Making it happen: a short guide to influencing skills

Influencing skills are essential for dealing with the challenges that life presents; and challenge is what the nursing profession, and practice nurses in particular, are currently facing on a number of fronts.

Influencing effectively is the one core skill that every leader and manager needs. In a business environment, there is no other skill that so clearly defines the competent from the merely average or outright disastrously inept performer.'¹

This applies to nurses and clinicians as much as it does to industry managers, in the business environment in which the NHS now operates. How will nurses influence commissioners to commission care they deem appropriate? How do we learn from the mistakes of others and prevent further incidences of poor nursing care?2

There has never been a better time to influence the future contribution of nursing to healthcare. To capitalise on this moment, nurses need to decide what is important to them and their patients and use their influencing skills to make the changes they believe will make a difference. Whether you want to influence at a local or a national level, now is the time to do something about it, to 'Stop Talking, Start Doing'.³

NINE STEPS TO INFLUENCING

The nine steps of a 'Framework for Influencing' (Figure 1)⁴ provides tools and tips to increase your chances of successfully influencing.

Setting out

The first seven steps relate to preparing to influence. An important consideration is to determine what you really care about. Where does your passion lie? Think of an issue where you want to influence those around you. On a scale of 0 - 10, where 0 is 'not at all' and 10 is 'care passionately' - how strongly do you feel about it? Successful influencing can take time and considerable effort. If you rank your issue less than 7 then consider whether it is worth the investment and if you have the staying power to see it through to the end.

Advice for the journey

An old, but apposite adage is that you cannot antagonise and influence at the same time.⁵ Success is gained by mutual agreement and should not damage your relationships with your employer or others in the organisation. Liking and influencing are linked, so when you set out to influence it is important to build rapport. People who influence others are, more often than not, deemed approachable.

The style in which your passion comes across is important if you are to avoid being perceived as aggressive, antagonistic or overly dogmatic.

We can all get passionate about things we have little or no direct control or influence over, e.g. the state of the economy, or political voting at the Eurovision Song Contest. Is the issue you are concerned about within your circle of concern or influence? (Figure 2).⁶ If it is not within your circle of concern, i.e. a global issue, then your personal impact may be small and you may need to join forces with others in order to lobby for change, for example, by working with the RCN.

If your issue is within your circle of influence, then you will have personal power to affect it. You can use the Framework for Influencing to be proactive in influencing others and can use your commitment intentionally to make a change. The Circle of Commitment (Figure 2) represents the area where you actually commit to doing something. You 'will' do it rather than 'can' do it.

Once you have decided that your issue is within your circle of influence, and that you are prepared to do something about it, you are ready to set about influencing.

STEP 1

Identify your goal

This is the most important step as it lays the foundation for the rest of your work. You need to be clear about what it is you are trying to achieve. (Figure 3)

STEP 2

Assess your current situation

Undertake an assessment of the current situation. This will help you understand where there are gaps in service, or other aspects of your issue. It will enable you to:

• Identify current good practice that you can build upon
• Determine what needs to change
• Begin to construct arguments for that change.

STEP 3

Check if you 'R' SMART?

Having identified your current situation and the impact it has on those in your immediate network it is time to understand the situation in the wider community. This step will also help identify the evidence you need to collect to support your case in step 4. The key question to ask yourself is:

'How does what happens in your workplace or with your issue locally compare with what happens in other workplaces throughout the country or in other communities across the UK/globally?'

This is the point at which you should take a 'reality check'. Is what you are trying to achieve realistic? Depending on what you find out you may need to adjust your original goal.

STEP 4

Gather evidence to support your case

Once you know what you are looking to achieve and have reality-checked your goal you need to gather evidence to make your case. The evidence will depend on the issue and where you work. Some of the evidence you might need to think about to make your case is illustrated in Figure 4.

STEP 5

Identify and map your stakeholders

Identify all the people with an interest or 'stake' in what you are trying to achieve. Most importantly, you need to know who has the power to grant your request. Is it one person, or a group of people? Does one person have a lot of influence with the group and who makes the final decision?

The NHS Institute for Innovation and Improvement developed the 9 'Cs' acronym to identify stakeholders:7

• Commissioners - those that pay the organisation to do things
• Customers - those that acquire and use the organisation's products or services
• Collaborators - those with whom the organisation works to develop and deliver products or services
• Contributors - those from whom the organisation acquires content for products or services
• Channels - those who provide the organisation with a route to a market or customer
• Commentators - those whose opinions of the organisation are heard by customers and others
• Consumers - those who are served by our customers, i.e. patients, families, users
• Champions - those who believe in and will actively promote the project or services
• Competitors - those working in the same area who offer similar or alternative products or services.

This acronym will help you to identify the people you need to influence to achieve your goal and, once you know who they are, will help you, in step 6, develop your key messages and what you need to say to influence them. Identifying the people who control decisions is vital to your success.

The Stakeholder Analysis tool (Table 1) can be illuminating. Use an 'X' to make a value judgement about where you see each key stakeholder in relation to the issue. Do they oppose your idea, would they bothered either way if it happened or not, will they help you to make it happen or do they have the power to make it happen? When you have decided this, put a tick where you need them to be successful in achieving your goal, to see where you are trying to move them to.

