An underutilized communication strategy to help any safety, quality, or culture change effort.

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 “What do you need in order to_____?” 

Here’s the how and why leaders at all levels can use this very powerful question:

First, the essence of this question can be a first step in building assertiveness.  Imbedded in it are presumptions that staff  have needs and they should be respected.  By the very nature of asking, we give permission to express needs and send the message that having them is expected.  If you are serious about building assertiveness, this important approach puts a focus on empowerment and accountability rather than command and control.  Some leaders may worry that staff requests may be unreasonable or unrealistic, but please don’t let that stop you.  You’ll have a chance to set limits, offer alternatives, advocate for resources, or change expectations….all sorts of variations can manifest in dialogue.

What do you need in order to….comply with our orientation expectations? (…minimize overtime?….take your meal breaks?)

Second, you’ll create an opportunity to practice respectful listening.    This critical communication strategy involves challenging behavior change and practice and is vital both for developing the skill and demonstrating our commitment to it.  You can be cautious about inviting inappropriate information by setting limits on time available and being clear about the nature of response expected.

I have 10 minutes before I have to be at a meeting and would like to hear your thoughts the overtime your day shift nurses are doing.  The last 3 months they were higher than any other unit in the hospital.   It is a problem.  What do you need in order to make sure your staff gets out on time?  If you can’t answer this on the spot I want you to schedule a time in the next 3 days to discuss it.

Third, we can tap into a vast knowledge and experience base that may contribute to creative problem-solving.  Often times, people on the front lines have key insights as to why a problem exists or solution isn’t working.

Our post-op infection rate is off the charts.  We’ve done training, added two wash stations, changed soap, and posted the policy everywhere.  Things improve, but only temporarily.  What do you need in order to comply with the hand-washing policy?  What makes it hard for you? How can I help?

Fourth, not only are we likely to gain new ideas, but we know that when people are involved in the process, they will be more invested in the change.  

It is like magic!

Beth Boynton, RN, MS, is speaker, trainer, author and coach specializing in communication BB closer Headshot 1-13 Cherationsand collaboration.  She is an organizational development consultant and author of “Confident Voices:  The Nurses’ Guide to Improving Communication & Creating Positive Workplaces”. 

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