Social Skills in Nursing: The Art of Validation

Countless nurses, new and seasoned, continually report problems at their various workplaces. A common theme that proves central to many of these problems is a notable deficiency in several important social skills. In essence, some nurses are creating discord at their places of employment without even realizing it. This article is the first of a two-part essay that aims to discuss the top social skills problems that nurses face today. Nurses Relations Article

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Before proceeding any further, here is a feasible definition of social skills. Also known as soft skills, relational skills or interpersonal skills, the term 'social skills' refers to the collective repertoire of intangible skills that individuals use to communicate, form connections, and facilitate interaction with other persons. Social skills are among the most important set of competencies an individual must develop because they influence success or failure in all aspects of life, including the formation and maintenance of good friendships, development of fulfilling romantic partnerships, and construction of a successful career. Frankly put, an unintelligent person can thrive professionally and personally if he has proficient social skills, but a highly intelligent individual may fail to find professional success and fulfilling personal relationships if he has poor social skills.

Over the years, a significant number of posts we've encountered seem to pertain in one way or another, either directly or indirectly, to the detrimental effects of poor social skills in the workplace:

  • "My preceptor hates my guts!"
  • "The CNAs don't respect me."
  • "My coworker is the unit snitch."
  • "The day supervisor practices favoritism."
  • "Kelly thinks she's better than everyone."
  • "How can he get away with being so lazy?"
  • "None of my coworkers like me."
  • "Kerry is the snottiest nurse ever."
  • "I am a new grad who cannot find work."
  • "Why do patients love my ditzy coworker?"
  • "Employee turnover is sky high on my unit."
  • "Jeff talks constantly about his fishing trips."
  • "The family member kept me in that room for two hours!"

It is no secret that some individuals possess more competence at utilizing social skills than others. Why does this happen? Well, some people have naturally picked up the necessary social skills during the mundane process of living their lives whereas others must explicitly be taught what to do, what to say and how to interact. Development of social skills is similar to construction of a skyscraper: the foundation is built through interactions with the individual's family of origin during infancy and childhood, and the subsequent floors are constructed with school experiences, socialization with classmates, and extracurricular encounters (sports teams, clubs, dance lessons, etc). The more an individual socializes, the more social skills they develop, and as a result their personal skyscraper becomes taller while they progress through life's situations.

How does this all relate to nursing? The nursing profession, and other occupations that entail a profound number of encounters with many different people, must have members with reasonably good social skills. The chemical engineer who spends most of the workday in an office by himself can get away with poor social skills, but the bedside nurse with poor social skills will have a 30-year career peppered with 30+ different jobs, most of which involved involuntary termination (read: "you are fired!") or forced resignation. Without further delay, I will start listing ways in which nurses with poor social skills may wreak havoc without even realizing it.

People need validation. Validate them, please!

Human nature can be bizarre because it operates mostly on emotion rather than logic. Many people are looking to be told what they want to hear, and nothing more. Personally, if someone dislikes me, I'd rather not participate in phony exchanges that involve the two of us pretending to be fond of each other. However, I am an odd turtle who grasped basic social skills later than most. It wasn't until I approached 30 years old that I developed an awareness of humankind's profound needs for validation and personal acknowledgement. In essence, calling someone a 'loser' within earshot is pretty darned bad, but walking past the same person on the street without speaking or making eye contact is viewed by many people as an offense that is a trillion times worse. Why? When we call someone a 'loser' or some other derogatory name, we've acknowledged his existence and shown that we've thought of him, even if our opinion and thoughts are negative. But when we walk past someone with whom we're acquainted without uttering as much as a "Good morning," we've failed to validate their existence, and to many people this is an offense that slowly kills off a piece of their souls.

