BONUS
CONTENT FROM LPN2009
7 tips to improve your
professional etiquette
By Kathleen D. Pagana, PhD,
RN
When you think of the qualities
you need for success in your nursing career, you probably
think of clinical, leadership, and management skills. But
another skill can't be ignored: professional etiquette,
a critical link for career success.
Etiquette is more than good
manners; it's a tool for cultivating good relationships.
More than most careers, nursing is characterized by professional
relationships among different people in numerous settings.
Based on the guiding principles
of kindness, consideration, and common sense, professional
etiquette can help you form new alliances and enhance established
ones. Use these seven professional etiquette tips to polish
your communication skills and strengthen your relationships
with patients, families, and colleagues.
Tip #1: Introduce yourself
You won't feel awkward during introductions if you're always
ready to introduce yourself. Don't just stand next to someone
waiting to be introduced; take the initiative. Put out your
hand for a handshake and say your name in a confident voice.
Example: "Hello, I'm Margie McDermott, the new nurse
educator."
Be ready to introduce colleagues
to others as well. Mention the name of the person you're
making the introduction to first, then say the name of the
person being introduced and say something about that person.
Then say something about the first person.1 Example: "Sharon,
I'd like to introduce Jack Brown. Jack is our new staff
nurse with 2 years' experience in the ED. Jack, Sharon Jones
has been our vice president of nursing since 2002."
A good rule of thumb is to
mention the higher ranking person in the organization first.
In the example above, the vice president (Sharon) is mentioned
first and the new nurse (Jack) is introduced to her. Note
that you're book-ending the introductions to include both
people.
Tip #2: Have a confident
handshake
A strong handshake creates a positive first impression.
Many people judge others by the quality of their handshake,
so make sure it's confident and firm (but not too firm—don't
overdo it). Stand up, lean forward, make eye contact, and
smile.
However, take into consideration
cultural preferences and sensitivities that can impact a
handshake. Example: In the Hindu culture, men don't shake
hands with women.1 If someone ignores your attempt to shake
hands, don't take it personally—someone may avoid
shaking hands because of arthritic pain. Gently drop your
hand to your side and continue as if nothing happened.
Tip #3: Keep conversations
on track
The ability to connect with colleagues and patients by making
conversation is essential for success. To avoid inadvertently
offending someone, stay away from controversial topics.
When talking with a patient,
remember that you're the caregiver. Don't unload your troubles
on your patients. Example: As a nursing instructor, I once
overheard a nursing student telling a patient about the
abusive relationship that led to her divorce. She had no
idea that this was inappropriate.
If you have trouble getting
a conversation started, try using the acronym OAR to help.
Here's an example with a patient in a clinical setting.
- Observe. Make an observation.
("It looks like you're hungry this morning.")
- Ask questions. ("Is
this the first time you've been a patient in this hospital?")
- Reveal something about
yourself, but avoid getting too personal. ("After
years of working in a large medical center, I like the
friendly atmosphere of this community hospital.")1
Tip #4: Watch your
body language
Your body language is an essential component of communication.
When making conversation, don't forget that the care you
invest in your words can be undone by nonverbal communication.
Example: Suppose while talking with a patient, you're slouching
and looking away. You're sending the message that you're
not interested in what the patient has to say. Tune in and
be aware of what image your body language is sending. Here
are some body language tips to follow:
- Stand tall with your shoulders
back and your chin up; avoid slouching.
- Keep your hands out of
your pockets.
- Don't put your hands on
your hips or cross them over your chest.
- Use a sincere smile to
convey warmth and friendliness.
- Look at the eyes of the
person you're talking with to show your interest.
- Don't wring your hands
or make a fist.
- Move with confidence and
purpose.
- Don't drag or shuffle your
feet.
As a healthcare provider, you
interact with patients and providers from diverse cultural
backgrounds. Be sensitive to the fact that your body language
could unknowingly offend someone; in some cultures, direct
eye contact is considered aggressive. Your mistake may be
obvious from someone's comments, expression, or body language.
Apologize immediately. If you don't know what you did, adopt
a humble and respectful attitude and ask.
Some gestures may be misunderstood
and considered offensive to people from other cultures.
To play it safe, try to avoid these in conversation:
- the "okay" sign
- thumbs up
- the "V" for victory
sign, especially with the palm facing inward
- pointing or snapping your
fingers
- waving your hand with your
arm raised.1
Tip #5: Cultivate a
positive work environment
The kindness, consideration, and common sense that characterize
etiquette are also essential for nurse-to-nurse collaboration.
