Monday, October 11, 2021

Crucial Conversations in Nursing - Juniper Publishers

 Palliative Medicine & Care - Juniper Publishers 

Abstract

Learning communication skills is very important for people who want to be successful in their life. Successes in crucial conversations can improve many aspects like education, health, administration, leadership, relationships, etc. Nurses can improve the quality of care through maintaining a safe environment and assisting students, patients, and staff members in continuing dialogue when they are under stress, scared, or angry. Communication skills and success in crucial conversations in nursing workplaces can provide leadership development and increase nurses’ educational opportunities. They support nurses in nursing care and improve the quality and safety of patient care.

Introduction

People need to communicate with each other to share ideas, thoughts, and opinions. There are many ways and strategies in communication and one of them is conversation. One of the purposes of conversations is to persuade others about ideas. These ideas could be simple like buying a toy for a kid, or it could be complex like the legislation process in the senate. Each person has his/her own strategies to persuade others, and these strategies may change according to the situation. A crucial conversation is a dialogue under stress. A successful crucial conversation requires effective communication skills that must be learned and developed.

Crucial Conversations

Tools for Talking When Stakes Are High is a book that describes strategies for high stakes and important conversation. This book is interesting for readers because it includes thoughts for successfulness in a crucial conversation and strategies to persuade others. Kerry Patterson, Joseph Grenny, Ron McMillan, and Al Switzler explain high stakes conversations and effective strategies in communication in their book.

Synthesis

Crucial conversations are daily conversations that affect our lives. There are three main characteristics of crucial conversations: opinion differentiation, high stakes, and emotions. Differentiation in opinions is one of the crucial conversation characteristics. For example, when a couple is talking about choosing the neighborhood for their home, and they each have different opinions about that. Second, stakes must be high. For example, a wife wants to buy new and expensive furniture, and her husband does not want to change their furniture. The stakes are high in this situation because the opinions are different between the couple, and that leads to an increase in the stress and tension between them. Third, emotions run strong. For example, a couple is talking about their plan to have a baby, and suddenly the wife remembers the furniture. Then the husband becomes angry, and emotions run strong. In this case the emotional situation plays an important role in the conversation and makes it crucial. Anger can make a person out of control, and a nervous person may say something without thinking and come to regret it later. Therefore, controlling emotions is the key to preventing stressful conversations. When two people or more discuss with different opinions, high stakes, and strong running of emotions, this conversation is a crucial conversation and may affect the quality of a person’s life. Success or failure in a crucial conversation can affect positively or negatively on communities, people’s relationships, and even people’s health.

The authors point out that in a conversation, there are some signs that indicate when a conversation can turn from a routine discussion into a crucial one. They identify three main reactions in a crucial conversation: emotional, physical, and behavioral. In emotional reactions, some people feel angry, hurt, or scared. These emotions can be cues for a person to slow down, step back, and take time to turn their brain back on. Physical reactions are different from one person to another. Some feel their stomach get tight or their eyes get dry, and some feel their palms get wet. Whatever they are, they can be signals of a crucial conversation. In addition, behavioral reactions can be the first cue for some people. They raise their voice, point their fingers like a weapon, or hit a desk with their hand. Therefore, these signals can lead a person to be aware that he or she is at risk of moving away from a healthy dialogue. Indeed, if people want to keep themselves in a dialogue, they must control their emotions.

The key for a successful crucial conversation is to use listening skills. There are some listening skills to retrace others’ paths from action to its origin, like expressing interest in others’ views, respecting emotions that people show, and paraphrasing some part of their speech to show understanding. The beginning and the end are the two riskiest times in crucial conversations. The beginning is risky because people must be able to find a way to begin safely. The end is precarious because people have to clarify the conclusion. However, people do not have to make decisions at the end of a conversation because not all dialogues end by making decisions.

Dialogue is a process of getting all related meaning into a shared pool, and it involves everyone. However, it does not mean everyone is guaranteed participation in making decisions. To prevent violated expectations, dialogues should be separate from decision-making. Therefore, turning a successful crucial conversation into good decisions needs to avoid violating expectations.

