How To Stay Positive When It Has All Gone Crazy

You walk in the door and make your way to the time clock. This typically mundane task usually takes all of 2 minutes. Today that pit inside your stomach has now consumed your liver and kidneys. You are bombarded with staff issues, dinging call bells, and yelling patients. Oh, it’s going to be one of those days huh! After finally making it to the time clock (15 minutes late) you make your way to report where someone looks at their watch, looks at you, looks at their watch, looks at you, looks at… you get the point. This positive day has since gone crazy!

Walking into a chaotic work environment is akin to waking up to the neighbor mowing their lawn at 5 am, it’s bound to set you on a negative path and put you in a terrible mood for the remainder of your day. When this happens, it’s not just your mood that suffers, your patients suffer, and your staff suffers. You’re apt to overlook important tasks and rush through assessments.

So how do you turn it around?
How do you recover a positive attitude?

I think it’s important to note that people are, well, people. We have emotions that color our days. But, I have known nurses who, once set on this path of negativity just can’t recover. It’s important to be able to bounce back and put aside the chaos to provide the best care possible for our patients and be the best nurse leader in our industry.

I worked with a nurse, for a short period of time, but something really amazed me. She was so positive, kind, caring, and competent. I didn’t know until much later that she was in the middle of an ugly divorce and just lost someone close to her. All the while going through financial troubles and dealing with the craziness of the job.

I thought about how profound that was. In an age where the world revolves around “self,” this nurse put her “self” aside and focused on the patients. I never did connect again, but I can only imagine how far she went in her life and in her career.

Now personally, I am more like a sponge. I am kind of person who sits next to someone who is crying and begins tearing up. If someone is yelling at me, I emotionally drop to their level. I recognized this about myself years ago.

I had a particularly grouchy boss. I mean every day she was in a bad mood. I would walk in the door happy hopeful and reach my desk miserable and dreadful. It was crazy how I reacted to her negativity. So, I began working on this in myself to become a stronger leader. I decided I wanted to influence others emotions in a positive way rather than let their emotions influence me.

Automatic Negative Thoughts

Positive, Ant

Copyright: bill2499 / 123RF Stock Photo

I remember driving to work, as I got closer my mood would get worse, anticipating the negativity. I realized as this mood peaked I would get negative thoughts running through my head almost on their own volition which would, in turn, sour my mood even further.

These negative thoughts that pop into our heads are called Automatic Negative Thoughts. I love how Dr. Daniel G. Amen, MD in ANT Therapy explains these “ANTs.”

“If you could look into the thoughts of people who are depressed, you would find one dispiriting thought following another. When they look at the past, there is regret. When they look at the future, there is anxiety and pessimism. In the present moment, something is most often unsatisfactory. The lens through which they see themselves, others, and the world has a dim grayness to it. They are suffering from Automatic Negative Thoughts or ANTs. ANTs are cynical, gloomy, and complaining thoughts that just seem to keep coming all by themselves.”

Dr. Daniel Amen goes on to speak about, how powerful thoughts are, and their impact on our physical state. He theorized that we can learn how to control these negative thoughts by correcting them as they happen.

Challenge your thinking

Positive vs Negative Thinking
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Next time an ANT crawls into your head. Challenge it. By challenging these thoughts we can change them and control them. When you are lost in that self-deprecated cinematic visualization of yourself bombing your interview and walking out in slow motion with people laughing at you as you pass. Stop the film. Rewind it. Now change it.

Visualize yourself landing that job and walking out with your head held high. It takes the time to master this task, but persistence is the key. I will also note how It feels awkward at first. Which is weird right? Why would it feel awkward to visualize yourself doing great things? I don’t know. But trust me it does. Soon, however, you will get the hang of it and begin to shape your mind and react by thinking positive.

Be Aware of your own mind

Brendon Burchard, a New York Times Bestselling Author, speaks in is video “How to Reprogram your mind (for positive thinking)” about becoming more self-aware of your thoughts. Brendon gives the example of any time you’re in line, for any reason, analyze your thoughts. Take time to think about what you are thinking about and ask yourself if that thought is positive and is going to help or negative only causing you stress and anxiety.

Focus on the now

Postive Thinking Now vs Later
Copyright: 3m3 / 123RF Stock Photo

“My life has been filled with terrible misfortune; most of which never happened.” Michel de Montaigne.

Many times, as things begin to go downhill, it’s not so much about what is happening now that has us all worked up. It’s the thought of what’s next.

The Huffington post in 2015 wrote an article entitled “85 Percent of What We Worry About Never Happens”.

“The stress hormones that worry dumps into your brain have been linked to shrinking brain masslowering your IQ, being prone to heart disease, cancer, and premature aging, predicting martial problems, family dysfunction and clinical depression, and making seniors more likely to develop dementia and Alzheimer’s.”

Press the Clear Button

Positive Thinking Clear Button
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In the article above Don Joseph Goewey gives an excellent way to clear ourselves and stop the worrying in their tracks mentally.

She explains that our worry center can be interrupted with a simple technique.

“You imagine a button at the center of your palm. You press it and count to three, thinking of each number as a color.

  • Breathe in, count 1, think red.
  • Breathe in, count 2, think blue.
  • Breathe in, count 3, think green.
  • On the exhale, completely let go of thinking anything for a moment.”

Don’t be a victim

Super Hero Positive Girl
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It’s easy to get trapped in a victim mindset. “This damn car always breaks down just when I need it!” “Why does this stuff always happen just to me?”, “Nobody else’s Job/Boss/Staff/Patients (you fill in the blank) are as bad as mine.” Well, I hate to break it to you, but no matter how bad you have it someone has it much worse. You think your day is bad, how about the patient you are caring for that just lost her son in the same car accident that has left her fighting for her life. Take a minute to feel sorry for yourself, soak it in, now push it away. Everyone has struggled, you are not alone or unique here. Don’t let that feeling over power and control you.

