Speaking up in the face of a moral dilemma takes courage. No one likes conflict…well, almost no one….and nurses, it is found, would rather compromise than confront, according to at least one research study. Overcoming a natural inclination to ‘go along to get along’ takes conflict management skill. Like so many other nursing skills, it comes with practice. Being assertive in a moral situation is easier when assertive communication is a natural part of professional practice.

Knowing Me – Knowing You

Assertive communication starts with a good understanding of your own feelings about the situation and a desire to understand the feelings and perspectives of others in the group. Thoughtfully considering the situation, and your best response to it allows an objective analysis of emotions that reduces the chance for an unhelpful aggressive or angry response.

Whenever you are distressed about a clinical situation, mentally identify your specific emotional response to become familiar with defining your feelings. Also, consider the perspective of others in the situation. “Step into their shoes” and try to imagine their emotions and motivations. By evaluating all perspectives you will be prepared to assertively engage in a constructive conversation about the event.

Build-A-Response

Practicing a planned response to a situation during less significant concerns can help when the stakes are higher. One helpful model for constructing an assertive communication involves four parts:

• A nonjudgmental explanation of the behavior to be changed
• An admission of the asserter’s feelings
• An explanation of the tangible effect of the other person’s behavior on the asserter or someone else
• An announcement of the desired behavior change solution you want, or an invitation to problem-solve.

Putting these pieces together might create a communication like this to the Med Line Officer: “When you call Inmate Jones a lousy pervert during pill line I feel upset. It is demeaning and it is important to me that we are civil with each other and everyone. Could you please not talk like that when I am doing pill pass?”

By overcoming the desire to compromise and the fear of conflict, you can respond to challenging ethical situations in your correctional nursing practice. Evaluating your own feelings, seeing the perspective of others, and planning an assertive response will develop moral courage to respond when needed.

Have you developed assertive responses to moral situations in your setting? Share your experiences in the comments section of this post.