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Make it a no go

no go

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on Twitter

 

The end of the year is a time to reflect on the good, the bad and the ugly.  For some, reflection on recent work experience produces the conclusion; “I gotta get a better job.”  They may be people who struggle in toxic environments in which the work they do is valued but, despite their contribution, they are not appreciated, recognized or rewarded for their efforts.  Those stranded in an onerous workplace may benefit from a new job and can truly justify leaving.  More frequently, however, people are motivated to seek a new position because they’re in a professional rut and no longer feel challenged or empowered by their ho-hum job.  In a nutshell, they are bored.

According to Alison Doyle, author for The Balance Careers, studies indicate that 51% of workers in America are planning to leave their current job and 47% of American workers who feel that they are in a good job would leave if an ideal job were available.  Millennials tend to not see themselves working at one job for the duration of their careers with 44% expecting to change jobs in the next 2 years.

 

Why People Leave

Business journalist, author, and CNBC business consultant, Suzie Welch, affirms the current unrest in the workforce and offers three reasons to explain why people seek new jobs.

  • They are no longer fully engaged in their work. People spend the early days of a job mastering the skills needed to be successful.  Over time, work becomes routine leaving the person feeling like a spoke on the wheel.
  • They have been at the same company too long. As years turn to decades, people settle into niches and robotically do their assigned task.  Not only is their spot on the pecking order assured, they are may have become embedded into the position with little opportunity to move either up or down the chain of command.
  • They are no longer challenged in their role. “You get good at what you do” remains true today and the risk of having acquired competent comfort is the onset of boredom. When a job no longer offers the stimulation of professional development, it loses importance beyond money earned, money paid.

 

Why People Stay

Are you ready to throw in the towel?  Not so fast!  Before you start a job search, consider some factors that make the current job a little more attractive.

  • Geographic ties The longer a person is in a community, the more engrained the person and their family become.  Friendships have been formed, and trusted resources have been located.  Leaving a community may require selling a home, packing and moving with the blind faith that the new community will be as good as the new job.
  • Interests of partner/spouse/family Those in a two-income family must consider both incomes before pulling up stakes and moving. Children have friends and school activities that would be disrupted by relocating. If your partner own/runs a business, moving may not be an option at all.
  • Current pay/benefits are good   Among the many reasons a person works, paying the bills is always on the list.  If the pay/benefits of the current job are good, it may be unwise at this point in your affairs to trade security for the stimulation of a new workplace.
  • Fear of the job hunt process  Searching for a job, interviewing, credentialing and onboarding are stressful and time-consuming. In addition, applying for a position opens you to unwanted scrutiny or potential rejection.
  • Prospect of changing the current workplace culture A great reason to stay in the existing job is the realization that your dissatisfaction with the present position can be alleviated by taking the lead in shaking things up and infusing energy into the present job.

 

The grass isn’t always greener on the other side of the fence so before you sell the farm, step back and look at your job objectively.   If the status quo is truly toxic or oppressive, and you’re able to move on, move on.  However, if the root cause of your unrest is plain old stuck-in-the-rut, you’re almost always better served by running toward the problem rather than running away from it.

 

When You Stay

For those who are committed to staying in the current job and want to feel fulfilled with a sense of purpose and enjoyment, try these ideas.

  • Develop a friendship. A friend at work gives you a trusted ear for sharing personal thoughts and someone whose company you enjoy.  Having someone in the workplace who you look forward to seeing each day increases loyalty to the organization and increases the likelihood that you will remain in the same job.
  • Just say no to negative talk. Negative talk and gossip are draining.  Refuse to say anything unfavorable about your job, a colleague or the organization.  When lounge talk deteriorates, change the subject or simply leave.
  • Leave it at work. Taking disagreeable thoughts home to share with a partner continues your discontent into your personal time.  Going home and assuming the role of a victim garners sympathy and reinforces your dissatisfaction with the job.  The emotions tied to victimhood will diminish your ability to make an intelligent decision about the potential benefits tied to the current job.
  • Take a break. Some people seek to make a job better by working longer and harder.  Doing too much for too long puts you at risk for burnout and even minor irritants at work become major issues.  Take a break, relax and return refreshed.
  • Acknowledge your own value. The importance that is tied to your good work may not get the recognition that it deserves.  End each day by reflecting on your positive contributions and your importance to the team.
  • Be proactive. Don’t expect the world to be placed at your feet; go after it.  When you have ideas for improving workflow or making the workplace a better place, take the initiative to make it happen.  Even little things can make you feel empowered and create a big difference for you and your colleagues.

 

In just a few days the new year will arrive, and you can quit the old job.   Start the new year with a new job by re-defining your position at your current workplace.  All that is required is renewed self-confidence and a shift in focus from, “I gotta get a better job,” to, “I can and will make this a better job.”  Don’t allow yourself to become a victim who enjoys wallowing in the mud of negative thought.  Instead, accept responsibility for making your job more satisfying by approaching the challenge with proactive, optimistic enthusiasm.  Expand your friendships, leverage group dynamics and consistently reflect on the positive.  When you think it’s time to go, reconsider and make it a no-go.

