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No more buts

Section Editor(s): Raso, Rosanne MS, RN, NEA-BC

Nursing Management (Springhouse): May 2018 - Volume 49 - Issue 5 - p 6
doi: 10.1097/01.NUMA.0000532333.44443.a4
Department: Editorial

Editor-in-Chief, Vice President and CNO, NewYork-Presbyterian/Weill Cornell, New York, N.Y.

Suspend the urge to keep the old. Let the fresh air in and the stale air out.

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Have you ever heard this reply to a suggestion you've made: “That's a good idea, but...” Or maybe a similar response to an accomplishment: “You did a great job, but...” Did you feel your heart sink? No matter what comes before the dreaded but, it's all ruined the instant after you hear it. If we're going to promote creative, innovative approaches to problem solving and improvements—as well as rid ourselves of what doesn't work anymore—we must do away with the dreaded b word.

Years ago, in a Relationship-Based Care workshop, my team learned about the power of “yes, and” as an alternative to “yes, but” and we really tried to adopt it. The habit of but is hard to shake; it took attention, diligence, and constant peer feedback, and it did make a difference. (Notice the and in that sentence.) We felt affirmation instead of rejection, which inevitably led to more brainstorming and constructive discussion.

Think also about the power of no more buts in terms of performance and conflict management. Instead of quashing someone's self-worth with one word, we can let people feel heard and supported by using and. For example, you may say, “On rounds today, your patient mentioned your excellent teaching skills, and couldn't remember his meds. Why do you think that is?”

The concept actually goes back to comedians and actors using improvisation in their work, building on each other's words to create stories. Ponder its application in our workplaces: a conversation that once went like this “I'd like to bring in remote monitoring as an alternative to sitters” “Oh, that's a good idea, but we tried it before and it didn't work” could go like this “I'd like to bring in remote monitoring as an alternative to sitters” “That's a good idea and I'd like to know the latest options and benefits since the last time it was tried here.” Bam, you've delivered hope, trust, and value in one sentence.

If eliminating but ushers in a safe environment for more ideas, will it help promote the opposite—exnovation, or getting rid of the old and useless practices that don't serve us anymore? Here's where a but may come in handy: “Pagers may have been a good idea 20 years ago, but now they're outdated with the advent of technology.”

Now you're wondering if I'm living under a rock; we can't throw out the old so easily. There are barriers, regulations, politics, budgets, and challengers. Yes, and we can chip away at all of it using our leadership skills. No buts about it, as our parents would say. Keeping old policies and practices in place forever is another habit we can break.

As a gift to the over 3.3 million RNs in the United States, let's eliminate the destructive use of “yes, but” and lead ourselves to innovation through “yes, AND.” After all, innovation is one of the American Nurses Association's three themes for Nurses Week this year: inspire, innovate, and influence.

Suspend the urge to keep the old. Let the fresh air in and the stale air out. We can do this!

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