Archive for the ‘Communication skills’ Category

Improving the “stickiness” of your big ideas by guest author Stephanie Scotti

Monday, August 30th, 2010

made to stickThe title of this book certainly “stuck” with me over the past few months – it seemed it was being mentioned wherever I went. When I finally picked up my own copy and brought it on a recent flight, I was glad I did. Like a fun, upbeat friend, Made to Stick kept me company during the trip, with content that was at once entertaining, educational and exhilarating. Accomplished educators and idea collectors Chip and Dan Heath offer up practical, tangible strategies for making your ideas stick – a concept that should resonate with any presenter faced with a high-pressure, high-stakes situation.

Made to Stick is a book that will likely transform the way you communicate ideas. Here’s just a sampling of some thoughts from the Heath brothers that captured my attention:

Curse of Knowledge
Like sliced bread or indoor plumbing, once we know something, it’s hard to remember life without it. Knowledge is often “cursed” by being taken for granted, and it becomes difficult to share what we know in moderation. In an effort to be complete, we can’t discern the most important information we’d like to leave with our audience, and run the risk of overwhelming them. We keep going…and going…and going, and what sticks? Absolutely nothing. Check out the six principles outlined in Made to Stick that will help you overcome the dreaded Curse of Knowledge.

Velcro® Theory of Memory
Velcro material has two sides: one covered in thousands of tiny hooks, the other in tiny loops. Press the two together, and presto! – they stick. Our memories work the same way, with an infinite number of loops just waiting to cling to an idea with lots of hooks. The more hooks an idea has, the better it sticks. Think about a favorite class where the information presented really “stuck” with you. What did that instructor do to help Velcro that information to your brain? When developing your next presentation, stop and ask: How can I add more hooks to my content via interactivity, stories, or stronger visuals?

Human Scale Principle
What’s something we can all do better? Make statistics more human and dynamic. Made to Stick references a 1992 press conference where the Center for Science in the Public Interest revealed that the typical medium-sized buttered popcorn at a neighborhood movie theatre contains more artery-clogging fat than a bacon-and-egg breakfast, lunch of a Big Mac and fries, and a steak dinner with all the trimmings — combined. Certainly something we could easily grasp. Remember: The power is not in the numbers themselves, but rather in their scale and context.

Here’s a nice bonus …
Sprinkled throughout this accessible, quick-reading text are eight “Idea Clinics” filled with practical tips for applying what you’ve read in a fun, realistic way. In completing all eight clinics, I gained some intriguing new insights, while also being reminded of important “sticky” factors that were already on my radar. For example, Made to Stick challenges readers to distill the essence of their message, get back to core principles, and communicate in a memorable way — advice that parallels Professionally Speaking’s own C.O.D.E. process.

Whether you’re a non-profit, an entrepreneur, or a corporate executive, Made to Stick delivers some terrific tools for improving the way you communicate ideas. In fact, it got me so revved up that I overhauled an upcoming presentation to make it extra sticky! You know a book’s made a real impact when your copy ends up dog-eared, covered in highlighter, and dotted with margin notes. Hope your copy of Made to Stick ends up the same way!

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Nurse violates confidentiality on Facebook by Pat Iyer

Monday, August 9th, 2010

Oakwood Hospital Employee Fired for Facebook Posting

Cheryl James enjoyed her job at Oakwood Hospital, Michigan. She never imagined posting something on Facebook from her own computer on her own time would get her fired. “He died for us, protecting us,” said James. Like so many others, James was emotional following the shooting death of Taylor Police Corporal Matthew Edwards. She worked for the hospital organization that treated the police officer and the shooting suspect, Tyress Mathews.

One night, while at home, she posted on Facebook that she came face-to-face with a cop killer and hoped he rotted in hell. She also posted another remark we can’t repeat.

Tuesday, she got a call. Her bosses wanted to talk.

“They called me in, told me that they got notice and word that I had posted this specific post on Facebook, and that they had to investigate it,” James said.

She says she immediately removed the posting and thought she might get written up or suspended. Instead, she got fired.

