Hard and Soft Skills

Two types of skill sets exist in nursing and in other professions: hard skills and soft skills. The hard skills are the hands-on procedural skills that a typical bedside nurse must use to perform the job effectively, while soft skills are the intangible interpersonal skills one needs to facilitate communication and navigate the workplace successfully. Nurses Professionalism Article


I attended an all-staff meeting that was being facilitated by the hospital administrator, chief nursing officer, and a couple of other members of the site leadership team. I will never forget a statement the administrator made.

"We are now hiring nurses for personalities. We no longer hire nurses for their skills," he said.

I raised my hand and kindly asked him to elaborate on this statement. He explained that almost any newly hired nurse can learn the skills necessary for bedside nursing. But what management desires in a nurse, and what they cannot teach every individual, are certain work-related social skills such as basic courtesy, getting along with others, caring for patients as part of a team, maintaining camaraderie, and being a good coworker and the type of caregiver that patients and colleagues will like.

He went on to say, "Now that Medicare reimbursement rates will be determined by patient satisfaction scores, it is important that we hire and retain nurses and techs who have good attitudes."

I clarified, "So you will now hire people based on their soft skills and hope they are able to grasp the hard skills?"

The administrator and chief nursing officer simultaneously confirmed that, yes, they would hire staff based on the personality conveyed during the interview process. The old way of hiring prospective employees would be gone forever.

Nursing Requires Two Types of Skill Sets

In the nursing profession and in other occupations, there are two types of skill sets: hard skills and soft skills.

What are hard skills examples?

The hard skills are the hands-on, technical, procedural skills that a typical bedside nurse needs in order to perform the job effectively. Examples of hard skills include starting peripheral IV lines, performing dressing changes, inserting urinary catheters, administering injections and checking vital signs.

What are soft skills examples?

Soft skills are the intangible social skills that an employee needs in order to facilitate communication and navigate the workplace successfully. Soft skills are comprised of the personality traits, positivity, cordiality, work ethic, dependability, workplace etiquette, behavioral competence, emotional intelligence, reliability, communication style, personal habits, optimistic attitude, interaction, and unspoken social graces that come together to render someone a desirable employee.

A person who does not possess soft skills is often viewed as an undesirable employee, even if he / she has a wealth of hard skills.

Employers Can't Train Soft Skills

It has been said that employees can be trained to perform the hard skills, but the soft skills come from within. For instance, an organization can easily teach someone to apply a wound vac machine, but they cannot train this same nurse to have empathy for others, communicate effectively, or change the selfish personality that she has displayed since middle childhood.

Soft skills are important enough to make or break a person's career because, although a pleasant person can thrive in the workplace without a high intelligence level, a very intelligent individual with hard skills will struggle in his or her professional life without polished soft skills. In fact, the Center for Public Resources did a national survey and found that 90% of the time people are fired for poor attitudes, inappropriate behavior and poor interpersonal skills rather than deficient job skills. A lack of soft skills will impede the ability to foster interpersonal relationships in all aspects of life.

Soft skills have merit, however not "everyone" can be taught skills. I know plenty of "nice" nurses I wouldn't let touch me with a 10 foot pole. I think you need to have a good balance. It is nice to get a heads up on what management is really looking for.

I think both hard and soft skills are equally important.

Is is definitely harder to change someone's personality than to teach them skills :)

The caveat is that some administrations do not have healthy boundaries on the lengths to which they go to secure that patient satisfaction score. If their strategies cause staff morale to sag, can you guess what the long-term effect on patient satisfaction scores is going to be?

I don't understand why so many people are upset about this. It's not an either/or thing. Just because you have these "soft" skills it doesn't mean you are an incompetent nurse. Many nurses who come to the field as a second or third career have already had to develop them to survive. I was one of those nurses.

I worked as a CNA part-time while I was going to nursing school and working in my previous career in Graphic Design. I was absolutely shocked by the lack of basic interpersonal skills that were evident in my coworkers. It seemed like the people I worked with had found, through trial and error, the only industry that would employ them and tell them it was okay to act the way they did.

Nursing is just catching up with the rest of the nation. I am all for it. There are very few legitimate reasons to have a bad attitude at work.

If you want, you can develop "soft skills" pretty easily. The next time you get a job, just listen in orientation. They will tell you exactly how they want you to act. Or look in your employee handbook. If you have no plans to get a new job and don't have access to your employee handbook, you can ask the education department at a local hospital what you can do to improve. They are usually happy to help.

Also, if you are reading this, I assume you have internet access and can Google it! Another option is to go to the local library and look for self-help books that are geared towards managers. One of the best I have read is How to Win Friends & Influence People by Dale Carnegie.

Specializes in Critical Care, Education.

Old fogey here -

There is a lot of information out there about the 'charm school' focus in health care (AKA HCAHPS). Evidence is emerging that organizations with the best satisfaction scores are not the ones with the best clinical outcomes. Is anyone surprised? It's like the age old service conflict of Wait times versus Cost effectiveness... if you hire enough staff to make sure that no one ever has to wait, you are sure to be overstaffed & profits will decline.

I think we're headed for a major industry-wide decompensation. Providers are being asked to comply/meet two conflicting goals... supporting extreme service satisfaction in the face of continuously declining revenues. Of course, the people most affected by both goals are (wait for it . . . ) Nurses & other direct care providers. If goals are not met, it will be our fault, right?

And it isn't just interacting with patients. It's other workers, doctors, bosses, visitors. And it's so true that skills are vital, but we also have to make people like us.