The individual with poor social skills will see many workplace problems disappear if (s)he starts validating everyone, even people whom he/she dislikes. Do you work with a mouthy CNA who disappears or hides frequently? Acknowledge her. Pretend to show an interest in her life. Ask about her children, if any. Remember the children's names. Compliment her on her hair clip, necklace, shoes, or scrubs, even though she might look hideous. Every once in a while say, "Thank you for all that you do!" Coworkers will want to work with you once you show an interest in them as a person. The point is to validate one's existence as a person. Some of our colleagues, superiors and subordinates are pathetically lonely people who crave validation at the workplace because they do not get it in their personal lives. "Good morning" has a deeper meaning to many people because it communicates to the receiver that "I matter to you."

Do you know a nurse who is beloved by patients, families and management even though she is somewhat dimwitted? Here's another question: do you know an intelligent, highly proficient nurse who has excellent procedural and assessment skills but cannot keep a job for long because she cannot seem to connect on an interpersonal level with patients, families and coworkers? It's all about the skill of acknowledgment. The nurse with the warm personality who knows what to say, when to smile, when to stroke the patient's hand, and how to allay the family member's fears will win their approval even though she's failed to rescue multiple times over the years. Patients and families judge healthcare workers based on how good they were made to feel, not by how good the nursing care might have been. This might not be fair, but few things in this life are fair. This same nurse knows how to validate the existence of her supervisors and unit manager by greeting them, showing interest in them as people, and being a pleasant person overall.

Meanwhile, the socially awkward nurse with outstanding assessment and procedural skills cannot understand why she generates complaints from patients and families. After all, she feels she's an excellent nurse with the education, experience and hard skill set to handle virtually any situation. She walks into rooms, says hi to the sick person laying in the bed, and starts her assessments without drumming up small talk that validates the patient's existence. She doesn't speak much to the family members at the bedside or take any actions to stroke their fragile egos. She never shows an interest in her unit manager as a person and sometimes walks past him without a greeting. The nurse seldom speaks to her shift supervisors or charge nurse, but is there to run codes with precision. Other nurses, CNAs and ancillary staff have referred to her as standoffish, quiet, unsociable, and snotty. The socially awkward nurse feels that her supervisors and managers practice favoritism.

The moral of the story is that social skills will make or break your career. Remember to validate people and acknowledge their existence as fellow humans. Show an interest in their lives, or at least pretend as if you care. If you are a new grad on orientation, be pleasant and agreeable to your new coworkers and spend some breaks with them on occasion. Always remember that small talk is never really about the weather, the latest fashion or the petty topic being discussed. Rather, small talk is the glue that helps formulate and maintain connections with your fellow human. Stay tuned for Part II, which discusses several other ways that socially awkward nurses may incite hard feelings without realizing it. Here are more pieces that discuss social skills:

Confessions of a Nurse with Poor Interpersonal Skills

Hard and Soft Skills

References

Skills You Need

Specializes in Family Nurse Practitioner.

Great topic!

Excellent article on an important part of being a nurse.

I think most of my social skills, which are pretty good, are because I've been a nurse most of my adult life. But I didn't start out that way, and until I 'got it' my life as a nurse was much harder than it is now.

One big revelation to me (in hand with this article) was how much better my life in nursing was when I shifted my focus to the well-being of the others around me. I don't mean some codependent thing, just natural interest in what's happening to a fellow nurse, and definitely, giving positive feedback even to the biggest curmudgeon.

It's kind of like 'feeling' your way around, there's no checklist or function chart.

I remember cringing and being so focused on how I was treated, what I imagined was being said or thought about me. I was petrified of making a mistake or of being the black sheep. Somehow, not sure how, but it occurred to me that I was just plain feeling sorry for myself, and that drew a lot of negative attention (or, it appeared to). It's not like my job got better or my coworkers easier to get along with, it was the way I looked at things that changed.

I still see all the insanity and chaos as much as I ever did. It bothers me as much as ever. I just don't take it personally, as if it were some kind of personal attack just to make my life suck (like, staffing issues). I have a choice to work or not in a poorly staffed unit. Hey, wait! It's understaffed EVERYWHERE. Literally. Some places worse than others . . . so lets find a better place.

