me when I say: boredom kills.
we get bored, we get sloppy. I understand that it can be tough to stay
interested when you have to give medication instructions for the nine hundred
and forty seventh time in your career, but you must remain diligent. You have
to keep it fresh for every patient, every time.
you find medication education becoming routine, use the technique of stage
actors. They get bored after a while, too, having to repeat the same lines
interest! What color are her eyes? What’s distinctive about her hair? What’s
unique about his voice? His mustache?
a way to stay present in the moment.
Reward Good Habits
My colleague Michael LeBoeuf said, “What gets recognized and
rewarded gets repeated.” The best way to hardwire good communication is to
recognize it when you observe it! The worst thing we can do is ignore something
extraordinary. Pull the RN aside right away and say, “I noticed you went an
extra mile, I’m so proud of you.” Be spontaneous and specific! Don’t save it
until the Christmas party.
ago, I was speaking in Louisiana, chatting with a new employee, who’d been
there four or five months. I asked her how she liked working with her boss, and
she replied “I love my boss.” How often do you hear that? I asked why, and she
told me: “When I started here, I worked on a project for about a month; I had
to stay and work an entire weekend. I didn’t tell my boss about it, but she
found out. When I came in on Monday morning, there was a jar of jelly beans
with a handwritten thank you note.”
asked how her boss knew she would like jelly beans. She said, “When I was
hired, my boss asked me to write down little things that I liked on a piece of
paper. One of the little things that I like are jelly beans.” Well, that story
inspired me to create a form called “My L.I.S.T.” We’ve been giving this out
for years, and people love it. My L.I.S.T. stands for “List of an Individual’s Special Things” – an effective leader should have one from every direct
giving your staff baseball caps and t-shirts they’ll never wear in public -
give them something meaningful.
“When do you actually find
time to do all this training, coaching, and precepting you’re talking about? We’re
there’s one thing I’ve learned, it’s that staff love training. They never
object, because they want to know more. Lack of interest is not an issue here.
was a lady in one of my seminars who said, “Yeah,
but you don’t know how busy we are, how lean we are. There’s no way we could
fit this training in.” I replied, “Tell
me what you do when compliance training is mandatory.” She said, “Well, we do it.” We all make time for
Learning Systems has a client that sets time aside on Wednesday mornings, once
a month, for every unit to schedule education. If you watch professional
sports, you’ve seen timeouts that are only twenty seconds or a minute long. In
that time, a coach gives instructions to the players, tells them what to do.
You don’t need two hours to coach someone - sometimes all you need is sixty
second corrective coaching.
“What do you do about
doctors? Doctors who are disruptive and disrespectful; who act out if they’re
challenged on prescriptions or patient care.”
Whenever I’ve asked nurses about physician relationships, I’ve had
to have Kleenex on the table. In many ways, I think nurses are conditioned to
accept whatever doctors dish out – but this in not effective communication, and
we need to shift the paradigm. I witnessed one very impressive nurse say to a
doctor (who was inappropriate in his communication): “I didn’t give you
permission to talk to me that way.”
You could see that he was startled, and I thought “Wow, what a
classy example of assertiveness.” It’s the responsibility of the nurse (or
supervisor, manager, director) to have a non-accusatory conversation with a
problematic physician. Whether they are employed by you or not: their behavior
toward coworkers is noticed.
a good citizenship policy for doctors, one that has teeth. Set the boundaries
for good behavior on the part of doctors. This also protects nurses who have a reason
to question the doctor; asking a legitimate question for the benefit of a
patient is always appropriate. At a
hospital with one of these policies in place, the system worked like this: if
the nurses felt they were being ignored or verbally abused, they used the code
word was “red light.” “Red light” meant the doctor was overstepping his bounds,
and should adjust his attitude.
truth is that a fifteen or thirty minute training session can be accommodated
almost anytime. . If you make effective communication a priority, people will
make time for it. Give your staff the opportunity to master communication skills for
patients and coworkers, and then recognize those behaviors in a meaningful and