Keeping Your Elbows off Your Career Table
Carol M. Headley

Carol M. Headley, DNSc, RN, CNN,  is Advanced Practice Nurse, Nephrology Division, Veteran Affairs Medical Center, Memphis, TN. She is a member of ANNA’s Memphis Blues Chapter. For more information on this article, contact the author at Carol.Headley@med.va.gov.

Professional etiquette is more than saying ‘please’ and ‘thank you.’ It is a reflection of who you are, what you value, and the respect you feel for others. It is an important aspect of how others view and respond to you and is a factor in your effectiveness in your job and in your success in your career. Professional etiquette can be defined as the employment of effective and respectful processes of communication and interaction with people in the workplace.

You may have alphabet soup behind your name, but if you lack professional etiquette, your chances of success are low. A lack of professional etiquette can jeopardize your professional image and job performance and prevent you from obtaining recognition as well as promotions. All of us have witnessed individuals who lacked professional etiquette. Professional etiquette is sometimes difficult to quantify, but is easily recognized when it does or does not exist. If you have been in nursing for several years as I have, you tend to become relaxed and to some degree, complacent. We reach a comfort zone with our peers and our patients. This is not a terrible thing unless we disregard the professional boundary lines and become amateurish or, worse, become so lax that you lack principals. The professional boundaries between patients and colleagues should always be recognized even though we may feel completely at ease. Our workplaces are not our homes and we should forever attempt to maintain a degree of formality. It does not necessitate a rigid demeanor or hand salute, but it is and should be a place of respect.

Calling Individuals By Name
A friend and colleague of mine recently recounted a complaint voiced by her mother who just began dialysis. The staff in the hemodialysis unit did not call her by her name, but used terms such as “sweetie” or “honey.” This annoyed her, because she felt it was belittling and somewhat demeaning. She was an adult and most of all an individual with a name. These terms may not evoke uneasiness in all patients, but it would be wise to use them discretionally or not at all since it is difficult to tell if someone is made uncomfortable by them.

People are also sensitive to what name you use when addressing them. Using a patient’s first name without knowing that they are comfortable with that term of address, can be viewed as you being overly familiar and disrespectful, especially in the case of elderly individuals. The best approach is to always ask the patient what name they want you to use.

Meeting and Greeting
One of the cornerstones of professional etiquette skills is the art of meeting and greeting. Many nurses’ careers are built upon their communication and networking skills. Always make a good first impression even though the opportunity may occur with a patient’s family on the 11th hour of a 12-hour shift or on the last day of a 4-day conference. Keep up the professional stamina. Your confidence, assertiveness, and professionalism will be remembered not only by that individual but by everyone who witnessed your interaction.

Introductions are also crucial to your professional skill set. Always introduce people in the standing position. Introduce them with their title (i.e., CEO, manager, director), give some pertinent information about each person being introduced, and, if appropriate, acknowledge their contribution or potential contribution to the meeting. When you are introduced to someone, make eye contact, and shake hands firmly.

Dining Etiquette
Have you ever been at a professional dinner meeting and eaten something that you could not swallow – even if you had chewed all night, there was no way it was going down? If you consulted the etiquette handbook, it would recommend that you swipe your mouth with your napkin and dispel the food stuff (or non-food). I attended a dinner meeting once and was witness to someone spewing food from their mouth while talking and chewing. The food particles just sailed across the table and landed on someone else’s plate. This is a controversial case for Miss Manners. Most would recommend ignoring it unless it was too obvious to ignore and then you must acknowledge the misfortune and politely remove it from the recipient’s plate. Dining is one of the biggest areas for professional etiquette mishaps to occur. We tend to think of meals as social events, but many employers will put job candidates to the test by conducting an interview during a meal. The rules have thankfully changed from the 1840s, when women were allowed to wipe their lips on the tablecloth, but not allowed to use the tablecloth to blow their noses. Even though the rules have changed, you are still required to know the updates. Your knowledge of them is not an option, it is an expectation.

Working With The Bosses
Professional etiquette always includes showing recognition and respect for people in authority. In doing so, you acknowledge their position, not necessarily their fulfillment of the role, but the position in and of itself.

What about disagreements? Is it ever OK to veto the boss, manager, director, or CEO? Of course it is. Have you ever met a “yes man or woman” in your place of employment? They never rock the boat and you often wonder if they have ever had an independent thought. Don’t be the employee that was known only for the ability to bend in whatever direction the memo mandates blow. If you disagree, then say so, but disagree without being disagreeable. Choose an appropriate setting and state your reasons for disagreeing in a professional manner. You must, however, realize the point when debate becomes insubordination. Once a decision has been made, dissent must end. Argue your points strongly and for the right reasons with sufficient cause (not just for the sake of argument) and you will gain respect, but know when to move on.

Allowing people to express their opinions openly and freely creates an atmosphere of innovation rather than stagnation. Thinking people tend to be productive people. A good employer will always seek to promote a staff of free thinkers. Challenging the status quo should be an expectation and never be seen as a threat to the work culture. If free thinking is discouraged, then employees will be afraid to challenge the system and make creative changes.

Honesty
Honesty is always the best policy and the only means of maintaining professional integrity. The “no fault” reporting system for errors in patient care has eliminated some of the fear that nurses once felt when a mistake was made. Errors will be made because we do not live in a mistake-free work environment. Hopefully, many of the safeguards in place now will reduce the number of errors. However, reporting the ones that do occur are paramount to making continued improvements in the system. The literature has consistently demonstrated that the mistakes that do occur are usually made as a result of system error rather than due to individual fault. No matter if it was the result of the individual or system, professional etiquette would always err on the side of honesty.

Improving Your Professional Etiquette
Think about your last work day. Imagine that someone placed a hidden camera over your work site. Now, play back that day in your mind. Did you say or do anything that might have been misconstrued or interpreted as less than professional? You may feel slightly embarrassed or even remorseful for your actions. Don’t carry the guilt, do something about it. We all can do better. Nurses who maintain professional integrity and have etiquette awareness can achieve much in their career. How you interact with others determines how others perceive you. Today, make a decision to address the next work day with an improved professional demeanor!