We also have to be dependable and have integrity.

We must not complain. We can see a problem, figure a couple of approaches to solve it, and respectfully submit it all to the boss.

But we can't just tell the boss a problem. The boss doesn't want to have to fix everything.

At least, that has been my experience. We can't step on toes, though, by going outside the chain of command.

Specializes in L&D, CCU, ICU, PCU, RICU, PCICU, & LTC..
RobtheORNurse said:
It is a sad commentary but so true. Everyone wants the sunshine and rainbows and they whine when they don't get it. I have said time and again to people I know, I would rather have the most gruff caregiver that is fully competent in their skills than a really nice incompetent one. I may sound bitter about it but a cute smile and sweet demeanor mean nothing when a patient is going down the tubes. A smile without skills is just a smile. I have been in some very difficult situations, in hospitals, in burning buildings and in battlefields, skills matter. You can smile later.

THAT is exactly how I feel. After a 40 year career, give me a nurse who KNOWS what she is doing. I can get my giggles and feel-goods from housekeeping or dietary. Of course a nurse with both is perfection!

I just read a little excerpt from Silence Kills. I probably never realized, until just now, that other nurses share my frustrations. It's a shame that we so often feel this way, but a real relief to know I'm not alone. Thank you so much for leading me to this book, msn10.

I work and have often worked with some really cowardly nurses. They know something isn't right or isn't the best, but will never, under any circumstances, say a word to the doctor, manager, supervisor. They are either much smarter than I, that is, really good at the soft skill of shutting up so as not to ruffle any feathers, or they are contemptible chickens. They see a problem, but leave it to me or other nurses who are bolder and stronger to solve it. I resent them a lot and envy their ability to look the other way. Case in point: a pt was deemed unacceptable to have a roommate because of his cursing. But the supervisor ordered us to put him in a room with another pt due to staffing shortages. The other nurses all moaned and complained, but no one spoke with the supervisor. One said, "I'm not Charge", thereby justifying to herself why she could not speak up, even though she was the curser's nurse. The Charge didn't speak up because she was scared. Result? The move was made, only to have to be undone because the roommate complained about the cursing!

Nursing as I learned it and have lived it requires self-minimalization. Is that a word? Putting oneself down, showing total respect to doctors and bosses. I understand this and even do it, having learned the hard way that it's easier for me if I go along to get along.

But I always feel I've been untrue to myself and then wonder why I have mixed feelings about Nursing and all of us characters who are involved in my work world. I have often thought that nurses should be religious - that is, called to serve the sick while never being married, having kids, and trying to have a life outside of Nursing. It seems easier to be fully immersed in work, not trying to balance it with personal outside life.

I once knew a nurse who kept a med stash in her locker because it was easier and quicker than dealing with Pharmacy's errors and the Supervisor's unwillingness to go to the After Hours Locker. She got fired. My shift used to stash extra meds around the Med Room, but they were often enough discovered and returned to Pharmacy by another nurse (who worked Days and could easily get the errors & oversights corrected, while Nights could not. I dreamed of pulling her hair out by the roots sometimes. Well, not really, but you get the idea).

Middle Age Nurse - the OR is no different. True, you have less contact with patients and families, but you still have coworkers and doctors to cope with.

I am going to re-read How To Win Friends and Influence People because it's the 2nd time in 2 days it's been mentioned to me.

We were taught to advocate for patients, but not how to do it without angering the docs and bosses. This I have learned the hard way.

Specializes in FNP-BC 2014.

Oh, please, give me a MAJOR break! Most nurses start out eager and kind - a few months or years on the floor takes care of THAT. Come on now! A person can only be dumped on by management so many times before it starts to show. Most abusive job I ever had. I'm an NP now, but QUIT 16 yr RN job a l-o-n-g time ago.

Specializes in cardiac, ICU, education.
I just read a little excerpt from Silence Kills. I probably never realized, until just now, that other nurses share my frustrations. It's a shame that we so often feel this way, but a real relief to know I'm not alone. Thank you so much for leading me to this book, msn10.

You are very welcome! I use excepts from it all the time at my speaking engagements. I also recommend Crucial Conversations (if yo can find the time). It is one of the best books on how to have those very intense conversations that will almost always lead to conflict if not approached correctly.

Think about the number of nurses who quit over soft-skills poor co-workers and the hospital has to keep hiring more just to see them quit. Think about it: the troublemakers/meanies rarely quit or get fired;

So true. I was recently at a Advisory Board meeting and one of the most amazing findings to me was that nurses would avoid conflict with other nurses more than they would avoid physician conflict. That is a paradigm shift that we are seeing in many hospitals. Nurses are starting to feel more confident confronting a physician about a patient concern than confronting someone they are having a hard time working with. If we do not enhance our interpersonal skill set, our cultures will continue to disintegrate.

Specializes in LTC, CPR instructor, First aid instructor..

My daughter's interview in Idaho in 2004 included this type of interview.

I guess it is time for me to find myself a new career. I am very much a tell it like it is person, while not mean, or intentionally hurtful, as we are demanded to do more with less resources I don't always have the time i wish I had to poo-poo and ***** foot around issues. I was hired to make sure my patients were ready for surgery in a timely fashion, to educate their families on the time frame for their waiting, and give patients and families the necessary education required to go home safely after a surgical procedure.

I personally don't tolerate having someone spit in my eye and tell me its raining, and I would hope my patients feel the same way.

I've seen this to be almost more important to my patients ( good soft skills) than their outcome sometimes. If they felt the caring & compassion they seemed less bothered about any complications.