Believe me when I say: boredom kills.
When 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.
If 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 every night.
Re-invigorate interest! What color are her eyes? What’s distinctive about her hair? What’s unique about his voice? His mustache?
Find 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.
Years 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.”
I 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 report.
Stop 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 busy!”
If 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.
There 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 our priorities.
Custom 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.
Have 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.
The Take Away
The 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 personal way
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