I think you do find what you are looking for :( If you are very anxious about how mean fellow coworkers are to you, you'll see EVERY LITTLE thing. I'm sure I've 'overlooked' a lot of evil thoughts along the way. What a lovely thing, really. Makes a hard job easier to tolerate. So nurse A isn't all that fond of me? That's her right. I don't like everyone either.

There have been some nurses I really looked up to, and wondered what it was about them that they didn't seem so stressed, actually appeared cheerful almost no matter what. I'll admit I suspected some were borgs, how could anyone be so darn cheerful all the time? In THIS place? But they often complimented or gave positive encouragement. They could discuss an error with another nurse without the nurse feeling insulted. They could withstand verbal abuse from a patient's family with the most amazing dignity. Again and again, no matter what went on, they held their chin up, kept their sense of humor about themselves (I think this is key).

Our job is hard. And we unintentionally make it much harder than it needs to be. "Social skillz" is the lubrication in a cranky mechanism called healthcare. You can be pleasant and polite with ANYONE, no exceptions. Even when they are spitting in your face, no need to lose your own dignity. You can have the most difficult conversations and maintain a pleasant facial expression and tone of voice. It takes practice. And no, it does not feel 'fake'. I do it from genuine respect, which I extend to myself as well as others. That's the idea, anyway, and no I'm far from perfect, but I've worked hard to 'get it' and I agree, it's made my life as a nurse SO much more satisfying.

SHGR said:
I do separate "being friends with" and "being friendly with"- I keep close boundaries, I don't socialize much with coworkers outside of work, but I have very collegial relationships with them. I know people professionally at outside facilities and other sites in our health system (case managers, home care people, etc) that we do favors for our mutual patients, and our patients benefit from these relationships that we share. We're just not running buddies or drinking buddies.

Yeah it makes sense when y'all say it like that. I really like all my coworkers and would consider them to be friends, but not the kind I would ask for a ride to the airport.

Specializes in LTC, Med-surg.

This reminds me of something that happened to me during my shift on Sunday as a CNA. One of the nurses made

a very rude comment to me when all I did was repeat back to her what the patient had said about her bowels. I guess

the nurse thought it was stupid of me to bring it up. Instead of replying back in a very aggressively hostile way and making an

awkward work environment, I chose to chat with her. I quietly relayed with her that I was not aware of the patient's status since I worked very little hours at the facility nor was I aware that this patient was not in her right mind. In other news, I continued to talk to her more so that we can somehow lose the hostility and to help myself "make up" for the hurt feelings I felt by her comment.

In the end, she taught me a thing or two and even suggested a very interesting medical television documentary for me to check out. I don't think we're friends but I feel like my approach made her an ally rather than an enemy in my book. Hopefully, she will treat me better since I've spent some time talking to her.

Social skills really do matter.

Specializes in cardiac-telemetry, hospice, ICU.

OP, great topic, you are right on. I honed my people skills with an OLD book,"How to Win Friends and Influence People" by Dale Carnegie. It was a huge best seller in its day and is still totally appropriate. The book is and easy read and you can get an old copy for next to nothing.

I remember one story he told where he was at a party and engaged in a conversation with a stranger about sailboats. At the end of the conversation the stranger considered Dale an interesting fellow and a new friend. Dale reported in the book that he didn't know a darn thing about sailboats, but he showed interest in what the stranger found interesting. Very much in tune with what the OP is saying.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
SubSippi said:
I really like all my coworkers and would consider them to be friends, but not the kind I would ask for a ride to the airport.

If you would not ask your coworkers for a ride to the airport, they're not really friends in my humble opinion. I'd refer to these types of people as acquaintances or associates: the people in our lives whom we know fairly well, but are not quite friends.

Most people would have no problem asking a real friend for something such as a ride to the airport or other types of favors that will be reciprocated someday.

Social skills is a really hard topic for me,as i have higher functioning autism.

