Systems thinking is congruent with Smart Nursing strategies, and magnet hospital principles. And it is responsible for the many achievements that successful companies enjoy.
Systems thinking promotes trust
good employee communication
solid relationships between staff members cultivation of diverse points of view sharing of power and information
Health care also needs systems thinking if we want to solve our many challenges. Involve your clinical nurses if you want to imple- ment these concepts. Put employee suggestions into effect immedi- ately. If an employee makes a suggestion in a staff meeting, implement it right after the meeting. If that is not feasible, implement it as soon as possible. Your prompt response shows employees that their ideas are valuable. Encouraging employees to think for themselves serves a twofold purpose: You stimulate innovation, and you increase staff satisfaction.
The causes of the nursing crisis began many years ago. The lack of respect has been around a long time, and so has understaffing.
But other factors such as the increased complexity of patient care and changes in the role of women in society added to the problem until a tipping point was reached. Around 1995, the nursing problems finally accumulated to the point that nurses started leaving health care. Because these events were distant in time and space, it took
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quite a few years for managers to understand the whole pattern.
And until they could see the whole picture, they were unable to find effective solutions.
It is time for health care organizations to pay more attention to their workplace environments. Even if you hire the best people, those employees will not be able to give you the desired results without a supportive environment. Make the most of your employ- ees' efforts. They are your most important resource. Create a staff- friendly culture.
PROMOTING A STAFF-FRIENDLY CULTURE Tips for Clinical Nurse s
Maintain a positive attitude Contribute your ideas at work Support your peers
Value your nursing contributions Teach others to treat you with respect
Tips for Managers Be knowledgeable about group dynamics Support cooperation
Put nurse innovations into effect within 24 hours or ASAP Create a positive environment
Recognize that nurses are high-value human resources
Tips for Educator s
Assess your students' potentials and seek to fulfill them Provide an open learning environment
Be knowledgeable about collaboration
Show students how culture affects nursing care Collaborate with clinical nurses and managers
Communication:
A Key Ingredient of Collaboration
The most important thing in communication is to hear what isn't being said.
—Peter Drucke r
Communication is an art. As with any art, different people have different styles. Effective communicators continuously scan their own communication patterns as well as those of others. They ask themselves, Are my communication strategies working? If the answer is no, good communicators modify their strategies to fit a new environment.
A variety of individual communication styles can become one of our greatest assets. This communication patchwork reveals the beauty of individual designs, shades, and textures that produce rich communication nuances.
Communication involves many variables—it's not just what you say, but how you say it. And your communication success can also be determined by what you don't say. Because many communication variables are intangible, everyone can stand to develop more com- munication expertise.
ROLE OF COMMUNICATION O N NURS E RECRUITMENT AND RETENTIO N
Even a small amount of insincerity on the part of management ne- gates many of their tangible offerings, such as premium pay and bonuses.
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Communication 77 How Is Communication Like Romance?
Perhaps one way to view the complexities of communication is by comparing communication to romance—another common life experience that could also be considered an art.
How would you answer the following 10 questions? (Note that 1 have answered some of the following questions for myself.
Your answers may be different.)
L Are there any hard and fast rules for romance? No 2, Does romance depend mostly on relationships? Yes 3, Is every romance different? Yes
4, Does the fact that you sent flowers or candy necessarily ensure a successful romance? No
5, Can a small amount of insincerity undo a large quantity of tangible offerings (candy and flowers)? Yes
6, Should even small amounts of abusive behavior be enough to end the relationship? Yes
7, Is consistency important? Yes
8, Can you improve your romantic skills by learning from your failures as well as your successes? Yes
9, Is romance an art? Yes
10, Is romance worth the effort? You have to decide that one for yourself.
If your employees view you as insincere, it really doesn't matter what else you do. Insincerity leads to a lack of credibility, resulting in your communication efforts being ignored. In other words, sincer- ity and credibility are a necessary foundation for your communica- tion efforts. Without this strong foundation, your communications will crumble even if you follow otherwise good techniques.
All health care professionals need to be effective communicators.
Nurses complain to each other in coffee breaks, but rarely to manag- ers who have the power to respond to those complaints.
Nurses have gained center stage because of the nursing crisis.
Rising to this challenge will require activation of dormant abilities
such as curiosity, but the rewards are great—respect, influence, professional fulfillment.
Managers, who have denied the severity of the nursing shortage in the past, must now pay attention to nursing perspectives. They cannot ignore the nursing crisis anymore because it has interfered with the management of their facilities. Now is the time for clinical nurses and managers to brush up on their communication skills and voice their opinions.
COMMUNICATION SKILLS FOR NURSES
Most nurses are skilled with informal nurse-patient communication, but may need to expand their repertoire of some or all of the follow- ing skills.
Assertiveness
Assertiveness is an important part of effective communication. In the past, managers often disciplined assertive nurses. But now you can use the nursing shortage as leverage to ask for what you need.
Discard negativity, be assertive, and state your needs in a posi- tive way.
Here are some suggestions for becoming more assertive:
Intervene in situations calmly and confidently.
Respond to problems in a timely way to avoid accumulation of negative feelings. Those who are passive for a long time run the risk of overreaction to small incidents.
Clearly articulate the importance of using nursing per- spectives.
Use language that management understands.
"I" statements are important when communicating your thoughts and feelings. But when persuading others to accept your viewpoint,
"you" statements often work better because they describe the bene- fits for the other side.
For example, you could say, "I don't like this policy and I don't think that many other nurses will like it either."
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But it would be better to say, "Using this policy will result in the loss of at least three nurses costing you over $150,000." Or, "This change will increase medical errors, drive patients away, and lower your accreditation score." You will be more likely to be successful.
Small Tal k
Skill with small talk is an important strength. It builds rapport so that your messages become more effective. Shy people often have difficulty engaging in small talk. But it is a learned skill, and you will improve if you are willing to make the effort.
Improve your small talk expertise:
Read books on small talk such as What Do I Say Next? by Susan Roane (1997).
Prepare for small talk by reading magazines and newspapers and choosing a few topics to bring up.
Prepare a few questions that will stimulate other people to talk.
For instance, ask people open-ended questions about common topics such as favorite vacations, books, and hobbies. These questions will give you clues about the other person's inter- ests, enabling you to follow up with more specific questions that will continue the conversation.
Public Speaking
Solid public-speaking skills will empower you and make you more visible in your organization. It is a good antidote to the power- lessness of nurses. It allows you to influence many people at the same time.
Consider the following example of an employee who enjoyed a rapid rise to a high management position:
Amy was a supervisor who recognized the value of becoming an excellent public speaker. She joined Toastmasters where she had the opportunity to practice her public speaking skills. She also gained experience as the master of ceremonies for meetings.
Amy used her skills to develop an effective training program for her employees. Her manager recognized her initiative and praised
her employees' excellence. Amy's manager had planned to emcee a retirement party for a high-level manager, but was called away by a serious family illness. She asked Amy to take her place at the last minute, because she knew that Amy was an experienced public speaker.
Amy had an opportunity to showcase her communication skills in front of most of the senior managers of the company. Shortly after Amy's successful performance as an emcee, she was given the opportunity to expand her management skills by rotating to several key corporate positions. After her positive performance in these positions, Amy received a promotion to an important high-level management position.