Read more

The nurse who posted her remarks offered enough information that readers were able to determine who she was talking about. This violated HIPAA, a federal statute that protects the confidentiality of medical information.

This nurse’s story is a good reminder that anything posted on social media sites can be easily desseminated, can hang around forever, and can come back to haunt a poster.

In the World War II era, the phrase was “loose lips sink ships”. Our parents and grandparents could not have foreseen that loose fingers could destroy a job.

What do you think? Have you seen comments on social media that make you cringe?

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Generations and Medical Malpractice Part Two

Wednesday, June 30th, 2010

There are four generations of people employed in health care. Consider how each reacts to situations that put patients at risk for medical errors and medical malpractice. These guidelines are generalities and may not apply to a particular person.

nurse clipboardsm 3. Gen X
Gen Xers were born between 1965 and 1978. The Watergate debacle, which revealed the extent of dirty politics, was an influence on this generation. Women’s liberation affected traditional household roles and saw the rise of strong feminists. The gas crisis in 1973 resulted in a sudden feeling of vulnerability. The Gen Xers were the first generation of children affected by both parents working. They were exposed to massive corporate layoff, leading them to value self reliance. Quality of life and balancing work and home life affects this generation. They may be less likely to accept working long hours and schedule changes as they are driven by a need for life and work balances. They saw an increase in divorce rates. This is the impatient generation. They are in a hurry, and want quick promotions and for work to be fun and informal. The Gen Xer tends to be more productive, producing more work in less time. They often prefer to work alone and may distrust and challenge authorities. This may influence their ability to work as part of a team and affect the need to communicate with others.

nurse on phone close up copy 4. Gen Y or Millennials
The Gen Y population was born between 1981 and 2000. This is the generation that is drawn towards the family for safety and security. They are a global generation who accept multiculturalism and multitasking as a way of life. The Gen Ys are savvy about technology and instant communication. They are highly creative and well educated, confident, hopeful and goal-oriented. They enjoy teamwork. They are a digital generation that is globally concerned. They expect 24-hour a day information. They have difficulty dealing with complex problems and are inexperienced within the medical world. They benefit from mentoring and structure. This is a group who has a high need for feedback and structure. Data shows that 30 percent of Gen Y nurses turnover in the first year of practice and 57 percent by the second year. They have been taught to question each situation to find meaning in every task.

The Veterans may be reluctant to challenge authority, which may be necessary when the healthcare provider needs to be a patient advocate. The Baby Boomers, Gen Xers and Gen Yers have been taught to speak up. Gen X and Gen Y healthcare providers get frustrated with older people who resist technology. All generations want to be respected, valued, and rewarded for their efforts. Healthcare workers do best when they recognize there may be generational differences, and welcome the diversity.

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Generations and Medical Malpractice Part One

Monday, June 28th, 2010

There are four generations of people employed in health care. Consider how each reacts to situations that put patients at risk for medical errors and medical malpractice. These guidelines are generalities and may not apply to a particular person.

balding docsm1. Veterans or Traditionalists
This generation has born between 1927 and 1946. They have specific values such as “remember the lessons of history”. They have loyalty to the organization. The Veterans worked to get their retirement. They have a nose to the grindstone work ethic. They are the keepers of the institutional memory. They tend to be patriotic, polite, and fiscally conservative. They have a high work ethic and are the senior employees and physicians, eyeing retirement and considering slowing down trial practice. Many of them are influenced by a military model as they grew up in World War II. They understand and follow a chain of command.

lab coat mdsm 2. Baby boomers
Born between 1946 and 1964, Baby Boomers are the largest group. They were influenced by several events in the tumultuous world of the 60s including the civil rights movement. The Baby Boomers have a strong work ethic. They are workaholics and loyal to the organization. They will stay until the work is done. They are highly competitive, question authority, and invented the type A personality. They have an overwhelming need to succeed. The Baby Boomer believes in team work and consensus building. They are optimistic. Baby Boomers are often found in management positions. The Baby Boomer is uncomfortable with conflict and reluctant to go against peers. It is hard for them to ask for help; they have difficulty admitting something is wrong. This may influence their behavior when caught up in a situation that could lead to patient injury.