 

“Grass is greener at other people’s feet because they watered it. You need not to let your environment control you; you have what it takes to make it look beautiful!” 
~Israelmore Ayivor,

 

Tom is a respected anesthesia clinician, author, speaker and leadership coach.  Forward this article to friends and help expand the network of healthcare leaders.

Better habits through science

By Thomas Davis, CRNA, MAE, DNAP candidate

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Resolutions

 

Men’s natures are alike; it is their habits that separate them.

~ Confucius

 

Resolutions are intentions related to the changes that we desire in our personal lives and are often based on notions and emotions.  Being “a better person” is a nebulous term that means different things to different people.  Habits, by contrast, are observable behaviors that define us as individuals.  The transition to each new year encourages people to make resolutions; however, the reality is that good intentions come up empty when theoretical concepts about the person you want to be do not change the behavior of the person you are.  Resolutions seldom work because they are simply ideas, and ideas do not change behavior.  It is actual behavior in the form of habits that define us as individuals.

 

The key to personal change is in transforming the abstract concept of a better you into     observable, habitual behavior that will define you in the future.

 

The fields of neuro science and behavior science merge when addressing the issue of changing behavior.  Scientists affirm that when behavior is repeated, neural pathways (grooves) develop in the brain, and when new behavior is repeated frequently, it becomes a habit.  Christine Comaford, a behavior scientist who specializes in coaching CEOs to be more effective, states in Forbes.com, “First it’s key to know that neurons that fire together, wire together. This means to learn something new, to set a new habit in place, repetition is required. When you practice something deeply, intentionally, and with some element of struggle, a neural pathway is formed. Neurons are now firing together in a new sequence, and thus are wiring together as a collective.” This statement is great news for those who are willing to learn by repetition because the behavioral patterns we repeat most frequently are etched into our neural pathways. Neuro science presented in Psychology Today affirms that through repetition, it’s possible to form and maintain new habits.

 

Applying the wisdom of the neuroscience community allows you to convert the abstract concept of a New Year’s resolution into observable new behavioral habit.  Show your commitment to changing your behavior by signing a personal contract to follow three rules for 30 days.

  1. Bring the desired change to mind and repeat the new behavior at least 5 times per day, every day, without exception.  You may not be able to go to the gym 5 times per day but you can bring fitness to mind and take time to stretch.  The change you desire must be etched in your brain at least 5 times per day.
  2. Prioritize the repeated behavior, especially if it’s difficult or inconvenient. Let nothing deter your effort.
  3. Repeat the new behavior with intensity, constantly visualizing yourself as successfully practicing the desired behavior.

 

Rather than seeking a total overhaul of yourself, select one behavior and use a 30-Day Challenge to make meaningful change.  Every time you duplicate the new behavior, the neural pathway becomes stronger and over time the new behavior will become your default action. When the new behavior becomes a habit, do a self-assessment, then select a second behavior that you want to change and start another 30-DC.

To get started, below is a list of categories and possible resolutions that are crying out to be included in a 30-day challenge. Select one, follow the rules above, faithfully complete the challenge, realize the results and celebrate success. If none of these bullets hits the mark, come up with your own idea and pull the trigger.  The goal is to implement the 30-day plan, alter neural pathways and build a new habit.

  • Personal health
    • Exercise 20-60 minutes per day.
    • Commit to a healthy, plant-based diet.
    • Restrict/eliminate one negative food such as sugar, caffeine or alcohol.
  • Professional development
    • Learn a skill that will enhance your work performance.
    • Learn key words in a language spoken by your international clients.
    • Write in a journal daily.
    • Select a topic and read one pertinent blog article per day.
  • Time management
    • Limit social media to 30 minutes in the morning and 30 minutes in the evening and SET A TIMER.
    • Make a daily list of realistic “must do” items and don’t stop doing until they’re done.
    • Set a personal boundary, ie turn off electronics at a specific time in the evening and go to bed at a time that ensures a minimum of 7 hours of sleep.
  • Workspace at work and at home
    • Organize and keep everything in its place.
    • De-clutter and do not leave the workspace until clutter is cleared
    • Set aside one item per day to donate and do it.
    • Give away or trash one item daily.
  • Social interactions
    • Speak to at least one stranger daily.
    • Once a week, extend an invitation to an acquaintance to meet for coffee with the intent of learning new things about the person
    • Send a thank you email or text to at least one person per day.
    • Give a sincere compliment to at least one person per day.
  • Financial
    • Stop eating out.
    • Log all money that is spent during the month…no exceptions.

