Conflict resolution is an essential skill for every nurse. Conflict in the workplace may be unavoidable, but it can be minimized and resolved. Learning to resolve your conflict effectively and early—in a way that does not increase your stress level—is important.
Nurses can experience different types of conflicts including personal, interpersonal, and interdepartmental conflicts. Any conflict can interfere with workflow and harmony. Conflicts can also decrease productivity and damage self-esteem. However, not all conflicts are bad; occasionally a conflict can be good for change in the workplace.
Here are some tips to improve your conflict resolution skills.
1. Practice active listening and communication skills.
Practice listening to what the other person has to say, without interrupting. Make sure you understand what the other person is telling you. Communication provides an opportunity to share thoughts and problems as well as the reason why they are having conflicts. Face-to-face communication is more effective than other forms because it allows for an active exchange of information. It also allows you to observe important nonverbal cues from the other party. It is important that you use open-ended questions to make sure each side understands what the other person thinks and how he/she feels. This invites people to delve deeper into the problem and find the root cause for the conflict.
2. Stay calm and recognize the conflict.
Being calm and aware of your emotions are vital aspects of conflict resolution. Recognizing the legitimacy of conflicting needs and analyzing them in an environment of compassionate understanding will lead to successful problem solving. Use critical thinking skills to analyze the problem and plan your strategy, including what you want to say, and then write it down and rehearse it. Create a note card, if necessary, with your main talking points.
3. Maintain a positive attitude and practice managing your emotions.
A positive attitude is what you need to solve half of the problem. Emotions play a greater part in most decisions so recognizing and understanding your emotion will help you control your emotional response.
“Anybody can become angry – that is easy, but to be angry with the right person and to the right degree and at the right time and for the right purpose, and in the right way – that is not within everybody’s power and is not easy.” — Aristotle
As Americans with chronic illness are living longer, more patients and families are faced with difficult questions about quality end-of-life care and what makes life worth living. As November is National Hospice and Palliative Care Month, it is important to bring this critical conversation to the forefront and encourage nurses who are on the frontline working with patients and families to be aware of the difference between palliative and hospice care, when they should be discussed and implemented, and the critical need for both services.
Defining Palliative and Hospice Care
There has been a shift in thought over the last forty years, with the recognition that extending life isn’t necessarily more important than quality of life, and palliative and hospice care have helped support this critical gap. However, confusion exists between the two, with most people familiar with hospice care but unsure about the term palliative care. While the disciplines may offer overlapping benefits at times, palliative and hospice care are distinct.
Palliative care is a specialized area of medicine that focuses on quality of life and relieving the symptoms of patients with serious chronic illnesses, such as heart and lung disease. Palliative care providers address the whole patient – spiritually, emotionally, and physically – and look at the big picture of how patients’ illnesses can affect their lives as they know it. Patients can continue to receive aggressive curative medical treatments, such as chemotherapy or dialysis, while receiving palliative care. These specialists help begin a dialogue between patients and their families about how to best live with disease or illness, discuss the need for advanced care planning, and also assist in making sure that families understand the patients’ wishes. They do not replace any of a patient’s health care team, but instead add a layer of support to improve their overall well-being. Patients seeking to improve their quality of life at any stage of their disease, can seek the assistance of a palliative care specialist, and there is no time limit for when or how long a patient can receive palliative care.
While also palliative in nature, modern day U.S. hospice care began in the mid-1970s, and is a type of specialized care for individuals who are certified by a physician as having a terminal illness and are expected to live for six months or less. Patients seeking hospice care have expressed a wish to have symptom management as well as emotional and spiritual support. The focus of hospice is caring, not curing, and is aimed at relieving pain and allowing a patient to die where and how they want. It can be delivered in a patient’s home, a long-term care facility, or a free-standing hospice home. The hospice team creates an individualized plan of care aimed at alleviating a patient’s suffering, allowing them to pass away with peace and dignity, while also providing support for the patient’s family.
