jeastridge
Columnist
-
Joined
-
Last visited
-
-
-
The air almost crackled with the intensity of the emotions generated by the conflict between two co-workers. They “had words” about a political difference, and as they left the area to go care for their patients, they left in their wake two of us as witnesses who felt truly upset by their intensity and the verbal tongue lashing that had just happened. No doubt, conflict has repercussions. It affects those involved, but it also affects those around them—co-workers, patients, and others. The natural response to such a scenario is to tell the two to take their conflict elsewhere. In this case, that was probably appropriate and necessary. Sometimes conflict cannot be so easily dismissed or dealt with. Maybe we all need to examine our ability to handle conflict in a healthy way so that when it happens to us, we will be prepared. The nursing profession can be fertile ground for conflict as there are many ways to approach the same situation. Nurses differ in training and in their approach to the problems of patient care; hospital systems and supervisory expectations are numerous—COVID-19, politics, vaccinations, social and religious differences, all converge to make for volatile conditions. It sometimes feels like we are increasingly polarized and at odds. Conflict in the workplace is universal. How we handle conflict is not. Many of us want to avoid conflict altogether. Is that you? If so, it is good to know yourself and recognize an aversion to conflict as part of your personal DNA. Some persons enjoy verbal sparring while others view conflict as a problem in want of a solution. Wherever you stand on the conflict spectrum, identifying your own approach to—or avoidance of—conflict is a starting point for handling conflict well. Some ideas to consider when looking to resolve conflict include: Cool down When our emotions are high, that is not the time to address conflict. It may be best to sleep on it, talk it over, write it down, meditate on it, or pray about it. After taking a “chill pill” you are more likely to accomplish your purpose of being truly heard. High-intensity emotions (note case above) leave lots of fallout. “Ultimately, what makes conflict difficult is that it gives us information about ourselves that is tough to take in.” Ask questions One of the keys to handling conflict well is to become authentically curious about what is behind and before the conflict. There is always more to the story than what is visible. If we are party to the conflict or simply witnesses, one of our best strategies may be to help by asking appropriate questions and listening—even if the other person’s view is widely divergent from ours. As Madeleine L’Engle said: “True is eternal. Our knowledge of it is changeable. It is disastrous when you confuse the two.” Problem solve After an initial cooling down time, it could be time to engage in problem-solving. Sometimes people need help working toward a solution. Most people don’t appreciate being told they “should.” Instead, asking questions and using conditional words such as “perhaps” can be more acceptable. When conflict is high, it can help to be on neutral ground with a third party there to help the interface. Be willing to apologize If you are the offending party, be willing to say you are sorry. It is hard to do, but so very worth it in the scheme of life. In the case above, one of the nurses engaged in the exchange came back and apologized. We forgave him. It was hard for him to do—that much we could tell from his demeanor. Acknowledging that we all make mistakes and that is part of being a human, can help us all to forgive and move on. Let it go Some fights are simply not worth having. And some are. Knowing which is which and acting accordingly can be the difference between a life of peace and one of turmoil. While it is not easy to distinguish the battles we must engage in vs. the ones we need to let slide into oblivion, this is a sign of a mature spirit and a nursing professional who will be able to serve well over a long career. People mess up. People say the wrong thing at the wrong time. Our friends will let us down. Our co-workers will sometimes disappoint. Happens. We have to pursue the wisdom of knowing when to engage in conflict resolution and when to release that conflict. If you have ever been involved in raising a small child, you will be able to identify with the experience behind the statement, “Pick your battles.” Which one of these tips speaks to you? Can you think of times when you have seen good conflict resolution skills put into action?
