Table Of ContentPraise for Critical Conversations
“This book is chock-full of ideas that will help any nurse in any setting. Clancy provides hints,
tips, and tidbits of communication advice, using real-life clinical scenarios and experiences
from her nursing practice. The use of acronyms throughout the book helps readers remember
information. The most basic is CAR (C=consider, A=act, and R=ROI), a tidy process that
can benefit nurses in a variety of settings. The author returns again and again to the CAR
model as a means to process new information. Complete chapters on body language, emo-
tional intelligence, and organizational culture are another plus, as are the ‘scripts’ that walk
the reader through situations that can be a communication nightmare: asking someone to
stop gossiping, checking in on perceptions, and giving difficult news.”
–Cheryl Dellasega, PhD, CRNP
Professor, Penn State College of Medicine
Author, When Nurses Hurt Nurses and the award-winning Toxic Nursing
“Critical Conversations is a treasure trove of pragmatic, action-oriented communication tools
for all levels of healthcare providers, from novice to expert. Leaders, mentors, coaches, and
educators can easily use the numerous mnemonic acronyms, such as CAR, to inspire and
engage every member of a healthcare team.”
–Victoria L. Rich, PhD, RN, FAAN
Associate Professor, Nurse Administration, University of Pennsylvania
ANCC Magnet Consultant
“Critical Conversations offers valuable information and tips on how to engage in dialogue.
The book is helpful and easy to read; it should be included in your reading list for self-
improvement and lifelong learning. The author’s presentation makes the material simple to
comprehend. I recommend that you read this book and share it with others.”
–Linda Burnes Bolton, DrPH, RN, FAAN
Vice President and Chief Nursing Officer
Cedars-Sinai Medical Center
critical
conversations
Scripts & Techniques for Effective
Interprofessional & Patient Communication
Cheri Clancy, MSN, MS, RN, NE-BC
Copyright © 2014 by Sigma Theta Tau International
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Their use here does not imply that you may use them for similar or any other purpose.
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ISBN: 9781938835469
EPUB ISBN: 9781938835476
PDF ISBN: 9781938835483
MOBI ISBN: 9781938835490
____________________________________________________________________________________
Library of Congress Cataloging-in-Publication Data
Clancy, Cheri, 1972- author.
Critical conversations : scripts & techniques for effective
interprofessional & patient communication / Cheri Clancy.
p. ; cm.
Includes bibliographical references.
ISBN 978-1-938835-46-9 (alk. paper) -- ISBN 978-1-938835-47-6 (EPUB) --
ISBN 978-1-938835-48-3 (PDF) -- ISBN 978-1-938835-49-0 (MOBI)
I. Title.
[DNLM: 1. Communication. 2. Nurse-Patient Relations. 3.
Interprofessional Relations. WY 88]
RT82
610.7306’9--dc23
2014012899
____________________________________________________________________________________
First Printing, 2014
Publisher: Renee Wilmeth Principal Book Editor: Carla Hall
Acquisitions Editor: Emily Hatch Development and Project Editor: Jennifer Lynn
Editorial Coordinator: Paula Jeffers Copy Editor: Charlotte Kughen
Cover Designer: Rebecca Batchelor Proofreader: Barbara Bennett
Interior Design/Page Layout: Rebecca Batchelor Indexer: Joy Dean Lee
Illustrator: Amy Parker Hassos
Dedication
This book is dedicated to:
My three beautiful children, Paige (13), Shane (10), and Colin (9).
“I love you right up to the moon—and back.” –Sam McBratney
My entire family, especially my Mom and Dad, for all your
unconditional love, support, and laughter.
My friends for supporting me on this endeavor.
My colleagues and fellow nurses for sharing in our life-long journey
of caring for others.
Acknowledgments
A special thank-you to Mary Ann Scott and Emily Hatch of Sigma Theta Tau
International and Jennifer Lynn for making it happen!
Thank-you to Dr. Shelley Johnson for your contributions to Chapter 8 and your
genuine friendship and mentorship over the years.
Thank-you to Dr. Marie O’Toole and my colleagues at Rutgers University,
Stratford, NJ.
Thank-you to Nancy Edwards and colleagues with Mead Johnson Nutritionals.
Thank-you to the American Organization of Nurse Executives (AONE), Ad-
vance Nursing, and ASHRM for publishing my articles.
