
18.2.4 COMMUNICATION
A. Nature and essence of communication
B. Face to face communication
C. Communication in small groups
D. Use of the telephone
E. Barriers to effective communication
18.2.5 NEGOTIATION
A. Purpose of negotiation
B. Strategy of negotiation
C. Negotiation tactics
D. Management of a negotiation session
E. Follow-up
18.2.1 ETIQUETTE WITH PATIENTS and THEIR FAMILIES
A. BED-SIDE ETIQUETTE
Obligation to visit the patient, wujuub iyadat al mariidh: The ward rounds fulfil one of the social obligations of visiting the sick (KS 505). Visiting the sick has a lot of excellence, fadhl iyadat al mariidh, (KS 505). Care givers get a lot of reward from Allah for fulfilling this social obligation in addition to the rewards for their medical work The caregiver should interact with the patient as a fellow human. The human relation has priority over the professional patient-physician relation. Some bedside visits should therefore be purely social with no medical procedures or medical discussions.
Etiquette of visiting a patient, adab ‘iyadat al mariidh: The prophet regularly visited his companions who fell sick (KS 505, MB #1956). His behavior at the bedside of the patient is good guidance for both the physician and the other visitors to the patient. The books of sirah have preserved for us memories of such visits such as what the prophet said during the visit (KS 505). The following are recommended actions during a visit to the patient: supplication, dua, for the patient (KS 505, MB #1961), reading Qur'an for the patient (KS 505), and asking the patient for supplication, dua. The Qur'an is a cure, al Qur'an dawa (KS p. 338). Dua is a cure, al dua dawau (KS p. 338). The Prophet gave us guidance on what can be said and what should not be said in the presence of the patient (KS 505). The following are enjoined: asking about the patient’s feelings, sua'al anhu, doing good/pleasing things for the patient, ihsaan, making the patient happy, tatyiib nafs al maiidh, and encouraging the patient to be patient, tashjiu al mariidh (KS 505). The patient should be discouraged from wishing for death wishing death, tamanni al mawt (KS 524).
Appearance of the caregiver: The caregivers must make sure that they are clean and are dressed appropriately. The type and style of dress create impressions and convey messages. The dress, hair, and shoes of the caregiver must convey the impression of a serious, organized and disciplined person. The use of cosmetics should be limited to just covering up any defects and restoring the normal, average, and natural appearance. Excessive use of cosmetics conveys the impression of egoism and lack of seriousness. Perfumes should be used in moderation to suppress any unpleasant body odors. Excessive use, when the patient is aware that the caregiver is wearing perfume, is discouraged.
Mannerisms of the caregiver: Caregivers must have a cheerful disposition, imbisaat (MB #2045). They must deal with patients with leniency, rifq (MB # 2025). They must strive to do good, ma'aruf (MB #2024). They must also have only good thoughts about their patients, husn al dhann. They must avoid evil or obscene words (MB #2026). It is important for the caregiver to have full interaction with the patient but must still observe the rules of lowering the gaze, ghadh al basar, except when medical necessity dictates otherwise. Caregivers must not be arrogant and show off (MB #2116). They must adopt an attitude of humbleness, tawadhu'u (MB #2117) all the time.
Emotional involvement: It is very wrong for caregivers to adopt a detached emotionally-neutral disposition thinking that is the way of being professional. Caregivers must be loving and empathetic, tawadud & tarahum (MB #2018). They must show mercifulness, rahmat (MB #2020). The emotional involvement must however not go to the extreme of being so engrossed that rational professional judgment is impaired.
Covering of awrat: Both the caregiver and patient must cover awrat as much as possible. However, the rules of covering are relaxed because of the necessity, dharurat, of medical examination and treatment. The benefit, maslahat, of medical care takes precedence over preventing the harm inherent in uncovering awrat. When it is necessary to uncover awrat, no more than what is absolutely necessary should be uncovered. To avoid any doubts, patients of the opposite gender should be examined and treated in the presence of others of the same gender. The caregivers should be sensitive to the psychological stress of patients, including children, when their awrat is uncovered. They should seek permission from the patient before they uncover their awrat. Caregivers who have never been patients may not realize the depth of the embarrassment of being naked infront of others. An epileptic woman who was embarrassed at the uncovering of her awrat during an attack came to the prophet. He prayed for her and Allah answered the prayer (MB #1954).
Medical procedures: Caregivers must be fully aware of their legal liabilities and responsibilities, mas'uliyat al tabiib (Sunan Abu Daud Kitaab al diyaat baab 24, Ibn Majah Kitaab al Tibb baab 16). The rules of seeking permission, isti' dhaan, must be followed whenever caregivers approach a patient. The patient must be forewarned about the approach of the caregiver and should not be surprised. The privacy of the patient must be respected and he or she should be examined after getting permission. Medical care must be professional, competent, and considerate. Medical decisions should consider the balance of benefits and risks. The general position of the Law is to give priority to minimizing risk over maximizing benefit, dar'u al mafsadat muqaddamu ala jalbi al maslahat. Any procedures carried out must be explained very well to the patient in advance.
Supporting care: The caregivers must listen to the felt needs and problems of the patients. They should ask about both medical and non-medical problems. Supportive care such as nursing care, nutrition, cleanliness, and ensuring physical comfort are as important as the medical procedures themselves. In terminal cases it is only the supporting care that can be given.
Managing fever: Fever is a generalized often non-specific patho-physiological response. It is a cause of much discomfort. Caregivers should detect it early and treat it effectively. The prophet described fever as a blow of hot wind from hell-fire. He recommended using cold water to cool the body during fever (MB #1972). Any additional methods of reducing body temperature should be used.
Managing pain: The caregiver should comfort the patient in pain. He can explain that there is reward, ajr, for being patient when suffering (MB #1953). The patient should persevere and not wish for death, tamanni al mawt, because of extreme pain (MB #1958, 1959, 1960). The patient should be reassured that there is eventually a cure for every ailment, dawa li kulli dai (MB #1962) so that there is no loss of hope.
Control of infections: The prophet forbade a sick person visiting the healthy (KS 504) to prevent spread of infection. Precautions against spread of contagion were also recommended (MB #1969). Caregivers are obliged to make sure they have all their infectious diseases treated so that they are not a risk to their patients.
B. DEALING WITH THE FAMILY
Support: The family is also a victim when any member falls sick. The caregiver must provide psychological support to them. Sometimes even material support may be necessary. It should be remembered that part of the well being of the patient is to know that the family left behind is not suffering.
Reassurance: Illness is a cause of much anxiety for the family. The caregiver must take time to reassure the family by explaining what is going and assuring them that the best care is being given. They must be told not to give up hope because Allah in His power can reverse the most serious or critical conditions. In communicating with the family caregivers must make sure they do not violate medical confidentiality except where it is necessary, dharurat.
Involvement: Caregivers should similarly realise the importance of visits by relatives and friends and should plan their ward routines to maximize such visits. The family can be involved in some aspects of supportive care. This is helping them fulfil kindred obligations, silat al rahim. It uplifts the patient's morale to see that the family care and are around being involved.
Interference: Caregivers should be on the guard to make sure that the eagerness of the family to be of assistance and to be involved does not step beyond the limits. The family may interfere with medical care causing disturbance of the medical routines. This should be resisted with firmness.
Conflict: Illness is a stressful condition that generates anxiety in the family. It may initiate conflicts or aggravate existing ones. Caregivers may unwittingly find themselves in the middle of such conflicts. They should have the clarity of mind to understand that it is none of their business solving family conflicts. If they do they may regret it since they may become party to the conflict and are considered by some members of the family to favor other members.
C. INFORMED CONSENT
Choice of physician: As long as patients are conscious and are in full control of their mental faculties, they should be consulted about choice of physicians. Minors, unconscious patients, and those who have lost legal competence can not choose physicians. Their legal representative, waliy, will have to make the decisions. The caregiver must realise that choice of a physician is a continuing resolution and must make sure that there has been no change of mind on the part of the patient or the legal guardian. Permission to treat must be sought at every visit though not necessarily in a formal way. It is illegal to treat a patient against their will unless provided for otherwise by the Law in defined exceptional circumstances. As guidance to the patient in physician selection, the following order of priority is followed: Muslim of the same gender, non-Muslim of the same gender, and Muslim of the opposite gender.
Choice of treatment, food, and drink: The sunnah has given us guidance about forced feeding and forced treatment (KS 505: Sunan al Tirmidhi Kitaab al Tibb Chapter 3). The patient retains freedom to accept treatment or to reject it. The patient can not be forced to take any medication or undergoes any medical procedures. Treatment with new/experimental drugs or procedures requires informed consent. If the patient has lost legal capacity, ahliyat, by being unconscious or by losing mental capacity, the guardian, waliy, will take binding decisions on behalf of the patient. Illogical refusal of treatment or food could be grounds for finding a patient intellectually and legally incompetent making it necessary for the guardian to make the necessary decisions. Some situations of refusal of treatment are not issues of freedom of choice but have criminal implications. For example a patient with pulmonary tuberculosis who refuses treatment is committing the crime of endangering the lives of other members of the community. A parent who refuses immunization of a child is endangering the health of that child and other children in the community.
D. CONFIDENTIALITY
The secret, al sirr: The Qur'an mentioned the term secret in many verses (p. 570 2:77, 2:235, 2:274, 5:52, 6:3, 9:78, 10:54, 11:5, 12:19, 12:77, 13:10, 13:22, 14:30, 16:23, 16:75, 20:7, 20:62, 21:3, 25:6, 34:33, 35:29, 36:76, 43:80, 47:26, 60:1, 64:4, 66:3, 67:13, 71:9, 86:9). The term secret is relative. What may be a secret for one person may not be for another. What may be a secret in one place and at a particular time may no longer be a secret when time and place change. Secrets are of various degrees of importance. Revelation of some secrets could hurt an individual. Others can hurt the whole community or the whole ummat. Some secret information could be harmful if it is related directly to one individual but could be harmless if it is generalised.
Concept of keeping secrets, kitman al sirr: Humans are capable of deliberately hiding and sitting on information (p. 986 3:72, 2:228, 2:271, 3:167, 4:42, 4:149, 5:61, 5:99, 6:28, 14:38, 21:110, 24:29, 27:25, 33:54, 60:1). Allah knows all what humans hide and reveal (p. 986 2:33). The natural default situation is for humans to divulge and share information during conversations even without being obliged or expecting any benefits. Keeping a secret therefore requires effort and discipline. Hiding information may be praiseworthy for example if a person does not reveal is iman infront of enemies, kitman al iman (p. 986 40:28). Keeping a secret, hifdh al sirr, entrusted to you in confidence is a sign of good Islamic character ( ). You may keep your own secrets from people who are potential enemies. The Prophet taught us to rely on keeping secrets in managing our affairs, al I'itimad ala al kitman fi qadhai al hajat ( ). Secrecy could be negative if it involves hiding the truth that should have been spread to others, kitman al haqq (p? 2:42, 2:146, 2:159, 2:173, 3:71, 3:187, 4:37, 5:15, 6:19). It is also negative to hide evidence, kitman al shahadat (p. ? 2:140, 2:283, 5:106). The basic position is to keep secrets and information and not reveal them even if there is no foreseeable harm. It is part of good Islamic character not to reveal all what a person knows. The Prophet taught that people should listen more and speak less.
Written Records: Secrets are kept within the person, al kitman fi al nafs (p. 987 2:235, 2:284, 3:29, 3:118, 3:154, 27:74, 28:69, 33:37, 40:19). With development of writing and electronic technology, we now have other ways of keeping secret information. The Qur'an mentioned the tools for producing written records as paper, sahifat (p 979 20:133, 52:2-3) and the pen, qalam (p 979 68:1, 96:4). The Qur'an used the term kitaab to refer to written records such as scriptures (p. 977 4:153, 6:7, 17:93, 21:103, 29:48, 34:44, 35:40, 37:157, 34:21, 62:5), the Qur'an ( ), the record of pre-destination, kitaab al qadr (p. 978 3;145… 57:22), the record of values, kitaab al qiyam (p. 979 98:3), the record of knowledge, kitaab al ilm (p. 979 27:40)., and correspondence letters (P. 979 27:28-29). He process of writing was mentioned about evidence, kitabat al shahadat (p 979 43:19) and contracts, kitabat al uquud (p. 979 2:235, 2:282-283). Writing of false records was severely condemned (p 979 2:79). The prophet gave guidance about writing and writers (KS p. 452). In a modern medical environment, many records are generated about each patient. These prove a challenge as far as keeping of secrets is concerned because many people can access them. Besides their use in medical care, the records ca be used for medical education, medical research, and for legal purposes. Prevention of access to records for educational purposes may fall under the prohibition of hiding knowledge, kitman al ilm.
