The 5-Step Guide to Effective Negotiations


Leadership Tips

Become a Better Negotiator

Learn how to get better at asking for what you need for yourself, your patients, and your staff.

In a new webinar series called Leader Exchange, AORN’s Center for Perioperative Leadership has assembled panels of experts who share their experiences as periop leaders in acute and ambulatory settings.

The webinars are live and then archived to provide easy, no-cost access for members and non-members.

» View the entire webinar: “Building Negotiation Skills for Key Interactions.”


Maureen Girard
Owner, MGirard Consulting and Coaching

Trevor Bennett, MBA, MSN, RN, CNOR
Associate Vice President of Acute Care Operations, Providence Swedish

As a surgical nurse your mind is wired for process. You learned it in nursing school, and you use it every day in and around the OR. You’re also negotiating every day – formally and informally – with your partner and your kids, and on the job with your boss, your staff, your suppliers, CFOs, colleagues, and your surgeons.

“Effective negotiation, just like nursing, is process that can be learned,” says Maureen Girard. Girard, along with Trevor Bennett, MBA, MSN, RN, CNOR laid out the five steps for successful negotiation and provided tips for applying those steps to various scenarios nurse leaders face.

Here are highlights from the webinar:

  1. ASK – If you don’t ask, you don’t get. Girard believes a sense of uncertainty is the most common barrier in part because we may feel like we’re asking for a favor. She recommends practicing making asks in low-stakes situations. Try getting a better price on an item at a flea market or ask for an upgrade for your hotel room. You can build confidence with practice.
  2. DO YOUR HOMEWORK – Prior to any negotiation, identify what is most important to you by understanding your motivations and value. Do the same for whoever you are up against. What’s important to them, what do they want out of the deal? And if you don’t know, ask. When you’ve done your homework, lay your priorities out on a piece of paper. Bottom line, be prepared to make your ask.
  3. BATNA and Walk-away – BATNA is the “Best Alternative to a Negotiated Agreement.” And your walk-away is how far you’re willing to go to strike a deal. When your BATNA is high, you have more leverage. And vice versa.

    Girard cited house-buying as an example – you have thought about what you want, and the market is cool – houses aren’t selling. This gives you a high BATNA and you can go in with an aggressive offer. If the market is hot and there are few houses available that meet your needs, then your BATNA is low because you have less leverage.

    You may have to give them their asking price. In both scenarios, you need to know when to walk-away from the negotiation. You’ll be ready because you’ve done your homework.
  4. MAKE THE FIRST OFFER – That’s the anchor, the point from which the negotiations begin. And never start where you want to end, advises Girard. Put your offer out there and stop talking. She says it’s important to pause and also important to never start where you want to end. If you want 5%, ask for 8%. If you hear no, ask why. You’ll learn more about their stakes and that will prepare you to return to the negotiation table.
  5. GIVE AND TAKE – You’ve done your homework, thought about where you can be flexible, and you’ve considered the other party and where they might be flexible. It’s okay to be aggressive but let the other person have some wins. If they get nothing, they’ll leave the table frustrated and that might thwart your chance to build a strong, long-term relationship with them.

Real World Examples

Trevor Bennett described an anesthesia contract he’d recently negotiated for his system – for $80 million. He had done his homework, knew his BATNA and his walk-away. Some of the best deals, he said, are those where the parties meet in the middle. He, too, agrees that a win can come from building a long-term relationship. The anesthesia deal didn’t come together in just one meeting, it took place over a period of months.

Jake Runion, MBA, BSN, RN, senior manager of AORN’s Center for Nursing Leadership had some periop specific questions for Girard and Bennett. He wanted to know about lessons learned and especially how negotiation skills can be applied to staffing issues.

Girard remembered a time when she hadn’t adequately done her homework. She believed she’d gotten the right price on the product, but she hadn’t figured in the cost of freight, packaging and engineering time. She conceded too quickly, she said.

Bennett acknowledged it took time to get good at negotiating and recommended asking what does “no” mean, what does “good” mean, and what isn’t acceptable. He says it forces a thoughtful response from the other person and helps you build skills for the future.

People discussing issuesFor staffing issues, all periop leaders face the need to increase volume without the staff to support the growth. There’s a battle, Bennet acknowledged, of “build it and they will come.”

Conversely, it’s “they will come, and we will build it.” In these situations, he recommends building a business case around the data and consider using a phase-in approach. You’ll need the resources to open the doors – that’s the business case.

Bennett and Girard agree. Regret is a powerful emotion. In negotiations, it’s better to regret something you’ve done rather than something you haven’t. And both have walked away from deals.


Listen & Learn

There is much more to learn about becoming successful at negotiations. Listen to the one-hour webinar here. You can also register now for the Leader Exchange webinar, “Using Innovative Technology to Manage Workload,” on Feb 21 at 1pm ET.

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