 

We are counting down the days until we count down the final seconds as the ball drops.  Rather than experiencing another year with good intentions in January that end up as February failures, try a using a new method for building new habits.  Combine the wisdom of the neuro and behavior science communities with your personal tenacity to commit, and follow through and enjoy lasting results that improve your leadership and last a lifetime.  Using your new neural grooves, get into a groove that will set the stage for a successful 2019.  Happy New Year!

“You can do anything you decide to do.  The most difficult thing is the decision to act; the rest is merely tenacity.”

~Amelia Earhart

Tom is a noted author, frequently requested speaker, and leadership consultant

There’s no harm in charm

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

Charisma

 

 

What do Winston Churchill, Nelson Mandela, and John Kennedy have in common?  They are all recorded in the history books as being charismatic leaders.  To some, the stereotype of a magnetic personality carries the negative connotation of an all-show predator who is constantly on the look-out for a sucker who will fall prey to a con scheme.  However, a closer look at charisma reveals a more positive view of the importance of an alluring personality in dynamic leadership. Some of the most memorable people in history and in our personal lives are those who use personal appeal constructively, and when you think back over the span of your career, it is likely that your favorite boss was a person with appeal beyond the actual job.

Engaging leaders use powerful communication skills to connect verbally, non-verbally and emotionally with all whom they encounter.  Larger than life leaders are able to articulate a compelling vision and are masters at motivating individuals to embrace their cause by inspiring people to give effort that transcends what is required.  In the words of Robert House, professor at the Wharton School, “Charismatic leaders cause followers to become highly committed to the leader’s mission, to make significant personal sacrifices, and to perform above and beyond the call of duty.”  Charisma can be learned and all it takes is the desire and the commitment to add dynamic magnetism to your list of positive traits.

Writing a guest article in recruitloop.com, author Hannah Lewis, UK-based educationist, recommends infusing charismatic energy by keeping the workplace light while displaying self-confidence and making every person you encounter feel as if they have your full attention.  Maintaining personal integrity while role modeling behavior consistent with your vision adds to your credibility and creates a desire in others to be loyal supporters of your vision and plan.

Captivating charm is not an inborn leadership trait, but rather a skill that is learned.  Writing in Business Insider, Author Vivian Giang affirms that anybody can learn to be more charismatic and offers advice for improving personal appeal.

  • Focus on others. Make everyone you interact with feel as if they are the most important person in the room.  Eye contact, listening and follow-up questions all give a sense of importance to the person talking to you.
  • Be present. Give every interaction your full attention even if only for a short period of time.  Checking mobile devices or having side bar conversations are taboo.
  • Relax and smile. Think of something pleasant…your body will respond and change your facial appearance.
  • Don’t be physically dominant. Put yourself at a similar height.  Stand as if you are sitting and don’t tower over others when you stand.
  • Give a warm greeting. Use a friendly facial expression and a firm but not overwhelming hand shake.
  • Value the other person. Listen, pause and ask questions.  Always seek a deeper level of understanding.
  • Leverage your physical position. Sit next to or 90 degrees from the other person…never across. Sitting across puts a physical barrier between people and increases the likelihood of disagreement/argument.
  • Avoid name dropping or gossip. Don’t compare yourself to others or talk about people who are not present.
  • Demonstrate moral integrity. Show inner strength through the way you conduct your business.  Yes means yes, no means no, and commitments are honored when brought to completion.
  • Be confident both verbally and non-verbally. Don’t be distracted with self-doubt.  Use positive language and confident posture.
  • Seek personal growth. Put yourself into uncomfortable situations so that you can practice your skills.

In today’s workplace a charismatic leader at any level of the chain of command is bound to elevate the team and add to the organization.  Winston Churchill proved that you don’t have to be physically attractive to be magnetic; all that is required is the ability to connect, communicate, motivate and inspire every individual you encounter.   Great Britain might not have survived WWII, Apartheid might never have ended, and Russian nuclear missils might be in Cuba if not for the charismatic leadership of Churchill, Mandella and Kennedy.  These three dynamic and captivating people used their ability to connect, inspire and motivate others to change the course of history.  You can do the same in your workplace by infusing genuine, dynamic charm into your leadership style.

 

Tom is a respected author, speaker, leadership coach and clinical anesthetist

Patient satisfaction is transforming healthcare

By Thomas Davis, CRNA, MAE, DNAP candidate

 

Satisfaction, 2018

One hundred years ago, American culture was in a time of rapid change with an influx of new technology changing the way people lived their lives.  Being phased out, the horse and buggy, kerosene lamps and outdoor privy were quickly replaced by autos, electric lights and flush toilets.  In the hundred years that followed, the shift in healthcare delivery has affected our lives to the same extent as the technology changes of a century ago.  In the 1960s, healthcare was physician-centric with little concern for the needs or desires of the patient.  It was a time in which “the doctor knows best” governed healthcare and patients were lucky that the doctor agreed to provide treatment.  Moving forward another fifty years to the 21st century we find a system in which patients manage their own health records and have mobility to seek care wherever they desire.  Role reversal has put the patient in the driver’s seat leaving doctors and healthcare organizations to compete for the patient’s business.  In today’s medical marketplace, patients select doctors and hospitals based on both the quality of care delivered and their memory of how they were treated.  Healthcare providers who survive are those who are sensitive to patient satisfaction while providing state of the art treatment.