Basis for medical confidentiality: Medical confidentiality has psychological, social, and legal bases. The psychological basis is the private and privileged relationship of trust between the patient and the caregiver. Revealing secrets that occurred to a third party is a violation of the trust. Such violation destroys future co-operation because the patient will hold back some information from the caregiver thus impairing correct diagnosis and appropriate management. The social basis lies in the prohibition of spreading rumors, namiimat (MB #2032) and backbiting. The legal basis is three Principles of the Law, qawaid al sharia, and the Law of Property. The Principle of Injury, dharar, states that an individual should not harm others or be harmed by others, la dharara wa la dhirar. The Principle of Hardship, mashaqqa, states that hardship mitigates easing of the sharia rules and obligations, al mashaqqa tajlibu al tayseer. Necessity legalizes the otherwise prohibited, al dharuraat tubiihu al mahdhuuraat. Necessity is defined as what is required to preserve the five Purposes of the Law (religion, life progeny, property, and intellect). If any of these five is at risk, permission is given to commit an otherwise legally prohibited action. The ownership of the records is not clear. Do they belong to the patient, the caregiver that wrote them, or the institution?. Using the law of property, a product belongs to the person who made it. In this case, the patient is the 'maker' of all the medical facts that are written and should be the acknowledged owner of the records. The patient is also the only person involved who has most to lose if records are misused. Thus, the contents of the medical records can not be revealed without the express permission of the owner. The general position regarding medical records is that they are a secret that can not be revealed without specific necessity, dharurat, as defined by the law.
Release of information by the patient: The patient should consider any injurious information as a secret and can not reveal it. If it is about his sins or dishonorable shameful things, fahishat, he is forbidden. The prophet condemned al mujahir. A Muslim should repent and conceal his sins (MB #2037).
Release of the information by the caregiver: It is prohibited for the caregiver to use the privileged medical information he has for any personal gain. For example, he can not use his knowledge of the health of a businessperson to buy shares in a certain company. He can not advise his relatives about marrying or not marrying a certain person because of what he knows about their health. Release of information in the public interest is a more complicated situation. The question arises whether a caregiver is obliged to reveal disease in a leader or airline pilot that could endanger the public? What should the caregiver do if he knows of a patient with a contagious disease that is in the community and is endangering others? Is it a violation of privacy for the caregiver to share medical information with other caregivers caring for the same patient? What about using the data for medical research or medical education? How much can the caregiver tell the relatives of the patient without compromising the regulation of keeping secrets? What should the caregiver do if approached by law enforcement agencies asking for specific medical information that can help them solve a crime? Can a caregiver testify in court against his patient using information obtained during the medical examination? All these are questions for which no easy answers can be given most of the time. The simplest situation is when the patient, the owner of the records, consents to their release provided no other individual is directly hurt by such a release. There are situations in which over-riding public interest will require refusing to release information even if the patient consents. If the patient or his guardian do not consent, the caregiver can not release information except in situations of legal necessity, dharurat, as defined above. Education, research, and crime investigations do not fall under the category of necessity. In cases of court litigation, The caregiver could testify in criminal cases that involve dhulm. The Qur'an forbids the revelation of the shameful unless there is dhulm (p 308 4:148, 24:19). The caregiver can not give false testimony (MB #1176). One of the ways for the caregiver to decrease his risk of revealing secret information is to have only the minimum needed for his work. This means that during history taking only those questions directly related to the medical problem should be asked. There should be no probing or digging for unrelated facts.
Testimony in court: false witness. Justice vs privacy. Revealing the shameful only if there is dhulm
E. GIVING BAD NEWS
The patient: tell half truth, do not tell at all, white lie/technical lie
The relatives: to convey info to patient in their own way
Officials: return to work, sick leave
Body language:
18.2.2 ETIQUETTE WITH THE DYING
A. COMFORT:
Narcotics are given for severe pain. Drugs are used to allay anxiety and fears. The caregivers should maintain as much communication as possible with the dying: patience. They should attend to needs and complaints and not give up in the supposition that the end was near. Attention should be paid to the patient's hygiene such as cutting nails, shaving hair, and dressing in clean clothes. As much as possible the dying patient should be in a state of ritual purity, wudhu, all the time.
B. IBADAT:
The dying patient should as far as is possible be helped to fulfill acts of worship especially the 5 canonical prayers. Physical movements should be restricted to what the patient's health condition will allow. There us guidance on salat even for the unconscious patient (KS 505)
C. SPIRITUAL PREPARATION.
Death of the believer is an easy process that should not be faced with fear or apprehension. The process of death should be easier for the believer than the non-believer (KS 525). The soul of the believer is removed gently (KS 525, 525, 525). Believers will look at death pleasantly as an opportunity to go to Allah. They should be told that Allah looks forward to meeting those who want to meet Him (KS 525). Dying with Allah's pleasure (KS 525) is the best of death and is a culmination of a life-time of good work. Thinking well of Allah is part of faith (KS 525) and is very necessary in the last moments when the pain and anxiety of the terminal illness may distract the patient's thoughts away from Allah. Having hope in Allah at the moment of death (KS 525) makes the process of dying more acceptable.
D. LEGAL PREPARATION
Helping patient make a will: During the long period of hospitalization, the health care givers develop a close rapport with the patient. A relationship of mutual trust can develop. It is therefore not surprising that the patient turns to the care givers in confidential matters like drawing a will. The health care givers as witnesses to the will must have some elementary knowledge of the law of wills and the conditions of a valid will, shuruut al wasiyyat. One of these conditions is that the patient is mentally competent. The law accepts clear signs by nodding or using any other sign language as valid expressions of the patient's wishes. The law allows bequeathing a maximum of one third of the total estate to charitable trusts, waqf, or gifts. More than one third of the estate can be bequeathed with consent of the inheritors. Debts must be paid before death or before the division of the estate.
Organ donation:
E. DEATH, BURIAL, and MOURNING
The last moments: The last moments are very important. The patient should be instructed such that the last words pronounced are the kalimat, the testament of the faith. Once death has occurred the body is placed in such a way that it is facing the qiblat. Eyes are closed and the body is covered. Qur'an and dua are then recited.
Etiquette of morning: The health care giver should take the initiative to inform the relatives and friends. They should be advised about the shariah rules on mourning. Weeping and dropping tears are allowed. The following are not allowed: tearing garments, shaving the head, slapping the cheek, wailing, and crying aloud. On receiving the news of death it suffices to say ' we are for Allah and to Him we will return'(KS 525). Relatives are comforted by telling them hadiths of the prophet about death. These hadiths talk about the reward of the person who loses his beloved one and he is patient (KS 524) and the excellence of one who loses three children (KS 524).
Preparation for burial: The health care team should practise total care by being involved and concerned about the processes of mourning, preparation for burial and the actual burial. They should participate along with relatives as much as is possible. The body must be washed and shrouded before burial. The washing should start with the right. The organs normally washed in wudhu are washed first then the rest of the body is washed. Perfume can be used, Women's hair has to be undone. After washing the body is shrouded, kafn, in 2 pieces of cloth preferably white in color.
Salat al janazat: The books of sunnat have given guidance about the etiquette of salat al janazat (KS 162). As many persons as possible should participate in this salat. If 100 persons pray for the dead, it is shafaa (KS 162). Dua (istighfar) in salat al janazat (KS 162).
Accompanying the funeral procession, tash'yii an janazat: Burial should not be delayed, ta'ajil bi al janzat (KS 161). Following the procession is enjoined (KS 159). There are big rewards for accompanying the funeral procession (KS 159). There is more reward for accompanying the funeral procession and staying until burial is completed (KS 160). The funeral bier is carried ny men. Hurrying in marching to the grave is recommended.
Burial (dafn): face to Makka.
After burial: consoling relatives, making food for the bereaved, adab of mourning (hidaad), condolences (ta’ziyah), inna lilaahi wa inna ilayhi rajiuun. Talking good about the dead.
Talking about the deceased: Say only good things. The good words about the dead, thanau al nass ala al mayt (KS 160)
Special cases: Case of woman who dies with a fetus in her woumb. Opening grave for forensic exam. Carrying the dead for burial in another country
18.2.3 THE HEALTH CARE TEAM
A. PRINCIPLES OF GROUP WORK
GROUPS: DEFINITION, CLASSIFICATION:
A group is several persons being interdependent and interacting with one another. The minimum size for a group is three. There are no hard and fast rules about group size; it all depends on circumstances. The optimum size for a group is 5-7 members. Larger groups do not give enough opportunity for discussion by individuals. When a group is too large, dividing it into subgroups each specialising on a certain task may be necessary.
There are several types of groups: teams, task forces, self-directed work-teams, families, tribes, clans, fraternities, etc. A team is an on-going group that identifies and solves problems; cross-functional on multidisciplinary teams are very effective in solving problems. A task force is a temporary group that dissolves when the problem is over. A task force researches into causes of a problem, and recommends corrective action. In some cases, it may be retained to solve the problem. A self-directed work-team is a group of workers that supervises itself in the identification and solution of problems. It plans, executes, and evaluates its work.
The first group you belong to is the family. As you grow you become aware of other groups that you belong to: clan, tribe, nation, religion, and the Ummah. You may freely join groups such as clubs, political parties or you may find yourself a member of groups such as the school, the university, and the community mosque. Groups may be formal or informal. Most groups you belong to are informal and you may not even be aware of your membership. Groups can be defined according to social distance as in-group or out-group. A reference group is one that is accepted as a model. Group work involves people, objectives, and a situation. A collection of people with no common objective does not constitute a group. A group of people with a common objective may not constitute a group in certain circumstances; for example when members of a local football team attend Friday prayers in the mosque, they are not in the mosque as a group because the situation is different.
Traditional society has small intimate groupings that gave people a sense of security. Industrial society is bringing about anonymity. The medical environment provides an opportunity to work in a multi-disciplinary highly trained team with its ethics, procedures, and culture. Group-work has its advantages and disadvantages; the advantages far out-weigh the disadvantages.
ADVANTAGES OF GROUP WORK:
Members of groups enjoy the benefits of integration, stimulation, motivation, innovation, emotional support, and endurance. Group performance is generally superior to individual performance. Abundant exceptions do exist. Some highly productive people can not work in-groups. This should be accepted. Forcing them to work in groups will only lead to their frustration and that of the group. Experience throughout history has taught us that productivity and progress are a result of cumulating of hundreds or even thousands of individual efforts. Individual initiative is the backbone. Societies and systems that suppress individual initiative eventually fail.
When we talk about group-work being superior we are actually saying that by coordinating, channeling, and complementing activities, as well as canceling contradictions an individual's productivity is higher in a team that outside a team. It is the individual's productivity and not that of the team that is the yardstick. A team of superior individual performers will itself be a superiorly performing team. On the other hand a team that is performing well as a team but has some members not performing to their full potential is essentially a weak team. A team that stifles the individual in the name of conformity will fail very rapidly. This concept of group-work parallels that of congregational prayer, salat al jamaat. An individual praying in a group gets a 27-fold reward he however still has to perform and take personal responsibility for results.