Thank-you to the leaders of Kennedy Health System for believing in my passion
to improve the patient experience and welcoming me into the Kennedy Health
System family.
About the Author
Cheri Clancy, MSN, MS, RN, NE-BC
Cheri Clancy is a seasoned leadership speaker and trainer, nurse educator, and
board-certified ANCC nurse executive with more than 15 years of healthcare
leadership experience. She holds a Bachelor of Science in Nursing (BSN), a
Master of Science (MS) in Health Administration and Wellness Promotion, and
a Master of Science in Nursing (MSN) in Organizational Leadership.
Clancy has been a keynote leadership speaker at numerous events and health-
care seminars across the United States. She is a member of many professional
organizations, including the National Honor Society of Nursing, Sigma Theta
Tau International; American Nurses Association (ANA); American Organiza-
tion of Nurse Executives (AONE); American Association of Ambulatory Nurses
(AAAN); The Beryl Institute; National Nursing Staff Development Organization
(NNSDO); and the American College of Healthcare Executives (ACHE). Clancy
has received various honors and awards, including recognition from the March
of Dimes in Nursing Leadership Excellence. She has also published numerous
articles on various nursing leadership topics.
Clancy began her career as a clinical neonatal and pediatric nurse. Her passion
for listening to the voice of the patient and family was the genesis for her pro-
gressive healthcare leadership experience.
Currently, Clancy is the assistant vice president of The Patient Experience at
Kennedy Health System, a faculty member at Rutgers University’s School of
Nursing, and a national speaker on nursing leadership and healthcare service
excellence. Some of her prevalent presentation topics include transformational
nursing leadership, conflict resolution, managing and leading change, above-
the-line leadership, rounding to improve the patient experience, and coaching
for success.
About the Contributing Author—Chapter 8
Shelley A. Johnson, RN, EdD
Shelley A. Johnson received her baccalaureate degree from The University of
Pennsylvania, School of Nursing in 1997. She received a scholarship from the
National Black Nurses Association to attend The Pennsylvania State University
in 1999, where she received a Master’s of Science in Community Health Nursing.
She completed her doctoral education at the University of Phoenix with a focus
on educational leadership.
Dr. Johnson has taught in undergraduate and graduate programs for more than
15 years. She has taught for The Pennsylvania State University, Raritan Valley
Community College, Rutgers University, LaSalle University, and University of
Medicine and Dentistry of New Jersey.
She is currently the founding director and chair of Nursing and Health Science
in the College of Sciences and Technology at The Lincoln University in Pennsyl-
vania. Her specialties are in education, leadership, mental health, and communi-
ty health. She is certified as a staff developer, a nurse executive, a nurse educator,
and as a comprehensive systematic reviewer.
She has conducted presentations and workshops, published articles, and partici-
pated in research related to a variety of topics. These topics include perceptions
of student bullying, health disparities, cultural diversity, advocacy, leadership,
and nursing education. Research interests include nursing and educational
practices, the academic environment, and leadership development.
Table of Contents
About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
About the Contributing Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvi
1 On Finding Common Sense . . . . . . . . . . . . . . . . . . . . . . . 1
The Driver’s Seat: Finding Common Sense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Your Road Map: Guiding Principles for
Effective Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
The Drive Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
2 Body Language Exposed . . . . . . . . . . . . . . . . . . . . . . . . . 31
In the Driver’s Seat: Understanding and Interpreting
Body Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Your Road Map: Improving Body Language Messaging and
Interpretations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Pulling It All Together With the CAR Framework . . . . . . . . . . . . . . . . . . . . . . . 61
Getting the Results You Want . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
The Drive Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
3 The Emotionally Intelligent and
Emotionally Competent Nurse . . . . . . . . . . . . . . . . . . . . 67
The Driver’s Seat: Understanding Your
Emotions and Your Intelligence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Your Road Map: Improving Your Emotional Intelligence
and Emotional Competence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
The Drive Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
4 Impromptu Scripting Techniques . . . . . . . . . . . . . . . . 111
The Driver’s Seat: Using Impromptu Scripts and
Acronyms for Recollection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Your Road Map: Scripting Techniques for Acronyms,
Body Language, and Emotional Intelligence . . . . . . . . . . . . . . . . . . . . . . . . . . 115
The Drive Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