 

Patient satisfaction is the person’s perception of their overall experience with you and your organization.  A patient’s perception is his/her reality so the impression that you make is the memory that they will share with others, sometimes for years after receiving treatment.  Toma Kulbytė, content marketing specialist at SuperOffice, says “If they like you and continue to like you, they are going to do business with you and recommend you ….”  Does satisfaction count in a patient’s assessment?  According to Kulbytė, a positive customer experience creates a 42% increase in loyalty (likelihood for repeat business) and a 33% increase in satisfaction scores.

 

 Loyalty is earned

Regardless of whether the need is for a car, computer or colonoscopy, today’s consumer demands a quality product at a fair price, delivered by people who understand their specific need and treat them with respect and dignity.  To build a loyal base of satisfied customers, three factors are foundational:  People, product and presentation.

 

People

It can be argued that the most important person in a healthcare facility is the first person a patient encounters at the point of entry desk.  The congeniality with which a person is greeted, and the expertise shown by the attendant when entering the patient into the system create a lasting impression.  Ciotti, blog author and marketing strategist, confirms the importance of customer service skills and recommends that those delivering health care, master this list.

 

Patience Attentiveness Clear communication skills
Clinical competence Positive attitude/language Acting skills
Calming presence Ability to sense patient’s mood Tenacity
Persuasion skills Empathy Willingness to learn

 

Patients moving through the healthcare system encounter many people along the way and feel reassured by being introduced to the next person by name and their role in the treatment process.  With the patient’s wellbeing as your top priority, always use a positive language and an undistracted, welcoming attitude when providing care

 

“Nobody cares how much you know until they know how much you care.” 

~Theodore Roosevelt

 

Product

People expect those delivering a service are competent, capable and committed to excellence.  It doesn’t matter if you’re delivering a double cheese pizza, or an anesthetic, in order to earn your customer’s satisfaction, you must be skilled at your job and create expectations that are realistic.   In the healthcare arena, connect with your patients pre-operatively, clearly describe what can and can not be done, and then deliver on the service as described.  The bottom line is that your patients want you to be good at what you do, and they expect to receive the product and experience the outcome that they have been promised.

 

Presentation

Healthcare delivery is a competitive business and people are free to seek treatment wherever they desire.  Marketing analysis by Keona Health reveals that 77% of patients use online reviews to find and select a physician. The physician compare area of the CMS web site makes rating healthcare providers quick and easy.  Likewise, when a physician uses more than one hospital, patients rely on online reviews when requesting their hospital of choice.  Once a provider has been selected, patients use mobile devices to schedule appointments and judge the organization by the degree of user-friendliness of their web site.  When online sites are difficult to navigate, patients move on to another provider with a more user-friendly online presence.

 

Indiana University Orthopedic surgeon, James Rickett, links patient satisfaction to outcome by documenting that reduced hospital stay, reduced readmission rates, and overall better quality of care all correlate to high patient satisfaction scores.  Dr. Rickett’s observation underscores the importance of delivering healthcare services in a manner that ensures patient satisfaction. The physician driven hierarchy for patient treatment that existed several decades ago no longer applies in our web-based, patient-centric world.  The healthcare marketplace is becoming more and more competitive and patient satisfaction may be the key factor separating those who lead the industry from those who are forced to close the doors and turn off the lights.   Patient satisfaction does matter.

 

Thomas is a respected author, speaker and clinical anesthetist.

Robert Greenleaf; The first serving leader

 

By Thomas Davis, CRNA, MAE, DNAP candidate

follow @procrnatom on twitter for leadership moments

“Where there is not community; trust, respect, and ethical behavior are difficult for the young to learn and for the old to maintain.”
― Robert K. Greenleaf,

 Greenleaf

 

Health care delivery in the United States and around the world is in a state of transition as traditional physician-driven hierarchies are being replaced with collaborative teamwork.  At the root of this drive is a hope for improving employee engagement, productivity and loyalty to the organization. More than at any point in history, empowering leadership at all levels is being viewed as the key to building powerful teams and the serving leadership style is being promoted as the panacea for workplace woes.

