I often hear that one of the big obstacles to “going Baby-Friendly” is getting the boss to agree to a policy proposal! I’m not surprised. The truth is, few – if any of us – have had 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 is part 2 of a 3-part series outlining six foolproof tips to get your boss to say YES to your Baby-Friendly policy proposal! For part 1, click here.
3. Write your Baby-Friendly Hospital Initiative proposal
Let’s say I’m your boss. You present me with a policy proposal. You roll it out, I shoot holes in it. But, you can’t shoot back because you didn’t bring enough ammunition. I say no. Bang, bang, bang. Your idea is now dead.
If only you’d written it out! This important step can help to keep your idea alive. I often think of evangelist Dawson Trotman’s observation that “Thoughts disentangle themselves when they pass through the lips and fingertips.” (It’s part of why I write this blog, really.)
As you write your Baby-Friendly proposal, you’ll begin to see the holes in your thought process, and the areas that need more back-up and detail. Trust me, this works!
Start with the end in mind
Kurt Lewin’s theory of organizational change posits that the process about moving from the current state to the desired state. It’s the simplest, yet most helpful model I’ve seen.
First, present your boss with the outcome or your recommendation for how to reach it. Being up front with the desired state improves focus for the conversation. Be brief. Be precise. Highlight your main point. Move on to the next main point.
Give some context
Give a short summary of the current state, to provide context for your proposed policy change. Be brief. A paragraph or so should do the job. If your boss likes statistics, be sure to summarize statistics. If she finds graphs more meaningful, provide one – or several.
The context needs to somehow convey that a problem exists. If there is no problem, there is no need for change, right? It’s an overused cliché, but your boss – like thousands of bosses everywhere – probably embraces it: “If it ain’t broke, don’t fix it.”
Provide a rationale
Okay, so let’s suppose that your boss acknowledges there’s a problem. That doesn’t mean she will go for the “solution” you are pitching. You’ll need to provide a rationale that resonates with her.
Whether you’re pitching the Baby-Friendly Hospital Initiative or some smaller, more focused policy change, I’ll let you in on a little secret: In my experience, bosses rarely go for the “breast is best” rationale. At all.
Brainstorm all of the reasons for how your idea will improve the current situation. Then, pick the top five to seven reasons that will resonate with your boss. This is where hitting the boss’s hot buttons comes in handy. Anything more is overkill or distraction.
Think like the boss
As a staff nurse, my thinking often followed clinical lines. However, for a proposal to be approved, I needed to think like the boss. I needed to think along administrative lines, favoring such issues as revenue generation, cost savings, safety, and compliance. (Not necessarily in that order.)
If your rationale doesn’t include something along those lines, you can expect bang, bang bang – a dead proposal.
Estimate a time commitment
A boss needs a good feel for your proposal’s “gestation” period. She’ll want to know how long it will take to move from “current” to “desired” practice.
Your policy proposal will have certain growth and developmental milestones. Write out the milestones for certain goals and/or activities. You’ll probably discover there are more than you had initially thought.
After that, use that list of milestones to make your best estimate of amount of time involved from “conception” to “birth.” Remember that any number of intrinsic or extrinsic factors can delay the proposed project or program. You may think in terms of time ranges (e.g., 3-6 months, 6-9 months) rather than specific dates.
My rule? Make a best estimate and add 50 percent more time. If you finish ahead of time, everyone will be happy. But a generous estimate helps ensure your efforts won’t be derailed if you experience delays.
Address the financial impact
Before you rush off to sell this Baby-Friendly proposal, be sure to address the financial impact, both what it will cost and what financial benefit there will be. And, don’t kid yourself. There is a financial impact, so address it.
Consider all costs
Look at costs from the standpoint of human, financial, technological, and material resources. I’m not suggesting that you anticipate the cost of every paper clip. But I am saying that there are number of costs your boss will need to consider in committing to the “Yes!” you want to achieve.
Include time in your analysis
Remember that time is a cost! Staff members that are in training can’t also be providing patient care, so there’s a cost when other staff must cover that time. Acknowledge that the boss must pay each staff nurse for time spent in training, and she must pay you (or someone else) to develop the training.
When you can clearly articulate where you’re going with the policy proposal, how it solves a problem, why it’s the right solution for the problem, how much time it will involve, and its financial impact – positive and negative – you’re likely to hit pay dirt.
4. Anticipate objections
So after you’ve identified your boss’ hot buttons, prepared, and written your proposal, including costs and a timeline, you’re almost ready to approach the boss. Before you do, you have to try to look through her eyes.
I promise you, your boss will have objections. She wouldn’t be doing her job if she caved in to every policy proposal and failed to ask the tough questions. Think of this as a true battle of the minds: It’s brain-to-brain combat. If you haven’t anticipated your boss’ objections, you will run out of ammunition. Your boss will fire away: bang, bang, bang! Your proposal will be dead.
Set aside 30-60 minutes to write about two things, using the “Who, What, When, Where, Why, Which, How, How much, and What if” approach.
First, write every question your boss could ask. Make sure that the most salient questions are answered in bullet-point form. As a result, you can pull these points into the written proposal you give your boss.
After that, list every objection to the Baby-Friendly proposal you can think of on a second sheet of paper. Recall other requests or policy proposals that you or your colleagues have made. Your boss has at least a few pet peeves; if you’ve paid attention in the past, you can almost hear them in your head. Write them down. Then, write a few relevant points in response to each objection. Put them on your clipboard in case you get stuck when talking to your boss. However, these are for your eyes only. Trust me, you’ll be glad you have them.