Introduction
Assertiveness is a concept that is not only important but also necessary to gain inner contentment and respect as a person and as a nurse. Many a time assertiveness is misunderstood with confidence, aggressiveness, and violation.1 Assertiveness is valuing who we are and is the behavior that promotes equality in human relationships, enabling us to act in our own best interests, to face up for ourselves without undue anxiety, to precise honest feelings comfortably, to exercise personal rights without denying the rights of others.2 Assertiveness promotes open and honest communication which builds up interdisciplinary collaboration and cohesion, improving staff performance and eventually standards of patient care.3 Assertive behavior by a nurse leader encourages staff to respond in the same fashion promoting goal achievement and appropriate assertive behavior is essential for advocacy of patients. Assertiveness is the quality a leader must have to assert themselves and to get things done. There is a need for strong nursing leadership to meet the professional demands of nursing. Leadership needs commitment, which is lacking in nursing, as nurses are basically job-oriented rather than a career.4 Assertiveness, contributes significantly toward nurse’s commitment to their profession.
Evidence of benefit from use of Assertiveness in Nursing Profession
Professional satisfaction is important as a profession is not merely a means of earning but is also a way of living. One of the sources of professional dissatisfaction is stress & frustration, which mainly comes when we are not able to express or ventilate what we are going through. According to Evers W, et al., psychological aggression has a significant relationship with depersonalization (a dimension of burnout), that is burnout among nurses leads to aggressive behavior and maybe that’s why the communication skill of nurses is being criticized.5 Another study conducted in Japan on the relationship between assertiveness and burnout among nurse managers by Suzuki, et al., revealed that increasing assertiveness with own care provision contributes to preventing burnout among nurse managers. That shows assertiveness will help to prevent burnout and enhance good communication.6 Sankelo M, Akerblad L (2008) studied Nurse Entrepreneurs' attitudes to management, their adoption of the manager's role, and managerial assertiveness. The aim of the study was to explore the attitudes of nurse entrepreneurs to management, their adoption of the manager's role, managerial assertiveness. The results of the study revealed that nurse entrepreneurs took a positive attitude towards management, but there have been obvious shortcomings in their adoption of the manager's, but there were obvious shortcomings in their adoption of the manager's role. They also showed a lack of managerial assertiveness.7
Assertiveness is a key tribute to high quality nursing practice
The role of nursing involves interaction with clients, peers, and other health professionals. This role is enhanced when nurses have an honest command of communication skills. An essential component of effective communication is that the power to behave assertively. Several studies have indicated that nurses lack assertiveness skills. This lack of assertiveness results in diminished effectiveness of communication and compromise patient care.8
Assertiveness is an important behavior for today’s professional nurse. As nurses move faraway from traditional subservient roles and perceived stereotypes it's increasingly being recognized that a nurse must behave in an assertive manner. Assertiveness is vital for effective nurse/patient communication, and it's suggested that its development also can aid the arrogance of the profession because it develops. Assertive behavior could also be encouraged through educational methods. It is preferable that nurses receive this educational preparation during undergraduate programs. Nurse educators have a crucial role within the development and implementation of assertiveness training/education programs for undergraduate nursing students.9
Significance of use of Assertiveness in Nursing Profession
The resource-constrained health service of the 21st century requires nurses who are assertive to satisfy the requirements of its users. Nursing students' assertiveness skills could be augmented through concentrated efforts from nurse educationalists and clinicians to reduce the communication theory-practice gap in nurse education today. To address the multi-dimensional nature of assertiveness, strategies to increase assertiveness should operate at the individual, interface, and organizational levels. To function as effective, safe practitioners’ registered nurses got to be assertive, therefore education in assertiveness should be an integral a part of their preparation.10 Assertiveness communicates one's professional position and feelings politely and firmly sustain an appropriate degree of independent authority necessary in upholding the rights and dignity of nurses. The current trends in health care settings are inclined towards team working with a multidisciplinary approach. Nursing must contend with its long history of subordination and identification with passivity. Assertiveness can be one of the powerful tools to improve the image of nursing in society. 11
Conclusion
Consequently assertiveness is a key attribute for nurses without which true autonomy, professional status or empowerment cannot be achieved. Nurses in practice have a crucial role in patient advocacy and counselling. Assertiveness is imperative for personal and professional progress towards the development of excellence in nursing practice.
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