Introducing Palliative Care to Patients
Palliative care should be introduced early in a chronic disease. Often it is added to the health care team too late in an illness trajectory, when patients are approaching or eligible for hospice care, when multiple hospitalizations have occurred, or when they have had a dramatic decline in their health. Like many medical issues, early intervention is imperative, and adding a palliative care specialist early helps patients have a sense of empowerment in making decisions about their life and health. Research shows that early involvement of palliative care specialists can actually help patients live longer.
It’s also critical that nurses and doctors are aware of the benefits of palliative and hospice care, and that they present the added health care layer in a positive way to patients, at the appropriate time for them to reap the maximum benefits of these important specialties. Doctors and nurses need to have confidence in their knowledge of palliative and hospice care, and understand that patients don’t need to choose between the two. They both have an important place in the medical field.
With the average life span in the United States now nearly 80 years old, and medicine continuing to advance, quality of life and end-of-life care will continue to be significant issues and discussions facing our population. Knowing when and how to incorporate this layer of support into your patients’ health care plan will help you provide the best possible care for your patients.
With dozens and dozens of nursing specialties, some nurses take varied paths to end up in the specialty that is the best fit. Many try different health care situations or medical training before deciding that one area of nursing is the career where they will make the impact they want and will satisfy their professional goals.
Jose M. Maria, MS, FNP, RN, CEN, director of emergency services at Brookdale Hospital and Medical Center in Brooklyn, New York, says he came to emergency nursing after gaining training and experience as an EMT and paramedic. “Emergency medicine was the next logical choice in starting my nursing career,” he says. “I haven’t looked back since.”
Maria, a native of the Dominican Republic, says his specific EMS experience really gave him a solid foundation to know what he wanted and provided him with the essential capability for any emergency nurse. “It allowed me to develop the skills to adapt to any situation while keeping a cool head,” he says.
But emergency nurses also benefit from having more than a cool head and a great skill set, says Maria. The flexibility to move from one situation to another one that is entirely different is essential for a successful emergency nurse. And then there’s the part where you work your tail off. An emergency nurse who doesn’t complain about the task (or 20 tasks) at hand and does what’s needed will have a much easier time working in such a fast-paced environment.
And when it’s time to transition a patient to inpatient nurses, challenges remain. In fact, Maria says that transition point is one of the most challenging aspects of emergency nursing. “This is a common challenge at every organization I have been a part of,” he says.
Preparation and planning, as with any part of the emergency nurse’s job, can help. And finding out how other nurses work also helps inform your own practice. “I try to stay current in practice and use resources like ENA CONNECT and to speak with colleagues across the states,” says Maria. “Like many professions, preparation is key for success in the emergency department.”
But with those skills and responsibilities, emergency department nurses encounter a lot of critical and crisis situations to adapt to. For Maria, those situations reveal why he does what he does. “The most satisfying and most important part of my job is to save lives,” he says. “It’s a powerful and overwhelming feeling to have brought someone back from death and see them walking out of the hospital.”
Anyone considering emergency nursing as a career path can follow Maria’s advice to rotate through other specialties before deciding on the ED. Each area offers you a new set of experiences and training that will be useful in the emergency department.
“Because we see a wide range of complaints, we can actually help our patients,” he says. “Working in psychiatry for example, helps you build conflict resolutions skills, improve communication techniques, and builds patience needed in the acute psychiatric emergency. Working in the ICU, with their attention to detail, improves your documentation. Working on a medicine floor helps in time management skills. Working a surgical unit, improves your teaching techniques with patients.”
And while the emergency department is intense and fast, emergency nurses do find a way to offer each other the kind of support and camaraderie that is distinct. Their humor might even be considered dark, says Maria.
“People have a hard time understanding that even in the darkest of times, humor helps us deal with our internal anxiety about the cases we work,” he says.
This week, the American Association of Nurse Practitioners is highlighting all the work nurse practitioners (NPs) do with National Nurse Practitioner Week.