As a leader attitude is everything. You set the tone for your work environment. You have the power to influence everyone else’s attitude. By learning to control your thinking and using techniques to shut down worry, you can turn a bad day around and find a strength you didn’t know you had.

Let me know if you liked this article by commenting below!

Onboarding Guide for Nurse Leaders 5 steps to Success

When hiring, you are investing in a person. You spend time, money, and resources. In fact, according to Forbes.com, US companies spent an average of 72 billion dollars or $3,300 per hire. That’s a lot of money! Now factor in that many new hires don’t work out and you can see how hiring and retaining is one of, if not the, biggest factors of success. To build a strong house, you must have a stronger foundation. This all starts with the onboarding process.

 “Replacing talent runs as high as two times annual salary,” said Peterson. “And it’s not just about dollars. Culture and job satisfaction is hugely impacted, as well as morale, productivity, lost insider knowledge. It’s painful to lose people.” Ben Paterson CEO of BambooHR

5 Steps to Onboard Star Players

Before You Hire

Nurse Resume On-Boarding
http://depositphotos.com/portfolio-1158045.html

Onboarding starts before you even hire the employee. It begins with the first contact with a potential candidate. Gone are the days of interviewing someone like an FBI interrogator where only the strongest survive. Instead, interviewing is about getting to know a person, their strengths, and weaknesses and deciding if they have the qualifications and personality for your company. Also carefully screening candidates and reading their resume before you even call them to come in respects their time and yours.

Set the tone

Nurse Interview, On-boarding
Copyright: petro / 123RF Stock Photo

I remember showing up to an interview right out of nursing school. I walked into the building where someone was sitting at a desk nearby, I walked over and stood patiently waiting for the person to look up as they were typing away on the keyboard. They just started to look up when the phone rang. I remember thinking ok they’re a little busy just be patient. Then as I was staring at the clock watching the time I was scheduled to interview slip away, she hung up the phone, and an employee walked by. She then proceeded to turn for a nice little chat with this employee who had a date this weekend with a girl he met last night at a club.

I had been standing there for some time and at this point was getting irritated thinking if this is any indication of how they treat their employees it’s not for me. I politely interrupted, “I am so sorry I just want to make sure I am in the right place, I am here to interview with _____.”

Now just to clarify, I did eventually get the job, but it did not work out. The too busy to acknowledge or work with people mentality was a theme throughout this company, and I ended up looking for employment elsewhere.

Compare this to a company I interviewed at where I walked in the door and was greeted with a smile and offered a cup a coffee while I waited for the manager to come get me. One left me questioning if this was right, even after getting the job. The other left me hoping they chose me so I could be a part of this dynamic team.

“About one-third of the new hires who had quit said they’d had barely any onboarding or none at all, and 15 percent of respondents noted that lack of an effective onboarding process contributed to their decision to quit.” Said Roy Mayor in his article Onboarding Key to Retaining, Engaging Talent

Keeping the tone

Nurse On-boarding, Training,
Kzenon

Setting the tone in the onboarding process begins with the interview, however, maintaining the tone is crucial.

“In today’s working world, employees want – and expect – more than just a brief introduction to the company they just joined, a few training sessions and a pay check. They want a personalized, interactive experience and a comprehensive understanding of the organization and how it can help grow them professionally. And, it does not take long for them to decide if they made the right choice.” First Impressions Count: Creating a Positive Onboarding Experience.

After a significant employee turnover rate within a 30-day period of time, I decided to do an exit interview with a candidate who left the company after only 2 weeks of employment. I was impressed with this candidate from day one and trying to find out why they left so soon. The candidate painted a pretty ugly picture for me. The interview was great, and they had been so excited to start. However, day one came, and no one remembered they were scheduled to start, they ended up walking around for almost 2 hours trying to find someone who would let them know what they were supposed to be doing. Ok mistakes happen they thought let’s give it an another chance. Day 2 they showed up and went to meet the person who was supposed to mentor them and found that person to be out sick. “Everyone looked at me like I had a disease, no one wanted to train me,” he said to me. This story went on and on, in fact, in the end, I questioned why he hadn’t left sooner.

Having a plan with contingencies is critical. It’s important to have the candidate feel like they are in the middle of a well thought out proven process designed solely for their success. These employees call off less and are much more stable because they see stability in the onboarding process.

Too much too soon

Overwhelmed on-boarding nurse
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One of the biggest mistakes I see companies make in any industry is pushing new hires through the onboarding process too early. With staff shortages, and call offs, it’s tempting to grab the new hire and throw them on the floor to fill the spot. Not only is this dangerous in the medical field but it’s setting them up for failure. It is important to assess where they are and mold the process around them. Companies with a strict time limit for onboarding are not capturing the needs of their employees. Some of the greatest employees I have worked with took extra time in the onboarding process because they just weren’t ready to do it alone yet.

Create an Onboarding Experience

Nurse on-boarding eating alone
http://depositphotos.com/portfolio-1258191.html

I remember my first day of high school. I didn’t know anyone. I walked onto campus with a map, books, and class list. Did I mention I didn’t know anyone? But you know what the one thing I dreaded from the time I woke up that fateful morning was? Lunch. You see, you can’t be too ambitious and sit with the popular kids but don’t want to jump into any group to early and get branded. At least until you get to know people. So instead you sit by yourself and hope no one notices you until you get the lay of the land.

What I didn’t know is that this dread followed me up through my career. Now I have grown much confident than the slightly nerdy kid I was back then. But it is always an uncomfortable social situation for me.

I then had an employer take control of this time. He took me to the cafeteria, showed me how to order, where to sit, and even sat with me during lunch. What an impression! I remember feeling very welcomed and relieved and built a great relationship from that day forward.

