Pushing Back on Pushiness

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Doctor Neha: Today we have a special guest, Devon, who is willing to ask her questions so all of you can learn. So welcome, Devon.

Devon: Good to see you.

Doctor Neha: Same here. So what’s been on your mind?

Devon: I’ve recently been told that in my community communication style comes across a little pushy and that people feel like I’m not really listening to them because I had an idea of what I thought was best for the situation and for the person. And that feedback surprised me a little bit. I didn’t recognize that aspect of me, but since someone pointed it out, I want to look at that and be a better listener.

Doctor Neha: First of all, I have to say that you have such grace and awareness and curiosity. So I know it’s not going to be that hard for you. Feedback is usually the hardest thing for people to overcome; you seem open to feedback—and when you get it, you see it as an opportunity to be a better version of yourself.

Devon: Yes. I like that. Thank you.

Doctor Neha: From whom did you get this feedback? Family, friends work at work? What type of work do you do?

Devon: I’m a hospice nurse.

Doctor Neha: OK. So you’re a hospice nurse. Did you get this feedback from a family?

Devon: My supervisor.

Doctor Neha: This is from your supervisor. What was the specific example that the supervisor gave you?

Devon: I had reviewed something that a family had expressed they weren’t quite ready to talk about, but I felt I was being supportive by getting that education across to them because I was seeing that things can happen really quickly in the hospice world. I didn’t want them caught without the tools they needed to react to the situation.

Doctor Neha: So you thought there was a sense of urgency. In hospice, it literally is life and death. So you wanted to address something, and they didn’t seem like they were ready. So the first thing to know is that a weakness is just a strength overused. So if somebody says something like, “Hey, our feedback is that one of your weaknesses is that you’re pushy.” The amazing thing about that is there’s a strength under it. Is it important that you advocate for others?

Devon: Yes.

Doctor Neha: Is it important that if there is a sensitive topic that you’re willing to bring it up and have the real conversation?

Devon: Yes.

Doctor Neha: So it sounds like what happened is that the sense of urgency for you overrode your ability to be sensitive to somebody who was in a highly emotional space in that moment. They might not have been ready—although you knew it was an important topic to address and to talk about. Does that sound like what happened?

Devon: Yes.

Doctor Neha: So this gives you a good clue. You seem like somebody who’s pretty direct. Are you pretty direct and open?

Devon: Yeah.

Doctor Neha: Sometimes our patients are less direct, and they have family patterns and sometimes even secrets they keep from each other. I’ve noticed as I cared for some patients at their bedside that when their family would come in or was about to visit, they’d say like, “Doc, don’t talk about x, y, z because my family doesn’t know.” Was there anybody else in the room when this was happening or was it just the patient?

Devon: Actually it was just two of us in another room.

Doctor Neha: Ah, OK, so it was you and a family member.

Devon: Yes.

Doctor Neha: Sometimes it gets complicated because those are tricky dynamics. It’s tricky when you’re speaking with family, especially if you’re saying something they don’t want to hear or it’s a sensitive topic. Now let’s go back to this pushy thing. What’s important about your communication style is that you’re direct, you care and you’re willing to speak about hard subjects, right? At the end of people’s lives, topics like guilt, regret, loss, despair, and sadness often come up, and it’s our job as health professionals to be able to address those topics. The art comes in with us being able to sense where the other person is. So all that happened here was the sense of urgency tipped your directness and compassion into coming across as pushy. That’s what it sounds like to me. Does that sound right?

Devon: Right. So when I saw the urgency, it overrode me being able to tune in and watch where they were at. I’ve been doing this job a long time. So I think that bothers me because I’ve always felt like I’ve been pretty good at sensing where people are at—and I missed it.

Doctor Neha: That’s a moment to grow, when you can pause to consider, Oh, wow, when I think something is urgent or I think I might miss something, what were the circumstances around it that made it urgent? Were you going on vacation? Did you need to have a conversation with the family? Did you think the patient might pass away while you were gone? Was there some sense of urgency like that?

Devon: Yes, the decline of the patient.

Doctor Neha: Well, then what would it look like to convey the sense of urgency while maintaining your compassion? Also you can ask someone if you can share with them and they don’t have to be ready. If they’re not ready to talk with you about something you know is really important and they say, “No, I’d rather not.” they’re allowed to say that. It’s not going to be your fault, you know? But it’s a fine line to walk. Then what you want to look at other areas of your life. Is there any place or time where urgency or a sense of urgency tips you from being direct and compassionate into pushy?

Devon: Right, that’s why I want to explore this whole exuberance thing because when I think I’m right, I really think I’m right. So I want to develop that better sense of listening.

Doctor Neha: It’s interesting because I’ve done another vlog with you. In that one, you were talking about how you typically say no first to any request and then you get yourself to a yes. So by the time you’re ready to say yes, you are so sure of your yes and to move forward that it might come across as pushy. Right?

Devon: Right.

Doctor Neha: So pay attention to whether it’s a sense of urgency that tips you toward being pushy. It might be a sense of feeling like you’re right that does it. And so it’s important to add a little dash of curiosity—where you say your opinion and then follow it with, “Does that ring true? Does this feel like the right way to proceed to you? What are your thoughts?” So you can still come to the table with your exuberance and urgency and ideas as long as you give a little sprinkle of curiosity.

Devon: So checking in with them and being open in that moment to however my words landed for them.

Doctor Neha: Yes. Thanks, Devon, for your time, for your energy, for your question. It’s a bold and brave move for you to take feedback and stay so undefended, open and curious about how it can make you a better human. Your patients are so lucky to have you.

Devon: Thank you. I appreciate it.

Awareness Prescription to Pushing Pushiness

1. Tell the other person you have something to share.

2. Tell them why it’s important to you.

3. Ask if they are open to hearing what you have to say, then…

   • If they say no, respect where they’re at, and refrain from proceeding. Allow them to choose to decline.

   • If they say yes, share your concern or idea and then get curious, such as “Does that ring true? What are your thoughts?”