Check my Conduct: Committing to a Better Way to Act with Colleagues

Christina Purpora, PhD, RN, is an assistant professor at the University of San Francisco School of Nursing and Health Professions. She has 30 years of hospital nursing experience.

Kindness quotation. Photo by Steve Robbins/Flickr by Steve Robbins/Flickr Creative Commons

I wonder whether any of my nurse colleagues can recall having said or done something less than kind to a peer at work. Looking back over 30 years of nursing, I am aware of times that I could have been kinder. Not too long ago, the way that Emily—a less experienced nurse who was new to our unit—conducted herself in response to my reaction to her request for help taught me that I ought to consider a better way to act.

Request for Help
I was walking out of a patient’s room when Emily greeted me by name, then said, “Ms. S has one of the new IV pumps and the alarm keeps going off. I can’t figure out what’s wrong. Can you please help me?”

I felt annoyed at her for making one more demand on my time when I could barely keep up with my current assignment. Rolling my eyes, I curtly replied, “Emily, I think you can handle it. You had the in-service like everybody else.”

Seemingly unrattled by my terse retort, Emily stood her ground. “Yes,” she told me, “I used the troubleshooting […]

2016-11-21T13:01:47-05:00November 10th, 2015|career, narratives, Nursing, nursing perspective|2 Comments
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‘Tables Turned’: When the Patient’s Family Member Is a Nurse

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Illustration by Eric Collins. All rights reserved. Illustration by Eric Collins. All rights reserved.

Nurses are not always comfortable when a patient’s family member is also a nurse. In AJN’s January Reflections essay, “The Tables Turned,” a critical care nurse describes her attempt to navigate the role change from nurse to family member when her sister is hospitalized with multiple injuries after a bike accident.

Her sister is in obvious pain, but pain management is complicated by a low blood pressure. The author asks her sister’s nurse about alternative analgesics. She writes:

“The nurse, perhaps caught off guard by my question, answered abruptly: ‘I don’t think so. We don’t do that here.’ There was a pause. ‘Don’t do what?’ I asked. ‘We don’t do IV Tylenol,’ she repeated. She did not offer an explanation, an alternative, or say she’d ask another provider… I felt helpless, both as a critical care nurse and as a sister.”

As if to reinforce that the patient’s sister is not welcome to participate in care discussions, the charge nurse soon comes by and suggests that the author “step out to get some rest.”

Of course we don’t know the nurse’s […]

2016-11-21T13:03:16-05:00January 7th, 2015|career, narratives, Nursing, nursing perspective, pain management, Patients|5 Comments
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Resisting the Rising Tide of Parkinson’s

By Barbara Hranilovich. All rights reserved. By Barbara Hranilovich. All rights reserved.

The Reflections essay in the October issue of AJN is called “After-Dinner Talks.” These are talks with a purpose, a form of physical therapy with high stakes. Writes the author, Minter Krotzer, of her husband’s long struggle with Parkinson’s disease: “Hal always says Parkinson’s is not his identity, and it isn’t, as long as he doesn’t let it claim him, or as long as it doesn’t claim us.”

Here’s an excerpt from the beginning:

‘I’d like you two to have a conversation every night after dinner,’ Hal’s speech therapist said to us.

. . . . Over the years, Hal’s Parkinson’s disease has made him difficult to understand. His vocal cords have restricted movement and it is hard for him to make it to the end of a sentence. He often swallows his last words or they just barely come out. Sometimes he sounds like he is underwater—the words indistinguishable from one another, blurry and pitchless.

But read the short essay, which is free. In just one page it manages to say a lot about chronic illness and the constant, conscious effort it can require of both patients and family members; about a clinician’s good advice; about marriage and communication; and about the power of language to keep us human.—Jacob Molyneux, senior editor.

Illustration by Barbara Hranilovich; all rights reserved.

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2016-11-21T13:03:45-05:00October 13th, 2014|patient engagement, patient experience, Patients|1 Comment
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Questions Dementia Patients Can’t Answer

by Ann Gordon, via Flickr Photo by Ann Gordon, via Flickr

By Amy M. Collins, editor

A few weeks ago I visited my grandmother, who suffers from dementia, at her assisted living home. In her room, my family and I noticed a complicated form with instructions for residents to get their flu vaccination. Residents had to fill it out, sign it, and bring it to the person administering the vaccine on a certain date. For my grandmother, this would be impossible—she can no longer remember what day it is, when or if she has eaten, who she’s spoken to within the last five minutes, or where her room is located.

When this concern was broached with the front desk of the facility, they seemed to be adamant that she needed to have the form with her on the day of vaccination. We could, of course, help her fill it out—but since it had been given directly to my grandmother, who was to say we would have ever learned of it except by chance? And who would make sure she brought it with her on the day of vaccination?

While the facility offers assisted living, they often remark that they are not a “dementia facility.” Looking around, however, one is hard-pressed to find a resident without […]

2016-11-21T13:05:26-05:00February 11th, 2014|patient engagement|14 Comments
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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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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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