“It’s important for new hires to create meaningful connections with colleagues, management, and direct reports. Personally introduce new hires to the team during the first week (depending on the size of the team, you may want to spread this out over a few days). A team lunch is a great way for everyone to get to know each other on a personal and professional level.” The Staffing Stream.

Conclusion

Onboarding sets the pace for the rest of an employee’s career. Messing this up not only costs you time and money but potentially losing excellent candidates as well. One theory I have is that an excellent candidate is much less likely to stay in spite of a poor onboarding experience than a weak candidate. Those candidates that remain are often the ones who want to come to work scrape by and leave. While the people with higher standards move on to companies that meet their expectations.

To sum it up treat your candidates as people. Tailor your onboarding process to the individual and set the tone from day one.

“Clients do not come first. Employees come first. If you take care of your employees, they will take care of the clients.” Richard Branson

 


Nurse Interview – 46 years of servant leadership

I recently had the opportunity to interview an incredible nurse leader Kathleen Brender. In her latest role, she was in a dual leadership role as an Executive Director and Health and Wellness Coordinator for a memory care community. I had the privilege to work with Kathy and see her passion for caring for residents with some of toughest cases of dementia. Kathy trained her team to work with Frontal Temporal Lobe Dementia and the most challenging of behaviors. Her community ran 100%, and she was known as the one to go to when no one else could care for their loved one.

Kathleen has been a nurse for over forty-six years. In this time, she has done everything from surgical nursing, geriatrics, to management, in fact in speaking with her there are few areas she has not touched on at some point or another. Kathy decided on becoming a nurse at the age of 10. Her father was in a very a severe car accident resulting in massive head injury and ended up in a coma for months. When he eventually came out of the coma, the hospital staff did everything to relate to him and illicit a positive response. It wasn’t until they showed him a picture of Kathy that he lit up and responded. Kathy was taken to the hospital every morning after that and spent the day working with him one on one. From that day forward she knew exactly what she wanted to do with her life.

I am so excited Kathy agreed to allow me to interview her and learn from her lifetime of dedication to the nursing field.

Interview

Derek Di Camillo: Thank you, Kathy, for doing this interview with me. There is so much we can learn from you and I appreciate your time.

Derek Di Camillo: Was there anything you specifically did with the sole purpose of growing your career?

Kathleen Brender: I sought out the best in the industry and positioned myself to learn from them.

Derek Di Camillo: You had worked in so many fields when did you decide to move into nurse management?

Kathleen Brender: I was 24 when I took my first leadership role.

Derek Di Camillo: In a world where skilled is king what made you decide to move into management and leadership?

Kathleen Brender: I didn’t like what I saw in management. I thought maybe I could make a difference and change things. My heart was with the geriatric population.

Derek Di Camillo: What influenced your leadership style at such a young age?

Kathleen Brender: I watched what others did and learned what made them successful. I was always learning and seeking out the best education I could for myself.

Derek Di Camillo: At 24 I am sure you made some mistakes. What mistakes did you make that changed the way you lead?

Kathleen Brender: I was always very trusting, and unfortunately I put trust in someone I shouldn’t have. I learned the hard way that you can’t always do that.

Derek Di Camillo: I think in many cases it is the little things that add up, forming the foundation of leadership success. What do you feel contributed to your success as a nurse leader?

Kathleen Brender: I learned early on you have to learn to work with others. I also never asked anyone to do anything I wasn’t willing to do myself. Also, I focused my time and energy on doing a thorough interview and finding the right professionals to work with and learn from and listened to them. I learned to think before I responded and not react in anger.

Derek Di Camillo: How did you find the right professionals?

Kathleen Brender: I found people willing to work hard and learn. I showed them how important they are and showed them I was always there for them. I also found, if you show them support and make them feel valued they will always be at their best for you.

Derek Di Camillo: Is there anything you would do differently in your career?

Kathleen Brender: No, every failure was a learning experience, I learned from them and never made the same mistake twice. I have no regrets.

Derek Di Camillo: Often I see new nurse new leaders struggle with work-life balance. What advice would you give them?

Kathleen Brender: That is a tough one. You have to take care of yourself before you can help others. I found that you have to give a lot of yourself to your career, your staff, and your patients. Finding the balance can be tough. I think it comes down to the individual and is something different for each person.

Derek Di Camillo: What is one of the biggest challenges you faced in your career?

Kathleen Brender: Working for corporations. They come in and talk the talk but don’t always walk the walk. Often it feels like they are all about control. I think they often need to learn that If you take care of what is under your roof everything else will fall into place.

Derek Di Camillo: What was the most rewarding moment of your career?

Kathleen Brender: I have lots of these! I guess the best is seeing the smile on the staff and families face when they see, working together, we can make a difference in someone’s life. Also, with the love and kindness of an incredible team, providing a quality of life for whatever time the resident has left.

Derek DiCamillo: Are there any tools or recourses you found helpful?

Kathleen Brender: One of the best things I ever did was take my team through a reality training. They learned how it felt to be one of the residents. I found this training made all the difference in the world in the way they cared for the residents.

Derek Di Camillo: Thank you. Is there anything you would like to share with the readers?

Kathleen Brender: Be true to yourself, never compromise on your beliefs, support those you work with, always have an open mind, listen, and never stop learning, and you will succeed.

A special thank you to Kathy for not only taking the time to do this interview with me but, more importantly, devoting her life to the nursing industry and taking care of our aging population. You are appreciated for your contributions and passionate care you provided.

 

Technology The 7 Characteristics of a Nurse Leader Part 7

When hiring nurses for leadership positions one of the most overlooked criteria is how well a nurse uses technology. The industry is changing, and old school paper and pen nurses are going to be left in the dust if they do not learn some necessary technological skills to compete in the job market of today. It is no longer enough to know how to draw blood, take blood pressures and document in the chart. We now must know how to use electronic charting, patient monitoring systems, sophisticated call systems and more.