 

Robert Greenleaf was born in Terre Haute, IN, in 1904, the son of a machinist and community steward.   Robert attended Rose Polytechtic and Carlton College earning a degree in engineering.  He took a position with AT&T where he worked as a loyal employee for 38 years and became known for his theories about empowering leadership.  During that time, Robert headed a division for management training and created the first center for corporate assessment in America.  One of the first to promote women and blacks into non-menial positions within the AT&T organization, Greenleaf became well known as a pioneer in leadership by seeking ways to utilize each person to his/her fullest capability.

 

Following retirement from AT&T at age 60, Robert worked as a consultant to businesses that had an interest in leadership development and taught them to implement his core belief that effective leadership is a partnership wherein “the organization exists as much for the person as the person exists for the organization.”  In 1970, Greenleaf published his essay, The Servant Leader which coined the term and introduced the notion that the best leaders are servants first.  The style of leadership that he espoused proved to be effective and requests for his leadership coaching grew into creation of the Greenleaf Center for Servant Leadership.  The center states as its mission: “to advance the awareness, understanding and practice of servant leadership by individuals and organizations.”  Long after the death of Robert Greenleaf, the center remains a strong advocate for servant leadership and continues to offer training through the Greenleaf academy.

 

Writing in EmergingRNLeader, nurse and author Rose Sherman identifies the leadership style described in The Servant Leader as an essential component of a highly effective healthcare workplace.  Crediting the work of Robert Greenleaf, the following were described by Sherman as essential characteristics of the Greenleaf serving leadership style.

  • Listening
  • Empathy
  • Healing
  • Awareness
  • Persuasion
  • Conceptualization
  • Foresight
  • Stewardship
  • Commitment to professional development of staff
  • Building community

Click here for an explanation of the 10 principles listed above.

 

Robert Greenleaf had an unshakable belief that through collaboration and the creation of a work environment that empowers people to work at their highest capability, people will be happy, engaged and highly productive.  History records that Robert was never driven by a quest for fame or fortune, but by a belief that the potential within each person that could be released, can be released, through servant leadership.  Etched in his grave stone are the following words, “Potentially a good plumber; Ruined by sophisticated education.”

 

In the decades following the publication of his famous essay, Robert’s principles of servant leadership have become the foundation for many versions of leadership development in America and worldwide.  Books, videos, and workshops may put a new spin on Greenleaf’s original work; however, when all is said and done, the beliefs of Robert Greenleaf are still alive and evident in leadership development worldwide.

 

 “A better society, one that is more just and more loving, one that provides greater creative opportunity for its people.”

~Robert Greenleaf

Tom is a noted author and popular speaker at State Association meetings.

Make it Safe; Essential Resources for Patient Safety

Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter for leadership updates

Safety

In 1999 the Institute of Medicine rocked the healthcare world with the scathing report that every year up to 98,000 people in the United States die due to medical errors.  Despite nearly 20 years of safety initiatives being introduced in hospitals nationwide, medical errors continue to be the third leading cause of death in the United States; a situation that can best be corrected by healthcare providers on the frontline of patient care.

It is easy to get the consensus of doctors, nurses and support staff to commit to patient safety; however, changing the workplace culture and making patient safety a priority can be a daunting task.  Fortunately, organizations have emerged to assist frontline workers who are committed to making healthcare safe and reliable for the patients they serve.

 

If you are committed to ensuring patient safety, you are not alone.  Here are resources to help you achieve the goal of eliminating ALL preventable medical errors.

 

Anesthesia patient safety foundation (APSF)  The APSF was founded in 1985 with the defined goal of improving patient safety related to anesthesia.  The board of directors is a group representing a wide variety of stakeholders including anesthesiologists, nurse anesthetists, nurses, manufacturers of equipment and drugs, regulators, risk managers, attorneys, insurers, and engineers.  The APSF newsletter is published in 5 languages and provides a wealth of information related to patient safety that supports the organization’s mission: “The APSF’s mission is to improve the quality of care for patients during anesthesia and surgery by encouraging and conducting patient safety research and education as well as related programs and campaigns.”  The AANA is an active partner with the APSF in promoting patient safety.

Patient safety movement  The patient safety movement has a stated goal of zero preventable medical errors by the year 2020.  The organization approaches patient safety by identifying risks to patients, challenging technology to assist by creating solutions, ensuring that providers follow established policy, and directly providing education to patients and their families regarding risks.  The patient safety movement bypasses the medical establishment by directly providing information to patients and their families to alert them to the risks of hospitalization.  The organization now offers the patient aider app that  alerts family members regarding risks to their loved ones and provides questions to ask those who are providing care.

AHRQ (Agency for Healthcare Research and Quality)   The AHRQ has the organizational mission; “…to produce evidence to make healthcare safer, higher quality, more accessible, equitable and affordable, and to work with HHS and other partners to make sure that evidence is understood and used.”   The AHRQ website has a section titled “evidence now” that outlines evidence-based information designed to help healthcare providers with clinical decision making.  The AHRQ site is a valuable resource for those who constantly update their practice based on the available best practice statistics.

