(3rd Edition) Etiquette and Communication Strategies For Nurses

Praise for Etiquette & Communication Strategies
for Nurses, Third Edition

“Kathy Pagana has done it again! This well-written, easy-to-use, comprehensive discussion
of social and professional etiquette is a must-read for all aspiring and experienced nurses.
Whether you are a new graduate interviewing for your first nursing position or a seasoned
nurse with years of experience, Etiquette & Communication Strategies for Nurses,
Third Edition, is your complete guide to setting a positive, professional tone; building collegial
relationships; and optimizing your nursing career. Pithy quotes, helpful FAQs, and essential
take-away tips add valuable insights and texture to Pagana’s fluid, skillful, and understand-
able writing style. Get ready for a fun, readable, professional etiquette experience!”
–Cynthia Clark, PhD, RN, ANEF, FAAN
Strategic Nursing Advisor, ATI Nursing Education
Author, Creating and Sustaining Civility in Nursing Education
“Navigating the professional pitfalls that we all find ourselves in can be challenging. Kathy
Pagana has made figuring out the nuances of meeting, greeting, connecting, and form-
ing lasting collegial relationships a breeze. This book is filled with read-it and use-it tools.
Whether you are new to your career or a seasoned veteran, you’ll learn something that will
pave the way for future success.”
–Vicki Hess, RN
Author, Top 5 Healthcare Speaker, Virtual Coach
Principal, Employee Engagement Solutions, LLC
“Etiquette isn’t just a nicety; it’s essential for a successful nursing career. Keep Etiquette &
Communication Strategies for Nurses, Third Edition, nearby as you steer your career. Its
streamlined format allows you to easily dip into it again and again to find answers on how to
handle professional situations. Whether it’s navigating social media, networking effectively,
dining out without embarrassing yourself, or becoming a more effective presenter and writer,
Kathy Pagana’s practical insights make this book an indispensable resource for nurses in all
specialties and practice settings.”
–Cynthia Saver, MS, RN
President, CLS Development Inc.
Editor, Anatomy of Writing for Publication for Nurses, Third Edition
“If you have questions about etiquette, chances are that Kathleen Pagana has the answer.
Her etiquette book is a comprehensive guide for any nurse wanting to appear polished and
professional. Illustrated with stories, key tips, and recommendations, it will prevent you from
embarrassing yourself. The organization of the material makes it easy to dip into the topics of
most interest. You’ll want this guide to help you put your best foot forward.”
–Pat Iyer, MSN, RN, LNCC
Author, 52 Writing Tips: Fast and Easy Ways to Polish Your Writing
“Kathy Pagana’s book Etiquette & Communication Strategies for Nurses, Third Edi-
tion, is an invaluable resource for nurses at any point in their career. Whether one is a new
nursing graduate learning to navigate the professional setting, an experienced nurse looking
to grow in new ways, or a nursing executive, Pagana provides the reader with tools to thrive
in any professional setting.”
–Rebecca FitzSimons, MBA, BSN, RN, NEA-BC
Director of Nursing Programs, UChicago Medicine
“Kathleen Pagana takes a fun look at the skills necessary to manage various professional situ-
ations with poise, grace, and common sense. She discusses situations that, if managed appro-
priately, can make a difference in your career. Definitely a book for aspiring, newly promoted,
or experienced nursing leaders.”
–Tami Taylor, MSN, MBA, RN, NEA-BC
Chief Nursing Officer, St. David’s Round Rock Medical Center
ETIQUETTE &
COMMUNICATION
STRATEGIES for Nurses
ADVANCEMENT TECHNIQUES FOR YOUR CAREER
THIRD EDITION
KATHLEEN D. PAGANA, PHD, RN

Copyright © 2020 by Sigma Theta Tau International Honor Society of Nursing
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Library of Congress Cataloging-in-Publication data
LCCN Permalink: https://lccn.loc.gov/2019952347
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First Printing, 2019

Publisher: Dustin Sullivan Managing Editor: Carla Hall
Acquisitions Editor: Emily Hatch Project Editor: Todd Lothery
Development Editor: Todd Lothery Copy Editor: Todd Lothery
Cover Designer: Rebecca Batchelor Proofreader: Gill Editorial Services
Interior Design/Page Layout: Rebecca Batchelor Indexer: Larry Sweazy
Dedication
This book is dedicated with much love to my husband, Tim, and our three
daughters, Jocelyn, Denise, and Theresa.
About the Author
Kathleen D. Pagana, PhD, RN, is a dynamic speaker and bestselling author.
She is an emeritus professor at Lycoming College in Williamsport, Pennsylvania,
and the president of Pagana Keynotes & Presentations. She has been a leader in
healthcare for more than 40 years. She has a BSN from the University of Maryland
and an MSN and PhD in nursing from the University of Pennsylvania. She has
earned the prestigious designation of Certified Speaking Professional (CSP) from
the National Speakers Association.
She is the author of more than 95 articles and 29 books. Her business etiquette
articles have appeared in more than 15 different national publications. Her most
popular books, Mosby’s Diagnostic and Laboratory Test Reference (14th ed.) and Mosby’s
Manual of Diagnostic and Laboratory Tests (6th ed.), have sold almost 2 million copies,
with translations in Chinese, French, Greek, Korean, Polish, Portuguese, and
Spanish.
In her positions as patient care manager, military officer, faculty chair, academic
dean, and director on the board of a healthcare system, professional etiquette has
helped her handle a number of business challenges. She has enjoyed the privilege
of helping thousands feel more comfortable in professional and business situations
where they are in the spotlight and need to look and act their best.
Table of Contents
About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi
Foreword. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
1 Making Your Acquaintance. . . . . . . . . . . . . 1

Introductions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Elevator Pitch. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Shaking Hands. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Remembering Names . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Business Cards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Frequently Asked Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
2 Conversations and Networking for

Career Success. . . . . . . . . . . . . . . . . . . . . 19
Conversational Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
The Art of Small Talk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Networking. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Generational Differences in Communication. . . . . . . . . . . . . . . . . . . . 28
Transgender Issues/Concerns. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Mentoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Name Tags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Communicating With a Person Who Has a Disability . . . . . . . . . . . . . 33
Nurse-to-Nurse Collaboration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Nurse-to-Physician Collaboration. . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
The Patient Experience. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
3 When Talking to an Audience:

Presentation Essentials. . . . . . . . . . . . . . . . 49
Starting a Presentation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Closing With Impact. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
viii Etiquette & Communication Strategies for Nurses, Third Edition
Targeting Your Audience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

Planning With the Analog Approach. . . . . . . . . . . . . . . . . . . . . . . . . 56
Determining Your Core Message. . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Harnessing Your Passion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Avoiding a Data Dump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Using Stories and Case Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Citing Quotes and Statistics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Adding Humor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Ending on Time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
The Value of Practice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
How to Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Getting Feedback. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Knowing When You’re Ready. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Managing Fear and Anxiety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Avoiding the Seven Deadly Speaker Mistakes . . . . . . . . . . . . . . . . . . 72
4 Your Professional Presence . . . . . . . . . . . . 77

Professional Clothing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Dressing in the Clinical Setting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Body Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
5 Interviewing. . . . . . . . . . . . . . . . . . . . . . . 91
Preparing for the Interview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Professionalism During the Interview . . . . . . . . . . . . . . . . . . . . . . . . . 96
After-Interview Professionalism . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Phone Interviews. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Frequently Asked Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
6 Meetings Still Matter. . . . . . . . . . . . . . . . 111

Planning and Preparation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Reasons Not to Have a Meeting. . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Table of Contents ix
Chairperson Etiquette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

Etiquette for Participants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Introductions and Seating. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Follow-Up Actions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Serving Food and Refreshments . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Virtual Meetings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
7 Communication Technology. . . . . . . . . . . 133

Email Etiquette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Telephone and Speakerphone Etiquette. . . . . . . . . . . . . . . . . . . . . . 141
Cellphone Etiquette. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Voicemail Etiquette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Text Messaging Etiquette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Fax Machine Courtesy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
8 Avoiding Social Media Blunders . . . . . . . 153

Social Media Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Complying With HIPAA on Social Media. . . . . . . . . . . . . . . . . . . . . 156
Facebook. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Twitter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
LinkedIn. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Instagram. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
Snapchat. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Pinterest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
Blogging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
9 Mingling Among the Cocktail Set. . . . . . . 181

RSVP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Greetings and Courtesy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Small Talk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
x Etiquette & Communication Strategies for Nurses, Third Edition
Alcoholic Beverages and Hors d’Oeuvres . . . . . . . . . . . . . . . . . . . . 188

Wine Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Beer Drinking. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Tasteful Toasting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
0 How Dining Etiquette and Business

1
Success Go Hand-in-Hand. . . . . . . . . . . . 197
RSVP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
Place Settings and Dining Utensils. . . . . . . . . . . . . . . . . . . . . . . . . . 198
Bread and Butter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Soup and Salad. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
The Main Course . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Coffee & Tea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
Paying the Bill. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
International Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
11 Thank-You Notes and Business Letters. . . . 217

Thank-You Notes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
Business Letters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222
Memos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
12 Writing for an Audience . . . . . . . . . . . . . 233

Why Write?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Getting Started. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Query Letters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
The Writing Process. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
Motivational Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Table of Contents xi
13 Flying for Success. . . . . . . . . . . . . . . . . . 249

Packing With Precision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Air Travel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Car Travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260
Hotels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
14 Going Global. . . . . . . . . . . . . . . . . . . . . 269

Basic Preparations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
Making Introductions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274
Conversations and Networking. . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Dining and Drinking Etiquette. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278
Gift Giving. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
Social Taboos. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
Travel Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
15 Putting It All Together. . . . . . . . . . . . . . . 291

Purpose Drives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292
Protocol Facilitates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Passion Propels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
References. . . . . . . . . . . . . . . . . . . . . . . 297
Index. . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Foreword
Have we met? Even if we have, I probably forgot your name almost instantaneous-
ly after having heard it. I’m shy and that makes me nervous. I missed your name
because I was thinking about what we might have in common to talk about next.
If this is a cocktail reception, I have the added stress of knowing that I must talk to
many more people yet tonight. I will not remember their names either.
My mother taught me manners. I am a master of saying “Please” and “Thank you.”

Why does that provide me with little comfort when it is time to network or when
someone asks me to tell them about myself? Perhaps that is why I was so smitten
with professional etiquette after I read Kathleen Pagana’s book. This book filled in
the gaps in my knowledge that I did not even know existed. Once I was armed with
the knowledge of professional etiquette, I began applying what I had learned, and
I became more confident. Now if I tell someone that I am shy, they do not believe
it! As Thomas Merton said, “We are not converted only once in our lives but many
times, and this endless series of conversions and inner revolutions leads to our
transformation.”
It was this revelation that motivated me to begin talking to my colleagues about

teaching nursing students comportment and etiquette. Some laughed at me. When
I led the creation of a professional development co-curriculum for the college of
nursing, it was originally dubbed “charm school” and was viewed as antiquated and
unnecessary. As nursing faculty, we prepare students to become registered nurses.
However, we are not necessarily preparing future nurses for the business of health-
care. Ask any seasoned nurse and they will tell you that healthcare is, indeed, a
business.
Students in business majors are prepared with skills related to branding, network-
ing, interviewing, socializing outside the office, and interacting with global part-
ners. This is not part of the standard nursing curriculum in the United States, yet
it needs to be if nurses are to advance and successfully navigate the business setting
in which the practice of nursing is situated. Nurses enter clinical practice believing
they are 100% prepared to advance in their career. They do not even know what
they do not know!
Yet, as I watch nursing students who have participated in the professional develop-
ment program walk with confidence to a potential contact, shake hands, and begin
to talk about themselves and what they want in their career, I see the results that
knowledge and skill related to professional etiquette yields.
xiv Etiquette & Communication Strategies for Nurses, Third Edition
I got to know Kathy when I invited her to present on the topic of dining etiquette.
She guided the students through a deliberately challenging three-course meal,
sharing insights on etiquette as well as conversation tips. This is now the most
popular portion of the professional development curriculum. Students can apply
this knowledge to personal and professional settings. Students report how they have
used dining etiquette when meeting their romantic partner’s parents over dinner.
They are applying these skills during dinners where nursing recruiters try to woo
them to their health system. Did I mention that nursing recruiters are actively and
aggressively recruiting these students? Kathy and I have discussed that the reason
may be that professional etiquette has given these students the polish that sets them
apart from the crowd.
You, too, can employ professional etiquette to obtain a position, keep it, or to
advance. Kathy’s content is engaging and easy to read. The question and answer
format with tip boxes, charts, faux pas, and good idea sections allows you to read
quickly but provides a focused and thorough coverage of each topic. It is what you
need to know without a lot of fluff. Her approach is fun and informative. Kathy’s
guidance on presenting, leading meetings, writing an article, and successfully nav-
igating cultural differences will assist you in developing or refining new skills. You
may even develop the confidence to venture into new roles, network with others, or
connect through social media outlets.
If you have picked up this book, you either recognize or are starting to recognize
the importance of professional etiquette in your nursing career. Whether you have
made a serious gaffe that has illustrated the importance of etiquette or simply wish
to learn more, reading this book is an important step in your path to both personal
and professional future success. Thanks to Kathy’s book, if we meet at a cocktail
reception in the future, we will both be a little better at remembering each other’s
names, and if we do forget, we will know how to handle it!
–Anne M. Fink, PhD, RN, CNE

Assistant Dean for College and Student Services
Director of the LEAD Professional Development Program
Villanova University M. Louise Fitzpatrick College of Nursing
Introduction
Although nursing education has been focused on leadership, management, and
professional issues, etiquette has been the missing link for success in the workplace.
This book describes how to get a job, keep a job, and move ahead in a job. It will
prepare you to handle awkward and challenging situations that could diminish
your confidence, tarnish your reputation, and derail your career aspirations. After
reading this fun and enjoyable book, you will be able to interact more effectively
in clinical, business, and social settings. You will be amazed at how often you will
think, “I didn’t know how much I needed to know.”
The premise of this book is that everyone can become an expert in etiquette. Fur-
ther, the better you become at it, the more you will be sought after for opportuni-
ties and positions. In these pages, you will find a reality check for those playing (or
about to play) the toughest sport of all—survival in a business world that is often
unforgiving and highly critical.
Why is etiquette important for nurses? Etiquette is about relationships. Nursing is

a career characterized by professional relationships with all kinds of people in all
kinds of settings. As more and more healthcare professionals move into top leader-
ship positions, you can be certain that etiquette skills are part of their power base.
By using the guiding principles of kindness, consideration, and common sense, pro-
fessional etiquette can help you initiate new relationships and enhance established
relationships. It can guide you in unfamiliar situations and help you know what to
expect from others. For example, this book can help you in the following situations:
• Interviewing successfully for a new job or position
• Introducing yourself and others with confidence
• Demonstrating proper handshake and business card etiquette
• Networking effectively on the job and at conferences
• Knowing how to run a productive meeting
• Learning how to create an online persona
• Dressing to mirror your professional image and responsibilities
• Sending a positive impression with thank-you notes and letters

xvi Etiquette & Communication Strategies for Nurses, Third Edition
• Using email, phones, and faxes in a courteous and professional manner
• Using social media to further your career
• Demonstrating leadership skills and advancing your career when giving

presentations
• Standing out from the crowd by writing an article
• Dining with confidence in any business or social setting
• Increasing your comfort and self-confidence during business travel
• Appreciating and respecting cultural differences in global interactions
There are no other etiquette books targeted at and customized for nurses. This
book contains key business etiquette content with an application to professional
nursing. It will help you level the playing field in your interactions with others.
Key Features
Each chapter challenges the reader with a series of DO YOU: questions.
DO YOU:
• Know what to do when you meet a colleague whose name you have
forgotten?
• Know how to introduce your spouse to your boss?
• Have trouble remembering names?
• Have a prepared and practiced elevator pitch?
• Know what to do if a client ignores your attempt to shake hands?
• Wonder when it is appropriate to give out your business card?
Introduction xvii
A unique feature of this book is its organization in a question-and-answer format.

This allows you to target what you need or want to learn or review.
Is there anything that can be done about sweaty hands?

Yes. Spray them with an antiperspirant once a day. This usually takes
about 24 hours to become effective. If that does not work, see your
physician.
What is a two-handed handshake?

In this situation, one person’s right hand shakes the other person’s
right hand, and the left hand is placed on the other person’s body.
The most common left-handed positions are on the wrist, forearm,
bicep, shoulder, or neck. The higher the left hand moves up the
body, the greater the possibility for manipulation and control. For
example, a left hand clasped around the neck may imply intimacy or
ownership (Brown & Johnson, 2004).
The business card

TIP is often described
Tips point out important points for you to as the handshake
remember. you leave behind.
Make sure you leave
a good impression.
Good Idea!
Faux Pas and Good Idea! boxes provide stories about
embarrassing and positive actions, respectively.
Faux Pas
The globe icon denotes material that explains how

etiquette may differ in other cultures.
xviii Etiquette & Communication Strategies for Nurses, Third Edition
Tables help itemize and illustrate concrete information.
1.1 Pecking Order for Introductions
Higher Ranking Lower Ranking

VP of nursing New nurse
10-year employee Two-year employee
Father Daughter’s boyfriend
Your boss Your spouse
Peer in another office Peer in your office
Client Colleague
Helpful frequently asked questions (FAQs) are included in each chapter.
? What do I do if I am being introduced to someone and that person

sneezes into his right hand and then extends that hand for a hand-
shake?
You can shake the person’s hand and then go to the restroom and wash
your hands. Or, you can say you are getting over a cold and would prefer
not to shake hands.
Each chapter ends with “Take-Away Tips.”
TAKE-AWAY TIPS
• Make an effort to remember names when meeting people.
• The most important thing to remember about introductions is to make

them.
Introduction xix
Finally . . .
“I never knew etiquette could be so much fun” is the most common response of
people attending my professional etiquette presentations. The goal of this book is
for you to learn (or recall) some career-enhancing material and to have fun at the
same time.
You have nothing to lose and everything to gain by reading this book. As an exam-
ple, Tom Corley (2016) did research on 177 average people who became self-made
millionaires. Five key strategies that helped people get ahead are part of this book.
The skills you learn can be put into practice immediately for career advancement
and lifelong value.
Professional etiquette is not optional for personal or professional success. It is an

essential part of your power base. You can benefit every day in clinical, business,
and social settings by using Etiquette & Communication Strategies for Nurses to come
across as polished, confident, and professional.
1 Making Your Acquaintance 1
1
MAKING YOUR ACQUAINTANCE
Handling Introductions
DO YOU:
• Know what to do when you meet a colleague whose name you have
forgotten?
• Know how to introduce your spouse to your boss?
• Have trouble remembering names?
• Have a prepared and practiced elevator pitch?
• Know what to do if a client ignores your attempt to shake hands?
• Wonder when it is appropriate to give out your business card?
These are concerns that can add to the stress of any situation where you are meet-
ing and greeting new people. Who hasn’t felt awkward during an introduction?
You will feel and act more confident if you understand the basic guidelines, and
you can improve your interactions with others by practicing these tips for making
introductions and creating a positive first impression.
2 Etiquette & Communication Strategies for Nurses, Third Edition
“Civility costs nothing and buys

everything.”
–Lady Mary Wortley Montagu
Introductions
Does it really matter who is introduced to whom in
an introduction?
Yes, it does. There is a pecking order to introductions. The person of honor is
mentioned first, and then the other person is introduced. The person of honor is the
higher-ranking person in the organization. For example, suppose a new graduate is
being introduced to the vice president of nursing at a hospital. The vice president of
nursing is mentioned first, and then the new nurse is presented or introduced.
What are the key steps of an introduction?

Introductions have three steps.
1. Mention the name of the person of honor first.
2. Say the name of and mention something about the person being introduced.
3. Say something about the person of honor.
Here is an example of a proper introduction, following these three steps:
“Theresa, I would like to present Ryan Deska. Ryan is our new

staff nurse with three years’ experience in orthopedics. Theresa
Williams has been our VP of nursing for the past five years.”
Sometimes, when you introduce two people, you will want to facilitate a conversa-
tion between them. Here is a way to facilitate conversation after an introduction,
using the preceding example:
“Theresa, I would like to present Ryan Deska. Ryan is our new

staff nurse with three years’ experience in orthopedics. He is also a
marathon runner. Theresa has been our VP of nursing for the past
five years. She is training for her first marathon.”
If you are not sure about the pecking order when making introductions, Table 1.1
can help.
1.1 Pecking Order for Introductions
Higher Ranking Lower Ranking

VP of nursing New nurse
10-year employee Two-year employee
Father Daughter’s boyfriend
Your boss Your spouse
Peer in another office Peer in your office
Client Colleague
When should I introduce myself?

Always be ready to introduce yourself. None of us is
a famous movie star with face and name recognition. Never approach
Don’t stand next to someone, waiting to be intro- TIP someone and say,
duced. The person you are expecting to introduce “Do you remem-
you may have forgotten your name. So, to avoid ber me?” Be consider-
embarrassing the person, just introduce yourself. Put ate. Put out your hand
out your hand and say your name. For example, say, “I and state your name.
don’t believe we’ve met. I’m Denise Miller.” Or, “Hel-
lo, I’m Denise Miller, and I am a nurse in Same Day Surgery.” The other person
should return your greeting and introduction. If the person does not give a name,
say, “And your name is?”
What should I do if I go blank and cannot remember

someone’s name when making an introduction?
This happens. Be honest about it. You can say, “I’m sorry, but I’ve forgotten your
name.” Or, “Excuse me, but I’m blanking on your name.”
One of my colleagues has asked me to introduce her via

email to a contact of mine. Any tips?
In this digital age, you will start seeing a lot more of this type of request. To handle
it, send an email to your contact that talks a little about your colleague and why she
would like to connect. Copy the email to your colleague, who should then follow up
with your contact.
Do you have any suggestions for introducing myself and con-

necting on LinkedIn?
I think the most important thing here is to personalize the request for connecting,
especially if you do not know the person. Tell the person why you are asking to con-
nect. For example, you might name a mutual friend who suggested the connection.
Elevator Pitch
What is an elevator pitch?
An elevator pitch is a short speech that sells an idea, markets an individual, or pro-
motes a business. The term is a metaphor for when you gain unexpected access to
someone to whom you would like to sell an idea or proposal. Essentially, you should
be able to explain a business proposal in an elevator in the time it takes to ride a few
floors. A great elevator pitch describes and sells an idea in less than a minute. Of
course, it is not restricted to elevators.
What is the desired outcome of a good elevator pitch?

With an elevator pitch, the goal is to capture someone’s attention so you can move
to the next step—a referral, a follow-up call, a meeting, or a partnership.
Why would a clinician need an elevator pitch?

The ability to sum up your service or expertise in a unique way is fundamental for
any professional. When someone asks you what you do for a living, a well-planned
elevator pitch can make the listener perk up and want to know more. Here are some
examples of when a good elevator pitch would be helpful:
• When attending a recruitment fair and hoping to get an interview at a certain

medical center
• When finishing a degree and hoping to be considered for a new position
• When writing an article and hoping to present the topic at a conference
• When planning to expand a consulting service
What are the key components of an effective elevator pitch?

To write an effective elevator pitch, you must know yourself, what you can offer,
and what benefits you can bring. For example, perhaps you are an expert in pro-
fessional communication and know strategies that you can teach others to foster a
better workplace environment.
Follow these guidelines for your elevator pitch (Pagana, 2013c):
• Keep it short. Limit your pitch to 60 seconds.
• Have a grabber. This could be a question, gesture, statistic, anecdote, or

personal experience intended to capture the listener’s attention and pique the
person’s interest.
• Demonstrate your passion. Your energy will help sell your proposal.
• Make a request. For example, do you want to schedule a meeting? If so, ask.
The person may be able to give advice on whom to email for further informa-
tion or whom to contact to set up a meeting.
• Practice. Rehearse so that when the opportunity arises, you are ready.
Shaking Hands
Am I judged by the quality of my handshake?
Yes, you are. You want to present a confident, firm handshake. Those few seconds
you shake hands can weaken or empower a relationship.
The handshake is part of creating a first impression and sending a parting message.
Follow these three steps for a proper handshake:
1. Extend your right hand horizontally with your thumb up. Do not cup your
hand.
2. Engage a person’s hand web-to-web with a firm grip. The web between
your thumb and index finger should be touching the other person’s thumb
web.
3. Shake two or three times and drop your hand.
See Table 1.2 for tips on handshake etiquette.
1.2 Handshake Etiquette
Do Don’t
Stand up. Remain seated.
Make eye contact. Shake with limp, damp fingers.
Offer a firm grip. Squeeze the other person’s hand too tightly.
Smile. Turn the person’s hand over.
Be considerate of personal Refuse or forget to shake hands.
space issues.
“A firm, hearty hand-

shake gives a good
first impression,
and you’ll never be
forgotten if you don’t
live up to it.”
–P. J. O’Rourke
Is there anything that can be done about sweaty hands?

Yes. Spray them with an antiperspirant once a day. This usually takes about 24
hours to become effective. If that does not work, see your physician.
What is a two-handed handshake?

In this situation, one person’s right hand shakes the other person’s right hand, and
the left hand is placed on the other person’s body. The most common left-handed
positions are on the wrist, forearm, bicep, shoulder, or neck. The higher the left
hand moves up the body, the greater the possibility for manipulation and control.
For example, a left hand clasped around the neck may imply intimacy or ownership
(Brown & Johnson, 2004).
Coming from someone you have just met, the two-handed handshake should alert
you to the possibility of a controlling or manipulative person. However, this may
be perfectly acceptable for friendly, long-term colleagues. Table 1.3 lists handshake
variations and their possible interpretations.
1.3 Handshake Variations and Possible

Interpretations (Brown & Johnson, 2004)
Handshake Possible Interpretation

Dead fish (cold and clammy) The person has a passive personality and
low self-esteem.
Pull-in (holds onto your hand The person is maneuvering you and wants
and moves you) to place you somewhere.
Hand on top (palm facing The person with the palm facing down
down) wants to be in control.
Finger squeeze The person wants to keep other people at
a comfortable distance.
Twister (grabs your hand and The person wants you in a submissive
twists it under his) position.
Bone crusher (extreme finger The person equates brute strength with
squeezer) power.
Does gender play a role in handshaking?

In the US, business is gender-neutral. A man or a woman may initiate the hand-
shake. However, at social gatherings, it is often considered prudent for a man to
wait for a woman, especially an elderly woman, to offer her hand. When shaking
hands with the elderly, take your cue from their grip and respond with similar or
less pressure.
What should I do if someone ignores my attempt to shake

hands?
Gently drop your hand back to your side. There are many cultural preferences and
sensitivities that affect a handshake. For example, in the Hindu culture, contact be-
tween men and women is avoided, and men do not shake hands with women. There
also may be physical limitations or sickness issues.
What should I do if my religion prevents me from

shaking hands with a man?
If a man extends his hand to shake, nod your head in acknowledgment and use
words to express the respectful greeting the handshake would have meant. For
example, “It’s a pleasure to meet you. Please excuse me for not shaking hands.” You
are acknowledging that you are doing something different than expected.
What should I do if the person I am meeting has a right hand

injury or is otherwise unable to use it?
Greet the person and then follow her lead. If the person offers you her left hand,
shake with your left hand.
What should I do if I am concerned about getting germs from

shaking hands?
You have two options here. You could say you are getting over a cold and do not
want to spread any germs. Or, you could shake hands, keep your hands away from
your face, and then (when possible) politely excuse yourself to wash your hands.
Should I shake hands if I am ill?

No. You should avoid close contact and the risk of infecting others if you are sick.
It is polite to offer an excuse for not shaking hands. For example, “Please excuse me
for not shaking hands. I have a cold.” That will be appreciated.
Does handshake etiquette differ in other countries?

Yes. If you are traveling to other parts of the world, do some research before leav-
ing home. For example, in Germany, a man should wait for a woman to extend her
hand for the handshake.
As another example, it may be insulting to look a person of Asian descent straight

in the eye. For more information about international considerations, see Chapter
14, “Going Global.”
Remembering Names
I am terrible with names. How can I get better?
Here are some tips for remembering names:
• Listen carefully. Often, we are more interested in impressing others than in

listening to and focusing on them.
• Repeat the person’s name. For example, say, “It is a pleasure to meet you,
Arlene.”
• Try to connect the person’s name to someone. For example, “Margaret.

That is also my mother’s name and my middle name.”
• Try to connect the name to something. For example, think, “Rose has red
hair like my rose bushes.”
• Ask the person to spell or repeat her name. For example, say, “Do you
spell Katharine with a C or a K?”
• Look at the person’s name tag during the introduction. This will help
you remember it as well as learn how to spell it.
• Write down the person’s name or ask for a business card. This will help
you remember names for the long run.
• Ask the person for a helpful way to remember how to pronounce his
name. For example, when people ask me how to pronounce Pagana, I tell
them to think of the word banana. Then say, “Pah-gann-a” like “bah-nann-a.”
Another way to help you remember names is to use the acronym CAR:
• Concentrate on hearing and remembering the name.
• Associate the name with something or someone.
• Repeat the name in your conversation.
What if I met someone before and forgot the person’s name?

Say something like, “I met you before. I am not good with names. My name is
_____.” The other person should say her name. Another option is to say, “I remem-
ber meeting you but have forgotten your name. My name is _____.”
If someone mispronounces my name, should I grin and

bear it?
No. It is a kindness to correct the person right away in a casual and friendly man-
ner. Any delay may add to the person’s embarrassment. You could also smile and
say, “I’ve had people pronounce my name many different ways, but the correct way
is _____.” Your smile implies that you don’t take the mistake personally.
Faux Pas
Dorothy frequently called the medical office of Dr. Nguyen. She pronounced the
name “Nu-gen” with a long “u.” Several weeks later, she learned from a colleague
that the correct pronunciation of the doctor’s name was “When.” She called the
office to apologize and was told that the staff had been getting a good laugh out
of this mispronunciation for weeks. She was embarrassed and wished they had
been more considerate and corrected her right away.
Business Cards
Do I need a business card?
Yes. Business cards are a great way to capture essential information in a quick and
user-friendly manner. Every professional needs a business card for networking.
Patients love having business cards from their healthcare providers. It gives them
important contact information.
You can attach a business card to any report or note you send. This lets the person
know that you are the sender and provides your contact information.
Are business cards still important to the younger generations?

According to young executives, not as much. Many are more likely to find some-
body on LinkedIn rather than get their business card. This is because people move
around now so much that the odds of their LinkedIn page being up-to-date are
better than a personal contact list (J. H. Bullen IV, personal communication, 2019).
What information should be on my business card?

That will depend on the purpose of the card. Some basics include your name,
degrees, position, and contact information, including your mailing address, phone
number, email address, and fax number. If your name is ambiguous (such as Pat or
Terry), use your full name (Patricia/Patrick or Teresa/Terrance) if applicable, or add a
title (for example, Mr. or Ms. Pat Smith).
If you are trying to promote a service—for

example, serving as a writing consultant—
make sure that is included on your card. Also
include your website if you have one.
Don’t cram unrelated information on your

card. If you have a side job or hobby, you
should have two different cards. For exam-
ple, your professional information and your
cake-decorating business need separate cards
(Pagana, 2006d).
Many nurses include after their names a confusing alphabet

soup of letters for their academic and certification credentials.
Is this a good idea?
According to Smolenski (2002) and Papandrea (2017), this “Campbell’s approach”
can be confusing to the public, other healthcare providers, and nurses themselves.
There are basically six types of credentials that can be used after a name:
• Degree (for example, BSN, MSN, PhD, DNS, EdD)
• Licensure (for example, RN, LPN)
• Advanced nursing specialty (for example, CRNA, CRNP)
• National certification (for example, OCN [oncology certified nurse])
• Awards of honor (for example, FAAN [Fellow of the American Academy of

Nursing])
• Other certifications (for example, certification for computer skills)
For individuals with multiple credentials, Smolenski (2002) and Papandrea (2017)
recommend the general rule of following the name with the highest credential that
cannot be revoked. Then, list in descending order the other credentials from hardest
to easiest to be taken away, with awards or fellowships last. To clarify this rule,
let’s use Janet Swingler, PhD, RN, APRN, as an example. The PhD degree is
permanent—cannot be taken away. The RN licensure could be revoked, and the
APRN certification could be taken away if the licensure is lost.
Janet could certainly list additional degrees and credentials if it would help her when
applying for a particular position. However, usually only the highest earned degree is
used. It is not necessary to use PhD, MSN, and BSN.
Is it OK to make my own business cards?

Only if that is the only way you will get a card.
The business card
Homemade cards look homemade. There are web- TIP is often described
sites that offer free cards for a minor shipping charge.
as the handshake
Keep in mind that a business card is one of the first you leave behind.
graphic impressions of you and your services. Make a Make sure you leave
good impression with a professional business card. a good impression.
How should I carry my business cards? Good Idea!

It is best to use a business-card holder or something Recently, a colleague
else that will keep the cards in good condition. A cheap asked me if I wanted
and simple solution is to use a plastic name-tag holder. to run with her in a
race to support a
Make sure the card you give is in good condition.
cardiac center. When
Don’t use a card if it is soiled, bent, or ripped because
I asked for details,
the card will not reflect a positive impression of you. It
she wrote the website
is better to give no card than to give one that is in bad address on the back
condition. of her business card
Develop a system for handling your business cards. and asked me to call
her with any questions.
For example, keep the cards you give out in your right
Isn’t that better than
pocket and place the ones you receive in your left
writing on a table
pocket. This will prevent you from accidentally hand-
napkin?
ing out someone else’s card.
Is there a proper way to pass out a Faux Pas

business card? Mike was eating lunch
at a national nursing
Yes. Cards should be presented with the content face convention. At the end
up and readable. The receiver should be able to glance of the meal, a new
at the card and make a comment—for example, “I see colleague asked him
you’re the clinical nurse specialist in the ICU.” for his business card.
Mike took his wallet
from his back pocket
What are some common mistakes that and pulled out a warm,
people make with business cards? mushy business card.
He quickly learned
Here are some common mistakes (Pagana, 2007a):
that his cards were not
• Passing out your cards as if you are dealing stored in a professional
a deck of cards: You want to be asked for your manner.
card. To achieve this, ask for the other person’s
card first and he will most likely ask for yours in return.
• Writing on someone’s card without asking permission: In some parts of

the world, such as Japan, the business card is viewed as a representation of the
owner. You deface the card if you write on it without permission.
• Not having your cards with you: You never know when someone will ask
for your card. Keep them with you at all times. If you are caught without
your card, you can send your contact information by a text message or email.
• Not having a card and asking for someone else’s card to write on the
back: This is rude. Jot your information on a piece of paper.
Faux Pas
Karen was relaxing in the hotel lobby after attending a conference in Los Angeles.
She met another nurse, Betty, who was in the process of setting up an ambulatory
surgery center. Betty asked Karen for a business card. Karen did not have her
cards with her, so she asked for one of Betty’s cards, crossed out Betty’s informa-
tion, and wrote her contact information on the back of the card. Karen did not
realize that this was rude.
Does business-card etiquette differ around the world?

Yes. Check this out before leaving home. See Chapter 14 for examples.
Note also the way business cards are presented. This differs around the world. If
someone presents you with a card, follow the person’s lead when presenting your
card.
Good Idea!
Recently, a new family moved into our neighborhood. As they met the neighbors,
they gave everyone a business card with their names (parents and children),
address, and phone number. What an impressive way to meet new neighbors and
be remembered!
Frequently Asked Questions

? What if I am introducing my boss to my new staff member and I
mention the staff member’s name first?
Just continue with the introduction and try to remember the proper pecking
order the next time. The most important thing about introductions is to make
them.
? What should I say about myself when I introduce myself?

This depends on the situation. If you are meeting someone in a work-related
setting, mention your position in the organization. If it is a social situation,
mention something pertinent to the setting. For example, if you are at a
neighborhood party at Mike’s house, you might say, “My name is Ella
Gaul. Mike is my next-door neighbor.”
? What should I do if I forget the name of someone I need to

introduce to another person?
One answer is to introduce the person you already know. For example,
say, “I’d like you to meet Donald Smith.” This will usually result in the third
person introducing himself or herself. Alternatively, you can say, “I’m sorry,
but I’ve forgotten your name.” Then, make the introductions.
? My manager and I will be riding together in the car to a lunch

meeting at our branch campus. Is this an appropriate time to bring
up a proposal I have been thinking about?
Yes. This is the perfect opportunity to use your elevator pitch. Hopefully, you
can capture the manager’s interest and plan a follow-up discussion.
? I have heard that it is a good idea to be the last one to release your
hand from a handshake. What do you think?
Some experts consider the pause at the end of a handshake a key
ingredient of a successful handshake. Pausing demonstrates confidence and
expresses sincerity and openness.
? Should a man wait for a businesswoman to extend her hand first

for the handshake?
Not anymore. American business is now gender-neutral. However, in a
social setting, a man often will wait for a woman to extend her hand first.
Handshaking etiquette is different in other cultures.
? What do I do if I am being introduced to someone and that person

sneezes into his right hand and then extends that hand for a hand-
shake?
You can shake the person’s hand and then go to the restroom and wash
your hands. Or, you can say you are getting over a cold and would prefer
not to shake hands.
? What do you think of having more than one business card?

This is a great idea if it will help you target your business to a specific
audience. For example, if you are a part-time freelance writer, it would be
great to have a card related to that—one that is separate from your main
job.
? Is it OK to use up my supply of business cards if some of my contact

information has changed?
Only use them as a temporary measure while you are waiting for your
updated ones. Then, throw away the outdated cards. Next time, arrange to
get new cards before your information changes.
? Is there any way to personalize my business cards?

Yes, business cards can benefit from a personal touch. For example, you
might add your cellphone number on the back if you are hard to reach
when traveling. It is a thoughtful gesture that will be appreciated.
? What do I do with the business cards I collect after an event?

On the back of the card, note where you met the person and any pertinent
information that you want to remember. Also add the date. If you have a lot
of cards, photocopy them on one or two pages. Write the date and event
name on the top of the paper. Some people have a card reader and enter
them electronically into a database. Cards can also be placed in storage
sheet protectors with slots for business cards. These business card pages
can hold 10 cards on a side and can be put into a binder. If you only put
one card in each slot, you can read any pertinent information you wrote on
the back of the card.
? What should I do if someone does not have a business card, and I

would like to have the person’s contact information?
Take one of your business cards and cross out your information on the front.
This will prevent you from accidentally giving this card to someone else.
Then write the other person’s contact information on the back.
? I recently graduated after a long climb up the ladder. As a result, I

have obtained many degrees and licenses (LPN, RN, AA, AS, BSN,
MSN). What should I include after my name when giving a
presentation?
Put your highest degree and your professional licensure after your name.
The highest degree assumes the prerequisite degrees. For example, I would
use “Deborah Tooney, MSN, RN” or “Deborah Tooney, RN, MSN.” If you
are speaking to a group of LPNs, you could add the LPN to connect with
the audience.
TAKE-AWAY TIPS
• Make an effort to remember names when meeting people.
• The most important thing to remember about introductions is to make

them.
• Practice your elevator pitch and be prepared to use it.
• People are judged by the quality of their handshake.
• The handshake is the only socially acceptable form of touch that can be
used in a business situation with a person of the same or opposite sex
without raising eyebrows. This is especially important in light of the “Me
Too” movement, with politicians and others being criticized for unwanted
hugging and kissing.
• A business card is sometimes described as “the handshake you leave

behind.”
• Present your business card with the content face up and readable to the
recipient.
• The person who receives a business card should look at it and make a
comment.
2 Conversations and Networking for Career Success 19
2
CONVERSATIONS AND
NETWORKING FOR CAREER
SUCCESS
When Talk’s Not Cheap
DO YOU:
• Know how to start a conversation during a networking opportunity?
• Need to improve your listening skills?
• Wonder if a certain topic is safe to bring up?
• Know the proper placement of a name tag?
• Know what comments may be offensive to a transgender individual?
• Know how to gracefully exit a conversation when it is time to move on?
These are concerns that most people have in networking situations.

Unfortunately, with today’s emphasis on electronic communication, we have
neglected some of our interpersonal skills. This has weakened our confidence and
skill in face-to-face communication. As an example, think of going to a gym. Note
the number of people with earphones. They do not even say “hello” to others.
The ability of nurses to connect with colleagues, clients, and coworkers is essential
for success. Read on for some tips designed to make you more confident and
professional both at work and in social situations.
Conversational Topics
What topics are safe for conversation?
When you are making new acquaintances within a professional setting, avoid
controversial topics. See Table 2.1 for a list of safe and taboo conversational topics.
2.1 Conversational Topics
Safe Unsafe
Weather Politics
Sports Religion
Traffic Salary or cost of items
Travel Jokes of questionable taste
Movies and books Medical problems
Current events Gossip
Education Personal misfortunes
New developments in science Controversial issues
Is it OK to talk about children?

Yes—to some extent. If people ask about your children, answer briefly. Feel free
to ask about their children. Be careful to avoid monopolizing the conversation by
talking about all the great things your children are doing. Be sensitive to the fact that
some people may not be able to have children. People without children may also be
bored hearing about your children.
What are some attributes of a good conversationalist?

In addition to being polite and truly caring about others, a good conversationalist
does the following:
• Shows interest in others
• Keeps abreast of major news items
• Makes good eye contact when speaking
• Pays attention to body language
• Doesn’t pre-judge others
• Avoids correcting a person’s grammar in public
• Accepts compliments gracefully
• Knows how to pay a compliment
• Addresses everyone in the group
• Does not monopolize the conversation
• Knows how to make a shy person feel included
• Knows how to ask questions without prying
• Steps in to fill an embarrassing void in the conversation
“Your listeners won’t care how

much you know until they know
how much you care.”
–Anonymous
The Art of Small Talk

Is small talk really important?
Yes. Small talk is an easy way to start conversations until you find a common area
of interest or until business begins. It is used to break the ice and to make people
feel comfortable. Small talk is a gateway to new relationships and is important
for maintaining established relationships. There is nothing small about small talk
(Pagana, 2009a)!
Faux Pas
Marlene was interviewing for a faculty position. As part of her tour around
the campus, she was guided by Janet through the library. Marlene made no
comments and did not ask any questions throughout the tour. Her responses to
Janet’s questions were all one-word replies. When the dean met with Marlene, the
45-minute scheduled interview was completed in 15 minutes. Her awkwardness
was readily observable. She was uncomfortable and made the interviews
uncomfortable. All of Marlene’s evaluations were negative, and she was not
offered the position.
“One always speaks badly

when one has nothing to say.”
–Voltaire
Do you have any tips for breaking the ice with small talk?
Yes. To aid your conversation, use the acronym OAR:
• Observe. For example, “It looks like there are 500 people here.”
• Ask questions. For example, “Is this your first

time in San Diego?” Use the OAR
TIP strategy to initiate
• Reveal something about yourself. For exam-
conversations with
ple, “This is my fifth time attending the Sigma your patients.
Theta Tau Convention.”
Practice this technique. You can do this anytime and anywhere—while standing in
the cafeteria line with a colleague, waiting for a meeting to begin, or chatting with
the grocery store clerk at checkout (Pagana, 2013a).
Networking
How important is networking for career development?
Networking is about forming relationships. It is essential for career development
because these relationships can benefit you, the other person, your careers, and
your lives. These relationships connect you with new colleagues, new opportunities,
new information, and different professional practice settings. Think of networking
as part of your career, not an add-on if you have time (Pachter, 2013).
Don’t make the mistake of thinking that networking occurs only in a professional
setting. It can happen anywhere—on the train, at an art class, in the gym. You
might be chatting with someone who knows a key person who can help you obtain
your next position.
Networking is also facilitated by social media, such as LinkedIn. See Chapter 8,

“Avoiding Social Media Blunders,” for more details.
Good Idea!
Eloise flew to Chicago to interview for her dream job. While eating lunch, she
was chatting with the waiter about her reason for coming to Chicago. To her
surprise, the waiter’s father was the person she was scheduled to interview with
the next morning! She learned a lot of key information that made her interview a
great success.
What are some ways to expand my network?

There are several ways to expand your network. Here are a few tips (Pagana,
2013a):
• Join professional organizations.
• Attend professional meetings.
• Use social media, such as LinkedIn.

• Join a health club or gym.
• Serve on committees and boards.
• Volunteer in your community.
Good Idea!
Kim was a new employee in a large company. She joined the company soccer
team and met many new friends. She volunteered to help coordinate the holiday
party. During the party, she was the master of ceremonies and introduced all the
company officers. This was certainly a great way to network and meet all levels of
people in a new position.
How can I prepare for a networking session at a

conference?
Networking is a powerful way to make new contacts and form new professional and
personal relationships. Prepare by being well-read. Read newspapers, magazines,
and key journals related to your conference or specialty. Find out who is going to
be there and plan to meet at least several new people. Also, research people online.
This is a great way to find out what they have done and any common interests.
Faux Pas
Donna, the executive director of a nursing association, was the closing presenter
at the annual state conference. She spent the day in her hotel room working on
her presentation and checking her email. Unfortunately, she missed hearing and
meeting the other invited speakers. The conference-planning team wanted to invite
one of the speakers to present at the national convention. Unfortunately, Donna
was unable to provide any feedback because she had missed the chance to
network with the other speakers and attendees.
What is the key to “working the room” at a business or

social event?
The key is to demonstrate respect, courtesy, and consideration for the feelings of
others as you stay alert for networking opportunities. Good manners are good for
business, and bad manners may mean no business.
Closed stance Open stance

Working the room does not entail flitting from If you can spot
person to person, handing out your business cards, TIP someone “work-
and pumping hands with as many people as possible ing a room,” that
in a short period of time. If you don’t care about person is doing it
people, they will easily sense your insincerity. wrong.
“I’ve learned that people will forget

what you said, people will forget
what you did, but people will never
forget how you made them feel.”
–Maya Angelou
How do I work the room?

The easiest person to approach is a single person standing alone. That person will
appreciate your walking up and introducing yourself.
If you see couples, take note if they are in an open or closed. If they are in an open
stance (standing side by side), feel free to approach and introduce yourself. If they
are in a closed stance (standing face to face), this implies they are having a private
conversation. Don’t approach them.
With groups of three, note the open or closed standing positions. Approach a
group with the open stance. If you observe a large group of four or more people
standing in a circle, that group is closed.
There are basically six ways that people assemble at a networking event:
• Standing alone
• The open two Even if you are a
• The open three TIP guest at an event,
act like a host.
• The closed two
When you think like
• The closed three a host, you act in a
different way. You
• Larger groups standing in a circle
will be more confi-
dent, purposeful, and
The first three types of groups will generally be certain.
welcoming. Avoid the latter three unless you know
someone in the group (Kintish, 2006).
What should I say as I approach a person or group that I

do not know?
Smile and say, “Hello, may I join you?” Then, introduce yourself and use small talk
to get acquainted.
What do I do if I hear myself talking too much?

You do not want to monopolize the conversation. You can demonstrate your
interest in others by letting them speak. Remember the old adage that you were
given two ears and one mouth for a reason. You want to listen more than you speak.
Table 2.2 lists common networking mistakes and how to avoid them.
2.2 Common Networking Mistakes and How to

Avoid Them
Networking Mistakes Tips to Avoid Mistakes

Skipping the networking reception Arrive early to mingle with other
at a conference guests or the speaker.
Approaching the event with a nega- Approach the event with enthusi-
tive attitude asm.
Focusing on your personal agenda Try to be a resource for others.

Networking Mistakes Tips to Avoid Mistakes

Forgetting your business cards Always carry your business cards
with you.
Not writing down pertinent Jot down notes on the back of a

information business card.
Connecting only with your friends Expand your network by making

new contacts.
Not following up afterward Schedule time afterward for

follow-up.
Drinking too much Drink responsibly.
What is the best way to handle a compliment?

Smile and graciously say, “Thank you.” You could add to this by saying, “Thank
you. I appreciate that.” Here are some helpful hints for giving or receiving a
compliment (Mitchell, 2004):
• Discounting a compliment makes you look unprofessional.
• Don’t feel compelled to return the compliment.
• Do not ask where someone bought an outfit or how much it cost.
• Do not brag about your designer labels.
• Make sure you are sincere when complimenting someone.
Are there cultural considerations for networking?

Yes. There are many cultural considerations, such as personal space, eye contact,
topics of conversation, handshaking, and use of the business card. If you know
who will be at a networking session, you should learn in advance about cultural
preferences and sensitivities. For example, Chileans stand very close when talking.
Chinese people may keep their eyes slightly averted as a sign of respect. See
Chapter 14, “Going Global,” for more guidelines on global etiquette.
How can I disengage gracefully from a conversation?

This is important when networking because your goal is to meet several people, not
to spend the entire time talking with one person. Here are some tips:
• Excuse yourself and say you are going to the restroom.
• Excuse yourself and say you have to make a phone call.
• Excuse yourself and say you need to touch base with a colleague.
• Say, “It was great speaking to you. I’ll let you have some time to speak to
others.”
• Say, “It was nice meeting you. I hope to see you later.”
• Say, “Well, Theresa, it has been nice talking with you. Will you excuse me? I
see my roommate over there, and I promised I’d catch up with her.”
• Introduce the person to someone else and then excuse yourself as you move
away.
• Keep your phone on vibrate at professional gatherings. If it should ring, apol-

ogize and move away to talk if you need to take the call.
Generational Differences in
Communication
Where do I start with generational issues in
communication?
A good starting point is to understand that differences exist between people of
different generations. These create both challenges and opportunities. Business is
all about building relationships. This can be harder when people come from other
generations. To begin, identify what generation you belong to, as well as what gen-
eration others belong to. Use the following guide (Jenkins, 2019; Post, Post, Post,
& Post Senning, 2014):
• Veterans: Born before 1945
• Baby boomers: Born between 1945 and the mid-1960s

• Generation Xers: Born between the mid-1960s and 1980
• Millennials: Born between 1980 and 1995
• Generation Z: Born in the late 1990s and early 2000s
How do I deal with different styles of communication?

