The Six Keys to Nursing Success Series

 

 

 

1^st Key- Shifting From the One Up Position to Equal Partnership

 

 

 

 

There are 6 essential keys for nurses to embrace to move from surviving to thriving in nursing:

1. Shifting from the “one- up” position (as the expert, mentor, caretaker) to equal partnership

2. Shifting from selflessness (being last on the list) to self-care

3. Creating work/life balance

4. Establishing boundaries

5. Identifying and learning to live their passion 

6. Discovering and integrating personal values into your life

 

This begins our nursing success article series with the overview of each of these essential keys. The 1^st key is shifting from the “one- up” position (as the expert, mentor, caretaker) to equal partnership.

 

A shift is defined as a change, transfer or transformation; to exchange one thing for another; to provide for one’s own needs (or the needs of the organization); a change in attitude, judgment or emphasis; 

 

We define the shift in this 1^st key as shifting out of the professional role as a nurse, into your personal role outside the profession.  Awareness of the shift is the 1^st step.  Then focus on specific actions that queue you in to consciously make the shift each and every day. 

 

These two ideas came from Duke nursing students during a Shift Change Coaching presentation of the 6 keys.  1. Changing out of your scrubs expediently upon completing your workday is one strategy.  2. Turning on your favorite music as you drive home from work to shift you back to a state of calm and enjoyment is another effective technique. What would be a good choice for you to achieve this shift?

 

Also be aware of the unique shift from “one up” (others looking up to you) as a nurse to equal partnership.  LEARN TO SHIFT!  People look to nurses for expertise, patient teaching, comfort, strength, calmness, caring and patient care. Other relationships such as the coach/client relationship (for us), romantic relationships, family relationships, friends and professional relationships require mutual respect and striving to be equals.

 

Staying in your “one up” role constantly creates exhaustion quickly and does not create a balanced life.  Having those in your life who you look up to is also essential. 

 

Who are your mentors, teachers, parents or others in your life where you are in the “taking in” role, the receiver if you will instead of in constant giving mode? 

 

You may be asking, “How will this shift benefit the nurse, the nurse’s family, the patients, the organization – the profession?”

 

Nurses utilizing this shift experience:

• Increased energy

• Recharged enthusiasm

• Amplified passion for work and personal life

• Greater productivity

• More reserves created (time, energy)

• Ability to stay in nursing profession longer

• Prevention of burnout

• Increased fulfillment with career and life

• Smooth transition from student life to professional nursing

• Clarity in choosing nursing specialty

What happens if the nurse and profession do not shift?  Staying in the “one up” mode leads to burn out and nurses leaving the profession.  Decreased quality of care, greater facility liability, increased “call outs” and higher health care costs for staff are other repercussions of failing to make this shift.

 

Internalizing and practicing the Six Keys to Nursing Success is critical in moving nurses from surviving to thriving!  The July issue of the Shift Change newsletter will explore the 2^nd key to nursing success.  Until then, practice the 1^st key and report your ideas and successes on the Shift Change Blog.

Shift Change Coaching Caring Series

This month we revisit an article from our series on Caring, Caring for Ourselves. This is the foundational building block for every nurse that is thriving and not merely surviving in their personal and professional life. One of the pillars in the Shift Change Coaching logo and one of our Six Keys to Nursing Success, is “Shifting from Selflessness to self-care” or, as we like to say, self-care before nursing care!

Shifting seasons, from summer to fall is the perfect time to revisit our philosophy on the new shift in nursing; a shift involving increased respect, self-care, excellence and autonomy for nurses and the nursing profession alike. We have long since surpassed the auspicious days of Florence Nightingale. Nurses are asked for far more than bedside nursing and we must create and sustain nurses that can rise to the level of excellence required of this profession in today’s world and have them “keep on keepin’ on” once they get there!

