Clarifying Expectations (Nursing)

by Amber Vanderburg

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    00:01 <b>The world of healthcare is quickly changing.</b> <b>You have new documentation practices, new tools and resources for patient care, updated best practices, alter roles and positions,</b> <b>organizational pivots, and adjustments from our ever expanding knowledge of the human body.</b> <b>There is a lot to learn and to keep up-to-date in your role to provide excellent patient care.</b> <b>All of these being said, complexity can jag clarity.</b> <b>If you or your team do not clearly understand your role and expectations,</b> <b>you will be less likely to perform with confidence and with excellence.</b> <b>For effective communication and performance in your healthcare organization,</b> <b>you should first seek to comprehensively and clearly understand the expectations at work.</b> <b>First, you should seek to understand outcomes expectations.</b> <b>These are expectations that are probably listed on the job description.</b> <b>When a patient comes in to the office, who is the first person they should speak to?</b> <b>Who will take vitals? What are the expectations in documentation?</b> <b>What are the expectations specifically at your organization?</b> <b>Some outcomes expectations could be organizationally fluid.</b> <b>Perhaps, one organization has low bandwidth for nurses assistance and as a result</b> <b>the nurse assumes some responsibilities that might be nurse assistant responsibilities in other organizations.</b> <b>Perhaps, there are specific expectations in documentation or floor communication.</b> <b>Clarifying these expectations is critical and can impact the confidence of work, work flow, and quality of patient care.</b> <b>So, take the time to clarify outcomes expectations.</b> <b>There are a lot of tools that you can use to clarify outcomes expectations.</b> <b>Here are a few simple action steps you can take to clarify expectations within your team.</b> <b>First, you can talk through patient mapping with the team.</b> <b>This is a fancy way of saying "talk through a story of a new patient coming through the doors of your healthcare organization.</b> <b>Walk through the patient's footsteps.</b> <b>Who is expected to do what by when? Share different patient scenarios.</b> <b>What is expected to happen when a patient does this, needs that, this happens?</b> <b>In this story mapping, I want you to focus beyond your responsibilities and also focus on the responsibilities of your team members.</b> <b>Understand who is the genesis of action for each step in the process of patient care.</b> <b>Understand how your actions influence the process overall.</b> <b>Understand who you should go to if you have any questions about a specific step in the process.</b> <b>Patient story mapping is a simple way to clarify outcomes expectations.</b> <b>You should also clarify expectations of focus and values.</b> <b>Ask team members and leaders about how success is measured in the team.</b> <b>This will probably be slightly different from team to team.</b> <b>And, this will help provide clarity on priority expectations.</b> <b>For example, a clinic nurse and an ICU nurse will probably have different areas of focus.</b> <b>I was interviewing a nurse for an ER position and she stated that she really liked to take her time,</b> <b>to slow down and talk to the patients and build relationships with them.</b> <b>There is absolutely a place for her as a nurse to make a powerful impact, but she was interviewing for the emergency room.</b> <b>This will probably not be the ideal environment for this nurse to be successful.</b> <b>We brought the nurse into the team, but in a different unit.</b> <b>And she thrived in your team, asked questions to clarify the focus, values, priorities, and matters of urgency in your team.</b> <b>You can clarify these expectations by asking questions and observing team behavior.</b> <b>For example, I was working with one department that really valued internal relationships.</b> <b>The team had a healthy camaraderie and valued the relational aspect of their work.</b> <b>One of their team members left to move to another organization.</b> <b>She confessed that the new organizational culture was also supporting and friendly,</b> <b>but the emphasis on internal relationships was not as overtly present.</b> <b>This team focused more on productivity and meeting numbers.</b> <b>It was a faster pace and the conversations were more in a professional context than a personal context.</b> <b>This wasn't bad, but it was a different value and focus than her previous organizational internal relationships.</b> <b>In your team, I want you to spend time in quiet observation,</b> <b>taking note of the context of the focus, the values, and the priorities in your team.</b> <b>In your observations, you might also ask some questions and clarify these focuses, values, and priorities in your department.</b> <b>Lastly, ask your team about the behavioral expectations within the team.</b> <b>This can vary dramatically from team to team and is generally not included in the job description.</b> <b>How are you expected to handle conflict? How does the team approach new ideas?</b> <b>How does your team address mistakes?</b> <b>I was working with a nurse, let's call her Luisa, who was upset because her new ideas were met with a lot of questions.</b> <b>I encouraged Luisa to follow up from the discussion and she discovered that the charge nurse and the manager both liked the ideas,</b> <b>but they wanted more information and to make sure the ideas were fully thought through.</b> <b>The charge nurse and the manager liked the ideas. But they seemed half complete.</b> <b>Rather than saying no, the leaders encouraged Luisa to think through the ideas with more solutions and information.</b> <b>Luisa learned that the questions and the skepticism she received should not be interpreted as a dislike of the ideas,</b> <b>but rather a communication of incompleteness of the ideas.</b> <b>Next time Luisa had an idea, she took some extra time to gather information</b> <b>and think through the questions before presenting to the leadership.</b> <b>The next meeting was more productive and effective.</b> <b>This is a specific example.</b> <b>Your department might have behavioral expectations when it comes to conflict,</b> <b>different ideas, new ideas, challenging situations, and more.</b> <b>One way that you can clarify behavioral expectations is by asking your team to role play certain situations.</b> <b>You can proactively ask how situations have been addressed in the past.</b> <b>You can also be intentional to observe the social norms in your team.</b> <b>There are a lot of opportunities for us to work collaboratively as a team to make a meaningful impact in the lives of our patients.</b> <b>Inconsistent and unclear expectations can dramatically impact your ability to be effective healthcare professionals.</b> <b>So, here is what I want you to do.</b> <b>Take the time to clarify expectations of outcomes, values, and behaviors</b> <b>by story mapping and clarifying the team responsibilities, observing team norms and practices,</b> <b>and asking questions with other team members to better understand your expectations.</b>

    About the Lecture

    The lecture Clarifying Expectations (Nursing) by Amber Vanderburg is from the course Communication in Healthcare (Nursing).

    Included Quiz Questions

    1. Seek a comprehensive understanding of work expectations.
    2. Enroll in a communications course.
    3. Identify their career goals.
    4. Identify and understand the manager’s communication style.
    1. Discuss possible client scenarios with the healthcare team.
    2. Ask management about how team success is measured.
    3. Observe team values and priorities.
    4. Ask team members about behavioral expectations.
    5. Rely solely on the job description.
    1. Clarifying behavioral expectations.
    2. Clarifying how team success is measured.
    3. Clarifying patient mapping.
    4. Clarifying team priorities.
    1. Discussing potential client scenarios with a focus on role responsibilities.
    2. Making policy changes based on data from client surveys.
    3. Assigning clients to nurses based on unique client needs and nurse experience.
    4. Discussing values, priorities, and goals with clients.

    Author of lecture Clarifying Expectations (Nursing)

     Amber Vanderburg

    Amber Vanderburg

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