-
“That’s it! I quit!” We all felt ourselves stiffen with tension as the voices traveled from the conference room and wrapped themselves in a layer of anxiety around all of us. The tension in our facility was high. We were all working overtime and lots of co-workers were out sick. Despite our best efforts, it often felt like conflict with management was on a low simmer—ready to boil over at the smallest provocation. Anger. Frustration. Fatigue. We all feel it. The pandemic has made conflict a daily event. We have conflict about the pandemic itself; about masks; about vaccines; about quarantines; about…well, everything related to the pandemic, and even things that are not related. People are struggling to cope to care for patients, to keep their jobs, and to take care of kids at home instead of in school or in daycare, and the list goes on. Tools to Help with Conflict Resolution When conflict becomes common, what tools can we employ to help us deal with it? Fortunately, there ARE some things we can do that are simple but have the potential to be helpful. Mind you, I didn’t say that this is a 100% guarantee that you won’t have conflict! These are simply some modest tools that could potentially help you cope when you are in the midst of conflict. So here goes… Don’t triangulate It is so tempting to talk to Suzy about the trouble with Paul instead of going straight to Paul. We all know this, but sometimes we just forget. Let’s remind ourselves to skip the intermediary persons and go to the person we are having a conflict with. When we go to Paul, let’s practice kindness by thinking about how we say what we need to say. Consider practicing what you are going to say ahead of time, or try writing it down first, so you can clear out some of the emotion before addressing the issue. No email or text when there is a conflict This one goes with the one above. It is tempting—and often the easy way out—to send a “hot” text or a zapping email to give someone a piece of their mind. Slow down. Not so fast. Once words go out via any medium they are there for all eternity. Venting via text is never a good idea. Never. Take a deep breath. Drink some ice water. Go for a walk. Count to 100. Whatever you need to do to simmer down. Then try the in-person approach or at the very least, pick up the phone. Give them the benefit of the doubt It may seem like you are being kind to THEM when you do this, but in reality, you are removing the potential for bitterness from your own heart. If you find yourself irate, steaming mad, ask yourself some questions about what might be going on with them. Are they in grief? Do they have a baby at home that has been awake every two hours since they took their first breath? Are they suffering from pain? Divorce? Money troubles? Who knows what the other person is going through, right? We cannot know what another person is going through, even if they are our spouse or our mother, much less if they are a co-worker! When we approach conflict with the lens of thinking about what they might be going through—stuff we know nothing at all about—it gives us a fresh dose of compassion to work with and pours some water on the fires of anger and frustration. Use questions instead of statements or accusations Maybe ask “Did you know that word is a racial slur? It upsets me when you say that.” It is possible that using a question may help diffuse conflict. So instead of the more reactionary and aggressive, “You should never use that word! You make me so mad,” let’s slow down and think about how we can say it as a question. The second statement contains two red flags: the “should” word and also the “you make me…” phrase which are tempting but probably best avoided. The truth is no one can truly make us feel anything, and “shoulding” rarely produces the results we think it should! Listen well and listen for understanding Listening is hard. We often listen with one ear and plan what we are going to say while the person is talking. We miss non-verbal cues, and people can simply tell when we are not listening. Not listening well escalates conflict. However, it is fair to say, “Can we schedule this conversation for another time? How about tomorrow after lunch?” When we say something specific, the person knows we plan to listen, but this is not a good time. In general, we don’t have to stop everything and address a conflict “right this minute,” but we do have to be willing to acknowledge that the conflict is there and needs to be addressed. Sometimes, we cannot provide resolution. Well, OK, often—if we are honest. But we can be a listening ear, a calming presence, and a person who can help ask questions to get to what is behind the conflict. We tend to want to do away with conflict. Conflict can be upsetting. However, when handled well, conflict can produce good fruit and positive changes that benefit us all. Learning how to resolve conflict is a great nursing skill to work on! Who are some of your role models for good conflict resolution skills? Can you think of a time when conflict produced a good change?
