Magazine article American Nurse Today

Stop: A Strategy for Dealing with Difficult Conversations

Magazine article American Nurse Today

Stop: A Strategy for Dealing with Difficult Conversations

Article excerpt

MONICA IS LATE for work again. June has body odor. Brian doesn't comply with the hospital's cell-phone policy.

As a nurse manager, you know you need to do something. Are you avoiding the tough conversations required to deal with these issues? What's holding you back from communicating openly with your staff? This article can help you open up your communication style and stop avoiding tough conversations. (See Topics that can make for tough conversations.)

Preparing for difficult conversations

As with anything, preparation is important. Before confronting someone about a prickly topic, ask yourself:

* What's the problem?

* How do I feel about it?

* What do I want to be different?

Suppose you need to confront a staff nurse who has been bullying new nurse graduates. Here are the key questions to ask yourself beforehand, along with possible answers:

1. What's the problem? Answer: A staff nurse is bullying new graduates, who aren't getting the support they need as they transition to the work environment.

2. How do I feel about it? Answer: I am angry and frustrated. If this keeps up, I will lose staff. There's also the issue of patient safety if new nurses can't seek help.

3. What do I want to be different? Answer: I want the bullying to stop. I want a positive work environment with collaboration and cooperation.

Putting STOP to work

The STOP strategy helps guide you through difficult conversations. Here are the key components:

* State the situation or problem.

* Tell the person-what you want.

* Offer an opportunity to respond.

* Provide closure (review, summary, or thanks).

State the situation or problem

Sharing facts increases your confidence: for example, "This is the third time this week...." But be sure to separate the behavior from the person doing it. Rather than labeling the person lazy or sexist, describe the behavior. For example, "I've noticed that...."

Share your feelings: "I feel ..." or "When you do A, I feel B." Avoid saying, "You make me feel...."

Sometimes it's hard to start a difficult conversation. Here are some tentative beginnings:

"Perhaps you're not aware ..."

"I'm beginning to wonder ..."

"I need your help with something."

Tell the person what you want

Don't expect people to know what you want unless you tell them. Suppose your college-age son is home for a weekend and running the washing machine and dryer outside your bedroom at midnight. If you tell him his laundry chores are interrupting your sleep, he may think he should stop at, say, 10 P.M. So be specific: "I'd like you to be done with your laundry by 8 P.M."

Offer an opportunity to respond

Make this a two-way conversation. Otherwise, you're just delivering criticism. Invite the other person to respond: "Do you agree?" or "Can we work something out?" or "What do you think about this?" The person's response provides an opportunity to evaluate how the conversation is going.

Provide closure

To prevent rambling and repetition, review or summarize the conversation. For instance, thank the person for meeting with you: "Thanks for getting together to discuss this important issue. I hope you can improve. We'd hate to lose you. You're an excellent clinician."

Using STOP for common workplace problems

Sometimes the best way to learn something is to see examples in common workplace situations. Review the six examples below.

Problem: Tardiness

S: Monday and Tuesday, you arrived 20 minutes late for work. …

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