Know where people are coming from with their communication style. For exam-
ple, veterans entered the workforce talking to one another in person, baby boom-
ers communicated by phone, Gen Xers use email, and millennials favor texting.
Generation Z is the first fully digital generation. YouTube is a must for companies
wanting to build a strong brand in the eyes of Generation Z talent (Jenkins, 2019).
Awareness and respect are the keys to working together. Awareness is especially
important for nurses, who work with colleagues and clients from different
generations.
Veterans may prefer face-to-face interactions. Boomers may prefer face-to-face,

telephone, or email. The younger generations prefer electronic communication
(Saver, 2011). However, don’t assume that all members of the same generation are
the same. There are many individual differences.
How do I determine how my colleagues prefer to

communicate?
Ask. Alternatively, follow their lead if they initiate the communication. For exam-
ple, if they sent you an email, respond by email. If they left a phone message, use
the phone.
Does multitasking affect communication?

This is an important example of generational differences. The younger generation
has grown up texting and doing several things at a time. To the older generation,
this behavior seems distracted, disorganized, and often disrespectful. Think about
this. Also, don’t forget the importance of eye contact when communicating face-to-
face.
Transgender Issues/Concerns
What is the best way to refer to transgender individuals?
The best way is to refer to people the way that they identify. If you don’t know what
pronouns to use, ask. It is important for all of us to support those struggling with
gender and other discriminatory issues.
What identity labels does the transgender community use?

They use many different terms to describe their experiences. Some examples include
transgender, transsexual, genderqueer, and cross-dresser. Don’t tell them what label
you think is best for them. They will determine what term fits them the best.
Is sexual orientation different from gender identity?

Yes. Sexual orientation refers to whom we are attracted to. Gender identity refers to
the person’s personal sense of being male or female. Transgender individuals can be
straight, gay, lesbian, or bisexual.
Is it acceptable to ask a transgender person to tell you their

“real” name?
No. For some, their real name is associated with a lot of anxiety. For others, it may
be a part of life they want left behind. If you already know the person’s prior name,
don’t share it without their permission. Likewise, don’t share photos of a person
before their transition without permission.
Are there any particular comments to avoid that can be hurtful

or insulting to transgender people?
Yes. Please avoid comments like the following:
• “You look beautiful. I never would have guessed you were transgender.”
• “You’re so brave.”
• “With a little makeup, you would pass much easier.”
• “You look great, but a voice coach would help you.”
• “You look like a real man. You are really hot!”
• “Have you had surgery yet?”
Mentoring
How can mentoring help with networking and career
development?
A mentor can be invaluable, helping connect you to people and opportunities. Listed
here are some of the benefits of having a mentor (Vance, 2011):
• Building your confidence
• Increasing your productivity
• Preparing you for leadership roles and other opportunities
• Developing your potential
• Increasing your career satisfaction
When is the right time to look for a mentor?

When you establish your career goals, you will know what you are looking for in a
mentor. Target a person with similar personal and professional aspirations.
How long does the mentoring relationship last?

Many of us think of a long-term relationship of mentoring over years or even
decades. But according to Vance (2011), mentoring can also include one-minute or
instant mentoring.
As a new graduate, I once asked an experienced nurse for help locating something
in the supply closet. She not only located the object for me but also went through
the entire closet and told me how everything there was used for patients. That one-
minute mentorship was invaluable! We can all be one-minute mentors for many
people.
Our hospital has an optional mentoring program for new

graduates. Should I join?
Absolutely. The first year at work is challenging for new graduates. Having a mentor
can help you learn about the hospital from an insider. The mentor can help you deal
with challenges and position you to meet your professional goals. Be sure to express
your appreciation to your mentor.
Are there mentoring problems that protégés should try to

avoid?
Yes. Problems with the mentoring relationship can occur. Here are some to try to
avoid (Vance, 2011):
• Unrealistic expectations: This can cause feelings of disappointment and

betrayal.
• Power and control issues: Power should always be used to enhance the
potential of the protégé rather than for manipulation or self-aggrandizement.
• Excessive competitiveness: This can weaken

Open, honest
trust and mutual sharing. TIP communication is
• Dependence: After receiving input, guidance, the foundation of
and encouragement, protégés should make a healthy mentoring
relationship.
their own decisions.
Name Tags
What is the proper placement for a name tag?
Place the name tag on the right side of your chest so it can be easily seen when
shaking hands. When you shake hands, thrust your right shoulder forward and
move your left shoulder out of the eye line of the other person.
If you are wearing a name tag on a lanyard, adjust the length of the string so it is
positioned at the upper part of your chest. It is awkward having to move your eyes
from a person’s face down the body to the navel
area to see the name tag. Also, check often to make
sure your name is facing out, not flipped over.
What credentials should a nurse in

a healthcare provider role wear on
a name badge?
At a minimum, a registered nurse should have RN
on a name badge. Patients have a right to know
who is taking care of them. If you list other letters,
it is your responsibility to educate others about the
meaning of your credentials.
Communicating With a Person Who

Has a Disability
Do you have any suggestions for communicating with a
person who has a disability?
Focus on the person and not on the disability. Here are some guidelines to avoid
offending someone with a disability (Brody, 2005; Mitchell, 2004):
• Avoid using the words victim, cripple, and invalid. Disability is preferred over
handicap.
• Ask if the person needs help with something before moving to help. Don’t
assume a disabled person cannot do something like open a door when in a
wheelchair.
• Be prepared to shake hands with a person who has a physical disability. Note
which hand the person extends for the handshake and respond in kind.
• Identify yourself as you approach a person who has a visual impairment.

Don’t raise your voice. If the person has a guide dog, don’t pet the dog with-
out asking permission. If the person is blind, make your presence known by
speaking and introducing yourself. When initiating a handshake, say some-
thing like, “May I shake your hand?” If the blind person initiates a handshake
and you cannot shake hands, explain why you can’t. For example, say, “I’d like
to shake your hand, but I am carrying several packages.” Say goodbye so the
person knows when you are leaving.
• If you are speaking with someone who has a hearing impairment, stand where
you can be seen. Stay within the person’s line of vision so the person can see
your lips. Reduce background noise. Speak directly to the person, even if an
interpreter is present. Add facial expressions. Listen patiently.
• Position yourself at eye level when speaking to someone in a wheelchair.

Never assume a person in a wheelchair cannot see, hear, or speak. Don’t
move a wheelchair out of reach of the person who uses it. Push a wheelchair
only if the person wants your help.
How can I ensure successful interactions with deaf and

hard-of-hearing patients?
To ensure successful interactions with deaf and hard-of-hearing (HOH) patients,
HOH patient and educator A. Kay Tyberg recommends the following (personal
communication, 2007):
• Deafness is an invisible disability. Do not be embarrassed when patients tell

you they are deaf or HOH.
• Speak face-to-face to the patient.
• Deaf and HOH patients can do only one thing at a time. So, for example, if
weighing the patient on a scale, do not ask other medical-related questions.
• Not every deaf or HOH patient is a skilled lip reader.
• It is inappropriate and rude to use the term deaf and dumb.
• Healthcare personnel should wear their name tag in the upper chest area so
patients can immediately identify their name and credentials.
• Post a sign above the patient’s bed indicating that the patient is deaf or se-
verely HOH.
• If the patient is hospitalized, nurses need to communicate to all shifts that the
patient is deaf or HOH.
• If the patient rings the call bell, do not respond over the intercom.
• While in the hospital, see if closed caption TV is available.
Can I ask family members of a deaf person to serve as

interpreters to save expenses?
According to the Americans with Disabilities Act, it is illegal for hospital personnel
to ask family members to serve as interpreters to curtail expenses. A sign language
interpreter should be provided upon the person’s request (Tyberg, personal
communication, 2007).
What is the best way to get the attention of a deaf person?

Physical touch is the normal way of getting the attention of a deaf or HOH patient.
Tap the person on the hand, arm, or shoulder.
Nurse-to-Nurse Collaboration
What are some tips for nurse-to-nurse communication?
Civility is the key word for nurse-to-nurse communication and interaction. Civility
is demonstrated in a clinical setting by nurses being courteous and polite with each
other. Their conduct should consistently show respect for others, make others feel
valued, and contribute to effective communication and team-building.
Incivility can be described as rude or disruptive behavior that often results in

distress (psychological or physiological) for the person targeted. Incivility can
progress through a wide range of behaviors, from eye-rolling all the way to physical
violence (Clark, 2013). Uncivil behavior has a negative impact on nursing job
satisfaction and turnover as well as patient safety and outcomes (Lower, 2007).
Table 2.3 lists examples of incivility in the workplace.
2.3 Examples of Incivility in the Workplace
Verbal Abuse Negative Behavior Physical Behavior

Making demeaning Humiliating a col- Throwing charts
comments league
Using condescending Scapegoating Assaulting someone
language
Making impossible Withholding informa- Punching a wall
demands tion
Expressing impatience Undermining staff Outbursts of rage
with questions morale
Insulting a colleague in Acting with a cultural Slamming doors
front of a patient bias
Telling ethnic jokes Spreading rumors Banging into others
(Lower, 2007)
Is incivility a new problem in healthcare?

No. It has been around for some time. However, the healthcare community is
increasingly making more of an effort to stop it. Here are three examples of how:
• The Joint Commission listed incivility and bullying as a sentinel event in

2009.
• State boards of nursing have sanctioned some nursing programs for this
problem.
• It would be unlikely for a hospital or medical center to attain or sustain Mag-

net status if this type of behavior exists.
What are some of the costs of incivility in healthcare?

There are many. Some of the most important are listed here (Clark, 2013):
• Increased stress
• Damaged relationships
• Lowering of self-esteem and morale
• Feelings of vulnerability
• Staff disengagement
• Staff turnover
• Lower productivity
• Decreased safety in the workplace
• Unsafe or compromised patient care
What behaviors promote a positive work environment?

Here are some ideas to promote a positive work environment:
• Greet colleagues with a smile and a “hello” when you arrive at work.
• Offer to help others.
• Thank people for helping you.

• Use polite language and good manners.
• Compliment others when appropriate.
• Avoid listening to gossip.
• Don’t be a complainer.
• Respond to phone calls, emails, or other forms of correspondence in a timely

fashion.
• Don’t interrupt conversations to respond to phone calls, emails, or text

messages unless they are urgent. If you must interrupt, ask permission and
apologize for the interruption.
• Participate in department events.
• Say “goodbye” to your coworkers when you leave the work setting.
How can I initiate tough conversations dealing with things

like tardiness, poor hygiene, bullying, and lack of teamwork?
Before confronting someone with a difficult topic, ask yourself three questions:
• What’s the problem?
• How do I feel about it?
• What do I want to be different?
Now you are ready to use the STOP strategy to guide you through difficult
conversations. Plan, prepare, and practice this conversation before confronting the
person. Here are the components (Pagana, 2014):
• State the situation or problem.
• Tell the person what you want.
• Offer an opportunity for a response.
• Provide closure (review, summarize, or thanks).

What is an example of the STOP strategy?

Here is an example for dealing with a staff member who is tardy:
• S: “Monday and Tuesday, you arrived 20 minutes late for work.”
• T: “I want you to be here at 6:45 a.m.”
• O: “Can we agree to this?”
• P: “Thanks. This will help us work together better.”
Nurse-to-Physician Collaboration
How can nurses better communicate and collaborate with
physicians?
The key to better communication with physicians is to remember that you are an
important member of the healthcare team. Research on Magnet hospitals shows
that improved collaboration between nurses and doctors leads to better patient
outcomes (Pagana, 2012a). Here are some tips:
• When you see a physician on the nursing unit whom you do not know, intro-
duce yourself and say, “I am the registered nurse taking care of _____.”
• Tell the patient that the physician is on the unit. This will give the patient an
opportunity to be ready and in position for an examination before the doctor
enters the room. The patient will also have time to think of concerns and
questions.
• Inform other nurses taking care of the physician’s patients that the doctor is
on the unit. This will give them time to organize their questions and con-
cerns.
• Make rounds with the physician and discuss pertinent care issues and needed
orders. If you cannot make rounds, have issues documented on a communica-
tion sheet.
• If the physician is covering for another physician, provide an update of the

patient’s hospital course. For example, say, “Mrs. Balon was admitted three
days ago for syncope. She had a pacemaker inserted two days ago and is hop-
ing to be discharged today.”
• Check the orders before the physician leaves the unit and clarify as needed.
• If the physician was called to the unit to handle an urgent situation, have the
physical assessment findings and updated vital signs available along with the
pertinent lab values. Put the patient in a position to be examined. Discuss the
concerns that led to the urgent call to the unit.
• If texting a physician regarding a patient, do not use patient identifying

information. Text a request to talk about a patient and ask the physician to
call you.
Why are some nurses reluctant to speak to physicians about

patient concerns?
Nurses and physicians are taught to communicate in different styles. Physicians
tend to be concise and get to the point quickly. Because nurses are taught not
to make diagnoses, they tend to be insecure about presenting their findings and
paint a broad picture of the situation when communicating with physicians. Often,
physicians become impatient with a lengthy and possibly rambling message (Tocco
& DeFontes, 2014).
Are there are guidelines to facilitate effective communication

with physicians?
Yes, there are several. I will give two examples. One is the SBAR technique, which
is widely used in healthcare (Pagana, 2012a). SBAR stands for the following:
• Situation: What is the reason for your concern?
• Background: Why was the patient admitted? What surgery or procedures

were performed?
• Assessment: What are the vital signs, lab results, and clinical findings?
• Recommendation: What would you like the physician to do or order?
For example, suppose you want to recommend an anxiolytic for your patient.
Here’s how you can use the SBAR technique to convey your recommendation to
the physician:
• Situation: “Mrs. Collins is complaining of severe anxiety.”

• Background: “She is one day post-op from a lumbar laminectomy.”
• Assessment: “She is alert and oriented, and her vital signs are stable. She has
no numbness or tingling in her extremities.”
• Recommendation: “She said she takes lorazepam 2 mg orally at home when

she is anxious. Would you like to order this or something else for her?”
Another technique is the check-back tool for ensuring clear communication and
teamwork. This is a concept promoted by TeamSTEPPS and CREW resources.
This tool employs closed-loop communication to ensure that information conveyed
by the sender is understood by the receiver as intended. Here is an example:
• Doctor: “Give me 25 mg of Benadryl IV push.”
• Nurse: “25 mg of Benadryl IV push.”
• Doctor: “That’s correct.”
What can I do to collaborate better when patient safety is at

stake?
Patient safety concerns may require the CUS technique. This is a mutually
agreed upon critical language derived from the airlines. For critical language
to be effective, all team members must understand it and accept it in a culture
that immediately addresses patient safety concerns. CUS is an acronym for the
following:
• I’m Concerned: For example, you might say, “Dr. Jenkins, I am concerned
about Mrs. Knight. The baby’s heart rate is in the low 60s.”
• I’m Uncomfortable: Here, you could say, “I’m

Open communica-
uncomfortable with these late decelerations.”
TIP tion improves the
• This is unSafe. Finally, you could say, “I don’t quality and safety
think it is safe to continue labor.” of patient care.
How can I demonstrate professionalism in a phone call with

a physician?
This is a key area for preventing communication breakdown and acting as a patient
advocate. Here are some suggestions:
• Be sure you are contacting the right physician. The orthopedic surgeon
will not want to be called about an abnormal heart rate.
• Contact the physician by whatever method the person prefers. Many

physicians use cellphones and do not want to be called on their home phone.
• Offer specific instructions to unit clerks. If you are asking a unit clerk
to initiate the call, be very specific with your instructions. For example, say,
“Please call Dr. Guisseppi at his office and say that I would like to speak to
him about the blood sugar on Mike Browning.”
• Be available for quick access when the call is returned. Make sure the
unit clerk can quickly locate you.
• Have pertinent information at your fingertips. For example, be ready

with the latest set of vital signs, intake and output, assessment data, current
intravenous solutions, recent lab reports, medication list, allergy information,
and patient chart.
• Be succinct. Use the SBAR technique mentioned earlier in the chapter.
• Be ready to take orders. Have an order form available and ready to use for
phone orders if the physician cannot enter the order electronically.
The Patient Experience

How does communication with patients affect the patient
experience?
This is a timely question with healthcare reimbursement. Value-based purchasing is
now used to determine the effectiveness of patient care and to determine payment
for services. Basically, this is “pay for performance” based on quality of care. The
patient experience is one of the four determinants of reimbursement along with
outcomes, efficiency, and clinical process of care.
Communication is one of the key components used to evaluate the patient

experience. Patient survey questionnaires such as the Hospital Consumer
Assessment of Healthcare Providers and Systems (HCAHPS) address core
questions about the patient’s hospital experience. Examples include questions about
communication with nurses, communication with doctors, communication about
medications, and discharge information. A key component of the patient experience
involves listening to patients.
How can I improve my listening skills?

Listening is one of the most generous and gracious human behaviors (Krames,
2002). Never underestimate the power of good listening. A good listener can make
the patient feel like the most important person in the world. Table 2.4 lists tips for
good listening.
2.4 Tips for Good Listening
Things to Do Things to Avoid

Make good eye contact. Finishing sentences for others
Ignore distractions. Daydreaming
Smile and nod your head. Interrupting
Ask questions. Changing the subject
Lean forward. Looking at your watch or mobile
device
Face the person with your body. Distracting body language (looking
around the room)
What is the best way to respond when a patient thanks you

for something?
Smile and say, “My pleasure” or “You’re welcome.” Don’t use the phrase “No
problem.” This minimizes the expense, education, and experience it took you to
become a professional nurse.
Good Idea!
After falling and fracturing his patella, Brian was admitted to the hospital for
a patella repair. He started physical therapy (PT) the morning after surgery.
After returning from PT, he was upset and told his nurse several reasons why he
was unhappy with his treatment by the PT department. The nurse contacted the
supervisor of PT and explained his concerns. The supervisor came to the unit to
discuss the problems. He was treated by a different therapist in the afternoon and
was pleased with the quick response to his concerns. This situation demonstrates
the nurse’s role as an advocate for patients in vulnerable positions.
How can networking and conversational tips be applied in

clinical settings?
There is a book called Don’t Sweat the Small Stuff. The advice not to sweat the
small stuff does not apply in networking and clinical settings, however. Sweat the
small stuff! Small things make a big difference, especially to a client in a healthcare
setting. Some guidelines are listed here:
• Address all patients as Mr., Mrs., or Ms. Use a first name or nickname only if
the patient gives you permission. Avoid all use of familiarities such as “honey”
or “sweetie.”
• Be sensitive to gender identity concerns. Be aware that some people have a

pronoun preference.
• Greet new patients with the following: “Welcome to _____. My name is [first
and last name], and I am the registered nurse who will be coordinating your
care until [time].”
• Review the plan of care and treatment goals for the day. Tell the patient the
times of any scheduled activities, such as physical therapy. Write this infor-
mation on a white board, if one is available. Ask for patient input. Don’t write
anything that would violate HIPAA privacy rules.
• When leaving a patient’s room, ask, “Is there anything else you need? I have
the time.” Make sure the call bell, phone, water, TV, and tissues are within
the patient’s reach.
• Many healthcare facilities are adopting policies and scripting to ensure more
positive interactions with patients. One of these is the AIDET tool (https://
www.studergroup.com/aidet), which is widely used:
• Acknowledge: Greet the patient by name. Smile and make eye contact.
• Introduce: Introduce yourself with your name, skill set, and experience.
• Duration: Give an accurate time frame for tests, consults, and next
steps.
• Explanation: Explain what to expect, answer questions, and indicate

how to contact you.
• Thank you: Thank the patient and/or family for choosing your hospital
or for their cooperation.
• See the following sidebar for other examples.
Tips for Professional Patient Encounters

• Knock on the door, speak softly, and wait for the patient’s
permission to enter the room.
• Wash your hands.
• Identify the patient.
• Make eye contact and smile.
• Introduce yourself.
• Provide an explanation of what you are going to do.
• Be gentle in handling the patient.
• Ensure maximum privacy (pull the curtains and close the door).
• Wipe down the needed equipment (such as blood pressure
cuff).
• Do not act rushed even if you are.
• Ask the patient:
• How can I help you today?
• Is there anything I can get you before I leave?
• Do you have any questions?
Used with permission of Ohio Valley General Hospital, McKees Rocks, Pennsylvania
Advice From a Clinical Specialty Area

Because of frequent contact with dialysis clients, nurses may reach a comfort
level and disregard the professional boundary lines. Even when nurses are
completely at ease with patients, they need to remember that the workplace
is not their home. They should maintain a degree of formality and consider
the workplace a place of respect. As an example, a colleague recounted a
complaint made by her mother, who had recently begun dialysis. The staff in
the dialysis unit did not call the mother by her name but used terms such as
“sweetie” and “honey.” The patient found this belittling and demeaning. She
was an individual with a name. This lax attitude annoyed her and made her
uneasy (Headley, 2007).

? What should I do if I am talking with a colleague and someone I do
not know joins us?
Introduce yourself. Your colleague may have forgotten your name or the
other person’s name and may not make introductions because of this.
? What should I do if someone keeps asking me questions and never

says anything about himself or herself?
Say, “Enough about me. Tell me about you.”
? How can I avoid getting drawn into a political or gossipy

conversation?
You can say something like, “I’ve got to go. I have found that politics (or
gossip) doesn’t mix well in the work environment.”
? If a colleague or potential client is unavailable when I call on the

phone, how can I find out a good time to call again?
In a polite manner, ask the receptionist, “When do you recommend I try
calling back?”
? What should I do if I am having trouble understanding someone

who is speaking English as a second language?
Ask the person to repeat what was said more slowly. Tell the person you
are having a hard time understanding and need help. Put the blame on
yourself, not on the speaker. Another option is to call interpreter services to
assist.
? If I am speaking to someone at a reception and a friend is waving

to me across the room, what should I do?
You can wave and nod, but then return your full attention and focus on the
person you are speaking with.
? What should I do if I am greeting and meeting people and I need

to sneeze?
Have a handkerchief or tissue in your left hand. That way, your right hand
will be clean for handshakes.
? After I’ve met someone at a networking session, how can I keep the
connection alive?
Make an effort to stay connected. For example, send notes, emails, or text
messages. Try to connect within a week or two so the person will remember
you. Call on the phone to say “hello” or to meet for a meal. Acknowledge
any awards or honors with a congratulatory note. If you see an article that
might interest the person, send it with a brief note.
TAKE-AWAY TIPS
• The essence of networking is the building of new relationships.
• Respect is a key component of effective intergenerational communication.
• Be sensitive to gender identity concerns.
• Plan a two- or three-sentence response for the inevitable question, “What

do you do?” Tailor this to the situation or event.
• There is nothing small about small talk.
• Try being a one-minute mentor.
• If your name tag is hanging on a lanyard, make sure it is turned so it can

be read.
• Use the term disability instead of handicap.
• Incivility among healthcare professionals can lead to compromised

patient care.
• Use the SBAR technique to facilitate communication with physicians.
• The patient experience is a determinant of healthcare reimbursement.
• When calling someone’s office, always treat the secretary or receptionist

with respect and courtesy.
• Make the first move when meeting new people.
• When someone tells you that you are a great conversationalist, it is often
a compliment to your listening skills.
3 When Talking to an Audience: Presentation Essentials 49
3
WHEN TALKING TO AN AUDIENCE:
PRESENTATION ESSENTIALS
How to Shine as a Speaker
DO YOU:
• Avoid the biggest mistake speakers make when beginning a
presentation?
• Carefully plan your time so you won’t go overtime?
• Wonder how you can bring your content alive?
• Collect information that makes you smile, chuckle, giggle, or laugh for
use in future presentations?
• Answer “What’s in it for them?”
• Practice out loud and often?
• Avoid the seven deadly speaker mistakes?
Public speaking is a powerful tool for informing, inspiring, persuading, and

initiating action. As an integral tool of the business culture, presentations are
an effective way to demonstrate leadership skills, gain recognition, and advance
a career. Good presentation skills can leave an impression that a person can
confidently and professionally demonstrate clear thinking and clear communication

in a high-pressure situation. In essence, the way you present yourself may be the
difference between an upwardly mobile career and a dead-end job.
Starting a Presentation
What is the biggest mistake presenters make when beginning
a presentation?
Some presenters have the tendency to begin weak and try to build up to a strong
presentation. This is a big mistake. Here are some things not to say or do at the
beginning of a presentation (Pagana, 2017):
• “Today, I’m going to talk about . . .”

Faux Pas
• “I know this is boring, but . . .”
I recently attended a
• “I am sorry I am not as prepared . . .” conference where the
speaker was intro-
• “I don’t know why I was asked to speak on this
duced by the hospital
topic, but . . .” president, Mike, who
• “I won’t take up too much of your time.” said he was going
to provide an update
• “So, how is everybody doing?” on the Zika virus. The
• “Please bear with me. I’m really nervous.” speaker began by
saying, “As Mike said,
• “Let’s review some housekeeping details . . .” I am here to give an
update on the Zika vi-
• “I’m getting over the flu and . . .”
rus.” This was a boring
• Share personal experiences unless they relate to opening. A grabber
the topic. was needed.
• Use overworked quotations.
What is the best way to begin a presentation?

You should grab the audience’s attention with something compelling like a story, a
question, or a quote. As Stevenson (2009) says, “Just because people’s butts are in the
seats doesn’t mean their brains are in the room.”
When you face an audience, you may be looking at people preoccupied by many
things. For example, they may be thinking about the presentation that preceded
yours, the work piling up in their office, or the conversation they have been having
with the person next to them (Steele, 2009) or on their cellphone. You must grab
their attention with an interesting and enticing beginning. You need a grabber or
an attention getter. Once you decide on a grabber, write it down. Then, prepare
it, polish it, and practice it, and you’ll be able to open with power. Here are some
examples of grabbers:
• Current events
• Unusual facts
• Exhibits
• Questions
• Statistics
• Quotes
• Stories or examples
• Comparisons and contrasts
Good Idea!
Here are some grabbers that could be used to begin a presentation about the Zika
virus:
• Fact: “According to the WHO, the Zika virus is an international emergency.

Let’s see how this virus is impacting our community.”
• Exhibit: Show a picture of a baby with microcephaly. “According to the

WHO, the most likely cause of congenital brain abnormalities is Zika virus
infection during pregnancy.”
• Statistic: “We now have more than 17,000 Americans infected with Zika.”
• Question: “How would you feel if your pregnant daughter just returned
from a vacation in a Zika-infected area?”
Should I provide an overview as I begin my presentation?

Yes. This helps the audience follow along. It may also keep them from shuffling
through a handout to find out this information. Take note as you watch the TV
news. The host will always give an overview of highlights of the show. This is
meant to entice you to keep watching. You want to achieve the same goal with your
overview. Here are some examples of overviews:
• “I will describe the etiology, treatment, and follow-up for patients with pros-
tate cancer.”
• “In this program, you will learn about the two main causes of sleep apnea and
the two most common forms of treatment.”
Faux Pas
Several years ago, I participated in a conference with other speakers from the
National Speakers Association. We were supposed to critique other speakers to
help them improve. One speaker was dynamic and spoke well. However, I was
distracted and confused during his presentation. During the critique, most of the
reviewers noted that because the speaker gave no overview, the audience had no
idea what was coming next. This is precisely the reason you need an overview. As
a speaker, you know where you are going, but nobody else does!
How do I establish credibility as a speaker?

This is key to answering the question, “Why should we listen to you?” There are
several ways to do this, such as noting education, experience, research, publications,
etc. This should be part of your introduction and should relate to the topic of the
presentation. For example, if you are speaking about orthopedic nursing, describe
your education, position, and experience in this clinical area. If someone does not
introduce you, you must introduce yourself and establish your credibility after using
your grabber.
Should I bring an introduction with me when speaking?

Yes. This is a great idea. Print the introduction in 14 font size. This makes it
easy to read and avoids the issue of people misplacing the introduction you may
have sent previously. Having the introduction with you is always appreciated.
Often, the speaker introduction is forgotten or misplaced in the logistics. This
prevents someone from saying, “I don’t know anything about you; please introduce
yourself.”
Faux Pas
Tammy had planned to show a video clip as part of her presentation. During her
presentation, she spent a lot of time trying unsuccessfully to get the clip to run.
She apologized to the audience at least 5 different times during her presentation.
Remember, it is not in the speaker’s best interest to keep reminding the audience
what they are not getting. Repeated apologies are distracting.
How can I get the audience to “buy in” to my topic?

You must be able to answer the question “What’s in it for them? (WIIFT)?” People
will not be interested if the topic does not pertain to them. You must tell them why
this presentation is worth their time and how it can help them. For example, years
ago I was the guest speaker for a middle school English class. I was asked to speak
about how I wrote my first book. The students did not seem too interested until
I asked them what questions they had. One brave boy raised his hand and asked if
I made money writing. When I said, “Yes, I make a lot of money,” I suddenly had
their interest and enthusiasm. I was now addressing WIIFT with a lively audience.
Do you have any suggestions for incorporating WIIFY

(What’s in it for you)?
Yes. Here are some suggestions (Weissman, 2004):
• “This is important to you because . . .”
• “So, you may be wondering what this means to you.”
• “You may be thinking, ‘Who cares?’ You should care because . . .”
• “Why am I telling you this?”
Closing With Impact

Are there things not to say or do at the end of a presentation?
Yes. Just as there is a right and wrong way to begin a presentation, there is also a
right and wrong way to end. To end with impact, avoid the following:
• “I’m sorry this was boring.” Don’t even put the thought of boring into the
audience’s heads.
• “I forgot to mention . . .” Do not bring up new material in your closing. The

audience does not need to know what you forgot to tell them.
• Introducing a new idea or new research study. If you did not mention it
during the presentation, don’t bring it up in the closing.
• Going over your time allotment. People complain about this all the time and
presenters keep doing it. This is disrespectful to your audience who have
other commitments.
• Packing up your materials while you are talking. Be focused on the audience
and be present in the moment. Packing up early will give the impression that
you are in a hurry to leave.
• Answering the last question and not using a planned ending. By mistake,
some presenters think the presentation ends after the last question. It does
not. Use your planned closing for impact.
How important is the ending of a presentation?

It is as important as the beginning. People tend to remember what they heard first
and last. The ending must be strong. Poor endings are a result of neglect.
The ending gives the presenter time to restate the purpose, review key points, and
end with something memorable. Here are some examples:
• “As a review, we focused on the cause, treatment, and follow-up of patients

with prostate cancer.”
• “If you only remember one thing today, remember that prostate cancer is
curable. Please schedule a prostate exam and screening test today.” (This is a
call to action.)
• “If you only remember one thing, remember that without treatment, people
can die from sleep apnea.”
Targeting Your Audience

How can I best connect with the audience?
Remember that your presentation is for the audience. It is not for you. Put yourself
in their shoes. How can you address their needs and their goals? What would be
meaningful to them? The best speeches make a connection between the speaker
and the audience.
What do I need to know about my audience?
The more you can learn about them, the better you’ll relate to them. You can also
avoid offending anyone and including too much or too little information. Here are
some things to consider (Pagana, 2017):
• What are the demographics (age, sex, education, race, income, occupation) of
the audience?
• Why will they be there for your presentation? Do they want to be there, or
do they have to be there? Is it the end of the da,y and are you the last event
before happy hour?
• How much do they know about the subject matter? You can avoid offending
people by not speaking above or below their level of understanding. Can you
use medical jargon?
• What keeps them awake at night? Are they afraid they might have recurrent
cancer?
• Does the audience have any particular issues or concerns? Downsizing?
• What will they take away to make their jobs or lives better?
• What do you want them to think, do, or say when they leave the presenta-
tion? Do you want them to go to the gym three times a week? Do you want
them to show more sensitivity to patients with psoriasis?
• Will they view you as a credible presenter?

How can I find out information about the audience?

A good source for audience information is the program organizer. You can also use
the internet, newsletters, annual reports, and promotional materials to help you learn
more about the group. Imagine how upset you would be if you begin your speech
discussing a new method of birth control to a group of retired war veterans. The time
it takes to prepare an audience profile could make the difference between success and
failure for your presentation.
Planning With the Analog Approach

I have heard that you should use the analog approach when
planning your presentation. What is this?
With the analog approach, you need to step away from your computer in the initial
planning stages. This is in contrast to going digital and sitting at your computer.
Some presenters make the mistake of sitting at their computer and planning their
presentation with PowerPoint, Keynote, Prezi, or some other presentation slideware.
This stifles creativity. So, get away from your computer. You’ll be using it enough
later. The analog approach is better and is used by most professional designers
(Reynolds, 2012).
What are the benefits of the analog approach?

With the analog approach, you can be creative and brainstorm ideas. Let your mind be
still and let it wander. How do you do this? Here are some strategies (Reynolds, 2012):
1. You can use a large tablet and pen to brainstorm, sketch out ideas, make lists,
and draw ideas for illustrations, charts, or photos. An advantage of using a pen
and paper is that you can work outside of your office at a coffee shop or on a
bench in the park.
2. You can use sticky notes and write down as many ideas as you can on separate
sheets. Use a marker when you do this so it limits how much you put on each
note and it’s easier to see the content. After brainstorming your ideas, you can
see the big picture and determine your core message. Then, you can move the
notes around and cut out what is not essential as you organize your presenta-
tion.
3. You can use a large whiteboard and colored markers. Many people feel un-
inhibited and more creative sketching on a bigger surface. This is great for
drawing ideas for charts, photos, pie charts, graphs, and illustrations.
4. Some people like a lot of space and stretch out a scroll of white paper on a
wall to sketch out ideas with marking pens.
5. Tablets, whiteboards, and scrolls of white paper are also great for
mind-mapping. You can start with your main idea and then start adding
lines to key points and sub-points.
6. Relax, let your mind wander, and be creative. I have found that getting away
from the office or home is key for quiet time without distractions. I usual-
ly go to a library, find a quiet area, and sit at a large table with a tablet of
paper. You can take a walk and jot down ideas that pop into your head. Keep
a pad of paper by your bedside and write down ideas you may get as soon as
you wake up.
These strategies using the analog approach will help you be creative and unique as
you prepare your presentation. As you solidify your message in your own head, you
get to see the big picture and identify your key points. It is then easier to go back to
your computer and lay out your ideas in presentation software.
Good Idea!
Personally, I find that when I swim, my mind drifts and I come up with great ideas.
I have gotten some of my best titles and grabbers this way. However, I can’t be
counting laps when I swim. That would be like sitting in front of a computer, and it
would kill creativity. If I plan to swim for 30 minutes, I relax and swim and occa-
sionally look at the clock. As soon as I dry off, I write down my ideas.
“When it’s foggy in the pulpit . . .

it’s cloudy in the pew.”
–Cavell Robert, founder of the National Speakers Association
Determining Your Core Message

How do I determine my core message?
It’s easy to plunge into developing your presentation with the idea of giving lots
of wonderful information to your audience. As healthcare professionals, we have
worked hard to gain information and want to share it all. However, a week later,
the audience may only remember 10% of what you said. Instead of just giving
information, focus on how effective the audience needs to be at knowing, doing, or
feeling after they hear your message.
Plan your presentation with the thought of what your audience will say when
someone asks what the presentation was about. Will they be able to summarize it in
a word, phrase, or sentence? For example, suppose you would want the audience to
say, “Early detection of breast cancer saves lives.” That is your core message. The
success of your presentation will be judged not by the information you send but by
the information the audience receives.
“If you can’t write your message

in a sentence, you can’t say it
in an hour.”
–Dianna Booher (professional speaker)
Harnessing Your Passion

Why is it important to have passion for my topic?
If your message isn’t interesting and exciting to you, it certainly won’t be for your
audience either. As Lilly Walters says, “Speak with passion for your topic and a
compassion for your audience and the rest will fall in line!” You need to do your
best to prepare and deliver your material in an interesting and passionate manner.
Of course, you need good content.
Audiences expect you to have content. But it is not just about content. People in
your audience are not as passionate about your topic as you are or they would be
up in front of the group. Audiences want you to make the content come alive. You
need passion for this to happen. Think from the perspective of the audience. Do
whatever you can to make the material interesting and exciting.
What if I am concerned that the audience may have heard a

similar presentation?
Remember, they have not heard it from you! This is your opportunity to approach
the topic from a different perspective—your perspective.
“If I had only one tip to give,

it would be to be passionate
about your topic and let that
enthusiasm come out!”
–Garr Reynolds (author of Presentation Zen)
What if I didn’t choose the topic and am not passionate

about it?
Then, it’s your challenge to create moments in the presentation that you are
passionate about. For example, it could be an appealing story that reminds you
of growing up before computers and cellphones. Oh, the good old days! Stories,
cartoons, photos, and statistics are examples of things that can help you elevate
your passion on topics you don’t care about.
The bottom line is that the effort you put into being a passionate speaker will pay
off because you are serving your audience. If you keep your audience in mind, you
won’t want to waste their time. Instead, you are showing respect for the audience as
you converse and connect with them.
“The more you say, the less

people remember.”
–Anatole France
Avoiding a Data Dump

Why do some speakers dump a lot of data on their
audience?
Many speakers make the mistake of thinking it is a good idea to have “more than
enough” material. This is a mistake. Effective communication is more about the
outcome than your output of content. Success is not measured by how much
material you can cram into an hour. Success is determined by what the audience
understands and can act on, if appropriate.
As the speaker, your job is to avoid information overload. Keep your content alive
and relevant. Audience members can only accept so much material without a chance
to process information by pausing, discussing, analyzing, questioning, or taking a
break.
What are some strategies to avoid a data dump?

One way to avoid a data dump is to use the 75% rule. If you have a 60-minute
presentation, plan on speaking for 45 minutes. Remember that presentations often
don’t start on time. There may be welcoming comments from the organizer. You
may be following a speaker who ran overtime. Following the 75% rule will help you
relax when your time is cut short without prior notice. And remember, if you do end
early, no one will complain (Brody, 2008).
Another way to avoid a data dump is to divide your material into must-know,
should-know, and could-know (Brody, 2008). Some people like to color-code their
information so it is easy to see. If you are running out of time, focus on the must-
know and eliminate the others as needed. Here’s an example.
Good Idea!
A speaker colleague of mine told me how helpful the “must-know, should-know,
could-know” strategy was when she was speaking about “the five keys to
leadership.” When she realized her time was shortened, she could not just cut out
#4 and 5. By focusing on the “must-know,” she handled the situation in a smooth
and professional manner. Conference organizers are impressed and appreciative
when they deal with people like my colleague.
“I will study and prepare and

perhaps my chance will come.”
–Abe Lincoln
Using Stories and Case Studies

How do stories and case studies help bring my content alive?
Stories make your message understandable and memorable. Case studies are stories
about patients. Stories and case studies can distinguish a good speaker from a great
speaker and a dry presentation from an interesting one.
Do you have any suggestions for stories?

Yes, the story must relate to the topic or illustrate a key point in your presentation.
According to Steele, when a speaker transitions to a story or example, the audience
senses that something is being brought to life to help make the message more real
or understandable. Audiences love to hear, “Let me give you an example” (Steele,
2009). They perk up and listen.
Are stories helpful in most presentations?

Yes, especially if the topic is dry. For example, the president of a pharmaceutical
company was giving an annual report that focused primarily on financial data.
However, he included a case study showing a photo of a woman in a wheelchair
with rheumatoid arthritis. He mentioned that their top-selling drug was indicated
for this problem. He then showed a photo of the woman walking after six months
of treatment. Stories like this made the rest of the report more interesting.
What are the main benefits of telling stories?

According to Doug Stevenson (2009), there are many benefits of storytelling. Here
are three examples:
1. Stories engage the left and right brain. Your left brain is linear and deals
with facts and data. Your right brain is nonlinear and deals with feelings and
creativity. Communicating to both sides of the brain is best. That is why
it is helpful to illustrate facts and statistics with stories and back up stories
with facts and statistics.
2. Stories appeal to auditory, visual, and kinesthetic learning styles. A good

story can address all these different learning styles.
3. Stories provide an opportunity to be original. Your stories are not common

knowledge. Audiences are eager to hear what comes next in your story
because everything is new. Stories can make familiar information fresh and
interesting.
Citing Quotes and Statistics

How can quotes benefit a presentation?
Incorporating memorable, unusual, or provocative quotes into your presentation
adds originality and changes the pace of the presentation. They can grab the
attention of the audience. They can wake up the audience and energize them.
It is helpful to have quotes that can be used as options in your presentation if you
are running out of time. This relates to the “must-know,” “should-know,” and
“could-know.” Maybe you have a great story or case study that you usually use to
make an important point. However, if you are short of time, perhaps a quote makes
the same point. Plan that out ahead of time.
How can I find good quotes?

If you read or hear a quote that makes you laugh, smile, stop and think, or disagree,
it may also cause the same response in your audience. Write it down and think
how you could use it in a presentation. Start assembling an arsenal of selective
quotations. Before your next talk, look over your file and pick the best quotation
that will support your data and reinforce your message.
How can statistics help bring my content alive?

Inserting a statistic into your presentation can spark attention. However, a statistic
is a numerical abstract that may be difficult to etch into your audience’s memory.
The challenge for the speaker is to present the statistic in a way that the audience
can grasp it. Here are some suggestions—sometimes called the three R’s of
numbers (Hume, 2002):
• Reduce the number of statistics that you cite. Be selective. Don’t overwhelm
people with statistics. Don’t use two statistics to prove the same point. For
example, if you say that 80% of your patients cannot afford their biologic
medicine, you don’t need to add that only 20% can afford the medicine. The
impact of the first statistic becomes lost when you cite the second.
• Round your statistics. Rather than saying, “21.2% of doctors choose decaf
coffee for breakfast,” say, “1 out of 5.” It makes more sense and is easier to
remember.
• Relate your statistics to something familiar to your listeners. For example,

suppose you are giving a presentation in New England and you are talking
about research in a small country in the Balkans. You might say that the
country is 5,000 square miles—this is equivalent to the size of Connecticut.
Those words put the number into a context that the audience can immediate-
ly grasp.
We have all heard meaningless statistics. Avoid them. Relevant statistics can be
influential and reinforce your point. Told in the right way, the right statistic can tell
a story that the audience will appreciate and remember.
Adding Humor
Does adding some humor improve a presentation?
Most presentations could be improved by adding a little humor. Humor can help
the audience respond to information that could be considered dull and boring.
Humor is anything that makes people smile, chuckle, giggle, or laugh. It is a
refreshing change of pace.
Here are two guidelines for adding humor to a presentation:
• Avoid telling jokes that make fun of anyone but yourself.
• Avoid remarks about topics (such as sex, religion, politics, obesity, ethnicity,
culture, gender, etc.) that could offend anyone.
Do I need to be funny to be a good presenter?

No. But, without a doubt, humor certainly helps liven up a presentation. However,
some people are not good at being funny, and they should not try to be funny if
that is not their forte. If you do say something intended to be humorous, don’t
smile or laugh unless the audience reacts first with smiles or laughter. If nobody
laughs or smiles, just keep moving along without leaving the impression that
something has fallen flat (Steele, 2009).
Are telling jokes the main way to add humor?

No. The good news is that you do not need to tell jokes to provide humor. Instead
of aiming for laughter, aim for smiles. The safest humor revolves around stories
about yourself. The story can liven up your message without having the audience
rolling in the aisles with laughter. They may be smiling and nodding along while
enjoying the story. Your story doesn’t need a punch line, and it has the validity of
being something you experienced (Steele, 2009).
Is it appropriate to use humor in a serious presentation?

When you sneak an amusing story into a serious talk, it provides comic relief. It
also helps memory.
For example, I was at a breast cancer conference and a young woman was telling
her heart-wrenching story about finding out she had breast cancer and going
through surgery and chemotherapy. A week prior to beginning chemotherapy, she
was out on the river in a boat with her family. Her long dark hair was blowing in
the wind. Her 10-year old daughter said, “Mom, at least you won’t have to worry
about getting your hair messed up after you start chemo.” Everyone laughed. The
woman said that at that moment, she knew she and her family would be OK. It was
a turning point. That humorous story was a breath of fresh air in her cancer story.
Weeks later, people were still talking about her daughter’s comment.
What’s a good way to start incorporating humor into a

presentation?
Cartoons are great options. You can simply describe a cartoon, or you can show
a cartoon on a slide (if you have permission). Practice this and other forms of
humor with your friends and family. If you get a good response, then use it in a
presentation.
Ending on Time
If I am giving a great presentation, is it really important to
end on time?
Yes, if you respect your audience. Going over time is one of the biggest complaints
of an audience. If you start and end on time, you will score points with your
audience (Steele, 2009).
Remember, you can cut some material by focusing on “must-know” versus “could-
know” content.
What if factors beyond my control create the likelihood of

running late?
Talk to your audience and see what they are interested in. Be willing to stop at the
end time and make arrangements for them to get the remaining information by
other means. For example, they could send you an email or go to a link on your
website. If most want you to stay late and continue, that is also OK. Be sure to give
permission for others to leave at any time.
The Value of Practice

“We are what we repeatedly
do. Excellence is therefore not
an act but a habit.”
–Will Durant
Why is practice so important in a presentation?

Some people think that once they have planned their presentation, the hard work
is over. This is a mistake. An effective presentation requires a significant time
commitment for practice. Although great speakers make it look so easy, you would
be shocked if you found out how much time they spent practicing.
As you practice, you increase your confidence and decrease your fear of speaking.
This allows you to take the focus off of yourself and put it on the audience.
Remember, your presentation is all about the audience. Practice enables you to
know the material so well that you can talk in a conversational nature, which is
exactly what you want. Your presentation will sound more extemporaneous as you
rely less and less on your notes.
“One important key to success

is self-confidence. An important
key to self-confidence is prepa-
ration.”
–Arthur Ashe, Jr.
Have you ever heard people say that they don’t practice
because they don’t want to sound rehearsed?
Yes. However, good practice does not lead to a rehearsed-sounding presentation. In
contrast, when you practice and refine your message, you own the material. Then,
you can put your notes aside and just talk. Now what looks spontaneous is the
result of a well-practiced presentation. The spontaneity you want needs to come on
the after side of practice.
How to Practice
What are some effective strategies for practicing before a
presentation?
Practice out loud. Don’t look over your notes and
say, “blah, blah, blah.” Many of us are eloquent in To write an
our heads. There is a world of difference between TIP effective speech,
ideas in your head and speaking to an audience. replace the rules
When you practice out loud, you will hear when for written English
you stumble over words or hesitate because you are with the rules for spo-
ken, conversational
unsure of something. This alerts you to the need to
English.
make alterations.
Should I try to memorize my presentation when practicing?

No. Don’t practice word-for-word recitation and try to memorize the presentation.
You need to be flexible in your word usage and allow yourself to say things
differently with each practice run. The purpose of your practice is not to memorize
a speech but to identify rough spots and smooth them out. For example, some
word combinations look great on paper but may be difficult to say out loud during
practice. This is your opportunity to change them.
Faux Pas
One of my favorite of The Far Side cartoons by Gary Larson is about Tarzan
as he prepares to meet Jane. In his head, he eloquently prepared several nice
introductory remarks. However, when he swung on a vine and landed near her in
a tree, he blurted out, “Me Tarzan! You Jane!” Then, he swears and covers his face
with his hands. This shows how your ideas can flow beautifully and eloquently in
your mind. Practice out loud.
“Think as wise men do, but speak as

the common people do.”
–Aristotle
What if I experience my highest level of anxiety at the begin-

ning of my presentation?
You would be like most people who then settle down after a few minutes and feel
fine. While it is reassuring knowing that calmness will eventually come, your
first few minutes can lead to a poor first impression. You can avert this situation
by putting extra practice into your introduction. You want to be able to do the
introduction on automatic pilot. So, keep practicing your introduction over and
over again. Then, when you step up to give your presentation, you can start strong
even if you are a little nervous. Extra practice on your introduction will set you up
for early success and is a great confidence booster.
Getting Feedback
How can I get feedback before my presentation?
The best way is to videotape yourself. You will be able to critique what you see and
hear. Try to be objective and critical as you listen and observe your presentation.
Do you have distracting gestures? Are you stumbling over certain words or phrases?
Are you using fillers (“ah,” “um,” “like,” “you know”)? Replace them with a pause.
Focus on making these improvements. Then practice and videotape again. This
process will keep improving your presentation.
What if I cannot videotape myself?

The next best thing is to audio record yourself. Although you will miss out on the
visual components, you will still be able to evaluate the vocal and verbal aspects
of the presentation. Keep repeating this process until you sound competent and
confident.
How about getting a peer to evaluate my presentation?

This is a great idea. Ask the person to provide several tips to improve the
presentation. Ask if the person noted any distracting gestures. Ask what sections
were unclear.
How about evaluation forms?

Focus not on how
These are great for feedback after your presentation. TIP smart you are as
Most speakers focus on their weaknesses. We can the speaker, but
surely learn from them. But we also learn from our on how smart you can
strengths. Keep your evaluations short. make your audience.
Knowing When You’re Ready

How do I know when I have practiced enough?
I have found that after a certain point of practice, I “cross the line.” For me, this
means that I am so well prepared that I would be very disappointed if the program
were canceled.
Dale Carnegie, the speech guru, said, “There are always three speeches for
every one you actually gave: the one you practiced, the one you gave, and the one
you wish you gave.” Only through practice can you hope to have all three be the
same.
Managing Fear and Anxiety

“Let our advance worrying
become advance thinking and
planning.”
–Sir Winston Churchill
Is it common to have fear and anxiety

before a presentation? Good Idea!
Yes! Most speakers feel anxious and fearful before During a recent
a presentation. Many people refer to this as “stage presidential race, the
moderator of a debate
fright.” Common symptoms include dry mouth, tight
was asked if she was
throat, sweaty hands, shaking hands, nausea, fast pulse,
nervous. Without a
and shaky knees. Stage fright does not happen when
moment’s hesitation,
you are just beginning to speak in public. It happens to she said “Yes. If I’m
seasoned professionals every time they make a change not nervous, I’m not on
and have new material. I have seen many interviews my A game.” That’s the
with famous, award-winning actresses and actors who way to look at fear. It
struggle with stage fright every day. So being nervous has benefits.
puts you in good company!
How do I handle fear, anxiety, and jitters?