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“How to Detect Lies From Impressions and Expressions When Negotiating” by Guest Author Greg Williams

Wednesday, May 26th, 2010

When negotiating, can you detect lies based on someone’s expressions, or the impression that he makes on you? You’ve no doubt heard the expression, “He lied to me with a straight face.” The body never lies. So, when someone is lying, the body will compensate for his untruthfulness by displaying cover actions. Cover actions can be almost imperceptible nuances that occur when people lie, or they can also be exaggerated expressions. Nothing succeeds like success. When a person becomes confident about his ability to lie in a negotiation, and he continuously gets away with it, he will continue to lie. In most cases, he will become emboldened to increase the intensity of his lies. You’ll have the opportunity to catch him in a lie.

The way to detect and deter a liar is to observe the verbiage he uses during the negotiation, and observe his body language when you suspect him of lying. When lying …

Body language gives away lies

Body language gives away lies

• People will tend to use phrases that make them feel comfortable. Take note of the comfort phrases that a person uses and note the change that occurs when he alters such phrases. When change occurs, he could be in the process of entering into a lie, or fully engaged in it.
• People will lie to make themselves appear to be more impressive or demur. The lie will usually be accompanied with body language that exemplifies the stature of the liar. Such gestures may be observed as when the individual raises his head higher, or thrusts his chin or chest forward when seeking to be perceived as being more impressive. A demur individual will tend to bow his head and present a less impressive image.
• People will also lie to get out of tough situations. Such maneuverings will usually be accompanied with gestures that reveal their discomfort. Thus, they’ll tend to keep their arms close to their body. They’ll also tend to be more reflective, as they try to keep their story on track.

To enhance your efforts of catching a liar in his lie, switch subjects in the middle of his suspected lie. Change the subject to anything that’s unrelated to what he was discussing. After a few minutes, ask him to continue speaking about what he was discussing when you suspected he was lying. When he resumes the discussion, take note from where he continues, versus where he left off. Also, take note of the degree his demeanor has altered. In addition, you can ask questions that highlight slight differences in what he said. For example, if he said the insurance carrier would not provide an offer of over $100,000, restate what you heard as the carrier would not offer more than $150,000. By slightly altering what you said he said, he’ll have to go into recall mode, if he was lying. If he’s telling the truth, more than likely, he’ll say without hesitation, “Oh no, it was $100,000.”

In any situation, before you can discern if someone is lying, you have to establish her baseline. That means, you have to be aware of how she gestures and use verbiage in normal environments. Then, as you seek to detect lies, note the differences between what is normal to what becomes different from normal. Therein will lay the signal to delve deeper into what she is saying. Once you discover how to hone your skills to detecting liars, it will be increasingly difficult for someone to lie to you successfully … and everything will be right with the world.

The Negotiation Tips Are …
• When you suspect a liar is lying, don’t be too quick to stop him. Observe the verbiage he uses and his body language. The more comfortable he becomes with his lies, the more lies he’ll tell. In so doing, he’ll give you greater insight into how he lies and why he lies. Then, you’ll know what to look for when you suspect he’s lying.
• If you’re astute at reading body language during a negotiation, you can pick up on nonverbal signals and detect a liar’s lie before he gets too deeply into it. In so doing, you will decrease the probability of being deceived.
• People lie because they’re seeking something they need at the time of the lie. In a negotiation, if you understand the need, you’ll understand the source of the lie. From that perspective, you can address it.

To inquire about having The Master Negotiator as a coach or consultant, or to conduct ‘live’ instructional sessions, and/or keynote presentations at your company, group, or organization, please send an e-mail to GregWilliams@TheMasterNegotiator.com and start getting more out of life, when you negotiate. Please include the verbiage, ‘Negotiation Inquiry’ in the subject line.
by Greg Williams – The Master Negotiator. If you’d like more information on how you can become a savvier negotiator, click here to checkout Greg’s new book, “Negotiate: Afraid, ‘Know’ More.” Please visit The Master Negotiator‘s website at http://www.TheMasterNegotiator.com for additional information and negotiation resources for individuals and businesses.

