Engage in Proactive Conversations (Nursing)

by Amber Vanderburg

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    00:01 Wilma and Betty have been experiencing tension in their working relationship for the past year.

    00:08 Betty joined the team and had consistently made the same mistakes with incomplete or unclear messaging on the communication whiteboard in the patient rooms which led to frustration, miscommunication, and impacted the patient care.

    00:25 Wilma was Betty's co-worker and was very conflict adverse.

    00:32 She would try to help alleviate miscommunication by speaking with the patients to backfill the mis or incomplete communication.

    00:42 Wilma never confronted Betty about the issue.

    00:46 She just shook her head, filled in the information, and went on her way.

    00:51 One day, Wilma noticed that none of the information had been completed in 3 of Betty's patient rooms.

    01:00 This was the last straw for Wilma. She was tired of picking up Betty's slack.

    01:07 Wilma went out to Betty and began to firmly belittle Betty's competence as a nurse.

    01:14 She told her that she was not being a team player with her lack of communication.

    01:20 She didn't meet the expectations of the job and she was causing more problems than solutions on the floor.

    01:28 Betty felt blindsided.

    01:30 She quickly retaliated that Wilma took longer breaks than what was outlined in the handbook and she was always hanging out at the nurse's station.

    01:40 This sparked an even fiercer battle of words among the 2 colleagues.

    01:45 The 2 had been casual work friends, but by the end of the exchange emotions were high, tensions were heated, and the relationship was severed.

    01:57 Think of how much better this conversation would have gone if the 2 were proactive in their conversations.

    02:06 This brings up an important factor of team collaboration I want you to consider for your team.

    02:13 Develop a game plan to address disagreements.

    02:18 In this lesson, I'll explain how to approach tension in your team and help guide through healthy conflict resolution.

    02:27 First, outline when and how to speak up about frustrations.

    02:33 Wilma liked Betty and did not want to confront her, but liking a team member isn't enough to avoid frustration.

    02:43 Have a proactive conversation before tensions rise.

    02:49 Some people do not want to admit that a challenge or frustration exists.

    02:55 Other times, people know that there is a problem, but do not know how to address the challenging situation.

    03:03 Ask the question proactively in a working relationship.

    03:07 At some point in our working relationship, there will probably be conflict.

    03:13 How should we handle that situation whenever it arises? Be specific in these conversations.

    03:21 Generic responses will not be specific enough to make a meaningful impact.

    03:27 I was working with one team that had known personality differences.

    03:32 Some were very direct in communication. Others were indirect.

    03:37 Some were very detailed, others were not. Some were very expressive, others were more reserved.

    03:46 These differences could impact the quality of patient care and team harmony among the department.

    03:53 The team took the time to address specific opportunities for conflict and complement within the different personality preferences.

    04:03 The not-so-detailed individuals encouraged the detailed people to speak up and vice versa.

    04:11 They ask specifically how they could help and created a conversation outline for how to address more detailed challenges.

    04:22 I was working with another team that had a habit of circular conversation.

    04:27 They would talk a lot about different ideas and changes, but never truly made a decision.

    04:35 They decided to time box their conversations which meant time to define the problem, time to discuss solutions, time for final remarks, and then ELMO which stood for "Enough, let's move on, time to make a decision." As you can see, these proactive conversations are much more than "if there is a problem, bring it up" type of chat.

    05:00 It is actually a catered intentional conversation to proactively identify possible areas of frustration and create an effective game plan to address these challenges.

    05:13 Sometimes, teams are weary to identify obstacles or potential challenges.

    05:21 However, this is a time to make adjustments now so that you can move more quickly and effectively with less frustration in the future.

    05:33 Like a track athlete running hurdles, identifying the hurdle allows the athlete to make the adjustment that they need to successfully overcome the hurdle and continue the race.

    05:47 Ignoring the hurdle does not make it go away. Tensions happen in teams.