-
-
Shared by: Rev. Caryl Griffin Russell, MSN, BSN, MDiv January 17, 2022 Celebrating a life-changing day, I share an experience of speaking to graduates at an assembly of an all-Black high school in South Memphis a few months after Martin Luther King, Jr. was assassinated in this city of great unrest and violence. As a one-year graduate registered nurse at Methodist Hospital in Memphis, Tennessee, 22 years old, I receive a call from my Black obstetrics and gynecology (OB) instructor from college inviting me to speak at a graduation ceremony of an all-Black high school in South Memphis. She will accompany me. My instructions are to speak to inspire the students into their futures. I remember the experience like it was yesterday. It may not have changed them, yet it has forever changed me. It was late morning when my black OB Instructor led me into a long, dim hallway with high windows along one wall. An uneasy feeling accompanied me as I stepped into a world beyond my comprehension. The past week I wondered what I could possibly say to Black students whose lives I knew nothing about? What were their fears? Their hopes? Their possibilities? My instructor assured me I would have the words. “Just inspire them to go further,” she said. Why me? What do I have to give them? I wondered. Now, here I was in the deserted hallway accompanied only by the tap, tap, tap of my instructor’s heels and the faint squeak of my nursing duty-shoes as we walked together down the long hallway. My instructor had asked me to wear my white nursing uniform to speak. My white dress? My white shoes? My white hose? “Yes,” she said, “and your white nursing cap.” And my lily-White skin. Into an all-Black high school? Will they be wearing black caps and gowns for graduation!? Really? There had been so much anger and hatred boiling over since the death of two garbage workers on February 2nd: Blacks were incensed that the workers had been crushed to death by the malfunction of a hydraulically powered garbage truck as they crawled in the back to get out of a driving rainstorm. Looting, daily marches, rioting and deaths ensued. The Memphis mayor refused to work with the newly formed garbage union. There had been a city-wide garbage strike and the stench of rotting garbage piled up all over the city as the strike continued into April. During the unrest, for my safety, I had been escorted for nursing shifts by armed guards in and out of the hospital. Today, several months later, I was accompanied by my unarmed OB instructor into an all-Black high school. An eerie, fearful feeling washed over me. Will I be safe here? I felt relieved that no one was in the hallway; still, I felt queasy and frightened. I wondered if the brave Black students who went into Little Rock High accompanied by policemen in 1957 had some of the same uneasiness I felt. My shivers were surely minuscule compared to their terror. After all, I was invited to be here; they were threatened with their lives if they set foot into the all-White high school. I was shaking a little and nervous as my instructor and I entered the side door of the already full auditorium. I kept my head down as we climbed the stairs to the stage where there were only two chairs. A podium was several yards to the right toward the front of the stage of the dimly lit auditorium. I felt like a flashing white neon light in a sea of blackness all around me. There were murmuring voices among the audience. Then, a hush as the music began. Pomp and Circumstance. I know how this goes, I had marched into my own graduations from high school and college. Slow, steady, solemn. Then I realized the music was ROCKIN’! Fast, syncopated, full of energy, promise, pure celebration. The line of graduates appearing in the back of the hall began dancing and swaying and laughing as they made their way down to the front seats. It was the most beautiful graduation “dance-in” I had ever experienced. My spirit soared as my fears melted. My heart pounded with excitement seeing the swishing gowns and feeling the delight that swelled and filled the air. In that moment God’s spirit was palpable. It was then I knew: these graduates are our hope as our neighborhoods, our city, our country struggle for justice and freedom for all. Earlier, in March, Martin Luther King, Jr. had come to Memphis to lead a march and help heal the terror and violence. Martin Luther King’s message was to inspire people to continue the struggle in Memphis. “You are demonstrating”, he said, “that we can stick together. You are demonstrating that we are all tied together in a single garment of destiny, and that if one Black person suffers, if one Black person is down, we are all down” (March 18, 1968). He further said this Memphis struggle was a struggle that exposed the need for economic equality and social justice that he hoped his Poor People’s Campaign would highlight nationally. In late March, 22,000 students, White and Black, joined the march. Were some in the auditorium today? On April 3, Martin Luther King, Jr. returned to Memphis determined that if a nonviolent struggle for economic justice was going to succeed, he would need to follow through. He was assassinated on April 4 on the balcony of the Lorraine Motel in Memphis, Tennessee. Two months later, now June 1968, the joy and celebration of the students in their swishing black gowns and lighted black faces imprinted indelibly into my heart. If one of these is down, I determined, so, too, am I down. I realized that their future is not the only future at stake. Whatever “neon” light I felt intruding into that day must continue to transform not just the young eyes, ears, minds and hearts of these filling the auditorium, but also must transform me to work with them in the struggle for economic and social justice. I and others must dance into the future with these young people: White and Black “tied together in a single garment of destiny” to create a new future for us all. Footnote: I wonder where those students are today, 2022—they would be 70+ years old by now—I wonder if any even remember my being there. Personally, I don’t remember a word I said, yet it has forever changed me. Rev. Caryl Griffin Russell graduated from the University of TN Nursing School in Memphis. She went on to get her Masters and later her Master's of Divinity.
