Chapter 2: Effective Role Negotiation

For successful role implementation, WOC nurses will benefit from developing and refining negotiation skills. This chapter discusses how to negotiate, describes methods and elements of negotiation, provides tips on how to prepare and conduct a negotiation, and discusses factors that WOC nurses should address in role negotiation.

Successful Role Negotiation: Attitudes and Approaches

Career advancement requires negotiation skills (Williams, 2007). It is important for WOC nurses to know their worth and become comfortable with promoting their unique qualifications, skills, and abilities that can benefit an employer.

Successful role negotiation requires all parties to share their ideas and listen to the ideas and issues presented by others. It is important to maintain an open attitude. It is best to begin the dialogue with a positive opening statement.

Methods of negotiation

There are 3 methods of negotiation that have been described: soft, hard, and principled (Fisher, Ury, & Patton, 2011). With soft negotiation, the negotiator wants to avoid conflict at all costs and gives in easily to reach an agreement. The hard negotiator, on the other hand, holds out for as long as possible because he or she views the negotiation as a battle of the wills. The soft negotiator may end up feeling exploited, while the hard negotiator may feel exhausted and might have damaged his or her relationship with the other side.

The third method of negotiation is called principled negotiation. This type of negotiation looks for mutual gains for both parties and, where conflicts exist, strives to apply independent and objective standards to reach a fair agreement. Additional information about the 3 methods of negotiation (Fisher et al., 2011) and their approaches is presented in Table 2.1.

Elements of negotiation

Although every negotiation is different, the basic elements of negotiation remain constant. With any type of negotiation, there are 3 stages: analysis, planning, and discussion.

During analysis, you are trying to figure out the situation. It is a process of gathering information, organizing, and thinking about the negotiation. In this stage, consider the 4 components of the negotiation: the people, your interests, the interests of the other side, and note any options already on the table.

In the second stage, again consider the factors you gathered in the analysis phase. Now you will generate ideas and decide what to do? How do you handle the problems identified?

The final stage in negotiation is the discussion. This is when you will actually meet with the other parties involved in the negotiation. It is best to focus the discussion on the 4 elements that were identified in the first 2 stages. In the discussion stage, both sides should come to understand the interests of the other and jointly generate options that are mutually advantageous.

Preparing for negotiation

To be successful in a negotiation, it is necessary to properly prepare in advance, rehearse, and come prepared for the encounter (Agrawal, 2011). Preparation should include gaining an understanding of the organization's overall goals and information about the administrator's decision making and negotiating style. It is also necessary to determine your overall goal before meeting with an administrator or supervisor. Simons and Tripp (1997) have proposed a list of questions that can be considered in preparation for any negotiation:

• Why do you want this job?
• What do you hope to accomplish?
• What are the issues involved with obtaining your goal?

By anticipating the issues involved in obtaining your goal in advance and identifying the issues that are most important to both you and the administrator, you can negotiate more effectively. Therefore, after identifying your goals and issues, the next step is to prioritize them. Putting this information into a table or other format to display the issues, goals, etc, might be helpful to identify any areas where you are not willing to compromise or specific issues you can use in bargaining.

The second step in preparing to negotiate is to understand the other side's point of view. If the company that you are seeking to negotiate with is unfamiliar to you, research the company to find out its mission and goals. Try to determine what issues are likely to be important to the company or are nonnegotiable.

The third step is to understand the situation. Is there a deadline? What topics or questions do you want to avoid, and how will you respond if the other side asks anyway? If attempting to use principled negotiation, what is the other party's interest rather than its position? For example, is the other party's interest to improve pressure ulcer prevention for its institution? If so, you may use that interest as part of your plan.

Finally, you need to determine the relationship between you and the other party. Are you negotiating with someone you will continue to work with on a daily basis? If so, what are the consequences of the strategy you have chosen for negotiation? Can you trust the other party? What do you know about the other party? What do you know about the other party's style and tactics? How much authority does the other party have (Simons & Tripp, 1997)?

Conducting the Negotiation

Be professional

Communicate professionalism through your conduct and appearance. It is usually best to schedule the conference in advance with an administrator. When meeting with an administrator, be ready to present a draft of a role design, a draft position description, and a list of concerns and issues. This approach communicates that you take the position and the meeting seriously and have done advance planning. Start the dialogue with a positive opening statement such as:

I appreciate having the time to talk with you about the potential to improve our patients' outcomes … through implementation of the WOC nurse role. I have a number of ideas and have prepared a draft role implementation plan. However, I realize that you have a more global view, so I would first like to hear your ideas about implementation of this role. (Wound, Ostomy and Continence Nurses [WOCN] Society, 2005, p. 31)

This approach allows you to hear the administrator's concerns or issues. Knowing the specific concerns or issues provides you with an opportunity to modify your presentation to address any issues that are raised.

Aim for a win-win approach

In a win-win approach to negotiation, the intent is to address the issues and solve the problems in a manner acceptable to everyone. Try to stay focused on goals and issues rather than on “your ideas” and “their ideas.” For example, you might say, “If I understand you correctly, one of the organization's goals is ———. Is that correct?” If the response is affirmative, follow with, “In looking at ways to meet that goal, what options do you see? Would you like me to perform a literature review? I could generate a list of possible approaches and then we could sit down again to analyze the list and select the best approach.”

