Nurses, Need Help with Difficult Conversations?

by | Mar 4, 2016 | 10 comments

Nurses are introduced to topics like communication and delegation in nursing school. Texts are provided that teach subjects like interpersonal communication, intercultural communication, and communication as it relates to patient safety.

Successful Nurse Communication by Beth Boynton
Delegation can be even trickier than communication skills to learn during nursing school. A nursing student is just trying to learn the clinical signs and symptoms of disease, speak to patients in a safe and effective manner, and navigate the healthcare system as a whole. How can they add delegating to unlicensed personnel at this point in their nursing careers? And is it even safe to?

So while a nursing student is provided with an introduction, albeit overview, of communication techniques and delegation processes- this certainly is not a time when they begin to excel at these tasks. OK- so nursing school is out, what about nursing orientation?

Does a brand new nurse know how to go up to an experienced provider and question the medication order? A nurse of two months time, do they feel comfortable delegating to an unlicensed team member who has been known to ‘have a bad attitude’ and roll their eye when asked to do things? Where and when do nurses learn these challenging skills? And, is the more important question, how?

We can read about communication in a text book. We can talk about safe and effective delegation in a staff meeting. But until one practices these skills over and over… and over again, a nurse may not feel 100% confident engaging in these difficult tasks. I had the pleasure of interview two experts over the past few months on these topics.

Ruth Hansten: Clinical Delegation ExpertRuth Hansten RN, MBA, PhD is the author of seven books based on her clinical, educator, and consulting experience with over 175 healthcare organizations, her doctoral research on critical thinking, and practice with healing relationships, nurse delegation, and leadership. Dr. Hansten has developed a care delivery model called Relationship and Results Oriented Healthcare® (RROHC), resulting in improved outcomes, clinical indicators, employee engagement, patient and provider satisfaction. Clinical Delegation Skills’ 1st edition was awarded the AJN Book of the Year award. Ruth’s speaking and consulting has included volunteering as U. Washington adjunct faculty, hospital trustee, and AHA Regional Advisory Board roles.

Ruth will be teaching The Art of Nursing attendees:

  • How to define delegation and supervision;
  • About the 5 Rights of Delegation and Supervision;
  • What the common questions or confusion about nursing leadership at the point of care.

Traci Hanlon: Professional Development and Communication ExpertTraci Hanlon is an expert in professional development. Her creative concepts and models have helped organizations create healthier work environments that include innovative orientation, precepting processes, and strong leadership teams. Her programs focus on engagement, care of self, patient experience, healthy work environment and patient safety. Traci understands the challenges of bringing new graduates into complex healthcare systems, and developing teams who thrive and nurture each other. In addition to her clinical experience, Traci has held positions as critical care educator, med/surg educator and nurse manager. Traci is a strong facilitator and sought after speaker, and contributing author of Nursing Orientation Program Builder; Tools for a successful New Hire Program.

Traci will be teaching The Art of Nursing attendees:

  • What is considered a “difficult conversation”;
  • How developing skills in managing difficult conversations is directly related to patient safety;
  • Two methods to engage and handle difficult conversations.

These two fantastic nurse leaders shared with me the who, what, and how on communication and delegation. They both talked about how imperative it was to not only learn the skills, but practice them with colleagues. In order for nurses to be confident and competent communicators in the healthcare setting, they need opportunities to develop and nurture these skills.

What did we miss? I’d love to hear about skills and techniques you have used with communication or in delegating to unlicensed personnel in the comments below. Thanks for reading!

Elizabeth Scala, MSN/MBA, RN; Founder of Nursing from WithinAbout the Author: As a keynote speaker, bestselling author and virtual conference host, Elizabeth partners with hospitals, organizations, associations, and nursing groups to help transform the field of nursing from the inside out. During the National Nurse’s Week online conference, ‘The Art of Nursing‘, Elizabeth supports nurses in achieving professional goals of continued learning and development. Click here to find out more about how The Art of Nursing appreciates and celebrates our profession in a meaningful way.


    • Elizabeth

      Thanks, Marilyn!

    • Elizabeth

      Thank you, Maureen.

  1. exceptionalnurse

    Hi Elizabeth,

    I often work with nursing students and nurses with disabilities who struggle with “difficult conversations” specifically about disclosing their disability or being asked about a disability.

    I encourage role playing and rehearsed responses…practice, practice, practice!
    The more a person practices the easier it will become.

    Thanks for shedding light on this topic!

    • Elizabeth

      Great to hear, Donna! I love how you share how you use it in your work and that it is effective. Other readers of the blog will take heart to this notion of practice, I am sure. Thank you for your comment!

  2. Dr. Rachel Danford, DNP

    Hi Elizabeth,

    I’m so excited to hear about what you are planning as host of The Art of Nursing for this year’s National Nurses’ Week in May. Effective communication is imperative for interpersonal teamwork striving for the common goal of improving patient outcomes and patient safety. Thanks for sharing information about these nursing leaders making a difference in our profession. I’m looking forward to learning more.

    • Elizabeth

      Thank you so much, Rachel. These nurses certainly are passionate about these topics and filled with great knowledge.

  3. Joan @

    Great resources, especially for new nurses. In this day where everything is electronic, communication skills are quickly being lost and evolving. Some awesome speakers ready to go for The Art of Nursing again this year!

    • Elizabeth

      Thank you, Joan. And you hit the nail on the head. As we continue to grow the science of nursing, many of these topics that relate to the art need time and attention. We will continue to bring these skills to nurses across the country!


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