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BONUS
CONTENT FROM NURSING MADE INCREDIBLY EASY!
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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