-
-
-
I read my email and felt that sinking sensation—change is coming and fast. The memo stated that in 7 days we would be changing over to the new system. Despite months of preparation, the looming deadline was anxiety-provoking. Would it go well? Would I be able to adapt? Would our patient care suffer? These and many other questions repeated in my mind as I clicked my laptop shut for the day, hoping that I would be OK with the changes. Nursing is all about change, isn’t it? Just when we feel we have adjusted to the new technology, system, machine, arrangement, we get the memo from administration, “Be aware that we will be converting to xyz next week.” Adapt accordingly. Some change is good and leads to improvement. Some change is pretty neutral and some is just plain old bad. The fact remains that we all have to learn to cope with changes and to keep our morale and practice intact no matter how much change comes at us and how fast. How do we stay on an even keel when faced with change? Stay centered When change comes, we all hope to be that unflappable nurse that handles everything with grace, quietly, serenely coping with the new skill or information that he/she is required to master. But no. Reality rarely resembles the dream and most of us struggle mightily to keep our composure, to learn the new way and to not allow our patients to experience any adverse effects. I recently attended a memorial service for a Jewish friend. The rabbi spoke eloquently and wisely about life truths. One thing he said really stayed with me, and compelled me to go back later and listen to the recorded service to capture accurately what he said. Here is the quote from Rabbi Wolfe Alterman from Asheville, North Carolina: “If you see what is in need of repair and a way to repair it, then you are seeing what God has called you to do. If you only see what is wrong and ugly in the world then it is you yourself that is in need of repair. And all of us are in need of repair in one way or another. There is so much in need of repair that this task feels overwhelming.” He finished with a quote from the Talmud: “You are not required to complete the task, neither are you free to ignore it.” Whether or not you are religious in any way, it is possible to see the thread of truth in both statements. We live in a broken world where people get sick and often die; where tragedies happen but where goodness also abounds. When we are able to stay centered on who we are, what our skills are, what our goals are, we are better able to identify our role in the change process and help in the repairs the change is attempting to make. The second quote is also freeing because it helps us shake off the guilt when the desired change doesn’t turn out as we had hoped. We have to continue to try; we cannot quit. Not every change is going to go well or produce the desired results. By not ignoring the problem and doing our best to effect change, we may have at least improved some part of the issue by trying. Stay flexible We have all heard the refrains, “That is not the way we do things,” or “The administration doesn’t care about nursing” or “I wish we could go back to the good old days of nursing.” When we read these phrases we hope that we are not the ones speaking them but, truth be told, we all struggle from time to time when asked to do something new or to endorse and support change when it doesn’t seem to be for the better. Staying flexible and seeing new possibilities is hard, especially as we gain age and experience. Becoming more set in our ways can go hand in hand with being around for a while and it can also mean that we run the risk of being the “stick in the mud” when it means adapting to a new EMR or to a new staffing system. In Simon Sinek’s book, Better Together, he encourages, “Don’t complain, contribute.” It is up to each of us to seek out the positive. Complaining can be a bad habit that threatens our well-being and the general feeling on our unit or office. Sometimes we think that venting our concerns helps to release tension and provides us with much needed psychological relief but the opposite may be true. Complaining can be a habit that drags us down and pulls those around us with it. On the other hand, making a contribution, or suggesting a positive change can do a lot for our job satisfaction and help to influence our whole workforce. I remember working with one of the women from housekeeping that was particularly upbeat. No matter how many rooms were switched out, no matter how much extra she had to do, she seemed to find a way to keep her comments positive and to refrain from complaining. And people noticed. We all loved working her hall! As we face repeated change, it may help us to look back and see times when change did turn out for the better; we can take encouragement from those times and be those nurses that smile and say, “Let’s see what we can do with this!”
