Nurses spend more time with patients than most other types of providers and have unique insight into patient care and the the healthcare system.

Making It Safe: Skills to Promote Healthy Conversation at Work

Photo from otisarchives4, via Flickr. Photo from otisarchives4, via Flickr.

Medora McGinnis, RN, has written several previous posts for this blog. She is now a pediatric RN at St. Mary’s Hospital in the Bon Secours Health System, Richmond, Virginia, as well as a freelance writer.

What makes communication at work feel safe? We can all identify situations that “go south”—we feel instantly uncomfortable in the work environment (or anywhere, really) if we are accused, blamed, insulted, or overlooked. It’s easy to recognize when our communication is not safe, not going well, and not professional. So what makes it safe?

Effective communication can only take place when all parties feel safe; we must feel comfortable sharing our clinical insights without fear of the reaction we might get from the other party. While we can’t always know what their reaction will be, by learning to make it safe we can learn to talk with anyone about anything. New nurses in my hospital go through a six-month “RN residency” program in which we meet once a month for education, journaling exercises, and sharing. The book Crucial Conversations: Tips for Talking When Stakes Are High was used in our training to help us further develop our communication skills in the workplace. As a first-year nurse myself, I’ve found that some of the book’s ideas have played a big role in my learning curve.

Mistake #1: Watering down the content so the message doesn’t get across.

When […]

2016-11-21T13:08:00-05:00March 27th, 2013|career, nursing perspective|0 Comments
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At Denver Nurse Exec Mtg: Sully on Sources of Errors, Chow on Crucial Role of Patients and Families

Some quick take-homes from AJN’s editor-in-chief, Shawn Kennedy:

690px-Plane_crash_into_Hudson_Rivercroped via Wikipedia

I’m in Denver at the annual meeting of the American Association of Nurse Executives (AONE), the organization comprised mostly of hospital nurse executives, administrators, and managers. As you can imagine, the focus is on leadership.

Captain “Sully” Sullenberger, the former US Airways pilot who safely landed a disabled passenger plane on the Hudson River in New York City in 2009, was the featured keynote speaker. He of course talked about the event that launched his second career as a speaker, author, and safety expert, but his message was really about leading in challenging times. Some key messages:

  • His success in landing the plane was the result of teamwork, with everyone executing what they had learned and practiced.
  • Core values must be made real on a daily basis in organizations.
  • Errors and bad outcomes are almost never the result of a single person or event, but a result of a cascading chain of events or failures.

AORN meeting cover image AORN meeting cover image

Marilyn Chow, who spoke only briefly after accepting the AONE 2013 Lifetime Achievement Award, could as easily have been the keynote speaker at the meeting. Chow, who is vice-president, national patient care services, Kaiser Permanente, spoke with humor and passion about her values and where she thinks nursing’s values should be. She told of her 87-year-old mother’s great joy […]

2018-03-13T10:49:45-04:00March 22nd, 2013|nursing perspective|1 Comment
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The Seven Surprises: What I’ve Learned About Nursing Through Yoga

By Medora McGinnis, RN, whose last post for this blog was “Practically a Nurse: Life as a New Graduate RN.” Medora is now a pediatric RN at St. Mary’s Hospital in the Bon Secours Health System, Richmond, Virginia, as well as a freelance writer. As a nursing student she was the Imprint Editor for the National Student Nurses Association.

By HealthZone (The Star) [FAL], via Wikimedia Commons Hot Yoga (Bikram), by HealthZone (The Star), via Wikimedia Commons The room is dark, and hot; 105 degrees, to be exact. I carry my mat, towel, and water bottle to the back corner of the room and settle into my space. I drink some water and lie down, trying to let go of all of the thoughts racing around in my head. A few minutes later, class starts and we start breathing, moving, stretching, and sweating . . . and really sweating. I’m shaking as I try to hold my plank position (which I still have to modify on my knees), then relaxing into a forward bend. Breathing, drinking water, moving, and stretching—and without realizing it, my thoughts are only about the present moment.

When I decided to try hot yoga about a month ago, I knew it would help me reduce stress and gain flexibility, and I was even hoping I’d lose weight. As a present day RN and a former ballet dancer, I looked forward to some of the health benefits I’d heard […]

2021-06-17T15:01:35-04:00March 21st, 2013|nursing perspective, personal health practices|4 Comments
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When Nurse-Patient Boundaries Blur, in Fact or Fiction

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May (2012) issue of AJN. She currently has an essay appearing in The Examined Life Journal.

Courtesy of the author Courtesy of the author

Professional boundaries, as defined by the National Council of State Boards of Nursing (NCSBN), are “the spaces between the nurse’s power and the patient’s vulnerability.” The NCSBN describes the nurse–patient relationship as a continuum, with “too little care provider involvement” at one end and “too much care provider involvement” on the other.

The ideal therapeutic nurse–patient relationship lies in the middle, with “no definite lines separating the zone of helpfulness from the ends of the continuum.” I don’t love the indeterminate nature of that definition, but I understand it.

Some time ago, I was surprised by a friendship that developed between a patient and me. It was an unusual circumstance, in that the patient was in the ICU for a very long time for chronic problems that didn’t affect his mental capacity. I was his nurse many times, and through idle chatter during routine care we discovered not only a shared appreciation of literature in general, but a fondness for many of the same authors and books. I started thinking of books I’d bring him, hoping to augment the tedium of his hospital stay. At some point, I started thinking […]

2016-11-21T13:08:04-05:00March 15th, 2013|Ethics, nursing perspective, Patients|7 Comments
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International Women’s Day: Remembering Lives Shadowed by Violence

DSC_0028 Photo by Karen Roush

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

She lived in a trailer with her boyfriend and her three children, all under the age of five. He beat her up regularly.

Every few weeks she came in to see me at the health center where I worked as an NP in urgent care. Sometimes she would come in with bruises, but most of the time it was for the less obvious sequelae of violence—unexplained chest pain, palpitations, anxiety attacks, back pain, relentless headaches. There was a policy in urgent care that you couldn’t ask for a particular provider. So she would call to speak to me directly and when the operator put her through she’d know I was on and would come in.

I’m not sure why she came to trust me over the other providers. Maybe she could sense that I understood and didn’t judge her, though I had never told her about my own history of domestic violence. But it was probably because I listened. There was not much else I could do. She had gone to a counselor when I encouraged her to, but that didn’t last long—it was hard for her to find transportation for the 30-minute trip into town. I […]

2016-11-21T13:08:10-05:00March 8th, 2013|nursing perspective|3 Comments
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