As a nurse leader, you may face situations where you need to have difficult conversations with your team members. These could be about performance issues, feedback, conflicts, or personal problems. How can you handle these conversations effectively and respectfully, without damaging your relationships or compromising your standards? Here are some tips to help you.
Before you initiate a difficult conversation, make sure you are clear about your purpose, goals, and expectations. What is the main issue you want to address? What are the facts and evidence you have to support your point? What are the possible outcomes and consequences of the conversation? How do you want the other person to feel and respond? Preparing yourself will help you avoid being emotional, defensive, or vague during the conversation.
Nurse leaders can handle difficult conversations with team members by creating a safe and non-judgmental environment where open and honest communication can take place. They can also use active listening skills to understand the concerns and perspectives of their team members and work collaboratively to find solutions and address any issues.
Be prepared. Make notes when preparing and during the conversation. A rule of thumb is to have positive conversations early and difficult ones towards the end of the day. Address problems early, don't wait to see if they get better on their own. Communicate your goal to help them succeed. Summarize then follow up.
Enter the conversation with curiosity. Learn their perspective of the problem or event first. Then with that additional knowledge—provide coaching/feedback. Nothings worse than providing feedback about a problem that doesn’t exist or was out of the persons control.
When I was working at a small rural hospital, in a Mother Baby Unit that had about 40 deliveries a month, we had a charge nurse who was bullying both physicians and other nurses. I was one of her targets for this behavior. I learned a new method of personality science (B.A.N.K.?) and began speaking to her in the values of her personality code. This allowed us to connect on a subconscious level. The bullying stopped within 3 days. Nurse managers from other departments asked me to do conflict resolution in their departments. By using this method, people learned the values of their coworkers. They connected on a subconscious level and began to value one another as human beings. Building connection and trust is key to difficult conversations.
Difficult conversation are never easy but necessary. Preparation and planning ahead will keep the conversation focused on the issue or behavior, maintain objectivity and avoid defensiveness. Here are a few guiding principals to prepare: 1. Plan ahead. 2. Schedule an appropriate time. 3. Present the facts. 4. Listen to the colleague. 5. Develop a plan. 6. Document the conversation. 7. Follow up with feedback. 8. Address the situation as soon as possible.
Timing and setting are important factors for a successful difficult conversation. You want to choose a time and place that are convenient, private, and comfortable for both of you. Avoid having the conversation when you or the other person are busy, stressed, or distracted. Also, avoid public places where you may be overheard or interrupted by others. Ideally, you want to have the conversation face-to-face, or at least by phone or video call, rather than by email or text.
Show respect for the nurse and the issue at hand by scheduling time together. Give them your full focus during the time. Be sure to do it away from patients and other staff. If you must do it virtually, always choose a video call. Seeing the other person's body language and face is so important when having challenging conversations. There might be something significant happening in their life that you'd never know about if you weren't meeting face-to-face. Plus, let's be honest - being a nursing leader is challenging, but if you can't look the other person in the eye when you meet, it might not be the job for you.
One of the key skills for a difficult conversation is active listening. This means paying attention to what the other person is saying, without interrupting, judging, or dismissing them. You want to show that you respect their perspective and feelings, even if you disagree with them. You can use phrases like "I hear what you're saying", "I understand how you feel", or "That must have been hard for you" to express empathy and rapport. Listening and empathizing will help you build trust and reduce defensiveness.
Another key skill for a difficult conversation is clear and respectful communication. This means stating your point clearly, using facts and examples, and avoiding assumptions, accusations, or generalizations. You want to use "I" statements rather than "you" statements, to focus on your observations and feelings, rather than blaming or criticizing the other person. You also want to use polite and professional language, avoiding sarcasm, insults, or threats. Being clear and respectful will help you avoid misunderstandings and conflicts.
The ultimate goal of a difficult conversation is to find solutions and feedback that are mutually acceptable and beneficial. You want to involve the other person in the problem-solving process, by asking for their input, suggestions, and opinions. You also want to ask for their feedback on how they think the conversation went, what they learned, and what they plan to do next. Seeking solutions and feedback will help you achieve your goals and improve your relationship.
Be prepared to help in any reasonable way you can. Difficult conversations are made worse when leaders simply reprimand rather than offer solutions or support. Keep an extensive list of resources so that you are prepared for any scenario when having these difficult conversations.
The bottom line is that staff are still people. They will have devastating things happen in their lives that affect their work - and that is okay. Even nurses are allowed to have bad days. The challenging part is making the nurse feel comfortable enough to share these challenges with you. Be open. Don't dominate the conversation. Don't judge. Be kind. Be human.
The last step of a difficult conversation is to follow up and support the other person. You want to check in with them regularly, to see how they are doing, if they have any questions or concerns, or if they need any help or resources. You also want to acknowledge their progress, achievements, and efforts, and provide positive reinforcement and encouragement. Following up and support will help you sustain the results and outcomes of the conversation.