Be polite and courteous to your colleagues, no matter how
stressful the situation. When you show respect for others
and make others feel valued, you contribute to effective
communication and team building. Example: Greet colleagues
with a smile and a "hello" when you arrive at
work, and say "good-bye" when you leave. Offer
to help others, and thank others for helping you. Use good
manners and polite language, and avoid listening to gossip
or complaining with colleagues. Participate in department
events to show your colleagues that you're a part of the
team.1
The key is to keep your work
environment positive. In July 2008, The Joint Commission
issued a new sentinel event alert about behaviors that undermine
a culture of safety.2 Disruptive behaviors include
anything that interferes with the ability of others to effectively
carry out their duties. Some examples include disrespectful
language, demeaning behaviors, outbursts of anger, criticizing
other caregivers in front of others, throwing objects (such
as patient medical records), and comments that undermine
a caregiver's self-confidence in caring for patients. Besides
being rude, these behaviors threaten patient safety.3
Tip #6: Dress for success
Although informality is a trend in many workplaces, remember
that the workplace isn't your home. It may not be completely
fair, but people do judge you by the way you dress. What
you wear supports or detracts from your professional image
and sends a clear message to others about how you see yourself
and how you want to be perceived by others.
Most nurses would agree that
they want to be viewed as professional, intelligent, and
competent. You need to ask yourself if your appearance mirrors
that image. If you dress too casually, patients may question
your professionalism and attention to detail. Example: Does
a nurse dressed in cartoon-print scrubs establish immediate
trust, authority, and credibility? Cartoon prints may be
appropriate for the pediatrics unit or the nursery, but
nowhere else. Many patients complain that everyone in the
clinical setting looks the same. This can be a safety issue
if patients can't quickly identify a nurse in an emergency.
Because patients and families
want their nurses to be clearly identifiable, many hospitals
are reevaluating their dress codes. A recent survey of 430
randomly selected adult patients found that 55% said it
wasn't easy to identify their RN, 73% thought nurses should
keep their hair back and off their shoulders, and 80% noted
that they'd like to see a large "RN" on the nurse's
name badge.4
As a general guide, make sure
your uniform, lab coat, scrubs, and shoes are clean and
professional looking. Clothes shouldn't be too tight or
skirts too short. Of course, don't wear black underwear
under a white uniform or scrubs. If your hair is long, pull
it up and out of your face. Make certain your name tag is
visible and readable.
Tip #7: Present a positive,
professional image
Recently, I went to a medical center across town for an
audiology consult. When I checked in, I was given a form
to fill out and was told to wait until someone called my
name. A woman dressed in white called my name and put out
her hand. Thinking it was for a handshake, I put my hand
out. However, she indicated that she'd put her hand out
for the form I'd filled out. She directed me to another
room, sat down, and started asking me questions. Because
she never introduced herself and her name tag was turned
over, I had to ask her to identify herself and describe
her role in the organization. Because she ignored my handshake,
she missed an important opportunity to introduce herself
and present a positive, professional image.
Go ahead--sweat the
small stuff
You may be familiar with the expression, don't sweat the
small stuff. That advice doesn't apply to the clinical setting—sweat
the small stuff! Small things make a big difference. In
fact, a recent editorial in The New England Journal of Medicine
noted that good manners are at the heart of the mission
of service-related professions and the finer points of patient
care should be based on good manners.5 Many healthcare
facilities are adopting policies to ensure more positive
and professional interactions with patients. Here are some
guidelines for professional encounters in all types of clinical
settings.
- Address all patients as
Mr., Mrs., or Ms. Use a first name or nickname only if
the person gives you permission. Never use terms such
as "honey" or "sweetie."
- Before knocking on the
door to enter a patient's room, take a few seconds to
compose yourself and put a smile on your face.
- Knock on the door, speak
softly, and wait for permission to enter the room.
- Greet patients in a manner
similar to the following: "Welcome to ______ (if
this is your first patient encounter). My name is (first
and last), and I'm the registered nurse who'll be coordinating
your care until (time)."
- Review the patient's plan
of care and treatment goals. Inform the patient of any
scheduled activities, such as physical therapy. Use open-ended
questions. Ask the patient for input.
- When leaving the patient's
room, ask, "Is there anything else you need?"
Make sure the call bell, phone, water, television, and
tissues are within the patient's reach.
- When a patient thanks you,
replace the phrase "No problem" with "You're
welcome" or "My pleasure."1
Plan for success
Exercising professional etiquette doesn't take a lot of
time or effort, so make it part of your everyday practice.
Professional etiquette isn't optional for personal and professional
success; it's the critical link for coming across as a polished,
confident, professional nurse.
References
1. Pagana KD. The Nurse's Etiquette Advantage: How Professional
Etiquette Can Advance Your Nursing Career. Indianapolis,
IN: Sigma Theta Tau International; 2008.
2. The Joint Commission. Sentinel event alert: behaviors
that undermine a culture of safety. http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_40.htm.
3. Porto G, Lauve R. Disruptive clinical behavior: a persistent
threat to patient safety. Patient Safety Quality Healthcare.
http://www.psqh.com/julaug06/disruptive.html.
4. Windle L, Halbert K, Dumont C, Tagnesi K, Johnson, K.
An evidence-based approach to creating a new nursing dress
code. Am Nurse Today. 2008;3(1):17–19.
5. Kahn MW. Etiquette-based medicine. N Engl J Med.
2008;358(19):1988–1989.
Source: Nursing2009.
November 2009.
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