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Crucial Conversations in Nursing Academics: Practical StrategiesApril L. Folgert, PhD, RN
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1. Identify assumptions that lead to chaos versus dialogue.
2. Value the benefits of dialogue in the workplace despite varying emotions, opinions, and positions of authority.
3. Apply practical strategies based on Patterson, Grenny, McMillan and Switzler’s(2012) book, Crucial Conversations, to build and maintain communication in nursing academia.
Purpose and Objectives
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Lateral violence and bullying in nursing
Nursing faculty-to-faculty incivility
Prevalence of incivility among nurse academicians – only recently studied.
The Issue
Barbosa-Leiker et al. (2015), Clark et al. (2009), Nikstaitis & Coletta (2014), Peters (2014), Warrner et al. (2016)
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Manage costs (financial insecurity) Increase/Manage admissions Increase/Manage retention Increase Manage NCLEX scores Recruit and maintain faculty
Challenges in Nursing Academics
Clark, C. (2013). Creating & sustaining civility in nursing education. Indianapolis, IN: Sigma Theta Tau International.
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Choose between the relationship and getting results Victim stories Villain stories Helplessness stories
Assumptions that Lead to Chaos
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial conversations: Tools for talking when stakes are high (2nd
ed.). New York, NY: McGraw-Hill.
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Fosters positive relationships Empowers faculty
impacted by incivility
Creates a healthy work environment
Benefits of Effective Dialogue
Burger et al. (2014), Clark (2013), Major et al. (2013), Peters (2014)
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Start with Yourself
Establish Safety
Practical Strategies
Clark, C. (2013). Creating & sustaining civility in nursing education. Indianapolis, IN: Sigma Theta Tau International.
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial conversations: Tools for talking when stakes are high (2nd
ed.). New York, NY: McGraw-Hill.
Understand the Other
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What do I want: for myself? for the other person? for our relationship?
How would I behave if I wanted these? What will happen if I start/don’t start
the dialogue?
Ask Yourself Some Questions
Clark, C. (2013). Creating & sustaining civility in nursing education. Indianapolis, IN: Sigma Theta Tau International.
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial conversations: Tools for talking when stakes are high (2nd
ed.). New York, NY: McGraw-Hill.
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Clarify what you really want. Clarify what you really do not
want. Combine the two.
Start with Yourself
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial Conversations: Tools for talking when stakes are high (2nd
ed.). New York, NY: McGraw-Hill.
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I really want to revise the course syllabus AND I really do not wantmy colleague to think I am criticizing her efforts.
Example
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Setting and timing Silence and violence Monitor
Content (what) Conditions (why)
Mutual purpose and respect
Establish Safety
Clark, C. (2013). Creating & sustaining civility in nursing education. Indianapolis, IN: Sigma Theta Tau International.
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial conversations: Tools for talking when stakes are high (2nd
ed.). New York, NY: McGraw-Hill.
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Gain other’s perspective Get clear about our roles Discuss common goals/interests Actively listen Assume an open posture
Understand the Other
Clark, C. (2013). Creating & sustaining civility in nursing education. Indianapolis, IN: Sigma Theta Tau International.
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial conversations: Tools for talking when stakes are high (2nd
ed.). New York, NY: McGraw-Hill.
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Alternate sharing objective information with perspective
Speak directly Compromise
Understand the Other
Clark, C. (2013). Creating & sustaining civility in nursing education. Indianapolis, IN: Sigma Theta Tau International.
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial conversations: Tools for talking when stakes are high (2nd
ed.). New York, NY: McGraw-Hill.
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Ask to meet Agree on mutual location and time Consider your contribution to the
problem Create a mutual purpose
Students learn the content Students enjoy learning Course assignments align with course
outcomes
Example
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“Thank you for sharing the course syllabus. I would like to exchange the written assignment for a folding case study and do not want you to think that I don’t value the work you’ve done in this course. I want to use the other assignments just as they are.”
Example
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Do others believe I care about their goals in this conversation?
Do they trust mymotives?
Mutual Purpose & Respect
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial conversations: Tools for talking when stakes are high (2nd
ed.). New York, NY: McGraw-Hill.
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Confidence Humility Skill
Maintaining Respect
Clark, C. (2013). Creating & sustaining civility in nursing education. Indianapolis, IN: Sigma Theta Tau International.
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial conversations: Tools for talking when stakes are high (2nd
ed.). New York, NY: McGraw-Hill.
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Apologize (when appropriate) Contrast – explain what you don’t
mean Ask them to tell their story Confirm feelings
When Safety is Violated
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial conversations: Tools for talking when stakes are high (2nd
ed.). New York, NY: McGraw-Hill.
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Paraphrase to acknowledge story Agree where you do Compare when you differ Re-establish mutual purpose
When Safety is Violated (Continued)
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial conversations: Tools for talking when stakes are high (2nd
ed.). New York, NY: McGraw-Hill.
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Objectives 1, 2, & 3
You are in the role of the program chair. An experienced faculty member informs you that students are failing a course that is being taught by a new faculty member. There is word that the new faculty member may offer extra credit to students, which is against policy.
Small Group Discussion
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Objective 1 The faculty handbook indicates that instructors/professors must hold 10 office hours each week. Your colleague is rarely in her office during her posted times and students frequently ask if you know where she is or when she’ll be available.
Practice Scenario
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Altmiller, G. (2012). Students perceptions of incivility in nursing education: Implications for nurse educators. Nursing Education Perspectives, 33(1), 15-20. Retrieved from http://www.nln.org/newsroom/newsletters-and-journal/nursing-education-perspectives-journal
Burger, K. G., Kramlich, D., Malitas, M; Page-Cutrara, K., & Whitfiled, Harris, L. (2014). Application of the symphonological approach to faculty-to-faculty incivility in nursing education. Journal of Nursing Education, 53(10), 563-568. doi: 10.3928/01484834-2010922-02
Clark, C. (2013). Creating & sustaining civility in nursing education. Indianapolis, IN: Sigma Theta Tau International.
Clark, C. M., Farnsworth, J., & Landrum, R. E. (2009). Development and description of the incivility in nursing education (INE) survey. Journal of Theory Construction and Testing, 13, 7-15. Retrieved from http://tuckerpub.com/jtct.htm
References
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Clark, C. M., Barbosa-Leiker, C., Gill, L. M., & Nguyen, D. (2015). Revision and psychometric testing of the incivility in nursing education (INE) survey: Introducing the INE-R. Journal of Nursing Education, 54(6), 306-315. doi: 10.3928/01484834-20150515-01
Major, K., Abderrahman, E. A., & Sweeney, J. I. (2013). Crucial conversations in the workplace: Offering nurses a framework for discussing and resolving, incidents of lateral violence. American Journal of Nursing, 113(4), 66-70. Retrieved from http://ajonline.com
Nikstaitis, T., & Coletta, L. S. (2014). Incivility among intensive care nurses. Dimensions of Crucial Care Nursing, 33(5), 293-301. Retrieved from http://journals.lww.com/dccnjournal/Pages/default.aspx
Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial conversations: Tools for talking when stakes are high (2nd ed.). New York, NY: McGraw-Hill.
Peters, A. B. (2014). Faculty to faculty incivility: Experience of novice nurse faculty in academia. Journal of Professional Nursing, 30(3), 213-227. doi: 10.1016/j.profnurs.2013.09.007
Warrner, J., Sommers, K., Zappa, M., & Thornlow, D. K. (2016). Decreasing workplace incivility. Nursing Management, 47(1), 22-30. doi: 10.1097/01.NUMA.0000476622.91398.c3