Constructive feedback in nursing is an essential part of both nursing leadership and professional development.
As a nurse leader, feedback can serve multiple purposes.
For example, feedback is a great way to build up your coworkers and motivate your fellow nurses to go from an undesirable behavior to a more preferred behavior.
As a nurse striving to be a nurse leader, it is imperative you learn effective forms of giving constructive feedback.
Failure to provide an appropriate type of feedback can have a disastrous effect in your workplace.
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Who Benefits from Constructive Feedback
Many people benefit from good constructive feedback:
Your nursing coworkers will appreciate the feedback, especially if they’re a new graduate nurse.
If done correctly, many will appreciate the heads up when there is something they could improve upon.
2. Nursing Students
I can't imagine a better group who could benefit more from feedback from an experienced nurse like nursing students.
Most nursing students will appreciate being told what they are doing right along with what they could do better.
During my nursing school years the clinical I appreciated the most was obstetrics (OB).
Keep in mind I had no intentions of ever going into labor and delivery, but I liked the clinical for one reason.
I received a lot of feedback during that clinical.
Because of the input I received, I learned so much from that clinical.
Many of the lessons I learned there were applicable elsewhere, even outside of OB.
Most hospital work is a team effort, and your unit is only as good as its weakest link.
Building up your fellow nurses builds up your unit.
This will indirectly and in some ways directly will make your life easier.
4. The patient
In clinical practice, patient safety is a top priority.
I'm not sure if anyone benefits more in healthcare when it comes to constructive feedback as much as your patients will.
Is there something one of your nurse peers are doing that is a patient safety risk? What if it's not a patient safety issue, but it could improve patient satisfaction?
4. The organization
Your hospital will benefit from feedback. It could be as simple as better patient outcomes which leads to better patient satisfaction scores.
5. The Nursing Profession
As I'll discuss further below many nurses shy away from constructive feedback and it's unfortunate because feedback can have such a positive impact.
People get better based on feedback.
If you're doing something wrong or inefficient wouldn't you rather know about it?
More nurses giving and receiving constructive feedback will only lead to good things for the nursing profession.
Why do Nurses Avoid giving feedback?
There are ample reasons why so many nurses avoid giving feedback.
Below are just some of the ideas we have found that make nurses want to shy away from such an important part of the nursing profession and clinical team building.
1. I want to Avoid Criticizing
Many nurses avoid giving constructive feedback because they don't want to come off as criticizing their nurse coworkers.
It could be they've been told off in the past for criticizing a fellow nurse or have been a victim of criticism themselves.
Either way, they want no part of giving their feedback to their fellow nurses.
This is very unfortunate because it stifles the opportunity for growth and mentorship.
2. I Don't Know How to Give Constructive Feedback
Some nurses would like to give feedback to their peers but don't know how to do it.
Providing appropriate feedback is not something that is really discussed in nursing school.
Unless you’ve been through formal leadership training, you probably don't know where to begin.
Don't fret, by the end of this article, you’ll learn the basics of what you need to know to start giving effective feedback.
3. It has Gone Terribly Wrong in the Past
Maybe you have had a negative experience in the past.
You might have had a bad experience because you went about it the wrong way or it could’ve been the person was just not interested in your feedback.
Keep this in mind, even if you do everything correctly, some will not take feedback of any kind well.
You could approach it with as much love and caring in the world, and have it received very bad.
From experience, those are few and far between, and it's just a matter of learning how to handle it with grace.
Feedback vs. Criticism
To begin with let's talk about the differences between feedback and criticism.
Oxford defines feedback as:
Reactions to a product, a person’s performance of a task, etc. which is used as a basis for improvement.Oxford dictionary
While criticism is defined as:
Show the faults of (someone or something) in a disapproving way.Oxford dictionary
If you look at the definitions at a quick glance, they may seem pretty similar.
They are not.
Let's dive into the differences between feedback and criticism.
1. The motives are different
The motivation for feedback and criticism are very different.