In 2015 over 4 in 5 of all non-federal acute care hospitals had adopted a Basic EHR with clinician notes, whereas, 80 percent of small hospitals with less than 100 beds, rural hospitals, and critical access hospitals had adopted a Basic EHR with clinician notes. Nearly all non-federal acute care hospitals have possession of an EHR certified by HHS.

Health IT Dashboard

I remember hiring a nurse with years of experience. She knew her stuff. However, when it came to technology she carried a flip phone, didn’t know how to text, and barely knew how to call someone on it. She never liked technology and never cared to learn.

This lack of technological fortitude first became an issue when she was given a company phone with email on it. She did not know how to work the phone in the slightest. I would end up calling, texting, and emailing to reach her and find out days later the phone was going off but she could not figure out how to unlock it! It was frustrating to the core. Over the course of her time with us, this regularly held her back. She missed emails consistently and rarely respond, even her assessments which were great on paper, were barely existent in the system.

While myriad forces are changing the face of contemporary healthcare, one could argue that nothing will change the way nursing is practiced more than current advances in technology. Indeed, technology is changing the world at warp speed and nowhere is this more evident than in healthcare settings.

From Nursing World

Now I will admit she is on the extreme side of the spectrum. Most nurses are not that technologically challenged. However, many lean towards technological ignorance.

Nursing Technology can be broken down into two categories. One being that of patient support technology. This group consists of monitoring tools and the ever increasing tools used to gather assessment data and documentation. The other category is that of necessary workplace technology. That copier you want to take outside and go office space on falls into this category.

Office Space Technology Nursing
http://gph.is/2dtrtpL

Nurse leadership requires a certain proficiency of both. While patient support technology typically comes with orientation and training, often it is left to us to learn the other.

Top 3 Programs to master to be an efficient nurse leader

  1. Outlook
Microsoft Office, Technology, Nursing, Outlook
Copyright: dennizn / 123RF Stock Photo

Outlook is the most used email platform in the world. While sending, an email is simple there is so much more to learn from this tool. A weird thing is an instrument that is so powerful we spend no time training people on how to use it.

It clicked for me one day when I was in my office and had just gotten yelled at by a patient by epic proportions.  I was supposed to see her that day and forgot. I thought there must be a better way to organize myself. So, I did what everyone does this day of age; I Youtubed it. This led me to hours of Outlook calendar videos on sending invites, organizing sorting, and setting up recurring appointments. To this day, I use my calendar extensively. It has even turned into my to do list!

  1. PowerPoint
Microsoft Office Powerpoint technology nursing
Copyright: vadymvdrobot / 123RF Stock Photo

By learning to create engaging power point presentations you can engage your staff, pitch your ideas, and grow your ability to educate and lead your employees. One piece I of advice I give people here is, though power point is simple to use there is a wrong way to do it. A bad power point presentation can just as quickly lose your audience as bad content. I have seen great ideas and thoughts poorly executed in presentations. So do you research on what makes an excellent power point presentation.

Check out
Damon Nofar’s power point slide on slide share for an excellent visualization of 8 Tips for an Awesome Powerpoint Presentation

  1. Excel
Microsoft Office Excel Art Technology Nursing
IMAGE: FLICKR, AMIT-AGARWAL

Trust me to excel doesn’t excite most people. It is a bunch of boxes with numbers or letters on them. However, the impact of this tool is enormous. While Outlook is my most used program, Excel is easily my second. Learning the basic functionality and formatting in Excel is easy, and will save you hours of time.

I was working with another nurse on an analytics project, and we were working on an excel file. There was one difference, I could apply a few filters and highlight a few areas and find the information I needed quickly and easily. I found out the nurse I was working with was hours in and still trying to locate the information she needed. I showed her how to get the information with a few tools, and her look she gave me was appreciation and maybe a little resentment.

These may seem like basic systems, but they are important. When going through resume’s one of the areas I look for is basic knowledge of how to use Microsoft Office. Not only does this tell me that they are efficient in work and communication but also that they can learn EMAR systems and have a foundation of knowledge to build on.

Find the Previous Articles, part 1 -6 at The Nurses Lounge

If you found this article enjoyable and informative, please consider liking and sharing.

Also, please comment below with any additional ideas or thoughts on healthcare’s future in technology.

 

 

 

The 7 Characteristics of a Nurse Leader Part 6 – Sales

 

Now before you hit the back button or click on that x that is calling your name in the corner of the page, hear me out. Learning sales skills can be one of the best investments in time and energy you can spend. In the last post, we discussed communication and the need to communicate effectively in our day to day roles as a nurse. Taking that next step is where selling comes into play.

Many nurses cringe at the idea of sales and nursing. Many others think it only applies to sales reps of the big evil pharmaceutical companies. After all, we went into nursing to help people, not sell them something, right? I am going to propose that learning to sell will not only lead to better career growth in any nursing profession but also better patient outcomes and satisfaction.

As a new grad, I can remember doing wound care on a patient. This was the third time the patient had been in, and the wound just wasn’t healing the way we were hoping. The patient was given all education in the world, but for some reason, it just didn’t stick. The patient didn’t understand or maybe care why it was so important to follow through in between visits. I spoke to the patient a few times and remember saying something like, “I really think it’s important that you do this” or “you have to do this when you are home, or it won’t get better” I even printed off some educational material and presented it including a nasty looking wound and trying to scare her into follow through. Nothing worked, the patient just didn’t care.

Then I got the opportunity to do a ride along with another nurse. She sat down with the patient and at first didn’t even ask about the wound. Instead, she commented on the house, the pictures, the memorabilia, and eventually the patient lit up! She went on and on about her son and how he is getting married and about his new wife. The nurse talked to her about this at length. She took to time to connect when the timing was right put a game plan in place for her to be able to attend her son’s wedding. In this game plan, you guessed it, the patient’s commitment to follow through on her wound care.

