An Absent Assertiveness Alarm should go off if any of these statements sound like you: Doing something you don’t want to do; Saying yes when you mean no; Meeting needs before being asked; Doing more than your fair share; Giving more than you receive; Fixing other people’s feelings; Thinking for another person; Suffering other people’s consequences; Failing to ask for what you need or want. The first publication of STAT: Special Techniques in Assertiveness Training for Women in the Health Professions was in 1978. Now in its fourth edition, this publication proves that indeed, some things never change. Reading this book is like looking at any nurses’ station in any hospital across the continent, where women continue to be the dominant gender in nursing, yet remain subservient to men in the profession for the most part. Veterinary medicine is really no different, EXCEPT that the number of female veterinarians is climbing! So does that mean this dynamic may change in the near future? That remains to be seen. In that scenario, perhaps instead of the “female vs. male” battle, we’ll just change it to the “practice owner vs. support staff” battle. Regardless, it never hurts to learn more about how to be assertive in the healthcare workplace. The author of STAT, Melodie Chenevert, RN, MN, MA, emphasizes that silence is consent; that by remaining silent when we see poor healthcare being delivered to humans (or pets, for us), we become part of the problem. “Whenever a patient receives less than satisfactory care, speak up. Whenever a patient is treated in an unkind manner, speak up. By failing to speak up, we condone current practices,” Chenevert affirms. While healthcare attracts people pleasers (those who are juggling touchy technicians, distraught doctors, arrogant administrators, and other peeved personnel, ever with the motto “peace at any price”), we fail to realize that often that “price” is paid by our patients. With this in mind, there is only one question we must ask ourselves to clarify our position: “Is what I am doing or about to do in the best interest of my patient?” By always keeping this as your guiding star, you can never go wrong, because you can always look yourself in the mirror and know you are doing the “right” thing for who or what matters most, your patient. What also helps you look square at yourself in the mirror is knowing that as a healthcare professional, you have certain rights, and the right to live by these rights: You have the right to be treated with respect. You have the right to a reasonable work load. You have the right to an equitable wage. You have the right to determine your own priorities. You have the right to ask for what you want. You have the right to refuse without making excuses or feeling guilty. You have the right to make mistakes and be responsible for them. You have the right to give and receive information as a professional. You have the right to act in the best interest of the patient. You have the right to be human. Chenevert states that “the assertive response is simply to put into words what you are thinking and feeling.” Of course, we all know that there are ‘good’ words to use, and ‘dangerous’ words to use, so we must temper our feelings with the ability to communicate in a professional manner. Here are recommendations from Chenevert’s book to help you become more assertive: If you sit in a corner and wait until you get enough confidence to be assertive, you will be covered with cobwebs. Confidence comes AFTER you dare to assert yourself. The more you assert yourself, that more confident you will become. The more confident you become, the easier it is to be assertive. Create a way of life that includes serving others without being subservient. We live to serve; that is why we are in the veterinary profession. However, that does not mean we have to be subservient, to anyone. State what you want or what is bothering you in as few words as possible. The fewer words you use, the more difficult it is to argue with you. Be persistent. You can get more mileage out of persistence than out of almost any other assertive technique. Before you retreat, repeat what you said. Once is not enough. Twice may not be enough. Repeat your case over and over again in a calm, even voice. Do not become angry or argumentative. Start. Start small. Start with strangers. These assertiveness tools and theories can be used on anyone, including family, friends and coworkers. As you begin to slowly assert yourself and stand your ground, it’s best to start small, and start with strangers who’s opinion means less to you than, for example, your mother or significant other. Earn a few small victories before tackling the “home team”, in other words. Before you are ready to move assertiveness into close relationships, imagine the most awful thing that could happen. The extremes usually involve getting a divorce or getting fired. Conjuring up dire consequences this way makes most women realize how unrealistic and exaggerated their fears are. Keep your requests visible. If you’ve made a request that appears to be ignored, don’t let it be. Remind your boss, for instance, that you want to be considered for that next position of surgery technician. Don’t count on them remembering your requests. Setting time limits is important. If you have brought something to someone’s attention and they may need time to fulfill or investigate the request, that is fine. But let them know you will be checking back in a few days, for example. Don’t leave it “open-ended” or the request may never get closed! Remember to use “I” messages: I feel…I expect…I want…I choose…I decide…I plan…I believe…I am (angry, confused, etc.)… Exploring all the “should-haves” is useful if what you learn can be applied to new situations. It is not useful to torment yourself with “I wish I would have said...,” “I should have….,” or “Why didn’t I…?” When there is no good way to share what you are feeling, choose to let off steam in an indirect way such as jogging, writing a letter then destroying it or sharing the feeling with a good friend who will listen. Whatever you do, do not swallow your feelings; they will make you sick. Being sensitive to others is one of our strengths, but it also leaves us very vulnerable to verbal abuse. Don’t be afraid to say, in the midst of getting thrown a variety of tasks all to be done immediately, “I only have two hands, just tell me what you want done first.” Remember our discussion about wages, i.e. money? “Human” healthcare sounds an awful lot like our world, to the point where Chenevert claims that “money is not the cause of unrest in our ranks. The cause is power. We don’t have any.” When it comes to offending someone to defend your patient, there really is no choice. If you let the patient and yourself down, you will be haunted by another I-wish-I-had-it-to-do-all-over-again situation. Accumulate enough of those, and you won’t be able to fall asleep or look at yourself in the mirror the next morning. Once you decide on a course of action that is in the best interest of the patient, stand up for your decision. Hopefully this series has given you ways to find, and keep, the job you love in veterinary medicine. It is not always easy, but with some understanding of the general principles, and the skills to make it happen, you can enjoy a long career doing the work you love! Previous: Are Your Ethics Being Compromised? More Staff Safari