Poor nurse leaders give criticism because their focus is on blaming you for what you did wrong.
Great nurse leaders will identify what went wrong but are focused on you doing better in the future.
2. One Comes from a Place of Caring
To care about someone is to want them to succeed and do well.
One of the big differences between criticism and constructive feedback is feedback comes from a place of caring.
You give feedback when you're invested in wanting the person to succeed.
Criticism comes from a place of not caring about the person.
3. Past vs. Future Focus
Feedback is focused on future performance.
Criticism is focused on past performance.
All nurse leaders pay attention to past performance.
The difference is mediocre nurse leaders focus on past performance while playing the blame game.
Great nursing leaders focus on future performance.
Great nurse leaders want you to develop and move past the behavior in question.
Their focus is on what you learned and what the steps to improvement are.
The Types of Feedback
Before trying to master the art of giving useful feedback, le’ts first talk about the three types of feedbacks.
1. Positive Feedback
This feedback is when you focus on everything the person is doing right.
Positive feedback helps to reinforce good behavior that's already going on.
It's imperative as nurse leaders that you're making attempts to give positive feedback.
Not only does it enhance the good behavior you see such as a strong work ethic, but it also helps to motivate employees doing the right thing.
Unlike some of the other feedbacks, this one can be given in front of others.
2. Constructive Feedback
Constructive feedback is the primary focus of this article, and it focuses on what someone can do better.
It should be delivered with care. In most situations, this should be given in private.
3. Negative Feedback
Negative feedback is the one you generally want to avoid.
Destructive in nature, negative feedback focuses on what someone did wrong without really giving a meaningful solution or adding value.
The Effective Ways to Give Constructive Feedback in Nursing
The following are steps to make sure you're giving constructive feedback in your nursing career.
I would recommend you check out the above material first because it brings it all together.
1. Build Rapport
One of the best ways to make sure when you give feedback it's received and received well starts long before you ever have to provide input.
Building rapport with your nurse coworkers makes it much easier to give feedback without the appearance of criticism.
To help illustrate this point look at these two scenarios involving Jane and Sarah:
You talk to Jane on a regular basis you guys joke around a lot at work.
One day she notices the way you’re putting in a foley catheter, and she says
“Hey, that's not the way you're supposed to put that in per hospital policy.”
The other scenario is Sarah. You don't know Sarah very well, and you may have spoken to her maybe once.
Just like the above example, one day she notices how you’re putting in a foley catheter and says to you
“Hey that's not the way you're supposed to put that in per hospital policy.”
In both scenarios, the same thing is said, and even in the text, you get a sense this could easily be taken differently.
There are ways to mitigate this, but in general, it's easier to give feedback if you have a rapport with the person.
2. What is your Personal Brand
Do you manage your personal brand?
When it comes to giving constructive feedback in nursing, the personal brand you created as a nurse matters?
Your personal brand as a nurse is important because that's what people think of you.
What people think of you has a rippling effect on how they will receive your feedback.
We'll use the Jane and Sarah example again:
Jane is known to be one of the nicest nurses working in the unit.
She is always willing to help others and has an impeccable reputation.
Sarah is once again someone you don't really know very well, but you have heard she can be a difficult nurse to work with.
If either one questioned you on why you were doing something a certain way which one are you more likely to get defensive with?
Which one are you more likely to be receptive of what they say?
As you can see your personal nurse brand does matter if you're trying to give feedback.
Make sure you manage your personal brand.
Giving excellent constructive feedback isn't something most can walk into.
You need to prepare for the encounter.
Take time to think about what specific things you saw that went wrong and what are specific ways they can improve.
Unlike positive feedback unless a patient is at risk for harm you probably want to find a quiet spot in private where you can discuss the situation.
4. Think About your Timing
It's important to think about when you're going to have the conversation.
A well-timed feedback can be the difference between it being received well and it being ignored.
There are a couple of things you need to remember about timing.