The key is to handle these feelings in a productive manner. It is important to think
of fear as your friend. It will increase your energy level, add a little color to your
cheeks, and put a sparkle in your eyes. Think of nervousness as “performance
energy.” It will prevent a bland and boring presentation. Fear will also make you
want to practice and prepare. Use fear to your benefit. The more you practice, the
less fear, anxiety, and jitters you will have.
Turn the focus away from you. Don’t be thinking about yourself. Think about the
audience. Remember, the audience is not there to judge you. They are there to
learn something, and you are prepared to provide it.
Have a positive attitude. View your upcoming presentation as an opportunity for

success instead of a potential for failure. Visualize yourself as confident and doing a
great job.
What can I do to relieve stress before the presentation?

Visit the room where you will be speaking. Walk to the front and visualize how the
room will be set up. Get a good night’s sleep. Eat your usual meals. If you normally
exercise, do that to help reduce your stress. Do some abdominal breathing. Rolling
your head, yawning, and making funny faces also help to reduce stress.
Get to the presentation site early and mingle with

some members of the audience. Ask them questions Volunteer to give
and listen carefully to their answers. Try to gather
TIP a presentation.
information and names you can incorporate into This will give you
a great opportunity
your presentation (Weissman, 2004).
to prepare, prac-
Avoid negative thoughts and negative people. tice, present, and
Think positive. Make affirming statements. For get feedback. Your
example, “I really know this material . . . I have been volunteerism will also
preparing this for months . . . I have a lot of helpful be appreciated and
information to share.” noticed.
How can I handle stress during the presentation?

Never say, “I’m really nervous.” This is upsetting to the audience and makes them
uncomfortable. Focus on the audience. Intensify your eye contact. Change the
dynamics. For example, you could ask a question or ask the audience members to
discuss something with the person next to them. Another technique is to invite the
audience to share reactions, stories, or ideas.
“Fear is a big factor in diving.

It’s a part of the sport, it’s a part
of overcoming the sport, it’s a
part of the thrill of the sport.”
–Michele Mitchell-Rocha (Olympic diver)
Good Idea!
Whenever Winston Churchill delivered a speech, he always had notes with him.
However, he seldom used them. When asked about this, Churchill replied, “I carry
fire insurance, but I don’t expect my house to burn down” (Chaney & Martin,
2007). Bring and use your notes.
Avoiding the Seven Deadly

Speaker Mistakes
We have all used an occasional “ah” or “um” when speaking. These are minor
problems that may diminish the effectiveness of a presentation, but they do not
doom the presentation to failure. However, speakers who make any of the seven
deadly speaking mistakes can doom their presentations. If you know the mistakes,
you can avoid them (Dlugan, 2009; Pagana, 2017):
• Laziness: This is committed by the speaker who fails to prepare. For

example, this speaker may begin with an apology for not being prepared or
for presenting uninteresting material. Speakers who say the presentation is
boring have not prepared enough. If they think the material is uninterest-
ing, they need to be challenged to work harder to bring it alive with stories,
examples, questions, humor, statistics, or unusual facts. You can make the
presentation interesting, but it requires a lot of preparation and commitment
to making the information interesting for the audience.
• Envy: Envy creates the false belief that great speakers are lucky to be born
that way. New speakers who lack confidence in their own ability sometimes
believe it is OK to mimic or copy experienced speakers. For example, they
may attend a presentation and copy the speaker’s PowerPoint slides and
use them in their next presentation. They may repeat personal stories they
heard in the presentation. This is wrong because those stories belong to that
person. Your stories need to be your own stories from your own experiences.
Note that you may admire great speakers, but you don’t need to envy their
success and style. Instead, imitate their hard work and commitment. Put your
time and effort into making yourself a great speaker.
• Lust: Have you ever heard someone say that you can calm your nerves when
speaking by picturing the audience in their underwear? Isn’t that silly? Lust
is a deadly mistake for speakers. It violates the premise that speakers should
show respect for the audience and connect with them. Respect and lust are
not compatible. One important way to connect with audiences is by eye
contact. However, I think it would be hard to make eye contact with people
in their underwear. Who would want to be part of that audience? Eye contact
is necessary to show interest in your audience and to connect with them. The
bottom line is to remember that the presentation is all about the audience. It
is OK to be nervous before a presentation. However, when you show your re-

spect for the audience by your planning, you don’t need to calm your nerves
by resorting to thoughts of underwear.
• Gluttony: The mistake of gluttony is based on the idea that more is always
better. This is the speaker who packs everything possible into a presentation
and speeds through it. The speaker is not focused on the audience. Instead,
the speaker is burdened down with too much information. There are too
many slides, too many facts, too many statistics, etc. So, how do you avoid
this mistake? The strategy goes back to the planning stage. Find your core
message. What do you want the audience to know when they leave the
presentation? That is your core message. Instead of just giving information,
focus on how effective the audience needs to be at knowing, thinking, or feel-
ing after your message. Select your best supporting material. Plan to speak
at a reasonable rate. Some speakers have too much material because they
are afraid of ending early. But have you ever heard someone complain about
ending early? I haven’t! Usually the audience is delighted. The key point to
remember is that the presentation is all about the audience. Find your core
message and plan how you can deliver it at a reasonable rate in an interesting
way to your audience. Remember, more is not better.
• Greed: The mistake of greed is one of excess. An example of this is the

speaker who thinks nothing of letting the presentation run overtime. This
is disrespectful to the audience and violates the time contract they expected.
You may have heard speakers say, “I am out of time, but I have a few more
points I want to make.” Or, “I know it is lunch time, but just give me 10
more minutes.” Or, “Since I started 10 minutes late, I will end 10 minutes
late.” These examples can kill an otherwise good presentation. So, how do
you prevent the deadly mistake of greed? One of the best strategies I know is
to use the 75% rule. Plan your presentation for 75% of your available time.
Sometimes the start is delayed waiting for someone of importance to give
some welcoming comments. Utilizing the 75% rule will prevent you from
going overtime.
• Wrath: The mistake of wrath is seen in speakers who get angry and handle
problems in a negative manner. For example, I observed an angry confron-
tation between a speaker and the event planner when a speaker could not
run a video clip. The speaker even complained to the audience several times
during the presentation. Sharing the problem with the audience only made
the situation worse. I’ve seen speakers get angry with themselves for making
a mistake. Does anger at yourself or someone else have a place in a presen-
tation? No. As speakers, we need to remember the presentation is not about
the speaker. It is about the audience. Correct your mistake and move on. We
are all human. There is no reason to saddle the audience with your prob-
lems. So, how do you prevent the problem of wrath? It is simple. Don’t be a
prima donna. Be professional. Treat the event planner and the audience with
respect. Know that things do not always go as planned. Do your best to work
out any problems in a professional manner.
• Pride: The first six speaking mistakes are basically all symptoms of pride.
The mistake of pride is seen in speakers who believe that speaking is all about
them. Speaking is never about the speaker. It is always about the audience.
The strategy to prevent this mistake is to focus on the audience. Think of it
this way: It is not about how smart you are as a speaker. It’s about how smart
you can make the audience.
If you really analyze and focus on the audience, most of the other deadly speaker
mistakes fall away. Let’s take three examples:
1. If during your preparation and planning you think about what would help
and engage the audience, you are eliminating the mistake of laziness.
2. If your message is focused and easy to understand, you are eliminating the
mistake of gluttony—thinking more is better.
3. If you respect the audience and their time, you avoid the mistake of greed.
You don’t go overtime.
When you look at speaking from the perspective of the audience, you eliminate the
mistake of pride and can fast track your development as a great speaker.

? Doesn’t all this planning get in the way of sounding spontaneous?
No. The spontaneity you want comes after planning and preparation.
Once you have a carefully crafted presentation and practice it, you can
then sound spontaneous. As Peter Hall, the former director of England’s
National Theatre, says, “You have to have the discipline and then you will
be liberated by it” (Steele, 2009).
? What is the best way to find stories for my presentation?

Collect stories. When you experience something or hear about something
that might make a good anecdote in a future presentation, write it down.
You can get ideas from watching TV, listening to the radio, reading, talking
to people, and being more observant of things happening in your daily
life. It is also a good idea to think back in your life to meaningful events
or situations that would provide a good story or example. Keep a file of
stories.
? How can I avoid offending people with jokes?

Be careful. Many people are looking for a possible offense. There is
a minefield of political correctness. It is sometimes difficult to know in
advance if a joke is safe. If you have any question about offending
someone in the audience or someone they know, avoid the joke. There are
other ways to be funny without telling jokes.
? How do I avoid being perceived as self-centered when I tell stories?

Don’t make yourself the hero or heroine of your stories or anecdotes. Tell
something amusing, strange, or enlightening that happened to a friend,
neighbor, family member, coworker, or acquaintance.
? Suppose I am getting near the end of my presentation and I don’t

think I’ll have time for a great story—what should I do?
Skip the story to avoid going overtime. The audience doesn’t need to know
that you are skipping something. They would rather end early than end late.
Who hasn’t appreciated getting out early from a presentation? It is better to
end five minutes early than five minutes late.
? Can you recommend any organizations to help me improve my

speaking skills?
Yes, join Toastmasters. It is an international organization made up of
thousands of local clubs. You can practice speaking and receive peer
review. Find out more by visiting www.Toastmasters.org. For more
advanced speakers, I would recommend the National Speakers Association
at www.nsaspeaker.org.
TAKE-AWAY TIPS
TAKE-AWAY TIPS
• Each time you speak, you have the potential to stand out and make a
good impression.
• When planning your presentation, ask yourself, “What would make this
memorable?”
• It is not how smart you are as a speaker that counts but how smart you
make your audience.
• Effective speaking is about effective communication. The audience’s

outcome is more important than the speaker’s output.
• Start strong and end strong. People tend to remember first and last im-
pressions.
• If a presentation is worth giving, it’s worth giving it well.
• Practice out loud and “alter where you falter.”
• Practice your introduction the most. You will begin more confidently.
• Show respect for people’s time by ending on time.
• Speak often. The more you speak, the better you will become.
4 Your Professional Presence 77
4
YOUR PROFESSIONAL PRESENCE
Appearances Are (Almost) Everything
DO YOU:
• Know how to look your best for a job interview?
• Wonder why people question what you say?
• Think you overdressed for an interview?
• Think you made a bad first impression?
• Want to look professional in the clinical area?
No matter what some people may say, you are judged by the way you dress. Your
clothes are either a positive or negative factor—never neutral. If you are aware of
the essentials for professional dress, as well as your body language, you can focus
more on what you are saying and doing without detracting from your professional
presentation.
“Clothes and manners do not

make the man; but, when he is
made, they greatly improve his
appearance.”
–Henry Ward Beecher
Professional Clothing
Do clothes really make a big difference?
Yes. Suppose you received two gifts. One gift was beautifully wrapped. The other
was sloppily wrapped in cheap paper. Which gift would have the greater perceived
value? Whether you are interviewing for a job, giving a presentation, or asking for
a promotion, the way you dress is an important part of your overall packaging. As
with gift-wrapping, the more put together your appearance, the more positive your
impression (Whitmore, 2005).
Faux Pas
Elizabeth was seeking a position as speaker for an international communications
company. As part of the interviewing process, she was expected to conduct a
seminar on presentation skills for business executives. Her speech evaluations were
favorable, but the company evaluators made note of her wrinkled suede suit. She
was very embarrassed and upset with the feedback about her suit. She had, in
fact, been wearing an expensive suede suit that had just been dry-cleaned. This
feedback caused her to rethink her professional attire, and she gave away the
suede suit and purchased a wool suit.
What judgments do people form about me based on my

clothes?
People unconsciously judge your socioeconomic status, background, level of
education, and personality based on your clothes (Whitmore, 2005). If you are
underdressed, you can embarrass yourself and your colleagues. If you overdress,
you can set the wrong tone and may intimidate others. Be aware that how you dress
makes a powerful statement about you.
What impression am I giving if I wear sloppy or

inappropriate attire?
Sloppy or inappropriate attire could imply that you do not respect yourself, that
you do not place value on appearance, or that you do not care that your appearance
affects the organization’s image.
How do I know the appropriate way to dress for different

positions?
Look how leaders or managers dress in different
positions and model your attire to match theirs. Dress for the role
For example, an educator might have a different TIP to which you
professional look than a corporate executive. If you aspire.
are looking to advance in your career, dress like the
people on the next level up.
Good Idea!
Jocelyn was delighted to hear that she was the recipient of an award for her
work with teens in Washington, DC. The award was to be presented at a large
banquet by a US senator. Jocelyn was planning to wear a sweater set and slacks
until she spoke to her mother. When her mother offered to buy a suit, the matter
was settled. On the day of the award, Jocelyn walked across the stage looking
confident and stunning in a beautiful suit. Most people walk a little taller and
demonstrate more confidence when they wear a suit.
Is professional dress more of a challenge for men or for

women?
Professional dress is more of a challenge for women. This is because professional
dress for men is more easily defined. Men look professional when they wear a suit
and tie. The leeway in defining professional dress for women leads to the potential
for inappropriate clothing. For example, common complaints about women in a
professional setting include tight-fitting and short skirts, unprofessional hair, too
much makeup, or clothing that is too casual (Pagana, 2005b).
Why do nurses need to be concerned about their style of

dress outside the clinical area?
One of the best features of a nursing career is variety. Not all nurses work at
the bedside. In many nursing positions, business dress is the norm, such as chief
nursing officers, hospital presidents, college professors, legal nurse consultants, and
board members. Also, when nurses continue their
education or change positions, they need to know Avoid clothes that
how to dress for interviewing and collaborating with TIP reveal too much
other professionals. or leave too little
to the imagination.
Table 4.1 provides tips for professional dress for
women, and Table 4.2 does the same for men.
4.1 Tips for Professional Dress for Women
Aspect of Outfit Tips

Suit colors Navy blue, charcoal gray, black, burgundy, and
taupe are traditional. Wear darker hues during the
winter. Wear colors that are flattering to your skin
tone.
Suit fabrics Buy fabrics that wear well. Wool knits, crepes, and
microfibers generally wrinkle less. Linens are known
for wrinkling.
Blouses Avoid blouses that are too revealing. If wearing a
sleeveless blouse, keep your jacket on.
Scarves Silk and silk blends hang better than cotton. The
classic size is 34 inches square. Scarves can soften
a tailored look.
Shoes The classic pump has a 1 1/2-to-3-inch heel.
Spiked heels (3 inches or higher) and flat heels look
least professional. Business colors are black, navy,
brown, and taupe. Do not wear shoes that are
scuffed or have worn-down heels.
Boots Boots can be acceptable for classic business dress
in some settings.
Stockings Neutral or flesh tones are always smart. Do not
wear dark stockings with light shoes.

Belts The classic width is 1/2 to 3/4 inch. Leather belts
should coordinate with your shoes. If metal, match
it to other metal (for example, earrings, necklaces,
buttons, or a watch).
Jewelry Your jewelry should accent, not dominate, your
outfit. Earrings should be compatible in size to
necklaces. Wear one ring per hand. (Wedding and
engagement rings count as one.)
Watches Match the metal of your watch to your other jewelry.
Eyeglasses Wear updated frames. Don’t let your glasses
compete with your jewelry. Match the metal of your
glasses to your other jewelry.
Purses The purse should be neat and functional. A poorly
made or worn-out purse can downgrade your outfit.
Coordinate your briefcase with your purse.
(Brody, 2005; Post, Post, Post, & Post Senning, 2014)
4.2 Tips for Professional Dress for Men

Suit colors Navy blue, gray, and black are the business
standards. Dark colors are associated with more
authority.
Suit fabrics Wool is the fabric of choice. The suit surface
should be matte, not shiny.
Slacks Pants fitted to the waist are more slimming. Flat
fronts are more slimming than pleats. Cuffs are
more classic in style than pants without cuffs.
Dress shirts White is the dressiest. Shades of blue, gray,
tan, and muted green are preferred. A point col-
lar looks fine open or with a tie. Always wear a
tie with spread collars.
continues
4.2 Tips for Professional Dress for Men (cont.)

Shoes Shoes should harmonize with the outfit. Wear
black shoes with gray, navy, or black suits.
Wear brown shoes with tan, brown, or beige
suits. Match shoes to your belt color.
Socks Match socks with your pants. Exception: With
tan pants, socks should match the shoes. Socks
should be high enough to cover your shins when
sitting.
Ties Silk is the best fabric. The tie should complement
the suit color but not match it. Wear a wider
tie with a wider lapel. Wear a thinner tie with
a slimmer lapel. The tip of the tie should end at
the top or middle of the belt. Don’t wear a tie
with a short-sleeve shirt.
Belts Match the belt to your shoe color. The standard
belt width is 1 1/4 inches.
Jewelry Keep your jewelry subtle and minimal. Do not
wear more than one ring per hand. Match
metal to metal with jewelry items (for example,
gold to gold).
Eyeglasses Wear updated frames. A round face looks
better with square frames. A square face looks
better with round frames.
Wallets Dark leather is the most traditional. The wallet
should be thin and not cause a bulge in the
back pocket.
Miscellaneous When wearing a single-breasted suit or sports
coat, button the top button when you stand.
Unbutton it when you sit down.
(Brody, 2005; Post et al., 2014)

“The apparel often proclaims

the man.”
–Shakespeare
Do you have any tips for handbags and briefcases?

Yes. These items can detract from your overall appearance if they are shabby and
worn. These articles do more than hold important papers, wallets, and cellphones.
They hold clues about your professionalism, success, and personality. Think
“classic” when purchasing these accessories (Whitmore, 2005).
Faux Pas
Jessica purchased a sexy black dress for a cocktail party at her college
reunion. She wore the same dress to the hospital’s holiday party several weeks
later. Unfortunately, she did not project the corporate image needed for the
administrative position for which she had just applied. When the committee met to
discuss the applicants, several people mentioned Jessica’s dress. The bottom line is
that what is appropriate for wearing with friends may not be appropriate to wear
in a work setting.
How can I put my best foot forward?

Make sure your shoes are in good condition. Dusty and worn-looking shoes detract
from a professional impact. Shoes are often assessed to evaluate your attention to
detail.
Faux Pas
Roberto was the CEO of a large healthcare facility. He had impeccably good
taste, and his clothes made a professional impression. However, his wingtip shoes
were shoddy. When he crossed his legs, duct tape was visible on the bottom of his
shoes. His shoes were an embarrassment to the corporate staff until one brave soul
had the guts to discuss his shoes with him privately.
How do I know what colors are flattering for me?

Hold a piece of clothing up to your face and study how you look. A flattering color
will make your eye color more intense and your skin tone more vibrant and will
give you an energetic look. In contrast, your skin will look sallow, your eyes dull,
and your face tired with an unflattering color (Post et al., 2014). If you’re not sure
what colors are right for you, consider hiring an image consultant.
What about makeup? TIP

Never comment
on someone’s
Most women look better with a little makeup. The weight. Even a
key is to use makeup to enhance, not to dominate. If compliment can be
you choose to wear lipstick, make sure you don’t have taken in the wrong
lipstick on your teeth. way.
What about professional women with long hair?

Hair should be kept out of the eyes. It can be tucked behind the ears, pulled back
with a barrette, pulled up in a ponytail, or twisted up with a clamp.
“Know first who you are; and

then adorn yourself accordingly.”
–Euripides
Dressing in the Clinical Setting

What impact does dress have in a clinical setting?
Dress has a bigger impact in a clinical setting than most nurses realize. The way
you dress supports or detracts from your professional image. It sends a message to
others about how you see yourself and how you want to be perceived by others. It
sets the stage for what others may expect from you. Most nurses would agree that
they would like to be viewed as professional, intelligent, and competent. They need
to ask themselves if their appearance mirrors that image.
If nurses dress too casually, patients may question their attention to detail and
their professionalism. Patients often associate appearance with trustworthiness
and ability. Does a nurse dressed in bunny print scrubs establish immediate trust,
authority, and credibility? Many patients complain that everyone in a clinical
setting looks the same. Patients want their nurses to be clearly identifiable. This
identification is also essential for having positive interactions with families,
physicians, and other members of the health team.
Can scrubs be part of a professional image?

Many hospitals are reevaluating their dress codes. Randomly selected scrubs in
various colors and print designs may be on their way out, as the credibility and
professionalism of healthcare personnel are under scrutiny.
According to image consultant Sandy Dumont (personal communication, 2007),

uniforms are necessary for professional identification. In her opinion, nurses look
most professional when wearing white. She believes that hospitals need to mandate
dress codes. If they permit scrubs, she asserts that there should be uniformity. All
nurses should wear the same color, so it doesn’t look like someone was hired off the
street and doesn’t have a uniform yet.
Many healthcare systems now have mandated colors for nurses and other
professionals. For example, in some hospitals, nurses wear navy blue, physical
therapists wear green, and respiratory therapists wear blue. When the hospital logo
is embroidered on the neatly pressed scrub top, the look is professional.
Faux Pas
As part of hospital orientation, a group of nursing students was told about the
hospital and university dress code policy. On clinical days, they were to wear their
uniforms and lab coats. But while preplanning, they could wear business casual
clothes with their lab coats and name tags. One week later, two of the students
arrived for preplanning wearing soccer shorts, T-shirts, and flip-flops. They were
not permitted on the unit, and the negative impression they left stuck with them. The
staff referred to them as the “soccer girls” for the rest of the semester.
Notes From an Image Consultant

In a hospital setting, things are often a matter of life and death, and you
show up wearing “pink pajamas” with cartoon motifs. How is a patient to
know that you’re not there to change the bedpans? Nothing about your
appearance announces that you are a highly trained expert who is a
member of an honored profession.
Imagine you’re boarding an airplane. If the co-pilot greeted you wearing a

polo shirt and khakis whereas the pilot wore the traditional uniform, would
you be taken aback? Would you assume that the casually dressed pilot was
still in training, or that perhaps he was called in to fly at a moment’s notice?
“Hope he wasn’t drinking the night before,” you might say to yourself.
Furthermore, what would you think about an airline that permitted pilots to
dress for their own comfort rather than wear a proper uniform?
Don’t cheat your patients of their expectation to be cared for by a highly
trained expert who is a member of an honored profession. If you are proud
of who you are and what you do, shout it to the world by looking like a
nurse!
Sandy Dumont is an image consultant with 30 years of experience.
What are some general guidelines for dress in a clinical

setting?
All nurses in all settings should look neat and professional. Uniforms, lab coats, and
scrubs should be wrinkle-free. Shoes should be clean. Long hair should be pulled
back and out of the face. Name tags should be visible and readable.
Body Language
What impact does body language have on the overall
impression a person makes?
We all communicate with each other verbally, vocally, and visually. The profes-
sional impression you provide is based on the words you use (verbal), the way
your voice sounds (vocal), and what people see (visual). The visual element has the
strongest impact and consists of everything people see when they look at you. This
includes your dress, grooming, and body language.
The care and time you invest in your appearance and words can be undone by body
language. For example, suppose you are dressed in a professional manner, but you
are slouching and leaning back in your chair. You are probably sending a message
that you are not as interested as you should be.
Avoid looking at your watch when talking with patients. This may suggest you have
something better to do. Also, when you enter a patient’s room, try not to drag your
feet, implying you are tired. The patient may feel uncomfortable asking for help.
Good Idea!
Kristin was teaching a workshop on time management. The workshop was
videotaped so it could be shown for evening- and night-shift personnel. When
Kristin viewed her tape, she was disappointed. She had an unpleasant look
on her face, and her posture was poor. Her body language detracted from her
professionalism. She used this feedback in a constructive manner and greatly
improved her presentation skills. Most people would benefit by critiquing
themselves on videotape.
“When the eyes say one thing,

and the tongue another, a
practiced man relies on the
language of the first.”
–Ralph Waldo Emerson
How can I tell if my body language is having a negative

impact on my professionalism?
Tune in and be aware of what image your nonverbal communication is projecting.
Many negative aspects of body language are bad habits that can be corrected with
awareness. Get feedback from others. Table 4.3 offers several body language tips.
4.3 Body Language Tips
Topic Tips
Standing Stand tall with your shoulders back and your chin
up. Keep your shoulders relaxed. Avoid slouching,
swaying, and shifting your feet. Don’t keep your
hands in your pockets. Folding your arms may
denote defensiveness or disagreement. Don’t put
your hands on your hips.
Sitting Sit up straight. Cross your legs at the ankles. Avoid
slouching. Don’t jiggle your knees or tap your feet.
Facial expressions A sincere smile denotes warmth and friendliness. A
false smile makes you look phony. A frown makes
you look angry or worried. Be animated, but don’t
overdo it.
Eye contact Looking at the eyes of another shows your interest.
Occasionally look away and move your eyes to
another part of the face. Don’t stare or shift your
eyes.
Movement Move with confidence and purpose. Don’t drag or
shuffle your feet.
Gestures Use gestures to make a point. Vary your gestures.
Gesture with open hands. Don’t wring your hands,
point, or make a fist. Don’t overdo gesturing.
(Pachter, 2013; Post et al., 2014)
Also, avoid the following:
• Playing with your hair or jewelry
• Biting your lips
• Twisting your mustache
• Drumming your fingers
• Clicking pens
• Picking your teeth

• Biting your fingernails
• Jiggling keys or change in your pocket

? Is it better to be overdressed or underdressed in a new work
setting?
In general, it is better to err on the more formal side. Remember, you can
always remove a jacket, but you cannot put one on if you didn’t bring it
with you.
? If I am dressed inappropriately, couldn’t it mean that I just did not

know any better?
Yes. But that is not an excuse. You need to find out the appropriate dress.
By your inappropriate dress, you could also be suggesting that you do not
care what others think or that you are too lazy to make the effort to dress
better.
? Where can I buy professional clothing without spending a fortune?

Shop at outlet malls and check department stores for sales. Other options
are Nordstrom Rack, T.J. Maxx, and Ann Taylor Loft.
? Why are corporate casual dress codes being eliminated in many

settings?
The informality of these dress codes gave many people the impression that
there were no guidelines or boundaries between dressing for work and
relaxing at home. This had a negative impact on professional image and
work ethic.
? How do I know if my body language is detracting from my

professional image?
Ask a colleague for feedback. Videotape yourself.
? Is it acceptable for men to wear baseball caps inside?

No. It is considered bad manners. Hats should be removed when entering
a business or room.
? Do you have any tips for men wearing suspenders?

Suspenders should be matched to the tie. A subdued or flashy pattern
should be compatible with the company culture.
? What about tattoos?

Keep them hidden. Don’t get tattoos on your hands or face. The tattoo
becomes part of your image and may hurt your chance of getting a job or
getting promoted.
? Is it professional for men or women to wear cologne or perfume in

the work setting?
Subtlety is the key. Remember, you are not an air freshener. Moderation is
best. If people comment about your scent in the afternoon, you are using
too much. Also, if your scent lingers in a room after you’ve left, you are
using too much. Be sensitive to the fact that many people are allergic to
cologne and perfume.
TAKE-AWAY TIPS
• You will have a better chance of feeling good on the inside if you
look good on the outside.
• Dress for the job you aspire to, not for the job you have.
• Wear clothes that fit well. Invest in a good tailor or seamstress.
• Your clothes affect your credibility.
• Don’t wear sunglasses inside.
• Sloppy clothing may imply sloppy work.
• How you present yourself is how most will know you.
• Unfortunately, the words you say can be undone by your body

language.
5 Interviewing 91
5
INTERVIEWING
What You Say Gets You What You Want!
DO YOU:
• Know what to expect during an interview?
• Know what to wear during an interview?
• Know what to bring to an interview?
• Know what to do if the interviewer asks you a question you can’t answer?
• Know how to react to the unexpected during an interview?
ARE YOU:
• Nervous before and during an interview?
• A less-than-stellar interviewee?
These are legitimate concerns that can add to the normal stress of an interview.
The trick is to know how to prepare and present yourself so you can minimize
anxiety and maximize your level of confidence. This chapter provides guidelines
to support you in any interview or even any business meeting.
Preparing for the Interview

What should I do before the interview?
Find out as much as you can about the company (for example, financial or Magnet
status) or position. Don’t just read the material sent to you prior to your interview.
Dig deeper and find out as much as possible about the organization. Check the
website for information about the people in charge. Check for published materials
about recent successes and PR announcements. For example, if you are interviewing
with a manager who wrote an article on civility, you could mention the article during
your interview. The more you find out, the more prepared you will be and feel.
You also need to review your public persona. Make sure your information presents a
professional and positive impression. Prospective employers will search the web for
information on you and may locate your website, blog, or social networking profile
(LinkedIn or Facebook, for example). You should be able to substantiate anything
you post online about degrees, professional accomplishments, awards, military
service, job titles, length of employment, and so on. Make sure you have nothing
there (words or pictures) that could embarrass you or your potential employer.
Never trash anyone online. Keep your personal information personal. Don’t post
about any illness or how you dislike your current place of employment or nursing
colleagues.
Faux Pas
John did a great job promoting himself for a cardiovascular sales position in
a pharmaceutical company. He eloquently described his various job positions
related to cardiac nursing. Unfortunately, when asked about the company’s new
cardiac drug that had received FDA approval a few weeks earlier, he could not
answer the question. One look at the company’s website would have informed him
of this drug’s approval and helped him to prepare himself accordingly.
What should I do if there is something online that casts me in

a negative light?
If possible, remove the negative item. LinkedIn and Facebook allow users to delete
information. If you cannot remove it, be prepared to explain it—and that it is not a
true reflection of who you are today. You could also add that you learned a valuable
lesson about social media and regret that you cannot undo the picture or words.
5 Interviewing 93
Is it OK for me to request to
connect with someone I
interviewed with on LinkedIn?
No. I would not suggest this. You are not
colleagues, nor are you in a situation to be of
any benefit to the interviewer. If you are hired,
you could reconsider this at a later date.
After the interview, can I ask to

take a selfie with the interviewer?
No. The interview is not a social event. Don’t trivialize it. It is a serious
professional encounter with a potential job on the line.
Is it OK to post a selfie of myself in front of the medical center

where I am interviewing?
No. Going for an interview is not like taking a vacation or going to an amusement
park. Focus on getting the job.
Faux Pas
Peg received several long-distance calls on her answering machine from a hospital
asking her for a reference. Because Peg was unaware of anyone interviewing who
might use her for a reference, she did not return the calls. A week later, she ran
into a former student who mentioned she had applied for an out-of-state job and
had listed Peg as a reference. If the former student had contacted her sooner, Peg
would have immediately returned the call to show her enthusiastic support of the
applicant. The polite way to handle this situation is to ask permission before listing
someone as a reference. Even if you have previously received permission to use
the person as a reference, it is important to contact the person before any new job
search to be sure nothing has changed.
Is it a good idea to have some names to drop?

Yes. Talk to family, friends, and people on the street, train, or bus. See if you can
get a name to drop. Leverage those you know. When used appropriately, personal
connections can enable you to walk through a door opened wide rather than just
get a foot in the door.
Try to familiarize yourself with names. If you are applying for a teaching position,
learn the names of faculty members. Review their websites. If you can’t pronounce
a name, call the department secretary and ask. You can also get help online with
pronunciation websites.
People like to
If I have inside contacts, should I use TIP do business with
them? people they know
and like. Responsible
Yes. Talk to them before the interview about the name-dropping can
position. What kind of personalities fit well in the take you from the
job culture? What are the hidden expectations for position of stranger to
employees? Why do people stay, and why do they insider in the blink of
leave? What is the turnover rate? an eye.
How can I find out who will be at the interview?

Call the person who scheduled you for the interview, explain that you want to be as
prepared as possible, and try to find out who will be there. Find out the title of all
interviewers and their roles in the organization. This will help you direct questions
to the appropriate person.
Often, you will be able to get biographical information on each interviewer on the
organization’s website. See if you have any commonalities. If so, bring them up
during the interview. For example, perhaps you both went to the same college, did
the same nursing internship, or served in the Army Nurse Corps.
What are some of the questions that may be asked?

The following list offers sample questions you might encounter. Role-play your
response in less than two minutes. Write out your responses. Practice answering
these questions out loud. Practice will help you sound more confident and avoid
filler words and sounds such as you know and um. Be sure to allow time for sponta-
neous comments.
• What attracted you to the nursing profession?
• What experiences do you have that will help you in this position?
• What distinguishes you from other job candidates?
• What are your major strengths?
• What are your major weaknesses?

5 Interviewing 95
• How do you react to stressful situations?
• Where do you see yourself in three to five years?
• What experiences have you had working in teams?
Also, questions could be centered around clinical scenarios. For example, if a patient
has a BP of 90/60 and an HR of 130, what concerns might you have and what might
you do?
What are behavioral questions?

These are questions where the interviewer asks you to recount a specific example of
a past experience that may be used as a predictor of future performance. Here are
some examples:
• Describe how you contributed to a recent team project.
• Give an example of your leadership ability.
• Tell me about a time when you learned to get along with a difficult person.
• Contrast a good decision with a poor decision you’ve made.
• Have you ever worked with a group where you had to help people younger
and less experienced than yourself? Give an example.
• Describe a situation when you were faced with failure and how you responded.
• What is the most creative project you have worked on?
• Provide an example of how you successfully used a network within an organi-

zation.
• If two managers were describing you, what would they say?
• Describe a time when you were able to persuade others to adopt your ideas.
“To show your leadership, you

do not need to have all the
answers but to understand how
to ask the right questions.”
–Peter Drucker
Professionalism During the

Interview
Faux Pas
At the end of a job interview, Ryan asked the interviewer how best to follow up on
the hiring decision. When the interviewer gave Ryan a phone number to call, Ryan
asked if he could borrow a pen and piece of paper to write it down. The first thing
the interviewer did once Ryan left was to make a note to himself: “Candidate was
disorganized and did not even bring a pen and piece of paper.”
What should I bring to the interview?

Bring a portfolio or folder with appropriate materials. For example, if you were
asked to bring a professional license, make sure you have it in the folder. At the very
least, bring the following:
• A list of questions for the interviewer(s)
• A pad of paper or notebook for making notes

or taking down follow-up information
• A writing utensil and a spare, in case the first

gets lost or damaged
• Between 5 and 10 professional-looking copies

of your resume
• Information about accessing your e-portfolio,

if you have one
What should I wear to the interview?

Wear a dark suit unless you were advised to wear something else. Avoid yellow,
red, or pink suits. However, these colors are fine for accessories or accent pieces.
Stay away from long, dangling jewelry. Some human resource experts recommend
the “rule of five” for jewelry. This limits jewelry to five pieces, such as two rings, a
watch, earrings, and a necklace.
Make sure the suit fits well and all accessories match. Clothing is never neutral. It
either adds to or detracts from your appearance.
5 Interviewing 97
Shoes are important, too. For men, leather soles are best. Before the week of your
interview, try on the suit to make sure your shoes are the right height if you are
wearing slacks. Give yourself time in case you need alterations in length or different
shoes. Even if employees dress casually, job seekers are
expected to dress more formally. This shows that you Faux Pas
are taking the interview seriously and that you respect There was a buzz in
the company. the hallway outside one
of the meeting rooms
Make sure your hygiene is flawless. A wrinkled shirt,
after a presentation.
food caught in your teeth, or chipped fingernails can The female speaker
detract from your professional impression. had worn a white suit.
If you are commuting from your current job to attend Her red underwear
could be seen through
an interview, you may not have time to change into
her suit, which
professional clothing beforehand. Mention this to
distracted the audience
the hiring manager. Make sure the manager knows
from listening to her
that you would have liked to have dressed more presentation. Her
professionally but were unable. Managers may not clothes undermined her
care if they know your timing was tight and you did professionalism and
not want to call attention to the fact that you were expertise.
interviewing for a position elsewhere.
“Clothes are never a frivolity.

They always mean something.”
–James Laver
Good Idea!
Monica was finishing her junior year of college and applying for summer
internships. She recently attended a seminar about business etiquette and thought
she needed to purchase a suit for her interviews. Because her mother disagreed
with her, Monica emailed the seminar speaker to specifically ask about the suit.
The speaker supported Monica’s position and reviewed the reasons for purchasing
a suit. Monica felt confident and professional in her suit, did great during her
interviews, and was offered the internship she wanted.
Faux Pas
Mary had worked in a hospital and was used to wearing scrubs. When she
interviewed with a pharmaceutical company, she thought wearing a sweater set
would be fine. She was embarrassed when she saw that she was the only one not
wearing a suit. It is always better for clothing to be more formal than too casual.
This shows respect for the interviewer and demonstrates that you made the effort to
present yourself in a professional manner.
Appearance and Hygiene Checklist

Men:
• Freshly bathed and shaven (even if interview is later in the day)
• Clean fingernails
• Deodorant applied
• Teeth brushed
• Clean, ironed clothes
• Shoes polished
• Minimal amount of cologne

Women:
• Freshly bathed
• Clean, manicured fingernails
• Deodorant applied
• No excessive jewelry, makeup, or perfume
• Wearing a bra with no underwear showing
• Clean, ironed clothes
• Clothes that are not too tight, too sexy, or too short
• Shoes polished
5 Interviewing 99
“You can’t climb the ladder of

success dressed in the costume
of failure.”
–Zig Ziglar
What about body piercings and tattoos?

A common stand on body art and piercings is, “We don’t care what you have
pierced or tattooed, as long as we don’t see it.” Limit any visible piercings to the
earlobes and keep tattoos covered, if possible. Remove the jewelry item from
piercings that cannot be covered (pierced tongue, eyebrow ring).
Is it OK to smoke while waiting for an interview?

Absolutely not. If you smoke, try not to do so before the interview. Otherwise,
your clothing will reek of cigarette smoke—a definite turnoff for many people.
Don’t smoke anywhere inside or outside of the facility. Also, be aware that many
healthcare facilities do not hire smokers. Tobacco use can be easily detected by a lab
test.
How can I be sure I’m on time for the interview?

If possible, visit the interview location before the day of the interview to plan
the best route to avoid potential traffic pitfalls. Find out where to park and note
the entrance to the building. This will eliminate a major stress on the day of the
interview.
Allow extra time for traffic and accidents on the day of the interview. Make sure you
have all relevant phone numbers with you. If you get stuck in traffic, notify your
contact that you might be late. Tell the person you will call back with an update.
Always plan to arrive at least 30 minutes early. This will give you time to park, take
care of personal business, and orient yourself to the medical center. Find out where
your interview will be held, but don’t report there until 5 or 10 minutes before
your scheduled interview. In the interim, relax in the lobby or coffee shop. Bring
a professional or other business-oriented magazine or book to read while waiting.
This will demonstrate that you are serious about continuing to learn and improve
professionally.
Allow time to use the restroom and check your appearance before presenting your-
self to the receptionist 5 to 10 minutes ahead of time. Be sure to greet the recep-
tionist with courtesy and respect. Remember: The receptionist may be asked by the
interviewer to comment on your behavior and manners. Wait for the receptionist to
advise you on where to sit.
Should I come prepared with some questions?

Yes. This shows careful preparation. If you don’t have any questions, it may look as
if you are either unprepared or uninterested. Here are two good questions to ask:
• What skills are considered most important for success in this position?
• What kind of educational opportunities do you offer to support career

growth?
If all your questions were answered, you could say something like, “All my
questions were related to Magnet status and clinical ladders, and you covered them
already.”
Faux Pas
A young man was interviewing for a position at a large medical center. He was
arrogant and aggressive in the type of questions he asked and the tone in which
he asked them. At one point, he flat out asked, “What are you going to do for
me?” Despite the interviewer’s attempt to guide the interview back to his history
and capabilities, the interviewee kept asking the interviewer questions. Needless
to say, the young man did not get the job. His method of reverse interviewing was
disrespectful and unwarranted.
What is a reverse interview?

A reverse interview is the same as a reverse-role interview. In this situation, the in-
terviewee asks the interviewer questions. When done with respect and tact, it shows
initiative and can differentiate the candidate from others. When done in a demean-
ing manner without showing respect, it is a sure way to ruin a job opportunity.
5 Interviewing 101
What are some examples of questions to use in the reverse

interview?
• Can you describe the workplace culture?
• How soon can I expect to get feedback on my work performance?
• Where are you on your journey to Magnet status?
Interview Do’s and Don’ts

Do:
• Use a firm handshake.
• Wait to be offered a seat.
• Make good eye contact with the interviewer(s).
• Maintain good posture.
• Speak so you can be easily heard but not too loudly.
• Be direct and to the point without rambling.
• Turn off your cellphone and any other electronic devices.

• If you have an emergency situation and may need to be contacted,
explain that at the very beginning of the interview.
Don’t:
• Use a limp or crushing handshake.
• Chew gum.
• Sit down until you are directed to do so.
• Give one-word answers.
• Give long, drawn-out answers.
• Interrupt anyone who is speaking.
• Bad-mouth a previous employer.
• Order an alcoholic beverage if you are taken to lunch.
• Comment about nationality, age, religion, or photographs of family or

children.
During an interview, is it OK to ask when I can expect to hear

about the position?
Yes. This is a reasonable question. You might say, “I am confident that I would do
a good job. What is the next step in the selection process?” You can also ask about
the time frame for filling the position.
Things Not to Say in an Interview

• “Do you have a smoking area?” Smoking is a turnoff and may
make you unemployable in healthcare. Medical insurance may be
higher for smokers.
• “I’m not sure what to do with my kids if I get this job.”

This suggests you may have childcare problems.
• “I really need this job to get away from my home situa-

tion.” This is too personal and could affect your ability to perform
your job effectively.
• “This city has great bars!” Will you have a hangover on Mon-
day?
• “Are those pictures of your children?” It is inappropriate to
discuss children, regardless of whose children they are, in interviews.
The conversation could lead into delicate or possibly illegal areas and
may make the interviewer uncomfortable.
• “Do you have disability insurance?” The interviewer may won-

der if you are trying to get a job to go on a disability claim. It is illegal
to discriminate against anyone with disabilities.
(Marianne P. Deska, HR consultant, personal communication, 2019)
What if I am asked a question that is not legal?

Questions designed to obtain information about age, gender, race, religion, marital
status, physical and/or mental status, country of origin, sexual preferences, and any
other discriminatory factors are generally illegal for making employment decisions.
If you are asked an illegal question during an interview, you have a few options:
• Answer truthfully if you think your answer will not hurt your employment
potential.
• Inform the interviewer that the question is illegal, but be aware that by doing
so, you run the risk of appearing confrontational or uncooperative.
5 Interviewing 103
• Examine the intent behind the question and respond with an answer related
to the job. For example:
• Illegal question: “Who is going to take care of your children when

you work extended hours?”
• Possible answer: “I can meet the work schedule that this job requires.”
Table 5.1 includes examples of illegal and legal questions you may be asked in a job
interview.
5.1 Examples of Illegal and Legal Questions

During a Job Interview
Illegal Legal
Are you a US citizen? Are you authorized to work in the US?
How old are you? Are you over the age of 18?
How many kids do you have? Can you work overtime if needed?
What is your height and weight? Can you lift a 50-pound weight and
carry it 100 yards?
Are you an alcoholic? What was your attendance record at
your previous job?
Do you go to church? Can you work on Saturdays and
Sundays?
What should I do if I don’t get a positive response about the

next step in the interview process?
Ask whether the interviewer has any areas of concern. Try to clarify any
misunderstandings. Ask again about the next steps and the hiring timetable.
What should I do at the end of the interview?

Shake hands and thank the interviewer(s). Say goodbye to the receptionist and
mention the person’s name. If someone walks you out, this is still part of the
interview. Don’t let your guard down, and be careful of what you say.
Maintain professional behavior and manners as you exit and get into your car.
Don’t light up a cigarette or take off your jacket as you walk out of the building.
Top 10 Interview Blunders

1. Making negative comments about former employers, su-
pervisors, or coworkers. No matter how bad they were, bashing
them never makes you look good!
2. Giving a call-back number that leads to an unprofession-

al outgoing voicemail message or using an inappropriate
email address. Avoid loud music, toddlers attempting to say
“Mommy/daddy isn’t home,” or slang on your voicemail. Be aware that
your email address can reveal a lot about you. Avoid addresses like
happygirl69@gmail.com. It’s worth the extra effort to create a profes-
sional email address for job searches. Email accounts are free and
easy to set up. This is discussed more in Chapter 7, “Communication
Technology.”
3. Wearing inappropriate attire. Flip-flops, plunging necklines, ex-

posed thongs, sweatshirts, and spandex material of any kind are never
appropriate. If you have to ask yourself or someone else “Does this look
OK?”, then it most likely doesn’t.
4. Arriving too early or too late. Arriving late obviously sends a bad
message, but arriving more than 20 minutes early to the interview site
can send a bad message as well. Simply put, it’s annoying. Remember,
it is good to arrive early at the medical center for your interview. This
gives you plenty of time to park, take care of personal needs, and orient
yourself to the center. But don’t present yourself too early for the actual
interview. Five or ten minutes is appropriate.
5. Divulging too much personal information. No matter how much

you want or need the position, do not dissolve into tears about your
marriage woes or childcare issues. This will not help you get the job.
6. Cellphone interruptions. Even on vibrate only, a cellphone going

off is still a distraction and potentially sends the signal that you will be
taking too many personal phone calls. Always turn off your cellphone!
7. Incomplete or incorrect contact information on your resume

or application. Take time to update former employer and reference
information. Also, make sure it does not have typos. Have someone else
read your resume before you send it out.
5 Interviewing 105
8. Inability to speak about or recognize past mistakes or

weaknesses. Everyone drops the ball sometime. Be prepared to talk
about it and explain how you grew from the experience.
9. Bringing friends, children, or significant others with you

to an interview. You’ll be expected to perform your job without
their support. Having them there is unprofessional and can make you
appear too eager and needy.
10. Lack of enthusiasm. This is especially bad for a new graduate.

A winning attitude and desire to learn can easily make up for lack
of practical experience. Make sure you get plenty of rest before your
interview so your eyes are bright. Smile and show your enthusiasm.
(Nicole Nardi, BSN, RN, former nurse recruiter)
After-Interview Professionalism
In a recent job interview, I was encouraged to follow up by
email. Is this OK?
This is something new that is now acceptable in many settings. The advantage of
this is that it allows for immediate follow-up and the ability to respond quickly to
questions or concerns. It also keeps you in the manager’s mind.
Should I write a thank-you note after the interview?

This form of etiquette is changing. Many hiring managers prefer getting an email
within an hour or so after the interview. If you want to follow the email with a
handwritten note, you can do that. Write clearly and neatly. If you type a note, limit
it to two short paragraphs. It may be wise to ask how the interviewer would prefer
for you to follow up.
If I haven’t heard about the position in the time anticipated,

what should I do?
Call and say that you are checking in about the status of your application.
If I get a rejection letter or find out the position was filled,

should I call and ask why I didn’t get the position?
No. Send a letter or email saying that you know the position was filled and that you
are interested in other related positions. This keeps your name in the forefront and
shows that you are not a sore loser.
Phone Interviews
I was hoping for a face-to-face interview and got scheduled
for a phone interview. Is this a bad sign?
No. Often, phone interviews are a standard first step. They also minimize travel
expenses for out-of-town applicants. In addition, Skype or other online video
communication methods can be used for interviews.
What is the main purpose of a phone interview?

Phone interviews are a cost-effective, timesaving method for screening job
candidates. As a job candidate, your goal is to determine if you are a fit for the
organization. If so, your next goal is to get an invitation for an in-person interview.
How can I ensure a successful phone interview?

See the following list for guidelines to ensure a successful phone interview (Pagana,
2012b):
• Prepare as you would for a personal interview: Because there is no chance

for eye contact or other nonverbal cues, you must be impeccably prepared.
This is your only chance to make a good first impression.
• Control your surroundings: You must be able to talk freely without dis-
tracting background noises. No crying kids or blaring televisions. Schedule
the phone interview when you will be at your best and in total control of the
situation.
• Get into a business mode: Many people dress professionally even for phone
interviews because doing so causes them to feel and act more businesslike
during the interview. If you are wearing pajamas, you may sound too casual or
tired.
5 Interviewing 107
• Stand up: Your voice will sound more confident and dynamic. Move around
a bit and use hand gestures.
• Smile: The smile on your face can be heard in your voice and projects a
positive impression.
• Have a pen and paper available: Don’t shuffle papers or waste time looking
for something to write with. Take notes. Ask questions.
• Don’t give one-word answers: Rather than saying a simple yes or no, pro-
vide a short explanation.
• Limit your answers to less than 2 minutes: If the interviewer wants more
details, he or she will ask.
• Have your resume and supporting data in front of you. You may be asked
questions about your background and previous experiences. Be ready to
answer them.
• Don’t interrupt the interviewer. Be a good listener. You want to gather

information to see if you are a good fit for the organization.
• Turn off the call-waiting option on your phone. The beep is distracting.
Besides, you should not put the interviewer on hold to take another call.
• Watch your manners. Use the person’s title and last name. Don’t chew gum,
eat, drink, or smoke. It’s OK to have water handy in case your mouth feels
dry.
• Close the interview. Ask about the next step in the interview process.
• Send a thank-you note after the interview. As noted, this can be by email
or regular mail.
Do you have any recommendations about outgoing

voicemail messages?
This could be your point of contact regarding the next step in the interview
process. Make sure your voicemail message reflects a professional persona.
Although your friends may enjoy hearing a snippet of your favorite music, the
interviewer may find it annoying and off-putting.

