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Nurses: Say This, Not That

Power can be taken, but not given. The process of the taking is empowerment in itself.
—Gloria Steinem

In a recent post, I promised a free tool adapted from The Image of Nursing.
If you’d like to download SAY THIS, NOT THAT: An Empowerment Glossary for
Nurses,
you’ll find it here. And while you’re waiting for the download, try this: 

If you hear yourself saying:

No one notices my contributions  

Say this instead:

I’d like to share with you how I’ve handled this situation

 

The Image of Nursing: Speak Up!

In a comment on one of my posts last week, Stefani suggested (strongly) that to improve the image of nursing, we need to speak up. I’m reposting her comment below to draw your attention to it.

I’d like to hear your thoughts about why nurses might not speak up when, by staying silent (out of fear?), their personal self-esteem takes a hit and—more importantly—care standards aren’t maintained. Have you developed techniques that help you overcome fear of confrontation so that you can truly speak up?

Speak Up image

Here are a few resources related to speaking up:

  1.  A terrific article from Susan Gaddis, PhD: Positive, Assertive “Pushback” for Nurses
  2.  A table you will be able to download from our reading room in a few days: Say This, Not That: An Empowerment Glossary for Nurses. Look for it on or before 3/19/15.
  3.  Books written by Kathleen Bartholomew, RN, MN, including Speak Your Truth and Team-Building Handbook: Improving Nurse-Physician Communications.

Improving the image of nursing

Every nurse can play a part in elevating the public perception of the nursing profession. The table below shows you how email, evidence-based research, reasonable work schedules, a diverse workforce, preceptorships, interprofessional communication skills, and name tags can promote the professional image of nursing. This table was adapted from the HCPro book, The Image of Nursing, by Shelley Cohen, RN, MS, CEN and Kathleen Bartholomew, RN, MN.

 imageof nursing table 2

Dealing with tardy nurses

Some people appear effortlessly organized and always manage to be on time. Others are perpetually frazzled and think five minutes late equates to being early. Parents of small children usually fall into the latter category!

How do you deal with nurses who are frequently late? Comment below and let us know.

Ben Franklin’s advice to nurse preceptors

Tell me and I forget.
Teach me and I remember.
Involve me and I learn.

How do you provide preceptees with constructive advice Ben Franklin2
or feedback? Do you tell them what they did wrong and spell out how to correct it? Or do you encourage them to use critical-thinking skills to truly ingrain a personal understanding of ways to improve their practice?

Look at these two approaches to feedback, and see which you think would be more effective. (More examples excerpted from The Preceptor Program Builder can be found in the Reading Room.)

The preceptor observes the preceptee greeting the manager correctly, giving her name, and stating that she is a preceptee. However, she was not wearing her name tag.

Evaluative feedback
Your name tag is missing, and the manager
won’t like it!

Descriptive feedback
You greeted the manager according to the facility protocol.
Can you think of anything that would help your manager remember you?

The descriptive feedback encourages the preceptee to use critical thinking, which illustrates Ben Franklin’s timeless recommendation to “involve me, and I learn.”

If you would like to share “aha” moments and techniques for constructive feedback, please feel free to comment below…

Nurses Week giveaway: Free excerpt from Ending Nurse-To-Nurse Hostility and a chance to win a copy!

HCPro has celebrated nurses all week long with special giveaways, prizes, and promotions.

We are giving away an exclusive excerpt from the brand-new edition of Ending Nurse-to-Nurse Hostility!

In this excerpt, Kathleen Bartholomew, RN, MN, is shining a light on horizontal hostility in nursing school. Read about the effect of horizontal hostility and bullying in nursing school and the positive ways nursing students can be supported and mentored as they begin their nursing career.

Download the excerpt here.

Plus you can also enter to win a free copy of the book!

We are giving away five copies of Ending Nurse-to-Nurse Hostility. Be among the first to read the newly updated book from nursing communication expert Kathleen Bartholomew, RN, MN.

Almost 50% of former nurses cite horizontal hostility as their reason for leaving the profession. Beat the statistics! Read this groundbreaking book and discover all-new strategies and solutions to improve the nursing culture at your organization.

Enter here for your chance to win.