-
As I pulled away from the home visit, I felt the grey fog envelope the car on the outside and threaten to seep into my holiday spirits. From where I sat, I could see the Christmas tree blinking crazily with artificial cheer, while the patient I had just left was filled with sadness and despair and pain that was more than physical. I did what I could to offer a few words of encouragement and to address the physical issues at hand, but my heart was heavy. This was the third difficult visit I had made on this week between Christmas and New Year’s, and I could feel my generally upbeat spirits begin to sag. What could I do to keep going? The holidays can be fun, festive, and spiritually uplifting for many. On the other hand, it is often a time of remembering those who are no longer with us. This can be good but at times sad and depressing. The season sometimes promotes comparisons as we see friends and neighbors who seem to have it all together. For most, it is some combination of these feelings. During the week leading up to New Year as I made my visits, I thought about what I could do to renew my spirits so that the gloom of the weather and the last visit didn’t cloud my own perspective. As nurses, we often face this dilemma. How are we supposed to change our attitude as we go from patient to patient without carrying over from one to the next? How do we manage to stay hope-filled? Offer the Gift of Presence It is not wrong to be happy and to celebrate our lives. When we encounter horrific circumstances in those we care for, we can be tempted to enter too far into their sadness and carry those away with us. It is not wrong to be present with someone, to be a professional offering care and compassion, and then to leave that burden there as we move on. It is a professional attribute that involves maturity and sometimes a good deal of practice to attain. It may be easier for some of us than others, and that is OK, too. Honoring their sadness, grief, and pain does not mean that we also have to be filled with sadness, grief, and pain. Offering the gift of presence can mean being able to leave that spirit of empathy there when we close the room door or the car door and go on to our next patient. Build Boundaries Building boundaries is part of being an excellent professional. Learning to have good boundaries is a nursing skill that we learn for the entirety of our professional lives. We all come to nursing with our own backgrounds and personalities, but the requirements at the bedside are the same: provide excellent, compassionate care each time to the best of our ability. Building good boundaries does not mean that we are immune or unfeeling. It does not mean that we never cry or go out of our way for a patient or a family. It does mean that somehow we have to find a way to still be able to walk away emotionally and attend our child’s basketball game and cheer wholeheartedly. What helps you set good boundaries? Seek Self-Care Seeking out self-care. As professional nurses, we sometimes fall into the trap of feeling that we have to meet everyone’s needs but our own. After all, we are usually attracted to the field of nursing because of an inner desire to care for others in their time of need. We want to help. This desire can push us to help past the invisible line that demarcates the space in our spirits between giving and resenting. We all know when we have crossed it: what once felt like doing good in our job now feels like we are scraping the bottom of our own physical and emotional well of resources. All of us have different ways to re-charge—for some, it is a brisk walk, a yoga session, or a dinner out. For others, it is a good book with a latte or a long bath. Whatever your way to plug in to the re-charge setting, it is necessary in order to be a great nurse! Feed the Spirit As de Chardin said, “We are not human beings having a spiritual experience. We are spiritual beings having a human experience.” Sometimes we forget that. However, you see spirituality, sometimes acknowledging that our spirits need tending can be a big step forward. The old native American story tells us that we are made up of two wolves, the light one and the dark one. Which one wins? The one we feed. As I pulled away from the home, I clicked my computer shut. With the click and the sign-off on my note, I tried to leave the sadness behind. I knew I had done what I could to help. For now, I needed to reframe my thoughts. I put the car in gear and drove through the fog. I could see a break in the clouds just ahead.
