How Can Fictional Stories Help People Deal With Real-Life Struggles Positive, Assertive "Pushback" For Nurses

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Positive, Assertive "Pushback" For Nurses

On one of her evening shifts, nurse Sally Stevens, an RN with 17 years of nursing experience, was caring for a new patient, a 46-year-old female diabetic who was suffering from tremors due to lithium toxicity. After starting an IV, the patient, Ms. Hawkins, developed some kidney complications, prompting doctors to bring in a renal specialist. After reviewing her chart, the specialist ordered an IV containing dextrose.

Knowing that dextrose could negatively affect her patient’s diabetic condition, Nurse Sally expressed her concern. Nurse Sally said in a non-aggressive tone, “Doctor, Miss Hawkins’ blood sugar was 315 at 4pm. I noticed you changed her iv fluid to dextrose. Would you like to change the iv fluid?”

Because of Nurse Sally’s ability to communicate effectively, Ms. Hawkins received the best medical care possible.

So, the real moral of the fictional account of Nurse Sally’s story is that you really can get your needs and wants met – not through aggressive, confrontational confrontation with you – but through effective, positive and assertive communication. Particularly in nursing, the ability to respond appropriately to potentially negative and/or harmful situations is an important – even a potentially life-saving – skill.

And, contrary to popular belief, you can communicate your concerns without permanently damaging your professional relationship. A “positive pushback” is the ability to provide an appropriately assertive response to a potentially negative and/or harmful situation. A positive pushback is executed by looking someone directly in the eye, and saying what you want or need in a firm, non-stressful tone. (Include the word “I” if you want to be really assertive, as in “I really need you to stop and review this right now…”)

Practice makes positive

It’s important to be confident when you’re giving positive pushback. A positive pushback does not leave the other person confused or unsure of your needs, wants, desires or messages! That said, a positive pushback is not delivered by a tone of voice, or an aggressive posture or facial expression.

Loser example: “I wonder if we should double check the lab work before…?” Example usage: “I think we should double check the lab work before…”

Samuel Masseri, DNSc RN, and chairperson of the Tennessee Nurses Association’s Commission on Workplace Advocacy offers some tips on nurse communication in potentially confrontational situations: “When you call the physician at two o’clock in the afternoon and you know they’re tired, you can do that right away. Say ‘I know you’re Mrs. Johnson is very concerned and I’m sure you’d like to do something about this situation’ – then you’re justified in disturbing their space and time. Addressing the other person’s needs first is important and the goal.”

Unfortunately, you can only handle positive pushback if you have enough positive psychological capital, meaning you are equipped with enough self-esteem, confidence, and self-efficacy to handle yourself in a conflict situation. You must continually build this capital, so it will be there when you need it.

Positive pushback benefits – and fears

One of the benefits of using a positive pushback is that you have a better chance of producing the results you want and need Other benefits may include inoculating against burnout (helping reduce your stress levels), and building self-esteem and confidence. Plus, it can help you build positive relationships with others and empower you to be a good patient advocate.

So why don’t people go back? Well, of course fear is a primary factor. Other factors may be previous negative experiences (eg no one has listened before or poorly), defense mechanisms (I cannot be responsible), as well as active avoidance of a response. Also, some nurses are working in a negative organizational culture, and whatever psychological capital they once accumulated may be depleted.

“There is a power play in any relationship,” Masseri notes, “while a physician may have more experience, the physician as an individual is not more human than a nurse. A nurse has the same level of human rights. When a nurse is strongly and professionally responsible and strongly When we are unable to assert ourselves, we are all humiliated.”

You’re right, I’m not: Submissive communication

When we learn assertive, non-aggressive, communication techniques we can communicate more effectively with others. Perhaps the best way to understand assertive communication is to see how it falls on a continuum of three categories: 1.) submissive (non-assertive), 2.) aggressive, and 3.) assertive behavior.

The first category is non-affirmative, or submissive, behavior. People who typically behave submissively show a lack of respect for their own needs and rights. Many loyal people do not express their honest feelings, needs, values ​​and concerns. They allow others to violate their space, deny their rights and ignore their needs. Rarely do they ever express their desires, even though they may have what it takes to satisfy their needs.