Poll results: Using technology to connect with patients

Last month, I posted about the ways that technology could improve patients’ communication with nurses but could also place a greater burden on nurses for round-the-clock care and feedback. To get a feel for how often nurses used technology and social media to interact with patients, we posted a poll on StrategiesForNurseManagers.com asking nurses and other healthcare professionals to weigh in.

Approximately three-quarters (74%) of those who participated in the poll responded that they did not use social networking sites such as Twitter, Facebook, or LinkedIn to interact with patients, while the remaining 26% replied that they do use those technologies for patient interaction.

While these results indicate that social networking sites have not become a place for healthcare communications, I still wonder whether nurses and other practitioners use other forms of technology, such as emails, listervs, or websites, to share information with patients and respond to questions about treatment plans. As mentioned previously, these resources have the potential to improve patient care, but they must be leveraged appropriately.

How do you communicate and follow up with patients outside of their scheduled appointment times? Leave a comment below!

When disrespect becomes a safety issue

A dysfunctional culture rooted in widespread disrespect is a significant barrier to patient safety, and affects everyone in a healthcare organization, according to a pair of papers published in the journal Academic Medicine earlier this year. The papers’ authors identified six broad categories of disrespectful behavior, including degrading treatment of nurses, residents, and students, passive-aggressive behavior, and dismissive treatment of patients. Other behaviors included disrespect for system-wide policies and processes, disruptive behavior, and passive disrespect. The authors concluded that such behavior prohibits teamwork and undermines morale, which in turn threatens patient safety.

Most, if not all, organizations have at least one practitioner who seems intent on making everyone else miserable. While these disruptive practitioners may only be a small percent of the people working in a hospital or other healthcare facility, their behaviors and the influence of their attitudes can have much larger implications, as the authors of the papers point out. Nurses are particularly at risk for taking the brunt of a physician’s abuse; in several recent studies, more than 90% of nurses reported experiencing verbal abuse.

The second of the two papers focuses on creating a culture of respect. The paper’s authors call on an organizations leader, specifically the CEO, to initiate changes within an organization. However, anyone in a leadership position could address the need for change and begin working towards a cultural shift. The paper recommends five major tasks: motivate and inspire, establish preconditions for a culture of respect, lead the establishment of policies regarding disrespectful behavior, facilitate frontline worker engagement, and create a learning environment for resident and students. By recognizing that there is an issue with disruptive behavior and taking steps to eliminate those behaviors from your organization, you can begin to move towards a culture that is respectful and safe.

How has your organization addressed disruptive behavior in the past? Leave a comment and let us know!

Nurses identify barriers and facilitators for clinical practice guideline use

Nurses’ adoption and use of clinical practice guidelines is largely affected by external barriers such as social and organizational factors, according to a study published in this month’s issue of American Journal of Nursing.  Clinical practice guidelines, which the Institute of Medicine defines as “systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances,” are designed to close the gap between evidence for best practice and actual patient care. Researchers chose to focus on nurses’ applications of clinical practice guidelines due to several previous studies that found that nurses were most often identified as being primarily responsible for ensuring patient safety.

Researchers examined responses to open-ended survey questions asking nurses about barriers and facilitators to using clinical practice guidelines. The top three most-identified categories for facilitating the use of guidelines were education/orientation/training, communication, and time/staffing/workload; similarly, these were also identified as categories in which there were barriers to guideline use. 44% of nurses responded that their ability to use guidelines was impeded by a lack of time and a heavy workload, while 25% cited a lack of education, orientation, and training and 22% cited poor communication as barriers. Researchers found that 91% of nurses identified at least one external barrier, or those outside of the individual nurse’s control, and 53% of nurses identified more than one external barrier.  Fewer than 10% of nurses identified internal barriers such as lack of awareness of guidelines or willingness to change practice to better adhere to guidelines.

The research suggests that social and organizational factors can be crucial in the use of clinical practice guidelines. Organization leaders should find ways to ensure that nurses receive sufficient education and adequate time to successfully implement guidelines. In addition, effective communication and cooperative teamwork should be encouraged and practiced by everyone within an organization. The study’s researchers conclude that nurses should ideally be involved in all stages of guideline development, implementation, and use.

How do your nurses respond to clinical practice guidelines? What are some ways you have found to ensure guideline use among your nurses? Share your thoughts in the comments section!