-
Bah humbug! Driving to the hospital, I reached over and clicked off the Christmas music that proclaimed a commercialized version of the holiday was fast approaching. I just wasn’t in the mood for “jolly” when all around me, I witnessed sadness, loss and broken hearts. Besides the heaviness for my patients, I also felt burdened by the expectations of others’: gifts, meals, cards, cookies all seemed to sweep through my busy mind, riding on the wings of a tornado-like wind that whipped the whole mess into a funnel cloud and plopped it all in my lap, there to sit with the other normal chores which required attention—just the usual laundry, grocery shopping, car maintenance (yes, mine was in the shop again…) routine. The "Right Way" I know. I know. It’s supposed to be fun and meaningful. The expectation is that this time of the year, focus solely on the reason for the season (for Christians, that is the birth of Jesus and for others maybe it is family gatherings and gift-giving with love). Whether you have a spiritual bent or not, we all know what it is to feel the pressure to do things the “right” way and the subtle competition to manage it all with great aplomb. As a Faith Community Nurse, one of the things I do is visit people when they are in the hospital with a focus on helping them transition to an appropriate post-hospital stay location. For some, that is as simple as suggesting rehab facilities to the family, and for others, it is helping them prepare to take a loved one home to a greater level of care than previously. At Christmas, illness, falls, disease, cancer do not go away. In fact, their prevalence and effect seem more pronounced as others hang garland and put on old Christmas sweaters and indulge in homemade Christmas candy. Charlie's Story I pulled into a parking space and headed up to visit Charlie, a parishioner who had been in the hospital for an extended stay with complications from a routine surgical procedure. Already elderly, Charlie’s small family was mostly gone, and he had very few resources. I sat down and caught up on the last two days’ news when the Case Manager stopped in to discuss possible placement in a local nursing home. Charlie was sad but resigned, realizing that he couldn’t go home and that he needed the rehabilitation this facility offered. But it was almost Christmas. And it was sad. I saw his eyes sparkle with unshed tears and squeezed his hand, offering the gift of presence and silence. He returned my gaze with a small smile and said, “I’m not worried. I will be OK. I have faith.” Charlie’s words both encouraged me and challenged me. His ability to maintain perspective in the midst of great obstacles inspired me to shed some of my feelings of resentment and heaviness and to replace those negative feelings with something that comes from light and life and love. In those few moments, I tried to reframe my own thoughts and ask myself a few questions about how I can face excessive expectations and maintain my morale? How to Encourage Others As nurses, how can we keep working to encourage others even when we feel discouraged ourselves? Keep First Things First Even in the middle of a busy season, let us not forget to maintain our centeredness—whether it is reading a spiritually encouraging book, doing Yoga, going for a brisk walk outside, corporate worship—whatever feeds our spirits needs to take precedence over the other chores that might try to crowd it out. Busyness has a way of wanting to be more important than it really is, doesn’t it? Get Rest And Eat Right. We can provide well for our patients, our co-workers or our families if we are running on empty. It may mean turning off that TV or letting our facebook feed rest for a few days, but it is critical care for our bodies to get balanced rest and food, especially during the busy and challenging holidays. Maybe Find Someone To Talk To. Holidays can bring out our own pasts and our sadness over previous losses. Unfortunately, this has a way of spilling out all over our lives in strange ways. We find ourselves angry and frustrated “for no reason” and over-reacting when someone asks us to bring a side dish to a gathering or participate in a secret Santa exchange…Over the top responses can signal that there is more going on than we are consciously aware of. When we feel like a pressure cooker waiting to explode, it may be time to pro-actively seek out some help in the form of a spiritual adviser or a trained counselor. Working hard in a therapeutic counseling relationship can be some of the best investments we make in time and energy. Working through past trauma and grief pays off big dividends in the present as we try to be the best nurses possible for our patients and the best family members we can be to our families. Cut Yourself Some Slack. When the external pressures are high, sometimes it helps to acknowledge it and to also accept our own limitations. Perfection can be the enemy of well-being. As I wrapped up my visit with Charlie, he said, “Thanks for coming. It will be a good Christmas no matter where I am.” After a quick prayer, I left and walked back toward my car, feeling lighter than when I came, daring the “Bah-humbug” spirit to try to bother me again!
-
Both is probably the best option! Well said. Joy
-
-
"Staffing made me feel safe, not valued." Amen to that. Respect and money=good care. In the end that's what we all want, isn't it? Joy
-
Thank you for sharing your experience. What you describe is a tragedy for all of us--even the administration who often end up being patients, as well. Your comments are a call for action from all of us. Thank you. Joy I appreciate your humor. Made me laugh out loud. Joy