DISADVANTAGES OF GROUP-WORK:
The best is to work in groups but like all human endeavors it has its problems and disadvantages that we must be aware of and must guard against. Members of groups may suffer from the following. They may fall into the trap of group think when they start feeling that their group is invulnerable, knows, and can do anything. They may start feeling arrogant and moralize feeling that they are right and everybody else is wrong. The strong to maintain group cohesion may lead to a false feeling of unanimity when actually people disagree but just suppress their opinions in the interests of the group. There is pressure on every member to conform to the group norms even if individuals do not agree. Human history has recorded the plight of individuals who committed many mistakes in order to conform to the group when they knew they were doing wrong. The pressure on individuals to conform may reach the extent that opposing or different ideas are dismissed. This rapidly leads to destruction of creativity. Creative individuals with new ideas are not tolerated. Any dissent from the group norm is rejected. The biggest disadvantage of group work in my view is mis-match of members. Persons who do not share the same vision or who do not have compatible background experiences can not work together comfortably. Mismatch of group members leads to low group productivity and even intra-group conflict.
GROUP FORMATION AND BREAK-UP:
There are three bases in the Law for group work: consensus, leadership, and co-operation. The consensus of the group is protected by Allah from error, al ijma ma'asum. Thus, a group is less likely to reach a wrong conclusion than an individual working alone. Humans must select and follow a leader for proper and purposeful conduct of their affairs; this means those followers must congregate in groups under a leader. The general directive of the Qur'an to believers to co-operate in doing good requires that people work in groups. Some groups are formed by individual choice. In some cases individuals find themselves put together by circumstances beyond their control.
The health care team falls between these two ends of a spectrum; health care workers freely made the choice of the medical profession but they can not choose whom to work with in the ward, the clinic, or the operation theater.
There are four stages in group formation. Groups and individuals that compose them go through various stages as they learn to work together. The four stages are: forming (acquaintance and learning to accept one another), storming (emotions and tensions), initial integration (start of normal functioning), total integration (full functioning), and dissolution.
Mature groups develop a group identity and have optimized the following characteristics: feedback, decision-making procedures, cohesion, flexibility of organization, resource utilization, communication, clear goals accepted by members, interdependence, participation in leadership functions, and acceptance of minority views.
Like everything in life groups are started, they grow and eventually break up. Some groups fail because they are constituted on the wrong basis. The members can not get along together, communicate with or understand one another. There is no commonality of interests, attitudes, and goals. In such a case individual effort will be preferable to a non-performing team.
There are behavioral diseases that destroy groups. All of them have been described and have been defined by the Qur'an: hasad, nifaq, namiimah, gaybah, kadhb, riyah, kibriyah, hubb al riyasa, tajassus, and dhun al soo. Seeking personal credit for group work alienates and demotivates. Denying credit where it is due annoys and alienates.
CHARACTERISTICS OF THE IDEAL GROUP:
An effective group has the following five attributes: First: An ideal group follows the Qur'an and sunnat in all its activities. It has a common clear and inspiring goal to which the whole group and its individual members adhere. Having a common goal helps make the group result-oriented. The group has its distinctive culture and norms. The culture should reflect both underlying Islamic values and the nature of activity. The most important aspect of culture is to develop a spirit of brotherhood. Group work does not thrive in cultures that instil and encourage extreme individualism and competition. Group norms help improve interpersonal relations because expectations are clear. Each group must establish norms defining standards and acceptable behavior. People may adhere to abnormal group norms because of the need to belong. A strong desire to conform and achieve consensus may be detrimental to a group. Individual members may be reluctant to challenge wrong assumptions and conclusions of the group. This phenomenon is called groupthink.
Second: Members in the group must feel secure and not suppressed. They must know that they are accepted in the group as they are with their shortcomings and human weaknesses. They therefore will express their opinions freely, criticize, and accept criticism.
Third. Understanding and sincere practice of group dynamics that are necessary for success of group work. Good communication and interaction are the bed-rock of positive group dynamics. Members must be interdependent, mutually influence one another, and have face-to-face communication. An ideal group should be solid like a building. Each member should be a brick holding the building together. Members must be loyal to group and to one another. It will develop a group spirit that puts group interests before individual interests. Members of the group may belong to several other groups. They may also have several different loyalties. However, these should never deviate from the teachings of Islam. Group feeling, asabiyyat, is a double-edged sword. In moderation it is positive in keeping the group together. In the extreme it pits the group against other groups and engenders conflict. It may reach a stage when truth, fairness, and justice are overlooked in order to maintain group solidarity. Asabiyyat that leads to giving member interests priority over the interests of Islam is strictly forbidden. Group members must trust one another and not fear that their colleagues will act or talk against them when they turn their back. A climate of collaboration and Cupertino in doing good must exist at all times. Group members must share their sorrow, happiness, failure, and success. Openness and no concealment of facts are the way of life for effective groups. An atmosphere of confidence, trust, and supportive of members.
Fourth. All members must be competent and committed to the group. They must take both group and personal responsibility for group activities. They must set and adhere to standards of excellence and superior performance levels. Only good planning, effective organization, and good use of human and material resources ensure superior performance. The members must understand group roles. There are several ways of cross classifying group roles. Group roles are of various types: expected, perceived, enacted, and assigned. Groups' roles may be group or individual ones. Group roles are either task roles (the roles that the group has to carry out) or building and maintenance roles (roles necessary to maintain the group. Group task roles include: initiating activities, managing activities, collecting and disseminating information, collection and discussion of opinions, reaching consensus, orientation, setting performance standards, implementation, evaluation, and control. Group maintenance roles include: encouraging, empowering, harmonizing, setting group norms, conflict resolution, communication, compromise). Some members in the group may play individual roles. These roles could be negative but in many cases, they may not be supportive of the group as a whole. Negative individual roles include: aggressor, blocker, recognition-seeking, player, and dominator, playing politics.
Fifth: Every group must have a leader. Success of a group depends on the leader. The leader may be assigned or may emerge in the group and becomes accepted by the others. An ideal group leader should not be selected on the basis of expertise because he may use his power to stifle open discussion. A leader should be selected on the basis of effective leadership, ability to run meetings well, ability to make sure the work is done, and ability to hold the group together. Leaders form groups and delegate specific tasks to them. A very directive domineering group leader may not succeed in leading a performing group because he denies others participation. Group leadership must be principled. It must have a vision that is shared with all group members. It must encourage talent. The leadership must subject its ego to group interests. The leader must be able to identify conflicts early and resolve them. A major role for the leader is to manage conflict to maintain the unity and smooth functioning of the group. When goals, actions, and interests are incompatible, there is conflict. Conflicts may not always be negative. A group may learn from a conflict situation and emerge stronger. Poorly managed conflict situations may end with the break-up of the group.
C. ETIQUETTE of TEACHING and LEARNING in THE HEALTH CARE TEAM
COMPOSITION OF THE HEALTH CARE TEAM:
The health care team in a teaching hospital is very complex. It is multi-disciplinary and its members play complementary and inter-dependent roles. It consists of both university and hospital personnel all engaged in the care of patients. The academic personnel are the medical faculty as well as the students (under-graduate and post-graduate). The hospital staff is the consultants, nurses, nursing aides, auxiliary medical personnel. All members of the team have the dual function of both teaching and delivering health care. The teaching process is complex. There is programmed and structured teaching. However most of the teaching is passive; there is a lot of learning of attitudes, skills, and facts by being present and watching what is being done to the patient. There is also continuous learning from one another. Students learn from consultants but consultants may also get new insights from students.
THE TEACHER'S ETIQUETTE:
Teachers should take their task very seriously. The education process, involving giving and receiving knowledge is noble (MB#70). Teachers should have the humility to know that their knowledge is limited and that they can always learn more. Arrogance because of knowledge is condemned (MB#102). Teachers must make the learning process interesting and avoid boredom (MB#62). They should make the atmosphere and circumstances of learning easy for the students (MB#63). Teachers must be careful in their actions, attitudes, and words at all times because being models and leaders they are seen and are emulated. They must be aware that sometimes they can teach using body language without saying anything (MB# 75 and 76); they have to be careful about their public dispositions They should be ready to carry out their function at all times and at any opportunity (MB#74). They should have an appropriate emotional expression. They can raise the voice to emphasize an important point (MB#55). They can show anger or displeasure when a mistake is committed (MB#79, 80, and 81). Asking students questions to ascertain their level of knowledge is part of the teaching process and is not in any way a humiliation for them (MB#56). Teachers should make sure that the students understand by constant repetition (MB#82).
THE STUDENT'S ETIQUETTE:
The Islamic etiquette of the relation between the student and the teacher should be followed. In general the student should respect the teacher. This is respect to knowledge and not the individual. The prophet taught admiration and emulation of the knowledgeable (MB#66). Students should be quiet and respectfully listen to the teacher all the time (MB#101). Students should cooperage such that one who attends a teaching session will inform the others of what was learned (MB#78). Students can learn a lot from one another. The student who hears a fact from a colleague who attended the lecture may even understand and benefit more (MB#61). Students should ask questions to clarify points that they did not understand or which seem to contradict previous knowledge and experience (MB#88). Taking notes helps understanding and retention of facts (MB#93). Study of medicine is a full-time occupation; students should endeavor to stay around the hospital and their teachers all the time so that they may learn more and all the time. They should avoid being involved in many other activities outside their studies (MB#98).
D. ETIQUETTE of CARE DELIVERY in THE HEALTH CARE TEAM
Each member of the team carries personal responsibility, mas'uliyat (KS p. 45 and p.338). Leaders of the team carry more responsibility than the others. Leaders must be obeyed (KS p. 44) to be able to carry out their work well. They however should not be obeyed in committing illegalities, corruption, or oppression, dhulm (KS p. 45).
The story of Rufaidah is very instructive in the etiquette of medical care for a Muslim. Rufaidah, the first professional nurse in Islamic history. She lived at the time of the Prophet Muhammad (PBUH) in the 1st century AH/8th century CE. Her history illustrates all the attributes expected of a good nurse. She was kind and empathetic. She was a capable leader and organiser able to mobilise and get others to produce good work. She had clinical skills that she shared with the other nurses whom she trained and worked with. She did not confine her nursing to the clinical situation. She went out to the community and tried to solve the social problems that lead to disease. She was a public health nurse and a social worker.
Rufaidah is an inspiration for the medical and nursing professions in the Muslim world. Rufaidah bint Sa'ad, is recognized as the first Muslim nurse. Her full name was Rufaidat bint Sa'ad of the Bani Aslam tribe of the Khazraj tribal confederation in Madinah. She was born in Yathrib before the migration of the Prophet Muhammad (PBUH). She was among the first people in Madina to accept Islam and was one of the Ansar women who welcomed the Prophet on arrival in Madina. Rufaidah's father was a physician. She learned medical care by working as his assistant. Her history illustrates all the attributes expected of a good nurse. She was kind and empathetic. She was a capable leader and organizer able to mobilize and get others to produce good work. She had clinical skills that she shared with the other nurses whom she trained and worked with. She did not confine her nursing to the clinical situation. She went out to the community and tried to solve the social problems that lead to disease. She was both a public health nurse and a social worker. When the Islamic state was well established in Madina, Rufaidah devoted herself to nursing the Muslim sick. In peace time she set up a tent outside the Prophet's mosque in Madina where she nursed the sick. During war she led groups of volunteer nurses who went to the battle-field and treated the casualties. She participated in the battles of Badr, Uhud, Khandaq, Khaibar, and others. Rufaidah's field hospital tent became very famous during the battles and the Prophet used to direct that the casualties be carried to her. At the battle of the trench (ghazwat al khandaq), Rufaidah set up her hospital tent at the battle-field. The Prophet Muhammad (PBUH) instructed that Sa'ad bin Ma'adh who had been injured in battle be moved to the tent. Rufaidah nursed him, carefully removed the arrow from his forearm and achieved hemostasis. The prophet visited Sa'ad in the hospital tent several times a day. Sa'ad was to die later at the battle of Bani Quraidhat. Rufaidah had trained a group of women companions as nurses. When the Prophet's army was getting ready to go to the battle of Khaibar, Rufaidah and the group of volunteer nurses went to the Prophet Muhammad (PBUH). They asked him for permission "Oh messenger of Allah, we want to go out with you to the battle and treat the injured and help Muslims as much as we can". The Prophet gave them permission to go. The nurse volunteers did such a good job that the Prophet assigned a share of the booty to Rufaidah. Her share was equivalent to that of soldiers who had actually fought. This was in recognition of her medical and nursing work.