Be prepared to offer options. For example, if you propose a full-time WOC specialty nursing position, sell your proposal based on the benefits to the organization. If the administrator resists, you can offer an alternative proposal to demonstrate your worth to the organization. For example, you could propose a trial period during which time you function half-time as a WOC specialty nurse and half-time as a staff nurse. During the trial period, you would document the services provided and the impact on patient outcomes and agency costs (Williams, 2007).

Know your bottom line

It is important for you to know when to walk away from a negotiation (Agrawal, 2011). If you are unable to negotiate a position that is acceptable to you, what are your options? If no alternative proposal is acceptable to the administrator, you will need to have an exit line ready so that you can leave the meeting gracefully, such as: “This is not exactly what I had hoped for and I need time to think about it further. Can I get back to you?” or “This approach is very different from what I had anticipated and I need time to think about the things you have said and the proposals you have made. Can we schedule a follow-up meeting next week?”

Factors to address in the negotiation

When negotiating a role, there are multiple factors to address. Specific areas to negotiate involve agreement regarding specific duties and responsibilities, compensation, hours/days of work, etc. Following are some of the key factors to include in a role negotiation:

1. Role design. Determining the specific expectations, duties, and responsibilities of the role is essential in role negotiation. Considerations for role design and implementation are addressed in Chapter 1, and sample job descriptions are provided in Appendices A to L.
2. To whom do you report. In general, you should report to someone whose scope of authority is consistent with yours (eg, if you have systemwide responsibility, you need to report to someone who also has systemwide authority).
3. The “basic package.” Details such as a pager, office space, access to a computer, and secretarial support should be specified.
4. Salary and benefits. Most WOC specialty nurses are paid at a higher rate than staff nurses because they have completed additional education and have systemwide responsibility. The results of a WOC nursing salary and productivity survey, conducted by the WOCN Society (2012), provide data about salaries, benefits, and caseloads of WOC nurses in different roles and settings across the United States that can be helpful in determining wages. The results of the survey are free to members from the WOCN Society in the Member Library (http://www.wocn.org/MemberLibrary) and available to purchase in the WOCN Bookstore for nonmembers (http://www.wocn.org/Bookstore). Additional employee benefits to consider during a role negotiation are budgetary allowances for reimbursement of continued education (eg, conference fees; travel and hotel expenses), professional membership dues, and/or certification fees.
5. On-call status. In an acute or extended care setting, a WOC or specialty nurse generally does not “take call.” Often the WOC nurse is in a consultant role and therefore is not responsible for direct patient care. Staff nurses are present per facility policy to meet the standard of nursing availability to meet patients' direct care needs. However, in a setting with multiple WOC specialty nurses, the responsibility for taking call is often rotated. If you do “take call,” you should be compensated, just as operating room and recovery room nurses are compensated for call time. In a home health setting, a WOC specialty nurse may or may not be expected to take call, depending on factors such as the size of the organization or the number of nurses who are rotating call status. If you do take call in a home health setting, there should be some type of compensation. The rationale for on-call compensation is as follows: Being on call requires you to remain available even on your own, off-duty time, so your time is only partially yours and can lead to burnout.
6. Coverage for the absence of the WOC nurse. Staff development is a critical component of the WOC nurse's role. Protocols and guidelines are essential for the staff to utilize in the absence of a WOC nurse. Nonetheless, you are responsible for your caseload, particularly in areas where the staff is not able to provide certain highly specialized care. For example, you might need to come in on a weekend to provide preoperative teaching and stoma-site marking for a patient who is having surgery on Monday morning. If arrangements can be made in advance, the alternative is to provide the care during the preceding week on an outpatient basis. Also, you might have a patient and his or her family who are not independent in managing a complex wound, ostomy, or fistula, but the patient is being discharged over the weekend. Therefore, you will need to either come in for an additional teaching visit or make another arrangement to ensure the patient's needs are met.

References

Agrawal, P. (2011, October 3). Practical negotiating skills. Independent Nurse, pp. 40–41. Retrieved March 2013 from http://www.independentnurse.co.uk/cgi-bin/go.pl/library/articlehtml.cgi?uid=86673;type=Professional

Fisher, R., Ury, W. L., & Patton, B. (2011). Getting to yes: Negotiating agreement without giving in (2nd ed.). New York, NY: Penguin Group (USA) Inc.

Simons, T., & Tripp, T. M. (1997). The negotiation checklist: How to win the battle before it begins. Cornell Hospitality Quarterly, 38(1), 14–23.

Williams, S. (2007, Spring). Negotiation skills for minority nurse. Minority Nurse, pp. 46–49. Retrieved November 2012 from http://www.minoritynurse.com/article/negotiation-skills-minority-nurses

Wound, Ostomy and Continence Nurses Society. (2005). Wound, Ostomy and Continence Nurses Society professional practice manual. Mt. Laurel, NJ: Author.

Wound, Ostomy and Continence Nurses Society. (2012). 2012 WOC nursing salary and productivity survey. Mt. Laurel, NJ: Author. Retrieved from https://wocn.site-ym.com/store/view_product.asp?id=1125546