Armstrong institute for patient safety and quality (The Johns Hopkins)   The Armstrong institute for patient safety is housed at The Johns Hopkins Hospital and is committed to making healthcare safe for every patient, everywhere.  The organization is dedicated to their mission:  We partner with patients, their loved ones and all interested parties to end preventable harm, to continuously improve patient outcomes and experience, and to eliminate waste in health care.  To ensure that providers at the grassroots level have the tools necessary for safe practice, the Armstrong institute provides patient safety courses for healthcare workers.  Individuals can earn CME by attending courses in Baltimore or their employer can arrange for the Armstrong institute to travel to their location and present safety workshops.

Institute for Healthcare Improvement (IHI)   The IHI has a global interest in improving the overall health of the world population through initiatives aimed at public health as well as education of healthcare providers in developing countries.  In the US, the IHI focuses on system improvement, whereas in developing areas of the world, issues such as vaccination and water purification are priorities.  As self-described on their web site, “We are an institute without walls, and together, we work as a cohesive unit with, common knowledge, common systems and unconditional teamwork. In all we do, we adhere to the principle of “all teach, all learn.”

AANA   The AANA has a commitment to patient safety and their web site has numerous articles intended to improve patient safety.  Topics such as opioids, radiation and OR distractions are just a few of those available on the AANA web site.  The Professional practice division has published evidence-based practice resources to aid clinical decision making.

AORN   CRNAs are not the only people in the OR who are committed to patient safety.  The AORN “is committed to promoting patient safety by advancing the profession through scholarly inquiry to identify, verify, and expand the body of perioperative nursing knowledge.”  The organization has published a patient safety position statement to guide the activity of nursing staff in the OR.

Center for Medicare/Medicaid services (CMS)   CMS is a major payor for healthcare services in the US and has a vested interest in patient safety.  The organization establishes standards  and updates them annually to create criteria that must be followed in order to receive reimbursement for services.   CMS seeks to improve patient safety by making healthcare providers accountable for the quality of care that is provided.

The Joint Commission (TJC)   The Joint Commission accredits healthcare organizations throughout the United States and certifies that they meet or exceed established standards, including standards for patient safety.  TJC has released the National Patient Safety Goals for 2019.  Currently, safety priorities are patient identification, syringe labeling and blood administration.  Areas of emphasis are updated to reflect perceived threats to patient safety.

Center for patient safety   Established in 2005, the Center for patient safety is an independent, non-profit organization dedicated to promoting safe and quality healthcare.  The organization is a resource for healthcare providers and offers information via blog, safety alerts and legal updates.

Centers for Disease Control and Prevention (CDC)   The CDC is a government agency with the mission “to protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights disease and supports communities and citizens to do the same.”  The CDC national healthcare safety network tracks medical errors, issues statistical reports and issues alerts related to patient safety.

Patient safety company  The patient safety company is an important bridge between safety initiatives and digital technology.  The company offers software to support safety initiatives including incident management, patient satisfaction, workplace culture assessment, information security and peer support.  They will also develop custom software for unique safety projects.

Patient safety is everybody’s business and making a commitment to ensuring a safe environment for your patient is easy on an intellectual level.   Reviewing the resources listed above provides information and support for your effort; however, knowledge is useless until it is put into action.  Making the transition from good intention to good practice requires a plan.  The Kotter model for implementing change is a useful way to initiate a safety initiative in the healthcare environment.  My previous blog, Kotter, for a change (Oct. 21, 2018), describes the model and how it can be used to make patient safety a priority in your workplace.

This article introduces the vast resources available to those who are committed to improving patient safety and provides a model for implementing change.  It is up to each individual reader to convert patient safety from a theoretical “we ought to” to the reality of a workplace where safety is job one.

“Safety is not an intellectual exercise to keep us in work. It is a matter of life and death.  It is the sum of our contributions to safety management that determines whether the people we work with live or die” ~Sir Brian Appleton

Tom is a noted author, speaker and mentor.  Contact tom@procrna.com for information about the 4-part values-based leadership webinar series.

The Voice against Lateral Violence

By Thomas Davis, CRNA, MAE

Follow @procrnatom on twitter

LV

 

In the nursing community, Lateral Violence (LV) is the term adopted for “bullying.” Consequently, an angel of mercilessness who might otherwise be labeled a bully is officially said to be “inflicting lateral violence.”  In medsurg nursing, authors Becher and Visovsky describe lateral violence as “hostile, aggressive and harmful behavior by a nurse or group of nurses toward a coworker or group of nurses via attitudes, actions, words and/or behaviors.”  Lateral violence often goes beyond things that are done to another person to include things that are not done or that go unseen.

“Never be mean to someone who can hurt you by doing nothing.”

