Shared Values and Essential Skills: What Nurses Can Teach Managers about Compassion and Boundaries
My then-nurse and co-author Angela Sigal Poock looked at the blood pressure reading, then at me, and said (or so I remember):
I am sorry you seem so in pain. I must rush to see other patients but wish I could stay to hold your hand.
That was all, and as they say, that was everything.
Like managers, nurses are shock absorbers — pressure from the top by performance imperatives and from the bottom by increasing human distress.
The pandemic catapulted managers into the role of emotional first responders. They were not trained nor equipped for it. Many breathed a sigh of relief at the official end of the pandemic, but it soon became clear that supporting employees has become central to good management.
“My manager cares” is a central feature of employee surveys. Caring is a proxy for being seen and heard and not being dismissed and ignored.
In honor of the 2024 Nurses Week, we share how nursing professionals deliver care and impact millions of lives and communities daily and reflect on how managers can learn from nurses to support employees.
Nursing Employees Back to Health
A nurse’s toolkit includes compassion, good listening skills, empathy, and a nonjudgmental approach towards patients who often feel vulnerable and have concerns about their healthcare needs.
To serve patients and their care providers, nurses learn to:
- quickly triage sensitive physical/emotional situations,
- set the tone,
- communicate clearly,
- see the whole person in context,
- adapt to changing circumstances,
- advocate for process improvements, and
- collaborate in a team-focused environment that, at its very best, can be laser-focused on coordinating patient care.
Triage with care
Most of us can help some people some of the time. What sets nursing professionals apart is that their job requires them to help ALL of their patients ALL of the time. But there is often a need to sequence that help.
Managers have to engage in a similar form of triage. They can only help some people at a time and often need to make judgment calls on properly sequencing events and allocating intensity.
With experience comes intuition, skill, and more expertise in who needs to come first and how. But experience also slowly creates blinders, ingrains automatic response patterns, and deepens our stereotypes around who is doing well or not.
Set the tone
Nurses set the tone on a ward or floor. They are often the stable cohort — doctors, technicians, and other staff come and go. Nurses know how things work and how processes and procedures ‘happen.’ That kind of institutional memory is essential for others. They lead by example, by the decisions they make and actions they take at the patient’s bedside.
Similarly, managers transmit culture and norms and can actively support new employees as well as existing staff in navigating a constantly changing workplace — one that is increasingly impacted by outside forces. Leaders and managers need to be seen as stabilizing forces in a shifting landscape but also vectors of hope to move people and organizations forward.
This means that nurses and managers often have to suppress their own emotions, defuse situations, try to remain neutral, diagnose problems, problem-solve, and persuade others that their approach might be right.
Communicate with clarity and empathy
Effective communication lies at the heart of both nursing and managerial roles. Nurses convey critical information to patients, families, and interdisciplinary teams with clarity, empathy, and timeliness.
Nurses are used to talking to patients under physical and emotional stress and their loved ones, who often feel helpless or do not understand what is happening. We heard about an operating room nurse calling a patient’s contact during every operation. Her conversation always stated, “…your loved one is warm and doing well.” This allowed family members to think that during the most stressful time in an individual’s life (under anesthesia in surgery), they were warm.
Similarly, managers must be trained to communicate clearly with constituents to facilitate collaboration, address challenges, and align organizational goals. During the pandemic, managers also had to learn on the go how to support employees and their loved ones when they themselves and their loved ones were stressed. Since the end of the pandemic, employees have sought clarity, action-orientation, and empathy from those who lead them.
See the whole person in context
Seeing the forest for the trees when working on any matter is central to successful nursing. Nurses spend the most time with patients and people who might come in and call about them. As a result, they know the most about patients and their familial and social circumstances. Nurses recognize the importance of treating the “whole patient,” including addressing any mental health needs associated with a patient’s physical symptoms.
For example, if a patient presents with a sore throat, nurses naturally ask about the physical symptoms. But what if that patient then exhibits emotional distress, such as a lack of eye contact, fidgeting, or sometimes crying? A nurse’s role involves treating the whole patient, which can involve ascertaining any related or unrelated mental health issues as well as treating a patient’s physical symptoms.
Adapt to changing circumstances
While there is some routine in most wards and clinics, surprises and emergencies present unpredictably. This requires both constant vigilance and flexibility concerning the humans and conditions that enter or inhabit the space daily and, in some settings, hourly.
The same is increasingly true of workplaces — technological tethering enables information and stress to spread rapidly, either about internal affairs or what is happening worldwide. Managers and their employees are increasingly responding to or affected by world events that may require some time off for reflection and healing as well as different types of support for individual employees.
Advocate for evidence-based practice
Both parties can advocate for patients and employees. They understand the power of assessment, data collection, coordination with other providers, implementation, and oversight. Nurses may advocate for patient rights, safety, and well-being, pushing for evidence-based practices and quality improvement initiatives and training.
Likewise, managers advocate for individual staff members, as well as for professional development and organizational initiatives that enable employees to learn, grow, and contribute.
Collaborate with intent
Collaboration lies at the core of both nursing and managerial practice. Nurses and managers collaborate with and through others and across disciplines and departments. They must speak differently to different constituencies and become fluent in and understand modalities, vocabularies, and silos.
What can we do for them?
The Hippocratic Oath, from 400 BC, provides a normative framework that shapes doctors’ identity, conduct, and orientation toward society. One of its famous tenets, which actually predates the oath, is “Do no harm.”
This is a good life goal, especially toward those who manage both our care and our well-being at work.
Burnout and turnover in nursing are at an all-time high. We must do what we can to ensure they can exercise their professions without harming themselves— without losing their health, hope,or talents.
As patients, we can do more to be prepared and explicit in our communications. Recognizing the physical and mental health distress we have when calling a nurse or meeting with one either onsite or via telehealth, we can help healthcare providers, generally, by summarizing our healthcare needs concisely, directly, and to the point. We can also leverage today’s technology when doing so (e.g., submitting a secure message in advance of an appointment or making sure you have important health information on your phone).
But we can also do less self-diagnosing and second guessing of healthcare providers based on Google searches and Artificial Intelligence tools. Nurses caution patients against self-diagnosis. Of course, nurses recognize the value of online information, including how informed patients lead to greater collaboration with their healthcare providers. Our nurses recommend, though, that the pathway to an informed healthcare decision begins with patients trusting that their healthcare providers have the knowledge, experience, assessment tools, resources, and skills to diagnose and treat their symptoms and identify both obvious and hidden needs.
In a work setting, employees should not expect managers or colleagues to intuit what they need and should do what they can to self-reflect before making demands or seeking accommodations. Also, they should seek help from mental health professionals or reliable sources for a diagnosis and additional support.
Lending a (Verbal) Hand
As Mother Teresa teaches us, “Kind words can be short and easy to speak, but their echoes are truly endless.”
The theme of this year’s Nurses Week is “Nurses Make a Difference.” When you next see a nurse, please know how much “Nurses Make a Difference!” And say thank you. Your thank you will make a difference, too. Wishing our country’s 5 million registered nurses a great Nurses Week 2024!
This post grew from an encounter at urgent care first shared on LinkedIn and subsequent research and conversation. Please read Angela’s article, “The CA[C]E for kindness in postpandemic nursing,” in Nursing Management.
