Two Steps for Feedback that Staff Will Take to Heart

If you ask a leader their #1 low-confidence task, it’s giving feedback.

This makes sense to Rebecca Roe, MSN-ED, RN, NPD-BC, CNOR. She’s spent more than 20 years in perioperative nursing, and many of those in leadership roles. In her current work as nursing faculty and a doctoral student, she’s investigating ways to help nurses improve leadership skills, including how to give better feedback. She’s learned that feedback in nursing can be particularly challenging for several reasons …

First, humans are wired to see the negative. Anyone getting feedback often feels like being judged and no one likes to be judged.

Second, surgical care is a high-stakes, life and death environment where mistakes impact lives.

Third, newer generations don’t take the type of feedback that was delivered in times past. “Baby boomers learned by fear, consequences of actions, and harsh reprimand. In contrast, younger generations want clear expectations and are looking for growth opportunities from their leadership.”

What Good Feedback Can Do

All of this can make it feel daunting to give feedback, which is why many leaders avoid it until they are forced to. But this is a losing scenario according to Roe because giving good feedback takes practice. If you aren’t doing the reps, you aren’t improving.

Leaders who are bad at giving feedback have a harder time with retention. On the flip side, staff are more likely to enjoy their job and stay in it when their leader is good at giving feedback—and this in turn drives a more positive work culture for all, Roe stresses. “If you want less drama, if you want more productive employees, if you want a better indication of what is going on in your unit, if you want to be a coach instead of a firefighter, then you need to reflect on your feedback approach.”

Two Steps to Give Better Feedback

Roe’s fix for being better at giving feedback boils down to this two-pronged approach:

“Extend grace to see the worth in what people do well and coach into growth rather than only recognizing them when something negative happens.”

Here are her tips for achieving this:

Step 1: Deconstruct Your Feedback Practices to Identify the Bad

If your staff show fear when they have to meet with you and seem to repel and resent what you tell them, Roe suggests asking yourself these questions:

• Is the point of me providing feedback to fix a situation or fix a person?
  If it’s about a situation then don’t single out one person because this risks resentment. It also creates a missed opportunity to identify a disconnect or missed communication as a team.
• Is my goal to control?

Any thought of controlling or correcting someone is unproductive, especially if you are nervous or fearful of the outcome and what you will have to do about it.

Step 2: Rebuild Your Feedback Practices to Improve the Good

Once you break down why your feedback is failing, you can see where to build skills to get it right, even before you start the conversation. Here are a few approaches Roe suggests:

• Prepare — Explore your feelings about this person and write down some open-ended questions you want to ask. Avoid too many “Yes/No” questions that gather knowledge, but don’t enhance discussion. Also, acknowledge any bias and don’t forget to listen.
• Think growth — Remember, not all feedback is negative or related to a negative event. In fact, it should be more for growth and development. Try using SITUATION, BEHAVIOR, & IMPACT (SBI) as a way to focus feedback preparation.
• Time it right — When nurses are given news that they may not want to hear, it can be detrimental to their ability to focus on the patient in their care. So, give feedback at a time and place to allow time for a staff member to process, regroup and be ready to focus on the patient, not themselves.
• Use universal language — Provide feedback in terms of a person’s job description because it is a factual document that clearly identifies expectations of the organization. This may flag a need for updating a job description, but that can be beneficial, too.
• Self-evaluate — Perfecting feedback skills requires self-evaluation to assess how staff react to you. Do they seek you out or avoid you? Do they seem comfortable providing suggestions for improvement? Leaders also need to track quantifiable measures for feedback success, including retention statistics, adverse patient incidents, errors, or the number of submissions for good catches or service excellence recognitions. On a personal level, a leader should ask themselves if they are getting better at providing feedback in a way that is intentional, factual and non-judgmental. “The goal is to evolve from looking at feedback less in a constructive/positive mindset into more from a place of curiosity and open inquiry, and it’s a work in progress for all of us, including me.”

Roe’s final pearl on providing effective feedback is to do it often because “feedback is more easily taken when it is more frequently given.”

Resources to Master Feedback Practices

Consider these go-to resources Roe uses to keep building her own feedback skills:

• The Nurse Leader Coach: Become the Boss No One Wants to Leave by Rose O. Sherman
• The Disconnect Principle: Eliminate difficult conversations with clarity and empathy by Ann Latham
• Mastering Precepting by Beth Ulrich
• Coaching for Leaders podcast with Dave Stachowiak