~Matt Hearnden

 

 

Recently, an anonymous post by a nurse anesthetist student on the Facebook CRNAs and SRNAs user group page described the meanness directed at him in his clinical training site because of his status as a learner.  The student started the post by humanizing himself as an attentive student committed to mastering the skills and the knowledge to become a CRNA.  Then he described his personal history – background, family, hobbies.  His post went on to inform readers that his clinical training included accusations of being “lazy, stupid, inept, and disrespectful…” and other demeaning allegations.  Clearly, he was on the receiving end of outrageous behavior at a clinical training site in which lateral violence is a toxic staple in the culture.  Given the opportunity, the student would likely change training sites tomorrow and not look back, and you can be certain that he will never seek employment there.

 

In-your-face yelling or a punch in the nose are obvious examples of hostile and aggressive behavior; however, the daily manifestations of LV in the workplace are often subtler and less obvious.  Here are some examples of behavior that qualify as LV and, over time, will have a toxic effect on your team.

 

Overt LV Covert LV
Name-calling Sabotage
Intimidation Unfair work assignments
Blaming Withholding information
Fault-finding Withholding credit or praise
Threatening Exclusion from group activities
Ethnic slurs

 

There is a cost associated with allowing lateral violence to exist in your workplace.  As noted by nurse educators Becher and Visovsky, all levels of persecution damage the self-esteem of workers, reducing productivity and ultimately having a negative impact on the entire profession.  The reputation that “nurses eat their young,” didn’t arise from nowhere; LV is a problem that has been associated with the nursing profession right along with other professions for decades.  It’s time to stop LV and turn the corner.

 

Avoidance of conflict fuels the flames of lateral violence in workplaces where bullying is tolerated.  Rather than confronting an aggressor and drawing a red line, it is easier to turn a blind eye and hope that you are not his next victim.  Writing in the CPI blog, Emily Eilers, author and editor for the Crisis Prevention Institute recommends team training that focuses on changing the workplace culture and establishing zero tolerance for bullying.  For training to be effective, the team must openly discuss the problem and develop a code of conduct that defines acceptable behavior.  Affirming Eilers emphasis on team training, nurse educator Ericka Sanner-Stiehr, PhD, recommends a 3-step approach to eliminating lateral violence: 1) Add lateral violence awareness to the curriculum of teaching programs; 2) establish and enforce a code of conduct;  and, 3) role model the respectful, courteous behavior expected of the team.  Your strong leadership combined with commitment to change will position you to transform your workplace culture. 

Stopping lateral violence starts with you.

Make it a priority.  Whether you are the official leader with the title or the opinion leader to whom others listen, draw the line and vow to end lateral violence in your workplace.  Show your commitment to culture change by establishing a policy of zero tolerance for LV and confront each offender immediately.  During the interview and hiring process, include a discussion of acceptable behavior.

Discuss bullying at team meetings.  An elephant in the room won’t go away until it is acknowledged, and conflict avoidance is akin to feeding the elephant.  Dedicate a team meeting to discuss the negative effects of lateral violence and have the team identify areas for improvement.  A one-time discussion will not have a lasting effect.  Address the topic repeatedly at subsequent meetings and elicit every person’s commitment to changing attitudes and behavior toward one another.

Develop and enforce a code of conduct.  Once the team understands the dimensions of lateral violence and has committed to change, use a subsequent meeting to develop a Code of Conduct. Reinforce zero tolerance as your policy for addressing covert or overt behavior that violates the Code.

Simulate triggering scenarios.  Help your team find better options for situations that commonly trigger lateral violence.  Take time at a team meeting to role play interactions that have generated negative behavior in the past.  After completing each scenario, challenge the team to come up with professional and productive ways to more appropriately address the same or similar situation if it arises in the future.

 

The CRNA candidate who posted on Facebook knew first-hand the devastating effects associated with being a victim. He perceived himself to be powerless, at the mercy of the sharks swimming around him in the waters – not an optimal training ground.  If you allow intimidation, oppression, bullragging or any form of persecution in your workplace, you will have team members like the student, living each workday in constant fear of the next attack, and ready to jump ship at the first opportunity.  Be the voice that stops lateral violence. Lead the other voices. Then direct the choir.

“knowing what’s right doesn’t mean much unless you do what’s right.”

~Theodore Roosevelt

 

Tom is a noted author, speaker and mentor.  Contact tom@procrna.com for information about the 4-part values-based leadership webinar series.

Team strength through diversity

By Thomas Davis, CRNA, MAE

Follow @procrnatom on twitter

“Diversity: the art of thinking independently together.”

~ Malcolm Forbes

 

Diversity

The combination of digital technology and the availability of dependable travel has linked people in distant areas of the globe and opened the door to blending cultures through unusual partnerships.  With the click of a mouse, executives in the United States can have a video conference with just about anyone, anywhere in the world.  People who were previously separated by geographical boundaries can now interact freely with one another thus creating the opportunity for diversity of thought within their organization.

