A couple of years ago, I shopped for wedding dresses with my sister. Being the caring and thoughtful human being that she is, she kept apologizing to the attendant who was bringing her different types of dresses and different sizes. Finally, the attendant told her to stop saying sorry because "it is okay to take up space."
I think about this often now when I’m faced with conflict or opposition. It is okay to take up space. It is okay to voice your opinion to a physician in a respectful manner. It is okay to communicate your feelings.
In nursing, it is common to see two main types of communication: assertive and aggressive. Assertive communication is standing up for your beliefs, voicing your concerns, and communicating different viewpoints without fear. It is an essential method for leaders because it does not just go with the flow—it uses words effectively to evoke a positive change. Aggressive communication is not normally effective because it downplays other views, does not accept criticism, and has the “I am always right” mentality. Rather than offering suggestions like assertive communication, aggressive communication demands a certain way.
Often (especially as a new grad), nurses are afraid to voice their opinion or their concerns in front of other nurses, managers, administration, other disciplines, and probably most notably, physicians.
But I know you have them. We are trained to be critical thinkers and careful observers, not just robots executing a task. We ask the questions and make the connections. And our patients trust us to be their advocate.
Being assertive is hard, and it is probably even harder with select people you encounter daily. But what are we risking by staying quiet? Errors in patient diagnosis because we second-guessed ourselves with our assessments. Delayed answers because we were afraid to confront the physician about a confusing order. Failure to advocate for a patient in their time of need.
There are some simple ways to navigate this:
- Make sure your suggestions come across as collaborative. You want to be confident but not arrogant.
- Deal only in facts, not opinions. Your observations are your evidence.
- You will, inevitably, meet people along the way who will push back. All you can control is your own response. Hang on to your calm emotions, and actively listen to feedback. The goal is to provide the best care for your patient, not win the battle.
Above all, please remember your critical thinking skills are an asset, not a threat, even if they aren’t always taken that way. Take up your space.
Shania Dubbert, BSN, RN, CMSRN, is an RN at Maury Regional Medical Center in Columbia, Tennessee, USA, and a member of Sigma’s Phi Gamma Chapter.