The profession is calling for a new breed of nurse, one with self- respect, self-fulfillment, consistent practices of self-care and passion and the usual required technical skills. This picture we are painting of a nurse with a well-balanced, fulfilled life is the nurse who will enter the workforce (or shift into) an area that creates a good fit for him/her personally and professionally. This is the nurse who may have been in the profession for a short time and is burned out or the nurse gracing the profession for many years and no longer able to stay in the current climate of nursing.

Shifting nurses from within and shifting nursing schools and employers to fostering these qualities in its nurses will create the sustainable workforce needed in this profession and one that regains and sustains its passion. The results are far reaching. The ripple effect can extend outward without limits.

There is an expression, “When the going gets tough, the tough get going.” This can be no more true than when applied to the nursing profession. The new shift simply changes this to deleting the currently implied after phrase, “at the nurse’s expense.” We no longer can afford nurses working “at their expense”. Disillusioned and burned out nurses are the ones working in a 2nd profession rather than nursing. Their talent, training, dreams and years devoted to becoming and working as a nurse are gone. The profession is left short staffed. The remaining nurses are all the more overtaxed.

Let us wake up and want more for ourselves as nurses, our nursing schools, places of employment and patients. Are you worried about a “bottom line”? Hiring nurses into a specialty where they will stay and keeping them in the profession drastically decreases overhead and hugely increases quality outcomes, which in turn positively impacts facility liability and productivity. Worried about transitioning nursing students into the “real world” of nursing? Give them the life and professional skills to get through school, make the transition and sustain a rewarding, fulfilling and long career in nursing.

Working with the nurses themselves is key. What can you do to take a step towards “Self-care before nursing Care” for yourself and/or your staff and organization? No longer are external fixes saving the profession. Plugging one hole in the dike is far from adequate. Support the shift. Be on the cutting edge of the profession. Add huge strides in health and wellness for the nurse. Healthy nurses are the best role models to create healthy patients and organizations. We must first walk our talk, then lead others to their best health. It starts with each nurse supported by nursing employers and educators. Help yourself and other nurses to meet the intrinsic needs first, then add technical training and expertise to create the most valuable package. Utilize our Shift Change Coaching foundational 6 Keys to Nursing Success to improve nurses and nursing from the inside out! The time is now. Today is the day. Make the commitment. Make the shift!

The NC Nurses Association’s new vision for nurses, “Caring for others, Caring for each other and Caring for ourselves.” Shift Change Coaching is taking part in creating and implementing this vision. We teach you what caring is really about!

We hope you have found value in this commentary on caring!

 

CARING

Last month we brought you the introduction article to the caring series. The NC Nurses Association’s new vision for NC nurses is “Caring for others, Caring for each other and Caring for ourselves.” Shift Change Coaching is taking part in creating and implementing this vision. We teach you what caring is really about!

Nurses are here to make a difference. We normally put everyone else in our lives first because we are the ultimate caregivers. Why then, do we often fail to support our fellow nursing colleagues, or worse, try to sabotage their efforts? Reports of bullying in the workplace and lack of conflict resolution are only two of the areas where nurses fail to be there for each. The culture must change to promote the nursing profession, the organizations they work for and support nurses to shift from merely surviving to thriving. Nurses lash out at others because their own needs are not met. We’ll address the unmet needs in next month’s “Caring for Ourselves” article.

What happens when nurses fail to care for each other? Quality of patient care and job performance suffers as nurses show up distracted and often fearful of retribution or simply lack of support on the job. Callouts increase due to increased job stress and resulting health problems. Patient satisfaction scores plummet as nurses come to work lacking the ability to perform at their best.

The North Carolina Nurses Association Hallmarks of Healthy Workplaces Recognition Program emphasizes the importance of caring for each other in several of their criteria including: new employee orientation, mentoring, facilitating understanding and respect among co-workers, collaboration among all disciplines, zero tolerance of employee abuse, employee turnover rate and promoting employee health and well-being.

