Tracy- When Emma and I figured out how to keep ourselves and each other out of the cannibals pot, we wanted to protect others from that fate as well. Knowing that permitting is promoting- we consciously worked to cultivate nurturing relationships with the new nurses that came after us. We put our hands up to be graduate nurse buddies, did preceptor training, and reached out to other new nurses to help them navigate the culture of the department. We encouraged the leadership development of others, even those who didn’t see themselves as leaders. We were generous in our praise of their efforts and supported our team through the practicalities of everyday emergency department nursing. I am proud to say that many of those relationships are stronger than ever today.
Emma- I don’t think we knew it at the time but what Tracy and I were working towards was a Leader-Leader model that David Marquet so elegantly articulates in his outstanding book Turn the ship around. At its heart (and at ours) is a belief that if you stop telling people what to do and instead encourage intentions you encourage leadership at all levels (as well as the critical thinking so integral to nursing practices). The benefit of supporting leadership at all levels is that instead of everyone looking to the ‘boss’ to make decisions, everyone is empowered and supported to be proactive thinkers and problem solvers. I think this was something that Tracy so positively demonstrated by leading a culture shift at Logan ED. She set a culture of positive change, and at the same time empowered staff at all levels to do the same – this is more than role modelling this is a leader-leader framework.
The reason this article is called ‘nurses hosting dinners’ is because when you host a dinner party, you invite great people, you ensure they feel safe and comfortable and you create an environment where all are welcome to speak freely. Dinner parties encourage robust but respectful communication, allow everyone invited to be at the table (no one is in the corner or without a chair), and there is a sharing of food and wine – sometimes people come empty handed, but they are always welcome as it’s their company that is the gift. In our analogy when you ‘host a dinner’ nurses entering our workplace are always given a chair at the table, workplace information is shared generously including our failings or mistakes in our nursing journey. This sets the scene for other nurses to know it is okay for them to try even if they fail, then be set back on their feet to try again.
Often nurses coming to the profession fear they haven’t brought anything to contribute to the dinner party, but it is our moral obligation as leaders to make them feel welcome, pull up a chair and involve them in the party. Tracy and I both believe strongly that everyone has so much to offer – the new graduate on their first day is blessed with contemporary knowledge, fresh perspectives and often have great improvement ideas that we haven’t thought of yet. Nurse cannibals would see the nurse that has only brought themselves to the dinner party and shut the door, or worse let them in but roast them in the cannibals pot!
In part two of the series, we discussed the importance of finding an ally to support your development. In this piece we take the next step in being proactive to stop the cannibal. This includes not bearing witness to the harm the cannibals cause. Cannibals believe that witnesses support them, so any act which does not oppose this behaviour encourages it. We know it can be hard to stand up to the cannibal and say no, especially if you still fear and remember the pot yourself. We all fear being ostracised, a sense of belonging is important to help us feel safe. There is only one thing worse than feeling ostracised- and that is feeling morally corrupt.
Without our values, who are we? Most of us chose nursing because we value care. We want to show that someone cares, we hold the hand of our patient on their hardest days. We support our patient on their journey – but what about each other? Are we truly caring people if we can stand and watch as another nurse gets oppressed or intimidated and we do nothing to stop it?
How can we stand up to the cannibals?
The first thing to know is that none of us are perfect. Theodore Roosevelt famously said ...
“the best thing you can do is the right thing, the next best thing is the wrong thing and the worst thing you can do is nothing”.
Here are three ways to show you do not support a cannibal:
· VERBAL INTERVENTION- Something as simple as saying ‘that is not okay’ could be effective. It doesn’t say the cannibal is a bad person, it focusses on the behaviour which needs to change.
· PATTERN INTERRUPT- To interrupt the cycle, you could interrupt the cannibal, and ask to speak with them in private. This stops the abuse and removes the cannibal from the kitchen. When you are in a private place, you can ask them if someone exhibited these behaviours to them when they were a new nurse? Or ask what the issue was and talk out a different way of dealing with it. The message needs to be clear that this was not okay.
· PHYSICAL POSITIONING- Another non-confrontational strategy is to go and stand beside the person receiving the tirade. This shows that you are on their side forming a physical and visible support system. Moving to that physical position and then speaking is doubly powerful. Don’t stand behind the recipient (as this could make them feel worse- cornered!).
In any conflict, the first step is to speak to the person with whom you have a concern. Many people feel daunted by this. Research done by the Cognitive institute has shown that 85% of people will change their behaviour based on a SINGLE conversation with a peer or superior. If one conversation can make a difference for the vast majority of people, it is worth having. This is the impact you can have on one person- but this will improve things for all nurses who come into contact with them afterwards. It is a short period of discomfort for you, but the results on the culture are infinite, think about the positive impact this also has on patient care – when people feel safe they are safer.
The second step is to escalate the concern (if not resolved in step one) to the persons supervisor or line manager – this should be done after you have tried to intervene yourself when possible. The third step is informal mediation, and the fourth step is to lodge a formal complaint. Most of these issues will be sorted in a single conversation and will not need further intervention. We just have to be brave and have that one conversation.
Nurses hosting dinner are nurses who want to support each other. They make other nurses feel more comfortable and this promotes patient safety, job satisfaction and allows us to provide the best care for our patients. As we have mentioned before, nurses who have brains in survival mode due to fear cannot learn anything. This impacts the care we give to our patients. To help our colleagues, ourselves and the future of health, we need to provide a supportive learning environment. We must nurture each other like we nurture our patients. We must do better. We acknowledge the nurses out there doing better every single day. We are making a difference and bringing a better future closer.
Have you stood up for another nurse in a difficult situation? We want to hear from you Nurse Hero!