The "blind" quadrant represents things that you know about me, but that I am unaware of. So, for example, we could be eating at a restaurant, and I may have unknowingly gotten some food on my face. This information is in my blind quadrant because you can see it, but I cannot. If you now tell me that I have something on my face, then this information is now part of the open quadrant's area. Now, I may also have blind spots with respect to many other much more complex things. For example, perhaps in our ongoing conversation, you notice that eye contact seems to be lacking. You decide not to say anything because you don't want to embarrass me, or you draw your own inference that perhaps I am insincere. Then the problem is, how does this information get out in the open, since it may be affecting the level of trust that is developing between us? How can I learn more about myself? Unfortunately, there is no readily available answer. I may notice a slight hesitation on your part, and perhaps this may lead to a question. But who knows if I will pick this up, or if your answer will be on the mark.
The "hidden" quadrant represents those things I know about myself that you do not know. Say, for example, that I have not told you what my favorite dessert is. This information is in my "hidden" quadrant. As soon as I tell you that I love creme brulee, I am moving the information from my hidden quadrant and enlarging the open quadrant's area. Again, there are vast amounts of information, virtually my whole life's story, that has yet to be revealed to you. As we get to know and trust each other, I will then feel more comfortable disclosing more intimate details about myself. This process is called "self-disclosure."
The "unknown" quadrant represents things that neither I know about myself, nor you know about me. For example, I may disclose a dream that I had, and as we both attempt to understand its significance, a new awareness may emerge, unknown to neither of us before the conversation took place. Being placed in new situations often reveals new information not previously known to the self or others. For example, I learned when I was an adult that I have a form of dyslexia that only occurs under stress. This new knowledge clarified for me why, when I was a child, I had so much difficulty reading during timed reading tests or in front of the class. Thus, a novel situation can trigger new awareness and personal growth.
The process of moving previously unknown information into the open quadrant, thus enlarging its area, has been likened to Maslow's concept of self-actualization. The process can also be viewed as a game, where the open quadrant is synonymous with the win-win situation.
In healthcare, we are constantly balancing autonomous practices between physicians and nurses along with other healthcare professionals. Striving for win-win situations always gets the best results. The more self-knowledge you have, the more successful you will be in your professional relationships. Likewise, the more open the environment the better. Of course, open disclosure is done in a way that is appropriate for the situation. Continue to strive to increase your self-awareness whenever possible, and if you have unfinished psychological work to do, then do it with a professional counsellor or coach. Make a personal choice about what you will share at work, and don't use the work environment for therapy.
Nurses and physicians care for the same patient and therefore have an overlapping scope of care. The patient is best served when there is open communication among all practitioners. As nurses, our most important role is to be an advocate for patients by bringing pertinent information to the physician's attention.
One problematic role nurses have taken on because of a sense of shortage is that of the physician's handmaiden. We've all seen nurses whose only role is to carry out doctors' orders. Physicians prescribe medication and treatment plans. As the patient advocate, the nurse reviews the medications and treatment plans, and evaluates them for appropriateness. This is a life saving role that nurses play.
Another problematic nurse role is that of compassionate nurse. Of course, nurses are and must be compassionate, but it takes more than compassion to do our job. The compassionate nurse role model will take as many patients as nursing administration gives and say nothing. Even if concerned about safety issues that may be involved with poor staffing practices, the compassionate nurse continues to try to be understanding. This is what leads to burnout and nurses leaving the hospital or, worse, the profession.
Some nurses say they simply leave organizations that have poor staffing rather then voice their opinions, because they fear no one will listen. This has contributed to the current nursing shortage, and such behavior doesn't demonstrate the expected qualities of the confident nurse who is the advocate patients need. The confident nurse knows when to step forward and make recommendations. It is important to do this with a calm confidence rather then waiting until anger and frustration gives the energy to take a stand.
Sharing personal information improves relationships when it is done professionally. Making recommendations becomes easier in an open, professional relationship. Working together and supporting each other is the way to get successful results for the people we serve.
Expand your "open" quadrant by sharing your self-knowledge with others where and when appropriate. Be willing to learn about your "blind" quadrant by owning your responses to the situations that arise. Even more important, take the risk to share things you notice about others in a respectful and nonjudgmental way. This is the way to build trust. Share your "hidden" quadrant only when appropriate. And finally, expand your "unknown" quadrant by striving for continuous personal growth. We often think trust is a statement about others-i.e., "I don't trust Jane." In reality, though, trust is a statement about yourself. Trust only comes from trusting yourself enough to handle whatever other individuals do. You can develop trusting relationships only by trusting in yourself and your ability to respond.
To learn more, contact Doris Young at 800.673.8005 or at Doris@DorisYoungAssociates.com.
