A crucial conversation, according to authors Patterson, Grenny, McMillian & Switzler (2012), is one in which “opinions vary”, “stakes run high”, and “emotions run strong” (p.1-2). Leaders will often avoid these conversations until the situation has become serious (Patterson et al., 2012). It is an important nursing leadership skill to effectively manage these tough conversations. Whether the conversation is about disrespectful behavior, professional practice issues, or patient safety, it is never easy (Maxfield et al., 2005a; Patterson et al., 2012).
Key Points
Some key ideas presented in this book include the following:
Start with the Heart
Before beginning a crucial conversation, ask what is at stake and what is the desired outcome. It
Patterson, Grenny, McMillian & Switzler (2005), gave a perfect example of a patient going in for a tonsillectomy. The patient woke with part of her foot missing, while none of her tonsils were removed. In this case, there were seven other people in the OR that day, each wondering why the surgeon was working on the foot, they said nothing. People were afraid to speak up, the crucial conversation didn’t have the chance to begin. As a nurse, it is part of our job to communicate with doctors and those above and around us. If nurses are able to communicate effectively, the flow and shared pool of knowledge can increase a group’s ability to make better decisions and utilize all resources
Whether it is avoiding the issue, lashing out in confrontation, or in a clam manner. By identifying reactions to crucial conversations, it allows for a better look at the situation and deal with it up front. These tools can also be used to look at how others will deal with a crucial conversation, and to help better a response (Maxfield et al., 2005b; Patterson et al., 2012; The Joint Commission, 2008). This can be applied when talking with families. In a group, people may feel angry or uncomfortable to speak up. The nurse may try starting a discussion rather than a conversation with one individual. This can help break the tension, and allow people to feel safe in the conversation and encourage dialogue. In these situations listening carefully is key, along with showing genuine curiosity about the talkers point or behavior (Patterson et al., 2012). This can also help newer nurses address peers, and help staff feel more comfortable communicating with managers and those above them. It can be helpful to use other nurses, or colleagues, as a sounding board to practice these crucial conversations where pushback from others involved is
A.B. reports smoking a pack of cigarettes a day for the last thirty years. He denies drinking alcohol or using street drugs. While he has insurance through his union, it does not cover the entire cost of his medications and he states that he does not have a stable primary care
Whitehead, D. K., Weiss, S. A., & Tappen, R. M. (2010). Essentials of nursing leadership and
“Physicians and other health care professionals all agree on the importance of effective communication among the members of a health care team. However, there are many challenges associated with effective interprofessional (between physicians and other health care providers) communication, and these difficulties sometimes lead to unfavourable patient outcomes” (Canadian Medical Protection Association, 2011 p. 11).
Cultivating teamwork is vital in the fast-moving pace of the Emergency Department. One of the most important ways to cultivate this process is through developing a plan of communication with the team. According to L.J. Hood, communication is “…the dynamic interaction between two or more persons in which ideas, goals, beliefs and values, feelings, and feelings about feelings are exchanged. Even very brief communication exchanges may change all involved parties” (Hood, 2014, P.81). In many scenarios some nurses and staff members are unwilling to be those team players that are needed in a busy nursing unit, and many times nurses and staff will not communicate professionally at all. In these situations, some nurses and staff will require coaching sessions on how to communicate, and in worst case scenarios some nurses and staff, who are unwilling to communicate professionally, will be asked to leave the team
Essential II basic organizational and system leadership for quality care and patient safety is also an essential that all nurses deal with on a daily basis. “Leadership skills are needed that emphasize ethical and critical decision-making, initiating and maintaining effective working relationships, using mutually respectful communication and collaboration within inter-professional teams, care coordination, delegation, and developing conflict resolution strategies.”(American Association of Colleges of Nursing, 2008, p. 13) This essential begins on the first day of orientation and ends on the day a nurse retires. One cannot stress the importance of ethical decisions, critical decisions, and respectful communication enough. Whether speaking with an aggrieved family member or fellow staff member one should always look to quality
“Communication is the heart of nursing… your ability to use your growing knowledge and yourself as an instrument of care and caring and compassion” (Koerner, 2010, as cited in Balzer-Riley, 2012, p. 2). The knowledge base which Koerner is referring to includes important concepts such as communication, assertiveness, responsibility and caring (Balzer-Riley, 2012). Furthermore, communication is complex. It includes communication with patients, patient families, doctors, co-workers, nurse managers and many others. Due to those concepts and the variety of people involved, barriers and issues are present. Knowing how to communicate efficiently can be difficult.