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Being Prepared for Objections by Guest Author Caryn Kopp

Wednesday, February 24th, 2010

male atty shake hands smNew business and expansion of business is dependent in part on being able to address objections.

One thing I can tell you about objections. If you can’t overcome them, you’ll never close the sale. Here are 3 tips to stay in control so you can get to the next step.

Tip 1. Identify all the objections you will face and then develop answers to overcome them (before you’re ever on the phone with someone)

Tip 2. Practice the answers until they don’t sound rehearsed.

Tip 3. Couple every response with a request for the next step. Which sounds like this. I understand you’re busy. Let’s look a little further out on the calendar, say the 3rd week of next month? How’s Thursday at 10?

If you’re prepared, rehearsed and request next steps, the sales cycle takes less time.

Next Step to Yes!

You can shorten the sales cycle with what I call Next Step to Yes! Ask for a next step during every contact point with a customer or prospect. Here’s an example. When a prospect asks for a proposal, secure a follow up date and time right there and then, at the moment when it’s most important. You can avoid all that wasted time trying to get them back on the phone.

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Should a Nurse go to Prison for Reporting Concerns about a Physician? by Pat Iyer

Wednesday, February 17th, 2010

Transcript of the trial now available at this site: http://www.scribd.com/doc/30364402/Transcript-of-Mitchell-Bogus-Criminal-Trial

Anne Mitchell RN

Anne Mitchell RN

Two West Texas nurses faced up to 10 years in prison and a fine of up to $10,000 for reporting concerns about the substandard care of Dr. Rolando Arafiles Jr. How did this happen? Nurse Vicki Galle and Nurse Anne Mitchell were part of the tiny staff of a tiny hospital in a tiny town in West Texas. Winkler County Memorial Hospital has 15 beds, employs 15 registered nurses and 17 licensed practical nurse, and has 7,000-8,000 people in the entire county. Both nurses worked at the hospital for over 20 years. Vicki and Anne reported concerns about Dr. Arafiles to the Texas Medical Board. They, as well as others, were concerned that his practices were inconsistent with the quality of care and patient safety. They were also concerned about his use of non-therapeutic treatments and prescriptions. The two nurses provided medical record numbers to the Board, but no patient names, to support their concerns.

When the physician was notified by the Texas Medical Board that he had been reported to the Board, he filed a complaint with the sheriff (who was one of his patients) alleging that he was being harassed. Sheriff Roberts tracked down the two nurses, who were indicted for misuse of official information and fired. The Texas Medical Board wrote a letter to the District and County Attorneys of Winkler County challenging the notion that the information provided to them was for nongovernmental purposes. They explained that the Board was exempt from HIPAA requirements and is a governmental agency.

Nevertheless, the case proceeded. Nurses throughout the country responded with an outpouring of support and dollars to build up the legal fund for the nurses. Patient advocacy, specifically reporting concerns about a practitioner’s standard of care, is protected under Texas laws and supported by the Nursing Code of Ethics. The case was seen as having the potential to affect the future of patient safety throughout the entire country.

The criminal case against Nurse Galle was dismissed on 2/1/2010, a week before trial was to start. But the case against Nurse Mitchell proceeded. The jury heard details of the cases of substandard care. During cross-examination, Dr. Arafiles struggled to define “standard of care”.

Doctor Rolando Arafiles said he supports the reporting process, but not in this case, because he felt Anne Mitchell was harassing him when she sent an anonymous complaint to the Texas Medical Board. The defense grilled the doctor about medical mistakes he made including one where he injected a needle into the bone of a patient and another where he sent a child with appendicitis home without treatment. The prosecution and defense agreed to nickname the instances on record in which Dr. Arafiles made medical mistakes. Those cases are being called, “Turkey Toe”, “Appendix Boy”, “Rubber Finger Tip”, and “Skin Graft”. “Rubber Finger Tip” references the instance when Dr. Arafiles sewed a part of a suturing kit onto a patient. It was a part of the kit not meant to be used on patients. During testimony, Dr. Arafiles said he meant to use it as a brace and accidentally sewed it to the patient.

