Expressing opinions

Objectives

1. Distinguish between giving advice and expressing opinions

2. Identify strategies to express opinions in an assertive way

3. Discuss examples of sharing positive regard for others

4. Identify the effects on empowerment of expressing opinions

5. Participate in exercises to build skills in expressing opinions

Boldness, without the rules of propriety, becomes insubordination.

Confucius

How to differentiate between giving advice and expressing opinions

Expressing opinions as a nurse refers to the act of disclosing what you think or feel about healthcare situations affecting your clients or colleagues. Expressing opinions or offering recommendations is an assertive behavior. Having confidence in your ability to communicate, self-efficacy, can help prevent miscommunication, a significant threat to the safety of hospitalized clients (Raica, 2009). The Joint Commission and Institute for Healthcare Improvement mandate healthcare organizations’ work to improve professional communication (Thomas et al, 2009). In a professional setting, your opinions are offered as additional information for clients’ and colleagues’ problem-solving and decision-making processes. In contrast, giving advice is a unilateral process of solving problems or making decisions for others. Offering advice prevents clients from becoming independent and gives colleagues the idea that you might think they are incapable of self-direction.

Expressing opinions can be part of providing clients with a fuller picture to make choices about their health and treatment plans. Clients have a moral right to information, and you as a nurse have a duty to provide information. Expressing opinions is not telling others what to do, but giving them the benefit of your point of view. It assists clients in their health decision making and avoids both the dependency when clients rely on their nurses and the anger and blame when the nurses’ advice is rejected at some point.

When to express your opinions as a nurse

Clients and colleagues may seek your nursing counsel when they are at a point at which they must make a decision about any of the following.

Whether to provide or withhold information: For example, clients may wonder whether they should expose information about their condition to a physician or to another family member. Colleagues may be in a quandary about whether to reveal information to clients and/or their families or to colleagues or supervisors. Fellow students may be undecided about whether to confide in their nursing instructors about personal problems.

Whether to comply with a treatment plan or resist it: Some clients may have conflicting doubts and hopes about their health problems and might be unsettled about whether to follow a treatment plan or attempt to survive without it. Fellow nurses may have mixed feelings about adhering to restrictions imposed on tasks they can perform while making a home visit. Student colleagues may face a dilemma about whether to report an honors violation.

Which strategies to implement to achieve the desired outcomes: Clients who know what expected health status they are aiming for may not be able to decide which treatment plan to follow. Colleagues at work may know exactly what outcomes they want but need help in deciding what actions they can take to most likely ensure that they reach their goals. Classmates may be lost about what approach to take to ensure that they receive a high grade on their next assignment.

Your views may be sought by clients or colleagues at any one of these decision points. Your opinions provide others with information that can be incorporated into their decision making.

Although they are referring to the psychotherapeutic helping relationship, Jensen and colleagues (1989) have several pointers about sharing information with clients that also apply to the client–nurse helping relationship. Nurses might share their opinions about any of the preceding situations when uncertainty exists about outcome, when the options have both negative and positive effects, or when one course of action is not necessarily superior to the other. Giving your opinions as a nurse can create an environment for discussing any one of these decision points and can provide an opportunity to collaborate in the healthcare of your clients. Both of these mutual acts strengthen your relationships.