If you are striving to achieve Hallmark status here in NC or providing new employee orientation, organizations can set the tone of “caring for each other” by teaching nurses Shift Change Coaching’s Six Keys to Nursing Success. When the nurse can step out of the “one up role” to equal partnership, they care for each other. By practicing self-care before nursing care, nurses have reserves to support their colleagues. When nurses successfully establish boundaries and experiences work/life balance their attitude becomes one of camaraderie. Living their passion enables nurses to find the best fit and to cooperate with their associates. It is important for nurses to know their values and to work in organizations and departments who have shared values.

Problem arise when nurses forget to care for each other and themselves in addition to caring for others. One of the frequent results of only caring for others is low morale. Nurses lose the passion for what they love and the energy to continue in the nursing profession. The Shift Change Coaching Group’s solution to improving morale focuses on the intrinsic needs of nurses. First, we coach nurses to understand and control fear by creating awareness and strategies to shift from a fearful mindset to one of purposeful awareness and positive action. Fear paralyzes, action moves us forward. In addition, we help nurses shift in other areas to build a strong foundation for this action. One of the keys to making this shift is going from selflessness to self-care. The next step is to reconnect with their passion and purpose in life. Continuing, we explore work/life balance and design strategies to embrace balance. Finally, through appreciative inquiry, we empower nurses to see and focus on the positive aspects of work and life. By shifting their thinking and building a firm foundation, nurses are better able to care for others and thrive. This enables them to be the happy nurses that create the happy patients and a successful organization.

Happy nurses pay attention to the patients’ and workplace needs and “go the extra mile”. Low morale is expensive due to decreased productivity, high turnover, and increased time wasted in gossip and complaining. By addressing the nurses’ intrinsic needs, the obstacles of fear, low productivity and high turnover are alleviated. By implementing the keys to improving morale, nurses and their organizations flourish – even in times of crisis. Nurses must be empowered to give the best care to others by giving them the permission and the tools to first care for themselves and each other.

We hope you have found value in this month’s commentary on caring. Next month we will bring you the second article in our series on CARING, “Caring for Ourselves.”

Just Say No – Yes You Can!

Saying no seems to have become an art form, something people think they can’t do. We are caught up in our busyness with the favorite line being, “Oh, I just don’t have time”. Yet, we say yes anyway. Schedules are frantic. Exhaustion, frustration and the never-ending impatience are common. Words like guilt abound. Do you feel like a hamster on a wheel with no idea how to get off? One-way is to set personal and professional boundaries. Just say no – Yes you can!

Where to begin? Look at your life and divide it into 5-8 personal and professional categories. You may choose relationships, financial, fun, health/wellness, work/professional, spiritual/religious or other categories that fit your life. In what areas are you the most satisfied? In which are you least satisfied? On a scale of 1-10 (10 being the most satisfied), how satisfied are you with each area?

When you are finished with your satisfaction ratings for each category, go back and rank each one on a “busyness” scale of 1-10. How busy are you in each category? How much time, effort and energy are you expending in a category in relation to how satisfied you are in that area?

Do you see yourself being very busy in very unsatisfying areas of your life? Or, expending lots of energy tolerating an area of your life where you just can’t say no? Is your time and effort filling up your calendar in areas that you are far from passionate about? Use a strategy designed by Marcia Wieder, CEO of Dream University in San Francisco, California and “turn your calendar right side up”. Marcia advises to “say no where you have a choice” to things that you are not passionate about, that don’t bring you joy and fulfillment. Going to work or picking up your children are responsible choices. However, volunteering in an area where you are miserable and resentful only because volunteering is a “good thing to do” and you feel obligated to do so is not a positive choice in your life.

Build a foundation for establishing boundaries by clarifying your values, passions and purpose in life. These are longer coaching conversations than this article can address, but getting clear about your satisfaction and “busyness scale” in the areas of your life are great first steps. Where are you in your life right now and where do you want to be? Where is it meaningful for you to say yes and how often?