The patient did fantastic after that. You see the nurse didn’t just educate her on why it’s important to follow the doctors’ orders or why she should care; she sold her on the idea of following through with her treatment. In effect, she connected and built trust then gave her the desire to follow through.

“Every Sale has five basic obstacles: no need, no money, no hurry, no desire, no trust.” – Zig Ziglar

I remember how impactful this was on me at the time. I considered myself an empathic person and someone able to connect with others. But after speaking with the nurse, she showed me that sometimes you must put your sales hat on but instead of selling perfume or meds or devices your selling desire and inspiration.

“to many people, the word selling implies manipulating, pressuring, cajoling–all the used-car-salesman stereotypes.But if you think of selling as explaining the logic and benefits of a decision, then everyone–business owner or not–needs sales skills: to convince others that an idea makes sense, to show bosses or investors how a project or business will generate a return, to help employees understand the benefits of a new process, etc.” – Jeff Haden Inc.com in his article Without This Skill, You Won’t Succeed

Starting out as a new grad nurse is tough. You have this 1-page document to summarize your life and convince someone to hire you. However, it doesn’t stop there. In your career, you will always be selling. Selling your skills, your techniques, opinions, and ideas.

Now some of you might be saying to yourself right now “but won’t my skills and work ethic speak for themselves?”. I know many nurses who are fantastic in their job who have been in the same job for 15 years without growth. Now don’t get me wrong a portion of them really don’t want to go anywhere or do anything else. But, for others, they just never learned to sell themselves and get that promotion they have always wanted.

“Everyone lives by selling something” – Robert Louis Stevenson

Nursing Sales 101

Zig Ziglar is world renowned as the master of sales. A great resource is his Selling 101: What Every Successful Sales Professional Needs to Know. This book by design is messaging those full-time salespersons making a career of it. But there is some fantastic information. Mr. Ziglar talks about selling by design not by chance. How can we adapt these to the nursing profession?

4 Steps in Selling Patient Care

Step 1 What’s the need?
Sales identify the need
Copyright: ivaleksa / 123RF Stock Photo

This first step in the sales process is identifying what the need is or in Nursing terms the assessment phase. In the example above we determined that the patient wasn’t following through with the provider orders. We can diagnose this as Ineffective Health Maintenance. By digging in, we discovered that the patient didn’t feel she needed to comply with the doctor’s orders. However, we found out she had a need and better yet a desire to go to her sons’ wedding.

Step 2 Help patient to see the need!
Sales helping customer realize there need
Copyright: bonninstudio / 123RF Stock Photo

The next step after identifying a need is communicating it in a way to help the patient clarify the need to themselves. “It sounds like going to your son’s wedding is really important to you!”. (In nursing terms this is active listening.)

Step 3
Sales solutions
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In Step three you provide a solution to the patients need. Again, going back to the above example “I know how important going to your son’s wedding is. It sounds like we have time if we really focus on getting this wound healed.”

Step 4
Closing the Sales
Copyright: iqoncept / 123RF Stock Photo

The last step is the commitment. “Here is a calendar I made for you. Why don’t you cross off each day that you complete your wound care? How does this work for you?”

As a nurse, my hope is that you will see the importance of sales in the nursing profession. By learning basic techniques, we can get the job we want, get the patient assignments we deserve and become advocates for the patient and nursing profession. We can not only a caring and empathetic voice but an influential voice as well.

 

 

 

The 7 Characteristics of a Nurse Leader Part 5 – Communication

Communication

We are 5 posts in on our path to identifying what makes great clinical leaders. This post we will discuss the role of communication. A clinical manager must also be an excellent communicator in both written, verbal, and non-verbal communication.  We will build on our previous posts and utilize these characteristics to enhance our communication skills. This single skill can contribute to greater job satisfaction, as well as personal growth.

Kathleen A. Vertino wrote in her article in The Online Journal of Issues in Nursing.

 “Although much has been written on workplace safety, lateral violence, and bullying to address issues that we face as professionals in the workplace, little has addressed how effective interpersonal communication can contribute to a healthy lifestyle in both the personal and professional life of the individual nurse.”

I think this is profoundly true! Learning to effectively communicate (and yes this is a learned skill) will have not only a huge impact on your professional life and job growth but also your personal relationships.  We learned some of this in nursing school when we took our interpersonal communications classes or through our acronyms such as SBAR. However, we should never stop learning and practice this skill.

The New England Journal of Medicine conducted an experiment published in 2014 to determine the effectiveness of communication during a change of shift. Titled Changes in Medical Errors after Implementation of a Handoff Program this study evaluated medical errors and the effects of a good handoff. It consisted of both written and verbal components of handoff and resulted in a 23% reduction in medical errors and a 30% reduction of preventable adverse events.

Effective communication is crucial for any organization, but at a health care facility, a communication breakdown can literally cost someone his life. – Chron.com

As a nurse leader, you are not just responsible for giving a report but also communicating with staff. I remember a great nurse I worked with. This was the type of nurse you could give any assignment, and you left for the day confident it would be completed. However, I also spent more time mediating arguments with this nurse than any other. He had excellent communication skills with myself, the patients, and the families, however, when it came to co-workers or care staff he was always rubbing people the wrong way. I got complaint after complaint about him being rude or unprofessional in his communication.

I decided to spend some time observing his interactions and found though I truly do not think it was intentional, people were right. He was abrupt and cut people off because he didn’t have time to listen and spoke over people. What he lacked was humility in his communication.

Below we will discuss ways to increase communication skills and improve our ability to be great nurse leaders.

3 Steps to improving your communication skills

  1. Listening and humility

    Listening and humility

There are numerous types of listening. For example:

Combative Listening is when we listen for our turn to talk usually to push our agenda or objective. We care little about what the other person is saying and more about what we must say.

