Introduction to crucial conversations

Introduction to crucial conversations

A crucial conversation is a discussion that takes place between two or more people who are not in good terms with one another with different options, and emotions are high. People with disagreements do not come to a consensus at the earliest time because of the grudges and opinions that don’t work out together. This calls for a close discussion that is mandatory between them to resolve the differences. There are several instances that people or a group of people disagree and confront each other (Patterson, 2016). In such cases, they need to come together and discuss the matter. Some of the critical situations that need crucial conversation include:

1. Talking to a co-worker who acts offensively or suggests so.
2. You are ending a relationship.
3. Critiquing colleagues work
4. Reminding a friend to pay back the loan
5. Talking to a boss is breaking the quality policies or breaking safety rules
6. Giving the information to the boss about his/behavior
7. Dealing with a rude teenager
8. Resolving a visitation or custody with an ex-spouse
9. Asking a roommate to move out
10. Asking in-laws to stop interfering
11. Asking a loved one to prevent substance abuse
12. Explaining to a coworker concerning a personal hygiene issue.
13. Providing a review of a bad performance
14. Handling a colleague who is posturing information or resources (Patterson, 2016).

There are some steps that essential to be followed while handling such kind of unfortunate situation. First, one needs to start with the heart or the willingness to resolve the issue. Again, one should be willing to stay in the dialogue until the case is resolved. The process should be safe to handle with no further physical involvements. The people involved should not be united with high emotions of anger. The individuals should also agree on the mutual purpose and should separate facts from the story in question. Finally, the disputing parties should agree on the perfect action plan that brings them to a consensus. The crucial conversation model teaches a lot about speaking persuasively and not offensively. The model also helps in fostering teamwork and better decision making. Moreover, the model builds the act of acceptance and resistance. It also helps in resolving cases of disagreements among individuals and groups (Patterson, 2016).

Consider a situation in a nursing fraternity

It’s paramount for the nursing leaders to address any issue associated with the healthcare unit and refuse any hostility. For instance, if a nurse approached the nurse manager for assistance in a collegial conflict, it’s vital for the manager first to direct the complainant to another staff member to deal with the behavior. They will make a crucial conversation among themselves to find a long-lasting solution. As previously mentioned above, there is a specific procedural framework, as outlined by Patterson and his colleagues on how to hold a crucial conversation.

1. Start with the heart. The person should define what they want at the end of the discussion. It should not be based on biased ideas such as seeking revenge, winning the argument, or keeping ones safe. The aim should be focused on the free flow of information and that based on every flow of information.
2. Learn to look. One needs to be conscious when crucial information is necessary. A proper plan should be made to avoid going into a discussion without any readiness. Also, one needs to assess the situation of oneself to make sure none is violent or silent in the process.
3. Make safe. A clear mutual purpose of the discussion should be outlined to each other to establish respect. They should be no ambiguity that can lead to the worst that causes discomfort, defensive, or both situations. Being defensive can stop the other person from listening to relevant information.
4. Mastering of owns story. Proper control of personal emotions should be portrayed. Paths to the conclusion should be made clear to help the counterpart to understand it better. There should be a boundary between the known facts (such as the nurse yelled at the other in front of her colleagues) from the story (she lacks respect for you). Also, true identity to the root cause of the problem is critical in resolving it.
5. Stating of the path. The facts from all the parties must be shared. It should be the raw facts and also remembering to consult the others how they have arrived at the stories or feelings. The conversation should embark on the right path.
6. Exploration of the other’s paths is crucial too. The four power listening skills should be employed in learning other people’s perspectives. These include asking questions to encourage others to share their opinions. It also entails how others look or are acting to confirm your understanding of their feelings. Thirdly, paraphrasing will convince them of your knowledge of their story. Lastly, an encouragement will make the rest of those involved to share the details which they might not have revealed.
7. Moving to action. A conclusion about the issue should be made together basing on the discussions held. A followed should also be part of the judgment. These protocols help minimize battle among the coworkers in organizations (Blatchley, 2017)

Case study

The following scenario shows the application of the necessary conversation framework that can be used in navigating and resolving cases and incidences among the nursing fraternity.

Confrontational Behavior

A nurse called Stella has worked in a particular hospital for five years. Some few months ago, some of her colleagues provided the nurse manager with information about her bad behavior. They claimed that Stella has unprofessional and confrontational interactions with others in the vicinity. She is usually seen rolling her eyes during the shift huddle when the nurses come together to discuss each patient. She also yells at her coworkers in the unit. In every incident, the nurse manager always asks her colleagues to speak to her about bad behavior. Stella still denies it and ends the conversation when the other nurses told her about the situation. However, the nurse manager had talked to her about three times in the previous year, and that has made tremendous improvements. The behavior has since rejuvenated in the past few months. The negative, abrasive, and aggressive behavior came back. The following cases about Stella have been reported in recent weeks. Firstly, the physician complained about Stella’s behavior and comment about the patient’s body odor within the patient’s perimeters. Secondly, a nurse coworker said that Stella yelled at her for asking too many questions about the report. In another instance, the nutritional aide informed the manager of the numerous occasions where Stella complained of the hospital’s food being horrible that it couldn’t even be fed to a dog.