Start where you are. Are you one of those “too nice” people who will always say yes? Start by practicing your “no”. Practice with a friend. Practice in front of a mirror. Practice your no without justifying your answer. Adding a complimentary phrase such as, “Thank you for thinking of me, but I am unable to attend.” is appropriate. Other responses are, “I appreciate your kind invitation but I must say no.” “I hear your situation but I am unable to help in that way.” You may want to offer an alternative resource. “I can’t take you to work but I believe our friend Sue goes that way each morning so you may want to try her as a resource.”

Decide your criteria for saying no ahead of time. Better yet, put a positive spin on it and decide your yes criteria. Your yes criteria might look something like this. 1. Am I passionate about this activity for myself or my family? 2. Can I fit it into my calendar without increasing my stress? 3. Is it financially within my means (or available assistance/scholarships)? 4. Is it fun? Create 3 or 4 questions that are important to you. If a situation does not pass your 3 or 4 yes criteria, then the answer is no. What yes creates fulfillment, meaning and fun in your life? Sometimes the best yes in your life is actually a no.

You will be giving more to those in your life and those you want to make a difference with by setting your boundaries firmly. You cannot give what you don’t have. Giving of yourself in ways that are detrimental to you, your health, well being, your family, colleagues and friends results in an unfulfilling life.

Say yes to your purpose and passion and no to the busyness, stress and heartache. It’s all about making the best choice for you, and you do have a choice in many instances. Exercise good choices so that you and those around you will reap the benefits over and over again. What will you say no to today to create room for your best fit of yeses?

Just say NO – YES you can!

Set the Stage for a Successful Difficult Conversation

Every conversation is a critical conversation. If they weren’t critical, why would we have them? Many conversation evolve into difficult conversations when:
1. Opinions vary
2. Stakes are high
3. Emotions run strong

Difficult conversations are challenging, frustrating, frightening or just annoying – and – the results could have a huge impact.

There are three things we can do when faced with a difficult conversation. We can avoid it, handle it poorly or handle it in a good way.

When conversations matter the most, people revert to their worst behavior. They yell, shout, are sarcastic and belittling.

We have generations of programming that have taught us how to react when we are under pressure. The reactions are fight or flight. There are warning signs that the “fight or flight” reaction is being triggered. The hair on the back of your neck stands up. You get goose bumps, feel a knot in your stomach, you blush. This is your adrenaline pumping.

A Tip for a Difficult Conversation:
Begin each difficult conversation with the right motives and stay focused no matter what happens. Focus your brain. Ask yourself what am I doing and what does it say about my underlying motive?

Four questions to answer before engaging in a difficult conversation:
1. What do I really want for myself?
2. What do I really want for others?
3. What do I really want for the relationship?
4. How would I behave if I really wanted these results?

Recap of Events of NCNA PPAC

The North Carolina Nurses Association Professional Practice Advocacy Coalition (PPAC) hosted the Nurses Transforming Nursing Summer Summit on June 26, 2010 at Southern Regional AHEC in Fayetteville, NC. Over 30 nurses and healthcare consumers participated in NCNA’s ongoing journey to transform the culture of nursing and healthcare in North Carolina.

Merrily and Betsy participated in this summit almost a year ago. At the end of the summit, the group had drafted a new vision statement for NCNA: In the year 2012 NC nurses will honor and value caring for others, caring for each other and caring for ourselves.

We, at The Shift Change Coaching Group, are thrilled that one of our Six Keys to Nursing Success, self care before nursing care, integrated into the vision statement – “caring for ourselves”.

After the summit, Merrily was asked to serve on the leadership team of the Professional Practice Advocacy Coalition and to chair the caring for ourselves committee. During the past year she conducted several meeting to create strategies to put into operation “caring for ourselves”.

Beginning in April, 2010 another round of forums was held throughout the state to spread the word about Nurses Transforming Nursing and to introduce the new vision statement. Merrily and or Betsy attended every forum and reported on the work of the “caring for ourselves” committee.