Passive listening is where we genuinely care about what the other person say’s with no goal or objective in the conversation.

Active Listening is where we find the most benefit as a nurse. The key to active listening is being humble by putting aside what you must say for a minute and listen to others. Probably the most given advice for men entering the dating scene is to learn to listen. Stop listening for your cue to talk and listen to what the other person says. This applies well to leadership. In any conversation, by using active listening skills, we can better understand the concerns of the other party and address their needs. In the example above the nurse was missing this ability. He was using combative listening and not taking the time to be an active listener. Learning this skill will not only get to better patient satisfaction but also improve personal relationships.

  1. Adapt

    Adapt

I often think of communication as more of an art than a science, needing constant adjustments and tweaks in our overall skill and often within individual conversations. Learning to read your audience and adjust your communication will have significant impacts on your skills. For example, while communicating a patient status to an MD, we will use SBAR. This is a very technical and straight forward communication. However, if we tried to apply SBAR to all our communications without adapting it would come across as lack of empathy and go over many patient and family’s heads.

A trick I find to communicate with patients and families clearly is to write out an SBAR but replace all technical terms with layman’s terms and put more emphasis on active listening and pulling from my SBAR tool rather than just regurgitating information. I often start out with questions and find what is the biggest question or concern, then pull information to clarify and answer.

  1. Systems

    Systems

In the experiment above we saw the impact of how a system of delivering handoff can significantly decrease errors. Communication is always happening if we want it to or not.

Communication can be largely affected (93%) by body language and tone of voice, leaving only 7% of the intent based on actual words. – HCPR

By putting systems in place and communicating on purpose, we can set the stage for a positive interaction. As a new nurse leader, I found myself confronted by questions and interactions often. In fact, I spent a majority of my time answering family and patient questions and concerns. Now we had a system in place for care conferences where we would spend time with each family and discuss care plans, but this was not done consistently and often not at all. By implementing this process and taking the time to set the stage for this meeting, I found people were more likely to wait for this formal meeting with questions and often we were able to answer questions more thoroughly and to their satisfaction.

As a nurse leader, this is compounded by adding staff to the mix. However, the same principle applies. Often I will put into my calendar key conversations I need to have. That way I can plan them out ahead of time and give my undivided attention.

Now I often go overboard here, but anyone who knows me knows I love systems. I have a system in place to communicate emergencies, call off’s, changes in patient condition, pharmacy concerns, etc. You name it, and there is a formal system in place to communicate it. I found this is the best way to ensure consistency and understanding on all parties.

Learn to communicate on purpose, if you don’t then you don’t know what your communicating.

The 7 Characteristics of a Nurse Leader Part 3 – Resourcefulness

The 7 Characteristics of a Clinical Leader Part 3 – Resourcefulness

In Part 2 of our series, we looked at the essence of confidence. We discussed the inter-relationship of confidence and humility and learned that you could only grow confident through humility. Lastly, we discussed steps to boost confidence and develop as clinical leaders. Today, I wanted to talk about the resourcefulness of a clinical leader.

If you have not read the previous installments in this series, please take the time to go back and read those before moving forward.

You can find them here:

The 7 Characteristics of a Clinical Leader Part 1 – Humility

The 7 Characteristics of a Clinical Leader Part 2 – Confidence

Resourcefulness

 “able to deal skillfully and promptly with new situations, difficulties, etc.”                    http://www.dictionary.com/browse/resourceful?s=t

Being interviewed for a role, the interviewer asked me what trait stands out. I replied, “I am resourceful. I am not the most knowledgeable (still true today) or the most experienced (again, still true today) but I am an expert at finding solutions, seeking answers, and making things happen”.

In a recent article in Entrepreneur.com by Sherri Campbell, she states, “There is not a more useful or important trait to possess than resourcefulness in the pursuit of success.” https://www.entrepreneur.com/article/272171

During a training session, I often give all the information, tools, and resources needed to do a task. However, no amount of training can replace what you learn by “figuring things out.”

I remember working with a nurse on a system. We had gone through a significant amount of training, and I left her with some easy homework. “Get in the system poke around and see what you see.” A week later I came back to do some follow-up training and found she had not even logged in. I asked her why she said she didn’t remember how. Now compare that to another nurse in the training group. She pulled out a folder with the how to guides she printed up, some she found by reaching out to other nurses, and got right in. She learned the system quickly and efficiently. That nurse has grown and climbed the corporate ladder flawlessly since then.

In the Harvard Business Review John Baldoni addresses the importance of Resourcefulness in business leaders today, “The leader who steps up and says “yes we can do this” is one who can push colleagues to do things that some might consider impractical.” – https://hbr.org/2010/01/leaders-can-learn-to-make-do-a. A capable leader is one who seeks information and solutions. They take stock of all they have put it together and find results where others have already given up.

It’s not resources but resourcefulness that ultimately makes the difference – Tony Robbins

Being resourceful isn’t about having the answers it’s about having the drive to seek the answers. One of the biggest assets employers are seeking in candidates today are ones who are resourceful. As a clinical leader, it is imperative to learn this skill and utilize it.

 

3 Steps to becoming a resourceful leader

Women Figuring it out. Thinking of solutions and showing resourcefulness.

  1. Figure it out

When given a task, figure out how to do it! I am not saying don’t ask for help. Everyone needs help, and to be shown how to do things. But, seek the answers instead of sitting and waiting for someone to hand them to you. Many companies have a website or system with how-tos and knowledge guides, take the time to get acquainted with these. Pull your policy and procedures, state regulations, or go to your state nursing board website. Learn how to research!

Man Crushing Barriers as a means of resourcefulness.

