BARRY WILLIAMS /Special

Pamela Samen, a nurse in the intensive care unit at Children's Healthcare of Atlanta, holds her ID badge, which has a yellow star that indicates that she is practical and detail-oriented.

The pediatric intensive care unit at the Sibley Heart Center of Children's Healthcare of Atlanta can be a pretty stressful workplace. Physicians and nurses are fully aware that children's lives are at stake every day.

Yet staff conversation these days is a little more colorful and relaxed, thanks to Nicole Jarrell, RNC, MSN, a nurse expert in the Egleston PICU, and Dr. Janet Simsic, a pediatric cardiologist. The two designed a project to enhance communication among staff members using a model that analyzes personality traits and preferred styles of communication, called Colorful Keys of Effective Communication.

"My husband had taught a class in communication and found this model," Jarrell said. "I thought it would be a fun thing to do at our nurses meeting, a fun way to approach communication issues in the workplace. The nurses liked it so well that they thought the doctors who rotate through the ICU should do it, too."

Participants in the Colorful Keys of Effective Communication model take a personal color analysis assessment to determine their preferred style of communication, which is classified by color.

The four colors are blue, red, yellow and green.

Jarrell suspected that there would be more blue nurses and red physicians, which proved to be the case, but she and Simsic were surprised that the dominant color in both groups was yellow.

"That told us that we were closer than we thought and that everyone was there for the kids," Jarrell said.

Nurses and doctors in the unit now wear little colored stars on their badges in their representative colors.

"New graduate nurses are often intimidated by physicians, so it helps to tell them at orientation about the color system. If they know a doctor is red, then they know they need to be factual and succinct in giving information during rounds," Jarrell said.

"Being more aware of differences means that people can better understand why conflicts occur," said Simsic, who, like Jarrell, is a green. "Does it work all the time? No. Under pressure, I want to get the facts and fix the problem. I care about saving this child's life, so I may bark out orders, and that may be perceived as being insensitive and uncaring."

In the midst of a crisis, no one's thinking about colors, "but it gives people a chance to go back later and discuss the differences of being green or blue and your reactions to pressure. It can help improve communication and relationships," Simsic said.

The study found that both doctors and nurses believed the colorful keys had increased awareness of communication styles. Jarrell has seen the model open up lines of dialogue and diffuse situations in a light-

hearted way.

She hears people say things like, "Oh, you're blue and I'm green. That explains it" or "I'm having a red day; you'd better leave me alone" or "Let's be a little more green here and think this through."

Jarrell also has noticed new nurses become more comfortable about sharing information with doctors and nurse/preceptor relationships improve.

"It's a unique way to deal with an important issue. Nobody's at fault for being a certain color, that's just the way they're wired, and we need all colors in the unit," Simsic said. "If everyone thought or communicated in the same way, we wouldn't think of all the alternatives that are necessary to give the best care."

Having teams on which people aren't reluctant to speak up makes for a less stressful environment. "When you can communicate effectively, the plan of care and patient outcome is going to be better. Our whole point with this model was to improve care," Jarrell said.

She recently reported the project and its findings to a meeting of the American Heart Association in Washington, D.C.

"People were really interested in how it worked," Jarrell said. "It doesn't take a lot of time or cost much to implement the model. I think it would be applicable for any group."