LEARNING KEY SKILLS IN NURSING MANAGEMENT
2. Through delivery: • Be enthusiastic. • Speak clearly and forcefully. • Make one point at a time. • Do not tolerate interruptions.
3. By listening: • Listen for facts. • Pay attention to emotions. • Listen for what is not being said (e.g., body language, mixed messages, hidden messages).
4. Through body posture and body language: • Sit next to your antagonist; turn 30 degrees toward the person when you address him or her. • Lean forward. • Expand your personal space. • Use gestures. • Stand when you talk. • Smile when you are pleased, not in order to please. • Maintain eye contact, but do not stare.
One nurse manager handled a problem with a physician as shown in Case Study 9-1. Additional techniques to counteract intimidation and threat are included in Chapters 12, 21, and 22.
COMMUNICATION Josie Randolph is nurse manager of a perioperative unit, including responsibility for the preoperative testing unit, 18 OR suites, pre-op holding, and sterile process- ing. The OR department supports the hospital’s Level I trauma service as well as all other surgical services.
Dr. Jonas Welborne is a plastic surgeon with a his- tory of aggressive behavior. He has several cases on today’s OR schedule. While he is in his first surgery, a trauma case is brought to the OR. Susan Richardson, the OR charge nurse, decides to bump Dr. Welborne’s sec- ond case out of OR #3 to make room for the trauma case. When Dr. Welborne has finished his first case, he is informed of the delay in his second case. Dr. Welborne storms into the OR scheduling office and begins yelling at Susan. The situation quickly escalates to the point where Dr. Welborne uses obscenities and throws several charts on the floor. Loretta Donnelly, an OR tech, runs to Josie’s office and asks her to come immediately to the OR scheduling office.
Susan and Dr. Welborne continue to yell at one anoth- er, in full view of patients in the pre-op area. Josie imme- diately steps between Dr. Welborne and Susan and firmly asks both of them to lower their voices. She instructs Susan to wait in the staff lounge while she speaks with Dr. Welborne. Josie asks Dr. Welborne to step into her of- fice so they can calmly discuss the situation. Dr. Welborne is still visibly agitated but agrees to discuss the problem.
After hearing his side of the story, Josie apologizes for the inconvenience, but reminds him of the OR poli- cies. Emergent cases take precedence over elective cases, and no other elective cases were on the schedule at that time. She asks Dr. Welborne if there are alternatives to scheduling his cases that would minimize delays or bumps. As they talk, Dr. Welborne becomes calmer.