The Role of Questions in Developing Nursing Staff

By Rose O. Sherman, EdD, RN, FAAN

“Leaders who are helping others to grow and innovate are always trying to craft the best questions to make a difference.” Kevin Cashman

One of my students told me about situation she had recently observed between a senior nursing leader and staff at a town meeting. There had been some changes in staffing ratios and staff in attendance were very angry. The staffing changes were being driven by financial problems and expected cuts in Medicare reimbursement. Rather than adopt a defensive posture about the changes, the nurse leader chose to ask the staff in attendance some very powerful and probing questions. What started as a very tense meeting ended up as learning experience with staff answering most of their own questions. Leaders often think that they need to have all the answers to be effective. Yet, taking the time to develop others through questioning will both help staff to grow and help them own their learning experiences.

Moving from having the answers to asking the right questions

Nurse leaders often build their early career success by having the answers. The challenge as we develop in our careers is moving from being the source of information to the deeper listening to the viewpoints of others. Good questions will open the door to discovery and a more open dialogue with others. Kevin Cashman in his book, The Pause Principle, observes that true innovators are consummate questioners with a passion for inquiry. Questions are also the way to spur development in our staff. Although it may seem that providing our staff with answers to their problems is the most efficient way to get things done, it does not foster growth. Judith Ross in a 2009 Harvard Business Review Blog suggested that the most effective questions create value. Here are some examples of the value that can be built and the sample questions that can be asked:

1. To create clarity – Can you explain more about this situation? What do you think the issue is here?

2. To help staff think analytically and more critically – What are the consequences if you take this action? If our organization does not take action to decrease our financial costs, what will happen when reimbursements decline?

3. To inspire reflection – Why do you think you were successful in that situation? What is different about today’s healthcare environment that when you initially began your career?

4. To encourage breakthrough thinking – Is there another way that we could do this? If you were redesigning care today with a blank slate, what type of delivery system would you develop?

5. To challenge assumptions – What would happen if we fail to take action in view of what is happening with health reform? Do you think that this type of care needs to be delivered in a hospital setting?

6. To create ownership of solutions – Based on your nursing experience, what do you suggest that we do here? What changes would be in the best interest of your patients? How would you deal with the dilemma of the 12 hour?

With the focus today on evidence-based practice, nurse leaders need to promote a culture of inquiry. A culture of inquiry begins by valuing the use of questions in one’s own leadership practice. Without asking questions, you may falsely assume you have consensus or that staff understand an issue or problem. Moving from telling to asking may be challenging but it is the way to help staff grow.

Read to Lead

Cashman, K. (2012). The Pause Principle: Step Back to Lean Forward. San Francisco: Berrett-Koehler Publishers.