TThis months #NurseBloggers 2020 blog topic is all about harnessing the nurses’ voice, influence and exercise our political power.
The Nurses Voice
Learning to use my voice as a nurse is something that I struggled with as a young nurse. Some of my learning undoubtedly has been trial and error. I have also been lucky enough to have had some fantastic career and leadership development opportunities that also helped me to learn how to influence and communicate effectively. I wanted to share some of the things that I have learnt as a nurse in this blog post.
My first experiences of learning how to communicate and influence effectively came from working as a community nurse in Manchester whilst completing the specialist practitioner course. For my practical placement, I had to complete a neighbourhood profile that was submitted at the end of the course. I had to find out about the history of the area where I was placed, the statutory and voluntary services that were available. The health, social care and public services that were available to the community. Part of collecting this information required extensive research looking at population data on age, sex, health distributions as well as disease patterns. It involved talking to the local community to find out their views on the services that were provided in the area where they lived.
I remember at the beginning of the course wondering why so much information was required for this assignment. By the end of the course, I realised how important this assignment had been in understanding the needs of the community. I was able to quote this information and present data when trying to present an argument for more resources or to inform a discussion in relation to community services. I learnt that having the data to support your argument was invaluable in making a point and getting people to listen to what you wanted to say.
On qualifying as a specialist practitioner I was offered a position on working in the Elderly Care team in the community. One of the first things that I did was to find out about the neighbourhood profile in the area that I was working. This information served me well many times during my career as a community specialist practitioner. This was when I realised just how important it is for nurses to really understand the area where they work and to be able to analyse and present data to support their case whatever that may be.
Opportunities using your sphere of influence
Using your sphere of influence is understanding who in your professional network can help you to take an idea, proposal or request forward. This is where the importance of networking comes in and knowing who in your network you can go to for help.
During early 2000 the organisation that I worked for became a Primary Care Trust and had an executive committee structure and board members. I successfully applied for one of the two nurse executive places on the professional executive committee. As this was a new structure I used every opportunity that came along to invite the board members to come and visit the service, meet the staff and accompany the nurses on visits subject to patients consenting. These opportunities could be used as a discussion to share some of the challenges that the service was struggling with bringing this to the attention of board members which in turn enable an informative discussion at the exec meetings. This is one of the key learnings that I applied in every senior role that I have held since. Executive walkarounds are a valuable opportunity to have the ear of those who can influence at a strategic level.
Mentorship has been hugely important in helping me to develop my communication and influencing skills. When I was new to the nurse executive committee member role I had no experience at all of ever having been part of a committee. In the early days, I felt like I was learning a new language. The rules and the terminology was foreign and I had no idea what I was doing. I sought out mentorship and one of the first things that my mentor asked me was “what skills did I bring to the role?” I remember answering “I have no idea right now”. My mentor pursued and asked me “what did I do every day” and I replied, “I cared for patients in the community”. Yes, she said and that is the knowledge, skill and experience that you bring to your role as an exec nurse committee member, don’t ever forget that. At that moment it was like the penny had dropped and I realised that this was what my role was all about and that this was how as a nurse I could add value through my voice and experience.
I can’t emphasise how important mentorship has been in my nursing career. It provided a safe space to ask the silly questions, admit that I didn’t know how to do something and to have someone who provided me with the guidance and support that I needed in a challenging role.
Putting my hand up for professional opportunities that came along also helped me to develop my voice in nursing.
I was offered a place on an NHS Nurse Consultant leadership Program. Part of this leadership development included “The Westminster Experience” which was designed to give NHS senior staff an insight into parliament, politicians and the politics of health. This one-day intensive course took me completely out of my comfort zone. I learnt how ministers get briefed about health issues, how the media works and part of the course included being interviewed by a BBC correspondent regarding the role that I had to play for the morning. We met politicians and gained real insight into the political world of health. The learning from this course really helped to understand the political nature of health not just in the UK but here in Australia too.
Whilst I realise that not every nurse will have access to this kind of training, as Nurses, we do need to be politically aware with both a small p and a capital P. It is important as a nurse to identify your areas for development and then plan your personal development accordingly. There are lots of great resources and courses that can help you to learn how to influence and present so that people take notice and listen. It does require you to be proactive in identifying what your development needs are and to look for opportunities that support your professional development as a nurse.
Being politically aware
Reading widely as a nurse is really important to understand the politics of health. Reading key Department of Health and Nursing documents is vital to understand what changes are coming over the hill in the not too distant future. Keeping up to date with policy changes and understanding how this will impact at a clinical level, helps you to plan and prepare your staff so that they understand the changes. As a senior nurse leader, it is really important to be able to explain changes and why the change is happening in terms that can be easily understood. Reading widely helps you to do this. By reading widely I mean not just nursing articles but reading about health, social care, global issues and industry trends and innovation in technology. There are many good resources online and some great TED talks that also help to expand your knowledge.
Being active with a Nursing body that represents nurses
Being an active member and part of a Nursing body such as the Royal College of Nursing, Australian College of Nursing and the International Council of Nurses. There is strength in numbers and there is power in a collective membership. This, however, is only effective if nurses raise these issues and lobby for change. The ICN recently announced the theme of International Nurses day 2021 as Nurses: A voice to lead, which post-pandemic is a very topical and timely subject.
Nurses often underestimate their ability to influence and seeking out opportunities to sit on focus groups or regional Department of Health events is a good way to start to develop these skills. Providing a clinical perspective to these discussions is crucial. Nurses, after all, know and understand the issues that they face day in day out. What is often missing is an opportunity to share their knowledge and influence at an executive level. Being proactive and seeking out opportunities to represent a speciality area in nursing and ensure that a clinical perspective is provided does much to raise the profile and provide a platform for nurses to speak.
Knowing your audience
It is important to know your audience when you are asked to write a report or present some information. You can tailor what you write and present to suit the audience. There are different ways of writing depending on if you are presenting to Doctors or board members or nursing executives. This should be part of every nurse’s professional development to learn how to do this well.
Media departments can also be a valuable source of support in helping you. It also comes back to who in your network can you go to for help with report writing and presentations. Preparing your report or presentation is time well spent and adds credibility to the profession as a whole.
Articulating your expectations
Knowing how to escalate something and have your concerns taken seriously is something that many people struggle with. There are a number of strategies that I personally have used over the years;
- Don’t respond in anger – always take time to think through the issue and construct a reply from a place of calm and clarity.
- Make sure that you have all the facts before escalating something, do your research. There is nothing worse than not having all the facts when you are asked after you have escalated something.
- Respond in a factual non-emotional way and make your escalation based on risk, patient safety or a compromise of the quality of care for the patient. In other words, use the language of identified risk what is the risk if nothing is done? How will patient safety be impacted? And how will the quality of care be impacted for the patient? I have used this strategy many times and it has always gained the attention of the person that I have escalated to.
- Always put your escalation in an email or in writing to your manager and keep a copy.
- Offer a solution to the escalation, articulate what it is that will solve the issue and what you need your manager to do and by when.
- Keep going until you find someone who will listen, offer a solution and can help you to escalate to the right person. This is part of the challenge of being a leader.
These are some of the things that I have learnt along the way in my career that have helped me to find and use my voice. It takes a certain amount of bravery to take yourself out of your comfort zone and push yourself forward both the develop yourself and to find your voice to influence. Sometimes it helps to find someone who does this really well and ask to meet with them to talk about how they learnt to do it. Listening and observing them when they are using their voice to influence can give you things to take away and try yourself. The most important thing is to keep on learning and trying!
If you would like to know more about the work that I do teaching and coaching leadership skills with Nurses and Midwives you can find out more here.