Do you know about - Positive, Assertive "Pushback" For Nurses
Voice Conference Call! Again, for I know. Ready to share new things that are useful. You and your friends.On one of her evening shifts, Nurse Sally Stevens, an R.N. With 17 years of nursing experience, was caring for a new patient, a 46-year-old female diabetic, who was suffering from tremors due to a bout of Lithium toxicity. After an i.v. Was started, the patient, Miss Hawkins, developed some kidney complications, prompting doctors to bring in a renal specialist. After reviewing her charts, the devotee ordered an i.v. Containing dextrose.
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Knowing that the dextrose could negatively affect her patient's diabetic condition, Nurse Sally voiced her concerns. In a non-aggressive tone, Nurse Sally said, "Doctor, Miss Hawkins' blood sugar was 315 at 4pm. I noticed that you've changed her i.v. Fluids to Dextrose. Do you want to convert the i.v. Fluids?"
Because of Nurse Sally's capability to characterize effectively, Miss Hawkins received the best potential medical care.
So, the real moral of the fictional catalogue of Nurse Sally's story is that you easily can get your needs and wants met - not through aggressive, in-your-face confrontations - but via effective, positive and assertive communications. Especially in the field of nursing, the capability to deliver an appropriately assertive response to a potentially negative and/or harmful situation is a considerable - even a potentially lifesaving - skill.
And, contrary to popular belief, you can characterize your concerns without constantly damaging your pro relationship. A "positive pushback" is the capability to deliver an appropriately assertive response to a potentially negative and/or harmful situation. A positive pushback is executed by finding someone level in the eye, and saying with an even, non-stressed tone what you want or need. (If you want to be easily assertive consist of the word "I," such as "I easily need for you to stop and characterize this now...")
Practice Makes Positive
It's considerable to sound positive when you are giving a positive pushback. A positive pushback does not leave the other someone confused or unsure about your needs, wants, desires or message! That said, a positive pushback is not delivered with a choppy tone of voice, or an aggressive posture or facial expression.
Example to Lose: "I wonder if we should duplicate check the lab work before...?" Example to Use: "I think we should duplicate check the lab work before..."
Samuel Maceri, Dnsc Rn, and chairperson of the commission of workplace advocacy for the Tennessee Nurses relationship offered some tips on assertive nurse communications while potential friction situations: "When you call the physician at two a.m. And you know they're tired, you can say 'I know you're very concerned about Mrs. Johnson and I'm sure you'll want to do something about this situation' - then there's justification for disturbing their space and time. It's prominent to first address the other person's needs and goals."
Unfortunately, you can only guide a positive pushback when you have sufficient positive psychological capital, which means that you are equipped with sufficient self-esteem, self-confidence and self-efficacy to be able to cope yourself in a friction situation. You must continually build this capital up, so it will be there when/if you need it.
Positive Pushback Benefits - and Fears
One of the benefits of using a positive pushback is that you have a good chance to furnish the results you want and need. Other benefits can consist of an immunization against burnout (by helping you decrease your stress level), and the construction of self-esteem and self-confidence. Also, it can help you build positive relationships with others and empower you become a better inpatient advocate.
So why don't people push back? Well, easily fear is a former factor. Other factors can be prior negative experiences (such as no one listened or listened poorly previously), defense mechanisms (I can't be responsible), as well as the active avoidance of a response. Plus, some nurses are operating in a negative organizational culture, and whatever psychological capital they once had accumulated, may now be depleted.
"There's a power play in any relationship," Maceri notes," While a physician may have more experience, as a someone the physician is no more a human being than a nurse. A nurse has the same level of human proprietary as anyone. It demeans all of us when a nurse is unable to assertively and expertly voice themselves in a responsible and firm way."
You're Okay, I'm Not Okay: Submissive Communication
We can characterize more effectively with others when we learn assertive, non-aggressive, transportation techniques. Perhaps the best way to understand assertive communication, is to look at how it falls along a continuum of three categories: 1.) submissive (non-assertive), 2.) aggressive, and 3.) assertive behavior.
The first class is non-assertive, or submissive, behavior. people who typically behave submissively demonstrate a lack of respect for their own needs and rights. Many submissive people do not express their honest feelings, needs, values and concerns. They allow others to violate their space, deny their proprietary and ignore their needs. Rarely do they ever state their desires, even though it may be all that was needed in order to have their needs met.
