“Negativity is a lot like cigarette smoke. If it’s around, you know it.”

The 26th Annual Convention of the Academy of Medical-Surgical Nurses (AMSN) took place October 12-15 in Palm Springs, California. More than 1,100 nurses from across the country as well as Canada, Saudi Arabia, Puerto Rico, and the Bahamas came to network, attend educational sessions, and enjoy stimulating company.

Negativity as a default response to workplace stress.

The opening address by Sharon Cox, “Staying Positive While Working with Pearl and Grumpy,” set an enthusiastically constructive tone for the four-day conference. Cox, a former staff nurse, unit manager, and medical center administrator, shared practical suggestions for managing the “stress, drama, and trauma” of today’s health care workplace.

Cox pointed out how easy it is in the current environment to turn on each other, see ourselves as victims, and create negativity that affects our personal health and working relationships—and also affects patients and their families. Said Cox, “Negativity is a lot like cigarette smoke. If it’s around, you know it.”

Good habits are intentional.

Cox emphasized the value of cultivating our ability to remain positive in the midst of daily challenges. There are options in virtually every situation—and, she emphasized with a smile, we are not talking about options to change the behavior of others and tell them what they need to do to make our days better, but to change our own response to situations. This involves learning new behaviors that may take us outside of our own comfortable habits, but “If you’re uncomfortable, it’s probably the right response.”

She also observed: “We fall into bad habits; good habits are intentional and take practice.”

Positive habits to strive for.

Cox had suggestions about habits to reach for—both as an individual goal, and in order to create more cohesive and collaborative teams. Some behaviors that can change our days include:

  • Use only the kind of “self-talk” that brings you energy: Not “we’re short-staffed, this will be a horrible day!” but “we’re a great team, we can do this!”
  • Practice “reframing,” another habit that is energy-enhancing rather than energy-draining: “We just haven’t figured this one out . . . yet.”
  • Celebrate successes. We nurses are lucky—the very nature of our work produces successes almost daily. But we take them for granted; “it’s what we do.” To avoid losing the good stuff in the midst of daily trials, give life to successes by posting them on a bulletin board or whiteboard, at work or at home.
  • Whenever possible, buy time to choose a well-considered response: “I’ll give this more thought and get back to you about it tomorrow.” Not every issue demands a STAT response.

Ideas for more resilient teams.

Cox shared some especially helpful ideas for creating more positive, resilient teams. These seem easier to more quickly ingrain than personal goals, perhaps because they are behaviors that we can so easily reinforce with one another.

  • Create a simple “team agreement” for your unit, care team, or other work group. Figure out what you need from each other in order to work well together, and write these things down. Maybe “Nobody’s through until everybody’s through (every shift),” or “Send the mail to the right address” (that is, talk to the person you need to have a conversation with; don’t complain to others about your issue with that person).
  • Adhere to zero tolerance for chronic negativity, bullying, and disrespectful behavior. It should be accepted practice to call each other out on these.
  • Arrange for on-site training in the skills that help us negotiate crucial conversations. Nursing is intense, and emotions are often heightened; it’s not necessarily simple or natural to handle difficult conversations.

Cox left the group with three final insights that may help us in shaping more positive and productive interactions. I won’t give her explanations, but they’re all worth thinking about.

  • “Watch what you start calling normal.”
  • “[The question is] never what anyone else is doing, it’s how we respond.”

Finally, and perhaps most thought-provoking and least intuitive:

  • “We teach people how to treat us.”