Communication is cited as a contributing factor in 70% of healthcare mistakes, leading to many initiatives across the healthcare settings to improve the way healthcare professionals communicate. (Kohn, 2000.)
Communication encompasses a wide range of processes such as the exchange of information, listening, posing of questions (Fleischer et al., 2009) or use of body language. In a healthcare environment where there are constant interactions among nurses, doctors, patients and other health professionals, professional and effective communication is important in ensuring high quality healthcare standards and meeting the individual needs of patients.
Furthermore it’s very important not to judge the patient pertaining to what they may have to say. Good communication helps nurses build a relationship with their patient. Linking my personal experience from the clinical area relates to the practical side of nursing. It is necessary for communication between the nurse and the patient to be clear, understandable, appropriate and
In healthcare it is very important to have strong leaders, especially in the nursing profession. A nurse leader typically uses several styles of leadership depending on the situation presented; this is known as situational leadership. It is important that the professional nurse choose the right style of leadership for any given situation to ensure their employees are performing at their highest potential. Depending on which leadership style a nurse leader uses, it can affect staff retention and the morale of the employees as well as nurse job satisfaction (Azaare & Gross, 2011.) “Nursing leaders have the responsibility to create and maintain a work environment which not only promotes positive patient outcomes but also positively influences teams and individual nurses” (Malloy & Penprase, 2010.) Let’s explore two different leadership styles and discuss how they can enhance or diminish the nursing process.
The introduction paragraph gives information on communication and the impact that it has on patient-nurse relationships. It gives the reader an understanding of what is involved in true communication and how that it is a fundamental part of nursing and skills all nurses need. It leads those interested in delivering quality nursing to read on. Showing us the significance that communication makes in the
Interpersonal communication within the field of nursing is imperative in all areas to deliver a holistic positive outcome in patient care. Specifically, active listening, questioning with intent and reflective feedback ascertain an understanding of a patient’s health, illness, and healthcare. Active listening allows the patient to convey their concerns and presents the nurse with an understanding of the patient when implementing a personalised care plan. Questioning with intent builds an appreciation of the situation, and reflective feedback promotes improvements to enrich work ethics of the nursing cohort. Listening actively involves many different styles whereby information is gathered through verbal and non-verbal communication. Questioning
Leadership is defined by Northouse (2013) as a transactional experience between persons whereby one individual influences a group of individuals who have a mutual goal. Leaders may hold authority attributed to them by the group, substantiated by how they are regarded, whether or not they have positional authority. In contrast to management, where the goal is to provide order through control, leadership is concerned with producing change through transformation and practical adjustments (Northouse, 2013). Because of the nature of nursing, its obligation to promoting health and healing of people, nursing leadership concentrates change efforts based on human needs and concurrently ponders the needs of administrations largely because they understand the interrelatedness of the two influences.
Robinson, F. P., Gorman, G., Slimmer, L., & Yudkowsky, R. (2010). Perceptions of effective and ineffective nurse–physician communication in hospitals.Nursing Forum, 45(3), 206-216.
Communication involves relaying information from an individual to another through the use of verbal and nonverbal techniques. Many factors affect the effectiveness of information relay. It involves evaluating verbal aspects such as tone of voice, the emotional content being communicated, the timing and rapport of the interaction with patients, and nonverbal techniques such as facial expressions, time invested. It is necessary for productive and satisfactory work environment, improved patient outcomes, and settling conflicts. The purpose of this paper is to identify issues with ineffective communication and ways to improve proper communication throughout the a hospital’s interdisciplinary team and patients.