Speaker: To improve patient care, work on relationships with yourself and others first

That’s according to Donna Wright, nurse and professional development specialist with Creative Health Care Management, a consulting firm based in Bloomington, Minn.

“If you truly want to have patient-centered care, you have to focus on three relationships: the patient and family, yourself and each other,” Wright said, addressing nurses May 5 at the Milwaukee VA Medical Center as part of annual Nurses Week activities.

“We’re not really great at two of these three relationships. The patients and family? We’re great at that. But the self and colleagues — we’re not so great,” she said. “And (because of that), here’s what ends up happening: We get tired. We get exhausted. Our best self doesn’t come forward. We don’t work well as teams.”

In an energetic presentation peppered with anecdotes from her time as a bedside nurse as well as her work as a consultant, Wright stressed that nurses need to truly consider their self-care and how they interact with their colleagues in order to avoid becoming bitter and burned out.

The problem, she said, is that nurses tend to be selfless, always putting the needs of others before their own needs. 

“This is not about being selfish. This is about being self-ful. You need to fill yourself up so you can give to other people,” she said.

Wright said on the path to patient-centered care, “you need to have a relationship with self first, then with your colleagues and then the patient and family. The patient and family are third, not first. They’re the destination. They’re the reason why we’re here. But you need to know yourself and care for yourself first. And then you need to connect with others. And then — and only then — can you enter the sacred space of the patient.”

Understanding yourself

Regarding the relationship with self, Wright said, “you need to know who you are and you need to take care of yourself. This is about clarity and caring. … You need to understand yourself as a person, as a professional as an employee in this organization and on so many different levels.”

Sometimes, a nurse’s personality doesn’t fit with the employer. She told the story of a nurse working at a Catholic hospital who was continually irked by religious practices and rites that permeated the workplace every day.

That’s not a good fit. The solution? Either the nurse moves toward embracing the hospital’s philosophy and mission or moves on to a different hospital.

“You really have to pay attention to what your organization asks you to do, and does that match your own self of who you are?” Wright said. “You need to find a place that brings the part of you forward that excites you every day.

“If we don’t have clarity of why we’re here, what we’re doing and what we want out of life, it is hard for us to be healthy as individuals.”

Working with colleagues

In working with others, Wright said every team typically contains people who are negative and resistant to change. To keep a team positive and moving forward, the negativity must be validated and the next steps articulated.

“You have to validate what the person says, but that doesn’t mean you have to agree,” she said. “You can validate someone and then say, ‘I’m going to articulate where we are going.’”

The key, she said, is to spend more time on validation than articulation. If you do it the other way around, “people will not listen to you anymore. People need to be heard; they need to be understood.”

‘Moments of excellence’

Beyond that, another way to build a successful team is to celebrate members’ positive accomplishments.

“If you see somebody doing something good, big or little … I want you to take some time to point it out,” she said. “The more you do that, the more likely that person is to repeat the behavior, and other people will mimic the behavior. That just happens automatically.”

She launched into a story from her nursing days when she and a colleague took on the unenviable task of cleaning up a patient who was soiled, nearly head to toe, in diarrhea. It was a difficult task, which resulted in Wright getting diarrhea on her shoes.

When they were done, the nursing assistant turned to Wright and said, “Right here, right now, we’ve had a moment of excellence.” Wright responded: “You’re right. We need to tell the rest of the team.”

They did so proudly, which was met by applause, though one nurse noted the poop on Wright’s shoe. Wright acknowledged that and said, “We did not let the poop get us down. We rose above the poop. We had a moment of excellence despite the poop on my shoes.”

This led, over time, to team members proclaiming their own moments of excellence, sometimes numerous times a day.

“It was great to be on that team,” she said. “But you don’t find a team like that; you make a team like that. … This is the secret to success.

“We celebrate moments of excellence by the work we do every day. So when we start to talk about connecting with each other, it’s not about just getting along, but … thinking about doing our work truly together in a collaborative way.”

The result? Better patient care

When the “self” and “colleagues” relationships are good, that will lead to the best patient care.

“It’s all about relationships. This is all about us being therapeutic with each other,” she said, listing the relationships in order:

• “I need to have a relationship with myself. I need to take care of myself.”
• “Then I need to connect with other people. There’s not a single person who does this themselves. We do this together. … We need to support each other to bring our best selves forward.”
• “And when we lift each other up, we’re here for the patients and the family, and we need to do that together around this community.”

“Even though the reality of health care is hard work, we have the skills to make things turn out any way we want,” she said. “Go forth and competently go where no one has gone before.”