Some people who exhibit submissive behavior express their needs, but do so in such an apologetic and diffident manner that they are not taken seriously. If you hear qualifying phrases like: “Oh, do whatever you want,” or, “It doesn’t really matter to me,” or, “I could be wrong but…” – what you are actually hearing is a form of hearing. “Oral Submission.” Nonverbal submissions may include shrugging shoulders, lack of eye contact, overly soft voice, hesitant speech, etc.

The submissive communicates: “I don’t care, you can take advantage

About me. My needs are insignificant – yours are important. My feelings are irrelevant; your business My idea is worthless; Only you matter. i don’t have

Right, but of course you do.” Because submissives often override their own needs, this often leads to frustration and anger.

Advantages of Submissive Communication:

1. Submission is a way of avoiding, postponing or hiding conflict.

2. Submissive people carry much less responsibility. If something goes wrong, the submissive is rarely blamed.

3. Often, submissive people appear so helpless that other people take over their care and protection.

Disadvantages of Submissive Communication:

1. Express frustration and anger.

2. Nobody knows what you want, so they can’t give you what you want.

Getting what you want at the expense of others: Aggressive behavior

At the other end of the continuum is aggressive behavior—usually defined as behavior that “moves against” or “moves with intent to hurt.” An aggressive person expresses their feelings, needs and ideas at the expense of others. They almost always win an argument, talk loudly and can be abusive, rude and sarcastic. Generally, aggressive people insist on having the final word and try to scold, dominate and overpower others. They can be very controlling. Aggressive people often feel that only their point of view matters.

Nonverbal communication in an aggressive person may include dominant eye contact (staring), pointing, fist bumps, a loud voice, and invasion of “personal space.” They may use words like “always” and “never” because exaggerations are common. Often, a lot of “you” language (like “you never do…”) is used.

Advantages of Aggressive Communication:

1. They can secure possible material needs and objects that they desire.

2. They tend to protect themselves and their own space.

3. They seem to maintain considerable control over their own lives and the lives of others.

4. Often people will not approach you with their problems or raise issues.

Disadvantages of aggressive communication:

1. Often, the aggressive person will suffer from fear. Often, most

Aggressive people are the scariest. Many people behave aggressively not because they feel strong, but because they feel week.

2. Inducing counter-aggressive behavior.

3. Loss of control, guilt and dehumanization.

4. Isolation from people. Again, people will not approach you with their problems or raise issues.

5. Ill health.

I’m OK and You’re OK: Strong Communication

This method of communication allows both parties to maintain self-esteem,

Pursue happiness and satisfaction of their needs, and protect their rights and

Personal space – without abusing or dominating other people. True assertiveness is a way of asserting your own worth and dignity. And at the same time, the determined person affirms and maintains its value

Other.

Assertive people stand up for their own rights and express their personal needs, values, concerns and ideas in a direct and appropriate way. While meeting their own needs, assertive people do not violate the needs of others or invade their personal space. They use “I” language (“I’m trying to…”) as opposed to “you” language (“You can never seem to…”), communicate with an open stance, maintain eye contact, and use appropriate distance. , nod and lean forward to listen carefully to the speaker.

Advantages of strong communication:

1. Strong people like themselves. Often, you emphasize the amount

You determine your self-esteem level.

2. Affirmation also encourages fulfilling relationships, releases positive energy towards others and reduces a person’s fears and anxieties to a great extent. Also, positive feedback reduces anxiety and tension.

3. Since demand is result-oriented, the chances of getting what you want and need are significantly increased.

Disadvantages of strong communication:

1. Often, claims disrupt one’s life. Pain is also associated with honest and caring conflict, and often it is a personal struggle to change your own habitual behaviors (especially for those transitioning from submissive or aggressive lifestyles).

In conclusion, it is important to remember that there are times when assertive behavior is not the best choice. You can relay your needs very positively and still have the other person respond unfriendly. As in any healthy relationship, conflict is bound to arise, and being your authentic self can sometimes be a painful experience. To be assertive you have to risk discord and make yourself a little vulnerable. However, once mastered, strong communication will make a positive difference in your daily interactions with others.

Ultimately, the proper goal of positive pushback training is to help nurses choose effective communication strategies and behaviors, not to force nurses to behave assertively in every situation. Sometimes it may be wise for you to defer to others, and conversely, it may be necessary for you to aggressively defend your needs and/or your patient’s rights. However, for the most part, positive pushback can be an effective, positive and successful means of communication for nurses working in today’s healthcare environment.

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