Rufaidah's contribution was not confined only to nursing the injured. She was involved in social work in the community. She came to the assistance of every Muslim in need: the poor, the orphans, or the handicapped. She looked after the orphans, nursed them, and taught them. Rufaidah had a kind and empathetic personality that soothed the patients in addition to the medical care that she provided. The human touch is a very important aspect of nursing that is unfortunately being forgotten as the balance between the human touch and technology in nursing is increasingly tilted in favor of technology.
History has recorded names of women who worked with Rufaidah: Umm Ammara, Aminah, Umm Ayman, Safiyat, Umm Sulaim, and Hind. Other Muslim women who were famous as nurses were: Ku'ayibat, Amiinat bint Abi Qays al Ghifariyat, Umm 'Atiyyah al Ansariyat, and Nusaibat bint Ka'ab al Maziniyyat.
D. THE HEALTH CARE TEAM: GENERAL GROUP DYNAMICS
GENERAL DUTIES AND RIGHTS OF BROTHERHOOD:
The following are general rights of brotherhood that all members of the health care team owe to one another: returning greetings, following the funeral procession, accepting invitations, visiting the sick, and responding to sneezer. The following are additional duties: tolerance, forgiveness, helping the oppressed, solving problems, fulfilling needs, compassion and kindness, gratefulness, protecting the honor of others, fulfilling promises and commitments, respect, sincere advice or nasiiha. It is part of the duties of brotherhood to avoid underrating and humiliating others. It is considered part of good behavior to remove any annoyance from the public places, imatat al adha an al tariiq (KS p. 69). In general, everybody must behave with the best of manners, husn al khulq (KS p. 69).
ETIQUETTE OF INTER-PERSONAL INTERACTION:
Greeting is necessary whenever members meet again even after a short separation. A small group will initiate greeting the larger group (MB#2057). The walking person initiates greeting the one sitting down (MB #2068). Everybody must be greeted whether known or not known (MB#2059). Those in an assembly must make room for any new comer (MB#2063). Two individuals should not engage in secret conversation in the presence of others (MB#2018) because that may create an impression of backbiting and suspicion. Standing up when a person enters is a sign of respect (KS 67). You should not force a sitting person from his seat (KS 67). When a person goes away for a temporary period, he has the right to reclaim his seat (KS 67). The following positive behaviors and attributes should be encouraged in the team: mutual love, tawadud, and empathetic caring for one another, rahmat & hilm (MB#2018, KS p. 68); leniency, rifq, in everything (KS p. 68); co-operation and mutual support, ta'awun (MB #2026); generosity, karam (MB #2028); truthfulness, sidq (MB #2039); patience, sabr (MB #2040); modesty, haya (MB #2043, 2044); cheerful disposition, imbisaat (MB #2045); calling people by their favourite names, ahabb al asma (MB #2055, 2056); recognising the rights and the position of those older than you, irfan haqq al kabir (KS p. 68); and self control in anger, malk al nafs inda al ghadhab (KS p. 68). The following negative attributes should be avoided: harshness in speech (MB #2029), rumour mongering, namiimat (MB #2032), excessive praise of others in their presence, al ghulw fi al thana (MB #2033, KS p. 68), mutual jealousy and turning away from other, tahasud & taba'ud (MB #2034 & 2035, KS p. 68), avoiding interaction with a colleague, hijrat, for more than 3 days following a misunderstanding (MB# 2038); anger, ghadhab (MB #2041); spying on the privacy of others, tatabu'u awrat al nas (KS p. 68); You should avoid repeating the same mistake twice (MB #2046). It is required not to volunteer information about your personal weaknesses, al satr ala al nafs (MB #2037, KS p. 98), unless it involves correcting a mistake related to the general medical work
E. THE HEALTH CARE TEAM: SPECIAL GROUP DYNAMICS
The medical team must of necessity include men and women. The interaction between the two genders is close and continuous which creates a special situation. Four basic issues arise: (a) manner of dressing (b) mixing of the 2 genders, ikhtilat (c) seclusion of a male with an unrelated female, khalwat (d) and lowering the gaze, ghadh al basar. Males and females in the team must dress and behave distinctly. Trans-sexual or unisex dressing and behaviour, takhannuth & stirjaal, removes the instinctual gender identity. Each gender should maintain its psychological, emotional identity and physical appearance in manners of dress, walking or speaking. Trying to blur the distinction interferes with the complementality that is supposed to exist between the two genders. The complementality is necessary to ensure co-operation. Blurring the differences could also make sexual misconduct easier. The Qur'an forbade free mixing of the genders, ikhtilat, in general (33:53). Islam fosters a bi-sexual society. This is however not absolute. There are cases when social and professional intercourse between unrelated men and women in necessary. It is allowed but with strict precautions to prevent any transgressions. A woman is for example allowed to serve male guests according to a hadith reported by Bukhari from Sahl Ibn Sa;d al Ansari. A woman can treat a male patient if there is necessity. A bisexual society does not prevent the women from being an active member of society. She can pursue her professional interests even outside the home provided she observes the rules of hijab. Forbidding seclusion of a man with an unrelated woman, khalwat, is a strong temptation for evil and should be avoided. The prophet forbade a man to be with an unrelated woman in the absence of a third person. When a man is in isolation with an unrelated woman shaitan is between the two and could lead them astray (hadith reported by Imaam Ahmad on the authority of Amir Ibn Rabiah). Looking at the opposite sex with desire is prohibited. The eye is a great communication organ. The Qur'an ordered Muslim men and women to lower their gaze, ghadh al basr (24:30)-31. Lowering the gaze could be complete or partial. It is partial because of practical necessity. Lowering the gaze doses not mean closing the eyes. It means being careful not to look fixedly or lustfully at the opposite sex. One of the ways of preventing lustful looks is covering what is considered nakedness, awrat. Both men and women must be modest by covering their awrat. Looking at the awrat of another person is forbidden whether that person is of the same or opposite gender. The prohibition includes both looking with or without desire (hadith reported by Muslim, Abu Daud, al al Tirmidhi). As part of preventing possible illegal relations, display of adornments that enhance natural beauty is restricted by the Qur'an (24:31, 33:59)
18.2.4 COMMUNICATION
A. NATURE OF COMMUNICATION
What is communication?: Communication is transfer of information from one communicator to another through the use of symbols. The meaning behind the symbols is interpreted subjectively by the recipient. Humans have the most advanced form of communication. They communicate in different languages and in various forms. You may communicate consciously or unconsciously. Communication may be verbal (oral or written) or non-verbal (body language & appearance). The elements of communication are: the sender. The message, the medium, the receiver, and feedback. The functions of communication are: informing, controlling, expressing emotions, and motivating.
Communication and leadership: Communication is an essential leadership function. Leadership can be looked at as communication to modify the attitudes and behaviors of others in order to meet group goals and needs. Communication failure rapidly leads to leadership and organizational failure.
Types of communication: Conscious communication is planned and the communicator is aware of the message. Unconscious communication is not planned and the communicator is not aware of the message. It may not even be verbal, it may use body language. Verbal communication, oral or written, uses words as communication symbols. Non-verbal communication conveys ideas without the use of words. Non-verbal communication can take the following forms: body language, physical appearance (hair, nails, cleanliness, and wardrobe), manner of greeting (voice, hand-shake, smile), image/impressions (public speaking, letters, faxes, behavior in public, behavior in crisis, quality of work delivered).
Language and communication: The structure of human language and its use in communication is the object of many disciplines of research and study. Phonology is the study of the pattern of sounds, pronunciations, and intonation. Syntax is how words are arranged in phrases and sentences. Semantics is meaning of words and sentences . Pragmatics is interpreting language according to social and contextual factors. Much is now known about human language. The simple fact however remains that the language is exceedingly complex.
Reception of communication: Any communication is not received as it is transmitted. It is perceived instead. Perception is organizing and interpreting incoming information. Perception is selective being influenced by environment, background knowledge, and background attitudes. Thus the same information may elicit different perceptions in different people.
Communication channels: Communication channels may be personal static such as a letter, impersonal static such as flyers, direct interaction such as face-to-face discussions, and indirect interaction such as a telephone conversation.
B. COMMUNICATION PROCESS
Communication process: A communication process starts with conceptualization of the ideas to be communicated. The ideas or message are then encoded, put in a transmissible form. The message is then transmitted and is received. The receiver decodes or interprets the message before understanding it and taking action on it. The process is completed by feedback from the recipient to the sender. Communication is a circular process involving a feed-back loop. Every communicator must monitor the feed-back to make sure that the communication process is effective. There is a need for further research in human communication. Much remains to be learned about communication. It is a complex phenomenon. It is not confined to humans; other animals do communicate. It may not be confined to the 5-6 human senses that we know. Communication with the unconscious mind is little understood.
Irreversibility of communication: Communication is irreversible; every communication has a lasting impact. Think before you communicate. A negative impact can never be fully wiped out by later retraction or correction. A lingering negativity, however small, always persists. You should be very careful and prudent in selecting the information communicated, the target of the communication, the timing and circumstances of the communication to make sure the impact is positive.
The power of words: The terminology used restricts and determines the limits of the thought process. It is therefore necessary to stick to the terminology of the Qur'an in our communication. New terminologies should be developed and understood in the same context. Use of foreign terminology either directly or in translation leads to confusion in thought to the uninitiated.
Use of appropriate language in communication: The language used varies by intimacy, professional circles, age group, and gender. When communicating make sure you use language appropriate to the communication situation. It is not hypocrisy of pretension to communicate to different people in different ways. It is a great mistake to communicate with everybody in the same way forgetting their special background and peculiarities.
Precise communication: Communication must be precise to be useful. Precision indicates that the mind is active and is dynamic. Precision indicates that the communicator has a definite communication objective. There is non need to use more words than necessary once the defined objective has been conveyed. Verbosity not only wastes time but creates a mistrust for the speaker in the minds of the listeners. You can always improve the precision and hence the effectiveness of your communication by training and experience.
Pleasant communication: Communication of pleasant information is different from communication bad news. The impact of the information depends on how it is communicated. Misuse of even one word or symbol can change the content and impact of communication. Communication must be pleasant in order to be absorbed and appreciated. Good and positive words are more effective. A good disposition, friendly greetings, smiling, shaking hands, all help the communication process. The voice should be pleasant and convey warmth and friendliness.
Humor in communication: A sense of humor helps communication. You must however know where to draw the line. Too much or inappropriate humor indicates lack of seriousness and is negative. Humor usually involves laughing at human follies better yours or anonymous but not the recipient of your communication. Never laugh at anyone however good the justification. A sense of humor can get you out of a difficult situation. It can disarm an angry person. A person who insults or puts you down can be disarmed by an appropriate joke.
Personality and social intercourse: Your communication style reflects your basic personality. You may learn a lot about improving your communication style. Never try to develop a phoney personality. Be genuine and be yourself. Communication is the basis of social intercourse and the overall functioning of society. A good word is charity. Say good or keep quiet. Avoid bad words. Use polite words even with people who have done wrong to you. Always have a personal touch.
Degradation of information quality: Content of communication is degraded as it is passed from one person to another because of the increase of the noise component and the decrease of the information content. Noise refers to those factors that distort the intended message.
Different understanding, perceptions and behaviors: A receiver of information may benefit more than transmitter: The receiver of a message may understand it at a deeper level and benefit from it than the messenger. Behavior is the result of perception which in turn depends on selection and interpretation of information. The same information can elicit different behaviors in different individuals depending on different perceptions. Background knowledge, attitudes, and environment affect the way the recipient perceives and interprets information.
Communication technology: Communication is changing with technological advancements and leaders have to face new challenges every day. Information overload is a problem today; you must guard against it by having clear objectives and knowing what information you need to perform your work well.
Barriers to effective communications: The following are common barriers to effective communication: prejudgment before communication, differences between communicators (self-image, status, roles, personality, cognitive ability, physical situation, social status, culture, vocabulary, and language), distractions, emotional resistance to being on the receiving end, time constraints, poor listening, poor speech, bad timing, and unsuitable circumstances. Other causes of communication failure are: multiple meanings of words, information overlord, verbosity, value judgment, and filtering. Prejudgment is one of the most serious causes of failure to communicate. As recipient of communication you must avoid assumptions and pre-judgments. Listen to the data and then judge. Cross-check information to be able to reach right conclusions.
