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 Case mgmt., rehab, (CRRN), LTC & psych.
firstinfamily said:
What advice to you have for those of us working in a more generational gap environment??

Firstly, I am in my 30s, so I am basically in an age group that is a tad bit too old to be 'young,' but too young to be considered 'old.'

My advice is to be yourself. When conversing, show interest in whatever your younger coworkers discuss, and they'll most likely reciprocate the interest when you discuss topics that are dear to you. I know I enjoy listening to the tales of my coworkers who are in their 50s and 60s, even though they are a couple of decades older than me and have children in my age range.

Also be mindful that it is good to strike friendships with people who came of age in different generations than you. We can all learn from each other, thereby creating enriching experiences.

Specializes in Geriatrics, Dialysis.
firstinfamily said:
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??

There are only a few staff in my workplace around my age [pushing 50 quickly] and all of the crew I usually work with are 20 to 30 years younger. They do occasionally overshare, it takes a LOT to shock me, but the way some of these young girls openly share details of their sex lives amazes me. When it gets to be a bit much I gracefully find an exit, after all there is always some legitimate work to be done since after all I am actually at work! Other than that minor issue, we are all very friendly with each other and I haven't found the age difference to be an issue at all.

It does make work much more enjoyable if you are friendly with your co-workers, there is always somebody you can vent to when your day just sucks and being friendly with them helps when you are willing to help that co-worker that is having a crappy day you know that favor will be returned when your day is less than good. It's also nice to have somebody to stop on the way home and have a drink with every now and then.

Specializes in nursing education.
TheCommuter said:
When you mentioned E/I, I assume that you are referring to emotional intelligence?

Yes, like Goleman's books.

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.

Is someone told you "Happy Eid" would you say "thank you"?

Would you go on to explain your religious beliefs?

This is why I would much prefer people just say nothing until one's religious beliefs are known.

The USA is so diverse.

Specializes in Complex pedi to LTC/SA & now a manager.
smartnurse1982 said:
Is someone told you "Happy Eid" would you say "thank you"?

Would you go on to explain your religious beliefs?

This is why I would much prefer people just say nothing until one's religious beliefs are known.

The USA is so diverse.

Yes I would say thank you and no I would not discuss mg personal beliefs as it is irrelevant especially if the greeting comes from a patient, patient family, coworker or supervisor. Or I would say I hope you have a nice day/evening/weekend. Ignoring a greeting is rude and belittling aside from being mean

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
smartnurse1982 said:
Is someone told you "Happy Eid" would you say "thank you"?

Would you go on to explain your religious beliefs?

Yes, I would respond by saying something similar to "thank you," "you too" or "same to you!" Failing to respond to a holiday greeting is outright rude and socially unacceptable, even if you are nonreligious or do not celebrate the holiday in question.

For instance, if someone says "Happy Rosh Hashanah," there's no need to explain your religious beliefs or say that you are not Jewish. There's no need to say you do not believe in that particular holiday. The respectful, socially acceptable response is a simple "Same to you!"

Although I have no children, I don't go into detail when strangers greet me with a well-intentioned "Happy Mother's Day!" I just thank them and keep moving. I do not expand upon the fact that I do not have any children because I don't want any stranger prodding me about why I'm not a mother.

Social niceties require us to respond to the people who greets us, especially if the greeter has good intentions and is not spiteful. As a rule of thumb, instead of getting into some awkward conversation about religion or family life, just thank the greeter. Just keep it simple. Just treat people in the same manner you'd want to be treated.

smartnurse1982 said:
Social skills is a really hard topic for me,as I have higher functioning autism.

Look into social skills training classes for people with Aspergers and other higher functioning forms of autism. I get the vibe that you are turning people off and maybe you do not even know it.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
817nurse said:
Look into social skills training classes for people with Aspergers and other higher functioning forms of autism. I get the vibe that you are turning people off and maybe you do not even know it.

I was going to mention the same thing. Some people need explicit instruction in proper interpersonal skills, especially those who cannot pick up subtle social cues due to higher functioning autism or some other reason.

Thank you for this! I would like to improve my social/soft skills and your articles are very helpful. I hope that you'll continue to write about what you've learned on this subject!

Specializes in ED, ICU, PSYCH, PP, CEN.

Great article, and right on the money. I am a little socially awkward myself. One thing I do is make myself available to any new people on the unit and make them feel at home. Being new is always painful and you can make a lot of "friends" by helping new people ease into the job.

I have learned much from you over the years my dear Commuter.

Specializes in ICU.

I can't wait to read the next chapter!!

gonzo1 said:
I am a little socially awkward myself. One thing I do is make myself available to any new people on the unit and make them feel at home. Being new is always painful and you can make a lot of "friends" by helping new people ease into the job.

I'm pretty good socially, but completely agree we can make friends for life by going the extra mile to help new coworkers or anyone who needs our help. We need to remember that no man is an island. Humans are wired to be social creatures.