Analysis

Authors of Crucial Conversations: Tools for Talking When Stakes Are High mentioned many situations as examples to help readers understand skills of successfulness in a crucial conversation. Indeed, authors explained the situations very well so that readers can imagine themselves in those situations. Also, this book contains many tips for how to deal with crucial conversations more effectively. However, these tips may make readers feel overwhelmed with techniques. Authors mentioned the techniques that are appropriate for each situation, so readers may be confused about which technique(s) to apply.

Authors in this book mentioned that people can control their emotions in crucial conversations. However, controlling the emotions is not probable, especially when stakes are high because hormones and body responses to stress can affect emotions [1]. In crucial conversations, emotional and psychological changes in the body play important roles in the success or failure of a crucial conversation. This book mentioned strategies and skills to use those changes positively to persuade others in a crucial conversation and make it successful. Indeed, success in a crucial conversation involves creating mutual goals in a dialogue. On the other hand, this book did not talk about failed conversations. In an argument, all participants may have adequate communication skills and may know how to deal with a crucial conversation. However, there may be a loser in that argument. This means people may not satisfied with the result of the conversation, so not all conversations end as we would like and not all conversations meet the mutual goals. I would like to name those conversations as “failed conversations.” Focusing on solutions for failed conversations can improve the outcomes. Maxfield [2] gave solutions in his study for teachers who have failed to communicate with their students and who have failed in the classroom. This failure leads to a decrease in students’ learning and an increase in stress. Failed communication with students can be turned into success through crucial conversations with peers, administrators, or students’ parents. Maxfield [2] mentioned that “only 13% of teachers have the crucial conversation and share their concerns with the failing teacher. … The teachers who step up to crucial conversations and resolve the problem with their failing peers are significantly more satisfied with their school” (p.28).

Indeed, communication skills play a significant role in the educational system. In the educational system, educators try to persuade each other and persuade students by evidence. However, persuasion by evidence in the educational field may be difficult because others also have scientific reasons. Sometimes a conversation between two teachers becomes crucial when they have different opinions and emotional reactions in the situation. For example, when two teachers have different teaching methods and each one is trying to persuade the administrator about the idea, a crucial conversation can start . In this case, the stakes are high, the opinions are different, and the emotions are strong. Conversations between teachers and students sometimes become crucial, too. For example, when a student is not satisfied with his or her grade and begins to argue with their teacher. The teacher and the student have different opinions about the grade. The student does not accept the grade, the conversation continues under stress, and both become angry. In this case, the conversation is crucial because the opinions are different, the stakes are high, and the emotions are strong. On the other hand, an effective communication is the key to success in learning and teaching strategies [3]. For example, in group learning, students who are in one group have to communicate with each other to meet their goals. Working together in a group cannot be possible if the group members do not understand each other with different ideas of each one unless they use effective communication skills.

In addition, communication skills and success in crucial conversations in nursing workplaces can provide leadership development and increase nurses educational opportunities who work as managers or staff. They support nurses in nursing care and improve the quality and safety of patient care [4]. Therefore, nurses without effective communication skills are at risk of failing in their care. Grenny [5] mentioned in his study that more than 20% of health professionals have seen actual harm come to patients because of bad communications. Nurses can improve the quality of care through maintaining a safe environment and assisting students, patients, and staff members in continuing dialogue when they are under stress, scared, or angry [6-9].

Conclusion

During a normal life period, people communicate with each other to meet certain goals. Meeting these goals, especially in stressful situations, is not easy and needs communication skills. However, understanding and applying communication skills are different for different people. For this reason, some people have the ability of persuasion and some do not. Therefore, learning communication skills is very important for people who want to be successful in their life. Failing in a crucial conversation can affect many aspects in life like careers, communities, relationships, or even personal health. On the other hand, success in a crucial conversation can improve many aspects like education, health, administration, leadership, relationships, etc.

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