C. COMMUNICATION IN SMALL GROUPS
Face to face communication is unique: Face-to-face communication is usually the best form of communication because of immediate feedback. Important messages should be both oral and written. Writing never conveys fully what is conveyed by direct face-face interaction. In a face to face situation the recipient is able to evaluate the honesty of the speaker by carefully observing behavior.
Believable communication: Some communication is credible and is believable. Some other lacks power and conviction. There are approaches than can enable you have believable communication. Own up your positions by not being afraid to stick out your neck and taking a position. Be emotionally honest such that your outward emotions reflect your inner feelings. This however does not mean that you should display aggression when angry. Islam teaches us to control our aggressive instincts. Be focussed in your communication, an indication that you have an objective. Try not to be selfish in your communication by avoiding making your person and your concern the center of all communication. Give others a chance also. Be evidence-oriented and always concentrate on facts and avoid speculative talk. Be respectful towards others and make sure your level of intimacy is appropriate for the person you are communicating with.
Successful oral communication: Measures can be taken to improve individual communication. These require training and constant practice. Success of oral communication (speaking and listening) is affected by language use, voice and inflexion, speed and volume, periods of silence, active listening, and body language. For successful communication speak clearly, be specific, objective, repeat to ensure understanding, and ask for feedback. Make sure your have clarity of speech to be understood by trying to speak clearly. Be concise and specific. Focus on the topic of discussion. Do not say too much and thus create an information overload. Repeat yourself for emphasis as well as clarity and make sure you are understood. Use simple but precise language. Repeat to ensure understanding. Base your communication on objective facts. Feedback is necessary to ensure that your message is going through. Watch for, ask for, and welcome feed-back. Take the initiative to ask questions to make sure you are understood. Listen more than you talk. Do not talk continuously, pause for questions and comments. Stop talking so that moments of silence may make the message sink in. Communication with people you know already or those who are close to you is likely to be more successful. Choose the time of communication carefully. People who are in a hurry or are engaged in another activity will not listen to you with attention. Your pitch, voice inflections, volume, and speed must be appropriate for the listener, the type of message, and the circumstances. The speed of conversation is important. Too rapid is difficult to follow. Too slow is boring and the listener's mind to wander off. Learn to use body language to enhance your verbal communication and make sure that the verbal and non-verbal communication cues are coordinated and are not contradictory. Be very careful about non-verbal communication. Your body language and appearance make statements about you. The message conveyed by body language may support or contradict that conveyed verbally. The body language message is more believable.
Using the telephone: When using the telephone, start with a pleasant but short greeting. Establish rapport immediately. Project a positive and credible image at the beginning; this will facilitate further conversation. Speak with a powerful and confident voice. Sound interested and motivated. Be brief and get to the point immediately. Pause and allow for responses. There are words and expressions used in face-to-face communication that will lead to misunderstandings in a telephone conversation because there is no supporting body language. Train yourself to signal that you want to end the conversation without offending your listener. You must learn technics appropriate to your culture of cutting off a rambling caller tactfully. When an angry, aggressive, and obnoxious person calls you, be careful not to get emotional. Listen him out and ask clarifying questions to understand his motives then act appropriately. It is always better to end such a talk quickly and plan a follow-up at a later time when the caller may be in a better emotional situation.
Difficult circumstances: Communication in difficult circumstances requires care, special tact, and knowledge. For example interviewing a new employee, informing an employee that he has been dismissed from work, disciplining a poorly-performing employee, termination of an employee, and the exit interview require tact to make sure the message is delivered but that the encounter does not become emotionally charged or even violent. It is very important to understand that in such circumstances you must separate the person from the problem. You attack the problem and solve it without attacking or in any way diminishing the dignity of the human even if he or she be at fault and common sense tells us that humiliating treatment is deserved
Careless talk: Communication becomes careless when Avoid careless talk. It is better to keep quiet than to say something that is wrong, offensive, or misleading. Not every correct things should be said. There are things that can confuse some people in some situations; these are better left unsaid.
Arguing your case: When arguing your case, start by establishing some common ground on which to build. Use only logical reasoning and avoid being emotional. If you have strong arguments be careful not to prove anyone a fool. That is the quickest way to lose an argument. Do not be defensive. Try to show advantages for others in agreeing with you. Plan: why? what? who to argue with? how? Choose the time carefully. Discuss with the aim of reaching agreement. Define area of disagreement. Watch for feedback. Do not talk about subjects you do not know (al imran:66). Concentrate, listen well, give undivided attention, paraphrase what others say to show you respect them, and be polite. Be calm, sympathetic, kind, and lower your voice. Avoid words that hurt. Do not be diverted to branches. Do not prejudge or judge hastily. Do not stereotype. Be brief and concise
THE ART OF LISTENING
Listening: Listening activity involves comprehension and 3 transactional processes (direct feed-back, indirect feed-back, and delayed feed-back). Listening can be active or passive. In active listening the listener shows obvious interest and asks questions. An active listener must ask questions to understand. The questions should seek clarifications or additional information. Questions that pre-empt the speaker or that are hypothetical should be avoided. Questions remove ambiguity and create clarity. The speaker can not know whether a passive listener is following or not. Listening can be empathic or critical. Empathic listening could be active or passive. Critical listening involves appreciation and discrimination and is always active.
Improving listening: Improve your listening skills in face-to-face communication. Analyze your listening behavior, analyze the speaker’s style and analyze the message and see how they relate to your listening behavior. The following behaviours or attributes of the speaker can improve listening:: appropriate rate of speaking, fluency, visibility, credibility, likability, and similarity in values with listeners. The message can encourage better listening if it is clear, organized, and is captive. As a listener you can improve your listening in various ways. Talk less and listen more. Clear your mind of other matters before start of the conversation and give undivided attention to the speaker. Let the speaker know you are listening. Write notes. Ask open-ended questions for clarification and also for encouragement of the speaker. Give feed-back. Summarize or paraphrase some of what the speaker says. Be open-minded and not judgmental. While listening avoid the mistake confusing content with feelings. Separate and deal with each accordingly knowing that each is important. Do not verbally or by use of body language show the speaker that he is ignorant or crazy. Do not be too argumentative even if you do not agree with the speaker. Listen, then think, then respond, and then comprehend.
Barriers to effective listening: The following are barriers to effective listening: weak extrinsic motivation, personal constraints, environmental constraints, and poor timing of the message. Whenever any of these situations arise, it is better to stop the communication process in a polite non-offensive way and resume at some other time.
ETIQUETTE OF THE MAJLIS
On the first meeting: The first impressions that people get about you on first meeting are lasting. Make sure you project a positive but true image of yourself. Take care of your physical appearance. Your hair must be combed well, the nails clipped, your clothes and face clean and appropriate. Your greetings must exude warmth and confidence. Eye contact with those of the same gender enhances communication. Before starting communication in small groups you can do somethings that facilitate the process: Greetings, shaking hands, standing up as a sign of respect, kissing, and embracing. Take the initiative to greet or shake hands first. Be personal and informal; the personal touch has a lasting impact. Meet others with a cheerful countenance and maintain it throughout the communication process. Express emotions and love for your partners.
Being in a group: When in a group gathering always talk about Allah. Try to always sit and talk with the pious. Do not exclude the weak and the poor from your gatherings. When sitting in a group, do not ignore anyone. People hate being ignored. Try to involve everybody in the conversation. You can not engage in secret talks in the presence of others. You should also not use a language unknown by some of the people in the group. Be kind and generous to the young and respectful to the elderly. Never embarrass anyone in a gathering. Always pray for those who say or do something good. Make a dua at the end of the gathering. When sitting in a gathering, give place to the newcomers and let them feel welcome. The newcomer should also avoid displacing anyone. it is better he sits even at the end.
D. PUBLIC SPEAKING
PUBLIC SPEAKING: NATURE AND CHARACTERISTICS
Purpose of public speaking: Public speaking serves several purposes that help in leadership situations: informing, entertaining, inspiring, convincing, motivating, teaching, training, and convincing. Speech can be used to define issues and bring about a change
Model of public speaking: Speaker. Message. Situation. Feed-back. Listeners
Impact of public0 speaking: Public speeches make a major impact if made well. Speaking is metaphorically a type of magic.
Fear of public speaking: Very few people are gifted speakers. Many people are afraid of public speaking. With good preparation, practice, and building self-confidence, you can overcome your stage fright. Stop being pessimistic. Do not procrastinate. If you have a speaking engagement prepare early. Train in speech-making. Taking care of your physical appearance builds your self-confidence.
Factors of success in public speaking: Success of public speaking is affected by the speaker, the delivery technic, the message, and the audience.
The speaker: The speaker must have integrity, knowledge, positive attitude, sensitivity to the audience and the situation, oral skills, self-confidence and self-control. A successful speaker must have a purpose. Repeat of some one else's great speech verbatim may turn out to be a dismal failure. A tired exhausted speaker with a well-prepared speech may not do as well as one in good mood. You may be a poor speaker because of lack of commitment to the topic though it may be well prepared. As the speaker you must be in control. Acknowledge tension as a normal phenomenon. You should remember that tension reduces as you start speaking. When tense think about things that interest you. You must be yourself and avoid an artificial disposition. Look at the audience. Establish eye contact. Communicate with both body and voice. As a speaker you must have interest and commitment to what you are communicating to talk well about it. You must in short be sincere and real. A good message delivered with superb technique but with no sincerity may leave the audience unimpressed. The audience can feel the speaker's sincerity and attune to him. You must be able to establish your credibility for your message to have an impact. The physical appearance, posture, gestures, movements and voice quality establish credibility and determine the success of the delivery. They should be appropriate to the audience being addressed and must fulfill the audience’s expectations. As a speaker you must understand that your appearance has a big impact on the audience; they may judge you even before hearing you. Dress appropriately. Maintain proper posture. Use natural gestures, maintain eye contact with the audience and avoid bad mannerisms such as fidgeting, meaningless movements, licking lips, picking your nose etc. Your voice must be confident, mature, and serious. You must appear accessible, be sincere and genuine, and be enthusiastic. Speak as long as there is interest. Do not bore the audience. Watch out for signs of audience disinterest such as sleeping, yawning, or walking out. Cut your talk short if the audience is clearly not interested. Learn from the current speech to improve the next one.
Audience: A great speech to one audience may bore another to sleep. You may have a good topic and deliver it is a masterful fashion to an uninterested audience. A less well-prepared speech delivered in less than perfect style may go well with a positive and expectant audience. The speech must be related to the audience, the speaker, and the topic. The speech must be adapted to the audience as individuals and as a group. Adapting a speech to an audience does not mean pandering to their vanities. The audience benefit depends on: purpose of listening, knowledge of the subject, listening skills, and attitudes. As a speaker you must choose your audience carefully. There is no point in speaking to an audience you know is not interested. If you are in the audience you must know that listening is more than hearing. Listen for ideas and not words. Take notes. Suspend judgment. Advance publicity can increase audience interest. The publicity could define who can benefit from the speech so that people who would otherwise be bored do not turn up
Message: Three parameters concern the message: content, structure, and style. You can learn a lot of technics of speaking effectively, being interesting and captivating the audience. All of these are necessary but can never be a substitute for substance. You must have a useful message to communicate to others. Each speech must have a clear mission. Do not talk for the sake of talking. Talk if you have something to achieve. A captivating title must show benefit to the audience. It must reflect objectives relevant to them. It must deal with real problems and must suggest solutions. It must be action-oriented, easy to remember titles that stimulate the imagination, phrased in a 'catchy' way attract audiences. Good preparation is always the key to success. There is no short-cut substitute to knowledge of the subject material to be presented. You must demonstrate that you are the expert. Do not exaggerate. Be honest about limitations in your knowledge. Make sure you tell the audience what are facts, what are opinions, and what are ideas or theories. The message must be innovative and creative.