I cannot show interest in a person if i truly do not like them,and i certainly cannot fake it.

I tried so hard to smile all the tine,but i felt so fake and stopped it.

Why should I have to alter *my* comfort level so someone else can feel comfortable?

Since it is Christmas,this makes this topic even harder.

I do not celebrate any holidays,including birthdays.

I do not celebrate the holidays,and when someone wishes me a Merry Christmas,i do not say anything back.

People think I am then being an itch.

Specializes in Complex pedi to LTC/SA & now a manager.
smartnurse1982 said:
Social skills is a really hard topic for me,as I have higher functioning autism.

I cannot show interest in a person if I truly do not like them,and I certainly cannot fake it.

I tried so hard to smile all the tine,but I felt so fake and stopped it.

Why should I have to alter *my* comfort level so someone else can feel comfortable?

Since it is Christmas,this makes this topic even harder.

I do not celebrate any holidays,including birthdays.

I do not celebrate the holidays,and when someone wishes me a Merry Christmas,I do not say anything back.

People think I am then being an itch.

Why not just say "thank you" or "have a nice day" if someone offers a holiday greeting? It's simple acknowledgement that someone spoke to you and offered a greeting not an offer of celebration. (Saying have a nice day was a suggestion by a speech pathologist for a middle schooler that has a form of autism and wanted an idea rather than turn away or ignore the person)

How does the generational gap come into play here? I work with nurses who are basically 20-30 years younger than I am. I try to be interested in their "chatty" subjects, but honestly, there is only so much I can listen to. I do not want to come across as the "old geezer with advice on everything," but I kind of feel outside the loop. I try to touch on a subject all of us may relate to, but sometimes that is very difficult. We are just forming a team because over half are new hires. What advice to you have for those of us working in a more generational gap environment??

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
JustBeachyNurse said:
Why not just say "thank you" or "have a nice day" if someone offers a holiday greeting? It's simple acknowledgement that someone spoke to you and offered a greeting not an offer of celebration.

Bingo! Even if you do not celebrate the holiday, proper social etiquette requires us to respond to holiday greetings by saying something like "thank you" or "same to you!"

Not saying anything in response to a holiday greeting is construed by many people as the rudest slap in the face ever because you are not acknowledging them or validating the person who greeted you. Instead, you are ignoring the person as if they are invisible. Look up the concept of invisibility; it is rather bleak to treat someone as if they aren't there.

Specializes in Complex pedi to LTC/SA & now a manager.
TheCommuter said:
Bingo! Even if you do not celebrate the holiday, proper social etiquette requires us to respond to holiday greetings by saying something like "thank you" or "same to you!"

Not saying anything in response to a holiday greeting is construed by many people as the rudest slap in the face ever because you are not acknowledging them or validating the person who greeted you. Instead, you are ignoring the person as if they are invisible. Look up the concept of invisibility; it is rather bleak to treat someone as if they aren't there.

Exactly. My son is dealing with this now. Former friends turn their back to him and blatantly ignore him as though he isn't there causing much difficulty. There is no excuse as these are "typical" children and my son is the child with autism and social deficits. Ignoring someone intentionally is extremely cruel. Simply saying have a nice day does not acknowledge the holiday celebration that you don't recognize/celebrate but simply affirms the existence of the human being that offered a greeting. By not doing do isn't being an "itch" but is being rude and possibly cruel. No one says you need to socialize or participate in trivial conversations with others whether or not you like them but being civil is necessary. You don't need to be friends with everyone.

TheCommuter said:
If you would not ask your coworkers for a ride to the airport, they're not really friends in my humble opinion. I'd refer to these types of people as acquaintances or associates: the people in our lives whom we know fairly well, but are not quite friends.

Most people would have no problem asking a real friend for something such as a ride to the airport or other types of favors that will be reciprocated someday.

It's come to my attention...that I might have been using the word, "friend," a little loosely! ?

We still have a good time though!