The week kicks off today and runs through November 18 and honors the work NPs do both on the job and as ambassadors for the nursing profession.
Minority Nurse caught up with Dr. Scharmaine L. Baker, FNP, FAANP, FAAN, CEO at Advanced Clinical Consultants, to talk about the role of a nurse practitioner. After Hurricane Katrina, Baker’s New Orleans patient caseload swelled from 100 to 500 in three months. With a critical shortage of health care facilities and providers, Baker’s skills as an NP not only saved her patients, but also clearly showed how invaluable her thorough NP training is.
National Nurse Practitioner Week, says Baker, is a way to give nurse practitioners the recognition they often don’t receive. “National Nurse Practitioner Week gives us the positive spotlight that we deserve,” she says.
This kind of national attention to the nurse practitioner’s work shows the devotion nurses have to caring for a patient, and also helps clear up any misunderstandings about the role and how an NP works within a health care team. “Nurse practitioners don’t just prescribe a medicine and send you out of the door,” says Baker. “We take the time to listen to the patient stories about their children, spouses, pets, and job promotions. These stories often solve the complicated puzzle of making an accurate diagnosis. It’s called holistic care of the total man.”
When prospective nursing students are deciding on a career path, Baker urges them to consider a few things. Top in their minds should be the honest assessment of their commitment to making this career decision. Taking the time to complete the challenging NP studies isn’t easy, she says. “Once they have decided that this is indeed the right time to pursue an Advanced Practice Nursing degree,” she adds, “then the necessary preparations as far as letting family and friends know that they will be somewhat unavailable for the next three to four years because the schooling demands all of your time for successful completion.”
But when the degree completion and training are done, the potential for a lifelong career that challenges you, uses all your skills, and lets you connect with and help people is gratifying on many levels. As a nurse practitioner, you’ll be diagnosing, assessing, and treating medical conditions. You’ll also look at the whole patient. NPs take into account the interplay between a patient’s physical and emotional well-being as well as the environment they live in. By doing so, they can help treat every part of a patient’s condition.
“I get to hear the stories that make my patients happy or sad,” says Baker. “Then, I get to connect those stories to their physical state. They are always related. I enjoy providing health care on this advanced level. I get to take care of the whole patient.”
Baker also points out that while NPs continue to earn recognition and some states are allowing them to practice on their own, there is still work to be done. “The most challenging and frustrating part of advanced practice nursing is the many restrictive laws that prevent us from practicing to the full extent of our scope,” she says. “It’s downright ridiculous! I long for the day when all states will actively have full practice authority.”
Currently, nearly two dozen states allow nurses to have full practice authority where they practice without physician oversight. Baker continues to advocate for full practice authority among all nurse practitioners. She also urges NPs and the nursing profession to continue to honor the nurses who worked so hard to get all nurses where they are today.
“Many have fought for us to be where we are,” says Baker. “Every time we show up and provide stellar care, we make our founding nurses beam with joy. We must never forget their sacrifices.”
Celebrate National Nurse Practitioner Week this week and spread the word about these highly skilled professionals. Use #NPWeek to share photos and tags on your social media posts to help others see just what satisfaction a career as an NP can bring.
Every nurse will experience that first day on the job and all the emotions that go with it. “This has happened to me a dozen times since I graduated from my nursing school. The first day on a job is the most memorable experience in my life,” says Mary Wiske, a retired community health nurse who has experienced several first days at jobs throughout her 25-year nursing career.
No matter whether you’re a new graduate or an experienced nurse, the first day at a new job or new location can be exciting, stressful, or overwhelming. There is so much to learn in addition to the duties or responsibility related to the job. If you are a new graduate, congratulations on your first job! This is your chance to begin your career in health care.
Here are four steps that will help you prepare for your first day.
1. Learn all you can about your new employer.
Read through any contracts, induction packs, or emails you have received. These will have important information about your employment, responsibilities, and what you may need to bring with you when you start. When you are familiar with your job description, you will be able to work more safely and efficiently.