- Make sure the feedback does not interrupt your workflow
- Unless a patient is at risk be mindful of feedback being given in front of a patient or other coworkers
- If possible, provide the input close to the time of the event to make sure details are remembered. If you wait too long, your contribution might not be received as well.
5. Make Sure you Know what your Goals are
- What am I trying to accomplish?
- What are my goals for having this conversation?
- What behaviors am I trying to change?
If you can't answer those questions, the discussion won't be as helpful.
Having a goal gives purpose to the conversation and makes sure the person you're critiquing will understand what behavior is bad and what action they need to do instead.
Make sure you set goals before the conversation.
6. No Sugar Coating
When someone hears this sometimes, it's taken with a negative connotation, but that's not what I mean in this situation.
I'm talking specifically about making sure you are direct with the coworker you're talking to.
Sometimes people will “beat around the bush” to avoid hurting someone's feelings and in the end confusing everybody involved.
Confusion breathes frustration, and that's exactly what you want to avoid.
So, make sure they understand precisely what you are asking of them.
Nursing Feedback Example
When talking to them, you might want your “constructive critique” to go something like this
- I saw you do “A”
- I noticed that doing “A” caused “B” to happen
- I think you should do “C” next time in a situation like that to keep “B” from happening
- Here is my rationale for that
Using that model, you are direct to the point.
You tell them what you saw them doing that way they know exactly what you're talking about.
Then tell them what you noticed happen as a result of what they did.
Tell them what they could have done differently.
Make sure you include your rationale for it.
In nursing like most other professions, the rationale is important.
Explanation of how you got to your conclusion can help give credibility to your take on things and help the person remember it.
Adopting your idea is easier and more likely to happen if they can reason themselves why you would make that decision.
7. Use the Feedback Sandwich
The feedback sandwich is one of the go-to ways to deliver useful feedback while avoiding putting the other person on the defensive.
The system is simple:
- Give positive feedback
- Give the constructive feedback
- Give positive feedback.
Notice you want to start off with something that encourages the person.
Afterward, you want to give your constructive feedback making sure to be direct.
Lastly, close with another positive feedback.
8. Involve them in the Process
Make sure you're not just talking to the person, but you're engaging them and encouraging them to be a part of the process.
Think about it as you're having a discussion with them as opposed to a lecture.
9. Give Actionable Next-steps
It's not just enough to say, “you have a problem” or “what you’re doing is wrong.”
You need to be able to tell them how it's wrong and what steps they can do to improve what they’re doing.
What to Avoid When Giving Constructive Feedback
1. Don't Act Like an Arrogant Know-it-all
When giving feedback, it’s not a reason to be an arrogant know it all or to act like you are better than the person you're talking to.
2. Be Receptive to Feedback yourself
If you're going around giving feedback, you need to make sure you are receptive when other people are trying to provide you with feedback.
3. Don't Push the Subject
If someone is not receptive to you talking to them, know when to bow out gracefully.
It's one thing if it's a patient safety problem or something of a similar nature but if it isn't you might have to let it go.
Frequently Asked Questions
What are some models of feedback in nursing?
1. Feedback Sandwich (we talked about that one earlier)
2. Pendleton's Model of Feedback: Highlight the good things the person is doing. Then you highlight what could be improved. You can find out more information about this model here.
What is the difference between constructive feedback and negative feedback?
Positive feedback encourages good behavior that is already happening. Negative feedback is focused on the bad behavior that's happening but doesn't add value by giving meaningful solutions to the problem.
To Sum it Up
When it pertains to giving effective constructive feedback for nurses, many people stand to benefits from it including yourself.
Did also mention the ability to give constructive feedback is an important trait when talking about the qualities of a good nurse.
Make sure to go about it in a way that is direct and to the point while avoiding putting the other person on the defensive because they feel like you're criticizing them.
If the other nurse is not receptive to your feedback, know when to leave it alone.
Related Articles on Constructive Feedback in Nursing
- How to Treat Nurse Burnout
- How to Deal with Difficult Patients
- How to Deal with Difficult Nurses at Work
What has been your experience in giving constructive feedback?
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