? Should I ask permission before listing someone as a reference?
Yes. Ask whether the person is willing to serve as a reference. Then send
the person a thank-you note and a copy of your resume. References may
also be obtained via online forms. Make sure your references are on the
lookout for these forms and that they fill them out quickly. Of course, you
need to be certain you have the correct email address for your reference.
? What should I do with my coat?

Take it off before you get to the interview area. Fold it over your left arm
so your right hand is free for shaking hands. Ask the receptionist where to
hang it.
? If there is candy on the table, is it OK to take a piece?

No. You want to be free to talk without food in your mouth.
? May I bring a water bottle into the interview?

Only if you keep it in your purse or out of sight. Don’t put anything on
the interviewer’s desk. If there is a table in front of you, you may put your
interview folder on it.
? What if I am asked a question that I cannot answer?

Think about it for a few seconds. Then, simply say, “I don’t know” or
“I can’t answer that question.” Don’t apologize. If you know where or
how to find the answer, you can explain that. This demonstrates your
resourcefulness. You could also say, “I don’t have an answer to that right
now. Can I think about it and can we come back to it later?”
? Is it OK to ask about salary in the first interview?

In general, no. It is better to focus on getting them interested in you and
wanting you for the position. Save the salary question for subsequent
interviews. However, if you are applying for a high-level position with wide
variations in salary, this may be appropriate. You don’t want to waste your
time or their time if the salary range is not going to meet your requirements.
5 Interviewing 109
? What if I am asked about salary?

Do your homework before the interview so you know what this type of
position pays. Say you are looking for something in the salary range that is
appropriate for the position.
? What should I say when an interviewer asks about my major

weakness?
Mention an area related to the job but not required for the position for
which you are applying. For example, suppose you are applying for a
teaching position in medical-surgical nursing. You could say, “I have several
ideas for articles, but I have not published anything yet. I am planning
to attend a writing and publishing workshop later this year.” Another
example relates to a new graduate nurse without experience. The person
could mention prioritization as a weakness. This is something that would
be expected and thus not really a weakness. It is something that will be
overcome with time.
? May I ask about advancement opportunities?

Yes, but be careful you don’t give the impression you are too ambitious and
are mentally planning your next career-advancement move.
? Is it OK to talk about interviewing with other companies?

Yes, but be careful. It might be better not to mention other companies until
you are discussing salary or you are asked, as opposed to bringing it up
yourself. Leveraging your situation with other interviews is a great way to
make you seem more desirable. If the interviewer is worried about losing
you to a competitor, your bargaining position can improve.
? How can I get correct names and titles of the interviewer(s) for
writing thank-you notes?
Ask for a business card, check the company’s website, or call the office.
If you call the office, say you are writing thank-you notes and want to be
certain that you have correct names and titles.
? How should I prepare for a phone interview?

Prepare as thoroughly as you would for a regular interview. Your goal is to
be invited for an in-person interview.
? Will standing up during a phone interview make my voice sound

more confident?
Yes. Try recording a message sitting and standing and you will see the
difference.
? Is it OK to post something on social media after my interview?

I would not do this. It is not professional. It may be a turnoff to a
prospective hiring manager reading your thoughts regarding the interview
process.
TAKE-AWAY TIPS
• Grandma’s right: You never get a second chance to make a good first
impression.
• Dress for the role to which you aspire.
• Turn your cellphone off before your interview. If it goes off by mistake,
apologize and quickly turn it off without answering it.
• Never bad-mouth former employers during the interview.
• Answer the employer’s questions in 20 seconds to two minutes.
• You can increase your chances of getting a job by projecting a positive,

upbeat, confident, and mature attitude during interviews.
• Ask the interviewer for a business card. This will give you the correct
spelling of the person’s name, the title, and the address for writing a
thank-you note.
• A smile on your face during a phone interview can be detected in your

voice.
• Sending a thank-you note or email demonstrates good people skills.

6 Meetings Still Matter 111
6
MEETINGS STILL MATTER
Making Meetings Work for You
DO YOU:
• Think meetings are important in the current climate of change?
• Wonder if you need to schedule a meeting?
• Consider meetings a waste of time?
• Know how to run a productive meeting?
• Know the responsibilities of a meeting’s leader and participants?
• Wonder about the seating arrangements?
Meetings are still a vital aspect of most businesses. They provide opportunities to
distribute information, strengthen team-building, support business relationships,
and display leadership potential. In addition, they enable members to take
measure and evaluate each other. Some meetings, however, are unnecessary,
boring, and unproductive time wasters. These negative components can be
avoided when meetings are well planned and properly conducted.
Planning and Preparation

What is the first step in planning a meeting?
The first step is to determine the purpose, goal, or outcome of the meeting. This
will help guide the meeting’s who, what, when, where, and why.
If, for example, the purpose of the meeting is to discuss a new healthcare
requirement, you should provide that information ahead of time so discussion can
take place at the meeting. If your purpose is to generate ideas and brainstorm, you
must actively encourage participation.
How do I know how much time is needed for the meeting?

Timing is important. You must consider the purpose of the meeting along with
the time constraints of the participants. Don’t waste people’s time. Most meetings
should not exceed one hour.
When scheduling a meeting, are there time slots to avoid?

It is usually best to avoid scheduling a meeting early or late in the day, Monday
morning, Friday afternoon, religious holidays, or the afternoon before a holiday.
People are often busy, unavailable, or simply distracted at these times.
Can I use technology to help set up a meeting?

Yes. Outlook, Google Calendar, and Doodle can all be used for scheduling
meetings. Meeting setup using these types of programs will appear on a person’s
work calendar.
You may even have the option of checking the schedules of other meeting
participants prior to sending out an invite. However, not all schedules will be up-
to-date. Sometimes, it may be best to send out an email with potential dates and
times before scheduling.
How do I determine the location for a meeting?

This depends upon the degree of formality or informality necessary for the purpose
of the meeting. The meeting could be held in a boardroom or in the cafeteria.
Things going on outside the room should not distract participants. If possible, the
location should be convenient for the majority of the participants.
The setting should be accessible and appropriate to those with disabilities.

People with visual impairments or hearing difficulties should sit near the speaker.
Wheelchair access should be considered if needed.
What should be included in the agenda?

This will depend on the type of meeting. An informal meeting may have only a few
topics for discussion. An agenda for a more formal meeting usually includes the
following:
• Date and location
• Start and end time
• Topics to be discussed, with the responsible person listed and time allotment
If the meeting is scheduled near a mealtime, note in the agenda whether food and
drinks will be provided.
What is the typical order for items of business on a

committee meeting agenda?
The typical order is usually as follows:
1. Welcome and call to order
2. Approval of the minutes from the last meeting
3. Reports
4. Old business
5. New business
6. Announcements
7. Adjournment
If you are new to the chairperson role, use previous meeting agendas as a guide.
Reasons Not to Have a Meeting

How do I know when not to have a meeting?
Unfortunately, many meetings are held that should not have been scheduled.
Before planning, determine whether the meeting is really necessary. Here are some
reasons not to have a meeting:
• You are planning to rubber stamp a decision you have already made. If
you have no intention of listening to the suggestions and opinions of others,
don’t waste their time at a meeting.
• Your goals can be accomplished through email. Consider whether people

really need to be physically present at a meeting. Is it worth the time and
energy to get people away from work for a meeting?
• You want to communicate a message to one member by avoiding an

uncomfortable one-to-one discussion. Don’t use meetings to camouflage
your motives and responsibilities.
• Your agenda is not clearly defined. This can result in a rambling, unfo-
cused, and long meeting.
• You just want an audience to hear yourself talk. This wastes people’s time.
Committee members will probably zone out and may avoid future meetings
that could be important.
What options do I have if asked to attend a meeting that is

usually unproductive?
Here are some ways to imply that you do not want your time wasted:
• Ask whether your attendance is mandatory or optional.
• Ask whether you can send a representative in your place.
• Ask whether you can offer input by phone or email.
• Say you are unavailable and ask whether the meeting is important enough to
change your schedule.
“People who enjoy meetings

should not be in charge of
anything.”
–Thomas Sowell
Chairperson Etiquette
How should the chairperson run the meeting to ensure it is a
good one?
The biggest mistake the chairperson can make is to assume that a well-planned
meeting will run itself. Here are some important guidelines for running a good
meeting:
• Distribute the agenda by email before the meeting.
• Attach supporting materials (including minutes for approval) to the agenda.

Sometimes, this material is posted online at a secure site to ensure privacy.
• Request confirmation of attendance. This can be done electronically.
• Arrive early to greet participants.
• Inform participants of the seating arrangements.
• Start and end on time.
• Follow the approved agenda.
• Speak in a voice that is easily heard.
• Use professional visual aids.
• Keep control of the meeting.
• Schedule breaks if needed.
• Don’t recap information for latecomers.
• Use effective facilitation skills so participants can ask questions and express
their views.
Helpful Tips for Facilitating Meetings

• Set the tone for the meeting at the beginning.
• Clearly state the purpose of the meeting.
• Use double-sided place cards on the table to learn names.
• If a certain person at the meeting has the specific information you

need, pose the question directly to that person. This is more efficient
and direct.
• Don’t shy away from sensitive subjects.
• Keep the meeting on track. Don’t let someone be long-winded or off

topic.
• Summarize so everyone takes away the same message.
• Remember that the facilitator is not the focal point of the meeting. The
facilitator draws others out.
(Adubato, 2005)
How can I prevent disruptive emailing

Plan breaks during
and texting during meetings? TIP long meetings so
Convey your expectations early in the meeting. people can check
Remind people to silence or turn off mobile devices. messages and return
Announce when you will be having a break so calls.
participants will know when they can check messages.
How do I keep meetings on track?

If a meeting starts to go astray, be polite and direct. Say something like, “That’s a
good point, and I’d like to discuss this with you after the meeting. Let’s get back
on track.” Another option is to redirect the conversation by asking a question. For
example, “Now that we understand the potential problems, what should be our next
step?” If someone continues to filibuster, say something like, “Sarah, we understand
your concerns. Let’s hear from someone else.”
Faux Pas
A group of medical doctors was invited by the hospital CEO to attend a one-hour
meeting at 7 a.m. to share ideas for improving the healthcare system. A week
before the meeting, the doctors received a folder of documents related to the
system. On the scheduled meeting date, the CEO arrived 10 minutes late and
spent the next hour reviewing the materials in the folders. Finally, at 8:10 a.m., the
doctors were given an opportunity to provide input. However, because the doctors
had scheduled office appointments with patients, they left the meeting feeling that
their time and effort had been wasted.
How do I handle people who keep interrupting others?

As the chairperson, you must stop this behavior. Try saying one of the following:
• “Can we please hold that thought until later?”
• “John is getting to that point. Please let him finish.”
• “Please let me finish.”
Or, raise your hand to the interrupter and continue speaking.
What if the meeting ends early? A good leader

TIP shows respect for
People will be delighted! Don’t drag on to fill the
people’s time.
time.
What if the meeting starts to run long?

Don’t try to cram in the agenda. Prioritize and determine what to discuss. Schedule
another meeting to complete the unfinished business.
Should I conduct an evaluation after

the meeting? Make sure you
TIP accomplish your
Yes. This is important because how you run a
must-do’s before
meeting is a reflection of your leadership ability and key people begin to
style. If you evaluate the meeting while the particulars leave.
are still fresh in your memory, you can make
improvements.
Here are some questions to ask yourself:
• Did you accomplish your goals?
• Did you invite the right people?
• Did any unanticipated problems crop up?
• Did you run out of time?
• Did you maintain control?
• Do you need to debrief with a supervisor or close colleague about the meet-
ing?
If you are not satisfied with any of your answers, decide what corrective action you
should take for the next meeting.
Sometimes, the chairperson will provide an evaluation survey for participants to

complete. This can be done on paper at the end of the meeting or electronically
afterward. Use feedback to make the meeting more productive and efficient.
Faux Pas
A committee meeting was set for 4 p.m., and several participants arrived early.
Unfortunately, rather than starting the meeting on time, the chairperson spent the
first 10 minutes chatting about his recent trip to Paris. As a result, the meeting ran
over. Not surprisingly, in their meeting evaluations, several committee members
criticized the chairperson for not starting the meeting on time, accusing him of
“grandstanding.”
Etiquette for Participants

What are some etiquette guidelines for participants?
Your active participation is essential for the success of the meeting. Remember, you
are there because someone thought you have something to contribute. Here are
some key guidelines (Chaney & Martin, 2007):
• Respond to the meeting notice concerning your attendance.
• Punctuality is expected. Arrive between three and five minutes early.
• Introduce yourself to those you don’t know and shake hands.

• Bring needed materials and the agenda. (Many people bring mobile devices
containing all the necessary information.)
• Come prepared to discuss items on the agenda.
• Bring a pen and paper for taking notes and following up.
• Watch your posture and body language. Be professional.
• Pay attention to the chairperson and other members.
• Stay for the entire meeting unless you have informed the chairperson in
advance that you need to leave at a certain time.
What are some distracting behaviors to avoid?

Avoiding distracting behaviors is important. Remember, others in the meeting
will be making judgments about and forming impressions of you. Here are some
behaviors to avoid:
• Failing to read supporting material before the meeting
• Rolling your eyes and looking at your watch
• Doodling, playing with pens, chewing gum, or tapping your feet
• Reading mail or checking your mobile device
• Interrupting others or dominating the discussion
• Propping your feet up on an empty chair
• Falling asleep
• Not contributing to the discussion
• Putting yourself down by saying things like, “It’s only my opinion . . .”
• Asking permission before making your point
How can I avoid wasting other people’s time in meetings?

When and if you talk, be concise. Don’t try to impress others. Use the WAIT strat-
egy to answer the question, “Why Am I Talking?” Consider these questions before
you begin:
• Do I have something important to share?
• Is this the time to share?
• Is it my turn?
• Is it a fact or an opinion?
• Did someone make this contribution already?
Does it matter what I wear?

Yes. As mentioned, people will be judging you and forming impressions about you
during the meeting. Dress professionally and demonstrate impeccable grooming.
Faux Pas
Darby was a new nurse manager in the health system. The dress code for
managers was a white lab coat over scrubs or other professional attire. One
afternoon, all the managers received a request to meet with the CNO at 3 p.m.
to discuss patient satisfaction scores. Unfortunately, Darby forgot her lab coat that
morning and was embarrassed to be the only manager not following the dress
code. She learned to always keep a clean lab coat in her office.
Is it OK to arrive for a meeting too early?

No. Arriving more than 10 minutes before the meeting starts can create an
awkward situation. Those in charge may be ironing out last-minute details. If you
arrive early and see that people are busy with last-minute preparations, step outside
the room and wait until the scheduled meeting time.
What should I do if I know I will be late for a meeting?

Tell the chairperson that you will be late. With advance notice, the chairperson may
be able to seat you in a place less likely to distract others. When entering late, walk
in as unobtrusively as possible. While taking your seat, don’t greet others, rattle
papers, or get refreshments.
What should I do if I need to leave a meeting early?

Notify the chairperson ahead of time. Sit near the door so you will be less
disruptive when leaving. Similarly, if you anticipate that a meeting may run late and
you need to leave at the normal end time, explain your conflict before the meeting
and sit by the door. On the other hand, if you don’t need to leave early, keep the
seats near the door open for those who do.
What if I think I should have been invited to a meeting but

was not?
You can interpret this in one of several ways:
• The organizer may have thought that your time would be better spent doing
something else.
• The purpose of the meeting may be to make decisions above your level.
• The organizer may have made a mistake.
If you feel comfortable doing so, you can ask why you were not invited. If a mistake
was made, it can be easily corrected.
How do I handle back-to-back meetings?

The best way to handle back-to-back meetings is to prevent them from happening
in the first place. If possible, keep a 15- to 20-minute buffer zone between
meetings. Also, be sure to allow for travel time. If you do have back-to-back
meetings, it is a good idea to inform the chairperson before the meeting starts that
you are on a tight schedule and will need to leave when the meeting is scheduled to
end (Post, Post, Post, & Post Senning, 2014).
Introductions and Seating

What is the proper etiquette for handling introductions?
The chairperson should arrive first to welcome participants and introduce new
attendees. Another option is to have participants introduce themselves at the start
of the meeting.
If an unknown guest is present, the chairperson should introduce that person at the
beginning of the meeting and describe the person’s role. Otherwise, people may be
intimidated or distracted, trying to figure out why the person is at the meeting. If
you don’t explain why the person is there, they may think the worst—for example,
that the person is there to discuss layoffs or cutbacks.
Meeting participants can also demonstrate initiative by arriving a few minutes early
and introducing themselves to others. This is a great networking opportunity.
Where should I sit at a meeting?

If there are place cards, the answer to this question is simple. If not, it is polite to
ask the chairperson where you should sit. Of course, you do not want to sit where
the chairperson should sit. Avoid the head or foot of the conference table.
Where should the chairperson sit?

The person in the position of authority usually sits at the head of a rectangular
table, farthest from the door. This is commonly referred to as the power perch. The
seat to the right of the chairperson is usually reserved for an assistant or for the
person next in importance. The person next in line of importance after that usually
sits to the left of the chairperson (Chaney & Martin, 2007).
The chairperson usually arrives first to the meeting and can sit anywhere in the
room. Some chairpersons choose a seat that offers the best view of the room and
enables them to engage the participants.
Faux Pas
Marlene was delighted to be asked to join the Quality & Safety Committee. The
meeting was held in the hospital auditorium at a U-shaped table in front of a
projection screen. Marlene arrived early at her first meeting and took the seat in
the center of the front table. She did this every month until one day she arrived a
few minutes late and found the chairperson sitting where she normally sat. She
was embarrassed to realize that she had been sitting in the chairperson’s place
every month.
Should place cards be used?

Using place cards is a great idea. It helps participants learn the names of others in
the meeting. Two-sided cards are best. They enable participants to easily find their
place and to learn others’ names.
What if there are no chairs?

Conducting a meeting with no chairs, where everyone stands, works only if the
meeting is short. In this case, you should minimize chitchat and focus everyone on
the task at hand. This would work for a clinical huddle.
Follow-Up Actions
What are the responsibilities of the chairperson after the
meeting?
For the sake of proper etiquette, the chairperson should ensure that the meeting
room is left in good order. Remove any plates, cups, papers, and trash from the
table. The chairperson should also send a reminder to all participants indicating
deadlines for completing follow-up tasks. Finally, the chairperson should arrange
for the preparation and distribution of the minutes.
What are the main components of the meeting minutes?

The components of the meeting minutes differ by organization or committee. To
gauge the amount of detail required, follow the format used by the organization or
committee. In general, minutes include any or all of the following:
• The name of the group, the date, the place, and the time
• A list of participants (present, excused, and absent)

• Approval of minutes from previous meeting (with or without corrections)
• Reports from committees or officers
• Unfinished business and action taken
• Action taken on motions (who introduced and who seconded)
• Follow-up responsibilities
• The date and location of the next meeting
• The time of adjournment
• In some situations, notices protecting the confidentiality of the information
Serving Food and Refreshments

Are table manners important for meet-
ings that include a meal? Don’t let the social
Yes. Watch your table manners. You will be
TIP nature of a meal
overshadow
scrutinized, and your table manners will leave a
the fact that this is
positive or negative impression. You will feel more
business.
confident and comfortable if you follow proper
dining etiquette. (See Chapter 10, “How Dining
Etiquette and Business Go Hand-in-Hand”)
Which meal is usually best for a business meeting?

Lunch is the most popular for the following reasons:
• It occurs during the workday and not on

personal time.
• Providing food can motivate people to attend

the meeting.
• It is short and time-limited because people

have to get back to work.
• Whether significant others should be invited

is not a concern, as it is with an evening meal.
What is the proper etiquette for handling the food and still
participating in a business meeting in a professional manner?
Be polite and arrive early to get your food and drinks before the meeting starts.
Avoid eating anything messy. If you should arrive late, don’t distract others while
getting food. Remember, you are there for business. Food is not the main priority.
See the following tips for etiquette during a breakfast meeting :
• If eating a croissant, break off a bite-sized piece and, optionally, add jelly or
jam before eating it.
• Use a fork and knife to handle a gooey cinnamon roll. (Don’t even think of
licking your fingers!)
• Break muffins in half, and then break off bite-sized pieces. Butter each piece
and then eat it.
• Butter and add jam to toast while it is on your bread plate. Cut the toast in
half or quarters and eat each piece.
• Tear off a bite-sized piece of a doughnut and eat it. Only dunk it in coffee or
tea in the privacy of your home.
If a meeting takes place in a restaurant, who pays the bill?

The person who scheduled the meeting pays the bill and tip. Note that this is
regardless of gender.
Virtual Meetings
Why are virtual meetings popular?
Face-to-face meetings are costly in terms of travel and the human wear and tear
that accompanies it. Many companies have branches across the country or the
world. Virtual meetings can connect people by computers, satellites, and phones.
Examples include web conferences, teleconferences, and videoconferences using
programs such as Cisco Webex, GoToMeeting, and Zoom.
What are the advantages of virtual meetings?

In addition to saving time and money for travel, a key advantage is that participants
can share information, discuss options, and make decisions in the privacy of their
own offices without being distracted. Other benefits include the following:
• Scheduling is easier because participants are more flexible when travel is not
involved.
• Real-time communication can take place between people in multiple loca-

tions and time zones.
• People are less likely to cancel because of personal issues because they can
handle personal issues better in their home or office and still participate in
the meeting.
• Participants can take turns presenting information without standing up, walk-
ing to the front of the room, and connecting their laptops to a projector.
• Large meetings can split into smaller sessions without the need for additional
conference rooms.
• Some forms of web conference software

generate full-text chat transcripts and audio
recordings, enabling participants to review
them later. This is also beneficial for those
unable to attend the meeting.
• People won’t come back to work exhausted

and bleary-eyed after a red-eye flight from
California to New York.
Faux Pas
Edward was asked to participate in a conference call to discuss his proposal for
a possible keynote during Nurses Week. While traveling, he called in, only to
find that the password with which he had been provided was incorrect. He tried
calling the coordinator but could not get through. Because he was out of his office,
the meeting coordinator was unable to contact him—although she did leave a
message on his office voicemail. When he finally thought to call his office 25
minutes later, he got the message and joined the conference call late. Although this
problem was not his fault, it did not provide a good first impression. To prevent this
problem in the future, Edward now always obtains the cellphone number of at least
one person who will be at the meeting.
What are the disadvantages of virtual meetings?

The main disadvantage of conference calls is the absence of nonverbal
communication, such as facial expressions, gestures, nods, and other forms of body
language. (Video calls allow some nonverbal communication.) Other disadvantages
of virtual meetings include the following:
• Decreased opportunity for team-building

• Decreased ability to control conversations that

go on tangents Make sure
TIP effective communi-
• Decreased spontaneity cation isn’t being
• Potential for compromised confidentiality traded or ignored for
bottom-line savings.
• Potential for equipment failure
What is the etiquette for participating in virtual meetings?

Participant preparation is key to successful virtual meetings. Of course, participants
also need to follow the meeting guidelines, reply promptly to messages, and
protect confidential information. If videoconferencing is used, participants should
remember to dress professionally.
Here are a few more tips (Schindler, 2008):
• Be polite.
• Log on at a specific time (often 10 to 15 minutes) before the meeting starts to

test connectivity. Some online products require installation and download. If
it is your first time participating in a virtual meeting, you may want to test the
connection as soon as you receive the invite. That would give you more time
to resolve any technical issues.
• Minimize background noise.

Planning prevents
• Identify yourself before speaking every time. TIP poor perfor-
• Avoid multitasking. Participate fully. mance.
• Turn off all mobile devices.
What are some tips for planning virtual meetings?

The guidelines discussed earlier in this chapter for planning face-to-face meetings
apply. Here are some important guidelines specific to virtual meetings (Post et al.,
2014; Schindler, 2008):
• Be alert to time zone differences. Timing and notifications are critical.
• Confirm availability of all invited participants.
• Send needed materials and make sure they have been received.
• Provide ground rules, such as when to use the mute button.
• Check equipment in advance.
• Make sure you are comfortable with the equipment or have a support person
available. You can’t run a good meeting if you are worried about which button
to press.
Use a co-facilitator
• Determine a backup plan in case of equipment
TIP to handle the tech-
failure. Will you postpone the meeting or use
nology and have
backup technology?
someone else take
• If you are participating in a videoconference, minutes while you run
pay attention to your dress and body language. a virtual meeting.
What considerations should I make when participants live in

different time zones?
Be aware of the participants’ working hours. Consider how the meeting time will
affect their work schedules—for example, requiring them to arrive extra early,
cutting into the lunch hour, or keeping them late at work (Schindler, 2008). If the
time is not good for some participants, rotate the time slot for the next meeting to
make inconveniences more equitable. Try to be fair to all.
Should I use the mute button during a meeting?

People disagree about the use of the mute button. Those that like the mute button
say it reduces background noise and improves sound quality. Those who dislike it
often feel that meetings are more spontaneous and productive if people don’t use
the mute button. This sets the expectation for interaction. Not using the mute
button also gives facilitators a better sense of each participant’s level of engagement.
Regarding the mute button, follow the instructions of the meeting chairperson.
How can I encourage participation during virtual meetings?

Here are several suggestions:
• Conduct a quick roll call at the beginning of the meeting. If a new person
joins the call later, ask for the person’s name at a good stopping point.
• Solicit audience feedback with polling features.
• Provide opportunities for each participant to speak without interruption for

30 seconds. Tell participants that if they wish, they can pass when their name
is called. Another round of speaking opportunities later in the meeting may
give those who did not speak the first time another chance to be heard.
• Direct questions to participants by name.
• Limit the size of the meeting. The smaller the number, the easier it will be
for people to participate and be understood.
• Keep the meeting short to ensure engagement.
Is it OK to put my phone on hold during a teleconference?

Be careful about doing this. If using a company phone, an infomercial or canned
music may play while the phone is on hold. This would be disruptive and annoying.
How do I handle meetings with a mixture of in-room

attendees and remote attendees?
It is a challenge for moderators to meet the needs of both audiences. This is
tricky because remote attendees at conference calls cannot see the nods of heads
around the table or the pause as people look through papers. They also can’t hear
low-volume conversations. Moderators must provide an audible connection to
remote attendees. They also need to direct their commentary loudly toward the
microphone, while encouraging others to do the
same (Schindler, 2008). If conducting vir-
The chairperson should regularly check back with
TIP tual meetings with
international par-
the remote members. Participants need to be
ticipants, see Chapter
reminded that the remote people may not be able to 14, “Going Global,”
hear when the noise level goes up in the room. for etiquette tips.

? How do I handle disruptions from mobile devices at meetings?
Remind people to turn them off before and during the meeting. If a person
is using a mobile device during a meeting, try asking that person a
question.
? If I attend regular meetings, is it best to sit in the same spot?

No. For team-building and to prevent forming cliques, don’t always sit near
the same people.
? What is the recommended time for scheduling breaks during

meetings?
Ideally, break after 60 minutes, but definitely after 90 minutes. People
need breaks to clear their heads and stretch their legs. Also, by scheduling
breaks, you encourage people not to use their mobile device during
meetings. They can check messages and return calls.
? How long should the break be during a meeting?

A good average would be 10 to 15 minutes. However, if there are a large
number of participants and the restrooms are not nearby, you may have to
add some time.
? How can I get people back from a break on time?

Point to the clock in the room and tell people the exact time the meeting will
resume. In the absence of a clock, tell people the time on your watch so
they can adjust accordingly. Restart at the designated time.
? If my meeting is out of time and I need an additional 20 minutes,

should I keep going and finish up?
No. You must respect people’s time and other commitments. Often, people
react to ending times as psychological breaking points. When the clock
ticks over the allotted time, their minds begin to wander, they lose focus,
and they may start feeling resentful. Only continue a meeting if doing so is
agreeable to all attendees. Give people permission to leave if they need to.
? If I am meeting to resolve a conflict, how do I determine a meeting

place?
Aim for a neutral place that does not favor any of the participants. For
example, rather than meeting in the CEO’s office, meet in a conference
room, which does not contain the CEO’s diplomas and awards.
? What advice would you give for using technology with virtual
meetings?
Use only the amount of technology needed to accomplish the desired
meeting outcome. Keep it simple so you can focus on your message and
not on the technology. Only use Webex if a presentation is going to be
done. If not, a conference call is all that is needed when the meeting is only
going to entail conversation.
? How can my career benefit from participation in meetings?

Meetings provide you with an opportunity to network and to learn more
about an organization. How you handle yourself can demonstrate your
leadership potential.
? If I think the purpose of a meeting could be accomplished by email,

should I say something?
Yes. I would contact the chairperson, who should appreciate the question
and be able to make a final determination.
? If I have scheduled a meeting from 4 to 6 p.m., should I provide

food?
Yes. This is polite because the meeting runs over a mealtime. Indicate on the
invitation to the meeting what kind of food will be provided. For example,
you may have hors d’oeuvres, light fare, or a full meal.
TAKE-AWAY TIPS
• Basic meeting etiquette applies regardless of location or whether the
meeting is in-person or virtual.
• Watch your table manners if food is being served at a meeting.
• Before planning a meeting, determine whether it is really necessary.
• Active participation is key to the success of a meeting.
• If you have a reputation for starting meetings on time, people are more
likely to arrive on time.
• When the business is done, the meeting should end.
• Don’t allow a meeting to run over.
• For virtual meetings, place photos and short biographies of the meeting
participants online or distribute the information with the agenda.
• Technology should support virtual meetings rather than drive them.
• Omitting the wrap-up of a meeting is like forgetting the closure of a

speech. Include it in the time schedule.
• Airport lounges are a good option for meeting with out-of-town

attendees.
• Multitasking is not conducive to an effective meeting.

7 Communication Technology 133
7
COMMUNICATION TECHNOLOGY
Controlling It Before It Controls You
DO YOU:
• Know what to do if your cellphone rings during a meeting?
• Want to demonstrate professionalism on a conference call?
• Wonder if you should fax or mail a key document?
• Know what should be included in an electronic signature?
• Know what to do if your email system does not have a spell-check
feature?
With today’s technology, opportunity rarely knocks anymore. Instead, it presents

itself in the form of a phone call, a voicemail, an email message, or a text message.
Technology is fast, efficient, and inexpensive. As convenient and efficient as these
forms of communication are, however, they can also be annoying, intrusive,
and rude. It is easy to abuse communication devices (such as smartphones), text
messaging, email, and instant messaging. This abuse can be costly to careers. If
you want to present yourself in a courteous and professional manner, use etiquette
with all forms of correspondence.
“Politeness and consideration for

others is like investing pennies
and getting dollars back.”
–Thomas Sowell
Email Etiquette
What are some tips for using email?
Email is now used more than any other type of communication. It is the prima-
ry form of communication in the workplace today. Whatever you write on email
could come back to haunt you. Even deleted messages can be retrieved. Therefore,
blunders become inerasable. Following are key tips to making email work for you
instead of against you (Pagana, 2007b; Pagana, 2007c):
• Never send confidential information via email. Assume it will be shared.

This information is one “forward” away from someone who may choose to
use it against you or your company. Of course, anything patient-related is
confidential. If you absolutely must send confidential information, mark it as
such.
• Make the subject line specific. This helps the reader prioritize messages,
file them, and easily retrieve them.
• Include a greeting and a close. It is more polite and less impersonal.
• Use short paragraphs. Being faced with an email with long paragraphs may
cause the recipient to put off reading it. Three or four lines is good.
• Never send long emails unless absolutely necessary. These types of mes-
sages can be overwhelming. In the case of a long message, a phone call may
be a better approach (unless you need to document something in writing).
• Don’t email if you’re upset. If you receive an email that elicits an emotional
response, wait 24 hours before responding. Alternatively, pick up the phone
and call the person to seek clarification.
• Don’t use all capital letters. Doing so is considered the same as shouting.
• Don’t use all lowercase letters. Doing so makes you look lazy.
• Proofread before sending. Use your email software’s built-in grammar and
spell-check tool.
• Maintain a business-like tone. Never use inappropriate language.
• Check your recipients before sending. This will avoid many errors.
• Avoid overuse of the Reply All option. Only include someone in your reply
if necessary. Failure to do so annoys people and contributes to email overload.
• Check your email regularly. How regularly you check your email will de-
pend on the type of work you do. But in most situations, you should plan to
check it at least two or three times a day.
• Occasionally check your spam mail folder. That way, you can recover
emails that were inappropriately tagged as spam.
• Confirm your receipt of emails containing important information. You

can’t assume the email got through unless you do this.
• Respond to emails within 24 hours. That is the general expectation of

senders, who know you have more to do than answer emails all day.
• When responding to a question, include

the question in the response. A message Email provides a
with just “yes” or “no” can be confusing. TIP searchable record.
You can be held
• Don’t forward chain letters or anything
accountable for things
else you would not want to receive. This you send and receive.
practice annoys people and adds to email
overload.
Faux Pas
A pharmaceutical representative was not happy with a secretary’s help with his
program setup at a hospital. After the program, he sent an angry email to the
secretary that contained some foul language. The secretary forwarded it to the
hospital president, who emailed the representative and permanently prohibited him
from being on hospital grounds.
Should my email include a signature block?

Yes. The signature block should include your name, address, phone number,
fax number, and email address. If you have an individual or company website,
you could add the URL. If this is a business email, check to see if guidelines are
available for font color and script. Your signature block provides several ways to
contact you. Your address provides people with information necessary to identify
your time zone, so they know when they can call you.
Setting up an email signature is very easy to do. For example, if you are using
Microsoft Outlook, go to the File tab and select Options. From there, select the
Mail tab and click the Signatures button. Finally, type the signature you want to
use and click OK. If you do not use Outlook, open your email program’s Help
feature and type signature, or ask your information technology (IT) support staff for
assistance.
Faux Pas
Ellen sent out an email to the nursing staff of 60 people encouraging them to sign
up for the Skills Update scheduled later in the month. At least 30 people used the
“Reply All” to respond. That means that the staff received at least 30 unnecessary
emails. Only include someone in the response if absolutely necessary. Help avoid
email overload.
What is the recommended length of an email message?

Keep it short. Try to keep the entire message viewable without scrolling. Long
messages can be tedious. Keeping messages short is especially helpful for people
who check their messages on a mobile device. For long messages, it’s better to
simply call the recipient on the phone.
What should I do if my email program does not have a

grammar and spell-check tool?
Copy the material and paste it into your word processing program. Check the
grammar and spelling there, and then copy and paste the text back into your email
message.
Don’t count on your spell-check program to catch everything. It may catch

misspelled words, but it will not catch words that are spelled correctly but misused.
(For more on these types of words, see Chapter 11, “Thank-You Notes and Business
Letters.”) It helps to read sentences backward to identify wrong words that are
spelled correctly.
W.A.S.T.E. Strategy
This is a strategy to help avoid wasting time on emails. Use the Why Am I
Sending This Email strategy and answer the following questions:
• Is it work related?
• Do I have a clear idea to share?
• Am I sending it to the right person/s?
• Do I need to tell everyone this?
• Am I angry or upset?
• Am I including only those who need to know?
Is there an acceptable way to forward messages?

Forwarding is a great way to pass on material that may be beneficial to others, but
be selective. Here are some forwarding tips:
• Forward only what your reader needs to see, or reference relevant sections of
the email chain.
• Don’t forward confidential information or anything that is related to patients.
• Decide whether you should change the subject line.
• Eliminate the email header showing everyone who has received the message
as well extraneous information, such as dates and times. Also remove any
instances of the > symbol.
How can I remember to add an attachment?

Often, people intend to include an attachment with their message, such as a word-
processing document or image file, but forget to attach it. To avoid this, make it a
habit to insert the attachment as soon as you mention it in the email. Do it before
finishing your sentence or beginning the next one. This will prevent you from
having to send a second email with an apology and the attachment.
If you are sending several attachments, find out if the recipient wants to receive
them separately or all in one email. Multiple attachments may slow down the
arrival of the recipient’s incoming messages.
Depending on the size of the files, the attachments may need to be sent in multiple
emails. If so, make sure the receiver is aware that several emails will be sent. Note
in the subject or body the number of emails, for example, 1 of 5.
Is it best to cover one topic per email message?

Yes. This makes it easier for people to respond and easier to file the email. If this is
not possible, number your items to simplify the response.
When should I use the BCC feature?

Use the blind carbon copy (BCC) when sending a message to multiple addresses.
People do not like having their email addresses broadcast to everyone on your list.
Put your name in the To box and the rest of the names in the BCC box. You should
not give out someone’s email address without permission.
It is not necessary to use the BCC when corresponding with a work team. These
people know each other and probably already have other recipients’ email
addresses. In this case, put all the addresses in the To box.
Is the BCC abused?

Yes. Be prudent with its use. When you use it, it is a clear indication that you are
sending something behind someone’s back. If you abuse this option, this can reflect
poorly on you as someone who isn’t forthright in dealing with coworkers or peers.
Use it with caution. Also, be aware that if someone in the BCC field uses the Reply
All feature, the reply will go to everyone.
The ABCs of CCs and BCCs

If you’re not sure when to use the CC and BCC features, follow these
guidelines (Shipley & Schwalbe, 2007):
• CC: Use CC when you want someone to know something, and you
want others to know that you want that person to know. This person
does not usually need to respond.
• BCC: Use BCC when you want someone to know something, and you
don’t want others to know that you want that person to know.
Should I use an auto-responder or out-of-the-office assistant

when I am unavailable?
This is a good idea when you will be unavailable for a specific period of time.
People won’t wonder if you received their emails. It will also tell them when you
will return. The message should indicate whom to contact if immediate assistance is
needed. (Note that some people choose not to do this for privacy reasons. They do
not want people to know that they are away if they are on vacation.)
What things should I consider when setting up an email

address?
Make sure it is professional. Here are some examples to avoid:
• mamabear@ . . .
• sexymama@ . . .
• billysmom@ . . .
Cute or clever email addresses may be appropriate for personal messaging or

social networking sites, but they are not appropriate for work. Use your full name
whenever possible, and be sure to set up your email address display to show your
full name on outgoing mail. If you don’t know how to set up your email address in
this way, go to the Help utility in your email software.
Are there situations when I should not use email?

Yes. Here are some examples (Pagana, 2007c):
• When resigning from a job
• When sending a thank-you note for a gift
• When discussing sensitive or confidential information, especially related to

patients
• When sending urgent information without follow-up (computer glitches can

happen)
• When you need an immediate response; use the phone instead or email and
then call if you do not get an immediate response
Do hospitals and other businesses have the right to monitor

email?
Yes. The Electronic Communications Privacy Act (ECPA) upholds a company’s
right to monitor its email. This is based on the premise that the company provides
and pays for the email; therefore, it owns it. It is best not to send personal emails
from a work address.
Do you have suggestions for addressing email errors?

Because of the volume of email, errors are bound to occur. Worse, although email
can get you in trouble, it typically doesn’t get you out of trouble. Here are some
helpful tips (Pagana, 2012a):
• Pick up the phone and apologize right away.
• Don’t blame the mistake on email (for example, spell-check).
• Use the email recall function. Note, however, that this may make people
more interested in reading the recalled mistake.
Are there special guidelines for international email?

Yes. You should be aware of differences in writing the date. Unlike people in the
US, who format the date as month/day/year, Europeans format the date as day/
month/year, while people in Japan use the year/month/day format. So, for example,
if someone in the US types 5/6/20 in a message, it would mean May 6, 2020. In

Europe, however, it would mean June 5, 2020. And in Japan, it would likely be
interpreted as June 20, 2005. To avoid this problem, spell out the month, day, and
year (May 6, 2020).
Telephone and Speakerphone

Etiquette
How can I communicate my professionalism on the
telephone?
The sound of your voice and your manners are essential components of phone
etiquette. When speaking on the phone, smile, because the smile on your face will
come through in your voice. Immediately identify yourself. Never assume someone
will recognize your voice. Keep your full attention on the person with whom you
are speaking. Here are some additional tips to follow:
• Keep background noise to a minimum.
• Concentrate on listening and avoid multitasking.
• Try to return calls within 24 hours.
• Get organized before placing a call.
• Schedule phone conversations to avoid playing phone tag.
• Put callers on hold only when necessary. If you must put someone on hold,
ask for permission.
• Don’t answer your phone if you have a visitor in your office unless you are
expecting an urgent call and have already informed your visitor of this
possibility.
• Don’t use call waiting in business situations.
• Avoid calling when you expect your contact to be busy.
• When returning someone’s call, consider the person’s time zone.
• Chewing gum on the phone is distracting.
• Be careful not to sneeze, blow your nose, or cough into the receiver.
What is the best way to transfer a call?

Always tell the caller the extension in case you are Courtesy begets
disconnected during the transfer. Brief the recipient TIP courtesy.
about the caller so the recipient can be prepared for
the call.
What is the polite way to conclude a business phone call?

The person who initiated the call should bring it to a close. If not, the other person
can politely ask if there is anything else to be settled. End on a positive note with a
comment such as, “It’s been nice talking to you,” or “Thanks for your help with this
project.” Then, say goodbye and gently hang up the phone.
Do you have any suggestions for using speakerphones?

Yes. To avoid blunders, follow this advice:
• Always ask permission before putting someone on speakerphone.
• Ask if the person can hear you clearly. Many people find it hard to understand
callers on speakerphones. You may want to turn up the volume.
• Close your office door when on speaker.
• Try not to rattle papers or make other noises that can distract the listener or
make hearing difficult.
• Make sure you are not discussing patient information or other confidential
data that can be overheard by those nearby.
• Don’t use your speakerphone to listen to your voicemail. It is annoying to

others who can hear it and could be embarrassing to the person who left a
message intended only for your ears.
What can I do if I suspect someone has put me on a

speakerphone?
If you are uncomfortable about being on speakerphone, say something like, “I’m
having trouble hearing you. Would you please take me off your speakerphone?”
Or, just ask if you are on speaker. The other person will usually pick up the handset
(Pachter, 2013).
What is the proper etiquette for using caller identification?

You should use caller identification only to prepare for a call by identifying its
source. It can create confusion and throw people off guard when they are greeted
by name without having a chance to identify themselves.
Good Idea!
After finishing graduate school, Matt was ready to interview for jobs in nursing
administration. Before sending out resumes, he added a signature block to his
email and updated his voicemail message to make it more professional. He
got rid of the music that preceded his outgoing voicemail message. He also
Googled himself to make sure he would not be embarrassed by anything that an
interviewer could find out about him on the internet. (A growing number of hiring
managers search Google and social media sites for information on potential
candidates before making a job offer.)
Cellphone Etiquette
How can I show respect for others and make myself a savvy
cellphone user?
Etiquette is about presenting yourself with polish and making those around you
comfortable. It is hard to find an area in more need of consideration than that of
cellphone usage. See the following list for some strategies to make cellphone usage
professional (Pagana, 2009b):
• Don’t let inappropriate ringing interfere with business. Turn off your phone.
• Don’t answer a phone call while providing patient care and discuss another
patient.
• Speak softly. Don’t annoy or bother those around you.
• Turn your phone off or set it to vibrate at dinner meetings.
• Don’t think you are so important that you need to be reachable every minute.
• Use your voicemail and return calls at an appropriate time.
• Make sure your voicemail system is working and your mailbox is not full.
• Ask permission before taking someone’s picture with your camera phone.
• Don’t air dirty laundry in public. Keep a civil and pleasant tone.
How should I handle confidential information on a cellphone?

It is best to avoid discussing confidential information on a cellphone, especially if
you are in a confined area with other people. People near you or the recipient may
be able to hear your conversation. Be careful not to violate anyone’s privacy by
mentioning the person by name or any other patient identifier.
What should I do if my cellphone rings

Faux Pas
during an interview? A woman was in her
final interview for a job
Apologize and turn off your phone without looking to position. She was the
see who called. People have lost job offers because they top candidate until her
answered their phones during an interview. Remember cellphone rang. She
to turn off your phone before the interview. answered the call and
proceeded to discuss
her dinner plans. She
Is it OK to put my cellphone on the was not offered the
table at an interview or in a position.
restaurant?
No. It looks like you are expecting a call. Making
or receiving a call on your mobile device is
inconsiderate and intrusive in these situations.
“Be a master of your

phone, not a slave to it!”
–Emily Post
What should I do if I need to be accessible by cellphone

during a business meeting?
The vast majority of callers do not need immediate access to you. Of course, an
exception would be if you are an expectant father or if you or a loved one is on a
transplant list. In these cases and in other important circumstances, alert others
prior to the meeting and keep your phone on vibrate. Excuse yourself and leave the
room if you get a call.
What is the polite thing to do if I am talking on a cellphone

and it is my turn to order at a service counter?
This has become a common problem. Get off your phone when it is your turn
to order. For the sake of the attendant and those waiting behind you, focus only
on your order. If you are in the middle of a call and your call is important, let the
person behind you order before you while you finish your call.
Do you have any recommendations for talking while driving?

Many nurses drive to and from work. Talking on a cellphone while driving a car
is dangerous. As a health professional, you don’t want to end up in an emergency
department. In many states, it is illegal to drive with a hand-held cellphone.
Driving performance, based on a cognitive distraction scale, is not much better
using a hands-free device. Hands-free devices are
dangerous because the driver is still distracted. If you’re talking
Avoid using your phone in high traffic areas or in TIP on your cellphone
tricky situations. Turn off your cellphone or let it in the car, let the
person on the other
ring. Check your voicemail when you get off the
end know if others
road. Pull off the road if you need to make a call
are in the car and can
while you are driving. Never read or send text
hear the conversation.
messages while driving.
How can I use my cellphone in a polite manner at airports

or train stations?
It is very important not to bother others, especially in enclosed areas where you
trap those around you as unwilling listeners. Here are some suggestions (Pagana,
2009b):
• Speak softly and face away from others.
• Move away from close proximity to others.
• Speak briefly.
• Don’t talk just to pass the time.

• Balance the convenience of the cellphone with the inconvenience it can cause
others.
• Save any nonurgent calls for later.
When Not to Use Your Cellphone

Here is a short list. Basically, avoid using it anywhere you can bother or
distract others.
• Worship services
• Weddings and funerals
• Public restrooms
• Libraries
• Doctors’ offices
• Public performances and movie theaters
• Restaurants
• Meetings
• Public transportation
Voicemail Etiquette
How can I make sure my voicemail message conveys the right
impression?
This is an important topic. Voicemail is a necessity for all professionals. How you
use your voicemail can work for you or against you. See the following list for some
guidelines to support a professional image (Pagana, 2011c):
• Jot down your key message points before you call.

• Always be prepared to leave a message. This will avoid ahs and ums.
• Be concise and brief. Show respect for the listener’s time.
• Maintain a business tone. Don’t respond when angry.
• Always state the purpose of your call. If calling patients, give them time to
register who you are and what you are calling about.
• Don’t say anything confidential in a voicemail. Others may overhear your

message.
• Don’t leave messages from noisy restaurants or parties.
• Be aware that voicemails can be forwarded to anyone.
• Don’t play your voicemail messages on a speakerphone.
• Don’t use voicemail to avoid having a difficult conversation.
How can I avoid leaving a garbled message?

Enunciate clearly and speak slowly. Instead of saying “fifty,” which can sound like
“fifteen,” say “five zero.” Any number ending in “teen” can be confusing. State
these numbers clearly, especially when mentioning
drug dosages. When you say
TIP your phone num-
If possible, listen to your message before sending ber, write it in the
it. Many voicemail systems let you listen to your air or on a piece of
message, erase it, and start over. Take advantage paper. This will slow
of this functionality whenever possible. This is you down and give
particularly relevant if you tend to pepper your the person time to
messages with ahs or ums. write it down.
How can I sound confident when leaving a message?

Stand up and smile when you leave your message. Your voice will sound more
confident if you are standing. Also, the listener will be able to hear the smile in your
voice.
Is it appropriate to mention a good time for the person to call

me back?
Yes, this helps avoid phone tag. People appreciate this information.
If the person already has my phone number, should I leave it

on a voicemail?
Yes. Leave your full name and phone number. This is more convenient, as the
person will not have to look it up. Say your name and phone number at the
beginning and end of your message. Or, say them twice at the end, so the recipient
does not need to replay your message.
How can I optimize my voicemail message system?

Here are some tips to make sure your system is running well and will support a
professional image (Pagana, 2007d; Pagana, 2011c):
• Check the outgoing message on your voicemail. Revise the greeting if it

sounds unprofessional or if you hear distracting noises in the background.
• Test your system to make sure it is working. Having your phone ring indefi-
nitely or having callers hear that your mailbox is full is unprofessional.
• Check your messages frequently so you can respond to all messages within 24
hours.
• Update your greeting message after a vacation or out-of-office period.
• Listen to all your messages before responding to any of them. A later message
may negate the need to return a call.
Text Messaging Etiquette

Can texting affect your professional image?
Yes. Common courtesy is just as essential with texting as with other forms of
communication. You need to be considerate and respectful.
Texting is about as informal as it gets. Some people send text messages routinely,
while others may be unfamiliar with this method of communication. Ask
professional people if they prefer to receive text messages over other methods of
electronic communication. Older people may not check for text messages as often
as younger workers. Therefore, texting can be challenging and unpredictable.
Faux Pas
A chief nursing officer (CNO) at a large Texas healthcare facility was networking
at a leadership conference after a busy week of interviewing candidates and hir-
ing for a new position. He was telling his colleagues about his new hire when he
received a text message from the person saying he had decided to accept another
position. The CNO was shocked and disappointed by this rude behavior. He said,
“Why didn’t he have the decency to call me?”
What are some guidelines for sending text messages?

