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Injectable Orange Editorial: So the call went out on Twitter for eager bloggers to share their words via injectableorange.com and Jennifer replied… big time. This post is the second in what we are hoping to be a series of regular guest posts focussing on professional communication and the so-called “soft skills” of nursing. Enjoy.
In this blog, I examine professional development, and other non-clinical aspects of nursing. It is important to illustrate why these skills matter for nursing, and why you should care about these issues. To understand this effectively, it is helpful to talk about the pillars of the nursing profession; this gives us a framework. In this post, I talk about how nursing is structured, and how soft skills fit into this structure, and why it is important for you.
We all love some excitement. Many nurses love the adrenalin rush of participating in a Code Blue or other high-intensity scenario. There are a multitude of psychomotor skills required in these events, and it gets your blood pumping to be in the middle of a critical situation. Today, I am here to advocate for a different type of essential nursing skill: soft skills. I believe that these skills are integral to nursing, and are among the most important abilities that a nurse can have at the bedside.
Soft skills, or non-clinical skills, or non-technical skills, refer to skills that are above and beyond the psychomotor tasks that nurses complete. They have been loosely defined as skills that enhance interpersonal interaction. Examples of soft skills are communication, advocacy, critical thinking, and interpersonal skills. It is important to see these skills as a distinct, and learnable part of nursing. All nurses can work to improve their soft skills, and in turn their nursing practice. In this post, I will cover 3 distinct reasons why soft skills matter: they connect domains of nursing practice, they express different kinds of nursing knowledge, and they make a difference for patients (and employers!). We’ll also explore what do to next.
Connecting Domains of Nursing Practice
It is important to consider how the nursing profession is structured. Nurses have 4 distinct domains of practice: clinical, administrative, educational, and research. Each of these areas is united by the fact that we all use the nursing process. While the bulk of nursing takes place in the clinical domain, each of these domains is essential. They reflect how nurses create professional knowledge (research), learn professional knowledge (educational), apply professional knowledge (clinical), and foster the creation/learning/application of professional knowledge (administrative). Side note: this is why we should refer to nurses by their domain of the profession, such as “clinical nurse” instead of staff nurse, frontline nurse, bedside nurse etc. It ties the role directly back to its pillar of the profession. Each domain is a leg of our table, and is essential to having a robust nursing profession. It is important to know how the profession is structured, so you can map where your role lies, and how you relate to other roles within the profession. This is not a hierarchy- it is an understanding that we are different but that we are all on the same team.
However, each domain is also different. You can discuss backwards regression analyses in research and progression of mobilization in clinical practice. So how do we talk to each other? Soft skills. We use interpersonal and communication skills to connect between domains of practice, and share our insights and our challenges. This is important because clinical nurses may have a great suggestion for new nursing research initiatives. Nurse educators may inform nurse administrators about a need for advocacy around educational funding. Our soft skills can break down barriers and strengthen the integration of our domains of practice, making nursing practice easier for all of us.
Expressing Different Kinds of Nursing Knowledge
In addition to having different domains of nursing practice, we also have different kinds of nursing knowledge. These kinds of knowledge cross all 4 domains of practice, and represent how nurses understand their profession. Carper’s landmark article outlined that nursing knowledge is categorized as art, science, ethics, and experiential knowledge. Chinn and Kramer later added social justice or emancipatory knowing as a fifth type of nursing knowledge.
|Domains of Practice||Types of Nursing Knowledge|
Everything we do is multidimensional, or it would not be nursing. Our unique types of knowing are expressed through soft skills, in everything that we do. Let’s take an IV insertion, which is a bread-and-butter psychomotor skill. While you get your supplies to put in the IV, you grab a hot pack- your experiential knowledge tells you your patient might be a hard poke, and your science knowledge tells you that heat will help this situation. While you prepare your supplies, you comfort the patient and explain the procedure. That’s the art of nursing. This patient may need a PICC line, but could be high risk for IV drug use- the ethics and social justice of nursing. One commonplace procedure; 5 types of nursing knowledge.
So how do we express our different types of nursing knowledge? You guessed it, soft skills. Nursing runs on this complex integration of knowledge; however, a lot of it can happen internally and it is not seen or recognized by others. When we can articulate what we are doing, using our nursing knowledge as a framework, we demonstrate the full range of nursing. This will increase the appreciation and respect for our profession.
Soft Skills Make a Difference for Patients (and Employers!
No matter where we work, nurses make a difference for patients. When you ask patients what makes the biggest impact to them during a hospital stay, nursing communication ranks consistently as one of the most important factors. In my experience as a clinical nurse, I found that many people placed emphasis on psychomotor skills. I remember the days of being a student and saying, I need an IM and an IV start! However, if we really want to make a difference for patients, we need to have good soft skills too. Research has demonstrated that communication makes a huge impact for patients, and is the most important aspect of being a health care leader. In light of this, we need to consider soft skills as seriously as any other type of nursing skill.
Increasingly, employers care about soft skills. Now that patient experience is a common measuring point in hospitals (whether it should be or not- this is reality), administrative nurses are hiring clinical nurses for personality instead of experience or background. I have heard this stated by many nurse managers- “We will teach them everything they need to know during orientation. What I need is someone to be part of our team.” If you are looking to score your nursing dream job, you need to demonstrate that you have strong soft skills. To see how to write a resume that does this, see this post.
So Now What?
Soft skills are an essential part of nursing, across all domains of practice and types of nursing knowledge. So what does a nurse do about this? Treat soft skills the same way as you would any other skill. Practice, seek out resources, ask for advice, and participate in continuing education. It is reasonable to ask your colleague, how can I improve at IV insertion? It is also completely reasonable to ask, what are some ways to communicate with a family that is grieving? You wouldn’t put in an IV without learning about it first, and the same logic applies to soft skills too. Consider soft skills an integral part of how you nurse and how you talk about the nursing profession. You will see great benefits for yourself, and also for your patients.
I will continue to explore soft skills and nursing in this blog, so stay tuned! In the meantime, how have soft skills impacted your nursing practice?
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