The nurse manager realizes the high emotions of losing the able nurse, Stella. She decided to follow the conventional framework for crucial conversations to try and resolve the battle (Folgert, 2017)

The manager started the negotiations with the heart. She has had the inner dialogue within herself before coming to Stella to have the outer conversation. She explained to her how she would want to see her happy and successful at work and that she’s great concern about her feelings and thoughts. She also pointed out that all of them in the fraternity share a frequent target and that the goal entails delivering quality healthcare in a unit that has collaboration among the patients, management, and the clinical team. The manager then informed her that the partnership no longer exists in the hospital and that a proper resolution is required for it to be restored. She also shared with Stella the concerns of her colleagues but letting her know that the purpose of sharing was not to blame anyone but to maintain the efforts of the team in restoring the lost agenda in the hospital.

The nurse manager made the environment safe for both of them through the maintenance of a respectful tone throughout the conversation. The situation was made equally safe from Stella to express herself honestly. ‘Everything I do is for the patients, ‘ Stella said. ‘I understand the fact that you always give the best to the patients and appreciate all efforts in this hospital.’ The nurse manager replied. The dialogue between them was very open since the environment was safe and that they understand each other’s feelings. She also asked Stella to explain more about why she said that no one supports her in practice. This thought is contrasting and is introduced by the manager to provoke Stella’s mind to give more information about the situation. She didn’t want to minimize her concern about Stella’s unprofessional behavior but her efforts towards her patients. For instance, Stella has been a leader in the hospital, teaching patients, and family members about diabetes. The manager used the phrase ‘it was reported to me…..That’. This encourages Stella to try and use some defense mechanisms. The phrase also creates a different technique to ensure the conversation is focused on their mutual purpose through respectful dialogue. The stories told by each one of them justified one’s actions. For instance, Stella explained how the hospital was so unsafe that there was no time for official communication about the awful food in the catering department. The manager ensured focus by reminding Stella that they were talking about the approach she handled the nutritional aide. The manager uses her power skills through several questions. She also employed a mirror technique to encourage Stella to give more detailed responses to her questions during the discussion. For example, she provoked Stella by asking telling her that she claimed not to be upset, but she said to have seen her with crossed arms. She went ahead and explained what she said to confirm that she understood her perspective. The manager also introduced the priming technique by asking her if she is overwhelmed by working and going for part-time schooling while caring for the family. This kind of technology ensured that both were in the dialogue for as long as they should until the case is resolved. It removes the boredom and monotony of asking direct questions all the time (Folgert, 2017)

In the end, both Stella and the manager came to the consensus that they will all cooperate in restoring the lost faith in the working environment. At the end of the discussion, the nurse manager restated their mutual purpose and noted that they had agreed on inappropriate interactions and behavior towards the staff, and the patients hinder them from meeting the common goal.

The manager also scheduled some follow-ups with Stella for the next six weeks through weekly meetings to discuss situations that frustrated Stella over that period. In these meetings, they talked about the ways Stella communicated in adverse conditions. At some point, Stella admitted that she had seen the importance of excellent communication and the relationship between her and the coworkers. The nurse manager noticed a tremendous change in Stella’s behavior in the way she talks to her coworkers and the minimized complaints about her from the colleagues

Conclusion Remarks

The influence of the success of any leader and especially a new one, depends on how to effectively conduct negotiations and conversations in the case of a conflict. Those who don’t have enough experience in leadership may resist the need to carry out crucial conversations, as outlined in Patterson and Colleague’s principles. This endless cause battles and several unresolved cases in the organization. The coworkers will hate each other to the point of separation, and teamwork is compromised. This results in reduced quality output and unconducive working environment. According to the experienced leaders, the idea of conducting a crucial conversation begins with the phase of knowledge gathering. It then proceeds to the decision making and implementation and a conclusion phase of feedback and adjustment. The ones involved will make a review of the necessity of any changes to be added. The creation of a safety protocol culture on any organization among the nursing coworkers and management will help incorporate all the phases of conflict resolution into the system hence avoiding violent incidences. The initial conversation framework will always provide a guide towards the peaceful settling of disputes in organizations.

References

Blatchley, A. (2017). A Nurse Manager’s Guide to Giving Effective Feedback. Nurse Leader, 15(5), 331-334.

Folgert, A. L. (2017). Crucial Conversations in Nursing Academics: Practical Strategies.

Patterson, K. (2016). Crucial conversations. [United States]: IDreamBooks Inc.

Major, K., Abderrahman, E. A., & Sweeney, J. I. (2013). ‘Crucial Conversations’ in the Workplace. AJN The American Journal of Nursing, 113(4), 66-70.

Lasater, K., Mood, L., Buchwach, D., & Dieckmann, N. F. (2015). Reducing incivility in the workplace: Results of a three-part educational intervention. The Journal of Continuing Education in Nursing, 46(1), 15-24.