The reception to the new vision statement is fulfilling. Nurses are excited to define caring and immediately embrace caring for others, caring for each other and caring for ourselves. The dialog around caring for each other and caring for ourselves is rich. Seldom do nurses take time to think, much less practice, caring for each other and caring for themselves.

On Tuesday June 22, 2010 Betsy attended the final forum in Winston Salem, NC. Other attendees included a representative from the NC Board of Nursing and the NW Area Health Education Coalition.

The next step in Nurses Transforming Nursing is to create “tools” that nurses can use to implement the vision statement. Shift Change Coaching will continue to participate in this transformational initiative.

Creating Work/Life Balance

Creating work/life balance is a process and one that is ever changing from day to day. Reevaluating where you are as an individual and your part in fulfilling the vision of your organization on a regular basis is essential.

For organizations, the “new” healthy workplace is at least a combination of a hierarchy and collaborative model and ideally, all collaborative. Creating balance and meaning within the workplace and life keeps us at our happiest and most productive. Employees skilled at life balance show up, give quality care and stay in the profession longer.

Strive for a balanced life now. Get clear on your definition of life balance. All work and no play makes Jack a dull boy! Is your life all about responsibilities and little enjoyment? When was the last time you did something just for you? Are you taking time to be still and reflect on your present life and what you wish for your future?

For organizations, is it all about what’s not working or also emphasis on a job well done?

What systems and resources are working well that can provide a foundation for excellence? The healthy balance lies in considering all these things to support continuous quality improvement and recognition of existing successes.

For the individual, living a balanced life doesn’t necessarily mean spending equal time in each area of your life. It does mean finding balance in your roles as giver and receiver. Take care of others and give to others a portion of your time versus 100% of the time. Dedicate time for self-care, learning and replenishing yourself on a regular basis. Who are you passionate about being and what are you passionate about doing?

What is your detailed picture of a typical day in your dream week? Dream life? If you see a gap between where you are and where you want to be, what action step are you willing to take this week towards the future you desire? If you are not sure, go back and set aside time to create the specific details so you can clearly see the life you want.

Where do you see yourself in your dream nursing career? Are you there yet? If not, get clear and then create stepping-stones to reach those goals. Any obstacles in your way are simply challenges to be overcome. Elicit help from others to support you on this journey.

Create a Dream Team. A Dream Team is everyone you know and everyone you don’t know that can help you achieve your dreams.

Make specific requests for ideas and assistance and make it easy for others to say yes! (Example; “Can you give me some advance practice scholarship information resources?” Vs. “Can you help me become a Nurse Practitioner?”)

How can you build your dream team today?

North Carolina Nurses Association (NCNA) Launches Innovative Program – Nurses Transforming Nursing

Shift Change Coaching participated with the NCNA’s forums for nurses and consumers.

Shift Change Coaching, Betsy Smith and Merrily Sable, were able to share their expertise and knowledge of the need for local and national support for nurses.
By 2012 NCNA North Carolina Nurses will value and honor:
• Caring for others
• Caring for each other
• Caring for ourselves.

It was exciting to share Shift Change Coaching’s passion for nurses from “Surviving to THRIVING”. We are excited to see the momentum begin across the entire state of North Carolina, and the country!

How will you support the nurses you know?

www.ShiftChangeCoaching.com

Creating Work/Life Balance

There are 6 essential keys for nurses to embrace to move from surviving to thriving in nursing:

• Shifting from the “one- up” position (as the expert, mentor, caretaker) to equal partnership
• Shifting from selflessness (being last on the list) to self-care
• Creating work/life balance
• Establishing boundaries
• Identifying and learning to live their passion
• Discovering and integrating personal values into your life

This is the 3rd in our nursing success article series with the overview of each of these essential keys. The 3rd key is Creating work/life balance (inside and outside the organization).

Creating work/life balance is a process and one that is ever changing from day to day. Reevaluating where you are as an individual and your part in fulfilling the vision of your organization on a regular basis is essential.