If you are moving someone from 'opposed to the idea' to 'letting it happen' you might use very different arguments and evidence than if you were moving someone from 'opposed to the idea' to actually using their power to 'make it happen'. Once you know what power the person has, you can decide when to approach them and what to say to them. You may approach someone who can help you 'make it happen' and ask them to support your request when the decision maker is making their decision. If you are approaching the decision maker directly, then you can make sure you have all your evidence and arguments in place.

STEP 6

Develop three key messages

With the evidence gathered in step 4, you now need to think about how you will use it to make your case to the person you want to influence. You may not use it all. The key is to know what evidence you need to influence that individual. For example, if the person you are trying to influence is mainly concerned about financial matters, then you will have to demonstrate that that your proposal will have a good return on investment. If their attention is on quality of care, then you will need to gather the evidence to demonstrate this aspect of your proposal.

The key question is: 'How will your objective help the person you are going to see achieve what they want to achieve?' You need to make this connection and see things from their perspective.

The 'Arrange Evidence To Achieve Goal (AETAG) template' (Table 2) is useful for gathering your selected evidence together so that you can make a confident and professional case for your request.

It is helpful to focus on three key influencing points. Any more can be overwhelming and you may run the risk of their losing interest by over stating your case.

STEP 7

Test out your messages

Work with a colleague, mentor or trusted friend to test out as many of your reasons for being granted, or not granted, your request before you go and see the person you are trying to influence. Ask your tester to give you feedback:

• Was your objective SMART?
• Were your arguments and reasoning logical?
• Can you anticipate some of the questions that might be asked and how will you counter them?
• Do you have the evidence to support your position?

Listen to their feedback and make notes about how you can improve your case. Practise answering their questions and, if necessary, go back to step 4 and gather more evidence to support your answer.

When working with your mentor, you need to speak your case out loud. You, and they, need to hear how you present your case so that you feel confident about what you want to say and can present yourself professionally. This will have a positive impact, demonstrating that you have thought out your case and have a compelling argument. Visualisation is another helpful way to prepare... what it will be like, where you will be, how might they react?

STEP 8

The meeting

If you have followed the above seven steps you will be well prepared, but to avoid 'falling at the final hurdle' you need to think through how you will manage the meeting. (Table 3).

When presenting your evidence and making your case:

• Be confident and create the right frame of mind for you to influence effectively
• Be self-aware and in control of your emotions and passion for the subject matter
• Be open to other points of view and do not become defensive when challenged
• Use your analytical skills to evaluate the objections or different views presented by the other person.

STEP 9

Review the result

Three possible results from your attempts to influence are:

1. You could be successful and get everything you set out to achieve

2. You may be partially successful

3. You may find that you have to go back to the beginning, do some more work and try again.

Where you have not been successful, it is helpful to seek feedback. What are their reasons for not granting your request? Is there something you need to do differently next time? Did you miss out on some key fact that influenced their decision to turn you down? If you have been successful, think about what worked well so that you can use this the next time.

Regardless of the outcome, record your learning from the experience in your portfolio. This will be helpful in the future when demonstrating your competence, whether looking for a new job or making a case for further development.

PRINCIPLES TO KEEP IN MIND

1. If you do not get exactly what you want, increase the options so that the person can agree to most or some of what you want. For example, if you wanted full funding for a course, time off to attend and travelling expenses, you might increase the options by agreeing to take annual leave instead of time off.

2. If you come up against objections do not fall into the trap of becoming entrenched in your position. Focus on the outcome of the change and the benefit to the other person and patients. Separate the person from the issues. Sometimes we may not like the person we are trying to influence. Do not let that influence you and your approach.

3. Finally, if objections are being raised, try to work with the person who is resisting, keeping them focused on objective measures of success and not on personal measures.

THE ISSUE OF TIME

To influence effectively you need time to prepare and time to carry out your actions.

Nurses regularly complain that they have no time. In reality there are only a limited number of hours in the day and it is how we use them that matters.³ If something is truly important to you then you will need to reprioritise and make time to influence on that issue.

Having 'no time' can be an excuse for not knowing how or where to start. The Nine Step model will break the challenge down into manageable chunks. Take one step at a time.

CONCLUSION

Influencing is an essential skill we all need in order to make a positive difference to quality patient care. There is no use having skill and expertise to envision a better future if you are unable to influence others to follow you on the journey. As US basketball player, Michael Jordon said: 'Some people want it to happen, some wish it could happen, others make it happen.'

Be one of the ones who make it happen. o

REFERENCES

1. Rogers J. Influencing skills: The essential guide to thinking and working smarter. London. Marshall Publishing Limited. 1999

2. Wasson P. We have been listening, have you been learning? Harrow, Middlesex. Patients Association. 2011http://patients-association.com/Portals/0/We%27ve%20been%20listening,%20have%20you%20been%20learning.pdf

3. Wasmund S, Newton, R. Stop Talking, Start Doing: a kick in the pants in six parts. Chichester. Capstone Publishing Limited. 2012

4. Vaughan P. Influencing for Change. London. Working in Partnership Programme. 2008. Not available in print.

5. Knox J.S. Salesmanship and Business Efficiency. Revised School Edition. London. The Knox Business Book Company. 1926

6. Covey SR. The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change. New York. Fireside. 1990

7. NHS Institute for Innovation and Improvement. Quality and Service Improvement Tools: Stakeholder Analysis (General) 2008 http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/stakeholder_analysis.html