1. Chapter 1 Role Transitions Dr. Sparks

2. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Transitions in Nursing What are transitions? Passages/changes from one situation, condition or state to another over time Complex processes Types Developmental Situational Health/illness Organizational

3. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Transitions in Nursing (cont’d) What are important factors influencing transitions? Understand from the perspective of person experiencing the transition Positive Negative Neutral Transition desired? Expectations realistic?

4. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Transitions in Nursing When you know what to expect, you can reduce your stress Give one example of how you can reduce your stress by knowing expectations?

5. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. What Is Reality Shock?  Reaction experienced when entering work force after years of preparation  New RN graduates are expected to be competent, capable nurses—without the experience  Increased acuity, combined with the nursing shortage, may leave you feeling depressed, insecure, and powerless and overwhelmed

6. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. What is Reality Shock? It is a truism that “the way in which the new graduate elects to resolve reality shock will influence not only how she views her first experience as a nurse but also how she will view her entire career in nursing.” Marlene Kramer, 1974

7. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. What Are the Phases of Reality Shock? Honeymoon phase—no one watching over your shoulder (exciting phase) Shock and rejection phase—when the bad days outnumber the good ones Recovery phase—humor, decreased tension Working toward effecting a better solution through conflict resolution

8. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Role Transformation When does the role transition to graduate nurse begin? Moved into novice role when you took your first nursing course Advance beginner at graduation

9. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Benner, Novice to Expert

10. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Role Transformation (cont’d) I'm getting close to graduation, how do I prepare myself for a role transition? During last semester No “mama management” Realistic client-care assignments/shifts Perform instead of observing Truth about real work setting Look for problem-solving opportunities/practice critical thinking Request constructive feedback Request clinical experience in area of interest

11. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Role Transformation (cont’d) How do I prepare myself for a role transition? Think positively Be flexible Get organized Stay healthy Find a mentor Find other new grads Have some fun! Know what to expect

12. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Ask yourself How Do I Measure Up? Excited and sincere about nursing? Open-minded and willing to learn new ideas and skills? Comfortable with your basic nursing skills? Able to keep a good sense of humor? Receptive to constructive criticism? Able to express your thoughts and feelings? Able to evaluate your performance and request assistance?

13. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Rules of the Road  Green light—yellow light—red light  Stop and take care of yourself  Detour—you will make mistakes  Curve ahead—get your life in order  Resume speed—maintain a positive attitude  Exit—Don’t burn any bridges with your job  School zone—plan to continue your education

14. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Rules of the Road (cont’d)  Slow speed zone—take the time to get organized  Caution—if in doubt, check it out with another nurse  Roadside park ahead—take a break

15. Chapter 2 Personal Management Student to review this chapter independently

16. Chapter 12 Effective Communication and Team Building

17. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Individual Student Presentation Skills and Techniques of Public Speaking  Eye contact  Asking open-ended questions  Restate the problem  Identify goals  Periodic summary  Know material without reading notes (notecards)

18. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Individual Presentation Planning and presenting an effective oral presentation  Know material well  Practice in order to appear relaxed  Do not fade into another presenter's material  Meet time requirements

19. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Basic Principles of Effective Communication Interaction between two people Make your message clear Use simple, precise words Encourage receiver to use feedback Nonverbal reaction communicates message Reputation and credibility make difference Acknowledge feelings of others

20. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Basic Principles of Effective Communication (cont’d) Communicate directly with person Communicate in the present Keep your personal values from interfering with your communication Be respectful of personal nature of your surroundings

21. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Communication in the Workplace What are principles and the health care team? Sharing information with members of health care team requires different approaches 0 Delegation 0 Clarification 0 Reevaluation 0 Coordination

22. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Ask yourself How Can I Communicate Effectively with My Supervisor? 0 Keep your supervisor informed 0 Focus on problem solving 0 Show your sense of responsibility 0 Avoid blaming others 0 Don’t respond with anger 0 To present new idea, give your supervisor a written proposal 0 Accept feedback 0 Never go above or around your supervisor

23. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. How Can I Communicate Effectively with Other Nursing Personnel? Professional Registered Nurses should view themselves as equals in their interactions with members of other health care disciplines Your approach to communication should be a lateral one, even with physicians

24. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. How Can I Communicate Effectively with Patient Care Assistants?  Get their full attention  Give clear, simple, step-by-step instructions  Ask for feedback to verify they heard you correctly  Be sure to follow up  Provide direction without being too harsh

25. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. What Does My Image Communicate to Others? Communication enhanced by your credibility Good personal hygiene Know your particular field of nursing thoroughly Flexibility is necessary for effective communication Be pleasant to be around ( do not be a nurse Ratchet)

26. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. How Do Gender Differences Influence Communication Styles? 0 Women See big picture More comfortable asking questions Use softer, quieter approach Less competitive Less aggressive in asking direct questions 0 Men More logical and direct Ask fewer questions More aggressive and assertive More team oriented

27. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. What Should I Know about the “Grapevine”? It flourishes in all settings When in doubt, check facts out! How to control it  Provide factual information  Communicate face-to-face  Don’t spread rumors  Hold a meeting to provide information and answer questions  Make what is put in writing is clear

28. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. How Can I Communicate Effectively in Writing? Upward communication needs to be formal Don’t send without careful proofreading Take time to make necessary revisions Organize your thoughts Be clear and concise Keep It Short and Simple (KISS) Principle How well you write strongly influences how you are evaluated

29. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. How Can I Learn to Speak Effectively? Develop positive attitude PRACTICE makes PERFECT Analyze your audience Do your homework Plan presentation Add spice to presentation Create cheat sheets Become familiar with room and equipment Make eye contact

30. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. How Can I Use Nonverbal Communication Effectively? Make eye contact with person Stand up straight, shoulders back Use forceful voice without pauses to suggest confidence Watch for distracting behaviors

31. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. How Can I Communicate Effectively by Using Technology? Don’t misuse or overuse fax machines, emails, VM When you leave someone a voice-mail message, speak slowly and distinctly Don’t leave callers on hold if you are using call waiting Make sure it’s a convenient time to talk With a teleconference, make sure each party to the call is introduced to the other people

32. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. How Can I Communicate Effectively by Using Technology? (cont’d) When you have business cards printed, include e-mail address and fax number Do not send emotional outbursts in e-mail Learn to use basic computer software Send handwritten notes

33. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. What Is Group Process?  Forming—common bond  Storming—controlled pandemonium  Norming—mutual goals developed  Performing—able to work together  Adjourning—disengagement from tasks and group members

34. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Dysfunctional Group Personalities? Self-servers Rules don’t apply to them Show up late Contribute very little Motor mouths Talk just to hear themselves Always interrupt Mouse Fearful of voicing opinion Takes no risks, no responsibilities Critical conservative Criticize any idea that is not their own Obsessively negative

35. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Ask yourself How Can You Improve Communications in Group Meetings? Come prepared Listen—be open to other viewpoints Keep on track—don’t visit or chit-chat Present your ideas or opinions—ask other members for theirs State disagreements—be able to back them up Clarify when needed—don’t assume

36. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Think of a Leader at your current job What Are the Responsibilities of a Group Leader? Be organized and communicate effectively Have a clear purpose for every meeting Send out agenda ahead of time Every item on the agenda should require some action by group Have your room and AV equipment ready Summarize decisions and identify plan of action Schedule next meeting

37. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Team Building  Group of individuals working as a team  Right mix of three attributes describe complementary and functional teams  Interpersonal skills  Problem-solving and decision-making skills  Technical or functional expertise  Working together toward some meaningful end

38. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Team Building Establish a positive cohesive bond Work toward honest and open communication Give positive reinforcement Create a mix of complementary skills and experience within the team

39. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Assertive Styles of Communication  Passive or avoidant  Lets others push him around  Assertive  A person stands up for herself in a way that doesn’t violate the basic rights of another person  Aggressive  Person puts his or her own needs, rights, and feelings first and communicates that in an angry, dominating way

40. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Why Aren’t Nurses More Assertive? Some have hard time believing in their own rights, feelings, or needs Experiences or comments may reinforce those negative messages about self-worth May be afraid of repercussions of assertive communication Assertiveness takes self-awareness and practice

41. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. What Are the Benefits of Assertiveness? It helps you to feel good about yourself and allows you to treat others with respect Being assertive helps you to avoid feeling guilty, angry, resentful, confused, or lonely Offers you a chance to be acknowledged and have your needs met Leads to more satisfaction with your life

42. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. What Are the Components of Assertive Communication? STRATEGY 1 I think... I feel... I want... STRATEGY 2 I feel... about... because... You must be willing to change and compromise

43. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. When To Use Assertive Communication Communicating expectations Saying No Accepting criticism Accepting compliments Giving criticism Providing feedback Asking for help

44. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. When To Use Assertive Communication You need to: evaluate how your assertive communication feels to you to seek feedback from other people know whether people perceive you as aggressive rather than assertive Find a workable solution There are some situations in which you must simply follow orders. Be a good follower.

45. Copyright © 2009, 2006, 2003, 2000, 1997, 1994 by Saunders, an imprint of Elsevier Inc. Thank you