You can’t go wrong if you follow these tips (Pagana, 2012a):
• Get to the point quickly. No one wants to read a long message on a mobile
device.
• Don’t text during meetings or presentations. Doing so is rude. Others can

see you clicking away or see the light from your screen.
• Consider the time when texting. Although you may be awake at 5 a.m., the
sound of your incoming message may disturb a sleeping recipient.
• Don’t expect an immediate response to your text. If the message is

time-sensitive, call instead.
• Always check autocorrect. Autocorrects are not always correct. They can be
harmless, but they can also be inappropriate and hurt your reputation.
• Proofread your message if using the voice-to-text feature. Your phone

can pick up background voices or noises.
• Slow down. Typing too quickly can result in errors. If a fast texting style suits
your needs, proofread the text before you send it.
• Never send bad news via a text message. Call instead. The person may
be upset and want to discuss the situation. This is especially important with
patients.
• Don’t text while driving. Reading or sending a text causes distracted

driving.
How can I ensure that a text message won’t bother me at

night or at the movies?
Turn your phone off. Don’t let your phone be your master. Be in control.
Is it possible to over-abbreviate in texting?

Yes. Abbreviations must be recognized to contribute to effective communication.
Stick to company-wide abbreviations and avoid informal ones. If texting to patients,
avoid abbreviations.
Fax Machine Courtesy

Is the fax machine dead?
Not yet. But its use has diminished markedly. However, it is still used a lot in
healthcare. When sending or receiving a fax, HIPAA privacy requirements are an
important consideration for patient information.
How can I extend my courtesy to people on the receiving end

of my fax transmissions?
A key consideration is not to send unsolicited faxes. Many people view them as
worse than junk mail because they waste paper and tie up the machine. See the
following list for some tips to guide you when you send faxes:
• Obtain permission before sending the fax.
• Always use a cover sheet and include the number of pages. This will alert the
recipient if only a portion of the fax comes through.
• If the recipient uses a shared fax machine, call and let the person know when
you send a fax.
• If the message is more than a few pages, use another option for delivery, such
as overnight or express mail.
• When composing a fax, use a slightly larger font so your message is easier to
read.
• Consider the hour of the night or morning that a fax is sent, especially when
dealing with a home office.
• There are several online fax services (such as myfax.com) that let you fax
online using your computer, tablet, or smartphone.
What should I include in a fax cover sheet?

The cover sheet should contain the name, address, phone number, and fax number
of the sender and the recipient. It also needs the date, number of pages sent
(including the cover sheet), and any pertinent messages. If delivery is urgent, that
should be written on the cover sheet.

? Is it OK to use emojis in professional correspondence?
In general, these bouncy smiley faces are OK in personal emails, but don’t
use them too much in a business setting.
? Can I use just the subject line for a short email?

Yes. As an example, you could say, “Can we meet for lunch?” Then finish
the sentence with “EOM,” the acronym for “end of message” (Whitmore,
2005).
? Do you recommend using a signature line on a mobile device to

excuse misspellings?
No. When you say, “Please excuse any typos because this was sent from
a mobile device,” it implies that you are unconcerned or in too much of a
hurry to reread a message for mistakes.
? Does call waiting have a place in business?

Only use it if you are expecting an important call and you have told your
current caller ahead of time. Otherwise, do not use it during a professional
call. Using call waiting implies the unknown caller is more important than
the person you are speaking with at the time. Ignore the clicks.
? Can people tell if I put them on my speakerphone?

Yes. The echo of a speakerphone is easily identifiable. You must ask
permission before putting anyone on a speakerphone.
? What do you think of people who begin a phone conversation by

saying, “How are you today?”
Don’t begin your call this way. You will sound like a telemarketer. Start by
identifying yourself.
? If I call someone and we are disconnected, who is responsible for

calling back?
You are. Because you placed the call, you know how to reach the person.
The person may not know how to reach you.
? Is it OK to leave an important message on a voicemail machine?

Yes. Only do so, however, if you follow up to make sure the message was
received.
TAKE-AWAY TIPS
• Your email is a reflection of your professionalism or lack of it.
• Keep your personal emails out of the workplace.
• Smile when you use the phone.
• Schedule phone appointments for important calls.
• Use speakerphones for conference calls only.
• Don’t read or send a text message while driving your car.
• Ask permission before taking someone’s picture with your camera phone.
8 Avoiding Social Media Blunders 153
8
AVOIDING SOCIAL MEDIA
BLUNDERS
How Social Media Can Affect Your Career
DO YOU:
• Google yourself and examine the results?
• Think Facebook is a waste of time?
• Have a LinkedIn profile?
• Follow anybody on Twitter?
• Know what kinds of photos are best for social media?
• Know how a website is different from a blog?
The impact of social media has been demonstrated time and time again, from its
role in political uprisings to its ability to influence decisions. As just one example
of the power of social media, fans of actress Betty White on Facebook created a
petition for White to host Saturday Night Live. Thanks to this petition, in 2010,
White served as host on the popular show. Not surprisingly, because of its power,
healthcare centers have made social media a key component of their marketing
efforts to connect with patients and attract staff.
Nurses have both obtained and lost jobs due to social media. One of the biggest
concerns for nurses regarding social media is maintaining patient privacy. This
chapter will update you about these powerful communication tools and help you
ensure that social media helps, rather than harms, you and your career.
Social Media Overview

Why do I need to know about social media?
Social media is changing the way people communicate. As with all new things,
expect a learning curve. Whether you are texting, tweeting, blogging, or using
Facebook, some etiquette guidelines apply. Learn to use these tools effectively and
politely.
As a nurse, how can social media help my career?

Student nurses and nurses at all stages of their career can be helped by social media.
Here are some of the key benefits:
• Learning things “hot off the press”
• Finding exciting jobs
• Getting help with your career
• Finding out about career fairs or educational offerings
• Networking with colleagues
• Meeting and connecting with new colleagues around the world
• Understanding professional dialogue
• Learning more about professional nursing issues
• Understanding many sides of a single issue
• Getting advice with clinical and professional dilemmas
• Answering questions and giving advice

How can I be certain my social networking sites aren’t

harmful to my career?
Make sure your online information leaves no room for misinterpretation. Potential
employers can view your profile. Many employers pre-screen applicants using social
media. Inappropriate comments and photos can disqualify job candidates (Liburdi,
2008).
Employers will use social media tools to get to know you. They can use social
media to learn about your contacts, how well connected you are, and your level
of maturity. It pays to be aware of your public profile. Spend time building your
online persona. See the following sidebar for some guidelines.
Social Media Do’s and Don’ts

Do:
• Google your name and see what appears.
• Evaluate your profile and postings.
• Use your privacy settings to limit access to your information.
• Be aware that what you post may affect your next promotion.
• Be aware that private posts don’t always stay private. Your information
can be shared by others.
• Tell your friends and colleagues not to post photos or videos of you
without permission.
• Post your accomplishments and interests.

Don’t:
• Post daily schedules, hotel room numbers, or home addresses.
• Share too much personal information.
• Post inappropriate photos or videos.

• Trust all users on social networking sites.
• Post anything you would not want a potential employer to read.
• Criticize your manager or company.
• Put people down, curse, or use racial statements.
• Underestimate what people can learn about you on social media.

Do you have any guidelines for photos on social media?

Your profile photo—that is, the photo you use alongside your name on a social
media site—will be part of the first impression you make on others. You do not
want it to detract from your professionalism. For a professional site, like LinkedIn,
use a professional photo. Photos help people know that they have connected with
the right person. Here are some guidelines to help you (Pachter, 2013):
• Post a headshot.
Be aware that if
• Make sure your face is in focus. TIP your profile photo
• Wear appropriate business attire. is older than 10
years, people may be
• Choose a recent flattering photo. surprised when they
meet you.
• Consider hiring a professional photographer.
How much does it cost to use social media?

Most social media sites are free to use.
Can competency in the use of social media help me get a

job?
Employers are looking for people who are proficient at social media. Digital trends
affect every company, including healthcare. As an example, it would be hard to
obtain a position as a nurse recruiter without this expertise. Competency in the use
of social media can also help you keep your job. Blunders can result in job loss.
In some types of jobs, lack of competency in social media may raise a concern. This
is especially true for baby boomers. Some companies may think people over 50
won’t be able to use social media and other digital tools.
Complying With HIPAA on Social

Media
Is it OK to discuss patients on social networks?
No. Nurses who do this may not realize that discussing patients on social networks
can lead to a breach in confidentiality. Healthcare workers are subject to strict
privacy and security rules. These were enacted in 1996 with the Health Insurance
Portability and Accountability Act (HIPAA). This privacy rule went into effect in
2003 and set national standards to protect personal health information and medical
records. The Security Rule, which took effect in 2005, sets standards for protecting
health information that is transferred in electronic form.
Can nurses violate regulations by sharing details about

patients without mentioning the patient’s name?
Yes. If, for example, a hospital employee has a casual conversation about a patient on
the elevator, that could be a HIPAA violation. Nurses know it is ethically wrong to
discuss this information in front of others. The challenge for healthcare providers is
to realize that these same standards apply to online conversations.
Faux Pas
Comedienne Joan Rivers passed away in 2014 after having a routine procedure at
an endoscopy center. It was later reported that the personal doctor of the 81-year-
old comedian snapped a selfie while Ms. Rivers was under anesthesia in the
procedure room. This doctor also performed an unplanned biopsy on Ms. Rivers’
vocal cords moments before Ms. Rivers went into cardiac arrest. The personal
physician was not authorized to practice medicine at the private facility. The head
of the clinic was let go. A medical malpractice lawsuit was settled in 2016. (THR
staff, 2016)
What are some individual identifiers under the HIPAA Privacy

Rule?
While not an exclusive list, the following are examples of identifiers (Pagana,
2011a):
• Names
• Photographs or images
• Social Security numbers
• Medical record numbers

• All elements of date (except year) directly related to an individual, such as

birth date, admission date, discharge date, or date of death
• Geographic subdivision smaller than a state
• Any unique identifying number, characteristic, or code
What are some of the legal ramifications for misuse of social

media?
There are many serious consequences for nurses who use poor judgment on social
media. Here are some examples:
• Violations can be reported to the State Board of Nursing, resulting in repri-

mands, sanctions, fines, or the suspension of your nursing license.
• Violations of employment policies can result in penalties, including loss of

job.
• Violations of state or federal law (such as HIPAA) can result in civil or crim-
inal charges, fines, and possibly jail time. The healthcare facility or program
affiliated with the nurse can also be subject to penalties and be named in a
lawsuit.
Do professional nursing organizations have guidelines for

using social media?
Yes. Take time to review the following:
• The American Nurses Association “Navigating the World of Social Media”

(https://www.nursingworld.org/~4af5ec/globalassets/docs/ana/ethics/fact_
sheet_-_navigating_the_world_of_social_media_web.pdf)
• The National Council of State Boards of Nursing “White Paper: A Nurse’s

Guide to the Use of Social Media” (https://www.ncsbn.org/Social_Media.pdf)
What responsibility do healthcare facilities have for social

media use?
They need to inform employees about the risk of posting information on social
media sites during and after work. Employers need to have clear policies for social
media use inside and outside the workplace.
Here are some issues usually addressed in policies:
• Maintaining the organization’s integrity, identity, and reputation
• Protecting patient privacy
• Using social media during work or on hospital property
• Not using your hospital email address as your primary means of identification
• Not expecting privacy for anything created, received, sent, or stored on the
hospital computer system
• Being personally responsible for everything you post
• Understanding that violations are subject to disciplinary action, including job

loss
Facebook
Why is Facebook so popular?
Facebook (www.facebook.com) enables users to stay connected and share
information between friends. On Facebook, a friend is someone who has agreed to
communicate with you and allow you some level of access to personal information.
Members connect by issuing a friend request. You can also connect by letting
Facebook search your email contacts or by looking at the lists of other friends’
friends.
Younger nurses have found creative ways to build closed Facebook pages for their
units. For example, they can share professional information such as scheduling
gaps, look for colleagues to fill holes, distribute newsletters, and facilitate online
learning. With the exception of these creative ideas and following professional
groups, nurses primarily use Facebook to connect with family and friends.
Problems can result when work issues (such as patient concerns) spill over into
social chatter.
How are medical centers using Facebook to attract nurses?

Marketing departments and human resources use Facebook for messaging relating
to hiring, news, awards, honors, celebration of events, and announcing upcoming
events. Social media is also used to announce disaster drills and communicate when
internals phones are out of order.
What is usually part of a Facebook profile?

Members typically include a photo and some basic information, such as where they
work, where they live, their educational background, their hobbies, their interests,
and any websites they run.
Good Idea!
I recently attended a celebration during Nurses Week. Seven nurses were
recognized for outstanding practice. The nurse sitting next to me was taking
pictures of the award winners and posting them to her hospital Facebook account.
She said the hospital nurses who could not attend were delighted to learn so
quickly about the winners.
What about privacy on Facebook?

You have choices here. Your profile can remain private until you approve someone
as your Facebook friend. Or, your profile can be public, meaning anyone can find
you and view everything on your site. (I would not recommend this.)
Faux Pas
In the summer of 2010, a Michigan nurse was fired for venting on Facebook. Like
many others, she was upset when a local policeman was shot to death pursuing
a suspect. As part of her duties as a nurse, she treated the shooter. The problem
resulted when she posted on Facebook that she came “face to face” with a “cop
killer” and hoped he “rotted in hell.” She was fired because she disseminated
protected health information about a patient. She made it easy to identify the
patient without revealing his name.
How can Facebook benefit nurses?

You can find many groups that pertain to nursing on Facebook. This is a great
way to connect and share information with other nurses. On Facebook, you can
“follow” a group. For example, you can “follow” the American Nurses Association
on Facebook to get the latest news and connect with other nurses. The following
sidebar offers suggestions of groups you can follow on Facebook. These groups can
help keep nurses up to date. They can also affect your (and your employer’s) ability
to provide care by enabling you to learn a new procedure or strategy and share it
with your nursing colleagues.
In addition to following a group, you can create a group of your own by building
a special page for it. You can determine if anyone is allowed to follow (open
membership) your page or if someone needs to be invited to follow (closed
membership).
Facebook Resources for Nurses

• American Nurses Association
• Johns Hopkins Medicine
• Mayo Clinic
• Nurse.com
• Nurse rounds
Do you have any etiquette tips for

using Facebook? Faux Pas
Yes. Here are some of the basics: Sadie, age 23, started
a fire in Oregon
• Don’t discuss patients with your family, even if because her firefighter
the patient is someone you know. friends were out of
work. Two days after
• To engage with your friends and followers, post
the fire began, she
entertaining content regularly.
went on Facebook and
• Make your friends and followers feel welcome posted an entry stating,
on your page. “Like my fire?” This post
led to her identity and
• If you want to post often in one day, spread out arrest. This shows that
your posts over several hours. you never know who
will read your posts.
• Respond to all comments—good and bad.
If I am using Facebook to connect with friends and family,

should I be concerned about business implications?
Yes. What you post can get you fired. For example, people have called in sick to
work and then posted photos of themselves at a casino. How silly is that?
Faux Pas
A former healthcare worker was receiving disability payments because she
claimed to be incapacitated by back problems from a work-related injury. Her
disability payments stopped, however, when pictures of her on Facebook showed
her dancing while on a cruise in the Mediterranean. You never know who will
share your information!
Twitter
Why is Twitter so popular?
Twitter (www.twitter.com) is all about quick and easy conversation. Its simplicity
is the reason for its popularity and amazing success. Twitter is a microblogging
application that asks the question, “What’s happening?” Posts or responses must be
280 characters or fewer. Users can post updates, or tweets, as often as they want via a
mobile phone, instant messaging, or a web browser. Posts are displayed on the user’s
technology of choice (text message, website, Twitter account, Facebook page, etc.).
What is the point of responding to the question, “What’s

happening?”
If your response is, “I’m eating pizza,” there is no point. However, when used
strategically, Twitter can help you to connect with others, make announcements,
build brands, provide project updates, and promote services and products. Many
professional conferences encourage participants to tweet about what they are
learning and who is speaking. This is valuable PR.
What are some examples of how organizations use Twitter?

Here are some examples to illustrate how Twitter is widely used and very helpful:
• Healthcare agencies tweet flu statistics.

• Nursing conferences encourage attendees to tweet and tell what they are
learning.
• Whole Foods Market uses Twitter to provide product information.
• NASA uses Twitter to provide updates on space shuttle missions.
• News agencies, such as the BBC, use Twitter to disseminate breaking news.
• Reporters and television newscasters often ask for and read comments sent in
on Twitter.
• Political campaigns use Twitter for publicity.
• The Los Angeles Fire Department uses Twitter to get up-to-the-second

information on where fires are breaking out and where people are trapped.
How do I join Twitter?

Signing up for Twitter is free and easy. Just visit www.twitter.com and follow the
prompts to sign up. After you sign up, you can subscribe to different Twitter feeds
to receive updates. You can follow the Twitter feeds of anyone you choose—for
example, doctors, nurses, movie stars, athletes, authors, newscasters, heads of state,
medical centers, friends, and family members.
The following box contains good Twitter feeds for nurses.
Twitter Feeds of Interest to Nurses

• @Womenshealth: The Office of Women’s Health, part of the US
Department of Health and Human Services
• @NavigateNursing: A resource for nurses seeking to create healthi-

er work environments
• @RNCentral: Nursing education, news, and healthy living tips
• @TheLancet: The world’s leading general medical journal
• @NursingWorld: ANA Government Affairs, leading the fight for

nurses on Capitol Hill
What is the basic vocabulary associated with Twitter?

Here are some of the basic terms (Safko & Brake, 2009):
• Tweet: Something that someone posts on Twitter.
• Twitterer: Someone who uses Twitter to send tweets, or posts.
• The Twitosphere: A name for the Twitter community.
• Mistweet: A tweet posted by accident or that you wish you could take back.
How is Twitter different from sending an email or blogging?

Because of the limit on the size of a tweet, Twitter is used to update networks with
information that is more casual than an email and more concise than a blog (Scott,
2009).
What are some etiquette guidelines for nurses who use

Twitter?
Here are some guidelines to follow:
• Respect patient privacy issues. Faux Pas

An employee of an
• Treat your Twitter posts as though they will be
advertising company
read by your parents and managers.
had a huge contract
• Avoid sharing too much personal information. with a car company
in Detroit. When he
• Don’t tweet about the minutiae of your day. tweeted negative
• Don’t tweet profanity or anything unprofession- comments about Detroit
drivers, he thought he
al.
was using his personal
• Use the at reply (@reply) function to reply on account. However, he
Twitter. To do this, hover over the tweet and was on the company’s
click the At Reply option. After you complete account. He got fired,
your @reply, click the Tweet button to post it. and his company lost
the contract with the
• Retweet posts you find interesting. car company (Pachter,
2013).
• Don’t just watch. Be part of the conversation.
• If sharing an article, include a link to the original

source. Faux Pas
• Upload a photo of yourself to differentiate your- During the 2012
self from spammers. London Olympics, a
Greek athlete was
• Be gracious to those who promote your tweets. kicked off the team
• Offer content that is a mix of information, for tweets mocking
African immigrants.
thoughts, recommendations, and resources.
Also, a Swiss athlete
• Respond to questions and comments quickly. was banned from the
Olympics for a racist
• Ask questions, provide answers, share news, and
tweet about South
provide links. Koreans. Rude and
• Don’t feel you have to follow everyone who unkind behaviors have
follows you. consequences and
affect careers.
• Use pithy sayings.
• Keep your comments positive.
• Don’t tweet anything negative about your workplace.
What if I get tired of following someone on Twitter?

Simply unfollow that person. When content shared by that person is no longer
relevant, it’s time to opt out.
“Social media has the word

‘me’ in it, so people tweet
about themselves.”
–George Takei
What if Twitter has overwhelmed my life balance?

Back off and unfollow. Moderation is the key.
Is Twitter valuable for networking?

Yes. Twitter is a great way to build your network. Twitter also has a job search
component to help people find jobs. Here are some ideas to help expand your
network:
• Follow interesting people. Use a Twitter search to find people by name,

profession, or interest.
• Share information, such as job postings and links

to journal articles.
Good Idea!
A nurse manager
• Populate your profile on Twitter, including links
went online to find a
to your website, blog, or other forms of social
hotel room in New
media.
York City for a nursing
• Have Twitter search your Google, Yahoo!, and conference. She
AOL accounts to help you find people you was disappointed
already know on the site. that no rooms were
available in Midtown.
• Follow conversations for a time and then join in. She sent a tweet
to her network for
• If you are interested in connecting with some-
help. Within minutes,
one, retweet some of the person’s posts before
she heard from a
introducing yourself. number of people
• Send tweets via your mobile phone with the with suggestions and
Twitter mobile app, available free for iPhone, got a reservation at
a boutique hotel in
Galaxy, and Windows Phone.
downtown Manhattan.
• Don’t spam.
Do you have any suggestions for dealing with negative

comments or tweets on social media?
Yes. I would be brief and professional. Here are some suggestions:
• “With all respect, I disagree with your comments.”
• “When you made that comment about [fill in the blank], I felt sad and dis-
appointed. I think your comment perpetuates a negative and untrue stereo-
type.”
LinkedIn
Why do professionals join LinkedIn?
It is important to separate your private life from your work life. LinkedIn (www.
linkedin.com) enables users to do just that. This site is an online professional contact
database for business professionals that allows members to create a profile and link
with contacts they know and trust.
LinkedIn helps users keep in touch with people with whom they have worked in
the past, even if they have changed jobs or switched positions. This site is great for
networking and can connect the right person to the right contact at the right time.
Nurses use LinkedIn to connect with other nursing professionals, highlight their
achievements, and find job opportunities. These are LinkedIn’s best benefits for
nurses.
How do I get started with LinkedIn?

Go to www.linkedin.com and set up a free account. You will be asked some questions
(for example, about your education and degrees) and will be prompted to provide
information about your work history. Include your current contact information and
keep people up-to-date on your accomplishments. Don’t hesitate to mention honors
and awards. Add your professional “elevator speech” about who you are and what
you do as a summary paragraph. (See Chapter 1, “Making Your Acquaintance,” for
help crafting an elevator speech.) Also include your photo. If you don’t add a photo,
your profile will feature a nonspecific silhouette, which is not very enticing.
LinkedIn Group Suggestions for Nurses

• American Nurses Association
• ADVANCE for Nurses
• Nursing Jobs
• RN Network
• Nurse Practitioner
• Nursing Beyond the Bedside
• Oncology Nursing Society
• Flight Nurses
How do I connect with others on LinkedIn?

You can use LinkedIn’s basic email invitation message to connect with others.
For best results, personalize the message by reminding people of how you are
connected. For example, you might write, “It was nice being on the panel with you
at the AORN conference in Boston.”
Should I ask people to recommend me?

Yes. If people haven’t recommended you independently, you can ask for
recommendations from those who know you and value what you do. You
should also provide recommendations for others who have done good work.
Recommendations are a two-way street.
A quick way to acknowledge others is to use LinkedIn’s endorsement feature. It

is another way to highlight someone’s expertise and skills—for example, public
speaking, leadership, nursing, staff development, and so on.
When should I post on LinkedIn?

Keep your profile up-to-date. Post when you publish an article or book or when
you receive a new position or award. Also, join groups that are beneficial to your
career and contribute to the groups’ discussions by sharing your knowledge and
experience.
What are some etiquette tips for using LinkedIn?

On LinkedIn, it’s critical that you present yourself as an articulate professional.
Consider the following points:
• Keep your updates related to professional matters.
• Don’t forget patient privacy issues.
• Save daily life updates for Facebook and Twitter.
• Once connected, send a welcome message to build connections.
• Don’t send a mass request for recommendations.
• Send requests for recommendations only to people who know you and can
vouch for your work.
• Use groups as a place to contribute valuable information.

• Don’t use groups to promote your business.
• Compare your resume and your online profile. Make sure there is not a dis-
connect between the two.
Do employers use LinkedIn?

They sure do. In fact, it is one of the first things
they check for background information on job First impressions
applicants. Employers can use LinkedIn to find out TIP begin long before
where candidates worked and for whom. They may the interview
have contacts who worked at the same place and process.
be able to get inside information about your job
expertise and professionalism.
What are the different levels of connection on LinkedIn?

There are different levels of connection on LinkedIn. These levels are based on
how well two people know each other. The levels are as follows:
• Primary or first-degree connections: These are people you know directly

and to whom you are immediately linked. These connections can be viewed
and contacted anytime.
• Second-degree connections: These are contacts known by people you

know.
• Third-degree connections: These are contacts of your second-degree

connections.
Additional degree connections follow the same pattern.
Your list of connections increases exponentially based on the connections of your

contacts. Through your connections, you increase the likelihood that someone you
know can facilitate a desired introduction for you.
Connecting via a personal connection is easier than making a cold call. For
example, suppose you are writing a book and want to get an endorsement from a
well-known nursing leader. One of your connections is connected to someone who
is connected to the nursing leader. It may well be that your connection can arrange
an introduction for you. That is the beauty of LinkedIn!
Instagram
What is Instagram?
Instagram (www.instagram.com) facilitates photo- and video-sharing. It is a fun
way to share your life with friends. It has filters that can transform your photos into
snapshots that look professional. You can snap a photo, transform the feel and look
of the photo, add comments, and then share. Instagram was launched in 2010 and
acquired by Facebook in 2012.
Instagram also has a messaging feature that includes multiple images or videos in a
single post. In addition, it now has a very popular Stories feature that allows users
to post videos and posts to a sequential feed, with each post available to others for
24 hours.
What about privacy?

By default, all photos on Instagram are public. This makes them visible to anyone
using Instagram or on the Instagram website. Additionally, if your account is public,
anyone can subscribe to follow your photos. However, you can control who sees
your photos if you choose the private option.
How do I find friends on Instagram?

Instagram has a Find Friends feature that can help you locate others with Instagram
accounts by using your contact list, through third-party social media sites, or by
searching names and usernames on Instagram.
What are some etiquette tips for using Instagram?

Here are some basic guidelines:
• Don’t overgram—that is, post too many pictures.
• Don’t take pictures of patients.
• Don’t post pictures that make fun of difficult patients.
• Keep your posts clean.
• Avoid selfies, food, and family photos.

• Don’t repost someone’s photo without permission.
• Don’t ask people to follow you.
Instagram Accounts for Nurses and Nursing Students

• @NursesOfInstagram: This account includes inspirational quotes,
humor, and style tips for scrubs.
• @FindNursingSchools: Here, you’ll see tips for finding the right

school for you.
• @NursingLOL: This account will make you laugh out loud with its
jokes and cartoons.
• @ExploreNursing: This account shares information about the

nursing profession and nursing shortage, mixed with inspirational and
humorous quotes.
• @TheDrOzShow: This account promotes highlights from The Dr. Oz

Show.
Snapchat
What is Snapchat and how is it used?
Snapchat is a multimedia messaging app initially released in 2011. One of its key
features is that messages and pictures are only available for a limited time before
they become inaccessible. Recipients should not take screenshots of your pictures.
That ruins the self-destruct spirit of Snapchat.
What are some etiquette tips for nurses using Snapchat?

• Don’t take pictures or videos of patients.
• Don’t take pictures or videos of you with patients.
• Don’t take photos of yourself that may be offensive to others.
• Don’t screenshot snaps from others.
• Be a positive Snapchatter. No one wants to see your complaints.

Faux Pas
A nurse took a photo of herself on Snapchat with the N-word written across her
forehead. The photo was screenshotted and shared on Facebook. The nurse was
later identified as being an ICU nurse at a large medical center. Because of the
racist post, she was fired.
Similarly, other healthcare providers have lost their jobs taking pictures or videos
of suffering and dying patients.
Pinterest
What is Pinterest and how is it used?
Pinterest (www.pinterest.com) is a digital scrapbook of photos and images on a
variety of topics. Examples include gifts, holidays, fashion, humor, quotes, recipes,
clothing, parties, camping, home decorating, fitness, weddings, and crafts. You can
find ideas for your projects and interests on Pinterest.
What are some etiquette tips for using Pinterest?

Here are some guidelines (DelBalzo, 2014):
• Pin directly from the source material. That way, you give credit to the origi-
nator of the content.
• Use high-quality images.
• Spread your pins out over the day. Don’t repin for one straight hour.
• Don’t use images unrelated to your content. That is only confusing.
• Make sure the images on your website are easily pinnable.
• Make sure your links are in order. Check this on a regular basis.
Blogging
“The tipping point for ‘wait and
see’ [about blogs] is swinging
like a metronome, toward
‘better do something now.’”
–Debbie Weil
Where did the term blog come from?

The word blog comes from weblog, which is an online journal. A blog is a website
maintained by someone with regular entries or posts that include ideas, thoughts,
and commentaries. Photos, graphics, audio, and video can be part of the posts
(Safko & Brake, 2009).
Blogs can provide content about a specific subject or can act as personal journal.
For example, you might create a blog that focuses on sharing tips for patients with
diabetes mellitus, sharing gluten-free recipes, your volunteer service in Haiti, or
your cross-country biking trip.
Can blogs benefit patients?

They sure can. For example, as mentioned, a blog with tips for patients with
diabetes would be a good resource for some patients. Or, patients with fibromyalgia
could benefit from reading blogs by others who suffer from the same condition.
As a nurse, you could help patients find blogs of
interest. For example, at the blog PatientsLikeMe Focus your blog
(http://blog.patientslikeme.com), people with TIP on a particular
different conditions share their health experiences, theme and a
find patients like them, and learn how to take target audience.
control of their healthcare.
What are some of the key features of blogs?

Here are some features that have contributed to the popularity of blogs:
• Blogs permit two-way communication. Readers can interact with the author.
• Starting a blog is simple.
• Blogs can help position the author as a thought leader.
• Adding a post to a blog is as easy as sending an email.
How are blogs different from websites?

Blogs are more engaging than static websites. Here are some of the main
differences:
• Blogs are interactive.
• Blogs are typically written in a conversational tone.
• Blogs are easily created. No technical expertise is needed.
• Blogs are updated frequently.
• Blogs get higher rankings in search engines than static websites.
• Blogs can alert readers whenever something new is added, without an email.
What kind of software is needed to start a blog?

There are a lot of free choices. WordPress.com (www.wordpress.com) and Blogger
(www.blogger.com) are popular. Setting up a blog is easy and can be done in a few
minutes. Other forms of software are available for purchase with monthly fees.
“Blogs are often misperceived

by people who don’t read
them.”
–David M. Scott
How often should blogs be updated?

This is up to you. Maintaining a blog requires dedication and effort. You can post
daily, weekly, or less often. The time you invest is related to the purpose of your
blog and your priorities.
That being said, don’t let your blog go quiet without an explanation. If you need to
take a break, tell your readers you are taking a hiatus and when to expect you back.
Faux Pas
In a 60 Minutes broadcast in September of 2004, documents were presented that
were critical of President George W. Bush’s service in the National Guard. The
documents were presented as authentic but had not been properly vetted. When
bloggers questioned the authenticity of the documents, veteran newscaster Dan
Rather dismissed them as a bunch of “geeks in pajamas.” Ignoring the bloggers
cost him his job. Had he taken them seriously and investigated the documents, he
would have concluded that they were false (Scott, 2009).
What is the best length for a blog post?

For the most part, posts are short. Lengths vary. A good goal is under 1,000 words.
How do blog readers know when I post a new entry?

One of the essential features of a blog is a Really Simple Syndication (RSS) feed,
or web feed. Readers receive an automatic update every time content is added.
Because email is not needed, the updates are not lost in a clogged inbox or blocked
by spam. Blog entries are displayed in reverse chronological order. The most recent
post appears at the top of the page.
What are some tips for boosting my nursing career by

blogging?
Here are some suggestions to help you boost your career by blogging (Pagana,
2013d; Safko & Brake, 2009):
• Write as if you are talking to your nursing colleagues or patients.
• Be yourself and let your personality shine through.
• Focus your blog around a certain mission or theme, such as healthy eating.
• Share your expertise on a topic, such as joint replacement.
• Offer unique and valuable information.
• Reflect on current practices or healthcare issues.
• Follow HIPAA guidelines for patient confidentiality.
• Post often.
• Use catchy post titles.
• Ask open-ended questions.
• Use images in your posts.
• Link to other blog posts.
• Link to your other social profiles.
• Read other blogs.
• When your post receives a comment, reply to further the conversation.
How much information should a blog include about its author?

Background information helps to establish your credibility. It is good idea to have an
“About” page with a photo, biography, affiliations, and other relevant information.
How do I find a blog for an area of interest or particular topic?

Some good places to start include Google (www.google.com), Yahoo! (www.yahoo.
com), and Blog Search Engine (www.blogsearchengine.org).
“Eventually, most businesses will

use blogs to communicate with
customers, suppliers, and
employers because it’s two-way
and more satisfying.”
–Bill Gates
Blogs for Nurses

• ER Nurses Care: http://ernursescare.blogspot.com/
• DiversityNursing Blog: http://blog.diversitynursing.com/blog
• The Nursing Site Blog: http://www.thenursingsiteblog.com/
• The Nerdy Nurse: http://thenerdynurse.com/
• Off the Charts: http://ajnoffthecharts.com/
• The Balanced Nurse: http://www.thebalancednurse.com/

the-balanced-nurse-blog/
How do I determine if a blog is credible?

Remember, anyone can create a blog. Don’t believe everything you read in a blog.
Blogs build credibility the same way as any other source of information. They need
to earn your trust.
Is it OK to pitch products or services on my blog?

That is a turnoff to readers. The goal of your blog
should be to create a demand for your services Self-promotion
though demonstrated expertise, relevance, and TIP gets old to
information versus solicitation. Pull the audience blog readers.
in; don’t push them out. If you have books to sell, it Minimize it.
is better to have a link to your website or shopping
cart.
How do organizations and businesses use blogs?

Here are some examples of ways organizations and businesses use blogs:
• For organizational leaders to communicate with customers or patients
• For employees to communicate with customers
• For customers or patients to provide unsolicited feedback
• For employers to share information with employees via an intranet
• To attract the best employees

• To attract new customers or patients
• To advocate specific issues (such as health insurance)
How can a blog be used within an organization?

A blog can be placed on an intranet and made available to employees. Blogs can
transform a static, one-way, top-down intranet into a dynamic, interactive tool
for collaboration. Here are some examples of internal uses of blogs within an
organization:
• News blogs (achievements, announcements, birthdays, etc.)
• CEO blogs (to explain financial decisions and ask for ideas)
• Project coordination
• Client feedback and satisfaction surveys
• Interdepartmental team blogs (to connect those who don’t work in the same
area)
How do I deal with comments on a blog?

Blogging software offers several options with respect to commenting. One option
is not to allow comments, but that eliminates a popular feature of blogs. Another
option is to permit comments that are not subject to your approval. Or, you can opt
to approve comments before they appear on the blog.
Many bloggers use the approval process to prevent users from posting
inappropriate comments on their blog. However, you should post comments that
show disagreement because healthy debate is an indicator of a well-read blog
(Scott, 2009). If only rosy comments are posted, credibility will suffer.
What are blooks?

Many bloggers have published books based on their original blogs. These are
called blooks. For example, a compilation of blogs about nursing leadership could
end up as a blook. A hospice nurse who blogs about work experiences may have the
foundation for a book on death and dying.

? How do nurse recruiters use social networking sites when hiring
staff?
Many employers use these sites to do background and character checks.
They also scan them for questionable posts, videos, or photographs.
? Is it OK to comment on Facebook about my patients as long as I

don’t mention them by name?
No. Check your healthcare organization’s policy about social media. Any
information about a patient that allows another to recognize the patient is a
breach of confidentiality. This could result in job termination, fines, penalties,
and jail time.
? If my manager or chief nursing officer (CNO) sends me a Facebook

friend request, should I accept it?
You are under no obligation to accept. Many people restrict Facebook
to their friends and family. Consider sending the person an invitation to
LinkedIn. Another option is to accept the invitation and use your privacy
settings to limit what sections of your profile your manager or CNO can see.
? If I unfriend someone on Facebook, should I offer an explanation?

That is not necessary. Facebook doesn’t send out notifications when
someone is unfriended. So, the person may never know and will just stop
receiving your updates in the news feed. If the person is someone you run
into often, you may mention that you are cutting back your use of Facebook
or limiting it to family only.
? When traveling, is it a good idea to detail my travel plans on social

media?
No. Many people’s homes have been burglarized because “friends” knew
they were away. Some burglars have selected houses based on Facebook
updates.
? How confident can I be about using privacy settings on my social

media sites?
Don’t take any chances! Remember that privacy settings do not guarantee
that something you post will remain private. Your link may be shared by a
friend, and then by a friend, and so on. That’s how posts go viral.
? When signing up for a social media site, do I have to give all the
information requested?
No. Only provide information you feel comfortable sharing with others.
? Can blogs increase traffic to a website?

Yes. Search engines love blogs. They generate higher rankings on Google
than websites.
? Who should I talk to if I want to post information about a job or the

latest news from our hospital on social media?
Check the hospital’s social media policy. You can also discuss this with
someone in marketing or human resources. If you want to post information
about a job, make sure the position is open to the public and not just for
internal candidates.
TAKE-AWAY TIPS
• Social media is redefining the way people communicate and do busi-
ness.
• Don’t post anything on social media that you would be embarrassed to

see on the front page of a newspaper.
• It takes a long time to develop trust and build a following on Twitter. It

takes only one tweet to alienate all your followers.
• Never share your passwords. If you do, change the password.
• Blogs provide both experts and wannabes with an easy way to make
their voices heard. Don’t trust everything you read.
• The value of social media is underestimated by those who haven’t both-

ered to learn about it.
• Plan time to explore and learn about unfamiliar forms of social media.
• Have a consistent image across all your online platforms.
• Social media is here to stay. You may appear out of touch if you don’t
stay up-to-date with it.
• Play nice, say thank you, and foster relationships with social media.
9 Mingling Among the Cocktail Set 181
9
MINGLING AMONG THE
COCKTAIL SET
Juggling Drinks and Hors d’Oeuvres at
Corporate Events
DO YOU:
• Feel anxious and wonder if you should attend the holiday party?
• Know what to wear?
• Know how to initiate and sustain small talk?
• Know how much alcohol you can drink and still act appropriately?
• Know how to handle drinks and hors d’oeuvres?
• Wonder if you should bring a gift?
• Have a spouse who does not want to attend your business function?
• Wonder if you should send a thank-you note afterward?
These are important concerns for new and even seasoned employees.
Inappropriate behavior at cocktail parties, receptions, retirement parties, award
ceremonies, and other corporate events can undo years of good impressions. Your
career aspirations can be enhanced or limited by your behavior as you navigate
these potentially disastrous social gatherings.
“Etiquette is what you are doing

and saying when people are look-
ing and listening. What you are
thinking is your business.”
–Virginia Cary Hudson
RSVP
Do I need to respond to an RSVP?
Yes. “RSVP” is derived from a French phrase meaning “please respond.” Your
response is important for two reasons:
1. It lets the person know you received the information.
2. It lets the person know whether you will attend. The person uses this
information to plan the food and room accommodations.
How soon should I respond to an RSVP?

The best practice is to respond within 24 hours of receiving the invitation or
evite (Post, Post, Post, & Post Senning, 2014). Definitely respond before the date
indicated. The RSVP means you have to respond one way or another. Don’t make
the host have to call you for your response. If you decline, include a brief reason for
your absence.
When is an RSVP unnecessary?

Invitations without an RSVP do not require them. For many of these events, the
invitation may indicate “regrets only” as a way of getting a head count. In this case,
you respond only if you are not planning to attend. Otherwise, your attendance is
expected.
What should I do if I have accepted an invitation and

discover at the last minute that I cannot attend?
Make every effort to let the host know why you will miss the event. Here are some
other suggestions:
• Call the location of the event and leave a message with the banquet manager or
maître d’ to be passed to the host.
• Send a handwritten note the next day explaining your absence.
• Call the host the next day. Apologize and explain your situation (Rickenbacher,
2004).
Greetings and Courtesy

Is it really necessary to attend my unit or department party?
Yes, unless you want to be remembered as the person who snubbed your colleagues
by not attending. Your absence at an annual function will be noted.
Attending the party shows you are a team player and gives you a chance to get to
know coworkers in a less formal setting. Think of the office party as part of your job.
If this is not your idea of a good time, consider it work. Put on your best attitude and
go. If you are unable to attend due to a scheduling conflict, let your host and others
know why.
Is a business party a time to relax and let loose?

No. It is a test of your social skills and your level of sophistication. Your interpersonal
skills, including your treatment of the wait staff, are on display.
One of the biggest blunders at a business function is alcohol abuse. You can undo
months and years of good impressions by excessive drinking. The key point to
remember is that business behavior is the number-one concern at the gathering
(Pagana, 2006c).
Why are many people uncomfortable attending social events?

In recent years, teenagers and children have faced unprecedented demands on their
time from school and extracurricular activities. In addition, most families are two-
earner families, with both parents working full-time jobs. As a result, fewer people
have time to focus on learning social graces—including small talk. This contributes
to the anxiety that many people feel in formal or business functions.
For many people, including nurses on the job, time is so precious that we practice
getting to the point and the task at hand as quickly as possible so we can move on
to the next point or task. However, many businesses expect employees to have the
social skills needed to make them a competent representative for the organization.
No matter your age, social skills are important for career advancement. Learn
them! In addition to this book, numerous resources are available. In addition, many
community, business, and school organizations offer courses that teach these skills.
When should I arrive for a company party?

It is best to arrive on time. Do not be more than 15 to 20 minutes late (Post et al.,
2014). A late entrance will make people think you are rude. Punctuality is expected
more at a business event than a social event.
On the other hand, don’t arrive early. This can be awkward for the host if he or she
is not quite ready for the party.
Should I bring family or a partner to a business event?

If they are invited and you would like them to attend, that is fine. Just be aware that
their actions and dress will reflect on you. You should brief them ahead of time on
proper dress, conversational topics, key people, and expected behavior.
Faux Pas
Bill was being honored at a cocktail party for receiving a national award. His
family members were invited. His sisters stuck together and made no effort to
interact with anyone else. Unfortunately, they lost the opportunity to meet Bill’s
colleagues. They could have asked, “How do you know Bill?” as a conversation
starter and met a lot of nice people. Instead, they came across as backward
and socially awkward. They were not an asset to Bill in his goal for career
advancement.
Do you have any recommendations for presenting oneself

professionally at a corporate event?
Think of a corporate event as a great opportunity to expand your network and
make new friends. At this type of event, you can practice your skills related to
introductions, handshaking, remembering names, conversations, and networking.

Here are some guidelines (Brody, 2005; Pachter, 2013; Sabath, 2010):
• Smile and be friendly to everyone.
• Avoid clustering in small groups with people in your department.
• Introduce yourself to people you don’t know.
• Take the time and effort to get acquainted with Good Idea!
new people.
As the new VP of nurs-
• Spend more time listening than talking. ing, Felix was looking
forward to getting to
• Ask open-ended questions. know the administra-
• Keep the conversational topics accessible to tive team better at the
everyone. annual holiday gala.
As part of his prepa-
• Minimize “shop talk” during social gatherings. ration for the event,
he found out as much
• Be sure to greet senior management. Use engag-
as he could about
ing small talk. the people who were
• If you don’t call people by their first names at going to be there. Be-
work, don’t start at the social event. cause of this prepara-
tion, he had no trouble
• Don’t take or make any phone calls. fitting in with the team.
He used small talk to
• Treat the servers with respect.
initiate conversations
• Don’t act bored. Be aware of your body lan- and begin to develop
guage. working relationships.
• Stay for an appropriate amount of time.
• Thank your hosts before leaving.

Women should
TIP avoid clothes that
are too tight, too
What is the dress code for a corporate short, and too sexy.
event?
The key word here is corporate. Make sure you dress appropriately for the function
by checking the invitation or calling the host for guidelines. Remember, the way
you dress when out with friends and family may not be suitable for a work function.
Dress up. It is always best to err on the more formal side. Your effort will be
apparent and reflect favorably on you.
How do I deal with gossip?

Avoid gossipers. It is not enough to abstain from gossip. Silence can be a form of
participation. Excuse yourself and remove yourself from the situation.
If there are no place cards on the dinner tables, can I sit

wherever I want?
Yes. But be sure you are not sitting at the host’s table. If people are already seated at
a table, ask them for permission to join them. For example, you might say, “Do you
mind if I join you?” or “Are these chairs available?” A chair tilted against the table
means that place is taken.
If I am invited to a party at someone’s house, should I bring a

gift?
Yes. The host expends a lot of time and money to put on a party. A small gift
expresses your appreciation and gratitude. The gift does not have to be expensive,
but it should be nicely wrapped. Some suggestions include a bottle of wine, fragrant
candles, or a box of chocolates. A small gift basket with jams or gourmet foods is
also a nice option. Attach a card so the host will know who brought it. If you bring
wine, do not expect the host to serve it at the party. If you bring flowers, put them
in a vase before giving them to the host.
Should I send a thank-you note after the occasion?

Yes. If you want to show appreciation, demonstrate good manners, and be
remembered, send a handwritten thank-you note.
Small Talk
Why is small talk important at a corporate function?
Small talk is essential for starting conversations until you find a common area
of interest. It is a valuable tool for breaking the ice and making people feel
comfortable. Small talk is a gateway to new relationships and vital for maintaining
established relationships.
If you have trouble getting started with small talk, try using the OAR approach to
help your conversation:
• Observe. For example, “It looks like this new restaurant drew a large crowd.”
• Ask questions. For example, “How is your daughter doing on the swim
team?”
• Reveal something about yourself. For example, you might say, “Now that
I’ve been at Susquehanna Health for three years, it is nice to know most of
the people here.”
How do I know what topics are safe for Faux Pas

conversation? Joe invited his friend
Avoid controversial topics, especially religion and Patrick to play golf with
politics. Don’t discuss salary, medical problems, or him and two of his col-
personal misfortunes. You can safely discuss weather, leagues in a fundraiser
sports, traffic, travel, movies, and books. Avoid off- for a new cancer treat-
ment center. Although
color jokes.
Patrick was a good
During a social event, don’t discuss work problems. golfer, Joe regretted
Avoid medical jargon. If a conversation turns to work, inviting him to the
change the subject by saying something like, “I heard tournament because
you mention a trip earlier. Where are you are planning Patrick talked the entire
to go?” time about his medical
problems. He domi-
Don’t forget to protect patient privacy in your nated the conversation
conversations. It is unethical and illegal to discuss and put a damper on
patients outside of the healthcare team. the golf outing.
How do I exit gracefully from conversations?

This is a key component of networking at corporate events. Your goal is to meet
several people, not to spend the entire time speaking with one person. Simply
excuse yourself and say something like, “It has been great talking with you. I’ll let
you have time to speak to others.” Or, “It was a pleasure meeting you. Will you
excuse me while I touch base with some other colleagues?”
Alcoholic Beverages and Hors

d’Oeuvres
“Always do sober what
you said you’d do drunk.
That will teach you to
keep your mouth shut.”
–Ernest Hemingway
Do you have any suggestions for drinking

at a corporate event?
Limit yourself to one or two drinks. This can be a
challenge when the drinks are free and the liquor
Remember, busi-
is high quality. Don’t think you need to drink to be TIP ness behavior is
part of the group. Stop drinking when you reach the number-one
your limit, and switch to a nonalcoholic beverage. item on the agenda at
You do not want to be remembered for any any business event.
colorful or inappropriate behavior. You will be held
accountable for your actions.
Faux Pas
Justin was at a corporate out-of-town dinner with his team. His boss offered wine.
Justin, along with the rest of the team, accepted the offer of a glass. When the
wine was brought to the table, a coworker who had been drinking before and
during the meal grabbed the glass the waiter had offered to the boss to taste
and approve. In addition, she was the only one to order an after-dinner drink.
Everyone at the table was embarrassed for her. Her career with the hospital was
short-lived, as this type of inappropriate behavior was also demonstrated—in less
dramatic ways—in her everyday work.
What is the best way to hold drinks and hors d’oeuvres?

The best way to hold drinks and hors d’oeuvres is
to handle them separately. It is very awkward to It is hard to be
hold a drink in one hand and food in the other. This
TIP polite when you
are starved. Eat
restricts your ability to shake hands. Remember, the
something before the
purpose of the event is to socialize, not to eat and
event.
drink. Don’t be hungry and thirsty when you arrive
at the event.
Faux Pas
Dave made sure he was appropriately dressed for the office party at a nice
country club. He limited his drinking to one glass of wine. However, he stood by
the shrimp bar and ate more than 20 pieces of shrimp. He forgot that the main
purpose of the event was to mingle and network. His coworkers did not forget this
incident. They endlessly teased him and made him the butt of many shrimp jokes.
Good Idea!
Theresa was attending her first corporate cocktail party. She didn’t want to make
a bad impression by heading straight to the buffet to get something to eat, so she
ate something before she arrived. Once there, she ordered a soda with a lime,
which she carried in her left hand, leaving her right hand free to shake hands. She
met many new people and had a great time at the party. She was very savvy and
conducted herself with charm, which her managers noticed. When she got home,
she and her husband shared a bottle of wine and discussed the party.
What do I do with the

toothpick used to serve food
from a serving tray?
Don’t put the toothpick back on the tray.
Put the toothpick in your napkin or on
a tray used to collect empty glasses and
plates.
Avoiding Buffet Blunders

• Put your food selections on a plate.
• Don’t snack over the buffet table.
• Move away from the table to eat your food.
• Don’t complain about the food. Just select food you like and pass on
food you do not want.
• Don’t double-dip your food in sauces.
Wine Service
What is the proper way for the host to handle wine at a meal?
Assuming the event is taking place in a restaurant, here’s the proper way for the host
to handle wine:
1. The host orders a bottle of wine.
2. The server presents the wine bottle to the host.
3. The host examines the label to make certain it is the correct type and
vintage.
4. The server removes the seal, extracts the cork, and places the cork on the
table.
5. The host looks at the cork to make sure it is in good condition.
6. The server pours a small amount of wine into a glass for the host to sample.
7. The host swirls the wine in a small motion, sniffs the wine, and takes a
small sip.
8. If the wine tastes good, the guests are served prior to the host.
9. If the wine tastes off or has a musky odor, the problem is reported to the
server. The server or wine steward may taste to confirm. A replacement
bottle will be provided.
Is there a different type of wine glass used for white and red
wine?
Yes. A red wine glass has a short stem and a large bowl. Red wine is served at room
temperature. Hold the glass close to the bowl.
A white wine glass has a longer stem and a smaller bowl. White wine is served
chilled. Hold the glass by the stem to avoid warming the wine with the heat from
your hand.
How much money should I spend on a bottle of wine?

