The 3 C’s: Communication

Infection Control Today, Volume 26, Issue 8

How infection preventionists communicate with those individuals with whom they interact is a tightrope of how to do it well and effectively. Read this article from readers' favorite, Heather Saunders, MPH, RN, CIC, to find out how to not fall off that tightrope in her second of 3 series on the 3'Cs of how to be a successful IP.

The word OK is my least favorite word in the English language. I have been guilty of obsessing over the word more than once in my lifetime. However, this obsession only takes place when it’s delivered in written form. In response to the word, my internal conversation usually sounds something like this: “Are they OK, or are they just saying they’re OK? Maybe I should ask whether they’re really OK or whether they’re only saying they’re OK, expecting me to know they’re not actually OK.”

Renowned for his work in nonverbal communication, Albert Mehrabian, PhD, a professor of psychology at the University of California, Los Angeles, combined 2 studies in 1971 to come up with the now-famous observation that only 7% of communication is verbal—7%!—which means 93% of all communication is non­verbal. This nonverbal communication consists of 55% body language and 38% tone of voice.1 This is why I am prone to obsessing over the meaning of OK when I see it in written form.

Today, communication is frequently exchanged through email, texts, and social media. More and more individuals are using these forms of communication to communicate sensitive information. Texting is now the most common form of communication for adults under the age of 50. I’d guess they also obsess over the word OK when they receive it as a reply. The shift in communication method has significantly challenged our understanding of one another, and mis­understandings resulting from written communication are just as present in the workplace.

In my last article, I introduced you to the concept of the 3 C’s: connection, communication, and collaboration. In the work we do as infection preventionists, the 3 C’s ensure our words are not only heard but listened to and acted upon. If you haven’t read the first article in the 3 C’s series, I’d encourage you to pause your reading of this one and read about the first of the 3 C’s: connection.

Good communication is such an important tool in the work we do as infection preventionists. But unless you’ve lived alone in the mountains for most of your life, you know good commu­nication is essential for everything. If you can learn to communicate effectively, you can resolve a great deal of conflict before it arises. If you communicate poorly, your messages are never received, or worse, misinterpreted. Misinterpretation leads to problems in all areas of life.

In 2005, social psychologist Justin Kruger, PhD, a professor at New York University Stern School of Business, published research that concluded 50% of emails are misinterpreted by individuals receiving them.2 This statistic shouldn’t surprise us. When we communicate in written forms such as email, we’re miss­ing tone of voice and body language to help us deliver messages clearly.

We’ve all received emails sent with good intention but whose meaning we question. I will receive an email that reads “Sure” and become concerned the recipient is angry at my request. However, a colleague will read the email and say, “No, I think he’s excited by the request! I don’t think he’s angry at all.”

Neither of us can tell whether the recipient is upset or excited by the request because the response is deliv­ered without any body language or tone of voice. Therefore, we read our own biases into the email. When so much of our communication is dependent on body language and tone of voice, it’s no wonder email and text messages are easily misin­terpreted. We’re robbing ourselves of 93% of our normal communication methods.

My grandmother had a pink rotary phone that hung on the wall in her kitchen for decades. She never used it. I thought it was broken for the longest time because when she wanted to talk to someone, she’d walk 10 blocks to their house and knock on their door instead of picking up the phone. Once I realized her phone worked fine, my millennial self thought this behavior was the strangest thing. Why not pick up the phone and call them? I think my grandmother understood and valued the importance of communicating in person when you’re able, especially when you have difficult messages that may not be well received. More recent generations (mine included) do not understand this point. We’re all arguing over texts and social media.

If you want to be heard and under­stood, communicate in person. Don’t use written forms of communication when you can pick up the phone, and don’t use the phone when you can communicate in person. In-person communication should always be the gold standard. As an infec­tion preventionist, you often have difficult messages to communicate, including ones your audience does not want to hear. Can you communicate them in person? Over the phone? Over the phone with video?

For example, you should avoid telling your surgeons via email you have ruled in a surgical site infection and believe poor sterile technique is contributing to high infection rates. That approach is wrong for so many reasons. Schedule a meeting and discuss those infections in person. Pick up the phone and call the important parties. And whatever you do, do not use social media.

However, sometimes the written word will be your only avenue for communi­cation. It’s not practical to communicate 100% of the time in person or over the phone. I knew an employee who would walk all over the hospital to deliver simple messages, wasting a great deal of time in the process. Decide what communication should take place in person and what is safe to send by email or text. In many ways, digital methods can increase our productivity and improve our communi­cation when done right.

With a few tips, you can become a savvy user of written words to commu­nicate effectively. Email will continue to be a large part of the working world, and mastering email communication will help us become more successful in our careers and life. First, become a better writer. Your sentences and paragraphs should flow, and your formatting should help the reader digest your message. Two emails may say the exact same thing, but the reader will have an easier time digesting one message over another because of its formatting. I cringe when I receive an email that is 1 page-long paragraph written in cursive, light purple font.

Second, proofread your emails. For sensitive emails where communication cannot take place in person or over the phone, ask someone else to proofread the email if possible. Ask them whether any part of the email sounds negative and whether your main message is clear.

Last, use emojis and punctuation as communication tools. You read that cor­rectly—use emojis. According to several surveys, emojis such as a simple smile are becoming more common in the workplace and are even viewed as professional. By carefully and strategically placing emojis, you can use them to approximate tone and body language. A well-placed emoji may help communicate difficult or more complex messages, meaning the reader is less likely to misinterpret the message. An OK sent with a simple smile emoji ensures the recipient isn’t left wondering about the meaning of the word.

As infection preventionists, we need individuals to not only hear our words but respond to them with action. However, in our digital age, effective communica­tion can be challenging. When only 7% of communication is in the words we use, digital communication methods leave out nonverbal signals to convey our message. When communicating difficult messages, in-person communication is always best. If not possible, phone calls, preferably with video chat, can be a suitable alternative. However, we can use digital communication to our advantage, increasing our productiv­ity. To do so, we must aim to become better writers, proofread our messages, and stra­tegically employ emojis and punctuation to substitute for nonverbal communication methods. If we want individuals to listen and turn our words into action, we must communicate effectively. I look forward to our next article where we’ll explore the last of the 3 C’s: collaboration.

Until next time.

References

1. Albert Mehrabian. British Library. Accessed September 6, 2022. https://www.bl.uk/people/al­bert-mehrabian

2. Kruger J, Epley N, Parker J, Ng ZW. Egocentrism over e-mail: can we communicate as well as we think? J Pers Soc Psychol. 2005;89(6):925-36. doi:10.1037/0022-3514.89.6.925