Start With The Heart Case Study

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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
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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…show more content…
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
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