by Sheryl Sommer, Ph.D., R.N., C.N.E. Minority Nurse Writer
Do you ever wonder about the impression we as nurses leave with our patients? Or the impact we have on our communities at large?
One can get an idea by taking a peek at Gallup's annual Honesty and Ethics survey. Since 1976, Gallup has asked Americans to rate the perceived honesty and ethical standards of different professions, and in 1999, they began asking Americans to rate those characteristics in nurses. I'm proud to say our profession has topped the list since then in all but one year, 2001, when fire fighters ranked highest and nurses still garnered high ratings. In essence, for the past several years, Americans have conveyed their belief that nursing professionals demonstrate the highest level of honest and ethical behavior.
That's quite an honor for us, and it's a responsibility to continue to uphold this perception. Patients rely on us for information, guidance, advice, and above all, physical and emotional comfort. Interestingly—although not surprisingly—a recent online article from Hospitals & Health Networks cited surveys that found patients are less intimidated by nurses than by their doctors and are consequently more apt to be open about how they feel.
As the health care environment continues to evolve, we're seeing the role of nurses changing and expanding for a number of reasons. In addition to patient expectations, nurses are operating in a rapidly evolving world of reimbursement and rising health care costs. Health care facilities are pressured to maintain or lower costs, while increasing their patient outcomes and satisfaction levels. This is a difficult balance, and nurses play a key role. Those who possess the skills to coordinate care, communicate clearly with patients, and advocate for them more effectively can help in ways such as reducing patients' length of stay and unnecessary readmissions, as well as improving patient satisfaction.
That's the good news for our profession. The challenge is to continue developing and fostering professional and interpersonal— or "soft" skills— among nurses. The value of these skills is recognized in the field and borne out by research. However, the educational time to hone skills such as communication and leadership are often sacrificed in the interest of other essential clinical skills nurses need to learn to be effective caregivers. According to a recent ATI Nursing Education survey conducted among practicing nurses, nurse managers, recent hospital inpatients, and those accompanying them, 98% of practicing nurses want more education to help them develop their soft skills.
The desire for this type of knowledge is well founded. The same survey revealed that 66% of recent hospital inpatients feel their hospital experience could have been improved by better interactions— specifically communication— with nurses. And from the employer side, more than 80% of nurse managers say they are seeking graduates with solid professional and interpersonal skills.
Understanding the soft skills that complement professional competencies
Obviously, nurses are expected to have a level of professional competency in care giving commensurate with their position. At the same time, the most successful nurses also possess other, less tangible skills, frequently referred to as soft skills. Soft skills are generally defined as the areas of communication, professionalism, informatics and technology, and leadership and management. In other words, nurses are expected to work and communicate well with colleagues and patients, offer sound judgment, solve problems, and move seamlessly through the world of electronic medical records and other technology facets. Although different from other skills, the process of developing soft skills in nurses requires many of the same methods and a research based educational process.
Characteristics of effective interpersonal or soft skills programs
Research tells us the most effective soft skills education programs designed to teach these professional and interpersonal skills share three main characteristics:
98% of practicing nurses want more education to help them develop their soft skills.
66% of recent hospital inpatients feel their hospital experience could have been improved by better interactions—specifically communication—with nurses.
80% of nurse managers say they are seeking graduates with solid professional and interpersonal skills.
The skills are based on a comprehensive theoretical framework and are connected to measureable outcomes. A theoretical framework simply provides a structure within the concepts and can be logically connected to form the program content. A logical framework enables educators to develop measurable outcomes to ensure competency.
Both education and practice of defined skills are provided. Education increases awareness of a subject and is complemented by practice, which makes an individual proficient at executing a particular task. Both are necessary for effective soft skills development. For example, applying and practicing the use of conflict resolution skills within a team-oriented task would not make sense to someone who wasn't familiar with what conflict resolution entailed. Conversely, there is limited value in teaching information about conflict resolution skills and evaluating the student's acquisition of that knowledge without also helping them to apply it in a relevant context.
A multi-method assessment system that supports and evaluates attainment of skills is incorporated. The most effective soft skills education programs tend to use a variety of assessment methods, including tests that measure knowledge about concepts and principles related to the skill and evaluation of the student's ability to apply the skills to a clinical situation. A multi-method approach meets the need to assess both knowledge of the skills and competency in applying them in a clinical setting.
Closing the gap
Over the past year, the ATI Nursing Education staff has garnered the input of our clients, studied the implications of research, and closely watched industry trends to develop a solution for soft skills education. Nurse's Touch, which will launch in the fall of 2012, is the first product of its kind, using an interactive learning format to enable students to gain skills in five key areas:
Informatics and technology
Wellness and self-care
Leadership and management
With an eye toward meeting the three criteria for effective soft skills education—theoretical framework, combined education and application to clinical practice, and multiple assessment modes—Nurse's Touch uses a variety of tools to convey the concepts and provide educators with the ability to accurately evaluate and track student progress. The tools include:
Tutorials that provide the educational foundation in each subject area
Interactive simulation, which offers opportunities to make decisions (i.e., practice) in a simulated clinical situation
Case studies providing an opportunity to apply knowledge of soft skills to clinical situations
Students are assessed based on their knowledge of content as well as on their level of competency in applying that knowledge to clinical situations. This ensures students are geared towards achieving desired outcomes of soft skills education. We are optimistic that Nurse's Touch will provide a resource through which nurses can gain the knowledge, skills, and attitudes needed to stay healthy and manage work-related stress, convey professional behaviors and attitudes, and serve as leaders and patient advocates.
We can anticipate that the demands and expectations of nurses will continue evolving and expanding—a belief borne out by the Institute of Medicine (IOM) assertion that nurses need to function as a critical member of the health team. Additionally, the difficulty of carving out classroom time to develop soft skills is not an issue that will go away. But the fact that the health care and nursing education communities collectively realize the need for these skills demonstrates how the industry is moving to provide resources and viable educational alternatives to help nursing professionals succeed on all fronts.