A Crucial Conversation with the Attitude Nurse

They don’t call her “the attitude nurse” for nothing.

Dr. Georgia Barkers, a registered nurse for more than 45 years, knows the priceless value of communication and positive relationships. Her nursing career dates back to the Vietnam War era as part of the Army Nurse Corps when ace interaction during crisis situations proved vital.

Today, she eases into retirement while still serving as vice-chair of the DeKalb County Hospital Authority, making public speaking engagements and offering Crucial Conversations training. The latter, a two-day course based on the bestselling book of the same name, gives workplace professionals “tools for talking when the stakes are high,” as the tome’s subtitle proclaims.

In the nursing field, stakes can loom above even the most seasoned RN, sometimes producing scorching hot discussions. This summer the Georgia Nurses Association/Foundation —Dr. Barkers is a two-term past president— will host Crucial Conversations training for nurses. And it features Dr. Barkers dispensing an arsenal of practical knowledge.

While engaging in a recent conversation ourselves with Dr. Barkers, she shared the serious significance of clear and amicable communication in nursing.

On the importance of solid communication in the healthcare field:

“If you’re in direct patient care, the first most important thing is communication with the patient and their family. …There are so many different reasons communication is important. If you look back at the Joint Commission, they list that as a very important aspect in terms of many of the issues that arise in the healthcare area. If you go into root cause analysis to see what the problems are, a lot of times communication is going to be right up there with important impact. I look at the fact that we work in an emotionally intense kind of field with interpersonal relations being an important part of how we accomplish our goals and how we take care of our patients. Whether that’s through direct patient care and one-on-one communication with the patient and the family or you’re looking at nursing education, research and technology, you really need to be able to communicate with people so you can accomplish your goals.”

On the types of communication in nursing:

“The specialties are inter-professional relationships, peer-to-peer, peer-to-colleague, helping to integrate new nurses into the field, and keeping new grads from leaving the field within one or two years. You really want to decrease that turnover. Even with employees, retention is really important, because of the cost in terms of money and other resources to hire new staff. And then it’s also important in those areas of incivility and bullying, because you’re in a field that needs collaboration and corroboration. When you get to incivility and bullying, you don’t usually think about that in a helping profession, but sometimes that can be there and can become a problem. The other thing that I think is really important in terms of communication is what I call intra-personal communication. That’s self taught, because you can allow yourself to talk yourself into a bad mood. Or you can calm yourself down and talk yourself out of it.”

On the Crucial Conversations course:

“The course helps you learn to talk when the stakes are high, the emotions are strong and there are opposing opinions. You leave with tools that you can try and work with and build on. You know how there are times when you get so angry or frustrated that it comes out all wrong and things escalate? You can learn how to be able to control that to some extent so that you can have dialogue. Dialogue doesn’t necessarily mean you agree on anything or even change your relationship immediately. What it does mean is that all of the information is out there in terms of shared knowledge. So all of the cards are on the table, and you can talk about it. How can we get along? Do we have a purpose here? Are we trying to accomplish the same thing just in different ways? So sometimes I think it’s very important to look at the common goal in terms of those relationships. Sometimes we’re not on our best behaviors when we’re under certain pressures.”

On her favorite technique that she shares during the course:

“I think the thing a lot of the nurses remember about me is my favorite thing I tell them in the class. When somebody has really irritated you and frustrated you, you humanize them. You allow that neocortex, that new brain to kick in, and you ask yourself a question. ‘Why would a reasonable, rational and decent person behave like this?’ You may not think they’re reasonable, rational or decent, but it does give you time to think about it and calm down. Then it gets you looking at it. What’s the rest of the story? What involvement did I have? And I have had times when I didn’t communicate well with someone, and I went back and asked an objective colleague, ‘How did you see this situation?’ And they said, ‘Yeah, you might not have considered their position.’ So I was able to go back, have a conversation and even apologize for not having necessarily taken their position into account. It doesn’t mean that you apologize all of the time. It just means that you look at the whole picture, not villainize the person and think that they’re always wrong without seeing their perspective. Then you actually have a chance to talk about what it is you want, see what it is they want and if there’s common ground.”

Georgia Nurses Association/Foundation will soon announce the dates and location for its Crucial Conversations training. Visit georgianurses.org for updates.