A sensible guideline is to spend as much on a bottle of wine as the cost of one
complete dinner. Be careful, however. Wine prices vary from a few dollars to
hundreds of dollars.
How can I ask the wine steward to suggest a wine in my

price range?
Point to some prices on the menu and ask for suggestions.
In which hand should I hold my glass of wine?

Keep your drink in your left hand so your right hand is free for shaking hands. You
don’t want your right hand to be cold and damp.
Should I tip the bartender?

If it is a cash bar where you pay for your drinks, you should tip the bartender. At
most formal affairs, gratuities are built into the wait staff’s fees (Post et al., 2014).
How do I select wine?

Red wine is usually recommended with red meat, although this rule is not carved
in stone. White wine is usually recommended with white meat or fish. However,
these are just suggestions. You can ask the wine steward to make suggestions to
complement your meal choices.
Popular examples of red wines include merlot, zinfandel, shiraz, and pinot noir.
Popular whites include chardonnay and sauvignon blanc (Pachter, 2013).
How do I know how many bottles of wine to order for a

group of people?
As a rule of thumb, order one bottle for three people (Pachter, 2013).
Beer Drinking
If I am drinking beer at a corporate event, should I use a
glass?
Yes. Pour it into a pilsner glass. Stay away from plastic glasses unless no others are
available.
Do you have any suggestions for drinking beer at a cocktail

party or dinner?
Yes. Pour the beer into a large glass that will hold If you have a
the entire can or bottle. This avoids the need to put
TIP question about
how to handle a
beer cans or bottles on the table.
drink or food, follow
At a formal party, it looks classier to carry a glass of the lead of your host
beer instead of a bottle or can. However, if you are or those in the posi-
at a function where the hosts are drinking out of a tion you aspire to.
bottle or can, feel free to do the same.
If I am at a ballgame with my boss and colleagues, is it OK

to drink a beer?
Yes, if you can handle yourself in an appropriate manner. Remember, your behavior
at the ballgame will be remembered in the boardroom.
Tasteful Toasting
Why do people make toasts?
The custom of toasting to health dates back to ancient Greece, when a sip of wine
was taken to demonstrate that the wine was not poisoned. Splashing wine from cup
to cup was also a safeguard against poisoning. Today, a toast is used to recognize a
special occasion (Whitmore, 2005).
How can I make a memorable toast?

Keep it simple and short. It is a toast, not a roast. Prepare ahead of time so you do
not fumble for the appropriate words.
Can anyone propose the first toast at an event?

The host or hostess should propose the first toast. If there is a guest of honor, the
host or hostess should toast the person. The honored guest should respond with a
toast. Other guests are then free to make toasts.
If the guest of honor is being toasted, does he or she take a

drink?
No. The person being honored should smile and say thank you. It is considered bad
form to drink to oneself.
If I do not drink alcohol, can I participate in a toast?

Yes. You can toast with a nonalcoholic beverage or water. You can also raise a glass
of wine to your lips without tasting it.
Avoiding Toasting Blunders

• Do not read a toast. However, you may glance at your written notes.
• Don’t clink glasses.
• Do not tap the rim of a glass to get everyone’s attention.
• Don’t toast yourself.
• Don’t feel you need to drink alcohol to propose a toast.
• Don’t raise your glass above eye level.


? Is it OK to rearrange the place cards at a table?
No. Sit where the host wanted you to sit.
? What should I do if I end up with something in my mouth that I

don’t like or can’t chew?
Transfer it to your cocktail napkin and then place the napkin in a trash can
or on a service tray for collecting used plates and glasses.
? If I meet someone at a cocktail party and suggest having lunch,

what is the appropriate follow-up?
Don’t suggest lunch unless you mean it. Be sure to follow up with a phone
call or note within a few days.
? How much should I tip a bartender?

The usual is $1 per drink at the bar.
? When should a guest leave a cocktail party?

It is polite to leave at or before the ending time for the event. Don’t overstay
your welcome. If you are having a good time, keep track of the time. If
the invitation said that the event would last from 5 to 7 p.m., don’t stay a
minute after 7 p.m.
? Should I stand up if the host stands to make a toast to someone?

Yes. However, the person being toasted should remain seated.
TAKE-AWAY TIPS
• Respond promptly to all invitations.
• Keep your conversation within appropriate parameters. Don’t say any-

thing to anyone that you will be embarrassed about later or that could
get you into professional trouble. Remember, loose lips sink ships!
• Be discreet with your conversation. Avoid divulging your personal

troubles.
• Avoid messy foods. Keep your hands clean for handshakes.
• You can be sociable and not drink alcohol.
• Business rules apply even in social settings.
• If in doubt, don’t. For instance, if you question whether you should wear
something, don’t.
• If someone is toasting you, do not drink to yourself.

10 How Dining Etiquette and Business Success Go Hand-in-Hand 197
10
HOW DINING ETIQUETTE AND
BUSINESS SUCCESS GO
HAND-IN-HAND
Seeing Through That Silverware Glare
DO YOU:
• Know which water glass is yours?
• Know what to do if you drop your fork on the ground?
• Know which fork to use first?
• Know what to do if you need to blow your nose at a meal?
• Know what to do if someone asks you a question and your mouth is full?
These are concerns that can make you feel flustered or uncomfortable during
a meal. The fast-food world and the school cafeteria do not provide many
opportunities for learning the finer points of dining etiquette. However, minding
your manners can make a lasting impression in a business or formal setting. Read
on for guidelines to make you feel more comfortable and confident while dining
during business meetings, job interviews, wedding receptions, and other special
occasions.
RSVP
Do I need to respond to an RSVP?
Yes. See the RSVP discussion at the beginning of the previous chapter. If you don’t
respond, the sender may think you have bad manners or that you did not get the
invitation.
Place Settings and Dining Utensils

Where is my bread plate?
One of the challenges of dining with others is figuring out which bread plate
belongs to you and which water glass is yours. Fortunately, several mnemonic
devices can make it easy to remember your way around a formal dinner table
(Pagana, 2005a; Pagana, 2006b):
• All food to the left of the entree plate belongs to you. This includes your
salad, bread, and soup. An easy way to remember this is to note that food and
left both have four letters.
• All drinks to the right of the entree plate are yours. This includes your water,
wine, and coffee cup. An easy way to remember this is to note that drink and
right both have five letters.
• If you can remember the expression “leftover bread,” you can remember that
your bread is on the left.
• Place the tip of your right thumb and forefinger together to make a circle.
Straighten your fingers, and your hand will form a small letter d. Do the same
with your left hand, and it will look like a small letter b. The d stands for
drinks and indicates that your drink glasses (water, wine, and coffee) are on
the right of your entree plate. The b stands for bread and indicates that your
bread plate is to the left of your plate.
• Another easy way to remember proper table setting positioning is to think

of a BMW automobile. Here, instead of standing for Bavarian Motor Works,
BMW stands for bread, meal, and water. Your bread is on the left, your meal is
in the center, and your water glass is on the right.
Your bread, meal, and water appear in this order from left to right, just like the letters
of a BMW automobile.
Which fork should I use first?

When it comes to dining utensils, a good rule of thumb is to work from outside to
inside. The salad fork will be the smaller fork on the outside, and the larger dinner
fork will be on the inside. Note that used utensils do not go back on the tablecloth.
They are placed on the salad or entree plate.
Faux Pas
As an acknowledgement of her Award for Clinical Excellence, Lindsey was being
honored at a banquet attended by the medical center administration. She was so
overwhelmed and confused by the many pieces of silverware, china, and glasses
that she could not enjoy the meal or the conversation. She worried the entire
time about making an etiquette blunder and leaving a bad impression on the
administrators.
Faux Pas
Mike had just finished his master’s degree. He was invited to a business lunch as
part of the interview process. Mike overheard the person to his right asking the
wait staff for a fork. He realized then that he was using the fork belonging to that
person. He was embarrassed and worried about other etiquette blunders he may
have committed.
What is the typical place setting for a four-course meal?

There are usually two forks to the left of the plate, two knives to the right of the
plate, and a soup spoon to the right of the plate. (The smaller forks and knives are
on the outside.) The soup spoon indicates that soup will be served first. After the
soup spoon is removed, continue working from the outside in. The smaller fork and
knife on the outside indicate that salad is the next course. After the salad, the larger
fork and knife are used for the main course. The spoon and fork at the top of the
place setting are for dessert.
When setting the table, which utensils go to the right and

which go to the left of the entree plate?
Here are a couple of tips to help you (Post, Post, Post, & Post Senning, 2014):
• The fork is placed to the left of the plate. Fork has four letters and so does
left.
• The knife and spoon are placed to the right of the plate. Knife and spoon have
five letters and so does right.
• Think of the mnemonic FOrKS. The O represents your circular entree plate.
The F stands for forks, which are placed to the left of the plate. The r indi-
cates that the knives (K) and spoons (S) are placed, in that order, to the right.
When setting the table, does it matter which way the blade of
the knife is pointing?
Yes. Place the sharp edge facing the entree plate.
Where do I put the napkin?

When everyone sits down at the table, napkins are placed on the lap. If you need to
excuse yourself during the meal, place the napkin on your chair so others do not see
your soiled napkin on the table. When the meal is finished and everyone is leaving
the table, put the napkin to the left of the plate. If the plate is already removed, put
the napkin where the plate was (Pagana, 2006c).
A waiter recently asked me if I wanted a black napkin. What

was this about?
This is a nice gesture. Most restaurants set their tables with white napkins.
Unfortunately, white napkins can leave white lint on dark clothing. Therefore, many
restaurants also stock black napkins. If you see other patrons with black napkins, you
can request one if you are wearing dark or black clothing. Often, in this situation,
the waiter will ask you if you prefer a black napkin before you request one.
Bread and Butter

Who should pass the bread around?
If the bread is in a basket in front of you, pick it
up and offer it to the person to your left. Then, Do not serve
take a piece yourself and pass it to your right. Or,
TIP yourself first.
you can just pick it up and pass it to your right
(counterclockwise).
If someone already started passing the bread the wrong way, just go with it. Also,
remember, as soon as you touch a piece of bread, it is yours. Do not reach into the
basket and feel around for a hot roll on the bottom.
How much bread can I butter?

If the butter is being passed around, put a pat of butter on your bread plate. When
eating the bread, tear off a piece. Then butter and eat one piece at a time.
Some restaurants feature special oil for bread. If so, pour or spoon out a small
amount onto your bread plate. Never dip your bread into the community oil.
What is the proper etiquette for handing a loaf of bread

rather than individual pieces?
Let’s start with what not to do. Do not pick up the bread with your bare hands and
tear off a piece. Do use a cloth or napkin to hold the bread while you cut a few pieces
with a knife. If you are served the bread without the cloth and knife, ask the waiter to
bring them.
Soup and Salad

How do I handle the soup?
Many meals start with soup, which can be a challenge. Keep these points in mind:
• When eating soup, dip the spoon sideways into the soup toward the back of
the bowl—that is, away from you. This technique prevents the soup from
splashing onto your clothes.
• Skim the top of the soup with the spoon and sip from the side of your spoon,
not from the front.
• Don’t crumble crackers into the soup. Take one bite at a time, just like with
bread.
• You can tilt the bowl away from you to get the soup from the bottom of the
bowl. If the soup bowl has two handles, you can pick it up and drink from the
bowl. However, this method is not widely known or commonly done.
• If the soup is hot, don’t blow on it. Just wait until it cools down a bit. When
you are finished, place your spoon next to the bowl on the plate. If there is no
plate, leave the spoon in the bowl.
If the meal is during an important work meeting, it’s best to avoid soups that are
messy and hard to eat. Even if you love French onion soup, don’t order it at a
business meal. If it is pre-ordered, use your spoon to break the cheese against the
back of the bowl so you do not stretch strings of cheese from the bowl to your
mouth.
“At a dinner party,

one should eat wisely
but not too well, and
talk well but not too
wisely.”
–W. Somerset Maugham
Can I cut the salad?

Sure you can. Most salads do not have bite-sized pieces of lettuce. Therefore, use
your knife and fork to cut the salad. Also, keep these points in mind:
• Be careful handling cherry tomatoes. Use one of the tines of your fork to
poke into the stem area of the tomato. This will prevent the cherry tomato
from shooting across the table when you cut it.
• If your salad has olives with seeds, use your fork to remove the seeds from
your mouth and place them on the edge of your salad plate.
• If the salad dressing is in front of you, pick it up, offer it to the person on
your left, serve yourself, and pass it to your right. Or, just pick it up and pass
it to your right. The idea is not to serve yourself first.
Why should diners pass food to the right?

It simplifies dining when food is passed in one direction. Also, because most diners
are right-handed, they receive the plate, basket, or salad dressing with their left
hand, which leaves the right hand free to serve the food.
The Main Course

How many pieces of meat may I cut at a time?
This answer depends on whether you follow the American or Continental
(sometimes called the European) style of dining. Although both are acceptable in
the US, the American style is most commonly used. The Continental style is the
norm outside of the US.
With the American style, sometimes called the zig-zag style, meat is cut with the
knife in the right hand and the fork in the left. (The opposite hands are used for a
left-handed person.) Two or three pieces of meat are cut at a time. Then, the fork is
switched to the right hand to eat the meat. The knife is placed across the top of the
plate with the blades pointing inward.
With the Continental style, the knife is again placed in the right hand and the fork
in the left hand. With this style, however, each piece of meat is consumed as it is
cut. The silverware is not switched to the other hand.
Do you have any tips for fast eaters?

If you notice that you are likely to finish your meal well before everyone else, you
must slow down your eating. Here are some tips to slow down your eating:
• Put your utensils down while chewing your food.
• Take smaller bites. Faux Pas

• Engage more in conversation. Several coworkers
were eating dinner at
an upscale restaurant
Do you have any tips for slow eaters? in Philadelphia. One
It is important to keep pace with others at the table. man pulled out some
dental floss and flossed
If you are a slow eater, you need to pick up the pace.
his teeth at the table.
Here are some tips:
This uncouth behavior
• While chewing your food, cut up food for the ruined the appetites
next bite. of everyone else at
the table. While this
• Take or order small servings. behavior may be
• Answer questions in short sentences. acceptable in other
areas of the world, it
• Ask questions and eat while others talk. is not appropriate in
Pennsylvania.
Tips for Buffets

• Wait for the serving staff or host to direct your table to the buffet.
• Don’t overload your plate. You can always go back after everyone has
gotten food.
• Don’t leave the serving spoon or fork in the serving dish. Place it on
the saucer in front of the serving dish. This will prevent the handle from
sliding into the serving dish.
• If you are the first one back to the table with food, wait for at least one
other person to join you before you start to eat.
• Use a new plate when you return to the buffet.
• Don’t ask for a doggie bag.

Table Manners Do’s and Don’ts

Do:
• Say “please” and “thank you.”
• Chew with your mouth closed.
• Pass the salt and pepper together.
• Place the salt and pepper shakers on the table in front of the person
requesting them.
• Taste your food before seasoning.
• Wait for others to be served before starting to eat.
• Encourage others to start eating if your food is held up.
• Say “excuse me” if you have to go to the restroom during dinner.

Don’t:
• Put your elbows on the table.
• Rearrange the place cards on the table.
• Wave your utensils.
• Slurp your soup.
• Pick your teeth.
• Blow your nose on the dinner napkin.

• Put on lipstick or makeup.
• Comb your hair.
• Ask for a doggie bag at a business meal or buffet.
• Say, “I have to go to the bathroom.”
Is there a way to signal to the wait staff when I am finished

with my plate?
Yes. You signal the wait staff by positioning your silverware on your plate in the
finished, rather than resting, position. The finished position signals to the wait staff
that the plate can be removed (Pagana, 2006a). In contrast, the resting position
enables you to slow down and keep your plate on the table. This is particularly
useful if you are a fast eater. Removal of your plate from the table puts pressure on
others to speed up.
So what is the finished position and what is the resting position? The answer to that
depends on whether you use the American style or the Continental style of dining.
If you use the American style, imagine a clock on your plate. To indicate that you
are resting and do not want your plate removed, place the fork with its top pointed
at 10 o’clock and the base at the 4 o’clock position. Place the knife across the top
of the plate with the blade pointed inward. To indicate that you are finished, place
the knife and fork in the 10 and 4 o’clock position with the tops of the silverware
pointed at 10 and the bottoms pointed at 4.
To indicate a resting position, in the Continental style, place the fork and knife in
an inverted V position. To indicate that you are finished, place the knife and fork in
the 10 and 4 o’clock position with the tops of the silverware pointed at 10 and the
bottoms pointed at 4. (This is the same as the American style.)
Faux Pas
In her new position as vice president of nursing, Veronica was invited to a
corporate dinner at an exclusive private dining club with the members of the board
of trustees. She was served an exquisite meal by a doting wait staff. During the
meal, she was asked a question, and she put her silverware on her plate. With
an attentive wait staff, someone was there in a flash to whisk away her plate.
Unfortunately, Veronica had placed her silverware in the finish position. She
was stunned, and her facial expression gave away her surprise to her dinner
partner, who was gracious enough to discreetly alert Veronica to the importance
of handling silverware appropriately during a formal dinner. Veronica decided
then and there to learn as much about dining etiquette as she could before the next
dinner party.
Do you have any recommendations for handling difficult

foods in a formal setting?
Yes. Don’t order them in a formal setting. Save them
for eating at home or with friends in an informal Faux Pas
setting. Remember, this is not your “last supper”! Here
Barb and her husband
are some tips for some challenging foods (Pagana,
went out to dinner
2006b):
with a work colleague,
• Bacon: Generally, you should use a fork. How- Denise, and her hus-
ever, if the bacon is crisp, you may pick it up band. While Barb was
with your fingers. squeezing a lemon, the
juice squirted across
• Bananas: Peel the banana, cut into slices, and the table into Denise’s
eat it with a fork. eyes. The discomfort
was significant for
• Cherries with pits: Use a spoon to put the
Denise, and it was sev-
cherry into your mouth and to remove the pit
eral minutes before the
from your mouth. group could continue
• Cherry tomatoes: Use the tine of the fork to the meal. Barb was
poke into the area where the stem was attached. mortified. After that,
she wasted no time in
Then cut the tomato into pieces.
learning how to handle
• Corn on the cob: Butter a few rows at a time. difficult meal situations
When you eat it, hold it with both hands. such as squeezing
lemons.
• French fries: Cut them into bite-sized pieces
and eat them with a fork.
• Lemons: Cup the lemon in your hand to avoid squirting as you squeeze it
over food or into drinks.
• Parfait: Start at the top and work your way down.
• Pasta: Use your fork to twirl a few strands against the edge of your plate.
• Petits fours: These are finger foods that are eaten in small bites.
• Pork chops: Use a knife and fork.
• Watermelon: Use a knife and fork. Use a spoon if the watermelon is shaped
into small balls.
Coffee & Tea

Should I turn over my coffee cup to indicate that I do not
want coffee?
No, never turn over any plate, cup, or wine glass. Simply tell servers when they ask.
If you are repeatedly interrupted and asked this question from multiple servers, you
can ask to have a cup and leave it untouched. You won’t be interrupted again.
What are some tips for coffee etiquette?

Coffee etiquette can vary around the world. Here are some general tips:
• Don’t cool a hot drink with ice from your water glass.
• Don’t dunk anything (biscuits, donuts) into your coffee unless you are in a
really casual place where that is acceptable.
• Don’t leave your spoon in the cup. Place it on the saucer or plate.
When the waiter brings a pot of hot water and you drop the
tea bag into it, how long do you let it seep?
Generally, tea should brew for three to five minutes. However, this also depends on
the type of tea and your personal preference. Don’t pick up the tea bag by its string
and jiggle it. Also, don’t wind the string around the bag while it is on your spoon
and squeeze it.
What should I do with my tea bag if my tea is served in a

mug?
Do not put the tea bag directly on the tablecloth. You have a few options here:
• You can place the tea bag on your dessert plate or other plate at your place
setting.
• If you don’t have a place available, you can place the tea bag into the bowl of
your spoon.
• You can ask the server for a plate for the tea bag.
What is the proper way to stir tea?

Place your spoon in a 6 o’clock position in the cup. Gently stir the tea toward the
12 o’clock position while being sure not to clink the spoon against the cup. Don’t
leave the spoon in the cup. Place it on the saucer to the right of the cup.
When holding a tea cup, should your pinkie be up?

No. There is a misconception that outstretching the little finger aids the balance of
the cup when taking a sip of tea. Keep the pinkie down!
Is it acceptable to dunk biscuits into my tea?

No. As with coffee, only do this in the privacy of your own house or in a very casual
coffee shop.
Paying the Bill

Who pays the bill?
The host should pay the bill and leave the tip. (Be prepared, however, in case the
host does not know this.) The host should be able to figure out the tip without
using a calculator. Good service usually is acknowledged with an 18 to 20%
tip. Apps are available for quick tip calculations. Some bills list the amount for
suggested tips.
Good Idea!
Amy was planning to take her father and stepmother out for dinner to celebrate
her father’s birthday. Two days before the dinner, she called to verify the
reservation. While on the phone, she found out that the restaurant accepted only
cash as payment. She had been unaware of this policy prior to calling to confirm
the reservation and would not have had the necessary cash. Amy now asks about
payment policies when she makes reservations.
Faux Pas
Colleen and four of her coworkers were invited to dinner by their manager to
celebrate the completion of a successful project. Colleen ordered a soup and
salad. The manager ordered prime rib. When the waiter gave the bill to the
manager, he divided it by six and told everyone to pay an equal share of the bill.
The manager’s inconsiderate decision was very upsetting for Colleen, because she
only ordered what she knew she could afford. Since the manager invited Colleen
and her coworkers out to dinner, he should have paid the bill.
What if the group ends up paying separately?

If everyone will be paying separately, inform the server before ordering to provide
separate checks. For a shared check, be sure to have cash on hand to pay for
everything you ordered, including tax and tip. If everyone ordered the same thing,
divide the check after adding the tip.
Good Idea!
In her position as vice president, Candace often hosts meals for male and female
colleagues. To avoid an uncomfortable moment when the dinner check arrives,
Candace gives the maître d’ her credit card ahead of time and asks to have a
20% tip added. After the meal, she is presented the bill and merely has to sign it.
She tells everyone that they are guests of the organization.
International Considerations
What are some considerations for dining in other countries?
When dining in other countries, you must consider many differences. These
include the following:
• Where to sit at the table
• Where to place your hands during the meal
• How to signal when you’ve had enough food
See Chapter 14, “Going Global,” for details and examples.
Are there differences in tipping?

Yes. Outside the US, the tip is usually included in the bill. If the service was good,
you can leave a little extra. Research the tipping practices of the country you are
planning to visit beforehand. For example, in some countries, patrons just round
the bill up to the next Euro or unit of currency.

? Where should women place their purses when dining?
If the purse is small, it can go on the person’s lap, under the napkin. If it’s a
large purse, she should put it on the floor between her feet or by her right
foot, with the plan to exit the seat by the right side. Purses should not be
placed on the backs of chairs. They can be in the way of the servers and
also get stolen easily.
? How do I let the waiter know when I am ready to order?

Close your menu when you are ready to order. You can also catch the
waiter’s eye and nod your head indicating that you are ready.
? Should I turn over my coffee cup to indicate that I do not want

coffee?
No, never turn over any plate, cup, or wine glass.
? What do I do when the silverware at the restaurant is wrapped in

the napkin?
Carefully unwrap the napkin so you don’t drop the silverware on the floor.
Then place the silverware where it belongs in the place setting. Forks go to
the left of the plate and knives and spoons to the right. Put the napkin on
your lap.
? May I tuck the napkin into my collar?

No. However, you may lift your napkin up and cover your shirt for a few
seconds when eating something messy. Men should not swing their tie
around the back of their neck.
? What foods should not be ordered at a business meal?

Avoid anything you do not know how to eat and anything messy. Examples
of messy foods include spaghetti, barbecue ribs, and French onion soup.
Eat messy foods on your own time and with your family and friends. Also,
don’t order expensive food like lobster or steak unless the host encourages
you.
? Before going to a business meal at an unfamiliar restaurant, is it

a good idea to get some information about the restaurant?
Yes, this would be helpful. You could do this online. You would be able to
see the menu and learn about specialty dishes. You might also learn some
local history about the place that would make for interesting conversation.
? May I dip my bread into the sauce on my plate?

Tear off a piece of bread and put it on your plate. Use your fork to spear
the bread, dip it into the sauce, and eat it.
? Before passing the salt to someone across the table, it is OK to salt

my food?
No. Pass the salt and pepper as a pair to the requester. Then, politely ask
to have the salt passed to you. Both salt and pepper should be passed
together to you.
? May I ask for an extra condiment, such as ketchup, steak sauce, or

dressing?
Yes. Don’t keep others waiting, however. Encourage them to start eating.
? What if I have food in my mouth when someone asks me a

question?
Point to your mouth and the questioner will get the hint. To take the pressure
off you, the questioner should ask someone else a question so everyone isn’t
looking at you and waiting for you to answer the question.
? What should I do if I get a fish bone in my mouth?

Use your fingers to remove the fish bone. Place it on the edge of your plate.
? How do I get a piece of meat gristle out of my mouth?

Most etiquette experts advise removing something from your mouth with the
same utensils used to put it into your mouth. In this case, that would mean
using your fork. However, many people do not feel comfortable doing this
and remove the meat with one hand while using the napkin to block their
mouth and dab their face with the other hand. Place the meat on the rim of
your plate, preferably under a piece of garnish.
? Should I tell a dinner partner if she has poppy seeds in her teeth?
Yes. People want to know this.
? What should I do if my water glass or silverware seems unclean?

Don’t announce it to everyone at the table. Politely ask the server for a
replacement.
? Are there any conversational topics to avoid during a meal?

Yes! Avoid discussing religion, politics, health problems, and anything
inappropriate. If someone raises one of these topics in conversation with
you, change the subject. For example, say, “How are your plans coming
along for your anniversary cruise?”
? What should I do if I drop my fork under the table?

Leave it there so you are not disappearing under the table during the meal.
Ask the wait staff for another fork.
? What should I do if the server asks me to keep my knife when the

table is being cleared?
You have two options here. One is to place your knife on your bread plate.
(Never put a used utensil back on the table.) The other is request a clean
knife for the next course (Post et al., 2014).
? Is it polite for the meal guest to offer to pay the tip?

No. This is because the guest would have to know the cost of the meal to
calculate the tip.
? If I am expecting an important call or text message, is it OK to

check my cellphone during dinner?
You would need to have a compelling reason to do this. If you do, inform
the host of this possibility and reason before the meal. If you receive a
message or call, excuse yourself from the table to handle the disruption.
? Where should I place the dinner program at a business meal?

Nothing should be on the table except the food and service utensils.
Therefore, place it on your lap under the napkin, in your purse, or on the
floor.
TAKE-AWAY TIPS
• If you are trying to decide how much you can spend on your meal, ask
your host for food recommendations. If the host plans to get filet mignon,
you can feel free to order it also. Without any recommendations or sug-
gestions, stay in the middle price range.
• When you sit at the table, enter your seat from the left and exit from the
right. This is especially important at a round table when 8 or 10 people
are entering and exiting their chairs.
• Food is delivered to the table on your left side and removed from your
right side. An easy way to remember this is the two Rs: remove from the
right.
• Pass all food to the right. It is easier if food is going in one direction.
• Leave the table if you need to blow your nose.
• Don’t chew gum at the table.
• When unsure of how to handle a certain type of food, sit back and
watch others.
• Follow the lead of the host. If the host passes on dessert or coffee, you
should, too.
• A business meal should focus on business more than food. Remember,

this is not your “last supper.”
• When eating with international visitors, be respectful of different eating

habits.
11 Thank-You Notes and Business Letters 217
11
THANK-YOU NOTES AND
BUSINESS LETTERS
How Expressing Gratitude Can Make an Impact
DO YOU:
• Wonder if it is proper to send a thank-you note by email?
• Know the proper way to format a business letter?
• Know thank-you notes are important but wonder when to send them?
• Know the recipient’s title, how to spell the person’s name, and so on?
• Know to whom the letter should be addressed?
Your written words are going to leave an impression. Your challenge is to make
this a positive impression because the written word has permanence and creates
a paper trail. Many people are great communicators in face-to-face contact, but
they are befuddled when they have to write a letter or note.
Thank-You Notes
“Gratitude is the most Good Idea!
exquisite form of Recently a nursing
courtesy.” assistant received

Christmas gifts for
–Jacques Maritain her children from
the nursing staff. In
addition to thanking
If I thank someone for something, is it
everyone profusely in
really necessary to also send a thank- person, the nursing
you note? assistant followed up
with thank-you notes
Yes. If you want to demonstrate good manners, show
from her whole family.
appreciation, and be remembered, send a thank-you
This meant a lot to the
note. A thank-you note is the five-minute difference staff.
between feeling grateful and showing your gratitude
(Spade, 2004).
Good Idea!
Three different administrators interviewed Jacqueline for a new position. During
each interview, Jacqueline noted how each person’s office was decorated. One
office had golf photos, another had small statues of frogs, and the third had
pictures of flowers. After the interview, she went to the mall and got thank-you
cards featuring golfers, frogs, and flowers. She got the competitive edge by
tailoring the cards to fit the personalities of the interviewers.
Faux Pas
When her son graduated from high school, Eileen had a big party for him. A
week after the party, the guests received a typed thank-you note addressed to
family, neighbors, and friends. It was unsigned, and the names on the envelope
were written in Eileen’s handwriting. It was obvious that Eileen had done
everything. She missed an important opportunity to teach her son good manners.
Is it OK to email a thank-you note for a gift?

Only if you are following it with a note. If you are thanking someone for a gift or
an event, send a handwritten note. Two or three sentences are all that is needed.
Make sure you refer to the gift or the event. Emails do not have the same impact
because they require only a few seconds of time and effort.
When is it not necessary to send a thank-you note?

Almost every gift deserves a thank-you note. If in
doubt, send one. However, suppose you received At work, many
flowers as a thank-you for something you did for TIP people tack a
someone. In this case, just call and let the person thank-you note on
know how much you appreciate the thoughtful a corkboard for
gesture. Otherwise, you might find yourself sending the recipient.
thank-you notes back and forth to the point of being
ridiculous.
What about sending a note after an interview?

You have some options here. If you are sending a note after an interview, the note
can be handwritten or typed, depending on its length. If you want to write more
than several sentences, two typed paragraphs are acceptable. Try to mention one
thing you had in common with the interviewer—for example, you both worked in
New York earlier in your careers.
Thank-you notes received after interviews are usually placed in the applicant’s file.
When the applicants are reviewed, a note on nice paper will reflect better on your
manners than an email.
That being said, email is now another option for

sending a thank-you note after an interview. In If you type a
fact, some job candidates are now told to limit all
follow-up correspondence to email. This is for
TIP thank-you note, be
sure to sign your
the convenience of the interviewer and to give the name.
person the ability to quickly respond to questions or
concerns.
When should I send a thank-you note?

All etiquette books agree that the sooner the better. For maximum impact, send the
note as soon as possible after receiving a gift or attending an event.
“An engraved or printed

thank-you card, no matter how
attractive its design, cannot
take the place of a personally
written message of thanks.”
–Emily Post
Good Idea!
Mark had four interviews scheduled the week before his graduation. Before the
interviews, he purchased some fine quality thank-you cards. After each interview,
he requested a business card. He wrote his thank-you cards in the evening after
each interview and mailed them the next day. He made a good impression and
had no trouble getting a position.
Good Idea!
Tim and his family were having dinner at a restaurant. Tim saw a friend there and
arranged to secretly pay for his dinner. The next day, Tim received a thank-you
note in the mail. The recipient had mailed the thank-you note at the post office the
evening after the dinner. Tim could not believe he received the note so quickly and
was impressed with his friend’s manners.
What if I forget to send a thank-you note and remember

several weeks later?
Send the note. It is better late than never.
Thank-You Note Etiquette Tips

• If you receive a gift or check, do not use the gift or cash the check until
after you write the thank-you note.
• Thank the person for the specific gift and mention the gift by name. If
the gift was money, don’t mention the amount in your note. It is suffi-
cient to say “your generous gift.”
• Tell the person how the gift was or will be used.
• Even if you don’t care for the gift, send a thank-you note.
• Send a thank-you note within a few days of receiving a gift or attend-

ing an event. If possible, do it within 24 hours.
• If you forget to send a thank-you note, go ahead and send it, even if it
is several months late.
• Keep quality note cards and stamps on hand for writing thank-you
notes.
Do you have any suggestions for sending thank-you notes

internationally after receiving a gift or having a phone
interview?
Yes. Here are a few tips:
• Send the note as soon as possible after the interview, event, gift, or visit.
• Use quality stationery.
• Type or print the letter to avoid mistranslation due to handwriting idiosyn-

crasies. While attractive, handwriting flourishes can be confusing for some-
one for whom English is a second or third language.
• Make sure you have the correct spelling of the person’s name, and include the
person’s title. Check correspondence you have received from the person to
verify this information.
• Print or type the address in the proper format for the designated country.
• Take the letter to the post office so it can be mailed with the proper postage
and airmail designation.
Business Letters
Are business letters being replaced by email?
Today it is common to see business letters sent as email attachments. For example,
contracts, purchase orders, and employment letters are usually sent by email with
electronic signatures.
What are the key components of a business letter?

Business letters should have the following components:
• Date
• Titles
• Addresses of sender and recipient
• Salutation
• Body or content
• Closing
• Signature
The body of the letter should be clear and succinct, with a focus on “what’s in it for
them.” Here are some helpful tips (Post, Post, Post, & Post Senning, 2014):
• Be clear in your thought process. Avoid jargon.
• Use active voice. For example, write, “Justin will contact the job candidate”
rather than “The job candidate will be contacted by Justin.” Active voice adds
strength and brevity to your sentence structure.
• Avoid using run-on or incomplete sentences.
• Vary the sentence structure.

• Use paragraphs. Paragraphs should be composed of two sentences at a min-

imum, but not more than four or five sentences or about seven to nine lines.
Double space between paragraphs for easier reading.
• End your message. For example, say, “I look forward to meeting you.” Or,
“Thank you for your time and consideration.”
• Use a complimentary close, such as “Sincerely,” “Sincerely yours,” “Best

regards,” or “Cordially.”
• If you are enclosing materials with your letter, type “Enclosure,” “enc.,” or
“encl.”
• If you are distributing your letter to others, indicate courtesy copies by typing
“cc” or “copies to.” The names of the recipients should then be listed alpha-
betically.
What are some common mistakes with business letters?

Table 11.1 lists some common mistakes with business letters and tips on how to
avoid making them.
11.1 Common Mistakes With Business Letters
Mistake Tip
Misspelling the recipient’s Call the secretary or check the website.
name or title
Having typos in the letter Use spell-check and have someone else
proofread your letter.
Using an informal tone Keep the tone formal, even if you know
the recipient. Others on a committee
may see the letter.
Forgetting to sign your letter Check to make sure you signed the let-
ter. Otherwise, you look unprofessional
and show a lack of attention to detail.
Forgetting an attachment If you say you are including something,
make sure you add it before sealing and
sending the letter.
What are some tips for minimizing frustration and rewriting?

Organize your thoughts before you begin writing. Decide what you want to say and
what you want as the outcome of your communication. Write a rough draft.
How can I avoid misspellings in a business letter?

Use your spell-check. But remember, misspelled words can be overlooked by spell-
check when the misspelled word is a homonym—like berth and birth, capitol and
capital, and stationary and stationery. A misspelled word can also be overlooked by
spell-check when it is another real word—like fist instead of first or bank instead of
blank.
Read your letter out loud. Have someone else read it for typos and misspellings.
See the following list for some common misspellings in business letters:
Acceptance Achievement Anticipation
Approximately Candidate Commitment

Confidential Conscious Correspondence
Definitely Equipped Exceptionally
Fortunately Immediately Inconvenience
Irrelevant Necessarily Occasionally
Opportunities Perceive Perseverance
Philosophy Possess Practically
Receipt Recommend Schedule
How can I avoid errors with words with different meanings

that look alike or sound alike?
Use your spell-check and grammar-check to avoid these errors. Also, have someone
proofread your letter. The following box contains common errors.
Common Writing Traps

• Affect and effect
• Affect is usually a verb, meaning to influence.

• Effect as a noun means result; as a verb, it means to bring to
pass.
The new legislation affected mandatory overtime, and this effect sup-
ported nurse recruitment.
• Among and between
• Among introduces more than two items.

• Between introduces two items.
This honor should be shared among the entire staff.
This matter should be kept between the two of us.
• Bring and take
• Bring indicates motion toward a person.

• Take indicates motion away.
Please bring this water to Mrs. Miller.
Take the dinner tray from the room.
• Can and may
• Can implies ability.

• May implies permission.
Jerry may obtain the blood sugar if he can.
• Complement and compliment
• Complement refers to something that completes.

• Compliment refers to praise.
The color of that scarf complements your suit.
He gave me a very nice compliment about my scarf.

• Emigrate and immigrate
• People emigrate or move out of one country;

• They immigrate or move into another country.
The Irish emigrant was given permission to immigrate to the United
States.
• Farther and further
• Farther refers to a physical distance.

• Further means more or additional and is used as a time or
quantity word.
Move that desk farther to the right.
Let’s take the point one step further to its logical conclusion.
• Fewer and less
• Fewer refers to items that you can count.

• Less refers to degree or quantity.
There are fewer nurses in the same day surgery unit, and they have
less experience than the recovery room nurses.
• Irregardless and regardless
• Irregardless is not a word and should not be used.

• Regardless means despite or in spite of something.
The budget has been predetermined, regardless of what transpires in
the meeting.
• Me and I
• Me is the object of a verb or preposition.

• I is the subject of a sentence.
This problem is between you and me.
I am certain this is the correct route.

• Stationary and stationery
• Stationary means fixed in place.

• Stationery refers to writing materials.
Once correctly installed, the new digital mammography machine
remained stationary.
I will write my thank-you notes using my new stationery.
• Was and were
• Was is used for things in the past. (Use were if the subject is
plural or you.)
• Were expresses a wish or states a doubtful situation.
I was surprised to find you there.
If I were a college student today, I would choose nursing as a career.
• Who and whom
• Who is used for the person who is the subject of a sentence.

• Whom (the objective case of who) refers to the person who is
the object of an action.
Who brought the new equipment?
The new equipment is to be used for whom?
Is a shorter letter more professional than a longer letter?

Yes. Be clear and concise. Don’t waste the reader’s time with unnecessary infor-
mation. Read what you have written and eliminate any extra words or data. For
guidance, see The Elements of Style, the classic grammar book by William Strunk, Jr.,
and E. B. White. This little book is often described as the best primer on writing. It
provides more information in less space than almost any other book.
“Do not be tempted by a twenty-

dollar word when there is a ten-center
handy, ready, and able.”
–William Strunk, Jr., and E. B. White
How should I handle the address and

Edit, edit, edit.
salutation of a letter if I do not know TIP
Eliminate gram-
the sex of the recipient? mar problems,
Try to Google the person. If you are unsuccessful, spelling errors, and
drop the courtesy title in the address and salutation to poor style.
avoid risking an unintended insult. For example, use
“Pat Stanley” and “Dear Pat Stanley.”
What should I write when I am addressing a position rather

than a specific person?
Address the position, such as, “Dear Infection Control Nurse.” This is preferred
over “To whom it may concern.” Or, a better way to handle this might be to
call the organization and get the person’s name. Often, when people receive
communications that are not addressed to them by name, they assume they are
marketing materials and toss them out.
Are there any particular phrases that should be avoided

when writing?
Yes. See Table 11.2 for some windbag phrases and their substitutions.
11.2 Windbag Phrases
Windbag Phrases Concise Replacements

Due to the fact that Because
The reason why is that Because
As per your request, enclosed please find I have enclosed
Enclosed herewith Here is
Until such time When
As to when When
In connection with About
Subsequent to After
Windbag Phrases Concise Replacements

As to how How
Any and all All
Prior to Before
“Brevity is the soul of wit.”

–William Shakespeare
Memos
Has email replaced the office memo?
Although email has replaced many memos, the office memorandum, or memo, is
still used for some interoffice correspondence. They are often attached to emails.
Memos are generally used to transmit ideas, suggestions, or announcements. They
provide a clear record of decisions made and actions taken.
What are the main components of a memo?

Most memos are formatted with four headings—Date, To, From, and Subject—
followed by the body of the message. These headings can be in any order.
Be specific with the heading. For example, rather than saying “Isolation Protocol,”
use “Ebola Isolation Protocol.” The heading also aids in filing and retrieval.
The body of the memo is similar to the body of a letter. Double space between the
four headings and triple space between the last heading and the first paragraph of
the memo. Limit the memo to one topic or message.
ading. For
230 example, rather than
Etiquette & Communication saying
Strategies “Isola-
for Nurses, Third Edition
bola Isolation Protocol.” The heading also

val.
Memo
o is TO: Susquehanna Health System Oncology Nurses
a letter. FROM:
CC:
Veronica Jones
Mr. John Wagner
the four DATE: October 14, 2019
ace be- SUBJECT: Patient and Family Education
TGD Communications will present to our Oncology Staff Nurses on November 11, 2019 at 4PM EDT and
and the prepare our team on the new communication and education benefits that Susquehanna Health System
is planning to adopt in January 2020.
memo. Your attendance is required for this one-time educational meeting. Please inform your nurse manager if
you have any questions, concerns, or conflicts.
e topic We are very excited for the new educational advances to come!
Is there a protocol for the To section?
for the There are several ways to handle this. It is best to follow the protocol of your
To section?
organization. Here are some options:
s to handle• this.
List theIt is best
recipients tomemo
of the follow the proto-
in alphabetical order.
• List the recipients in descending order of corporate ranking. For example,

on. Here are some options:
the president’s name should precede the chief financial officer.
nts of the• memo in systems.

Mix the two alphabetical order.
List one or two prominent names followed by an alpha-
betical listing of the remaining names.
nts in descending order

• If the audience of corporate
is a specific group, addressranking.
the memo that way, without listing
names—for example, To: The Breast Health Center.
he president’s name should precede the chief
r. Where is the memo signed?
There is no designated place for a signature on a memo. You can sign your name or
initials after the From line or at the end of the memo.
4/26/15 7:57 PM

? Is it OK to send a thank-you by email for a baby shower gift?
No. Sending a thank-you by email should be an option only if you do not
plan to send a handwritten note. Email is better than no mail, but it is always
a second choice to a handwritten note, especially for a gift. An email does
not convey the message that you went out of your way to send your thanks. It
appears to be a hasty attempt to cross a task off your to-do list. However, it is
OK to use email to thank a colleague for a small favor. This is different from
receiving a gift or being taken out for dinner.
? Should I type a thank-you note if I have poor handwriting?

No. Neatly print a short note and sign your name. However, if your note is
longer than a few sentences, type it.
? Is there a proper way to fold a business letter before inserting it into

an envelope?
Yes. A business letter is folded in thirds. First, fold the bottom third up. Then fold
the top third down. Insert the letter into the envelope so it is right side up and
readable when removed from the back of the envelope.
? How do I address a thank-you note to two people with different sur

names who live at the same address?
Each person gets a line for his or her name. If it is a man and a woman, the
woman’s name is listed first.
? How do I address a letter or thank-you note to a couple where one

or both are doctors?
Here are some options:
• Dr. and Mrs. Brian Myers
• Dr. Linda Myers and Mr. Brian Myers
• Doctors Brian and Linda Myers
• Dr. Linda Myers and Dr. Brian Myers
? Should I use a comma or a colon after the salutation line in

a business letter?
The colon is preferred for most business letters (for example, Dear Ms. Dewar:).
TAKE-AWAY TIPS
• Think of a thank-you note as the five-minute difference between feeling
grateful and showing gratitude.
• Whenever someone gives you time, advice, a gift, or a helping hand,

send a thank-you note.
• When it comes to business letters and memos, brief and to the point is
far better than long and wordy.
• Neatness counts. Your letter is a stand-in for you.
• Err on the side of politeness. Use “Ms.,” “Mrs.,” or “Mr.” until you have
established a mutual rapport.
• Who doesn’t enjoy receiving a thank-you note in the mail?
• Invest in good quality stationery for your business letters.
• Don’t use a postage meter when sending thank-you notes. Use a stamp.
• A late thank-you note is better than no note at all.
• Bad grammar leaves a bad impression, especially with business letters

and memos.
• Proper grammar and spelling demonstrate your care and attention to

detail.
12 Writing for an Audience 233
12
WRITING FOR AN AUDIENCE
Standing Out From the Crowd and Boosting Your
Career by Writing an Article
DO YOU:
• Need to develop and improve your writing skills?
• Know how to motivate yourself to begin and complete a writing project?
• Wonder where authors get ideas for writing articles?
• Lack knowledge of the writing and publishing process?
• Wonder how you can develop good writing habits?
• Know how to select and target a journal for publishing your article?
• Know how to proceed if your manuscript is rejected?
Writing an article for publication is something that many nurses would like to
do but few actually pursue. There are probably numerous reasons for this, but
the two most important are: 1) lack of knowledge of the writing and publishing
process, and 2) lack of motivation and confidence. This chapter describes the
mechanics of the writing process and focuses on motivational strategies needed to
begin and complete a writing project.
“What is written without effort is in

general read without pleasure.”
–Samuel Johnson
Why Write?
What are the benefits of publishing an article?
By writing, you share your knowledge and expertise with others. This can make a
difference to patients, colleagues, and the nursing professional. Perhaps one of your
greatest rewards will be the amount of learning you have gained.
How does writing affect my nursing career?

Getting published can advance your career by getting raises, promotions, and high-
er evaluations. Sometimes authors are asked to give presentations and workshops at
conferences.
On a personal level, the satisfaction of seeing your name in print is indescribable.

Recognition from your peers is stimulating. Because success breeds success, you
will be motivated to keep writing (Pagana, 1989).
Getting Started
If I want to write articles, what is the best way to get started?
Approach the process as a learning experience.
Nurses are lifelong learners. Remind yourself that
you have had to learn many harder things to get to
your current position. Accept the challenge in front
of you. Tell yourself that you have something of
value to contribute that can help others. Take things
one step at a time. See the following sidebar for the
key steps.
Key Steps of the Writing and Publishing Process

• Getting an idea
• Researching the topic
• Selecting the target journal
• Writing a query letter, if indicated
• Drafting an outline
• Writing the first draft
• Revising the draft
• Submitting a completed manuscript
• Revising and resubmitting, if rejected
Where do I get an idea for an article?

Think of a topic that is of interest to you and would be of interest to other nurses.
You can write different types of articles to reach different audiences (Roush, 2017).
If you want to write but don’t have any ideas for articles, consider the following
questions:
• Have you ever wondered why no one has written an article on a certain topic?
• Have you ever searched the literature unsuccessfully to find pertinent infor-
mation?
• What particular challenges are you facing in your work setting? Can others
benefit from your experience?
• Is there a new procedure or technique that you think could be explained

better?
• Have you ever written a paper for school and been encouraged to publish it?
• Can you provide a new slant to a familiar topic?
• Can you brainstorm with some colleagues to narrow down a topic idea?
• Do you have research findings that can improve patient care?

“Writing comes more easily if

you have something to say.”
–Sholem Asch
How do I select a target journal?

Peruse a number of journals. Every journal has a distinctive style and is directed to
a particular audience. The audience may be identified by the name of the journal.
For example, the Journal of Nursing Education and Nurse Educator are geared to
nurses in education. Reading through journals will give you an idea of the content
and style. For example, Nursing Research focuses on scientific research, while
Nursing ’19 focuses on “how to” clinical topics. The five “rights” of publishing are
listed here (Plaisance, 2003):
• Right journal: Did you target the proper audience?
• Right topic: Is the topic right for the journal? Do you have the knowledge
base for this topic?
• Right information: Is your information accurate? Are your citations correct?
• Right words: Is your writing concise and clear? Did you mimic the format of
the journal?
• Right time: Is your material timely and up-to-date?
Once you have identified several target journals, rank them from most to least
desirable. This provides an order in which to format and submit your manuscript.
If your paper is rejected, you have a backup plan for the next journal to target.
What do journal editors want?

According to Roush (2017), journal editors are looking for articles that do the
following:
• Provide nurses with clinical information that can be used in their practice
• Improve the quality of patient care

• Help advance the profession
• Contribute to the body of scientific knowledge
Query Letters
What is a query letter, and is it recommended?
A query letter is a letter of inquiry to the journal editor to determine interest in re-
viewing your manuscript. Some editors prefer a query letter and others do not. You
can find this out by reviewing the author guidelines, which are found in the journal
and usually online.
What are the advantages of writing a query letter?

The editor’s feedback can direct your manuscript to
A manuscript
make it more publishable. Remember that a positive
response to a query letter is no guarantee that the jour-
TIP without a target
audience will
nal will accept your manuscript (Pierce, 2009). The
probably never
editor can also say that there is no need for your article
become a published
since a similar one has already been accepted. Although article.
disappointing, this saves you time and energy.
Good Idea!
Many years ago, when I was trying to publish my first article, I followed the
author guidelines and submitted a query letter. I described the manuscript I was
writing on jejunostomy tube feedings. The editor responded and suggested that
I focus my manuscript on “preventing complications.” My subsequent manuscript
was accepted for publication after a few minor revisions.
How do you write a query letter?

