Karen Roush PhD, RN, is an assistant professor of nursing at Lehman College in the Bronx, New York, and founder of the Scholar’s Voice, which works to strengthen the voice of nursing through writing mentorship for nurses.
By Amancay Maahs/Flickr
“Patients are never satisfied!” “Only bedside nurses really understand nursing!” “Management always takes advantage of you!”
These are examples of the types of statements I’ve heard recently, whether talking with other nurses or reading blogs or other social media. Often presented as contributions to discussion, in reality they are rants—more interested in eliciting rote agreement than in true dialogue. This has got me thinking about how we create dialogue, especially about topics that stir an emotional response—particularly when anger is front and center. I’m a firm believer that:
- creating dialogue is necessary and transformative
- strong emotions are often the impetus for needed change
But we can’t allow emotions to dominate. When they do, our discussion is no longer a dialogue; it’s a rant. And rants are not productive for creating change. They eat up the energy that could otherwise be directed to positive action.
So, how do we do create dialogue about the issues that get our backs up? Here are my thoughts:
- First, we need to separate our emotions (anger and frustration, for example) from the facts of the issue. We can present our perspective and opinion, but with a thoughtful and reasoned argument. Bracketing your feelings can be difficult, but it’s not impossible. Gathering and examining information and thinking in terms of actions can help. What is known about this issue? What do you think are the underlying factors contributing to this problem? What approaches have been tried to address them? What do you think may be worth a try? What does the research tell us? What can nurses do? What have you done to work toward resolving it?
- Second, we need to take a good honest look at ourselves, our beliefs, and our presumptions. We need to be willing to consider other views or ways of interacting with what the world presents us. A dialogue is not one-sided, it is not didactic, and it is not finished. Real dialogue offers others a space for continued discussion. It evolves. It invokes questions. That only happens when we are open to reconsidering or modulating our views or beliefs or integrating others’ ideas with our own.
- Third, we need to avoid generalizations. Whenever we use words like all, never, only, or always, we’re approaching rant territory. Our experience is our experience; it is not necessarily evidence of what happens in general. It can be a jumping-off point for a discussion that offers insight. But we need to put it in the context of other experiences and of what is known (the evidence) if it is to contribute to a dialogue in a meaningful way.
- Fourth, we must be respectful of others. Stay focused on ideas and opinions and issues. Never make it personal.
- Finally, a dialogue is not a competition to prove who is right; it is more of an exploration. When viewed as such, we can listen to others from a position of openness, rather than one of attack.
There is no question that problems exist in this profession. When we are dissatisfied or frustrated to the degree expressed in some of the rants I’ve read or heard, we need to question the status quo and get involved in efforts to create change. The first step is creating or joining in a dialogue in a way that moves us forward toward effective action.
Patients rant, too. As a long-time health care journalist, I’ve been impressed by how well nurses and other clinicians apply author Roush’s principles in their interactions with patients. Then one day I was the bad patient…an experience that made me cringe every time I thought about it, and eventually led me to write about how expertly–and kindly!– everyone handled me: http://jama.jamanetwork.com/article.aspx?articleID=1938570
This makes me think the training and skills are all there…possibly it’s just harder to deploy them in the inter-professional context?
Great article. Thank you writing the piece and stimulating this discussion. I enjoyed the comment above from the previous person as it reminds me of the very fact that we must become part of the solution, instead of only focusing on the problems.
I think one of the reasons that people hide behind the generalizations is that they are afraid to rock the boat. For example, the spotlight on bullying in the workplace. If someone were to make a statement that disagrees with all of the media, conversation and uproar on the topic they might fear being seen as an outcast or worry they will be judged for their beliefs.
I value energy principles and universal truths. I believe in the notion that what we put out comes back to us. In fact, one of my favorite quotes is from Mother Teresa on war and peace that says ‘I will never attend an anti-war rally; if you have a peace rally, invite me.’
That’s how I feel on the topic of bullying. The more fuel we add to the fire; the more we perpetuate the behaviors. Thank you for an article that reminds us to stand true in our values, speak from our authenticity and allow us to internalize love and respect. Once we can feel comfortable in our own skin, it is that much easier to help another human being.
I think much of the frustration stems from the fact that nursing is such a misunderstood profession. I agree that rants are not productive. However, it seems as though nobody understands exactly what nurses do. We feel undervalued by management, abused by patients, and our families certainly don’t understand the physical, emotional, and intellectual toll nursing takes on us. We need to move away from the public perception of nurses as “angels in scrubs handing out blankets” and to the image intelligent healthcare professionals that we are. When nurses feel they are given the respect they so deserve the ranting will subside. But it’s up to us to change that.
Excellent…possibly the missing piece in Nursing education