By Cynda Rushton
Nurses are regularly in complex, conflict-laden, and high-pressure situations with colleagues and the people they serve. Providing the best possible health care involves passion and dedicated communication, but sometimes our natural reactions can affect the way we speak to others.
In order to provide respectful, integrity-preserving care, we need to be mindful of the way we communicate with one another. In high-stakes situations, it’s easy to be swept away by automatic response, but if we don’t speak skillfully and carefully, we can cause harm.
Before speaking, it’s important to consider the elements of of “wholesome speech” which can help evaluate what you are saying, whether it is valid, and if it’s the right time and place.
- Is it true? We must have facts and use them properly to back up our statements and rely on evidence, not opinion, to make strong, educated statements. Dishonesty can lead to more complications and lead to bigger problems with colleagues and patients (not to mention damage your credibility).
- Is it beneficial? We must be mindful of the significance of what we are about to say to the person(s) we are speaking to and to our own integrity. Will what we are about to say produce benefit or harm? To whom? A patient or colleague might not find value in something that we feel we needs to be said and vice versa. Knowing what we hope to accomplish with our speech helps us prevent inflicting our views on others.
- Is it necessary? Sometimes we feel the urge to ass something that is not helpful or may reflect a personal agenda or opinion. Pausing to inquire whether what you are about to say will advance the conversation or add clarity or insight helps disrupt the urge to share whatever comes across our minds. Speaking for the sake of speaking may undermine our effectiveness.
- Is it kind? Kind words don’t suggest political correctness necessarily, but rather their intent. Our intention should come from a place of kindness, empathy, and honesty to ensure that our message is genuine, accurate, and has the person’s best interest at heart. If the intention is from a place of anger, resentment, or in getting your way, we lose validity and can cause complications in communicating to others. Even when it is necessary to deliver sensitive or uncomfortable information, it can be done in a manner that is both respectful and compassionate.
- Is it the right time or place? By understanding the context of a conversation, we can discern whether our response should be held for a later time in another place or can be addressed right then and there. As nurses, we are in a pressured environment, so knowing when and where to communicate can help to avoid confusion, aggravation, and complications.
If your answer is “no” to any of these questions, then pause and reflect on what you are about to say. The right tone, content, and intention is vital in effective communication and wholesome speech. Sometimes a pause can be helpful in redirecting the conversation and providing a period of time to help “get the ego out of it.” Sometimes silence can be the most powerful menas of communication. Silence allows you and the other participants in the conversation to collect thoughts and perhaps better understand what the other person is attempting to communicate.
Wholesome speech can be applied both verbally and electronically. It is common for people to feel a sense of anonymity when they’re on their computer or have the impression that their phone screen provides a protective wall. In truth, electronic speech can affect your reputation and cause as much confusion as verbal conversation. What’s more, tone and context can be hard to decipher when reading a text message or a social media post. It is critical that we carry wholesome speech across our electronic and verbal communications.
The next time you are about to speak or write an electronic communication, take a breath and consider these elements before your words are spoken or your words are written. Make it a moment-to-moment practice.
ABOUT THE AUTHOR: CYNDA RUSHTON, PhD, RN, FAAN
Cynda Hylton Rushton is the Anne and George L. Bunting Professor of Clinical Ethics in the Johns Hopkins Berman Institute of Bioethics and the School of Nursing, with a joint appointment in the School of Medicine’s Department of Pediatrics. Her current scholarship in clinical ethics focuses on moral distress and suffering of clinicians, the development of moral resilience, palliative care, and designing a culture of ethical practice.