Channels: Verbal. Visual. Pictorial
Situations: Physical setting. Social context
Short and simple speeches: A good speech is usually simple, short, and to the point. The importance of the message conveyed can not be judged by the length of time it took to convey it. Use repetition instead of giving too much information. Do not overlord the audience with information. Concentrate on a few main points but present them well and effectively
Sincerity: Professional speakers and politicians tell the audience what the audience wants to hear and sometimes get away with it. Specific packaging or customizing a speech is of paramount importance to them. You are not in that league. You may only customize the delivery techniques, the intellectual level, or even content of the message. You however can never compromise the truth just to please the audience. You are a leader and the audience are followers. It is a failure of the leadership process if you tell then what pleases their ears instead of talking as a leader and showing them the way ahead. Pleasing audiences is the work of performers and entertainers. Body language such as hand gestures can be put to good use but could also be misused with negative impact.
PUBLIC SPEAKING: PREPARATION AND DELIVERY
Preparation: Preparing a good speech takes time and effort. Some estimate that one minute of speaking requires one hour of preparation. Familiarity with the subject matter or experience in delivering similar speeches help reduce the time of preparation. Start by planning a time-table and setting specific goals. The following are steps in speech preparation: selecting and narrowing down the subject, determining the general and specific purposes, determining the central idea, analyzing the audience and the occasion, gathering material for the speech, making an outline, and practising the speech. Prepare an outline dividing your presentation into three parts: introduction, body and conclusion.
Topic: Narrowing a topic involves selecting 2-3 points that you can discuss well in the time allocated. You must have the purpose of the speech very clear in your mind. Choose a title for the speech that is relevant to you, the audience and the occasion. The title should be provocative and brief. When planning a speech start by deciding what you will speak on. Choose what to talk about being guided by subjects you know about, ideas you believe in, or what interests you and the audience. Audience interest is evoked by: concerns over health, security or happiness; solutions to recognized problems; controversy of conflict, a subject appropriate to the occasion.
Introduction: The introduction is an overview of the speech. It is concise. It raises interest and expectations. You must preview background, special terms, and key points at the start. Plan to capture audience interest at the start or risk losing it forever. Humor is one way of capturing audience interest. Other methods are: starting with questions, telling stories, anecdotes, and personal experiences
Body: In structuring the body, outline your ideas. The following approaches may be used in outlining: chronology, questions (what?, where?, how?, when?), cause and effect, narration, process, definition, classification, analogies, illustrations, problem-solving scenarios, deductive logic (general to specific), inductive logic (specific to general), time and place characteristics. A thesis must be developed. The thesis statement is the controlling idea, the central theme of the speech. It must be a single declarative sentence. Since it sets the cue for the whole speech, it should be presented early in the speech. Ideas must be organized as main points and linking ideas or transitions from one idea to another must be included for smooth flow of the speech. The language must be clear and appropriate for the topic, situation, and audience.
Conclusion: The conclusion must summarize the material and end with humility. A good conclusion summarizes the key ideas, gives a sense of completeness, and appeals to the audience.
Supporting material for a speech: The best speeches are those that are original ie the central ideas are from the speaker. Supporting material is needed to make the speech more effective. Examples of support material include: opinions (public or expert), specific examples or instances, comparisons, and statistics. The speaker must research to obtain support material. The following are possible sources of library support material: books, magazines, periodicals, government documents, newspapers, computer data-bases. Non-library sources include: interviews,...
Rehearsal: Rehearsing a speech before delivery increases the speaker's confidence, helps find difficult parts, assists in identifying mistakes, and helps time the duration of the speech. Rehearsal helps you modulate your voice, improve your gestures, and check visual aids. The most important benefit from rehearsing is the feeling of self-confidence in the knowledge that you have prepared well and have rehearsed and are sure you can deliver a good speech. The following are methods of rehearsal that can be used: reciting aloud, using a tape recorder, silently talking to yourself,
Delivery: Delivery involves both physical and vocal aspects. The physical aspects include: gestures, posture, facial expression. The vocal aspects include: pitch, volume, rate, fluency, and pronunciation. A good presentation must be natural, dynamic, articulate, and displays emotion. As a speaker you must aim at getting and maintaining audience interest. You must capture the attention of the audience from the start if you are to keep it through the speech. Make your topic specific and unique. Either establish yourself as an authority on the topic or quote authorities. To keep the audience interest, tell them what interests them but not in a hypocritical way. Do not pander to their vanities. You must convey your message even if you differ from them. Show interest in your audience by mentioning facts that indicate you did take the trouble to find out about them. The following also help maintain audience interest: activity, reality, proximity, familiarity, novelty, suspense, conflict, humor, issues that affect vested interests. Reinforce and repeat your main points throughout the presentation. Be human, personal and accessible. Try to link your personal experiences with the presentation. When speaking, define technical terms and avoid jargon as much as possible. Use anecdotes & examples, give details, speak as if you are in conversation, use simple everyday language. Use natural gestures and maintain eye contact. Talk only when there is interest. Stop talking as soon as there is a distraction.
Powerless talk: Avoid powerless talk that loses you audience interest. Powerless talk makes you lose authority and credibility in front of the audience. Matters may become so bad that they ask themselves even why you came to talk to them at all! Do not hesitate. Hesitation indicates lack of knowledge or confidence. Do not hedge by using phrases like 'I guess' or 'I think'. Do not use tag questions like 'isn't it?' or 'wouldn't it?'. Do not make any disclaimers like 'I am not the most knowledgeable on this topic', 'I did not prepare'. Do not make any excuses like 'I was not the scheduled speaker; I am substituting', 'I do not know the subject well' etc
Methods of presentation: Choose a method of presentation (memory, reading manuscript, ex-tempore, impromptu) and rehearse. Try to personalize the delivery method. Know what works best for you. The most effective delivery would be from memory. There is however a high risk of being confused, forgetting some parts, or saying things you did not plan to say. The very effort of memorizing a speech is also not easy. Memorization is appropriate for short oft-repeated speeches such as election campaign speeches or toasting. Success requires constant practice. It is a good precaution to keep a piece of paper in case you get stuck. Use of a manuscript is precise but interferes with active interaction with the audience and could be boring. Use a written speech should be used only for the most important and sensitive matters especially when details are important. Try to memorize certain sections and do not read every word. Try to speak in as natural a way as is possible. The favored delivery is ex-tempore. Extempore delivery uses notes as points to guide the speaker and this is the best. You should have a manuscript with which you are very familiar but you however speak from notes and outlines. Direct quotes should be written out in full to avoid making mistakes. Practice is needed for a perfect delivery. There is no impromptu speech. What does for impromptu speech has usually been planned and thought about a long time ago and is not spontaneous to the speaker. An impromptu presentation must be brief. Essentially it involves stating a main idea, developing an argument, and stating a conclusion. Practice is mandatory. Impromptu delivery should be avoided except for very experienced speakers who are very knowledgeable about the subject and have delivered a similar speech before.
Increasing retention: Try to make your speech unique so that it can be remembered. The following can be used to increase retention: audio-visuals, repetition, periods of silence to allow internalization, audience participation. The following speech characteristics also help retention: short and simple, use of examples and stories to illustrate, Use of acronyms, memorable quotes, and illustrations, appropriate language use. The following speaker characteristics help retention: sincerity, appropriate body language, and emotion
Audio visuals: The following audio-visuals can be used: hand-outs, charts, maps, models and exhibits, chalk-board, slides and the over-head projector, computer graphics, and personal demonstrations by the speaker. When using audio-visuals be careful that they do not overwhelm you and your message. Do not be so pre-occupied with the A_V that you forget to focus on the audience. The A-V must be displayed such that the audience can see it clearly
Use of language: The following measures help improve language use. Words must be used parsimoniously. Be accurate in your word use. Choose words carefully. Avoid loaded words, slang and colloquial expressions. Use vivid language by employing analogies, allusions, alliterations, parallelisms, metaphors, and similes. Verbosity and pompous language should be avoided. Your language must be clear. Use appropriate abstract or concrete language depending on the audience and the topic. Your voice must be active.
Emotion: Speaking with emotion captivates the audience. They may share in the emotion. However too much emotionalism may be negative. You must know the audience and its culture. Some cultures are associated with high emotions whereas others are more subdued. The language employed must be appropriate to the emotional level. The emotion must be appropriate to the subject of discussion and to the audience.
Examples: Liberal use of relevant examples helps illustrate points and also increase retention. The examples must be relevant and not offensive. The example must not become a point if controversy or introduce a new idea that distracts from the topic
Stories: A story especially if humorous helps understanding and retention. The story helps build a visual image; visual images are better retained. The story should be simple and brief and should not itself become the focus of interest. The story should be relevant to the speech and should only emphasize one of the points already made. The story should present only one non-controversial idea that does not allow more than one interpretation. The standard used is that any story told in a speech should be understood by a child even before the telling is completed.
Audience problems: The following are common audience problems: heckling, experts in the audience, hostility by the audience, people speaking among themselves. You must learn how to deal with problems from the audience firmly and tactfully. Stay cool when you are heckled. Try to understand the motivations of the heckler. In most cases they want to draw attention to themselves. Sometimes they want to provoke you to react in a way that will reflect negatively on you and the message you are trying to convey. Acknowledge people in the audience who may be experts on the topic and do not try to compete with them. When you make mistakes admit them immediately and even joke about them. If the audience is hostile, listen and ask polite questions to understand the motivation. Try to find some areas of agreement and build on them. It is better to end the speech early and in an organized way than to continue speaking to a hostile audience and may be end in an acrimonious brawl. There may be people in the audience who want to draw attention to themselves by asking too many questions or making too many comments. They need to be handled with tact. Accommodate them however be firm and polite in stopping their interruptions. Be prepared to interrupt your speech for a good reason. Late comers should not interrupt the speech. When people in the audience are talking among themselves, try to show them you notice like looking at them. If this does not help, draw them into the process by asking them direct questions. It sometimes helps to stop speaking until the noise abates. You must maintain your gaze at them so that they realize that they are the cause of the silence.
Responding to comments and questions: Comments could be positive or negative. The comment must be related to the topic. Make sure comments are not too long or themselves turn into mini-speeches. Questions may be framed to seek information or to express disagreement. Answering questions successfully is an art. It involves ability to empathize with the questioner and showing them you understand them. You must think fast on your feet. The best technic is to anticipate questions and prepare for them. Make it a point to respond to every question and comment. Answer only those questions that are related to the topic. Politely reject those that are not related. Listen very carefully to questions. Ask to clarify. Rephrase the question and inquire from the questioner whether you have rephrased the question right. Answer briefly. Respond to the entire audience and not only the questioner. You may sometimes give more information than was asked for to pre-empt similar questions. Be prepared for follow-up questions. Be tactful in answering questions. Do not be defensive.
Physical facilities and arrangements: As a speaker you should take interest in the physical arrangement of the hall. An uncomfortable atmosphere interferes with the success of the speech. If people come late, they should be accommodated as much as possible. They however should not try to force a person who came early to give up a seat.
Emergency and panic situations: Every public speaker will sooner or later run into a crisis and emergency situation. Examples of such situations are: losing your notes, the microphone does not work or has annoying acoustic feed-back, slides are out of order etc. The problems may be more serious. You may have prepared a speech for a specific audience and you are surprised by a completely different audience. The featured speaker may be late or not turn up altogether. The first rule is that you do not panic. While sorting yourself out you must make light of the situation. An appropriate joke may relieve the tension. Study the situation carefully and take the appropriate measure.
E. EFFECTIVE WRITING
Importance of writing: This chapter deals with writing letters, internal memos, reports, and papers. Clear writing reflects clear thinking...Written communication projects image about the writer. Written communication leaves a permanent record
Precise and brief writing: The aim of official writing is to express and not impress. Writing must be brief, precise, direct, forceful, accurate, and result-oriented. Long convoluted sentences should be abandoned; instead short powerful sentences should be used.
Simple language: Remember that some of your readers may not be subject specialists like you therefore do not use too much technical jargon
Believable communication: The following are characteristics of believable written communication: the writer owns his positions ie expresses his opinions and stands clearly and does not hide behind vague words and expressions, the writing must be emotionally honest, evidence-oriented, and directed at solving problems.