For organizations, the “new” healthy workplace is at least a combination of a hierarchy and collaborative model and ideally, all collaborative. Creating balance and meaning within the workplace and life keeps us at our happiest and most productive. Employees skilled at life balance show up, give quality care and stay in the profession longer.

Strive for a balanced life now. Get clear on your definition of life balance. All work and no play makes Jack a dull boy! Is your life all about responsibilities and little enjoyment? When was the last time you did something just for you? Are you taking time to be still and reflect on your present life and what you wish for your future?

For organizations, is it all about what’s not working or also emphasis on a job well done?

What systems and resources are working well that can provide a foundation for excellence? The healthy balance lies in considering all these things to support continuous quality improvement and recognition of existing successes.

For the individual, living a balanced life doesn’t necessarily mean spending equal time in each area of your life. It does mean finding balance in your roles as giver and receiver. Take care of others and give to others a portion of your time versus 100% of the time. Dedicate time for self-care, learning and replenishing yourself on a regular basis. Who are you passionate about being and what are you passionate about doing?

What is your detailed picture of a typical day in your dream week? Dream life? If you see a gap between where you are and where you want to be, what action step are you willing to take this week towards the future you desire? If you are not sure, go back and set aside time to create the specific details so you can clearly see the life you want.

Where do you see yourself in your dream nursing career? Are you there yet? If not, get clear and then create stepping-stones to reach those goals. Any obstacles in your way are simply challenges to be overcome. Elicit help from others to support you on this journey. Create a Dream Team. A Dream Team is everyone you know and everyone you don’t know that can help you achieve your dreams. Make specific requests for ideas and assistance and make it easy for others to say yes! (Example; “Can you give me some advance practice scholarship information resources?” Vs. “Can you help me become a Nurse Practitioner?”)

Internalizing and practicing the Six Keys to Nursing Success is critical in moving nurses from surviving to thriving! The September issue of the Shift Change newsletter will explore the 4th key to nursing success. Until then, practice the 1stthrough 3rd keys and report your ideas and successes on the Shift Change Blog.

*For those of you who want more of this work for yourself or your organization, we offer life balance teleclasses or on site workshops and individual and group coaching.

Best regards,
Merrily Sable, RN, BSN and Betsy Smith, PhD

“From Surviving to Thriving in Nursing-Six Keys to Nursing Success”

Register for our FREE Teleclass

“From Surviving to Thriving in Nursing-Six Keys to Nursing Success”

Next teleclass date: Wednesday April 14, 2010

(1 Nursing contact hour available for this class)

The mission of the Shift Change Coaching Group is to make a positive difference for nursing institutions, employers and nurses alike. The increasing high demand for nurses and the ever-present quest for excellence in nursing cry out for a new shift. The stakes are critical. The shortage has risen to a crisis point. According to one national study, one in five newly licensed nurses quits within the first year. Personnel experts estimate the cost of recruiting and retraining a replacement nurse who “washed out” is about $50,000. Empowering nurses to show up at their best will help create the quality and quantity of nurses needed for the future and will sustain our current nursing workforce. It’s the right time for the new shift in nursing. Invite the Shift Change Coaching Group to show you how!

The Shift Change Coaching Group is a consulting and coaching business providing affordable and effective coaching strategies. The experts at Shift Change have over 68 years of accumulated experience in nursing, coaching and health related education.

The uniqueness of the Shift Change Coaching strategy is simple – concentrate on the intrinsic needs of nurses and nursing students themselves. The current and projected shortage clearly demonstrates that the existing external strategies – pay incentives, flexible schedules changes, and more training, are fruitless. Rising from surviving to thriving occurs by shifting from external fixes to internal solutions.

Register Here: http://www.shiftchangcoaching.com/teleclass-form.htm

(You will receive a reply with the teleclass call-in information. Please share this invitation with others.)

Contact Merrily Sable msable@shiftchangecoaching.com 919-413-7888 or Betsy Smith bsmith@shiftchangecoaching.com 919-521-4734 (for more information)