March 1, 2000
By Vilma Raettig

This post has been moved from its original location at PeerSpirit.com and archived here, so you can continue to access it.

Each month we share with you a story of how circle is being used effectively in a variety of settings. Our goal is to help people offer "council" in mainstream settings. This month’s story, written by Vilma Raettig, illustrates the use of circle in a health care setting at a major Florida hospital. Thank you, Vilma.

There is a nursing shortage in America at this point in time. This is especially so in the hospital setting. As we listen to nurses, one of the most frequently cited reasons for the shortage is relationship problems with physicians, supervisors, peers, and other members of the interdisciplinary team.

Nurses are by nature very caring compassionate human beings who find it difficult to deal with conflict or problems in a direct manner. So rather than becoming part of the solution they leave one hospital hoping those things will be better in a new place.

I was curious as to whether circle would provide a container strong enough to allow a group of nurses to have a conversation about the shortage and their own role in the retention of other nurses in the different areas that they represented.

The nurse managers provided me with a list of nurses they thought would be verbally skilled in a group setting, and stressed the need to create a safe environment for the discussion. I wrote invitations to twelve people asking them to join me for the purpose of exploring ways to decrease the turnover of nurses in the hospital. I created a center using the Nightingale Lamp as a symbol of knowledge and light, the mission statement for our organization and packets of flower seeds. I introduced the concept of circle, reviewed the principles and we developed a set of agreements.

There were several questions provided for dialogue but two proved to be especially powerful in the quality of the sharing. One was: "As we move into the 21st century what about nursing do you want to take with you and what do want to leave behind?" They want to take with them their knowledge, compassion, advocacy, optimism for the future, collaboration and clarity of intent to make a difference. They want to leave behind old grudges, hurt feelings, anger, victim mentality, perfectionism, judgmental attitude and negativism.

Another question was: "Is your unit like a well fertilized garden where nurses can bloom and grow or is it more like a dessert full of rocks and sand where people dry up and die?" The comments were priceless: "There are times that I know I have been more like weed killer than fertilizer, the garden needs to be weeded of the people who just don't care, doctor x is like a lawn mower cutting off everyone in sight, we are not a garden we are a cactus field full of thorns, I want to be less critical of new nurses in my unit, appreciation could be a form of fertilizer ... the chance to meet like this would be helpful to people I know who are struggling with nursing as a whole".

At the end of our council, the group made a list of changes that they could make to improve their working environments and expressed willingness to speak to their colleagues about these changes. The evaluations indicated that they would be willing to recommend the circle experience to those who were absent and volunteer to cover the assignment for their friends so that others could come to circle.

This approach produced insight and a commitment to action in this group beyond anything I have seen before with the traditional methods of facilitation or problem solving. Of course this is the beginning of our process, but I wonder what will happen to nurse satisfaction, and nurse retention if we can continue dialogue using the circle process over time.