Ampy de la Paz, MSN, RN, a 40-year nursing veteran who works as a quality management analyst at Bayshore Medical Center in Pasadena, Texas, uses an incident from her own career to demonstrate to newly arrived nurses from the Philippines how to negotiate in the American workplace.


The incident occurred when she was offered a promotion a number of years ago [by a previous employer] and met with her superior to discuss her new salary. The first lesson de la Paz imparts to her colleagues is that she didn’t walk into the meeting blindly. She prepared for it by deciding how much of a raise she deserved on a percentage basis and how much various percentages meant in actual dollars.

Then, when the initial offer came, she knew the dollar amount was a smaller percentage increase than she deserved, and she told her superior the amount he was offering wasn’t enough. A few weeks passed before the superior returned to say he had spoken with someone in human resources who claimed that a survey of people at other hospitals employed in the same position had found that the amount de la Paz had been offered was average for the position.

Her response was: “I’m not average.”

She had lots of management experience, she told him, as well as a master’s degree, so she couldn’t accept the salary the organization was offering. Several more weeks passed before the superior met with her again. This time, he made what de la Paz considered an acceptable offer and she took the job.

Although negotiating is more often associated with legal, business or union issues, advancing your nursing career requires negotiation skills, too. Many people find negotiating difficult and some experts believe minority nurses are at a particular disadvantage when it comes to lobbying for promotions, raises or support for their projects and ideas. For example, they may come from cultures where disagreeing with superiors is considered disrespectful, or where being humble and part of a group is valued over self-promotion.

“The majority of [Filipino women] are very shy, so they [are] not as assertive as [they need] to be,” says de la Paz, the former executive director of the Philippine Nurses Association of America (PNAA). “They’re taught to avoid arguments and not rock the boat.”

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Filipino nurses often get passed over for promotions because of this, she continues. “Sometimes you have to encourage them and tell them, ‘Why don’t you apply for it? You’re qualified to do that.’ They want to be asked [rather than ask for it themselves]. They would not go out of their way to ask for [a promotion], but if it’s offered to them they would take it.”

Know Your Value

In negotiating for a promotion or a pay increase, de la Paz says it’s important to know your worth, become comfortable with the person you’re negotiating with and demonstrate your value to the organization by promoting yourself whenever you get the chance.

For Ruth W. Brinkley, RN, CHE, president and CEO of Memorial Health Care System in Chattanooga, Tenn., negotiating in the workplace means “having the confidence to position yourself in a way that helps you best put forth your unique qualifications, skills and abilities, so that those skills and abilities become apparent to the organization.”

That may mean obtaining skills and knowledge you currently lack. “However,” Brinkley maintains, “I believe that in many cases people [already] have the abilities and skills they need, but don’t know how to position themselves and package themselves correctly. Once you know what skills you have and you’re confident in what you have, then you’re better able to negotiate from a position of strength and sell yourself to your organization.”

When a position that you want becomes available, she continues, “the first thing you’ve got to do is be able to package your unique set of skills that [are a good fit for that job]. It’s not always apparent. Many times we don’t recognize the skills we have.”

Years ago, Brinkley left a job as a chief nurse at an academic medical center to become a consultant for a professional services firm. “It took me a while to understand how to repackage my skills from an operational framework to a consultative framework,” she says. “I began to recognize that I did have the skills to be an effective consultant. What I needed to do was use the skills I had in a different way.”

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Know Your Organization

Gwendylon Johnson, RNC, MA, a staff nurse at Howard University Hospital in Washington, D.C., and past president of the District of Columbia Nurses Association, says one of the most important things a nurse can do is to understand his or her organization as much as possible. This means not only knowing the direct care aspects of your working environment but the business aspects as well. Selling your idea, or yourself, will be easier if it fits in with the organization’s mission, she says.

“You have to make sure to bring to the table something that will expand the mission of the organization in a positive sense,” Johnson explains, “because [that way] you’re more likely to be able to get them to accept what you’re trying to do.”

Johnson, a past member of the American Nurses Association board of directors, says knowing the organization you work for means knowing its culture and how that culture defines value. This will help when it comes time to promote an idea, seek a higher-level position or negotiate for a pay raise. Determine what qualities the organization values and then seek to obtain those qualities.

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Keep in mind, she says, that successful nurses don’t limit themselves to activities at the bedside. They bring other skills to the table, such as leadership abilities, organizational skills or knowledge of the community.