The query letter is a mini sample of how you write. It should be well written and
thoroughly proofread for spelling and grammatical errors. The letter should in-
clude the following:
• The correct name and spelling of the current editor’s name

• The tentative title of the manuscript
• A succinct paragraph describing your proposed manuscript
• A description of tables, graphs, or illustrations—if they will be included
• An explanation of why you are qualified to write the manuscript
The Writing Process

Do you have any ideas for researching the topic?
All professional writing begins with a review of scholarly literature. A great place to
start is the Cumulative Index to Nursing and Allied Health Literature (CINAHL;
https://health.ebsco.com/products/the-cinahl-database). This is a comprehensive
database for nursing publications. It indexes nearly 5,500 journals. CINAHL is
available through most medical center and university libraries.
PubMed is a search engine for accessing the MEDLINE database of journal cita-
tions and abstracts on life sciences and biomedical topics. Use Google and other
general search engines to supplement PubMed (Schull & Saver, 2017). These
provide another important source for gathering information, such as published
research, scholarly reports, books, and government recommendations.
I have found it beneficial to schedule an appointment with a librarian who can help
determine the best subject headings and help broaden or narrow a search. Be open
to ideas as you do your research. Research is stimulat-
ing for many reasons other than just collecting data. Check article
It reveals gaps in knowledge. It may inspire a new TIP references to help
focus for your original idea. It will let you see other identify other
journals in which similar articles have appeared. This important articles on
may help you think of several journals to target or to your topic.
avoid.
How important is an outline for writing an article?

An outline is essential for providing a critical link between the writer’s thoughts and
the visual representation of them. The amount of detail varies from one writer to
another. It is important to note that the outline is not written in stone and can be
altered easily throughout the writing process (Pagana, 1989). For example, suppose
you are writing about a clinical problem and a promising new drug gets approval by
the Food and Drug Administration. Adding this new information would make your
paper more valuable.
How does an outline affect my time

frame? Before writing,
TIP review recent
Following an outline provides direction and keeps issues of the target
you on track in between writing periods. You don’t journal and mimic the
waste time wondering what to write next because the format.
decision has already been made. Your guidelines are
there, and you stay on target.
Do you have any tips for revising your manuscript?

Yes. Remember that all good writing requires rewriting. With practice, your
writing can be honed, polished, and refined. Try to let a few days pass between
rewrites so you have time to be more objective about your writing. Here are things
to consider:
• Did you say what you wanted in a clear manner?
• Is the purpose clear?
• Did you eliminate unnecessary words?
• Is any content missing?
• Is the content logically sequenced?
• Did you design a chart or table to help explain complex information?
• Did you follow the author guidelines?
• Did you imitate the journal’s format?
• Did you cite all references correctly and in the proper format?
• Did you carefully check grammar, punctuation, and spelling?
“Vigorous writing is concise.”

–William Strunk, Jr.
What is the best way to submit a manuscript?

The best way is to precisely follow the journal’s rules for submission. Most journals
now prefer articles submitted by email or online. Follow the directions and contact
the editorial office if you have any questions. Make sure you receive confirmation of
receipt of your material.
If my article is accepted, what is the next step?

Be prepared to wait for an edited version. If the editor has made extensive changes,
verify that the content and meaning are still accurate. Don’t make additions to the
final edited copy unless something is unclear or inaccurate.
Don’t take edits or title changes personally. They usually improve your manuscript
and make it more appealing to the readership. Be sure to meet all deadlines. Most
journals follow a tight publication schedule. Respond promptly to all requests. If
you miss a deadline, your work may not be published. If you are having trouble
meeting deadlines, contact the editor and try to arrange an extension (Johnstone,
2004).
What are the most common reasons for rejections of

manuscript?
Although rejection is painful, consider the following possibilities (Pagana, 2011b):
• The journal may have recently published a similar article.
• The journal may have a similar article in the queue about to be published.
• The manuscript may not be a suitable fit for the journal’s editorial priorities.
• The manuscript may be poorly written and viewed as an early draft needing
too many corrections.
• The manuscript may not follow the author guidelines.
• Jargon or technical terms may be used that are

unfamiliar to the readers. Revise. Revise.
TIP Revise. (Heming-
• References may be outdated or irrelevant. way wrote the
• The manuscript may not be interesting to read. ending to A Farewell
to Arms 39 times!)
• The writing style may not match the journal’s
style.
• Content may be considered inaccurate or unimportant.
• The manuscript may read like a school paper.
How do I deal with rejection?

Take a little break after reading the rejection notice so you can view the comments
as constructive criticism. Remember that rejection isn’t final. Determine another
journal to target and revise the manuscript to comply with the style of the new
journal. Follow the author guidelines for writing and submission. The process will
be easier based on your experience. Know that most authors consider rejection
letters as a normal part of the writing process. Learn from the experience and move
on. Don’t give up!
“Most people won’t realize that

writing is a craft. You have to
take your apprenticeship in it
like anything else.”
–Katherine Anne Porter
Motivational Strategies
What if I think my ideas may not be worthy of publication?
Avoid false modesty. An important part of writing depends on developing a positive
attitude. Have you ever read an article and said, “I could have written this” or “I
could have written this better”? Don’t underestimate yourself. Your wealth of infor-
mation and unique perspective may be beneficial to others.
To advance the profession and advance your personal goals, you must get rid of
false modesty. Don’t worry—if the manuscript is not ready for publication, the
journal editor will not publish it.
What are some key resources for writers?

Reading articles and books and attending education sessions on writing are helpful.
However, don’t procrastinate and get bogged down with “how to write” books,
articles, and seminars. The challenge of writing is not met by reading about it. You
must write, write, and rewrite. As for key resources, all writers (new and seasoned)
need a good dictionary and thesaurus. Other invaluable resources include:
• The Elements of Style, by William Strunk, Jr., and E. B. White
• The Careful Writer, by Theodore M. Bernstein
• Anatomy of Writing for Publication for Nurses, 3rd Edition, by Cynthia Saver
Can I improve my writing by reading journals?

Most definitely. Time spent in this manner will uncover ideas for writing topics
and ideas of how to write. When you read good writing, you will become a better
writer. Reading also exposes you to different writing styles and helps you develop
your own style. A lot of what you learn about writing can be absorbed by reading
and refined by writing and revising.
Good Idea!
Roseann was very well established in her clinical career and was determined to
write an article. She mentioned her desire to a colleague, Cindy, who was an
established writer. When Cindy was asked by a nursing editor to write an article
that seemed to fit Roseann’s area of expertise, she contacted Roseann and sup-
ported her in writing her first article. This shows the value of sharing your writing
goals with others. They may be able to help you, and they will make you more
accountable.
How can I develop good writing habits?

Remember that this is a learning process. Here are some strategies that should be
helpful:
• Carry a small notebook or card to write down ideas. You may be working,
eating your lunch, or driving a car when you think of a great title, an idea for
an introduction, or a great example. If you do not write these ideas down,
most likely you will forget them.
• Whenever you feel inspired to write, do it. For example, you may be
researching your topic and come across an article that stimulates you to write
your introduction. These spontaneous writing endeavors are often very cre-
ative and invaluable.
• Designate a time for writing. Make sure this is the time of day when you
feel most creative. For example, as a morning person, I do my best writing
in the morning. I am not as creative and struggle trying to write later in the
day. Guard this designated writing time and try to prevent distractions and
interruptions.
• Find a place conducive to writing. This may be in your dining room or at a

library. Wherever it is, you need to be productive in that place.
• Plan ahead for your writing sessions. Because it is often difficult to start
writing, use the last 10 to 15 minutes of a writing period to focus on your
next session. For example, I try to write the first sentence of the next section
and then put my materials away in an orderly manner that will facilitate easy
retrieval.
• Utilize your outline. The outline should be flexible and modified as the
writing proceeds. The outline gives you direction. For example, if you be-
come stymied and wonder what to do next, the outline directs you to the next
point or to another section you may feel like writing. Note that you do not
need to write in the order of your outline. However, when you are finished,
all the points should be addressed.
• Seek opportunities that lead to writing. For example, volunteer to offer a
continuing education seminar. After researching, planning, and giving your
presentation, you probably have the foundation for a manuscript. In this
manner, the completed manuscript may be a bonus for providing the educa-
tion seminar.
• Get to know other nurse authors. Seeing that they are regular people just
like you can be very inspiring. They may be willing to mentor you (Pagana,
1989).
• Proceed in small steps. The whole process of writing and publishing can
be overwhelming. A helpful strategy is to divide the entire process into small
steps. Use a checklist to divide up the process and keep track of your prog-
ress. As an example, you could use the following writing checklist or devise
something that better meets your needs.
Checklist for Writing an Article

• Did I thoroughly research the topic?
• Did I read all the references?
• Did I prepare an outline?
• Did I determine a target journal?
• Did I follow the author guidelines?
• Did I write a query letter (if indicated)?
• Did I write a rough draft?
• Did I revise the draft?
• Did I have a colleague read the draft and provide feedback?
• Did I revise the manuscript several times?
• Did I write up the references in the proper format?
• Did I carefully proofread the final draft?
• Did I follow the journal submission guidelines?
• Did I receive confirmation that my manuscript was received?
“Nothing is particularly hard if

you divide it into several steps.”
–Henry Ford
How do I handle frustration during writing?

Try not to expect to do too much too quickly. Don’t deprive yourself of other
activities that you enjoy. You need some rest and recreation to keep some balance
in your life. Plan to take breaks and incorporate some restorative activities (such as
swimming, walking, etc.) into your schedule. For example, you will be amazed how
your writing can improve after a short walk.
How do I deal with procrastination when writing?

Recognize procrastination when it is happening and take steps to stop it. For exam-
ple, if you are trying to write at home and find yourself doing things unrelated to
writing (such as laundry), you may need to work somewhere else. Maybe you would
be more productive in a library.
Schedule writing times frequently so you can see that progress is being made. Plan
to reward yourself for progress. As an example, you may decide to call a friend or
go shopping when you finish a section. Another approach is to have an “account-
ability colleague” for checking in with on a regular basis.
Faux Pas
Mark attended an inspirational seminar at a major medical center about writing
and publishing. At the end of the session as he was leaving the room, he told the
speaker he was ready to write his first article. Unfortunately, he added that he was
going to take a grammar course first. The speaker advised him to start writing and
worry about grammar when revising the manuscript.
If you want to write, start writing! Don’t procrastinate.

? What should I do if I am researching a topic and find that it has
been extensively covered in the literature?
Include the latest information and research on the topic and try to approach
the topic from a different perspective. Consider targeting a different
audience.
? What is the difference between a manuscript and an article?

A manuscript refers to the original text of an author’s work that is submitted
to a publisher. An article is a published manuscript. As an example, you
submit a manuscript and hope it will be accepted and published as an
article.
? Can the query letter be sent to several journals at one time?

Yes. This is an acceptable practice and is commonly done.
? Can a completed manuscript be sent to several journals at one

time?
No. It is unfair for an editor and reviewers to spend time reviewing a
manuscript only to have it published elsewhere. Journal editors consider this
unethical. Submit your manuscript to one journal at a time. If the manuscript
is rejected, revise it and submit it to another journal.
? What options do I have if I do not agree with edits made in my

manuscript?
Explain your concerns. Don’t accept inaccurate materials. If it is a style
issue, the edits will usually improve your submission. If you cannot come to
an acceptable compromise, you can withdraw your manuscript.
? What is a refereed journal?

This is the same as a peer-reviewed journal. This means the submitted
manuscript is sent out to two or three reviewers who read, comment on,
and recommend acceptance or rejection of the manuscript. The manuscripts
are double-blinded by the editor, which means neither the author nor the
reviewers should be able to identify each other. Peer reviewing improves
the content and readability of the paper and improves the quality and
standing of the journal in the professional community.
? Do authors get paid for writing articles?

Most authors do not get paid. However, some journals pay an honorarium
for feature articles and continuing education segments. Authors usually
receive several complimentary copies of the journal issue containing their
article.
TAKE-AWAY TIPS
• The challenge of writing is not met by just reading about it.
• Like any skill or sport, writing requires effort, discipline, and practice.
• Selecting the right journal increases the chance of getting published.
• Outlines are not written in stone. They can be easily altered.
• Consider converting presentations and seminars into written articles.
• Volunteer to write an article. It sets you apart from the crowd and pro-
vides practice and feedback.
• A query letter is a mini sample of how you write.
• All good writing requires rewriting.
• Don’t take it personally when an editor edits your work. Editors edit.
• Rejection isn’t final. Learn from it and move on.
• Think of a rejected manuscript as one that has not yet found its place.
Don’t give up.
13 Flying for Success 249
13
FLYING FOR SUCCESS
Business Travel and Etiquette
DO YOU:
• Know the best way to get from the airport to your hotel?
• Wonder if you should check your luggage or carry it on the plane?
• Feel uncomfortable eating alone?
• Feel concern for your safety?
• Know how much to tip when traveling?
There’s no doubt about it: Business travel can be stressful, and stress makes it
hard to demonstrate the kindness, consideration, and common sense associated
with etiquette. Things do go wrong, and the unexpected does happen. However,
if you know some basics, you will decrease your stress and increase your chance of
having an enjoyable trip.
A good traveler focuses on four basic objectives: Have a cosmetic

• Being prepared
TIP kit or shaving kit
always packed
• Being self-reliant and ready to go. Refill
necessary items after
• Being flexible
each trip.
• Being safe
Read on to find out how to be a good traveler and bring your business etiquette
along with you on your trip.
“No act of kindness, no matter

how small, is ever wasted.”
–Aesop
Packing With Precision

What should I pack?
Carefully plan your packing. Pack only what you
need and leave the rest at home. Mix and match
outfits as much as possible.
Think of the events you will attend during your

trip and plan your outfits for each one. I find it
helpful to place my outfits with accessories out
on my bed before putting them in my suitcase.
I use a travel checklist every time I pack. I cross

off anything that does not apply to the trip and
then check off everything else as I pack it. The
following packing lists provide suggestions for
developing your own customized versions.
Packing List for Personal Items

Program/Event Personal Items
• Suit • Makeup kit
• Shirt/extra shirt • Toiletries
• Shoes • Shaving kit
• Stockings or socks • Curling iron
• Underwear • Contact lenses
• Jewelry • Medications
Night Clothes Miscellaneous

• Robe • Cellphone
• Slippers • Chargers for cellphone, Kin-
• Pajamas/nightgown dle, watch, etc.
• Sunglasses, reading glasses
Fitness
• Hat
• Swim cap, swimsuit, and
• Earplugs
goggles
• Gym shirt
• Gym pants or shorts
• Sneakers/running shoes
• Jacket for outside exercise
• Sunscreen
Faux Pas
Angelina was excited to be presenting at a prestigious nursing conference. Al-
though she had submitted her handout months ago, when she arrived, it was not
available for the participants. The problem could have easily been resolved if she
had brought a clean copy of the handout or a jump drive containing the handout.
Unfortunately, the conference personnel had to retype the handout at the last min-
ute. Now Angelina packs one to prevent this reoccurrence.
Packing List for Business Items

Hardware Essentials Presentation
• Laptop • Presentation notes
• Laptop power source • Printed copies of presentation
• Program loaded on laptop (PowerPoint)
• Program and handout backed • Clean, unmarked copy of the
up on flash drive handouts
• Extension cord • Program details
Travel Documents Miscellaneous

• Hotel reservations • Business cards
• Travel directions • Tablet
• Airline reservations • Highlighter
• Photo identification • Calendar
• Passport • Writing utensils
• Contact information
How should I organize my suitcase?

Fold small items and place them in reusable, sealable bags, such as Ziploc bags.
That way, nothing will get wet and nothing will spill (Pagana, 2008). This is a great
way to organize and group items. For example, put all underwear in one bag.
Fold and then roll each garment separately, and then tuck each one into a quart,
gallon, or two-gallon sealable plastic bag. This cuts down on wrinkling and allows
you to quickly find your items. When rolling pants, start at the hem and roll up.
When folding shirts and sweaters, fold a section on each side with the sleeves back,
and then roll from the bottom up.
Faux Pas
When Tim’s flight landed, it was raining—hard. He was relieved to retrieve his lug-
gage. However, when he unpacked at his hotel, he discovered that all his clothes
were wet. Everything had to be cleaned. Because of this experience, he now
packs his clothing inside a plastic dry-cleaning bag. It doesn’t take up any room,
and it keeps his clothes dry.
Should I bring an iron?

No. Most hotel rooms have an iron and ironing board in the closet. If not, the hotel
staff can usually supply one. You can call ahead to verify this or check the hotel’s
website for a list of amenities. If you unpack your clothes and find they are wrin-
kled, try hanging them in the bathroom while you take a hot shower. The steam
will usually remove the wrinkles.
If you are traveling overseas, you probably won’t have access to an iron. Also, you
may need to bring an adapter for electrical items because of different electrical cur-
rents. As an example, you will not be able to use an American blow dryer in France
without an adapter.
Faux Pas
Marianne was traveling for business and stayed in a very nice hotel. After show-
ering, she tried to dry her hair with the blow dryer, but it did not work. By the time
she received a replacement, she had only 10 minutes to dry and style her hair. She
had to rush out of her room to be on time for her meeting. Now, she locates and
tries the blow dryer as soon as she checks in.
Air Travel
If I need to fly out of town for business, who is responsible for
scheduling my airline reservations?
This will vary. Some companies give you guidelines for making your reservations
and expect you to do it. The guidelines may include a maximum ticket price and
what airport to fly into. Other companies have a travel department with which you
must connect to make your reservations. Companies usually have an expectation
that all tickets be booked at least a month before the event to get the best airfare
possible.
Is it a good idea to stick with one air carrier?

If possible and financially prudent, yes. You often get better seats if you are a fre-
quent flyer. In addition, frequent flyers with a lot of earned miles often can board
before other passengers, get seats near the front of the plane, and, when upgrades
are available, be offered first-class seats. Also, frequent flyers build up points and
can earn free flights.
When my travel plans are finalized, who should get a copy

of my itinerary?
The person you are meeting, your office, and your family should get copies. Make
sure the itinerary includes the following essential details:
• The flight schedule, including the name of the airline, flight numbers, and
departure and arrival times
• The name, address, and phone number of your hotel
• The locations and times of your meetings
• The name and contact information (including cellphone number) of the

person you are meeting
What can I do to prevent frustration with airplane delays and

cancellations?
Prepare yourself by not expecting that everything will go well. Give yourself plenty
of time to get to your destination. Never take the last plane of the day out of the
airport. If it gets cancelled, you are really stuck. It is best to arrive much earlier than
necessary to allow plenty of time to work or relax before business. Plan to arrive the
day before any important event.
What should I do if my flight is cancelled?

This is an unfortunate situation, but handling it effectively is part of the flexibility
needed to be a good traveler. Here are some suggestions:
• Do not get angry at the airline service personnel.
• While standing in line to speak to an agent, use your cellphone to call the
airline or your travel agent to book another flight.
• Download the airline’s app to your smart-

phone. Use the app to find a new route to
your destination.
• Ask the airline representative if any partner

airlines can accommodate your travel.
• Inquire about meal tickets and hotel

vouchers.
• Have important contact information with you and readily available. That way,
if, for example, you are going to a job interview, you can notify the contact
person about your situation.
What suggestions do you have to make my flight check-in go

smoothly?
This is a stressful event for most travelers. Here are some suggestions:
• Check the status of your flight beforehand. Do this by phone or on the web
several hours before leaving your home for the airport. Print out your ticket
within 24 hours of your departure time. Or, have a copy sent to your email for
your mobile device. You may be able to get a better seat when you check in as
early as possible.
• Bring photo identification. Use your driver’s license or passport. Make sure
your license is REAL ID–compliant. The Transportation Security Administra-
tion (TSA) will require this starting in October 2020.
• Make sure your checked luggage does not exceed the weight restrictions.
This will be clearly stated on the airline’s website. Hefty fees can result if you
exceed the weight limit. Most airlines charge for luggage. However, if you are a
frequent flyer with a lot of accrued miles, one or two bags may be free.
• Make sure your carry-on luggage does not exceed the size limitations. If
you have two bags, put the larger one in the overhead compartment and the
smaller one by your feet.
• Check with the TSA on the policy for packing liquids. Containers with
more than a few ounces of liquid are not allowed in carry-on luggage. Your
liquids, including toothpaste and creams, must fit into a one-quart plastic
bag. These policies are clearly described on airline websites and on the TSA
website.
• Arrive at the airport early. Check the airline website or TSA website (www.
tsa.gov) for suggested check-in times. Many airports advise arriving one to two
hours before the flight time to get through security.
• Arrive early for international flights. For international flights, be at the

airport at least two hours before the flight time. Be sure to bring your passport.
Also, make sure you are in the right terminal. International departures from
large airports, such as Chicago O’Hare or New York LaGuardia, will often be
in a separate terminal because of the larger aircraft.
Faux Pas
Margie and Josephine were booked on a cruise to China and Southeast Asia.
Due to confusion with email addresses, they did not receive the cruise informa-
tion about visas in a timely manner. Since Margie lived near New York City, she
offered to take the train into the city and present their visa applications at the
Chinese embassy. However, since Josephine lived in another state, her application
was not accepted in New York. She had to get her paperwork to the embassy in
Texas. This caused a major hassle and headache in their trip preparation. Jose-
phine finally hired a visa service to take the paperwork to the embassy.
• Check the visa and entry requirements of each country before you book
travel or depart. For some destinations, such as Singapore, your passport
must not expire less than six months before your departure date. Obtain your
visas as early as possible. For some countries, you may have a long wait. They
can also be expensive (over $100). Some em-
bassies (for example, Chinese) require someone There are agen-
to request the visa in person and return a few
TIP cies that can help
days later to pick it up. Some country visas you get visas.
One example is Texas
(such as Cuba) can be purchased online. Check
Tower.
out these requirements several months in ad-
vance of your trip.
• Do not have any wrapped gifts in your carry-on luggage. They may need
to be unwrapped by TSA when your bag is scanned.
• Eat before you leave home or bring some food. Few airlines provide food
or snacks on regular flights. In most cases, however, you can purchase a small
meal or snack while in the air.
• Do not leave your bags unattended or ask anyone to watch your bags.
This is a safety issue that is strictly enforced at airports.
Is it better to carry on my luggage or check it on the plane?

Both have advantages. If your trip is purely business, minimize your packing and
carry on your luggage. If your trip is for pleasure, you can pack more things if you
check your bag. However, make sure you carry any medications or valuables with
you.
Plan for the possibility that your checked luggage will get lost or be delayed. Put
some essentials, such as a toothbrush, toothpaste, and possibly a change of under-
wear, in your carry-on bag or purse.
How much do I tip the skycap at the Bring your man-

airport? TIP ners with you on
your trip.
The usual tip is $2 per bag. Some airports now
charge a fee of $2 per bag, not including tip.
How should I dress on the plane?

This will depend on how soon you will be meeting people at your destination and
whether you plan to check your bags. If you plan to meet people before you will
have the opportunity to change, dress for that meeting. If you are checking your
bags, wear something presentable in case your bags
get lost. If you are carrying your bags and not meet- Carry a small
ing anyone until after you have checked in, you have TIP blanket with you.
more options for dressing in a casual manner. Blankets are no
longer available on
Always carry a sweater or jacket. Wear slacks instead
most flights unless you
of shorts—even during the summer. You will be more are in first class.
comfortable in the airport and on the plane.
How can I demonstrate professional Stand to the right

etiquette while flying? TIP and pass to the
Because flying can be stressful and because you are in left on escalators
close quarters with many others, you need to demon- or moving walkways
strate good manners. See the following sidebar for in the airport.
some helpful tips.
Etiquette Tips for Flyers

• Wait your turn when boarding and disembarking from the plane.
• If you bring food onto the plane, make sure it does not have a strong
odor.
• If your luggage does not fit in the overhead compartment or under the
seat in front of you, tell the flight attendant so it can be checked.
• Ask your seatmate’s permission before adjusting the window shades.
• Turn off your cellphone or keep it in airplane mode.
• Don’t block the aisle for more than a few seconds when putting your
luggage in the overhead compartment.
• Don’t crush anyone’s belongings in the overhead compartment to

squeeze in your item.
• Don’t ask to put your luggage in someone else’s foot space.
• Keep your things in your own space.
• Don’t stretch out into the aisle.
• Nod and say hello to your seatmates.
• Don’t keep talking if the person next to you wants to sleep, work, or
read.
• If the person next to you keeps talking and you don’t feel like chatting,
put on your earphones, open a book, or close your eyes for a nap.
• Don’t try to read the computer screen of people nearby.
• If you are in the aisle seat and want to sleep, leave a way for others
to get through without waking you up. For example, don’t use the tray
table as a headrest.
• Be courteous with the flight attendants.

• If the child sitting behind you is kicking your seat, talk to the parents in-
stead of scolding the child. It’s not appropriate to correct the behavior
of someone else’s child.
• Be considerate of the person seated behind you. If you want to recline

your seat, it would be nice to warn the person whose space you are
about to invade. In some planes, if you crank your seat back, you can
end up in the lap of the person behind you. This is very annoying and
prevents that person from working on the computer. Keep your seat up
during meal times.
• When exiting the plane, let everyone ahead of you out first. Be ready
to leave when it is your turn.
“Rudeness is the weak man’s

imitation of strength.”
–Laurence Sterne
What are the options for transportation from the airport to

the hotel?
Taxis are a convenient way to get to your hotel, especially if you are in a hurry and
it is dark. Before traveling, call the hotel and ask for the usual fare from the airport
to the hotel. It is also a good idea to use the internet to get directions. You will find
out the most direct route and the estimated time for travel. Carry small bills in case
the driver cannot make change. Tip the driver 15 to 20% of the fare.
You can also hire a car service. In this case, you will have a car waiting for you and
a person standing near the baggage claim area holding a sign with your name or
company name. Because the cost is determined upfront, there are no surprises. You
can also pay with your credit card with most limousine services.
Other options for travel include trains, subways, and buses. Some hotels provide
free pickup services. Find out about available services by calling the hotel ahead of
time. If you are attending a conference, this information is usually available in the
brochure or with the registration confirmation materials. Also, there are usually
discounted shuttle rates for conferences. Shuttles can be booked online.
Another transportation option, similar to a taxi, is a service like Uber or Lyft. With
these, area residents provide transportation using their own cars. You can access
these services by using the app on a mobile device. Prices are set, and you can pay
with a credit card. Tips are usually included in the price or can be added by using
the app after your ride. Some people prefer this over the hassle of renting a car
or the expense of taking a taxi. For safety, make sure the car you are getting into
matches the license plate on your app.
Demonstrating Professional Etiquette on Trains, Subways,

and Buses
As with airplanes, you are in close quarters with other travelers on these modes
of transportation. Here are some tips:
• Board after everyone leaving has made it out the door.
• Minimize use of your cellphone. If you do have to use your cellphone,

speak softly and briefly. Be aware that in some cases, cellphone use is
prohibited. Don’t distract others who are trying to read or relax.
• Don’t spread out your things and tie up seats.
• Do offer your seat to pregnant, disabled, or elderly people.
• Be courteous to the conductor or driver.
Car Travel
What travel tips do you have for a road trip in my car?
You need to know exactly where you are going, how to get there, and how much
time it takes. As with flying, don’t make this a last-minute stressor. Here are some
additional road-trip tips:
• Obtain the exact location of the event, including the zip code. This makes it
easier to use a navigation system.
• Use an online mapping service, such as Google Maps, for directions.
• Print your directions in large type for easy reading.

• Rent or purchase a global positioning system (GPS) car navigator. Many

people now use phone apps, such as Waze, for navigation.
• Make sure your car is trip-ready. Fix any indicator alerts, such as a low oil
level.
• Bring your sunglasses.
• Be aware of your gas level and keep it above a quarter of a tank.
• Travel with your cellphone.
• Always lock your car doors.
• Park only in well-lit areas.
• If you feel uncomfortable, ask a security guard to walk you to your car.
• Leave only your ignition key with a parking attendant.
Good Idea!
Monica was traveling across the country after attending a nursing symposium in
California. Due to thunderstorms and air traffic delays, she arrived late in Phila-
delphia and missed the last commuter flight to her hometown. Her husband rented
a car for her while she waited in a long line to retrieve her luggage. When she
finally got to the car-rental site, it was 11 p.m., and the line for the counter extend-
ed out the door and around the corner. The estimated wait for a car was over one
hour. She called her husband to give him an update. He told her that he already
had paid for the car and to get into the fast track line. No one was in this line,
and she had her car within five minutes! This tip has been invaluable in Monica’s
subsequent travels.
Do you have any recommendations for renting a car?

Renting a car should be part of your pre-trip planning. Otherwise, you could get to
your destination and not be able to rent a car. Here are some tips:
• Have a copy of your rental-car reservation in your hand when you meet the
agent.
• Be careful of the agent’s push to sell unneeded services. Your own car insur-
ance is usually enough, but be sure to check with your insurance agent if this
is your first time renting a car.
• Do not agree to pay a cheaper gas price for the car-rental agency to fill the
tank when you return the car unless you plan to return the car on empty.
They will charge to fill the entire tank, even if you only needed a few gallons.
Your best option is usually to fill the car yourself right before you return it to
the rental agency and pay only for the gas you used.
• Do not discuss any private business on a cellphone or with a coworker on the

rental-car shuttle bus. You never know who is on the bus and how they might
use your information.
• Check to make sure the gas tank is full before you leave the lot.
• Make sure you have directions before you leave the lot. You can get a map
from the rental company. However, it is usually better to bring your own
directions from a service such as Google Maps.
• Consider renting a GPS to avoid getting lost in an unfamiliar area. Or, use a
navigation device on your cellphone.
• Try to pick up and return rental vehicles during daylight hours.
• Keep the car doors locked at all times.
• Put your luggage in the trunk.
Hotels
How can I stay safe when staying alone in a hotel?
This is an important issue, especially for women traveling alone. Following are
some safety tips for when you stay in a hotel:
• Keep your room number private. If the bellman asks for your room number,
show your key rather than say the number.
• If the desk clerk makes your room number public, ask for a different room.
• When shopping in the gift shop or eating in the dining room, don’t mention
your room number when you are charging something to your room.
• If it is dark and you are fearful, have the bellman enter your room with you
and stay while you check the room.
• If you are uncomfortable about the location of your room, ask to have it
changed. It’s a good idea to ask for a room that is not on the ground floor
when you make your reservation or when you are checking in.
• Do not open the door if anyone knocks. Call the front desk to verify any
room work or service.
• Bolt the door and apply the safety latch.
• If there is a sliding door, make sure it has a safety latch and a metal bar.
• If your room has a connecting door, make sure it is locked. If possible, try to
book a room without a connecting door. You can also request this at check-in.
• Don’t leave the door open with the latch lock if you leave the room to get ice.
• Always have your room key out and ready to use as you walk to your room.
• Use the room safe to secure your valuables.
• Make sure your door closes and locks every time you leave the room.
• Keep a light on in the room when you leave so it is not dark when you return.
• If the hotel fitness center does not have an attendant and you feel unsafe, use
the facility only when other people are around.
• Use valet parking if you arrive late. That way, you won’t have to walk through
a dark parking lot alone (Rickenbacher, 2004).
Always be alert
• If you are leaving your room after it has been TIP and aware of your
cleaned, put out the “do not disturb” sign so it
surroundings.
appears that someone is in the room.
Good Idea!
Elizabeth was traveling to speak at a conference. She got to her hotel early and
checked in. When she got to her room, she found it was not part of the main ho-
tel. It also did not have an inside entrance, and the room was on the ground floor.
Not feeling safe, she returned to the registration desk to discuss her concerns. She
was switched to a nicer room with a safer, inside entry. Safety is a number-one
concern for women traveling alone, and hotels will do their best to accommodate
solo travelers.
If I need to hold a business meeting at the hotel, is it OK to

use my hotel room?
No. Arrange to use a meeting room. Or, meet in a dining room. It is too personal
to meet in your hotel room, especially when with a member of the opposite sex.
Should I bring an alarm clock?

This depends. Most hotels have alarm clocks. Check the alarm clock when you get
into the room. (Note that the alarm may still be set by the previous person.) If you
cannot figure out how to set the alarm, call the front desk. For some people, it is
more convenient to bring a small travel alarm that they know is dependable and
that they know how to use. I prefer to use the alarm on my cellphone.
Should I use the wake-up call service?

Yes, this is a great idea. However, have a backup If you need more
strategy. Sometimes, the call system goes down.
TIP light in your hotel
Also, be certain to hang up the phone properly after room, call house-
keeping and request
placing the call to schedule the service or it will not
a lamp.
ring in the morning. Use the alarm in your room or
on your cellphone as a backup.
Do I need to bring my laptop to a hotel?

It depends. Bring your laptop if you need it for your work. Otherwise, many hotels
have a business center with computers. In some cases, there is a small fee for usage.
Call in advance to learn about computer and printer usage at your hotel.
Back up presentations on a flash drive or email them to yourself in case of technical

difficulties. If you have emailed the presentation to yourself, you could use someone
else’s computer.
Is internet service available in most hotels?

Yes. It is not always free, however. Often, the charge is about $10 to $15 per day.
This is billed on a 24-hour period or billed as a full day until the next day’s check-
out time. Interestingly, low-cost hotels often have free internet service.
If my conference lists several hotels, which one should I

choose?
Find out which hotel is hosting the conference. That would be most convenient.
Check other hotels for distance, price, and amenities. You may also be able to find
another nearby hotel that was not listed but is available at a cheaper rate.
How can I expedite checking out of a hotel?

You should receive a copy of your bill under your door on the morning of checkout.
Review all the charges and read the checkout instructions. In many cases, you can
call a number and indicate the time when you are vacating the room. You may also
be able to check out using the TV or a kiosk in the hotel lobby. If you are unsure of
any items on your bill, call or go to the front desk to discuss them. Everything will
be charged to the credit card you have on file, and your balance should be $0 on
your statement. Receipts can also be sent by email.
If I am sharing a hotel room, how can I get a receipt for my

expenses?
This can easily be done at the front desk. The clerk can separate the charges and
give both of you an individualized, itemized receipt.
Handling Expenses and Reimbursements on a Business Trip

Before you begin your trip, find out what will be reimbursed and what the
caps are for reimbursement. For example, you may be limited to a per diem
of $30 or a meal total of $30. You also may be reimbursed for a shuttle
service but not for a taxi.
Keep receipts for everything. It is very helpful if you have a designated place
for keeping receipts. You will need an itemized hotel bill if you charged your
meals to your room. Alcoholic beverages are not usually reimbursable. As
soon as your return from your trip, make a copy of your receipts and submit
your reimbursement form. Most companies have a time limit for submitting
these forms. Often this limit varies from 3 to 30 days.
Faux Pas
Kathy and her 78-year-old father were checking out of a hotel when Kathy saw
her dad putting all the snack items in his suitcase. He thought the snack items were
free. He did not realize that every snack or minibar item missing from the room
would be charged to the room bill. These room items are also priced much higher
than those in the gift shop.
Are there etiquette guidelines for tipping in a hotel?

Yes. It is a good idea to travel with a lot of $1 bills for tipping. Here are some sug-
gestions for tipping (Fox, 2007; Post, Post, Post, & Post Senning, 2014):
• Housekeeper or room attendant who cleans your room: At least $2 per

night
• Doorman who carries your bag: $2 for the first bag and $1 per additional
bag
• Bellman who carries your bags to your room: $2 for the first bag and $1
per additional bag
• Concierge who gives you a map and directions: No tip
• Concierge who makes dinner reservations for you: $10 to $20
• Concierge who finds hard-to-get theater tickets for you: $10 to $20 per
ticket
• Doorman who hails a cab: $1
• Wait staff in a restaurant: 15 to 20% of the tab (excluding tax)
• Room service wait staff: No tip or $1 (the gratuity is usually added to the
bill whenever you order room service)
• Valet parking: $1 to $2

? Should I carry my blow dryer on a trip?
No. Most hotels have these in the room. Call the hotel to verify this.
? I am often asked to change seats on a plane so family members

can sit together. Am I obligated to switch?
Not at all. The frustrating part of being asked to move is that you may have
paid for an expensive aisle seat. The family who wasn’t willing to pay
more to get seats next to each other may now be making their thrift your
problem. Do what you want and don’t feel compelled to change seats (Post
et al., 2014). Note, though, that sometimes, flight attendants will provide
seat upgrades or other amenities for you to move to accommodate families
with small children.
? If I am traveling with a person of honor, who gets into the cab first?
You should get in first so you are the last out and can pay the driver. The
person of honor should have the rear seat closest to the curb. This avoids
the person needing to slide across the seat.
? How much should I tip a cab driver?

The usual tip is 15 to 20% of the fare on the meter. Add $1 per bag if the
driver loads your bags in and out of the trunk.
? Is it OK to bring my spouse on a business trip?

Yes, if your spouse knows that business comes first. Keep separate receipts
for reimbursable expenses, such as meals.
? If I am traveling alone, should I order room service and eat in my

room?
Not unless you want to. It is perfectly acceptable to eat by yourself in the
dining room. It is common for travelers to eat alone. Bring a magazine or
book to read until your food arrives. Many people check for messages on
cellphones while they wait for their food.
TAKE-AWAY TIPS
• Keep your travel clothing simple, lightweight, and wrinkle-free.
• Don’t forget to pack clothes for evenings.
• If you do not know what to wear, ask your host.
• Carry a prescription for needed medications.
• Carry a lens prescription for glasses or contacts.
• Take inconveniences in stride.
• Maintain a confident but low-key profile.
• Make a copy of your itinerary and give it to a family member or friend.
• Have all luggage identified inside and outside.
• Before getting into a cab, confirm the fare.
• Trust your instincts. If you feel uncomfortable, leave.

14 Going Global 269
14
GOING GLOBAL
Business and Etiquette Around the World
DO YOU:
• Wonder how you should dress for business in another country?
• Know if you should give a gift to your host?
• Know that some gestures can be offensive but don’t know which ones to
avoid?
• Know handshaking etiquette for women?
• Wonder how to present and receive a business card?
• Know the dining etiquette differences in other countries?
Just as with business travel, preparation, self-reliance, and flexibility are key com-
ponents of a successful international travel experience. However, international
travel and interactions are complicated by cultural differences in etiquette. Each
culture has its own traditions, rules, and priorities. It is important to learn about
these variations before setting out on your trip.
Important Note to Nontravelers

You may think you will not get any benefit out of reading this chapter.
Wrong! As a healthcare professional, you interact with patients and provid-
ers from diverse cultural backgrounds. Reading this chapter will enhance
your cultural awareness and sensitivity in your interactions with others.
“Manners must adorn

knowledge and smooth its way
through the world.”
–Lord Chesterfield
Basic Preparations
What is an “ugly American,” and how can I avoid being
called one during my travels?
The term originated from the 1958 book The Ugly American, by Eugene Burdick and
William Lederer. The term describes Americans abroad who are perceived as arro-
gant, demeaning, and thoughtless. For example, you may come off as sounding supe-
rior and judgmental with comments such as, “I can’t believe this restaurant does not
have ice cubes” or “These people seem lazy, taking a siesta every day after lunch.”
Educating yourself before you travel and having an appreciation for cultural differ-
ences can help you avoid this stigma. Remember, the American way is not the only
way. Your behavior should not be offensive to the people whose country you are
visiting.
What points of etiquette should I research as I make my travel

plans?
What is polite and appropriate in one culture may be offensive in another. See the
topics in the following sidebar. Research these topics before you leave home. Use the
internet or get a guidebook. Or, see the resources listed near the end of the chapter.
14 Going Global 271
Etiquette Research Prior to Travel

• Appropriate greetings
• Handshake, kissing, and bowing

customs
• Public displays of affection
• Gift-giving etiquette
• Dress codes
• Gestures
• Eye contact
• Religious beliefs and customs

• Business interactions
• Social structure, such as the role of women in the culture
• The relationship between bosses and subordinates
• The concept of time (being prompt or late)

(Pagana, 2013a; Purnell, 2012)
What are some basic facts I should learn about a country

before my trip?
If you do your homework, you will avoid the lack of preparation that is a shortcom-
ing for many US travelers. The following list covers most of the basics to investi-
gate so you can feel more comfortable and appreciate your travel adventures (Post,
Post, Post, & Post Senning, 2014):
• The correct name of the country (for example,

the Czech Republic, not Czechoslovakia) Ignorance of
TIP business etiquette
• The nation’s capital is simply not
• The form of government acceptable in the
global arena.
• The names of the top government officials
• Types of religion
• National holidays that occur during your trip
• Dietary laws
• Leading industries
• Type of currency and exchange rates
• Prominent geographical features (for example, the Great Wall of China)
• Famous cultural landmarks (for example, the Catacombs)
• Famous men and women (for example, writers, musicians, and artists)
• Popular sports
Currency Conversions
To handle currency conversions, visit www.oanda.com. Then do the
following:
1. Click the Currency Convertor.
2. Indicate the currency you have and the currency you want.
3. Click the Traveler’s Cheatsheet option.
4. Print out this conversion table. You may want to tape it to a small
index card.
This information is invaluable for knowing the exchange rate. With this infor-
mation, you can estimate currency calculations without needing a calculator.
There are also several phone apps for currency conversions.
Should I try to speak the language in a foreign country?

Yes. Demonstrate your respect by learning a few words and key phrases. This infor-
mation is free on the internet. You can even find pronunciation guides. Even if you
mispronounce the words, people will appreciate your effort. Here are some words
to try to learn:
• Hello
• Goodbye
• Please
• Thank you
• Good morning
• Good afternoon
14 Going Global 273
• Good night
• Excuse me
Carry a pocket dictionary or a list of phrases to help you communicate with people
who do not speak English. Also, many language apps are readily available for mo-
bile devices.
Do you have any suggestions for working with translators?

Yes. If you are using a translator to communicate with someone, look at and speak
directly to the person instead of the translator. Avoid jokes. Humor does not trans-
late well. You could easily offend someone.
How do I know how to dress for a business meeting while

abroad?
This is definitely an area to investigate before packing. In general, dress on the
conservative side until you see what your international colleagues are wearing. In
most circumstances, women should avoid skirts or dresses above the knee. Women
should be especially conservative in deeply religious countries. You should care-
fully investigate appropriate dress in these countries. A good place to begin your
investigation is with the country link on the US Department of State website (www.
state.gov).
If I make an etiquette blunder, what should I do?

Your mistake may be obvious from someone’s comments, expression, or body lan-
guage. Apologize immediately. If you do not know what you did, say, “Please help
me. Let me know what I did so I don’t do it again.” Demonstrate a humble and
respectful attitude. It is not acceptable to simply say, “I didn’t know.”
If I am hosting a visitor from another country, how can I be a

gracious host?
You can be a gracious host if you take time to learn about the person’s culture. Here
are some guidelines to ensure a nice visit (Pachter, 2013):
• Know the visitor’s usual method of greeting.
• Learn about the visitor’s customs and values.

• Meet or send someone to meet the person at the airport.
• Ask about dietary restrictions in advance, if possible.
• Send flowers or a basket of food to the person’s room. Be culturally sensitive

when making your selection.
• Arrange for transportation during the person’s Refer to your

visit. TIP overseas visitors
as international
• Plan interesting things for the person to do. instead of foreign.
• Invite the person to your home for dinner.
Making Introductions
How should I greet an international business associate?
If you are not sure how to greet the person, start with a handshake or follow the
person’s lead. If the person greets you with a kiss, follow suit. You may offend the
person if you pull away. A bow or a hug may be appropriate in other cultures.
How does handshake etiquette differ around the world?

In the US, a firm handshake is used to communicate confidence and self-assurance.
Don’t judge people from other cultures by their handshakes. Here are some things
to find out about handshakes (Pagana, 2013a):
• Who initiates the handshake? It may be the most senior person.
• Do men wait for women to extend their hand? Yes, in many European
countries.
• Can men shake a woman’s hand? Not if they are Muslim or Hindu.
• Should the grip be gentle or firm? In Denmark, Finland, Ireland, Norway,

and Sweden, handshakes are firm but brief. In China, handshakes are softer
and longer.
• Is a bow the equivalent of a handshake? Yes, in Japan and some other

Asian countries.
14 Going Global 275
If a bow is used instead of a handshake, who bows first?

In a rank-conscious society such as Japan, the person of lower rank bows first and
lowest.
What should I do if someone ignores my handshake?

Gently drop your hand back to your side. Many different cultural preferences and
sensitivities affect the handshake. For example, in the Hindu culture, contact be-
tween men and women is avoided, and men do not shake hands with women. There
also may be physical limitations or sickness issues.
Is business card etiquette different around the world?

Yes. If you’ll be traveling in a foreign country for business, do some research on
business card etiquette before leaving home.
People in some countries, such as Germany, are impressed by education and like
to see all degrees and titles above the bachelor’s degree. In Saudi Arabia, the card
should be printed in English on one side and Arabic on the other. When travel-
ing to Poland, bring plenty of cards and give one to everyone you meet (Pagana,
2006d).
Business cards should be presented with the content face up and readable, but you
will find many variations associated with presenting business cards when you are
traveling internationally. For example, in China, hold the card with both hands
when offering it. In India, the right hand presents and receives the card. In Japan,
business cards are given with one hand, but received with both hands (Pagana,
2007a).
Conversations and Networking

What topics of conversation should I avoid in my travels?
Avoid discussing religion and politics. It is easy to offend people with what may
seem like a harmless remark. If someone tries to engage you in a conversation
about politics or religion, say something like, “I’ve learned never to discuss politics
or religion.” Then change the subject. For example, ask about a cultural landmark.
Are there any American expressions, jargon, or idioms to

avoid?
Yes. Even if people understand and speak English, they may be confused by certain
expressions. If you say something and get a confused look, think of another way of
saying it. Here are some examples of phrases that do not translate well:
• ASAP
• Twenty four seven (24/7)
• Shoot yourself in the foot
• Take your foot out of your mouth
• It’s a double-header
• Think outside the box
• Hit the ground running
• Dead as a doornail
Should I be concerned about using gestures?

Yes. Several gestures can be misunderstood or considered insulting. Here are some
examples of gestures to avoid:
• The OK sign (making a circle with the thumb and forefinger and having
three raised fingers) is offensive in many countries, such as Brazil. It means
money in Japan and means worthless in France (Pachter, 2013).
• The thumbs-up sign is considered rude in Egypt.
• The V for victory sign, especially with the palm facing inward, is offensive in
Great Britain and Canada.
• Pointing or snapping your fingers is offensive in many countries.
• Waving your hand with your arm raised may be misunderstood to mean no.
Is it considered friendly to use first names when traveling?

No. This informality is common in the US, but it will probably be considered dis-
respectful when traveling abroad. Instant familiarity usually does not make a good
14 Going Global 277
impression in other parts of the world. Never begin

using first names until given permission (but be In general,
aware you may never be given permission). Address
TIP businesspeople
people by their proper titles. Titles such as doctor should follow the
customs of the country
and professor are highly valued in Germany, Italy, and
they are in.
many other countries (Whitmore, 2005).
How do I know how much eye contact is appropriate?

Investigate this. In the US, people are encouraged to look into the eyes of the
person with whom they are communicating. In many Asian countries, however,
looking away is a sign of respect. In France, you may be looked at more intently
than you expect (Pachter, 2013; Purnell, 2012).
How can I develop effective relationships in a business

setting?
The American business practice of “getting right down to business” is not shared
by other cultures. Do not expect other cultures to do business the American way.
Instead, focus on relationships. Don’t try to push past relationship-building to get

to business. The “getting to know you” phase builds trust. Executives in regions
such as Asia, Latin America, and the Middle East place a premium on relationship
protocol. In Japan, for example, you may be invited for tea several times before
someone decides whether to do business with you (Whitmore, 2005).
How do I handle personal space issues when traveling?

Handle this with care. Be aware that proximity when conversing with someone is
dictated by custom. The average US distance is approximately 3 feet. In Italy and
Argentina, it’s closer. In Japan, it’s farther away (Pachter, 2013; Pagana, 2013a).
What key etiquette ideas can I learn by observation?

You can learn how people treat each other, act, and dress by being alert and watch-
ing those around you. For example, in some cultures, you should not put your
hands on your lap during a meal. Notice if people rest their wrists on the edge of
the table.
Notice how a diner signals for the wait staff. If you do not understand why some-
thing is done, it is OK to ask. If you do not know what utensil you should use at a
meal, follow the example of the native host or guest.
“A traveler of taste will notice

that the wise are polite all over
the world, but the fool only at
home.”
–Oliver Goldsmith
Should I accept social invitations when on business in another

country?
Yes. If you are invited somewhere, go and enjoy the experience. You will get a
better understanding of the culture. If the invitation is to a home, be sure to bring
a gift for the host. If you refuse an invitation, your host may feel insulted. That can
have a negative impact on your business relationship.
Good Idea!
Anita traveled with her family to the Ukraine and met many relatives. She was sur-
prised at dinner when a large bowl of soup was placed in the center of the table
and everyone was given a spoon. Although she wanted to ask for her own bowl,
she followed the example of her hosts. That is the kind of flexibility and tolerance
needed for traveling abroad.
Dining and Drinking Etiquette

What are some differences in dining etiquette?
This is a key area for research before getting to your destination. Many business
discussions take place over a meal. You don’t want to be caught off guard with your
actions or your expressions. Here are some examples (Pagana, 2013b):
• You may have to sit on the floor and eat with your hands.
14 Going Global 279
• You may be served food that looks slimy or has eyes. You may offend your
host if you do not eat the food.
• Observe how people ask for more food and how they signal when they have
had enough. For example, in Thailand, leaving food on your plate means you
are finished and the food was delicious. In Cambodia, cleaning your plate
means you still want more food. In Japan, cleaning your plate means you
appreciate the food (Whitmore, 2005).
• Don’t comment on table manners. Be aware of your nonverbal expressions.

