AACN News—February 2001—Opinions

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Vol. 18, No. 2, FEBRUARY 2001

President's Note: Make Waves: Always Choose the ‘High Road’

Denise Thornby, RN, MS
President, AACN

Almost daily, we must decide whether to take the “high road” or the “low road,” when confronted with difficult situations. By taking the high road, we choose to exercise positive influence, an act that requires courage and helps us focus others and ourselves on the future. Taking the low road, on the other hand, causes us to respond in a reactive, blaming and often negative manner.

Examples of taking the low road are easier to find. I see evidence of this choice daily, especially in healthcare where many are demoralized, lacking in energy and overwhelmed by feelings of frustration, anger and cynicism. Taking the low road allows us to point the finger of blame and express our cynicism. Usually motivated by anger, jealousy or simply negative emotions, it is a way to punish those who did not meet our expectations and discredit others. Some examples of low-road behavior are overt; others are covert in nature. Here are just a few:
• Talking about people behind their backs
• Offering “catty” remarks or snipes on the character of another person
• Gossiping and spreading rumors, even though you know they are untrue
• Making derogatory remarks when referring to others
• Leaving unsigned, negative, hurtful notes or jokes in the communication book, on the restroom door or on the report room wall
• Blaming others for situations that are not their fault or within their control
• Criticizing others without talking to them about the issues at hand or trying to assist them
• Rolling of the eyes or sighing disgustedly when others ask for help or need assistance
• Focusing on who should be blamed when something goes wrong and feeling justified for making sure that they are publicly chastised
• Being unwilling to hear another side of a story or possible perspective that might offer an explanation
• Saying things under your breath that you would never be willing to say out loud

Our healthcare systems are so broken and fraught with chaos and turbulence that many of us are overwhelmed by the negativity. When I visit hospitals or meet with nurses in my role as president of AACN, I overhear snippets of low-road conversations, such as: “She is such an airhead” “He is an ego maniac.” “We are full of SICU trash (off-service SICU patients).” “What a prima donna. Who does she think she is?” I am astonished at the number of people I hear giving into frustrations and taking the low road.

No matter how you look at it, taking the low road is never a fulfilling journey. Although you may feel temporary relief in venting your emotions or taking out your frustrations, choosing the low road never leaves you in a better place. Certainly, it does not leave you in a more influential place, where others look to you for leadership or with admiration.
Instead, taking the low road drains you of needed energy and leaves everyone with a “bad taste” in their mouths. Every time I have chosen the low road, I have regretted it. In fact, I have had to do a lot of crawling back up the road to right the situation.

How can we influence and change the environments in which we practice? How can we change the way we support each other? How can we gain the perspective to identify the changes that we will need to create a healthcare system driven by the needs of patients and families? We must join together and choose the high road to influence our work environment, our relationships and our profession.

When we consistently take the high road, we truly become leaders within our profession. We can influence others to pause at the crossroads and think a little harder before they choose their route. We can help them find the courage to take the high road when confronted by negativity and coworkers calling them to join their low-road journey.

Here are some travel tips to help you make your journey through the day:
• Be loyal to those who are targeted by negative remarks when they are not present. Encourage their critics to talk directly with the person with whom they have an issue or by suggesting that
you are sure that person’s intentions were good.

• Do not talk about others behind their backs, unless you are sincerely expressing your admiration of or gratitude to them.
• Be assertive, not aggressive in your communication with others.
• Be truthful and honest, yet deliver your message clearly, giving others a chance to share their side of the story.
• Do not punish those who make mistakes. Instead, help them learn from them.
• Acknowledge the “baby steps” of improvement we all make when learning a new skill.
• Use inquiry to better understand a situation. Avoid assumptions and judgments.
• Focus on your circle of influence. Take action to change or influence those things you can control or change.
• Work hard to keep perfectionism under control. Always strive for excellence, while accepting that perfectionism is in the mind of the beholder and never completely achievable.
• Assist others to be successful by showing them “the way,” giving them helpful feedback and empowering them to be their best.
• Let the values of respect, trustworthiness, dignity and courage guide your actions.