2. Plan the route you will take to work as well as some alternate routes.
Find a map, get directions. Incorporate contingency time for bad traffic, public transport delays, or getting lost. If you are driving, remember to find out where you can park.
3. Get yourself ready – pens, a notebook, and a high-quality stethoscope.
Look for comfortable and durable scrubs that make you look professional. You should also plan to wear comfortable shoes that offer strong arch support and a roomy toe box, in addition to heels that do not pinch or slip and a no-slip sole.
4. Take care of yourself.
Be calm and relax. Remember to go to bed early the night before and have breakfast before you go to work. Give yourself plenty of time to get to work so you do not show up late.
Finally, you are here–the first day on the job. It is normal to feel nervous or excited. It is wise to remain calm and carry yourself with confidence; that is the key to this. Keep a positive attitude and an open mind. Remember to take an active role in your orientation and do not be afraid to ask questions. Make an effort to learn new things and learn how to do something a new way. All you can do is try your best and do your job the best way you know how.
Emergency Nurses Week kicks off today and offers a reflection of the lifesaving efforts and skill of emergency nurses who are called on to deal with catastrophic conditions, both natural and human-created, with little or no notice.
Karen Wiley MSN, RN, CEN, and president of the Emergency Nurses Association, says recent events highlight the unpredictability of the job and the exceptional need for emergency nurses.
“I am most proud of the way our nurses have come together in the past several weeks,” she says. “With the devastation from multiple hurricanes and the unconscionable event in Las Vegas, we have seen countless acts of sacrifice, selflessness, and dedication in emergency care from our nurses. I am proud of my colleagues every day, but the effort I have seen through these tragedies is truly remarkable.”
Wiley says emergency nursing is a complex role that involves treating the physical reasons for the visit, but also careful and expert communication with the team and the patient, families, and loved ones. “Most people do not realize the diversity of work emergency nurses must perform besides treating physical injuries,” she says. “Patients enter emergency departments struggling with addiction, mental health issues, as victims of sex trafficking, and, all too often, are violent themselves.”
If nurses are considering moving into emergency nursing or are wondering if the path would be right for them, Wiley says it helps to consider the range of what nurses encounter on a given day. “Thinking quickly on your feet is an essential skill for emergency nurses,” she says. “Situations change in a moment in the emergency department and nurses must react effectively.”
In the midst of an environment where many things are happening simultaneously, emergency nurses are still in charge of the patient’s comprehensive needs. “Emergency nurses must keep patient advocacy foremost at all times,” says Wiley. “The care, safety, support, and education of patients is our primary focus and dominant concern during a shift in an emergency department.”
Because they will take care of patients with many different conditions and situations, emergency nurses have to stay current on the latest medical information, so they have to be willing and able to constantly reeducate themselves about new developments, treatments, and methodologies. Emergency nurses continuously hone their craft, says Wiley, and that means being able to multitask effectively, efficiently, and accurately in a high-stress situation.
Emergency nursing is physically taxing, but it can also be an emotional challenge as well. Because of the very nature of an emergency room, patients don’t always survive despite the heroic efforts to save them. “Emergency nurses need to be prepared for the death of patients while not letting emotions affect their care,” says Wiley. Many hospitals have supports for their emergency room teams, especially after a trauma event, but the day-to-day exposure to death is something emergency nurses must cope with for their own job performance and their own mental health.
In addition to the challenges of treating so many physical and mental health issues, emergency nurses have to be able to quickly decipher and assess patients’ needs and conditions. “Choosing which patients need the most immediate care is challenging because the number of factors that need to be taken into consideration,” says Wiley.
For some nurses, the emergency room is where they perform best. And the ability to make such deep connections during that time is powerful. “Caring for patients who are in the most vulnerable state of their lives is an absolute privilege and an honor,” says Wiley. “The ability to comfort the patients and their loved ones when they need it most is humbling.”