Some people who exhibit submissive behavior express their needs, but do it in such an apologetic and diffident manner that they are not taken seriously. If you hear qualifying phrases such as: "Oh, do whatever you want," or, "It easily doesn't matter to me," or, "I could be wrong but..." - What, in fact, you are hearing is a form of "verbal submission." Nonverbal submission can consist of a shrugging of the shoulders, lack of eye contact, an excessively soft voice, hesitating speech, etc.
The submissive someone communicates: "I don't matter, you can take advantage
of me. My needs are insignificant- yours are important. My feelings are irrelevant; yours matter. My ideas are worthless; only yours are significant. I have no
rights, but of policy you do." Because the submissive someone will often quash their own needs, very often this leads to pent up dissatisfaction and anger.
Advantages of submissive communication:
1. Submission is a way of avoiding, postponing or hiding conflict.
2. Submissive people carry a much smaller load of responsibility. If things go wrong, rarely is the submissive someone to blame.
3. Oftentimes, submissive people appear so helpless that other people take it upon themselves to look after and protect them.
Disadvantage of submissive communication:
1. Pent up dissatisfaction and anger.
2. No one knows what you want, so they can't give you what you want.
Getting What You Want at the charge of Others: Aggressive Behavior
On the other end of the continuum is aggressive behavior- commonly defined as behaviors that "move against" or "move with the intent to hurt." An aggressive someone expresses their feelings, needs and ideas at the charge of others. They roughly all the time win in an argument, speak loudly and can be abusive, rude and sarcastic. Normally, aggressive people insist on having the final word and tend to berate, dominate and try to overpower others. They can also be very controlling. The aggressive someone often feels that only his or her point of view is important.
Nonverbal transportation in an aggressive someone can consist of dominant eye contact (staring), pointing, fist banging, a loud voice and an invasion of "personal space". They may use terms like "always" and "never," as exaggerations are common. Frequently, a lot of "you" language (such as "You never do...") is used.
Advantages of aggressive communication:
1. They are likely to secure the material needs and objects that they desire.
2. They tend to protect themselves and their own space.
3. They appear to preserve considerable control over their own lives and the lives of others.
4. often people will not arrival you with their problems or raise issues.
Disadvantages of aggressive communication:
1. Often, the aggressive someone will suffer from fear. Frequently, the most
aggressive people are the most fearful. Many people behave aggressively not because they feel strong, but because they feel week.
2. The provocation of counter-aggressive behavior.
3. Loss of control, guilt and dehumanization.
4. Alienation from people. Again, people will not arrival you with their problems or raise issues.
5. Ill health.
I'm Okay and You're Okay Too: Assertive Communication
This recipe of transportation allows both parties to voice self-respect,
pursue happiness and delight of their needs, and defend their proprietary and
personal space - all without abusing or dominating other people. True assertiveness is a way of confirming your own personel worth and dignity. And simultaneously, the assertive someone confirms and maintains the worth of
others.
Assertive individuals stand up for their own proprietary and expresses their personal needs, values, concerns and ideas in direct and suitable ways. While meeting their own needs, assertive people do not violate the needs of others or trespass on their personal space. They use "I" language ("I am trying to...") as opposed to "you" ("You can never seem to...) language, characterize with an open stance, voice eye contact, and use suitable distance, head nods and lean send to listen attentively to the speaker.
Advantages of assertive communication:
1. Assertive people like themselves. Often, the extent to which you assert
yourself determines the level of your self-esteem.
2. Assertion also fosters fulfilling relationships, releases positive vigor toward others, and greatly reduces a person's fear and anxiety. Plus, assertive responses weaken anxiety and tension.
3. As assertion is result-oriented, your chances of getting what you want and need are significantly increased.
Disadvantages of assertive communication:
1. Often, assertion will cause disruptions in one's life. There is also pain connected with honest and caring confrontation, and often it is a personal struggle to alter your own habitual behaviors (especially for those who are changing from submissive or aggressive life styles).
In conclusion, it's prominent to note that there are times when assertive behavior is not the best choice. You may relay your needs in a very positive manner and still have the other someone react in an unfriendly manner. As in any salutary relationship, friction is bound to arise, and being your authentic self can sometimes be a painful experience. To be assertive you have to risk dissension and make yourself a bit vulnerable. Once mastered, however, assertive transportation will make a positive variation in your day to day interactions with others.
In the end, the allowable goal of positive pushback training is to aid nurses in selecting transportation strategies and behaviors effectively, not to have nurses behave assertively in every situation. Sometimes it may be wise for you to give in to others, and conversely, it may be considerable for you to aggressively defend your needs and/or your patient's rights. However, for the most part, positive pushback can be an effective, positive and thriving means of transportation for nurses working in today's healthcare environment.
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