PROFESSIONAL DEVELOPMENT

Relationships: from staff nurse to nurse consultant

Part 1: good relationships John Fowler

© 2015 MA Healthcare Ltd

T

his is the first article in the new staff nurse to nurse consultant series, which will be exploring ‘relationships’. Over the next 12 issues the series will be examining the nurse–patient relationship, working in a team, relationships with junior staff, medical and allied health professionals. It will look at relationships with terminally ill patients, people with mental health problems, relatives and some tips on how to handle personality clashes. As we begin to explore this vast topic of relationships, take time to think about and reflect on the relationships that you and your colleagues have with each other, the patients and relatives in your care and the variety of staff you work with. Why are some of the relationships positive, caring and affirming and why are some of the relationships strained, possibly negative and occasionally destructive? Take some time to think about this and see if you can spot any pattern or factors that influence the quality of your relationships and those of others. When I pose this question to different nurses and different groups of people I get a wide variety of answers. Some of the common themes that emerge relating to good relationships are: good leadership and team spirit, adequate staffing levels, clear focus and objectives for the shift and ongoing work, the feeling of being valued and respected. Themes relating to poor relationships are: not enough qualified nursing staff, people being rude and offhand, patients who have abused alcohol, trying to do too many jobs at the same time, people not ‘pulling their weight’, having to apply for your own job, or managers not seeming to understand the pressures of the work. To what extent is the quality of the relationship that you have with others influenced by external and environmental factors, such as staffing levels and workload, as opposed to your internal standards of how you treat and relate to other people? Undoubtedly there is an element of both internal and external factors influencing the way most of us relate to other people, but some people seem much better at dealing with

British Journal of Nursing, 2015, Vol 24, No 5

the external negative factors and not letting them override their internal standards. Put simply: why do some staff become somewhat offhand when they are very busy but others in the same situation remain calm and caring? Start thinking about how much you let external factors influence your internal standards and subsequent behaviours. I suspect that your first reactions to this question will be quite closed and defensive, making excuses for why the external factors that influence you are so imposing and draining. However, if you genuinely want to develop your relationship skills and grow as a nurse and as a person then you need to see beyond those initial defensive thoughts and start listening to and being honest with yourself. A text book on relationships will have sections on communication, empathy, eye contact, listening, genuineness, feedback, and non-verbal communication. While these are all important principles and they will be explored as the series continues, they are all dependent on this one key principle of listening to yourself. In your student nurse training you will have covered all of those principles and can probably still talk about the difference between active listening and passive listening and the importance of empathetic understanding. Relationships in practice and particularly in a busy clinical area require more than simple academic knowledge. The fostering, nurturing and development of those skills in yourself require a genuine desire to enhance your skills, not only clinically, but also socially and emotionally. Their application to clinical practice and life in general require a genuine self-examination—identifying initially your strengths but also being prepared to acknowledge your weaknesses. Schon (1983) identifies the importance of two types of reflection that are particularly relevant when considering interactions between people. The first is reflection ‘on action’, that is thinking about and considering what happened and why after the event occurred.You feel angry or annoyed with someone and then take time out and, over a cup of coffee, try to identify

why that occurred, how you responded and if you could have handled it better or could prevent it happening in the future. The other is reflection ‘in action’, that is the ability to stand back and consider what is happening while it is happening. As you are interacting with a person you are aware of a growing annoyance or anger.You examine your own actions ‘in real time’ and adjust your behaviour; you monitor feedback from the other person and continue to adjust your behaviour. It sounds complicated but if you are an expert practitioner you will recognise this ability in yourself—and those aspiring to be expert practitioners will need to focus on developing this ability. Once you begin to reflect ‘in practice’ on the effect that you are having on the people that you are interacting with, and modify your behaviour accordingly, then your ability to develop relationships will improve significantly. Over the next 2  weeks take some time and energy to focus and reflect on your relationships with patients, relatives, colleagues and friends. Initially reflect ‘on action’ but then try to develop your ability to reflect ‘in action’: to think about what you are saying verbally and non-verbally, the content and tone of your communication, how the other person is responding and have confidence in your own inner ability to develop BJN your relationship skills. Schon D (1983) The Reflective Practitioner. Jossey-Bass, San Francisco. Dr John Fowler is a general and mental health nurse. He has worked as an Educational Consultant to primary care trusts and as a Principal Lecturer in Nursing for many years. He has published widely on educational and professional topics and is series editor of the Fundamental Aspects of Nursing Series and the Nurse Survival Guide Series for Quay Books

293

British Journal of Nursing.Downloaded from magonlinelibrary.com by 129.011.021.002 on July 5, 2015. For personal use only. No other uses without permission. . All rights reserved.

Relationships: from staff nurse to nurse consultant.

Relationships: from staff nurse to nurse consultant. - PDF Download Free
576KB Sizes 0 Downloads 10 Views