I often hear that one of the big obstacles to “going Baby-Friendly” is getting the boss to agree! This doesn’t surprise me. The truth is few, if any of us, have good information on how to get the boss to say YES to any proposed change in clinical practice. But that doesn’t mean it’s impossible! This three-part series outlines six fool-proof tips to getting your boss to say yes!
1. Focus on the boss’s agenda.
Around the mid-1980s, I told my boss that I wanted to implement a practice for mothers to be able to breastfeed in the recovery room. She practically laughed me out of her office because she wanted nothing to do with the idea.
I felt defeated. Humiliated. Powerless. Bewildered. She hadn’t even offered any objections. She just flat-out said no. I didn’t know what to do, and I was down, but not out. I was determined not to give up. The trouble though, was that I didn’t know what I could have done or said differently that would have gotten her approval. I was stumped.
At some point, I realized that although she liked and respected me, she didn’t care about my agenda. Like all bosses, her own agenda was her focus.
Recognize the boss’s agenda
As I watched for something I might be able to use to persuade my boss, I began to notice that when any of us wanted to change a practice, her first question was, “Does Hospital X (our biggest competitor) do that?”
Hmm. I began to recognize a pattern. She wanted to keep up with the Hospital “Joneses.” It suddenly dawned on me that if I could show her that something – recovery-room breastfeeding or anything else – could help her to do that, I could probably sell her on my idea. I knew that practices that appeal to patients lead to more patients choosing that hospital, which leads to increased market share and ultimately more revenue.
“Telling” her science and facts about clinical care was not “selling” the idea, which was key. I most certainly hadn’t been “selling” her on how my idea fit with her agenda.
Selling, not telling
Fast forward, 6 to 12 months: I was ready to try again. Going into the boss’s office, I had all of my “selling” points lined up. My opening pitch was not, “Breastfeeding in the recovery room is good for mothers and babies.” It was now, “I have an idea for how to increase market share.” Not only her mouth but all of her non-verbal messages were saying, “Tell me more!”
She bought the idea. (Notice I said “bought” – because I “sold” her on the idea!)
Yes, we implemented the practice of having mothers breastfeed in the delivery room. (In the 1980s, that was a pretty far out idea!) Honestly, I have no idea if it actually improved market share, but mothers and staff were happy. We weren’t going to undo what we had done.
Different hot buttons
Time passed, and eventually I had a new boss. I realized that “market share” wasn’t the “hot button” it had been with my previous boss. I had to figure out what the new “button” was.
Truth is, each person has a different hot button, or buttons. You do, I do, your boss does. If you want to win your point, learn to develop your proposal so that it hits that boss’s hot button.
Here are some common hot buttons I’ve encountered: better market share, increased revenues, lower costs, higher visibility or national recognition (e.g., Magnet status), better quality improvement measures, and/or fewer headaches with The Joint Commission. Sometimes, the boss just wants to look good in front of the next boss up the chain!
The secret to getting your boss to accept your proposal is to make it about her agenda, not yours. Until you can identify what the boss’s hot button is, you won’t be able to sell your proposal.
2. Plan to hit pay dirt
As a staff nurse, I started plenty of IVs. Nursing peers and physicians thought that I just had a knack, or some luck, that enabled me to “hit pay dirt on the first try.” Their praise was nice to hear, but it was not entirely true.
I would inspect the patient’s veins carefully. If I didn’t feel I could “hit pay dirt” the first time, I simply didn’t try to insert the IV. I called someone who was more experienced and more skilled. People didn’t seem to notice when I didn’t try. They only noticed the times I succeeded. So how does this relate to getting your boss to say Yes?
Don’t poke until have a plan
When I attempt to start an IV, I look at more than one vein. I press and tap around. Maybe I’ll choose a different sized needle. I may tie the tourniquet tighter, or place it lower. I know exactly how I’ll get the job done, and I plan for success. But I don’t poke until I’m confident I can hit pay dirt.
Here’s my advice: Don’t pitch your idea for a change in clinical practice until you have a clear plan for how to hit pay dirt. Not because you’re afraid of taking a risk, but because if you stab and miss, your credibility is at stake.
These two steps focus on the boss’s agenda and knowing to be prepared before approaching her, if you want to succeed. Stay tuned for Part 2 and Part 3 with more insight about getting your boss to say yes. (You can make sure you don’t miss that post by subscribing to the blog.)