During his cross-examination, Dr. Arafiles discussed the nutritional supplement called “Zrii” that he recommended to patients. The doctor admitted that Sheriff Roberts sold Zrii and even held meetings at the local Pizza Hut to recruit others to sell the product. According to the defense, the main ingredient in Zrii is white grape juice and it sells for around $40 a bottle.

At one point Dr. Arafiles was asked whether diabetic patients might have a tendency to heal worse than patients without diabetes. To the dismay of the audience, he said no, that there is no difference. The audience gasped, after which point Hon. Judge James Rex told the audience to keep quiet or else risk being thrown out of the courtroom.

It took the jury less than an hour to return a not guilty verdict on 2/11/2010. The jury foreman said the panel of six men and six women voted unanimously on the first ballot, and questioned why Nurse Mitchell had ever been arrested. “We just did not see the wrongdoing of sending the file numbers in, since she’s a nurse” said the foreman. After the verdict, the nurses’ lawyers quickly turned to the lawsuits they filed in federal court against the county, the hospital, and various officials, charging that the firings and indictments amounted to a violation of due process and their First Amendment rights. Nurse Mitchell’s lawyer said, “We are glad that this phase of this ordeal has ended and that Anne has been restored to her liberty, but there was great damage done in this case, and this does not make them whole.”

President of the American Nurses Association Rebecca Patton called the verdict “a resounding win on behalf of patient safety. The message the jury sent is clear: the freedom for nurses to report a physician’s unsafe medical practices is non-negotiable.”
Sources:
http://www.nytimes.com/2010/02/12/us/12nurses.html
http://www.texasnurses.org
cbs7news, Beau Berman

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More writing tips

Wednesday, February 10th, 2010

This is the final set of submissions for my writing tips contest.
CD
Another tip is not to forget to write out medical abbreviations in long hand and to include simpler term explanation of complex medical terminology as some documents may be used by legal representatives that do not just deal with medical legal issues.
Deborah Ben-Abu

As for my writing tip I would say “just do it, start somewhere then edit, edit and edit again.” There are so many avenues to write now, I was able to write an article for earticle.com and it was published. Just a starter on advocating for yourself in healthcare but none the less I did it!
Valerie Lane, Springville, CA

I thought I would send my best practice tip “pet peeve”. Do you make sure that you do NOT put apostrophes in abbreviations for multiple tests and/or diagnostic studies? Write EKGs NOT EKG’s, MRIs NOT MRI’s, etc. I see this all the time.
Jane D. Heron, RN, BSN, MBA, Matawan, NJ

Write it and save it. Then in the next day or two, open it back up and read it again. You may see mistakes you did not see the first time. You cannot use this tip if you wait till the last minute to write your report.
Kathie W. Condon, RN, MSN, LNCC, Birmingham, AL

Always try to finish the product so that there is enough time to leave it for a day, or even a few hours, then go back and reread it with fresh eyes. This often allows one to pick up on typos or grammatical errors that one might not pick up on when tired or when one has been working on a piece for a lengthy period of time.
Susan Gunter

When I write using medical terminology or medical words that the computer does not recognize I check for proper spelling and add it to my dictionary for future use. I never assume I wrote the word correctly.
Aileen and Israel ColÒn Jr., Tulsa, OK

My tip for writing is to make sure you send it in a format that the receiver can open. This oversight can delay your report and but more importantly will disappoint the receiver. Customer service is the key. Keep the doors open and send the report in the form they prefer.
Candyce Ross, Tulare, CA

Use action verbs.
Susan B. Priest, MSN, RN, CNS

Join us for a free class on how to stand out as a Legal Nurse Consultant, February 25. See http://www.patiyer.com/lncstandout/index.html

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Writing Tips

Monday, February 8th, 2010

computerkeyboardThese are additional entries from my writing tips contest.

