How many times have you been frustrated by some inefficient aspect of your job? Or wondered why no one has created a shortcut through the mound of paperwork you have to wade through daily?
Only nurses know the in’s and out’s of bedside nursing. We know what works and what doesn’t. We know nursing’s challenges and obstacles like the backs of our hands. And as a group, we’re highly creative and resourceful. So it’s only fitting that the solutions to the problems we encounter should come from nurses on the front lines, where the obstacles—and the benefits of overcoming them—really hit home.
You can complain about obstacles until the cows come home. But unless those higher up the food chain at your facility understand the implications of those obstacles, things aren’t likely to change. To make them understand, you need to devise solutions, put your ideas on paper, and present them to your boss.

Brainstorm a solution
To make sure your ideas get the serious consideration they deserve, you’ll need to do some critical thinking. So grab a notebook and follow these steps:
• Define the problem. Let’s say, for example, your unit has four different forms that ask for the same information.
• Identify the consequences of the problem. Using the above example, you’d probably identify decreased productivity and duplication of effort (and possibly some others). Then figure out how these consequences affect caregivers, patients, and the facility overall. Ideally, try to quantify the impact.
• Develop the solution. For instance, devise a single form that replaces the four forms without sacrificing important information.
• Get critical feedback. Ask colleagues for their opinion of your proposed form. Is anything missing? Should something be changed or omitted? What, if anything, aren’t you seeing?
• Bulletproof your solution. Look at it with a critical eye, and consider its downside. Has it been tried before? If so, why didn’t it work? If you know where the weaknesses are, you can make adjustments.

Strategize for success
You did it. You created a workable solution to a problem. Now all you have to do is present your idea to your boss. That’s easy, right?
Not exactly. In the business world, great ideas get shot down every day. Many variables can chill a manager’s reception to a great idea—
the cost of implementing it, a workplace culture that resists anything new or creative, even the boss’s bad-hair day. It’s hard to push an idea up the food chain if your workplace culture doesn’t embrace change or creativity.
But try anyway. You’ve done your research; you know how the problem affects productivity and how much it will cost to implement your idea. Bingo! Bottom line.
The key is to present your solution to the boss in a way that suits her preferences and needs—not your own. Chances are you understand how she thinks and have identified her natural preferences for processing information and ideas. This knowledge can help you move your idea closer to reality.
If she’s a “just the facts, ma’am” type, keep your presentation heavy on facts and figures. Don’t try to sway her by stressing the emotional impact of the problem—say, the frustration it causes you and your colleagues. Instead, emphasize the bottom-line impact of implementing your solution, and she’ll be more likely to push your solution through the proper channels.
On the other hand, suppose she’s a nurturing, “people-person” type. When presenting your idea, focus on how the problem affects the staff and the workplace culture.

Get visual
Consider using charts or other visual aids to reinforce your presentation. This will give your proposal the best chance for acceptance.

Great ideas vs. bad bosses
In a perfect world, your boss is a wonderful, nurturing, got-your-back person. In the real world, bosses run the gamut from good to ghastly. Here are a few boss archetypes you’ve probably encountered:
• The Martyr. He keeps a running account of all the times he has “thrown himself under the bus” for the facility. There’s a payoff for him when things don’t go well, so your best approach is to make him feel his sacrifices have paved the way for the solution.
• The Manipulator. Everything is always about her, and she takes no prisoners. Be careful…and be sure to make her look good to her boss.
• The Clueless One. Usually, this person has been promoted beyond his capabilities. Try to bring him up to speed and make him look informed and prepared as he pushes your solution upstream.
• The Perfectionist. She obsesses over details to the point that she may let the most trivial detail derail a great idea. Your best bet is to perfect your preparation and pore over every detail, even if it seems insignificant.
You get the point: Understand who your boss is and tailor your presentation likewise.

Joan C. Borgatti, MEd, RN, is owner of Borgatti Communications, which provides writing, editing, and coaching services. Her website is www.joanborgatti.com.