Good table manners vary from country to country. For example, making a
slurping noise while eating is acceptable to the Japanese (Pachter, 2013).
• Mealtimes vary. If you are the visitor, you must adapt. For example, in Spain,
the dinner hour is usually much later than 7 p.m.
• It is proper etiquette to remain standing until

shown where to sit. For example, in Japan, an
Carry hand
honored guest sits at the center of the table TIP sanitizer with you.
farthest from the door and begins eating first. Not all bathrooms
• In some countries, such as Germany, you may have soap.
see people cutting food with a fork. This com-
pliments the chef by showing the food is tender.
You can learn a lot by observing and following the actions of the hosts.
Faux Pas
When Dennis was traveling in the Middle East, he was a guest at a large banquet.
Each time he finished eating his food—when he “cleaned his plate”—he was
served another helping. Because the server wanted to be polite, he kept adding
food to Justin’s plate. Justin finally learned that when you are finished eating, you
should leave food on your plate.
What should I do if I am the guest of honor in a foreign

country and am served an unknown local delicacy?
Try the food. If you leave it on your plate without trying it, you may insult your
host. In some cases, your host may wait for you to take a bite before beginning to
eat. Keep in mind that in many countries, acceptance of food and drinks implies
acceptance of the host.
Only ask about a particular food or what is in a particu-

lar meal if you have allergies or need to be on a special Faux Pas
diet. Be prepared to communicate this information in a Tim invited a colleague
clear and respectful manner. If possible, try to commu- from the hospital and
nicate dietary restrictions before the meal. that colleague’s spouse
to his home for dinner.
The couple was from
If I am hosting a dinner for Turkey. Tim’s wife made
international visitors, what foods her dinner specialty:
are considered taboo? flank steak rolled up
with pieces of bacon.
Check this out before you plan the meal. You can ask Unfortunately, the
people if there are any foods that they do not eat. This guests could not eat the
consideration is very important and demonstrates meat because of the
respect for other cultures. For example, Muslims and bacon.
Jews do not eat pork. Hindus do not eat beef.
What about drinking alcohol?

Don’t consume too much. Observe and respect the local customs. In some areas,
you will be encouraged to drink. For example, drinking wine is an important part of
a European meal.
If you drink, be smart about it. If you do not drink alcohol, have a soda with a lime
or lemon. Note that it is against religious principles to drink alcohol in many Mid-
dle Eastern countries. Don’t drink if your host does not drink.
Faux Pas
An American college professor was traveling with a group of students in London.
One evening, before leaving a pub, she paid the bill and left a tip. A few minutes
later, the bartender handed her a piece of paper with a time and his address. He
assumed the tip was a proposition! Her students enjoyed telling that story at home.
14 Going Global 281
Gift Giving
How do I know if I need a gift?
Gift-giving customs are tricky and need to be researched. For example, expensive
gifts in China may be considered a bribe. In the Middle East, gifts are exchanged
with the right hand because the left hand is used for hygiene.
If you are dining at someone’s home, you should bring a gift for the host. In some
countries, the host expects a business gift. For example, gifts are expected in Japan,
but not in Germany.
How can I give the right gift?

Research gift-giving customs ahead of time. It is hard to go wrong with nice pens,
chocolates, toys for children, local crafts from your area, or illustrated books from
your country.
Sometimes, a gift can have a negative meaning.

Here are some examples to avoid:
• China: A clock is associated with funerals.
• England: White lilies are only for funerals.
• Germany: Red flowers are only for lovers.
• Saudi Arabia: Alcohol is illegal.
• Mexico: Yellow flowers symbolize death.
How do I know when I should open a gift?

Etiquette dictates whether to open a gift in another country. Keep these points in
mind:
• In China, it is inappropriate to open a gift when you receive it. By not open-
ing it, you show that the giving of the gift is more valuable than the actual
item (Pachter, 2013).
• In some cultures, such as South Korea, the gift initially will not be accepted.
Be persistent, because the refusal is part of the ritual.
• In Muslim countries, your left hand is considered unclean. Do not give a gift
with your left hand.
• In Japan, gift-giving is a refined art with many symbolic meanings. It is best

to seek guidance from an advisor or a Japanese friend. For example, gifts
should be wrapped in lightly tinted paper, not white paper, as it symbolizes
death. They should be given and received with both hands. They will be
opened after the gift-giver has departed.
Social Taboos
What are some social taboos I should be aware of?
The following examples will give you an idea of the wide variety of potential faux
pas that can occur with international travel. You will see blunders related to com-
munication, body language, gestures, personal space, and dining. Use these guide-
lines to develop awareness and to serve as a starting point for your country-specific
research. This information will enable you to present yourself in the best light
possible.
Argentina
• It is rude to yawn in public or eat while walking down the street.
• Placing your hands on your hips is interpreted as a challenge.
• Don’t put your feet up on any furniture.
Australia
• Do not imitate Australians by saying “G’day, mate” instead of “hello.” It may
be perceived as patronizing.
Canada
• The V for victory sign is perceived as an insult when flashed with the palm
inward.
• In some areas, it is bad manners to eat while walking down the street.
• Don’t be boastful.
14 Going Global 283
China
• Don’t ignore the importance of rank in your business relationships. Keep this
in mind during all communications.
• Don’t use large hand movements. Chinese people do not talk with their
hands and may find this distracting.
• Don’t point when speaking.
France
• Don’t walk down the street greeting people and smiling. Many Americans are
friendly and smile easily as an expression of happiness. In Paris, people will
think you are crazy (Steves, 2013)!
• Don’t speak in a loud voice in a restaurant.
• Don’t wear overpowering or glitzy jewelry or other objects.
Germany
• Never place a business call to a person’s home. Family and business are kept
separate.
• The OK sign is considered obscene.
• Keep your hands out of your pockets.
• Don’t wave or call out a person’s name in a public place.
• Don’t chew gum while talking to someone.
• Punctuality is the norm and is expected.
Great Britain
• Avoid the expression “What do you do?” In Great Britain, inquiring about a
person’s livelihood is considered intrusive and rude.
• Don’t talk business at social events.
• Men should wear shoes with laces, not loafers.

Hong Kong
• If your colleague is silent, don’t jump in and start talking. Silence is a form of
communication in many Asian cultures.
Italy
• Don’t exchange business cards at social events. Hold them for business func-
tions.
• Don’t expect quick decisions or actions. The bureaucracy is slow.
• Don’t talk about politics or World War II.
Japan
• Avoid physical contact after the initial handshake.
• Don’t look people directly in the eye. It invades their privacy.
• Never boast. A self-effacing manner is preferred.
• Never say “no” or “I can’t do it.” The Japanese prefer not to use the word no.
This can confuse negotiations.
Mexico
• Mexicans like to get close. It is rude to pull away when talking.
• Don’t stand with your hands on your hips. This suggests aggressiveness.
Poland
• Avoid shouting. Poles speak softly.
• Don’t put your hands on your lap when dining. Keep your hands above the
table.
Russia
• Don’t ignore age, rank, or position. Hierarchy is very important. The most
senior person generally makes the decision.
14 Going Global 285
Saudi Arabia
• The thumbs-up sign is considered rude.
• Don’t discuss religion, politics, or sex.
• Don’t pull away if a Saudi colleague embraces you or holds your hand.
• Never show bare shoulders, stomach, calves, or thighs.
• Never show the bottoms of your feet.
• Don’t eat with the left hand. It is considered unclean and used for hygiene.
Turkey
• Don’t cross your legs or show the soles of your shoes.
• Show respect to elders. Shake hands with the oldest person first.
• Stand when an older person enters the room.
• Don’t cross your arms when facing someone.
Venezuela
• Avoid being too attentive to someone of the opposite sex. Your intentions
may be misconstrued (Post et al., 2014).
• Avoid slouching when seated.
• Don’t dominate the conversation. Venezuelans like to be in control.
Where can I get information on things like gift-giving

customs, restaurants, hotels, social expectations, and
cultural taboos?
Here are some valuable resources:
• Kiss, Bow, or Shake Hands: The Bestselling Guide to Doing Business in More Than
60 Countries, by T. Morrison and W. A. Conaway
• International Business Etiquette and Manners for Global Travelers (www.

cyborlink.com)
• International Business Etiquette (http://visual.ly/international-business-

etiquette)
• Guidebooks, such as Fodor’s, Frommer’s, Lonely Planet, and Rick Steves
• Phone apps that provide information about different countries
Travel Safety
How can I ensure my safety, especially when traveling alone?
Here are some suggestions:
• Don’t be taken by surprise. Always be alert.
• Appearing timid or scared makes you look like a victim. Walk with confi-
dence. Don’t look like a victim.
• Bring maps.
• Avoid walking in alleys or deserted areas.
• At night, walk in well-lit areas.
• Only visit ATMs during the day (Rickenbacher, 2004).
• Choose an ATM in a busy public place.
Is it safe to use local transportation?

It may be safer to travel with the locals. Pickpockets and terrorists may not target
local buses as much as tourist buses. Local transportation is a great way to get a
feel for the culture of a country. You get to see what the local people wear and talk
about (if you can understand them).
Local transportation may not be your best option if you need to get somewhere by
a certain time. Frequent stopping results in slower travel (Pagana, 2008).
14 Going Global 287
How can I avoid being a pickpocket target?

Look confident and goal-oriented, even if you are lost or nervous. Use a money
belt to keep your passport and money hidden. Keep expensive electronic gadgets
or jewelry out of sight and away from easy-access pockets. It is a good idea to leave
these items at home so you won’t worry about them getting lost or stolen (Pagana,
2008).
See the following list for common scams that can distract you and make you a vic-
tim of a pickpocket (Steves, 2013):
• A young woman carrying a baby trips and falls into you. While helping her
up, she steals your wallet or purse.
• Someone approaches you and asks you to help with a demonstration. The
person makes a friendship bracelet on your arm. When finished, you are
asked to pay for the bracelet.
• An innocent-looking person picks up a ring off the ground and asks if the
“gold ring” belongs to you. When you say no, they offer to sell it for a good
price. While you are distracted, a nearby and unnoticed partner-in-crime
grabs your wallet or purse and runs off.
• Someone asks you if you speak English. When you say yes, the person asks
you to sign a petition. While you are signing, the person grabs your valuables.
What should I do if I am approached

Pickpockets
by a potential scammer? TIP regularly work
Say “no” in a firm voice and walk away. Don’t smile in churches. Be
and don’t apologize. on your guard at all
times.
What should I do if I am lost?

Don’t panic. Go inside somewhere safe. Then look If you feel unsafe,
at your map or ask someone for help. Avoid looking TIP follow your intu-
confused while out in a public area. It may make ition and remove
you an easy target for thieves (Pagana, 2008). yourself from the
situation.
What should I do if I have an emergency?

In case of an emergency, contact the US embassy or consulate immediately. You
should be sure you have the location and contact information for the embassy or
consulate before you leave home. (See www.usembassy.gov for a list of embassies
worldwide.) If you need the number of an English-speaking doctor, the consulate
can give you one. If you get in trouble with the police, the consulate can help you.

? Can I use the American style of dining when traveling in Europe?
Yes. Be aware, however, that almost everyone else will be using the
Continental style of dining.
? What should I do if I lose my passport in a foreign country?

Report your loss to the nearest US embassy or consulate or to the local
police. It is easier to replace a passport if you have a photocopy of the
data page. If you are traveling with someone, give the person a copy of
your passport. It is also a good idea to have a scanned version of your
passport available via web mail or online in some other location that you
can access if you need to.
? How do I know if I need a visa for traveling abroad?

Call the consulate or embassy of the country you want to visit. Most of this
information is available online.
? If I do not understand why someone does something in a certain

way, is it OK to ask the person?
Yes. Polite questions show you have an interest in another culture. This will
help build relationships.
? Is it OK to use humor when conversing with people abroad?

It is better not to use humor because humor is subjective. Some jokes do not
translate well and could cause offense or confusion.
14 Going Global 289
? Is it acceptable to wear native clothing when attending a business

meeting in another country?
No. This is inappropriate unless encouraged by your hosts.
? Is it appropriate to help myself to the food at a business meal?

No. Helping yourself is an American custom. Wait until food is offered.
? When traveling out of the country, is gift-giving a nice touch?

Gift-giving is expected in some countries. Find this out before you travel.
Also learn what gifts are appropriate.
? I am planning a trip to Japan. Should I learn how to use chop

sticks?
Yes. Learn and practice using them before you travel. Don’t point with them.
Don’t pierce food with them. When you are taking a break to drink or talk,
rest them on the chopstick rest.
? Where should I put my hands when dining?

In America, it is OK to place your hands on your lap. However, in many
countries, such as France and Poland, the hands are kept above the table. It
is inappropriate to put them on your lap.
? Can I use my cellphone while traveling abroad?

Before you travel, check with your cellphone provider. You should be able
to purchase a travel plan for a short period of time. Find out about calling
and data charges so you do not end up with unexpected high charges.
TAKE-AWAY TIPS
• Think of international travel as an adventure, an opportunity, and a
learning experience.
• The old adage “When in Rome, do as the Romans do” is true.
• Respect cultural differences.
• Notify your credit card companies prior to travel.
• If possible, avoid changing money at airports, where it is more expen-

sive. Instead, use a local bank or ATM.
• Don’t brag about American culture. This is rude.
• It is not acceptable to make a mistake and simply say, “I didn’t know.”
• Refrain from using first names without prior permission.
• The American way isn’t the only way—nor is it always the best way.
15 Putting It All Together 291
15
PUTTING IT ALL TOGETHER
Using a Leadership Strategy as an Example
As a professional speaker, one of my popular presentations targets reaching

personal and professional goals. Since an underlying premise of goal achievement
is the importance of professional etiquette, this should be a good opportunity for
putting the book’s ideas into practice.
This leadership strategy is based on the 3 Ps: Purpose drives, Protocol facilitates,
and Passion propels.
Purpose Drives
To reach a personal or professional goal, you must clearly
define where you are aiming. If you are not sure, there are
three ways to help define this.
The first strategy is to keep learning. Keep expanding

your knowledge base. As a colleague of mine said, “The
best room in the house is the room for improvement” (D.
Madison, personal communication, 2018). You will expose
yourself to new ideas and new people. For example, a young
nurse was complaining about the need to go back to school
to get her BSN. However, when she was finishing up her
degree, she commented how much she had enjoyed her
rotation as a school nurse. She loved it so much that she is
now planning to get her school nurse certification. She is
heading back to school with a new idea and a new purpose!
“The greatest danger for most of us

is not that our aim is too high and
we miss it, but that our aim is too
low and we reach it.”
–Michelangelo
A second strategy for finding your purpose is to accept opportunities and challeng-
es. As a young nurse, I was working as a head nurse on a cardiac unit. In the near
future, I planned to get my master’s degree in adult health with a minor as a cardiac
nurse clinician. However, one of my new responsibilities as a head nurse was to
provide a hospital-wide in-service related to cardiology. I never would have volun-
teered to do this, but it was part of my job description. To my surprise, I found that
I loved the challenge of preparing a presentation and making it interesting. After
giving the presentation, a number of people asked me if I had planned to go into
teaching. Well, that opportunity and a few other teaching-related experiences made
me change my minor in graduate school to education. Opportunities unveil a piece
of the puzzle of who we are. This opportunity gave my career a new direction.
At a later point in my career, I filled in as academic dean for a year at a college. It

was a great opportunity and a great experience. However, that experience convinced
me that administration was not a passion for me. That opportunity unveiled a piece
of the puzzle of who I wasn’t! It was clear to me that I belonged in teaching versus
administration.
A third strategy for finding your purpose is by proactive positioning. In this situation,
you know where you want to end up and you need to figure out the steps to get there.
For example, if you want to be a nurse anesthetist, you need to find out what clinical
experiences you need to have before you are a candidate for this next educational
step. While in graduate school, I was really impressed with the faculty members who
wrote books and framed the book covers in their office. They seemed like regular
people, and I thought that if they could write, I could also. I positioned myself to be
a writer by reading every book and article about writing and publishing. Several years
later when I got an idea for a book, I was positioned and ready!
Using these three strategies will help you determine the purpose that will drive you
onward.
Selective Sample of Professional Etiquette Skills

Supporting Purpose
• Introductions • Professional dress
• Shaking hands • Interviewing
• Networking • Email etiquette
• Small talk • Cellphone etiquette
• Mentoring • Social media competence
Protocol Facilitates
Once you have your purpose, protocol will help you get there. Think of protocol as
a navigational device. It will keep you on the right path and avoid problems. What
skills do you need to reach your goals? For example, do you need to improve your
speaking and writing? Do you need to update your computer skills? Do you need to
tap into social media?
Perhaps you are chairperson of a committee and you need to showcase your lead-
ership during meetings. I know a young man who was a volunteer on an Outward
Bound committee. One of the committee members (Brian) moved across the
country. In Brian’s new position, the company needed to hire a person with a cer-
tain skill set. Brian remembered being very impressed with the young man on his
Outward Bound committee. His former colleague was invited to apply for the new
position because of qualities he demonstrated during meetings.
Maybe you need work on being more productive. You may need to manage your
procrastination and learn to delegate. You can take seminars or learn on your own
with help from your colleagues. Here is where networking can be invaluable. Net-
working can occur at any time and in any place. I remember being in a yoga class
and networking to help someone get an interview at a company where I had con-
tacts. One woman told me her current job is related to a conversation on the train.
Don’t underestimate the power of a mentor. Mentors can accelerate your learning
curve, help you make connections, and encourage you to discover your potential.
Don’t be afraid to ask someone to be your mentor. Most mentors are delighted to
help. Mentoring does not have to be a years-long commitment. It can take place in
minutes and hours. I will never forget the nurses who briefly mentored me as a new
nurse and a new faculty member.
So, find out the skills you need to support your navigational system in helping you
reach your goals.

Supporting Protocol
• Networking • Email etiquette
• Mentoring • Introductions
• Writing • Shaking hands
• Speaking • Business cards
• Dining etiquette • Remembering names
• Cocktail party etiquette • Professional dress
• Meeting behavior • Interviewing
• Social media • Business travel

Passion Propels
When you have a purpose and know the protocol for reaching your purpose, you
are ready to let your passion propel you forward. With passion, you are ready to
take action. Passion helps you “fail forward” when disappointment hits. For exam-
ple, if your manuscript is rejected, learn from this and move ahead with passion. If
you did not interview well for a position you wanted, determine how you need to
improve. Use your passion to keep trying. Use your network to help.
“Failure is the opportunity to

begin again more intelligently.”
–Henry Ford
Passion also helps you put setbacks in perspective and move forward. For example,
an OR manager lost her position due to downsizing. At first she was devastated.
Then she applied for another position and got a much better job. An orthopedic
technician lost his position due to the combination of several practices. He used
this opportunity to get a degree in nursing. He now has a much better position with
a better salary. As one young woman recently said, “My boyfriend dumped me, and
I married the man of my dreams.” If you look back at your life, you will probably
find many setbacks that resulted in improved situations. Let passion help you “fail
forward,” and do not let setbacks stop you.

Supporting Passion
• Networking • Social media
• Mentoring • Email etiquette

• Dining etiquette • Interviewing
• Business correspondence • Professional dress

Professional etiquette skills will help you build a power base and level the playing
field. I like to think of these skills as the “missing link” between education and the
workplace. Using purpose, protocol, and passion will help you reach your personal
and professional goals. This leadership strategy works and is a great way to support
the growth of your colleagues.
References 297
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Index 301
INDEX
NOTE: Page references with a t are tables.
A checklist for interviews, 98

clothing, 78–84
acceptances, manuscripts, 240 dressing in clinical settings, 84–86
accessibility, cellphones, 144 Argentina, social taboos, 282
adding humor to presentations, 64–65 articles
addresses, email. see email ideas for, 235
after-interview professionalism, 105–106 outlining, 238–239
agendas, meetings, 113 rejections, 240–241
airports, cellphones at, 145–146 writing, 233–247
air travel, 253–260 attachments, email, 137–138
cancellations, 254–255 attending department parties, 183
carry on luggage, 256–257 attention getters, 51
check-ins, 255–256 attributes of good conversationalists, 21
clothing, 257 audiences. See also presentations
delays, 254 avoiding data dumps, 60
ground transportation, 259–260 buy-in, 53
itineraries, 254 delivering similar presentations, 59
professionalism, 257–259, 260 focus of, 74
scheduling reservations, 253 targeting, 55–56
selecting air carriers, 253 Australia, social taboos, 282
tipping, 257 auto-responders, email, 139
alarm clocks, 264 avoiding data dumps, 60–61
alcohol
beer drinking, 192
drinking at parties, 188–190
wine service, 190–192
B
American dining style, 203, 206 baby boomers, 28
analog presentations, 56–57 back-to-back meetings, 121
anxiety about presentations, 68, 69–71 bacon, 207
appearances, 77–78 bananas, 207
body language, 86–89 bartenders, tipping, 191
BCC feature, email, 138–139 proofreading, 224, 225

beer drinking, 192 salutations, 228
behavioral questions, 95 business parties, 183. See also parties
behaviors buy-in, audience, 53
distracting behaviors in meetings, 119
positive work environments, 36–37
black napkins, 201
blogging, 173–178
C
benefit of, 173 caller ID, 143
blogs for nurses, 177 Canada, social taboos, 282
blooks, 178 cancellations, air travel, 254–255
comments on, 178 careers
credibility of blogs, 177 affect of social media on, 153–155
difference between websites and, 174 benefits of blogging, 175–176
features of, 174 development, 23
organizations, use of blogs, 177–178 mentoring, 31–32
pitching services on, 177 writing articles, 233–247
topics, 176 Carnegie, Dale, 69
updating, 175 carrying business cards, 13, 16
blooks, 178 carry on luggage, 256–257
body language, 86–89 car travel, 260–262
body piercings, 99 case studies in presentations, 61–62
bows instead of handshakes, 275 CC feature, email, 138–139
brainstorming presentations, 56 cellphones
bread accessibility, 144
and butter, 201 etiquette, 143–146
plates, 198–199 ringing during interviewing, 144
bread, meal, and water (BMW), 198, 199 when not to use, 146
breaking the ice, 22–23 while driving, 145
briefcases, 83 chairperson etiquette, 115–118
buffets, 190, 204 checking out of hotels, 265
bullying, 37 check-ins, air travel, 255–256
Burdick, Eugene, 270 cherries, 207
business cards, 11–15, 16 cherry tomatoes, 207
carrying, 13, 16 children, talking about, 20
credentials on, 12, 17 China, social taboos, 283
etiquette, 14, 275 citing quotes/statistics, 62–63
homemade, 12 clinical settings
information of, 11 dressing in, 84–86
mistakes, 13–14 networking in, 43
business items, packing, 252 clinical specialty area, 45
business letters, 222–229 closing presentations, 53–54
components of, 222–223 clothing
frequently asked questions, 231 air travel, 257
length of, 227 appropriate for positions, 79
mistakes, 223 briefcases, 83
phrases to avoid, 228–229 cocktail parties, 185
Index 303
dressing in clinical settings, 84–86 small talk, 186–187

dressing in scrubs, 85 styles of, 29
handbags, 83 technology, 133–134
impressions based on, 79 compliments, 27
international travel, 273 components
for interviews, 96–98 of business letters, 222–223
judgments based on, 78 of elevator pitches, 5
meetings, 120 conferences, networking sessions at, 24
for men, 79 confidence, 31
for nurses, 80 shaking hands, 5
professional presence, 78–84 when leaving messages, 147
selecting colors for, 84 confidential information
for women, 79, 80t–81t cellphones, 144
clothing for men, 81t–82t email, 134
cocktail parties, 181–195 Continental dining style, 203, 206
beer drinking, 192 conversations, 19–20. See also networking
courtesy at, 183–186 disengaging from, 28
dress codes, 185 exiting, 187
drinking alcohol at, 188–190 frequently asked questions, 45–46
exiting conversations, 187 generational differences in, 28–29
frequently asked questions, 194 international travel, 275–278
gossip at, 186 name tags, 32
greetings, 183–186 nurse-to-nurse collaboration, 35–38
RSVPs, 182–183 nurse-to-physician collaboration,
small talk, 186–187 38–41
toasts, 192–193 observe, ask, reveal (OAR), 22, 187
wine service, 190–192 patient experience, 41–45
coffee, 208–209 with persons with disabilities, 33–34
collaboration small talk, 22–23, 186–187
nurse-to-nurse, 35–38 topics, 20–21
nurse-to-physician, 38–41 core messages of presentations, 58
colors, selecting for clothing, 84 corn on the cob, 207
comfort at parties, 183–184 correspondence
comments on blogs, 178 business letters, 222–229
communication. See also conversations; email (see email)
networking frequently asked questions, 231
with deaf people, 34 memos, 229–230
email, 134–141 phrases to avoid, 228–229
generational differences in, 28–29 thank-you notes, 218–222
hard-of-hearing (HOH) patients, 34 costs
multitasking and, 29 currency conversions, 272
nurse-to-physician collaboration, of incivility, 36
38–41 of social media, 156
patient experience, 41–45 of wine, 191
patient safety, 40 courtesy at parties, 183–186
with persons with disabilities, 33–34 cover sheets, fax, 151
professionalism on telephones, 141 credentials on business cards, 12, 17
credibility distracting behaviors, meetings, 119

of blogs, 177 dress codes, 185. See also clothing
speaking skills, 52, 55 dressing in clinical settings, 84–86
CREW, 40 drinking. See also alcohol
cultures. See also international travel alcohol at parties, 188–190
handshakes in different, 9 international travel, 278–280
networking and, 27 driving with cellphones, 145
Cumulative Index to Nursing and Allied Dumont, Sandy, 85
Health Literature (CINAHL), 238
currency conversions, 272
cutting salad, 203
E
Electronic Communications Privacy Act
D (ECPA), 140
The Elements of Style (Strunk/White), 227
data dumps, avoiding, 60–61 elevator pitches, 4–5, 15
deaf people, communication with, 34 email, 134–141
delays, air travel, 254 attachments, 137–138
delicacies, dining on, 279–280 auto-responders, 139
demographics, audience, 55 BCC/CC features, 138–139
department parties, 183. See also parties creating addresses, 139
different cultures, handshakes in, 9 forwarding, 137
difficult foods, 207–208 grammar-checking, 136–137
dining, 197–215 international, 140–141
bread and butter, 201 introductions, 4
bread plates, 198–199 length of, 136
coffee and tea, 208–209 during meetings, 116
difficult foods, 207–208 mistakes, 140
four-course meals, 200 monitoring, 140
frequently asked questions, 211–214 not using, 140
international considerations, 211 signature blocks, 136
international etiquette, 278–279 spell-checking, 136–137
international travel, 278–280 thank-you notes, 219
on local delicacies, 279–280 topics, 138
main courses, 203–208 Why Am I Sending This Email
paying the bill, 209–210 (WASTE) strategy, 137
place settings, 198–201 emergencies, international travel, 288
RSVPs, 198 employers and LinkedIn, 169
selecting forks, 199 ending
soup and salad, 202–203 phone calls, 142
table manners, 205 presentations, 53–54, 65
disabilities, communication with persons entrees, 198. See also dining
with, 33–34 envy (speaking mistakes), 72
discarding tea bags, 209 etiquette
discussing patients on social media, air travel, 258–259
156–157 business cards, 14, 275
disengaging from conversations, 28 caller ID, 143
Index 305
cellphones, 143–146 first impressions, 6, 169

chairperson, 115–118 five rights of publishing, 236
coffee, 208 follow-up actions, meetings, 123–124
email, 134–141 food, meetings, 124–125
Facebook, 161 forgetting names, 10. See also
fax machines, 150–151 remembering names
handshakes, 6t forks, selecting, 199
Instagram, 170–171 formatting
international travel, 270–271, 277–278 business letters, 222–223
LinkedIn, 168–169 memos, 229
meeting participants, 118–121 salutations, 228
passion, 295–296 forwarding email, 137
Pinterest, 172 four-course meals, 200
protocol, 293–294 France, social taboos, 283
purpose, 293 French fries, 207
SnapChat, 171–172 frequently asked questions
table manners, 205 cocktail parties, 194
telephones, 141–143 correspondence, 231
texting, 148–150 dining, 211–214
thank-you notes, 221 international travel, 288–289
Twitter, 164–165 interviewing, 108–110
virtual meetings, 127 introductions, 15–17
voicemail, 146–148 meetings, 130–131
evaluating meetings, 117–118 networking, 45–46
exchange rates, 272 professional appearance, 89–90
exiting conversations, 187 social media, 179–180
expanding networks, 23–24 speaking skills, 74–75
eye contact, international travel, 277 technology, 151–152
travel, 267
writing, 245–246
F
Facebook, 159–162
benefits of, 160–161
G
business implications of, 162 gender, handshakes, 8, 15
dealing with negative items, 92 gender identity, 30
etiquette, 161 generational differences in conversations,
privacy, 160 28–29
profiles, 160 generation Xers, 29
recruiters on social media, 159 generation Z, 29
resources for nurses, 161 Germany, social taboos, 283
facilitating meetings, 116 germs, shaking hands, 8, 16
families, taking to business events, 184 gestures, international travel, 276
The Far Side (Gary Larson), 67 gifts
fast eaters, 204 international travel, 281–282
fax machine etiquette, 150–151 to party hosts, 186
feedback, presentations, 68–69 thank-you notes, 219
globalization, 9, 269–290. See also Hong Kong, social taboos, 284

international travel hors d’oeuvres, holding, 189
gluttony (speaking mistakes), 73, 74 Hospital Consumer Assessment of
gossip at parties, 186 Healthcare Providers and Systems
grabbers, 51 (HCAHPS), 42
grammar-checking email, 136–137 hosts
gratitude, 218. See also thank-you notes international dinners, 280
Great Britain, social taboos, 283 international travel, 273–274
greed (speaking mistakes), 73, 74 taking gifts to, 186
greetings at parties, 183–186 wine service, 190–192
ground transportation, air travel, 259–260 hotels, 262–266
guidelines alarm clocks, 264
adding humor to presentations, 64 checking out, 265
attending parties, 185 internet, 264
for chairpersons, 115–118 irons at, 253
communicating with disabled people, meetings in, 264
33 tipping, 266
communication with physicians, 39 wake-up call service, 264
dressing in clinical settings, 86 humor to presentations, adding, 64–65
elevator pitches, 5 hygiene, 37
making acquaintances, 1 checklist for interviews, 98
for meeting participants, 118–119 for interviews, 97
networking, 43
photographs on social media, 156
social media, 154–155, 158
texting, 149
I
writing emails, 134–135 ideas
for articles, 235
for topics, 238
H worthiness of, 241
ignoring handshake attempts, 8
habits, writing, 242–244 illegal questions, interviews, 102–103
hair styles for women, 84 illnesses, shaking hands with, 9
handbags, 83 image consultants, 85, 86
handshakes, 5–9, 15 improving
in different countries, 9 body language, 88t
etiquette, 6t interviews, 101
gender, 15 listening skills, 42t
with handicap people, 33 reading journals, 242
international travel, 274–275 remembering names, 9–10
variations, 7t voicemail systems, 148
hard-of-hearing (HOH) patients, 34 incivility in the workplace, 35t, 36
healthcare facilities, social media, 158–159 injuries, shaking hands, 8
Health Insurance Portability and inside contacts, 94
Accountability Act (HIPAA), 156–159 Instagram, 170–171
homemade business cards, 12 accounts for nurses, 171
Index 307
benefits of, 170 preparing for interviews, 92–95

etiquette, 170–171 professionalism during, 96–105
privacy, 170 punctuality, 99–100
international considerations, dining, 211 questions asked in interviews, 94–95
international email, 140–141 reverse interviews, 100, 101
international travel, 269–290 things not say, 102
avoiding American expressions, 276 what to bring, 96
business card etiquette, 275 introductions, 1–4
clothing, 273 business cards, 11–15
conversations, 275–278 elevator pitches, 4–5, 15
currency conversions, 272 email, 4
dining, 278–280 frequently asked questions, 15–17
drinking, 278–280 international travel, 274–275
etiquette, 270–271, 277–278 LinkedIn, 4
frequently asked questions, 288–289 meetings, 121–122
gestures, 276 networking, 26
gifts, 281–282 pecking order of, 3t
as guest of honor, 279–280 presentations, 52–53
handshakes, 274–275 remembering names, 3, 9–10, 15
hosts, 273–274 self, 3, 15
introductions, 274–275 shaking hands, 5–9, 15
language restrictions, 272–273 steps of, 2–3
networking, 275–278 who introduces who, 2, 15
preparing for, 270–274 invitations. See also parties
researching destinations, 271–272 gifts to hosts, 186
resources, 285–286 RSVPs, 183
safety, 286–288 irons, travel, 253
social taboos, 282–286 Italy, social taboos, 284
taboos, 280 itineraries, air travel, 254
using first names, 276–277
internet in hotels, 264
interviewing, 109
after-interview professionalism,
J–K
105–106 Japan, social taboos, 284
behavioral questions, 95 joining
cellphone rings during, 144 LinkedIn, 167
clothing for interviews, 96–98 Twitter, 163
connecting with interviewers, 93 jokes, 64. See also humor
dealing with negative items, 92 Journal of Nursing Education, 236
ending interviews, 103–104 journals. See also articles; writing
frequently asked questions, 108–110 reading, 242
hygiene for interviews, 97 targeting, 236
illegal questions, 102–103
inside contacts, 94 knives, pointing, 200
mistakes, 101, 104–105
phone interviews, 106–107
L difficult foods, 207–208

leadership, 291–296
landline phones, etiquette, 141–143 manuscripts. See also articles, writing
language rejections, 240–241
body, 86–89 revising, 239
restrictions in international travel, submitting, 240
272–273 meals, 198–201, 200. See also dining
Larson, Gary, 67 media, recruiters on social, 156
laziness (speaking mistakes), 72, 74 MEDLINE, 238
leadership, 291–296 meetings, 111
passion, 295–296 agendas, 113
protocol, 293–294 back-to-back, 121
purpose, 292–293 being late for, 120
Lederer, William, 270 chairperson etiquette, 115–118
legal questions in interviews, 103 clothing, 120
legal ramifications of misuse (social controlling, 116–117
media), 158 discipline, 116
lemons, 208 distracting behaviors, 119
length of business letters, 227 ending, 117
life balance and Twitter, 165 evaluating, 117–118
LinkedIn, 23, 167–169 facilitating, 116
benefits of, 167 follow-up actions, 123–124
connecting with interviewers, 93 frequently asked questions, 130–131
connecting with others on, 168 in hotels, 264
dealing with negative items, 92 introductions, 121–122
employers and, 169 leaving early, 121
etiquette, 168–169 minutes, 123–124
group suggestions for nurses, 167 not invited to, 121
introductions, 4 participant etiquette, 118–121
joining, 167 planning, 112–113
levels of connections on, 169 punctuality, 120
posting on, 168 reasons not to have, 114–115
recommendations, 168 seating, 122–123
listening skills, 42t serving refreshments, 124–125
local delicacies, dining on, 279–280 virtual, 125–129
locations, meetings, 112–113 wasting time, 119–120
lost, international travel, 287 memorizing presentations, 67
lust (speaking mistakes), 72–73 memos, 229–230
components of, 229
frequently asked questions, 231
M signing, 230
men
main courses, 203–208. See also dining checklist of interviews, 98
makeup, women, 84 clothing for, 79, 81t–82t
managing mentoring, 31–32
anxiety about presentations, 68, 69–71
Index 309
messages disengaging from conversations, 28

email (see email) expanding networks, 23–24
text (see texting) frequently asked questions, 45–46
voicemail (see voicemail) handling compliments, 27
Mexico, social taboos, 284 international travel, 275–278
Microsoft Outlook, 136. See also email introductions, 26
millennials, 29 mentoring, 31–32
minutes, meeting, 123–124 name tags, 32
mispronouncing names, 10 nurse-to-nurse collaboration, 35–38
mistakes nurse-to-physician collaboration,
buffets, 190 38–41
business cards, 13–14 with persons with disabilities, 33–34
business letters, 223 sessions at conferences, 24
email, 140 small talk, 22–23
interviews, 101, 104–105 talking too much, 26
mentoring, 31–32 Twitter, 166
networking, 26t–27t working the room, 24–26
presentations, 72–74 Nurse Educator, 236
social media, 153–180 nurses, clothing for, 80
speakerphones, 142 nurse-to-nurse collaboration, 35–38
toasts, 193 nurse-to-physician collaboration, 38–41
monitoring email, 140 Nursing ’19, 236
motivational strategies, writing, 241–245 Nursing Research, 236
multitasking and communication, 29
mute buttons, virtual meetings, 128
O
N observe, ask, reveal (OAR), 22, 187
outcomes of elevator pitches, 4
names outlining, 238–239
mispronouncing, 10
name dropping, 93–94
remembering, 3, 9–10, 15
napkins
P
black, 201 packing for travel, 250–253
placement of, 200 parfaits, 208
National Speakers Association, 52 participant etiquette, meetings, 118–121
need parties, 181–195
for business cards, 11 beer drinking, 192
for elevator pitches, 4–5 courtesy at, 183–186
for sending thank you notes, 218 dress codes, 185
negative behavior, 35t drinking alcohol at, 188–190
negative comments on social media, 166 exiting conversations, 187
networking, 19–20. See also social media frequently asked questions, 194
career development and, 23 gossip at, 186
in clinical settings, 43 greetings, 183–186
conversational topics, 20–21 professionalism at, 184–185
RSVPs, 182–183 for interviews, 92–95

small talk, 186–187 for meetings, 112–113
toasts, 192–193 presentations, 49–54
wine service, 190–192 adding humor, 64–65
passing analog, 56–57
bread, 201 anxiety about, 68, 69–71
food to the right, 203 avoiding data dumps, 60–61
passion, 58–60, 295–296 being ready, 69
pasta, 208 citing quotes/statistics, 62–63
patients closing with impact, 53–54
discussing on social media, 156–157 core messages, 58
safety, 40 ending on time, 65
sharing details about on social media, feedback, 68–69
156–157 frequently asked questions, 74–75
paying the bill, dining, 209–210 introductions, 52–53
pecking order of introductions, 3t memorizing, 67
personal items, packing, 251 mistakes, 72–74
personal space, 277 overview of, 51–52
persons with disabilities, communication practice, 66–68, 69
with, 33–34 relaying passion, 58–60
petits fours, 208 starting, 50–53
phone calls, professionalism in, 41 stress about, 68, 69–71
phone interviews, 106–107 targeting audiences, 55–56
photographs using case studies/stories, 61–62
Instagram, 170–171 pride (speaking mistakes), 74
on social media, 156 privacy
physical behavior, 35t Facebook, 160
physicians Instagram, 170
guidelines to speak to, 39–40 professionalism
nurse-to-physician collaboration, after-interview, 105–106
38–41 air travel, 257–259, 260
professionalism in phone calls, 41 dressing in scrubs, 85
reluctance to speak to, 39 impact of body language on, 87–88
pickpockets, 287 during interviews, 96–105
Pinterest, 172 at parties, 184–185
place settings, 198–201 patient encounters, 44–45
planning in phone calls, 41
meetings, 112–113 texting and, 148–149
presentations, 56–57 professional nursing organizations, 158
virtual meetings, 127–128 professional presence, 77–78, 78–84
Poland, social taboos, 284 profiles, Facebook, 160
poor hygiene, 37 programs, mentoring, 31
pork chops, 208 pronunciation guides, 272
positive work environments, 36–37 proofreading business letters, 224, 225
practicing presentations, 66–68, 69 proposing a toast, 193
preparing protocol, 293–294
for international travel, 270–274 public speaking, 49–54. See also speaking
skills
Index 311
publishing. See also writing revising manuscripts, 239

five rights of, 236 rewriting, 224
process of, 235 RSVPs
PubMed, 238 to cocktail parties, 182–183
punctuality dining, 198
at company parties, 184 Russia, social taboos, 284
interviews, 99–100
meetings, 120
purpose, 292–293
S
safety
Q in hotels, 262–263
international travel, 286–288
query letters, writing, 237–238 patients, 40
questions salad, 202–203
asked in interviews, 94–95 salutations, business letters, 228
behavioral, 95 Saudi Arabia, social taboos, 285
bringing to interviews, 100 scammers, 287
illegal in interviews, 102–103 scheduling
reverse interviews, 101 airline reservations, 253
quotes, citing, 62–63 meetings, 112
searching
for mentors, 31
R for quotes, 63
seating at meetings, 122–123
reading journals, 242 selecting
Really Simple Syndication (RSS) fees, 175. air carriers, 253
See also blogging colors for clothing, 84
reasons not to have meetings, 114–115 forks, 199
recommendations, LinkedIn, 168 salutations, 228
recruiters on social media, 156, 159 topics for articles, 236
red wine, 191 wine, 191
refreshments, meetings, 124–125 selfies with interviewers, 93
reimbursements, travel, 265 sending
rejections, manuscripts, 240–241 email, 134–141
relationships with mentors, 31–32 faxes, 150
relaxing at parties, 183 text messages, 149
religion, preventing handshakes, 8 thank-you notes, 219, 220
remembering names, 3, 9–10, 15 serving refreshments, meetings, 124–125
renting cars, 261–262 sexual orientation, 30
research, 238, 271–272 shaking hands, 5–9, 15
resources etiquette, 6t
international travel, 285–286 with handicap people, 33
for writers, 242 variations, 7t
responding to RSVPs, 182, 198 sharing
resting positions, 206 details about patients on social media,
reverse interviews, 100, 101 156
hotel rooms, 265
signing analog presentations, 56–57

memos, 230 avoiding data dumps, 60–61
thank-you notes, 219 being ready, 69
silverware. See also dining citing quotes/statistics, 62–63
selecting, 199 closing with impact, 53–54
signaling finish, 205–207 core messages, 58
situation, background, assessment, credibility, 52, 55
recommendation (SBAR) technique, ending presentations on time, 65
39–40 feedback, 68–69
slow eaters, 204 frequently asked questions, 74–75
small talk, 22–23, 186–187 mistakes, 72–74
smoking, 99 practice, 66–68
SnapChat, 171–172 relaying passion, 58–60
benefits of, 171 starting presentations, 50–53
etiquette, 171–172 targeting audiences, 55–56
social events, 183. See also parties using case studies/stories, 61–62
social media, 23 spell-checking email, 136–137
blogging, 173–178 starting
costs, 156 presentations, 50–53
dealing with negative items, 92 writing, 234–237
discussing patients on, 156–157 state, tell, offer, provide (STOP) strategy,
Facebook, 159–162 37–38
frequently asked questions, 179–180 statistics, citing, 62–63
guidelines, 154–155 stewards, wine, 191
healthcare facility responsibilities for, stirring tea, 209
158–159 stories in presentations, 61–62
Health Insurance Portability and stress about presentations, 68, 69–71
Accountability Act (HIPAA), Strunk, William, Jr., 227
156–159 subject lines, email, 134
Instagram, 170–171 submitting manuscripts, 240
legal ramifications of misuse, 157 suitcases. See also packing
LinkedIn, 167–169 carry on luggage, 256–257
mistakes, 153–180 organizing, 252
negative comments on, 166 sweaty hands, 7
overview of, 154–156
photographs on, 156
Pinterest, 172
sharing details about patients on,
T
156–157 table manners, 205. See also dining
SnapChat, 171–172 table settings, 198. See also dining
Twitter, 162–166 taboos
social taboos, 282–286 international travel, 280
software needed for blogs, 174 social, 282–286
soup, 202–203 tardiness, 37
speakerphone etiquette, 141–143 targeting journals, 236
speaking skills, 49–54 tattoos, 99
adding humor, 64–65 tea, 208–209
Index 313
TeamSTEPPS, 40 translators, 273

teamwork, lack of, 37 travel, 249–268
technology air, 253–260
cellphones, 143–146 car, 260–262
communication, 133–134 frequently asked questions, 267
email, 134–141 hotels, 262–266
fax machines, 150–151 international, 269–290 (see also
frequently asked questions, 151–152 international travel)
telephones, 141–143 irons, 253
texting, 148–150 packing, 250–253
using in meetings, 112 reimbursements, 265
virtual meetings, 125–129 Turkey, social taboos, 285
voicemail, 146–148 Twitter, 162–166
teleconferences, 129. See also virtual benefits of, 162–163
meetings etiquette, 164–165
telephone etiquette, 141–143 feeds of interest to nurses, 163
texting joining, 163
etiquette, 148–150 life balance and, 165
during meetings, 116 networking, 166
thank-you notes, 186, 218–222 unfollowing on, 165
forgetting to send, 221 vocabulary, 164
frequently asked questions, 231 two-handed handshakes, 7
sending, 219, 220
time zones, virtual meetings, 128
timing
meetings, 112
U–V
presentations, 65 The Ugly American (Burdick/Lederer), 270
tipping unfollowing on Twitter, 165
air travel, 257 utensils, dining, 198–201
bartenders, 191
hotels, 266 Venezuela, social taboos, 285
international considerations, 211 verbal abuse, 35t
toasts, 192–193 veterans, 28
toothpicks, discarding, 189 violations, HIPAA, 157
topics virtual meetings, 125–129
for articles, 236 vocabulary, Twitter, 164
blogging, 176 voicemail
conversations, 20–21 etiquette, 146–148
email, 138 garbled messages on, 147
ideas for, 238 voicemail messages, 107
international conversations, 275 volunteering, 24
for presentations, 55
small talk, 187
that lack passion, 59
train stations, cellphones at, 145–146
W–X–Y–Z
transferring phone calls, 142 wake-up call service, 264
transgender issues, 30 wasting time, meetings, 119–120
watermelon, 208
Waters, Lilly, 58
websites, difference between blogs and,
174
what’s in it for them? (WIIFT), 53
White, E. B., 227
white wine, 191
Why Am I Sending This Email (WASTE)
strategy, 137
wine service, 190–192
women
checklist of interviews, 98
clothing for, 79, 80t–81t
hair styles, 84
makeup and, 84
working the room (networking), 24–26
workplace, incivility in the, 35t, 36
wrath (speaking mistakes), 73–74
writers, resources for, 242
writing. See also correspondence
articles, 233–247
blogging, 173–178
business letters, 222–229
common writing tips, 225–227
email, 134–141
frequently asked questions, 245–246
frustration during, 244
habits, 242–244
motivational strategies, 241–245
outlining, 238–239
phrases to avoid, 228–229
presentations, 56
process of, 235, 238–241
procrastination during, 245
query letters, 237–238
reasons for, 234
rejections, 240–241
resources for writers, 242
starting, 234–237
worthiness of ideas, 241
zig-zag style, 203

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Praise for Etiquette & Communication Strategies

for Nurses, Third Edition

KATHLEEN D. PAGANA, PHD, RN

LCCN Permalink: https://lccn.loc.gov/2019952347

First Printing, 2019

1 Making Your Acquaintance. . . . . . . . . . . . . 1

2 Conversations and Networking for

3 When Talking to an Audience:

Targeting Your Audience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

4 Your Professional Presence . . . . . . . . . . . . 77

6 Meetings Still Matter. . . . . . . . . . . . . . . . 111

Chairperson Etiquette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

7 Communication Technology. . . . . . . . . . . 133

8 Avoiding Social Media Blunders . . . . . . . 153

9 Mingling Among the Cocktail Set. . . . . . . 181

Alcoholic Beverages and Hors d’Oeuvres . . . . . . . . . . . . . . . . . . . . 188

0 How Dining Etiquette and Business

11 Thank-You Notes and Business Letters. . . . 217

12 Writing for an Audience . . . . . . . . . . . . . 233

13 Flying for Success. . . . . . . . . . . . . . . . . . 249

14 Going Global. . . . . . . . . . . . . . . . . . . . . 269

15 Putting It All Together. . . . . . . . . . . . . . . 291

My mother taught me manners. I am a master of saying “Please” and “Thank you.”

It was this revelation that motivated me to begin talking to my colleagues about

–Anne M. Fink, PhD, RN, CNE

Why is etiquette important for nurses? Etiquette is about relationships. Nursing is

• Interviewing successfully for a new job or position

• Introducing yourself and others with confidence

• Demonstrating proper handshake and business card etiquette

• Networking effectively on the job and at conferences

• Knowing how to run a productive meeting

• Learning how to create an online persona

• Dressing to mirror your professional image and responsibilities

• Sending a positive impression with thank-you notes and letters

• Using email, phones, and faxes in a courteous and professional manner

• Using social media to further your career

• Demonstrating leadership skills and advancing your career when giving

• Standing out from the crowd by writing an article

• Dining with confidence in any business or social setting

• Increasing your comfort and self-confidence during business travel

• Appreciating and respecting cultural differences in global interactions

A unique feature of this book is its organization in a question-and-answer format.

Is there anything that can be done about sweaty hands?

What is a two-handed handshake?

The business card

The globe icon denotes material that explains how

Tables help itemize and illustrate concrete information.

1.1 Pecking Order for Introductions

Higher Ranking Lower Ranking

Helpful frequently asked questions (FAQs) are included in each chapter.

? What do I do if I am being introduced to someone and that person

Each chapter ends with “Take-Away Tips.”

• The most important thing to remember about introductions is to make

Professional etiquette is not optional for personal or professional success. It is an

• Know how to introduce your spouse to your boss?

• Have trouble remembering names?

• Have a prepared and practiced elevator pitch?

• Know what to do if a client ignores your attempt to shake hands?

• Wonder when it is appropriate to give out your business card?

“Civility costs nothing and buys

What are the key steps of an introduction?

1. Mention the name of the person of honor first.

3. Say something about the person of honor.