  1. Crush barriers

Once you learn to research you will have the tools to figure out how to complete your task on your own. But, what about that time when an obstacle rears its ugly head right in the middle of your job. I have found there are two types of people here. Ones who throw their hand’s up and give up and ones who start getting creative. When you find yourself facing these obstacles, take a step back. If I am working on the computer, I will often print it out and go to another room to review. Just changing scenery can sometimes spark problem-solving juices and help find solutions. Go for a walk. Grab lunch. Go bounce things off, co-workers. The key word here is “GO” don’t wait for someone to find a solution for you.

Networking and working together show resourcefulness.

  1. Know people

Learn who the expert is. During my work in memory care, we had an admit coming in. The husband (primary care provider) had an emergency, and his wife needed our help. They had been turned down by many places and didn’t want to have to admit her into the hospital or psychiatric department. We reach out to a local doctor who could reach out to her primary and get all the information we needed. I grabbed a caregiver who was fantastic with memory care and off we went. We had this resident admitted and safe within an hour! I could never have made this happen, but because of my relationship with others we pulled together and moved mountains for this resident.

Always be building relationships and fostering them. Also, find ways to go out of your way to help others, and when the time comes more than likely, they will be there for you.

The 7 Characteristics of a Nurse Leader part 2 – Confidence

This is Part 2 of the 7 Characteristics of a Clinical Leader – Confidence

In part one we explored what I believe to be one of the most important parts of becoming a great clinical leader, Humility. We discussed how the humble person can step back and ask great questions and seek answers unashamed. The Importance of realizing you don’t know and can’t know everything, the need to step onto the ground floor and hip to hip with the front line, and how constantly comparing yourself to other’s may only hinder your improvement and not allow you to live up to your potential.  In Part two we will discuss what might look to be the antithesis to Humility and that is Confidence.

If you haven’t read part one I recommend clicking here and reading before going forward. 

Confidence

Per Dictionary.com, being confident is “Having a strong belief or full assurance; Sure;” http://www.dictionary.com/browse/confident?s=t

As I said, being confident might seem to be the opposite of being humble. When looking at a clinical leader, this is simply untrue, one can be both confident and humble. I have learned there is a time and place for everything. Can you be both confident and humble at the same time? I don’t know. But can you learn when to humble yourself and when to stand strong. Absolutely! In fact, in my opinion you can only grow confident through humility.

You know the term “fake it till you make it”, well that pretty much described my first step into leadership. I remember being terrified I was going to fail. Thinking I have never been a leader before why would someone follow my direction or take my advice.Putting on a poker face I would do my best to act like I knew what the heck I was doing! What I learned was to allowed myself to be humble and learn from everyone. I would ask questions and seek advice and took lots and lots of notes. For example, if I led an all staff meeting I would learn from what went right and what went wrong. Eventually I learned what worked and built confidence on a foundation of knowledge. What I found when doing this is that just like knowledge changes and new ways of doing things are being discovered when your confidence is based on knowledge you actually grow with it, learning not only how to do something but why.

Being confident is important in any leadership role. However, as a clinical leader your confidence may be the difference in someone living or dying. No pressure, right?

I had a fantastic nurse leader working with me in an assisted living setting. The nurse identified some wounds on a patient and reported to the patient’s provider. However, the provider did not address the wounds and they continued to get worse. The nurse became increasingly bothered by the look of the wounds and reported them multiple times asking for some intervention. When no intervention came, they decided enough was enough and sent the resident to the hospital for evaluation. The patient ended up having a major infection, and was becoming septic. This nurse truly saved the patients life by identifying the seriousness of wound and the systemic response the patient was going through. It was the nurse’s confidence that gave them the courage to disagree and be a patient advocate.  Have I done the same thing and been wrong? Absolutely! But I also learned when looking at something and my gut is screaming I better follow it because it might be wrong, but it also just might be right.

Abraham Lincoln in a letter to Major General Joseph Hooker wrote – “You have confidence in yourself, which is a valuable, if not an indispensable quality”. The letter was one of strengths and weaknesses he saw in Major General Joseph Hooker but I think his view of confidence as being indispensable is very true in leadership today nearly 150 years later. https://www.abrahamlincolnonline.org/lincoln/speeches/hooker.htm

Below you will find 3 steps to get you empowered and on your path to confidence.

1.       Body Language

Picture this, you are a nurse and a provider has given his patient a poor diagnosis and is talking about hospice. The family walks into the room very unsure with feelings of guilt and regret. The nurse offers the family to sit down and talk. She is very knowledgeable about hospice but unsure of herself. She sits behind her desk with legs crossed at the ankles her arms hugging her torso and her head tilted down making very little eye contact.  What you see here is very typical of those first conversations. The family often leaves feeling they have not gotten what they wanted from the conversation and continues to struggle.

This time the nurse asks the family sit down and pulls out her chair at a 45-degree angle. Her feet are on the floor and back is straight. Her arms at her sides and she is slightly leaning forward. She is confident with her information but knows it’s not about her and instead listens. The family explains how they are feeling and brings up some questions that she answers confidently. When the family becomes emotional she sits quietly and rests her hand on their forearm and maybe even cries with them.  They leave feeling they have been listened to by someone who knows what they are doing and one step closer to accepting their loved one’s diagnosis.

In a Ted Talk from 2012 Amy Cuddy described in her talk entitled “Your body language shapes who you are” how body language not only reveals much of ourselves to others but also internally sets us up to succeed or fail.She gives the advice to put yourself into the superman pose for 2 minutes prior to going into those interviews or tough conversations. This will change your mindset and put you in a place of confidence ready to take on any challenge.