Two processes in writing: Creating. Revising
Purposive writing: Written communication must be purposive. Avoid no-results writing. Write to inform but not to impress. Each letter must be written with a specific purpose in mind. Letters are written for one of the following purposes: persuade, complain, reject, good will, ask for something, report, or propose.
Types of letters: Persuasive . Complaint . Reference . Rejection . Good will . Application . Reports . Proposals
Using faxes in communication: Do not send long faxes to people not expecting them. Provide your telephone and fax numbers on the cover sheet . Number pages . Treat incoming faxes as urgent . Do not fax sensitive information
Writing good memos: Ask yourself if the memo is necessary . What are the communication needs of the recipient?: approval - information . Be personal . What do I want to say? . End with good will . Politely mention what actions & responses you expect and when . Arrange ideas logically . Keep opening paragraph short . Vary length of subsequent paragraphs. Be consistent in organizing the memo. Do not communicate negative matters in writing
Writing good letters: The letter must be organized to show the date, name, address, and subject. The subject must be written upfront. A personal or spiritual salutation is necessary. The body should contain the message being communicated. The letter should have a polite and friendly conclusion. A letter should generally be no longer than 2 pages. Details can be attached as addenda instead of being put in the body of the letter. A check-list or readability, correctness of language and format, appropriateness, and thoughts should be used to check the letter before it is sent off. A letter must have a smooth flow of ideas...
Writing to difficult persons: When writing to difficult persons or about difficult subjects, you must aim at conveying the message without making the situation worse or creating new problems. Try to personalize the communication. Be positive. Avoid use of the first person because it sounds dictatorial. Do not explain negative news because that could lead to misunderstandings and misinterpretations; just deliver the news and no more. Conclude with specific directions on what to do next.
Problems writers face: Blank page/writer’s block. Lack of motivation. Lack of perseverence. Fearing the reader. Lack of information. Fear of errors
Writer's block: Writer's block is common and should be dealt with forcefully. It is advisable to develop formats and formulas for writing usually undertaken.
Models of good writing: Reading good model letters helps you develop your style
Logic in writing: Logic whether inductive or deductive is used in producing precise effective writing. Writing is helped by thinking logically of blocks of ideas and then translating them into a document.
Writing papers: Quote or paraphrase source material if it is clearly not your thoughts and document carefully. Write a draft first. Divide the paper into introduction, body, and conclusion. The structure of the body: narrative, description, exemplification, process, cause and effect, comparison/contrast, classification/division, definition
Technical writing: Reports and manuals: Reports and manuals are more difficult to write than ordinary letters. Errors in them are of a worse consequences because many people and operations depend on them. They also require strict documentation: sources, lists, tables, figures, etc. Technical reports should be reader-friendly and avoid cliches and jargon that non-specialist readers do not understand. Reports have their own styles and formats designed with the end-user in mind. A report must have an executive summary. Important points must be emphasized. It must be organized in a logical order.
Revision and proofing: All documents must be proof-read. Proofing involves checking for: spelling, punctuation, grammar, style, syntax, data cross check
Writing by assistants: As a busy executive you can not find the time to write documents. You must rely on assistants to draft them. The assistants must learn your style so that their drafts are like yours.
18.2.5 NEGOTIATION
A. NATURE and PURPOSE OF NEGOTIATIONS
OVERVIEW
Negotiations are pervasive: Leaders spend a lot of their time in negotiations. Daily life, public or private, revolves around negotiating with others. You may not even be conscious of being involved in negotiations. Most major decisions, private and public, are not unilateral. They involve negotiations with others to reach an acceptable consensus.
Purposes of negotiations: Negotiation is necessary to protect your interests, and get as much advantage as possible without entering into costly and bruising confrontations. Most conflicts can be resolved through negotiation. Good negotiation turns confrontation into cooperation.
Learning negotiation skills: Negotiation skills can be learned. They can be improved by experience and discussions with experienced negotiators.
WIN-WIN NEGOTIATIONS
What is win-win negotiation?: Negotiations can be win-win in which each party leaves satisfied or win-lose in which one party leaves with a feeling of winning and the other leaves with a feeling of having lost. A win-win outcome is the best in a negotiation. It ensures that each party gets the maximum it can from the transaction, part as friends who can work together again. Both objectives and relations be considered. Future relationships may be lost by aggressive pursuit of objectives. Win-win negotiation requires avoiding stereotyping the other party. Such stereotypes confuse your judgment. Win-win negotiation requires avoiding extremes. The just equilibrium is the way to negotiate. Win-win negotiation is joint problem-solving; the alternative is power negotiation using threats, intimidation, and other power tactics that will end in deadlock. Win-win negotiation focuses on positive solutions. It aims at reaching an agreement satisfactory to both sides by a process that is as painless as possible. Satisfaction could be achieved even if one party has through miscalculation compromised its interests. It is all well as long as they are not aware of their mistake.
Elements of win-win negotiation: Win-win negotiation has the following elements: separating people from the problem, looking at interests and not positions, creating options for mutual gain, getting all parties to use objective criteria, enough time to prepare for and carry out negotiations, and optimum circumstances under which negotiation is carried. The focus should be on solving problems and not on personalities. Interests and not positions should be defended. A negotiating position can be given up or changed without giving up your interests. Options for mutual gains should be vigorously explored. Win-win negotiators concentrate on objective criteria. A win-win outcome in negotiations requires enough time to prepare so that decisions and moves are well-studied and are not emotional reactions..
Alternative to win-win: If you are not interested in a win-win outcome, you have the liberty not to negotiate at all and to use other approaches to solving the problem.
B. STATEGY OF NEGOTIATION
PRINCIPLES OF NEGOTIATION
Negotiation strategy: Negotiating is strategy. You must have either an equilibrium or dominant strategy. If your strategy is dominated you will lose your interests. Since negotiation is strategy, never enter a negotiation unless you have a well worked out strategy and a clear objective. You should know your bottom-line from the beginning. You could change it upwards but never downwards. You should always have your worst-case scenario well worked out. You must take enough time to plan your negotiating strategy. Identify what is non-negotiable for you and the other party. Ask yourself whether you or they can afford a deadlock? What are your and their alternatives in case of a deadlock? You must not give away your strategy by careless talk. You can be truthful without divulging secrets. When pressed, it is better to say 'no comment' or non-disclosure of confidential information.
Understanding the other side: A key to good negotiation is to be able to understand the other party's negotiation strategy from the start of the negotiation. You should get as much information as possible about the negotiating party and their organization. Try to assess the other side's negotiation style: aggressive, cooperative, emotional etc. The other side may have hidden agendas. You must look for clues to uncover and understand them.
Understanding the validity of others’ arguments: Mature negotiators acknowledge the strong and valid points of the other side and convince them that they understand their point of view. Understanding does not imply acceptance but goes a long way toward a win-win outcome.
Wise use of negotiation power: A powerful negotiator can walk away in a deadlock and not lose much. He has alternative ways of securing his interests. He is patient and has no deadlines. He has a right sense of timing and is a good listener. It is possible to use both power and persuasion. Never forget that power by itself can not get you to a settlement. It only helps prevent break-off of negotiations. Power should be used only to make it hard for the other party to say no. The other party must be 'helped' to see reality. They have to realize what will happen if the negotiations fail. Telling the other party that if agreement is not reached on price the deal will be abandoned is using power to prevent them from saying no to further negotiations. To make them say yes you have to employ the win-win technics. Warn the other party but do not threaten. Warning can be positive as an advance notice. A threat is negative and counter-productive. It will elicit a reaction and complicate everything. Power is better demonstrated than used. Once used it loses all its effect because the other side then retaliates. If power is to be used, it must be used as a last resort. Avoid provocations. If power is to be used, it must be employed in a graduated way. Start with minimum power and increase it incrementally until the desired effect is obtained. Be prepared to neutralize any reactions. In a negotiating situation, you can extend your power by forming coalitions to increase your leverage. You can appeal to third parties to support your position. Whenever you exercise power in a negotiation be careful to leave the other party a way out. You are likely to achieve your objectives this way with minimum effort.
Win-win vs win-lose: You have to be very careful in using a win-lose formula in negotiations. It can work only if you have a decisive advantage in power and if future relationships do not matter (a rare combination). Win-lose situations often end up as lose-lose to the detriment of both parties. It is advisable aim at a win-win outcome even if you can get away with a win-lose outcome. This is to avoid potential problems and bad feelings in the future. You should always remember that there are risks associated with winning in a confrontational negotiation situation. You may win the battle and lose the war. Future opportunities may be forfeited by winning in a way that leaves behind scars that can not heal.
Rationality and objectivity: Never allow negotiations to wander from rationality. Justify your positions all along and require the others to do the same.
Interests and concessions: Each negotiation has a mixture of compatible and incompatible interests. There will be no negotiations at all if the parties involved have nothing compatible at all; if there is no common ground to start from. Every negotiation involves making concessions and compromises, otherwise there is no rationale for starting negotiating at all. Direct conflict or avoidance may be the other alternatives. A successful negotiator should plan to achieve set objectives while making concessions and compromises on issues of no consequence to him but may be important for the other party. Negotiation is finally a refinement of the ancient art of tit for tat. If good faith is shown and the other party responds likewise, more good faith can be shown. If the response is negative, it is matched and some concession given earlier can be withdrawn.
Privacy: Difficult negotiations with a potential for conflict or even deadlock should always be conducted in private. Parties not directly involved should not be informed. Negotiators who have to consider public reactions to the negotiations may resort to irrational positions that will ruin negotiations that could have succeeded.
Negotiation handicap: In a negotiating situation each party has a handicap that can be exploited by the other party: what will be lost if no agreement is reached?, how much can it afford to wait?. A good negotiator always works out the worst-case scenario. Among the handicaps are: lack of time, deadlines, etc
Patience and time in negotiations: Patience is power; the most patient party usually wins. Patient negotiators are more calm, and relaxed. They take their time and control the negotiation process. You may be under pressure of a deadline in some cases, never disclose the fact to the other negotiating party. They will try to force you into concessions you do not want. You should never negotiate in haste, however be aware of prolonged never-ending negotiations. They may wear you out mentally so that you end up making concessions that you should not have made.
Multi-issue negotiations: Simultaneous negotiation over several issues at the same time increases the possibility of a compromise because one party may make concessions on some issues it does not value very highly while the other party does the same for other issues.
Brinkmanship: You should be careful about the use of brinkmanship or bluffs. They lead to disaster in most negotiating situations. When faced with an ultimatum, do not be hasty in responding. Try to probe and understand how serious it is. What are the underlying circumstances. What would happen if you called the bluff?
C. NEGOTIATION TACTICS
Pressure tactics: The other party may employ pressure tactics against you such as stonewalling, direct and personal attacks, ticks, and intimidation. Do not strike back, give in, or break off negotiations. You should recognize the provoking action. Stop to think and if possible ask for the session to be adjourned. Do not get angry and do not make any hasty decisions on the spot. Exercise self-control and self-restraint. Often the other party just wants to provoke you so that you may make a fool of yourself. The following pressure tactics can be used against you: intimidation, kid-glove, good-guy/bad-guy combination, invisible authority, erosion of your confidence, stonewalling, deception, provocation and emotions, anger, and personal attacks
Intimidation: Intimidation is never a good negotiation tactic. If the other party intimidates you, do not react to them by appearing to be intimidated or replying in kind. Ignore the intimidation. It will lose its impact. In case of intimidation, stick to the issues being negotiated. Do not discuss the threat. Assess your vulnerability to the threat so that you may study the best response. Always stick to objective criteria and do not get emotional.
Kid-glove: The other party may use a kid-glove approach giving you an unfavorable deal that is sweetened. Consider your values and long-term interests before responding.
Good-guy/bad-guy combination: The other party may present the good guy/bad guy scenario. One of the party may be outwardly hostile while the other one pretends to be friendly and on your side. Recognize the tactic and tell them that you understand what they are about. Then go back to objective negotiations.