Store perfected phrases and language in the autotext feature of your word processing program.  That way, you can just click on a key word and immediately produce the desired text at the correct position within your document.  This is a big, big time saver.
Sue Kelly Paralegal, Red Bank, NJ

Keeping current includes newer uses of language, descriptors, etc. It also means your work product.  Use current styles of paper, fonts, format, display folders, marketing tools, business cards, letterhead, etc.  I find that after being in business since the 80’s, it is essential to update and upgrade all that we do from fashion to products.
Lorraine A. Shoaf RN, BSN, LNCC Legal Nurse Consultant

One of my final checks is to make sure my tense is consistent rather than moving from past tense to present tense and back and forth.  Sometimes a tense change is necessary, but it should not occur at random throughout the document.
Kathy Clark, MS, RN Oklahoma City, OK

My writing tip is in a word, organization.  Did I organize my facts? Is there a flow to the report? The organization of thoughts and facts should start with a beginning, middle and end and make it easy for the editor/ reader to follow the story line.  It also makes reading the report a pleasure.  Understanding that you are writing for a non-medical professional whose forte happens to be verbiage is limitless in value too.

It takes time to write a good report. I find that casual emails are not written with the same intensity that a report or a story is composed with.
Claire Hull, RN, CCM, CLNC

Remember this:  Know your audience and gear your writing accordingly.  If you don’t, your writing could be too technical, not technical enough, or you could miss the mark entirely, writing something for the wrong person or group of people.  If you’re writing for business, you also risk disappointing your client.

For instance, I recently became a staff writer for two local medical magazines, each with a totally different audience.  One is geared towards physicians and office managers; the other has an audience of lay people–”patients”– interested in health and wellness.  I initially struggled with my articles, trying to figure out what the “angle” would be and how to write something that would be of interest.  It then occurred to me that I just needed to remember my audience:  those who are health providers, those that manage their offices, and everyday people (albeit with their own set of demographics) who are interested in improving their health.  Knowing my audience helps me focus on what’s important to each group.
Karen Devin, RN, BSN, Lexington, Kentucky

Join us for a free class on how to stand out as a Legal Nurse Consultant, February 25. See http://www.patiyer.com/lncstandout/index.html

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Tips for Writing by Joan Pate

Wednesday, February 3rd, 2010

I ranCD a contest asking for suggestions for writing. This was the winning entry by Joan Pate.

I often have a “writer’s block” of sorts when I sit down to write a report on a case and have used a couple of techniques I used in a previous life as a Navy Public Affairs Officer. These suggestions helped me enormously when writing news releases, articles for publication, particularly on sensitive issues. They may be helpful to others who experience a similar situation.

Before writing a report, I follow the steps listed below and find my reports are succinct, precise and to the point.

1. Read similar material to the issue(s) in the case. This may be articles from the AAALNC Journal, medical legal references, medical references or clinical journals or research. There’s no prescribed period of time to read, but I find that after reading several articles or chapters, the words I need, flow quickly from my head to paper.

2. Using a 5X8 card, I jot down every thought about the report that comes into my head, placed in random fashion on the card. Such words in a ambulatory clinic case might be: clinic SOC, who’s the supervisor, assess/re-assess, verify med dose/action, fall risk, serial vital signs, old injuries?  If what I wrote doesn’t seem to cover the issue, I go back to reading another article and then add more thoughts to the 5X8 card. These thoughts are collated into similar or like topics or headers.

3. Prepare a general outline for the report, just the way we were taught in school with sections like, I. A. B. C., II. A. B. C. D, etc

4. On a separate piece of paper, list all the players in the report, (with full name, position, title) and important dates/times/locations. Double check this information before proceeding. This list is critical to ensuring accuracy in the report.

5. I generally write my opinion first on whatever issue, I was asked to review, and then fill in the sections of the outline with appropriate data and information.

6. I review the written report at least twice before submitting it, with one review after a good night’s rest.

I hope this is the gist of what you were looking for; it was very helpful to me to write the thoughts down this way, because I realized that I was using tools that were very successful in the past.

Joan M. Pate’, MS, RN, Rio Rancho, New Mexico

Join us for a free class on how to stand out as a Legal Nurse Consultant, February 25. See http://www.patiyer.com/lncstandout/index.html

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