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Chapter 7: Interprofessional Coaching Conversations

INTRODUCTION

No matter what people tell you, words and ideas can change the world.

–Robin Williams

Instead of using common descriptors like “courageous conversations” or “difficult conversations” in the title for this chapter, I purposefully used the phrase “coaching conversations” to help reframe the negative connotations associated with those terms. Examples of interprofessional coaching conversations might include:

  • Talking to a coworker about a problem she’s having that is affecting your work

  • Giving your nurse manager feedback when she’s doing something that’s demotivating you

  • Providing corrective criticism to a colleague

  • Talking to a colleague, doctor, or patient who is not keeping up her end of a bargain

  • Confronting a coworker or colleague about disrespectful behavior, such as discrimination

  • Pointing out someone’s shortcomings that are affecting patient care (for example, noticing that a colleague didn’t wash her hands)

These types of conversations are just plain hard—especially when emotions are high or the conversation involves someone you sincerely like (or dislike). Not surprisingly, most people tend to avoid these conversations completely, hoping the situation will miraculously improve. A better alternative is to learn the skills needed to have effective coaching conversations and then facilitate the dialogue with grace and finesse. That’s the focus of this chapter.

Interprofessional coaching conversations can help others better contribute toward a shared goal, enhance their competence and commitment, and improve relationships.

IN THE DRIVER’S SEAT: HOW TO DISCUSS WHAT MATTERS MOST

When faced with the prospect of engaging in a hard-to-have conversation, it can be helpful to have scripts in place, such as the ones outlined in Scripts 7.1 and 7.2.

Script 7.1

What to say when… you want to ask your manager to stop micromanaging you.

A page of script shows what to say when you want to ask your manager to stop micromanaging you. The text within a speech bubble corresponding to the text Tell reads as follows: To your nurse manager: Judy, I would like to speak with you about our mutual involvement in [insert name of project if this is a one-time instance or a trend that you are noticing]. I appreciate that you asked me to take the lead on this. I’m just hoping you can explain why I need to obtain your approval before moving onto the next level. An arrow from this speech bubble points to two exchanges corresponding to the text Explain. The first exchange reads, Your nurse manager is understanding: I didn’t realize I was doing this. You’re right, I don’t need to approve this at every level. Your response: Great, thank you. I’ll still keep you abreast of my progress, though. The second exchange reads, Your nurse manager is defensive: Well, I just want to make sure you’re on the right track. Your response: I appreciate your concern. But I’m worried you might not be comfortable with my judgment. Arrows point to two exchanges corresponding to the text Lead by example. The first exchange reads, Your nurse manager is understanding: How should we proceed? Your response: Moving forward, I’d like to send you a summary of how I complete the next section of the project, and you can give me feedback. Does that sound reasonable? The second exchange reads, Your nurse manager is defensive: I never said I was uncomfortable with your judgement. Like I said, I just want to make sure you’re on target. This is a big proposal. Your response: I was hoping I could be more instrumental in the decision-making process. I would like to complete [insert task] and then gain your insight. Is it acceptable from this point forward that I meet with you [insert time] and at that time you can provide further guidance, instead of me submitting this every day for your approval? Arrows from these exchanges point to two exchanges corresponding to the text Learn the consequence. The first exchange reads, Your nurse manager is receptive: Great, that sounds reasonable. Your response: Thank you for your support. I really appreciate it. I’ll send you a meeting request today. The second exchange reads, Your nurse manager is unreceptive: I need to think about this. Your response: I respect that. Is there anything else I can do in the meantime? (If the manager is unreceptive, ask more open-minded questions to understand why he or she needs to be so involved in every aspect of the initiative(s) at hand. The consequence may be that you will need to continue working in this way.)
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Script 7.2

What to say when…a coworker isn't respectful of diversity.

A page of the script shows what to say when a coworker isn’t respectful of diversity. The text within a speech bubble corresponding to the text Tell reads as follows: To your coworker: John, I was told you didn’t think Shweta (coworker) could handle the project since she was from India. An arrow from this speech bubble points to three exchanges corresponding to the text Explain. The first exchange reads, Your coworker denies it: No, I didn’t! Your response: I’m glad this source was incorrect because that was a very offensive comment. The second exchange reads, Your coworker says he was joking: Oh, come on, it was funny. Your response: I’m sure that was your intent, but it was offensive, not funny. The third exchange reads, Your coworker says he did: Well it’s true! Your response: Your personal feelings have nothing to do with her performance. Your accusation is inappropriate. Three arrows point to three exchanges corresponding to the text Lead by example. The first exchange reads, Your coworker denies it. Your response: It’s a shame people feel the need to undermine others because of varied backgrounds. I hope you would join me in confronting staff who do this and even report it. The second exchange reads, Your coworker says he was joking. Your response: Can you share with me why I thought your comment was so inappropriate? (Teach back). The third exchange reads, Your coworker says he did and apologizes: Your response: If I ever hear such a comment again, I will report you on that occurrence and provide documentation on this prior occurrence and this conversation as well. Three arrows from these exchanges point to a speech bubble corresponding to the text Learn the consequence. The text in the speech bubble reads, Your response: (At this point, either take further action or move forward. Either way, you showed John his accusations are not tolerated.)
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The primary purpose of a having a hard-to-have conversation is not to persuade or get one over on the other person. It is to explain what you see, why you see it that way, and how you feel about it, and to come to a resolution—and for the other person to do the same. You simply can’t move the conversation in a more positive direction until both people feel they have been heard and understood. Each person involved in any situation has a different story about what happened; your job is not to judge who’s right and who’s wrong, but to manage the situation to achieve a better outcome.

It follows, then, that a real conversation is an interactive process in which you are constantly listening. Listening shifts the goal of the conversation from trying to persuade someone to actually learning from him. As a bonus, when you ...

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