Improving Your Practice

Why the G and W words are the Real Naughty Ones, Part 1.

“Gossip undermines all integrity” – Maggie

Nurses all know it. You don’t even have to finish nursing school to learn the oft spoken rule. You NEVER comment on how quiet the unit/shift is, lest you be damned with full on catastrophe as punishment.  You’d think that it was the naughtiest word we know (but we’re nurses, so who are we kidding?).

Not to negate the power of the quiet Gods, but there are words we leave nameless that cause far more and lasting damage.  Words that suffocate an entire unit, erode the trust between co-workers and ultimately decimate a working environment. Those nameless attackers are gossip and whining, and they can be pervasive if you don’t have a staff actively fighting against them.

“If it isn’t your story to tell, you shouldn’t be telling it”

Let’s start with gossip, and explore how it damages a unit and undermines patient safety. According to Merriam-Webster, gossip is “a rumor or report of an intimate nature”. It’s the revelation of someones personal struggles, assumptions about intentions, or sometimes just pure juicy fiction. Regardless of the form, its use always erodes the foundation of trust within a working unit.

We must trust our colleagues.  So much of our time is spent with them, we often too share our lives. How can we trust them though,when we hear them talk about others? How can they trust us, when they hear us do the same?   I know I’ve personally heard things about my co-workers that I guarantee they wouldn’t have wanted me to know. We share intimate details with the expectation they are going to be shared with anyone else, yet shared they are. For me personally, it erodes the credibility of the person telling the story.  It changes them in my eyes to someone who isn’t trustworthy, and that carries over to untrustworthy in practice as well. I know I’m not alone in this assessment. While it’s disappointing to not be able to trust our colleagues with personal information, the ultimate cost is paid by our patients.

Working with very sick people, nursing is and should be a team sport.  We must rely on one another to provide the best and safest care possible.  I ask though, how can we practice at our best, if we’re worried our weaknesses will be revealed to the world? We shouldn’t have to worry that in asking for help, or admitting to imperfection, that it will be used to undermine our credibility. This.Should.Not.Happen. This however, is precisely how pervasive gossip works. Pervasive gossip undermines the credibility of both speaker and subject. It makes asking for help a dangerous act, which ultimately sacrifices patient safety.

How do we fix it?

To fix the cycle of gossip takes deliberate group action, and individual leadership.  We’ve all participated in some form at one point or another, and it’s up to all of us to create the necessary change.  The first step to creating change is to discipline yourself to not participate, either by listening or passing it on. You must get up and leave or change the subject, and render it powerless. Practice this, day after day.

Once you’ve created the discipline, it’s then time to take action.  Speak up and advocate for your colleagues. Hold each other accountable, even if it means someone else stops you. When you hear gossip start, tactfully suggest that they might be speculating or sharing something too personal.  Gently (or not if need be) point out the fact that, as their friend they may be betraying a confidence. Don’t assume malicious intent, but stop it nonetheless. This action takes courage, but it’s the first step to preserving safety and rebuilding fractured trust.

Nobody enjoys playing the hall monitor, and people will bristle at being corrected.  Unit wide change will take time, but we must build a foundation of trust within our units.  We need to lead by example, demonstrate our own integrity, and create spaces free from gossip. In the end, our patient’s lives will depend on it.

In our next post we’ll explore the W word, and how to combat it.  Enjoy!



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