Check out the full ted talk here:

 2.       Do your homework

One of the ways I learned to become confident was to dedicate myself to learning. I read books. Lots of them, read blogs like this one, and listen to lectures. I pick from what I read and stick it in my note book adding to my arsenal. Going into situations I like to look at as much of the background as possible. If I am meeting with a family or an associate I often research and get a feel for what’s going on before I even enter the situation. This allows me to step in with a game plan and often a 2nd and 3rd game plan just in case the first one doesn’t work. I remember in Nursing school they spoke about SBAR – you all remember SBAR right? Situation Background Assessment Recommendation. I have found this applies to leadership very well. Going into a situation I will often research the situation, find out some history, talk to those near the situation about what the current feelings are of those involved and ask for recommendations. I can gather this information and be ready as I step into that conversation. Then make confident decisions or recommendations.

3.       Positive thoughts and Affirmations

I remember something my grandma would say to me years ago. I would come home say something along the lines of ” I can’t do this grandma” or “I always do this wrong”. To which she would look me in the eyes and say, “You’re right.” I would give her this quizzical, thanks a lot for the encouragement look and she would proceed to tell me, “If you say you can’t, you’re right, if you say you will always do it wrong, you will keep doing it wrong. But when you begin to say you can, and say you will, that is when you will succeed.” I will remember that for the rest of my life. Once you begin speaking positive things into existence they begin to stick. Trust me on this one, you will feel pretty silly standing in front of that mirror saying how confident you are and well-spoken, but soon you will begin to believe it, and once you believe it, you become it. 

7 Characteristics of a Nurse Leader Part 1 – Humility

Becoming a Clinical Leader is a unique challenge and calling. Some of us nurses are called to be at the bed side, some behind a desk, and yet others to become managers and leaders in our industry. Whatever your calling in the nursing profession you can find your niche, one of the amazing rewards of being a nurse! However, if you are at the bedside, in the office, in the car visiting homes, we are all viewed as leaders. As nurses, we are looked up to, counted on for our expertise, and are a part of one of the most trusted professions in the world. As we go on this journey of discovery together. We will explore how to be better nurses, stronger leaders, and maybe even better people.

I have worked in many fields. However, since becoming a Clinical Leader I have discovered a glaring truth. There are many great nurses out there. There are few great nurse leaders. In the medical field, we love having nurses step into management rolls and be a part of the decision-making process. However, nurses are not always ready for this role. So as  a foundation I wanted to explore those characteristics that make a great clinical leader. We will break this into several parts as we explore these characteristics.

Copyright: <a href='http://www.123rf.com/profile_pixelsaway'>pixelsaway / 123RF Stock Photo</a>

Part 1. Humility 

“Humility- the quality or condition of being humble; modest opinion or estimate of one’s own importance, rank, etc.”
– vocabulary.com

In many areas, there is a misconception you have be the expert, all the time, to be a good leader. This is simply not true. I remember when I first got into my leadership role as a District Director with multiple communities reporting to me, I thought I had to know everything. In fact, it wasn’t until I had a fantastic boss (who has shown me a lot in leadership) that I realized it was ok not to know everything, it’s ok to say I don’t know.

Take for example nurse… we will call her Susie… I hired nurse Susie from a floor nurse position into a Health and Wellness Director position. She interviewed fantastic and was a great nurse. Then it came time to train her. While spending the first 5 minutes with her it became apparent she knew everything there was in her field and did not need my assistance. I spent weeks with her trying to get through a basic orientation. Fast forward 6 weeks and nurse Susie quit. Why? Because she didn’t feel she had the training to do her job and felt she was failing. It made me question, why? Nurse Susie was a fantastic nurse. She probably knew more in the clinical field than I did. I spent more time in training and in very much the same manner as some of my most successful HWD’s.

What went wrong here? What did I miss?

An article in the Economist states:

“If leadership has a secret sauce, it may well be humility. A humble boss understands that there are things he doesn’t know. He listens: not only to the other bigwigs in Davos, but also to the kind of people who don’t get invited, such as his customers.” 
The Economist, 26 Jan. 2013

She liked to flaunt what she knew to the point of being so consumed with proving her knowledge and how great she was, she never stopped to learn. Since then I have learned both to seek candidates willing to learn, humble in their career, and when I do get those that lack humility have the confidence to call them out on it and bring it into the light. The pressure as a nurse to never make a mistake (I mean it’s not like people’s lives are in our hands or anything) bleeds over into our role as a clinical leader making it hard for us to accept our faults. on my path, I have discovered only when I humble myself can I grow and become better.

“There is nothing noble in being superior to your fellow man; true nobility is being superior to your former self.”
 Ernest Hemingway

3 steps to a humble you:

  1. Realize you don’t know and can’t know everything.

  • Once you accept that you don’t know everything and can never know everything there is freedom. You can learn and not be ashamed, ask questions, and gain knowledge and inspiration from everything everywhere. You begin to seek knowledge to better yourself as a journey of growth rather than fasted route to destination.
  1. Step onto the ground floor

  • I love the show undercover boss. I love to see these CEO’s step into the shoes of their ground floor workers and learn what their company is about. By giving yourself time to step in and work hip to hip with caregivers, CNA’s and even housekeepers you often get a new perspective and yes, learn a thing or two from these valuable players. I worked as a Health and Wellness Director for a memory care unit and one day I decided to come in with the morning shift and work alongside the team. Not because we were short staffed, but because I wanted to learn. I learned more about my role and how it effects the residents and caregivers in that one day than all my orientation combined. To value my team and to listen to their vast knowledge and experience.
  1. Quit comparing yourself to others

  • Don’t get me wrong I love to read about my hero’s both in the fiction worlds and in biographical world. But I have learned to look at them for inspiration on how to become a better me rather than a mirror I am trying to reflect myself in. There is always someone better at something than you, but no one will ever be better at being you. You are your greatest attribute. Let your uniqueness shine and when someone comes along and does something better be humble enough to learn from them and you will grow beyond what you ever thought you could.

Part 2 Coming soon will provide link here.

Written By: Derek Di Camillo RN