One of the greatest sources of frustrations I hear from nurses is that they feel like it’s all about money. The everyday things that matter to nurses and their patients get pushed way down the priority list, behind the demands of doctors and management and whoever else has the loudest voice. Whether the hospital is public or private doesn’t make that much difference to nurses. No matter what else the hospital does or doesn’t have money for, nurses feel like their thoughts, ideas, suggestions, needs go unheard.
Nobody’s going to go in to bat for us; if we want changes, we have to argue our own cause. But nurses aren’t always that good at making ourselves heard. By comparison, doctors are great at it. It seems they have more leverage, and they certainly know how to use it.
Doctors are really good at exploiting the pain points of whoever they’re talking to. A “high-revenue” doctor in a private hospital can say “I’ll take my business elsewhere!” and they’ve positioned themselves perfectly at negotiating with a very real and tangible pain point. They can build a really good case for what they want. Nurses don’t do that.
The question we must ask ourselves is: Why? One reason is that there is a significant body of data that tells us that nurses are primarily limbic thinkers. We use our brains largely for intuition. Ask yourself how many times you’ve looked at a patient and thought “Oh, we’re in trouble here”, yet the data isn’t there yet. Their vitals are fine, they’re awake, pathology and radiology aren’t backing you up either. Lo and behold, half an hour later, they’re peri-arrest.
We also use that limbic thinking for taking preventative action, advocating, executing on evidence based practice, organising our patients within an inch of their lives and navigating their pathway through a very complex and often emotionally distressing healthcare journey. The thing about the limbic brain is that it has no capacity for language. Articulating precisely why that patient is in trouble is impossible: we just… know.
That same body of data tells us that doctors largely are largely cerebral thinkers. What comes with that is an impressive dexterity with data, logic and quantitative facts. It gives them an innate ability to make an persuasive argument. It’s us that brings the intangibles, the intuition and the advocacy that can sometimes be overlooked.
When you look at it this way, it’s not surprising that doctors and nurses have been a match made in heaven for decades, if not centuries.
So what do we do? Limbic thinkers do what we do best: we use our interpersonal tendencies, come together in the tearoom and share stories with each other about our challenges, our patients, our dissatisfaction. If the Zip Water Boilers in the nursing tea rooms across Australia could talk, they could probably solve every problem in the healthcare system. They’ve certainly heard us talk about the solutions often enough.
But maybe it’s not just about whether or not we have as much power and leverage as doctors; maybe it’s about how communicate. Nobody’s going to listen to a Zip Water Boiler. But they might listen to you, if you could get your point across in a way that relates to theirproblems too. The key to working with management, instead of fighting against them, is being able to walk in their shoes.
Let’s say you’re really upset because the lovely old bloke in bed three didn’t get a shave today. That’s a big deal to a nurse: a small thing, maybe, but our ability to ensure that basic nursing cares are provided to our patients is fundamentally who we are. The truth is, the general manager doesn’t really care about that as much as we do. She’s got bigger fish to fry than bed three not getting a shave. A big part of getting through to her is having the imagination to walk a mile in her shoes. If you know what’s important to her, you can present your case in a way that addresses those things she actually cares about. And you can get across what’s really important to you.
We’re not doing ourselves any favours by telling ourselves “doctors just have more power than we do” or “nobody ever listens to us.” What we can do is get on the right side of the people that have the power to change the things that matter to us. Let’s watch and learn from the cerebral thinkers and completely plagiarise their strategies – they’re welcome to plagiarise our limbic ways (after all, they’re pretty damn impressive!). It takes some thoughtfulness and some communication skills. If we can talk their talk, we can speak to their pain points—and get them to appreciate what it’s like to walk in our shoes too.
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