A nurse, Maria, was working in the ICU. There were 8 patients with 4 nurses. The acuity was very high and for everything that needed to be done for each patient, they needed more staff. One patient coded and 2 nurses were assisting with the code while the other 2 nurses were caring for the remaining 7 patients. One of the remaining patient’s condition was deteriorating and it went unnoticed. That patient coded and died. The nurse was so upset, she took the code sheet and slammed it on her manager’s desk and said “This is what happens when we don’t have enough staff.”

Communication is a two-way street. The communicator is not only responsible for sending the information but for making sure that the receiver properly heard the information. The listener is responsible for actively listening and accurately hearing the information.

But with many of us our brains at times go on auto-pilot and we communicate without really saying anything. Or we communicate out of a reaction, like Maria. In these cases, we’re not really so concerned about whether the listener heard and understood the information we said.

Other times when we communicate, we’re not really listening as much as we’re thinking about how to respond or what to say next.

To get the results you want when you communicate, I suggest that you not do it from a reactive standpoint. You should think through your communication and be proactive. Decide what you want to create when you share the communication. Unfortunately, many of us who communicate from a reactive standpoint find it will create animosity between the two people.

By thinking in advance about what you want to create will help you find the words and the proper tone to communicate effectively.

Had Maria just taken a couple of minutes to cool down, she would have had the opportunity to think what she wanted to create with her supervisor. It probably would have been “I want to talk to you about my last shift. I was wondering if it was possible that we could work together to figure out a way to get more staff when the acuity is higher? And I’m sure that you’d want that too because, as you know, this patient lost his life because we couldn’t be everywhere. So, can we work together on this? Because I know you want the best for the patients too.”

Those responses rather than slamming down the code sheet on her boss’s desk and ranting would have received a whole different reception.

So, keep in mind when you next want to communicate something important, think about how you will be more responsible for the communication delivered and making sure that the listener received it can best communicate. Think about what you want to create from the communication and ask yourself if you are approaching your communication with that end in mind.

The definition of “insanity” is doing the same thing over and over again while expecting to get a different result. Sometimes I feel like a hamster on a wheel – I try to escape the wheel but it keeps going round and round. I also am thinking that if I keep going on this wheel, I’m going to get somewhere, get a different result and then be able to jump off this wheel.

But the obvious reality is that if I keep going around on the wheel the only thing I will accomplish is to keep going around on the wheel. This is what a lot of us in nursing do. We have a certain job, that we would like things to be different and yet everything stays the same.

There are two reasons why things don’t change. The first is called “the cybernetic mechanism,” which is a setting we all have, like a thermostat. If the thermostat is set at 72º and it gets warmer, the thermostat will kick on the air conditioning to bring the temperature down. If it cools down past 72º, then the thermostat will turn on the heat to get it back to that set temperature.

The same is true within our body. We are programmed through the cybernetic mechanism to have a certain comfort zone. We are programmed to make a certain amount of money, to respond to events in a certain ways, etc. This keeps us in our comfort zone.

So, even though we would like things to change, we’re programmed for things to stay the same.

The second reason is what I call “the vicious cycle.” An event will occur and we will have a thought which will create an action in which to respond to that thought which, in turn, will create a belief. Then, when a similar event occurs, we have the thought which triggers the same action which leads again to the same belief.

For example: let’s say that you’re not a person who enjoys gossip. But somebody on the unit starts telling stories, so you’ll think, “oh, good grief, they’re gossiping again,” which will trigger a response in the form of either a thought or comment and then it would trigger a belief about that situation. What’s more, the cycle will continue to perpetuate itself.

To use my kids’ fighting as an example; one does something to annoy another which will trigger an action which then would trigger a belief and the whole cycle starts over and over again.

The only way to break the vicious cycle is to create a vision of something being different. If you manage that, then all of your actions have to be in line with that vision.

So, if you have a vision of creating a non-gossip workplace, then, when gossip occurs, you must take a different action than what you have been taking before with the intention (vision) of creating a non-gossip workplace. It may be as easy as saying, “you know, I love working with you but when you gossip, I find it upsetting. How do you feel about gossip? Wouldn’t it nice if we could all help each other to have a gossip-free unit? As a suggestion, maybe we could have a sign or gesture to let each other know that we have to stop the gossip? Let’s get everybody on board with this new way of being.”

Believe me, it works. However, it needs to be introduced in a way where everybody buys into the new philosophy.

So, the next time you’re wondering why things are staying the same, now you know and your not crazy! But you now also know a way to have it be different by doing something different and getting everyone to buy in to create a good result for everybody.