Crucial Conversation Skills for Nurse Preceptors

Crucial Conversation Skills

As a preceptor, certain situations provide the perfect opportunity to coach and mentor your orientee in the art of difficult, yet productive, conversations. You may have to give difficult feedback to a team member, question a physician’s orders or advocate for your patient. When we stay silent in critical situations, let a nagging problem continue or lash out, we jeopardize the team and put patient safety at risk. By modeling professionalism and having difficult conversations, you can teach your orientee how to openly discuss and communicate an issue.

Research shows that the ability to hold crucial conversations is the key to influence, job effectiveness and improved personal and professional relationships. A study from the Joint Commission shows 65 percent of sentinel events and 90 percent of root cause analysis involved inadequate communication. In 2006, the Joint Commission added a requirement to Nation Patient Safety Goal 2 on improving the effectiveness of communication among caregivers. Crucial conversations could prevent medication errors, increase effective team work, enhance work relationships and save a patient’s life.

Crucial conversations occur when the stakes are high, opinions differ and strong emotions are involved. Use the suggested tips to increase communication among all team members and practice these skills with your orientee. Using these skills early in your nursing career is invaluable experience.

Tips for Speaking Up without Causing a Blow-up

Follow these tips for speaking your mind to get your message heard.
Reverse your thinking. Most of us decide to speak up by considering the risks involved. Those who are best at crucial conversations don’t think about the risks of speaking up; they think about the risks of not speaking up. They realize if they don’t share their unique views, they will have to live with the poor decisions that will be made as a result of holding back their informed opinions.
Change your emotions. The primary reason we do badly in crucial conversations is that by the time we open our mouths, we’re irritated, angry or disgusted with the other person’s views. Then, no matter how much we try to fake it, our negative judgments creep into the conversation. Before opening your mouth, open your mind. Try to separate people from the problem. Try to see others as reasonable, rational and decent — even if they hold a view that you strongly oppose. Maintain a good thought so that you come across as entirely different. Remember, if you hold court in your head, the verdict will show on your face.
Help others feel safe. Unskilled people believe certain topics are destined to make other people defensive. Skilled professionals realize people don’t become defensive until they feel unsafe. Try starting your next high-stakes conversation by assuring the other person of your positive intentions and your respect for them. When others feel respected and trust your motives, they let their guard down and begin to listen, even if the topic is unpleasant.
Invite dialogue. After you create a safe environment, confidently share your views. Then, invite differing opinions. This means you actually encourage the other person to disagree with you. Those who are best at crucial conversations aren’t just out to make their point; they want to learn. If your goal is just to dump on others, they’ll resist you. If you are open to hearing others’ points of view, they’ll be more open to yours. If you can’t remember anything else in the heat of the moment, ask yourself : “Are we in silence or violence?” If so, do your best to return to healthy dialogue.

-- Contributed by Kerry Patterson, author of The New York Times bestsellers “Crucial Conversations” and “Crucial Confrontations.” These books are excellent resources for preceptors and all hospital employees. www.vitalsmarts.com