The road you choose tells the world a great deal about you, your values, your courage and, in fact, the kind of wave maker you are. I have found that the high road is the best road to take. Because it is proactive and future-focused, it helps me have the most positive influence or be the best leader I can be. When you take the high road, you are seeking out what can be done to right a situation, to solve a problem or to figure out how to make something better, instead of looking for someone to blame. When you take the high road, you uphold the values of respect for others. Taking the high road means that you will not feel uncomfortable or embarrassed if you are later quoted.

This is not a “Pollyanna” approach. It is an approach that makes you part of the solution. You become a truth teller in a way that helps guide us forward to a better place. When you take the high road, you will be someone who others admire, because you act with integrity, respect and truthfulness—and with courage.

I try to stay on the high road in practical ways. For example, I try to pause and think before responding. I picture a flashing stop sign in my mind and see two paths. One leads me up the high road and the other leads me down the low road. I ask myself which path I want to take. Another way I try to keep on the high road is to surround myself with other high-road travelers. They support and encourage me. They are there when I need them and, most importantly, they direct me back to where I want to go when I veer toward the low road.

I hope you will join me on the high road, the road of positive influence. This road isn’t always easy. Traveling the high road requires discipline and courage, yet the journey is always rewarding. I know I am joined by many of you on this high-road journey through our profession, and hope each of you will reach out to others who have slipped into negativity, cynicism, powerlessness and hopelessness.

With every act, we catch a wave of influence, a wave that offers opportunity to influence and that paints a picture of who and what we are. All of us must take this high-road journey together to confront the difficult situations in our workplaces and the challenging realities of healthcare today.


Support Legislation to Protect Nurses and Patients
I applaud AACN for directing attention to the series of articles published in the Chicago Tribune (Sept. 10-12, 2000), which focused on nursing errors. Errors in the delivery of healthcare most certainly occur. However, solutions will not be found in disciplinary actions sanctioned by state boards of nursing or individual hospitals.

AACN took aim and successfully identified “system errors” as a significant, contributing factor when errors occur. Workplace environment weighs heavily into these system malfunctions. Identifying, addressing and correcting these problems will ultimately ensure a safer delivery of healthcare.

Correcting some workplace problems will be difficult. Current and projected staffing shortages will only feed into identified system problems. It has become commonplace that nurses are subjected to mandatory overtime to maintain employment. This single issue has no doubt contributed to errors in the delivery of healthcare. Let’s fix the system causing the problem.

I would strongly encourage all nurses to support current legislation that would ban this system error, thereby reducing individual error. House Bill 5179, the Registered Nurses and Patient Protection Act, takes direct aim at prohibiting mandatory overtime for nurses. This bill is sponsored by Rep. Tom Lantos (D-Calif.) and cosponsored by 16 other representatives. It is imperative that nurses let these officials know that we acknowledge their involvement with this bill and credit them for demonstrating concern for the nursing profession and their community’s health and well-being. The list of representatives can be found online at thomas.loc.gov We must also solicit support from other elected officials to demonstrate their community concern by supporting HB 5179.

Mary P. Hicks, RN, BSN, CCRN
Detroit, Mich.

Editor’s Note: As part of a continuing effort to promote safe working environments for patients and nurses, AACN has endorsed the Registered Nurses and Patients Protection Act to prohibit mandatory overtime for healthcare workers, including registered nurses.

Make the Desert Bloom
I am writing in response to the recent “President’s Note” column (“Make Waves: Find Your Oasis in AACN,” AACN News, December 2000) that referred to AACN as an oasis.

As a bedside critical care nurse with 25 years of experience, I say that we do not need an escapist refuge but, an organization that will help us change a sorry situation. Instead of seeking an oasis, we need to make the desert bloom.

Andrew Sivak, RN, MA, CCRN
La Vernia, Tex.

Editor’s Note: AACN appreciates and encourages feedback from members on issues that affect all critical care nurses. Following is additional clarification by AACN President Denise Thornby on the issue addressed in the December 2000 “President’s Note” column.

I agree that we “need to make the desert bloom,” and tried to incorporate this idea into the oasis concept on which I based my column. I believe that one way to accomplish this is through sharing resources and supporting each other in a community environment such as AACN, which can help empower critical care nurses to truly make a difference in the lives of their patients and their families. AACN provides a common ground where we can join with others who support and understand our values. It is a place where we can gain additional skills and knowledge and share ideas and expertise in an effort to influence our practice and “make the desert bloom.”

Denise Thornby, RN, MS
President, AACN
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