    05:54 Be proactive in having a somewhat uncomfortable conversation now to avoid a very uncomfortable conversation later.

    06:07 Next, recognize the difference between intention and action.

    06:12 There were times when Wilma was incomplete in her communication on the communication whiteboard.

    06:19 There were times that Betty overstayed her allotted breaktime.

    06:24 The 2 were not immune for mistakes and mishaps, neither ask about intention.

    06:31 They only looked at outcomes.

    06:35 Remember the fundamental attribution error, which states that we too often judge other people by their actions and ourselves by our intentions.

    06:46 When you confront performance expectations, I encourage you to establish a norm of assuming positive intent in your team.

    06:58 Remember, understand the context, ask for intention, and offer support.

    07:06 Now, in our proactive conversations, let's switch roles as we keep the fundamental attribution error in mind.

    07:15 I want you to recognize that you are agreeing to respond to a conversation in which someone may address your unmet performance expectations in a healthy manner.

    07:30 This can be challenging.

    07:33 Sometimes a team member may bring up one of my mistakes and I want to get mad, defensive, act irrationally.

    07:42 And then I remember our proactive conversation.

    07:45 In the conversation, I agreed to assume positive intent and behave in a certain manner.

    07:53 I agreed to assume that the person is trying to help me be better.

    07:59 Now, let's say that the person is actually genuinely not intending to be positive.

    08:07 In this situation, I encourage you to address the challenging situation with the individual one on one first.

    08:16 Ask for understanding and try to reach a solution.

    08:20 If a solution is not reached, you can utilize your charge nurse or manager for help in navigating the situation.

    08:29 If the challenging situation is with your charge nurse or manager, I encourage you to look to human resources for assistance in navigating this challenging situation.

    08:42 Hopefully you do not find yourself in this situation.

    08:46 But if you do, understand that you are not alone.

    08:51 There are other people in the organization that are there to help champion your success.

    08:58 Lastly, create a framework of conversation to address disagreements in a healthy manner.

    09:07 How will you approach disagreements? What action steps will you take? Create an environment of understanding and communication with your team members so that team members will be equipped to confront challenging conversations in a healthy manner.

    09:27 When team members are collaborating, they are oftentimes challenging norms and raising standards.

    09:35 This rarely comes without growing pains and some change adjustments.

    09:41 Keep in mind the overall goal, everyone on your team is there to provide excellent patient care.

    09:49 Keep the common goal in mind. While differences of opinions, personalities, approaches, and experience may make up the diversity of the team, keep sight of the common goal.

    10:03 Setbacks, failures, and mistakes often accompany a collaborative dynamic but this does not mean the team is doomed to frustration.

    10:16 By creating a game plan with your team on how you will address frustrations, you will greatly increase your collaboration and work environment harmony.

    10:30 So, here's what I want you to do.

    10:33 I want you to identify 2-3 opportunities for complement or conflict within your team.

    10:43 Then I want you to have a catered proactive conversation with your team members to create a game plan for a better working environment.

    About the Lecture

    The lecture Engage in Proactive Conversations (Nursing) by Amber Vanderburg is from the course Communication in Healthcare (Nursing).

    Included Quiz Questions

    1. Outlining when and how to speak up about frustrations.
    2. Implementing daily team-building activities.
    3. Describing how to report complaints effectively.
    4. Detailing examples of different types of conflicts.
    1. Assuming positive intent.
    2. Selecting consequences based on individual involvement.
    3. Reviewing baseline performance expectations.
    4. Involving the team member’s peers.
    1. Talk to their coworker one-on-one.
    2. Mention the situation to the charge nurse.
    3. Discuss the incident with the manager.
    4. Send out an email to the whole unit on role responsibilities.
    1. Human resources
    2. Another nurse who works under the same manager
    3. Occupational health and safety
    4. The department head

    Author of lecture Engage in Proactive Conversations (Nursing)

     Amber Vanderburg

    Amber Vanderburg

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