Invisible authority: Your negotiating partner may hide behind a higher authority. You reach a deal and he claims that he has to consult his superiors. This can be prevented by establishing at the start of the negotiations whether they have authority to negotiate. You can also use this tactic in reverse. Also hide behind an authority even an imaginary one.
Stone walling: Stone-walling occurs when the other party claims no flexibility and starts foot-dragging. Tell them you understand that they are using this tactic. Test the stickability of the stone-wall; if it is not firm just ignore it. If it is relatively firm, either try to get around the stone-wall or behave as if it did not occur and just continue negotiating. Try to reinterpret the stone-wall as an aspiration and not a firm irrevocable stand. Continue negotiating calmly.
Deception: When you think there is deception or false information, ask questions to clarify. Expose the trick. Try to turn tricks to your advantage. Avoid discussing new information that looks suspect.
Erosion of your confidence: When the other party tries to erode your confidence and credibility, to dot react. Just emphasize objectivity.
Provocations and emotions: You may be provoked into a negative reaction by an opponent. Guard against this. Always keep your calm and objectivity. Never lose sight of your objectives in a fit of temper. You may become emotional without any provocation. Admit the fact at least to yourself so that you may deal with it objectively. Try to return to objectivity. Focus on the future and positive results. Listen more and try to be objective. If you can express your emotional feelings factually do so; this acts as an emotional release. If the other party becomes emotional, ask them to justify their position rationally. Encourage them to communicate their emotional feelings. Empathize with them and do not react in like manner.
Anger: In case of anger aimed at intimidating you, listen to them. Acknowledge their feelings. Verbalize agreement with them without conceding your point of view. Do not reject their emotionally-expressed views; reframe them as a problem requiring solution. Treat them with respect even if they are making fools of themselves. Express your views while avoiding any further provocation.
Personal attacks: Ignore personal attacks and do not become defensive. Treat them as attacks on the problem and not on you. Reframe hostile personal attacks as friendly ones and make joke about them. Change pronouns from 'you' and 'me' to 'we'. Stick to discussing the merits of the issues. Criticize ideas and not the people who propound them. Reframe past wrongs as future remedies.
Risks in negotiation: There are risks in negotiations. You can never be sure that the other side is negotiating in good faith. You can not be sure that they will be honest in keeping the terms agreed on. You must guard against treachery and prepare for broken promises. In case of treachery be prompt in disowning the agreement that had been reached. Never be deceived twice by the same party. A believer is taken for only one ride and he learns from it.
Incremental approach: Do not throw play all your cards at once. Always keep some cards or negotiation chips in reserve for the last stages. They may salvage a deal beneficial to you. Avoid careless talk after the deal is reached but is not yet signed. You may introduce an idea or a dimension that can spoil everything. If possible never conclude a negotiation in one session. Give yourself time to think about the best compromise that has been reached by asking the other party to give you time to get approval from your superiors or colleagues.
Follow-up and implementation: Before entering into negotiations, you should take time to think about the follow-up steps after conclusion of negotiations. This will guide your negotiating strategy.
D. MANAGING A NEGOTIATION SESSION
PRELIMINARIES TO NEGOTIATIONS
Commitment to negotiations: If you have a vested interest in the success of the negotiations, set the ball rolling and make sure the process moves along. The other party is less likely to walk away from the table after investing time and energy in the process.
Personal relations: Any opportunity to build personal relations with negotiating partners should be used. Examples include: receiving them at the airport, a dinner, a breakfast etc.
Self discipline and self-control: You must be very self-disciplined at all times when you are with the other party to the negotiations. Such discipline will save you from costly mistakes. Discipline yourself to listen to the other party without interruption. Listen more; talk less. Listen without interruption; you will get valuable information and insights that will save you from costly mistakes. Do not react to statements before analyzing them. Do not be hasty in reaching conclusions.
Atmosphere: The atmosphere of the negotiations determines the outcome. It is easier to negotiate as friends in a cooperative atmosphere rather as enemies in a competitive atmosphere. In a cooperative atmosphere there is open communication, free and honest exchange of views and information, emphasis on compatibilities, reducing the scope of incompatibilities, and mutual problem solving. In a competitive atmosphere there is hostility, suspicion, escalation of conflict, a determination by each party to win all, and little communication.
Negotiators: Not everybody can negotiate well. The negotiators must be selected very carefully to ensure success. It is a mistake to assume that the leader or head must lead the negotiation team even if incompetent in negotiations. Negotiations can take place between 2 individuals, between groups, or between an individual and a group. Sometimes a third party is brought into the negotiation as a mediator, arbitrator, conciliator, or consultant. Negotiating in a team has advantages over negotiating as an individual. The team has more patience, is less susceptible to pressure tactics, can draw on a wider and specialized expertise. The disadvantages of team negotiating are that team negotiations can be prolonged. Coordination is difficult to achieve. The formalistic impersonal nature of team negotiations makes reaching agreement more difficult than the informal personal atmosphere of two individuals negotiating. To succeed in team negotiation, you must have a strong leader. Prior consensus must be reached on negotiating positions. Roles of speaking on particular issues or defending particular points must be assigned to individuals according to their specialization and ability. A rehearsal may make the process smoother. During the negotiations, the team must present a 'united front' so that the other party does not succeed in splitting the team and getting its members to argue against one another.
Preparing for a negotiation session: The actual negotiation session should be planned as much as possible. Never leave anything to chance. Role playing is useful. You may actually act out the probable behavior of all participants to the negotiations. Never be surprised at the negotiation table. You must be prepared for any eventuality so that you do not react emotionally but you react according to a well-studied strategy.
Background for negotiations: Background information is everything in negotiations. Never enter any negotiations without first making research and gathering the relevant information. Collect relevant information about the issue being negotiated, the negotiating party, and yourself, weaknesses and strengths.
Planning a strategy: Identify objective standards that can be used to settle issues to everybody's satisfaction. List what are satisfactory solutions for you. List what are satisfactory solutions for other party. List interests: yours vs theirs.
List limitations: yours vs theirs.
List options: yours vs theirs
List impact(s) of suggested solution(s): on you vs them
Role play, pretend you are the other party
Work out worst case scenario: for you vs other party
Identify what is non-negotiable: for you vs them
Identify alternative(s) to negotiation: for you vs them
Assess whether a deadlock can be afforded?: by you vs by them
Identify alternatives in case of deadlock: yours vs them
Make a conscious decision to negotiate
Plan the actual negotiation session
Plan follow-up to the negotiation
Finally write a ‘worry’ list of what could go wrong
PHASES OF NEGOTIATION
Phases of a negotiation session: A negotiation session has the following main stages: setting the agenda, opening the negotiations, demands and offers, narrowing differences between the parties, final bargaining, persuading the other party to cross the last hurdle to agreement, and implementation of the negotiated deal.
Setting agenda: What to negotiate and how to negotiate
Opening the negotiation: Start by identifying issues of common concern and perhaps agreement. This helps relax people and build confidence before the more difficult issues are tackled. The common sense to let the other party speak first in order to identify their strategy is not always applicable. There are situations when you should speak first and state your position. This will give you an opportunity to 'anchor' the negotiations by providing information or positions that others respond to and do not raise other issues that you do not want discussed. Making an opening offer is not as risky as many negotiators may have you believe. If you have a clear strategy, and well worked out contingencies, an opening offer lets you decide most of the parameters of the subsequent discussions. Human being are inclined to react to an idea on the table rather than be creative and bring up a new idea. The opening offer should not so substantial that it reveals your whole strategy.
Demands and offers: Outline issues objectively. Listen to other party's reaction; do not interrupt
Narrowing differences: Discuss differences in perception of issues. Ask the other party to state their solution alternatives. Offer your solution and show its benefits for both parties
Final bargaining technics for win-win outcome: Splitting the difference is trying to make every side make concessions so that you may meet in the middle. Using fair or objective standards to settle the issue. You can shift positions as long as the overall objective is to be achieved. Ask the right questions to create options for consensus such as why?, why not?, what if?, what do you advise?
Persuade other party to cross the last hurdle to agreement: Start from their position and move them to agreement. Include their ideas in your proposals. Ask for and build on some of their ideas. Ask them for constructive criticism of your ideas. Offer alternatives to choose from. Identify and satisfy unmet needs such as esteem, respect, security. There is no reason for the negotiations failing for such matters that are not of strategic significance to you. Look for and give low-cost high benefit concessions, this requires that you have a clear strategy that helps you identify what is a low-cost concession. Get them to give conditional agreement such as ‘if...then..’ and build on that to reach agreement by fulfilling or agreeing to the condition. Help other side save face so that agreement on substantial issues can be achieved with minimum pain to them and to your entire satisfaction. Use a third party to propose the final solution so that it is easier to accept. Use fair standards that are objective and are accepted universally so that the other party does not feel that you imposed a solution. Give the other party credit for success of negotiations. Praise in a genuine way any contribution they make however small towards a solution. Go slowly and incrementally. Make step-by-step small requests. Do not move to the next until the preceding one has been granted or some promise is made to grant it. Do do not ask for final commitment until the end when the whole deal has been worked out. Once the deal is completed, avoid any further discussions because that could lead to change of mind and destruction of all what has been achieved
Think about implementation of negotiated deal during the negotiation: Minimize risks in the deal. Include dispute-resolution procedures in the final deal. Preserve post-negotiation relationships; remember this is not the last encounter and the negotiated deal has still to be implemented. Aim at mutual satisfaction and not outright
victory.
E. DIFFICULT NEGOTIATIONS
DEAD-LOCK NEGOTIATIONS
Deadlock is natural: Deadlocked negotiations are natural. There are issues that are clearly stated by the Qur'an or the sunnah that are not negotiable. What is wrong is to deadlock on trivial inconsequential issues. Negotiations may become dead-locked on either procedural matters or substantial negotiation issues.
Both parties desire a deadlock: There are situations in which one or both parties to a negotiation know that there is no common ground and that the negotiations will fail. They enter negotiations either under pressure from a third party or to explore any weaknesses in the opponent that could be exploited in a more aggressive interaction. Some parties enter into a negotiation to deliver an ultimatum, generally expected to be rejected but they may be pleasantly surprised by a submission.
Lessons from deadlocks: Even deadlocked negotiation are useful, you can learn valuable lessons from them that can help in later negotiations.
Barriers to successful negotiation: The following are barriers to successful negotiations: a negative attitude to negotiations such as a win-lose stance, poor communication skills, lack of knowledge, lack of confidence in negotiations, fear of confrontation, being emotional and not being objective, being reactive, treating the other party as adversaries who must lose, and aggressive behavior
Causes of deadlock: A dead-lock may result from personal factors such as an inflated ego. It may be due to poor negotiation technic. There are some issues that are non-negotiable for one of the parties and introducing them into the negotiations rapidly leads to a deadlock.
Anticipating and planning for deadlock: As a strategic negotiator you should never be surprised by a deadlock. You should have anticipated it from the beginning and should have planned a contingency strategy.
What to do in case of deadlock: You must decide from the beginning whether you can afford to walk away from the negotiating table. If you can, you are in a very strong negotiating position. If you can not, never allow negotiations to proceed to a deadlock because you may then be forced to walk away from the negotiation table and you can not afford it, or you may reveal your handicap and weakness and be forced to make concessions you would have never made for the sake of saving the negotiations. If it is in your interests to continue the negotiations, devise ways and means of getting around a dead-lock. Stay calm and keep negotiating. You have to change the rules of the game or reframe issues. Consider all alternatives and look for options. Utilize maximum flexibility but never lose sight of the final goals and your permanent interests. Stick to objectivity. Stay calm. Avoid ego complications, yours and those of the other party.
COMPLICATED NEGOTIATIONS
Chapter overview: This chapter will discuss advanced technics for complicated negotiations. These are negotiations that involve more than one issue, are multi-stage, involve both win-win and deadlock elements, and also involve force and threats before a final conclusion is reached.
Starting a complicated negotiation: It is advisable to start a difficult negotiation by something light, relaxing, and calming for all part in order to break the ice. Too high an initial tension augurs badly for the whole process. Difficult negotiations may have to start with negotiations about negotiations ie setting and agreeing on the rules of the game.