“[Hospitals] are now asking direct care nurses for ideas about how to market the organization,” Johnson points out. “If you are the nurse who comes up with the best idea, then you are probably the one who is going to be asked to advance or promote that idea. Also, [it’s important to have] a business sense of what the organization’s needs are and [how those] needs are in line with the mission statement of the organization.”

Gloria Ceballos, MS, RN, CNAA, BC, former chief nursing officer at Kettering Medical Center in Ohio, recommends volunteering to serve on a hospital committee that advances the organization’s mission.

“Volunteer for maybe some ad hoc work that the committee has to do,” she says. “This will expose you to other people, their ways of thinking and other professions outside of nursing. Not only that, the leaders [of your organization will] focus on people who want to advance. Those are the first people that leaders think of.”

Participating in committees and other volunteer activities helps increase your visibility within the organization and sets you apart as someone who is interested in more than just collecting a paycheck. “No leader is going to give advancement to somebody who’s just doing their work, coming in and going home,” explains Ceballos, who now works as a fill-in nurse while pursuing her doctorate. “You have to demonstrate that you bring value to the organization and that’s when the salary increases come.”

For example, Hispanic nurses should remember that their knowledge of the Spanish language and Hispanic culture can often be an asset, she says. “If [they work for a facility that serves] a lot of Hispanic patients, they add great value in communicating culture and differences in care that Hispanic patients would need.”

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Ceballos recommends serving on diversity committees or volunteering to translate brochures into Spanish.

Prioritize and Practice

Johnson, who has worked as a union activist for the District of Columbia Nurses Association, advises nurses not to rush into things when preparing to negotiate with their employers.

“Take your time and fully develop what you see as a priority interest for you and the organization, because you have to set priorities,” she says. Build a strategic plan if necessary for how you can achieve your goals and how you can best sell yourself.

“Do not feel embarrassed about taking ownership of a new idea and doing something with it,” Johnson continues. “There are times when you have to step up and say, ‘Yes, this is my idea.’ But you also have to take ownership of the challenges and problems as well as the successes. Use every opportunity as a learning experience you can build on for future use, both from an individual growth perspective and an organizational growth perspective.”

Like other important nursing skills, negotiation skills can be learned. Johnson points out that many hospitals offer professional development programs that focus on cultural diversity and how different cultures address issues such as conflict resolution and assertiveness. She also advises minority nurses who have difficulty in asserting themselves to role-play.

“If you have difficulty doing it in a mixed-culture group,” she says, “one of the things I suggest is practicing in some type of group where you can feel comfortable–where you can say ‘this is what we have to learn how to do’ and practice it.”

Johnson says she has seen it work in minority nursing associations, such as the National Black Nurses Association (NBNA) and the PNAA. “I have experienced it firsthand with the NBNA and with Chi Eta Phi Sorority. Organizations like these have programs that focus on teaching nurses, regardless of their cultural background, to speak up and stand out as a positive influence in the workplace.”

Strength in Numbers

Having an advocate in the workplace who can lend support to your cause is also beneficial. “One of the things that helps is if you have a mentor,” Johnson says. “That person can also serve as a conduit for floating some of your ideas.” If you don’t have someone who can serve as an advocate, she adds, then finding a partner who has the ability to enhance your proposal is the next best thing. “That means knowing your colleagues and knowing the organization to be able to make that determination.”

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Brinkley agrees that it’s helpful to have an advocate in the workplace who can tout your abilities. It’s also important, she says, to be willing to take on extra duties and responsibilities, especially unpleasant or difficult ones, in order to get noticed and increase your value. Plus, you should be willing to take risks and work outside your comfort zone.

If you don’t have certain skills, learn them and work with a mentor or a career coach, Brinkley advises. Talk with that person about ways to position yourself to improve your value at work. “I would encourage any minority nurse who’s having trouble with that, or who can’t find a mentor within their organization, to invest in a coach,” she emphasizes.

It’s important to remember, Brinkley adds, that because of the nursing shortage, nurses are in a good negotiating position at the moment. “Organizations don’t want to lose valued employees, they just don’t. So to the degree that you are able to constantly repackage and refine and continue to develop your skills, you make yourself that much more valuable to the organization.”

Improving your negotiating skills also means being willing to change employers if necessary. “If it isn’t going to happen for you in the organization that you’re in,” says Brinkley, “then you have to decide whether you’re willing to move on and [find] an organization that values you.”

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