 

In addition to connectedness created by technology, immigrants fleeing terrorism or seeking opportunities for employment are flooding across borders both in Europe and America, changing the ethnic makeup of the population, and contributing to diversity in host countries.  Clearly, demographics are changing in many areas of the world and organizations on the cutting edge of their industry welcome and capitalize on opportunities that accompany diversity.  Cultural diversity in the workplace is promoted when employers actively seek to hire employees from every religious and ethnic background and then capitalize on the variety of experiences that they bring to the workplace.  Building a diverse team strengthens the organization and here is why.

 

A member of the Q6 customer service team in Perth, Australia, R. Heryati documents the following advantages that arise from a diverse workgroup:

  • Increased productivity
  • Improved creativity
  • Increased profits
  • Improved employee engagement
  • Reduced employee turnover
  • Improved company reputation

 

Writing for Entrapraneur.com, author Kim Abreu adds to the list of advantages to having diversity on a team by noting that diversity correlates with improving innovation and recruiting.  From blogs to books, authors evaluating the relationship between diversity and productivity affirm the importance of having a diverse team when seeking creative answers to workplace challenges.

 

Two types of diversity are commonly found in the modern healthcare workplace; cultural and interprofessional.  

Cultural diversity refers to a person’s family heritage. Do people at your workplace have different skin color, facial features and hair color? Do they speak a second language?  What religious holidays do they celebrate?  The greater the variation between individual workers, the more diverse the workplace.

Interprofessional diversity arises from the mix of professions that must work collaboratively to render evidenced-based care to the patient.  Doctors, nurses, technicians and support staff are only a few of the professions that combine their efforts in a busy hospital environment.  Each sub-group has a different purpose, has received different specialty training and brings a different perspective to the table when discussing issues and developing plans.  In an ideal situation, every sub-group will have equal say and be given equal respect when interprofessional teams are formed to address issues or create policies.  The term abrasive collaboration is used to describe diverse professional groups working collaboratively to find a mutual solution while, at the same time, ensuring that their individual professional needs are met.

4 ways to promote diversity in your workplace

Educate yourself.  Connect one on one with people on your team and learn about their family’s country of origin and family traditions that carry over to today.  If members of your team have different religious beliefs, learn about their traditions.  Adjust your work schedule to enable team members to attend important religious or cultural activities.

Solicit different perspectives.   In personal conversations and at team meetings openly encourage each person to voice their point of view.  Seeking a variety of opinions is especially effective with reference to interprofessional groups.  To be effective, the hierarchical “doctor knows best” attitude must be replaced by a commitment to collaboration where each person has an equal say.

Develop diversity activities.   Include dates on the team calendar that recognize the culture or religion of your team members.  Encourage people to share their traditions with the group and schedule ethnic food days to celebrate the various cultures represented on your team.  When team members celebrate one another’s heritage, they respect for the contributions that each person makes to the team and become more receptive to their ideas.

Be the leader.  You are the leader and set the tone for the workplace.  If you are dismissive of diverse thoughts, your team will follow your example.  Conversely, if you welcome and openly solicit diversity, your team will follow your lead.  Openly welcome both cultural and interprofessional diversity in your workplace.

The best ideas arise from many ideas combining ideas from people with different cultural and professional background strengthens the team.   First, assemble the right group and then be inclusive of their ideas when making decisions.  Doing so will position you and your team for success.

“When we listen and celebrate what is both common and different, we become a wiser, more inclusive, and better organization.” ~Pat Wadors, Head of HR at LinkedIn

“If you hire only those people you understand, the company will never get people better than you are. Always remember that you often find outstanding people among those you don’t particularly like.”

~Soichiro Honda, founder of Honda

 

Tom is a noted author, speaker and mentor.  Contact tom@procrna.com for information about the 4-part values-based leadership webinar series.

Encore Symposiums: Bar Harbor 2018

Encore, Bar Harbor 2018

Meeting Date: 2018

Meeting location:  Bar Harbor, ME

Meeting sponsor: Encore Symposiums

Strengths of the meeting: 

(reviewed by SP) The speakers were terrific. They were very engaging with their lectures and I learned a lot. The topics were very thought provoking even for CRNA’s who have been in the profession for over 20 years. The schedule was great as it allowed for so much time to explore the area which was magnificent. It was wonderful in so many ways and I will definitely attend future meetings with Encore!
(reviewed by AK) Since the meeting started at 7 am each morning it was much appreciated to have a full breakfast included.
Carrie Frederick’s lectures were by far the highlight of this conference. She is a fantastic speaker and it is clear that she is providing researches, up to date information.

Suggestions for improvement:

Sal Ciresi, is an experienced, nice guy and would be even more effective with fewer personal stories.

Value for the money:

(reviewed by SP)Great value! The meeting even included a welcome reception with outstanding food and a full breakfast each morning. I can’t say enough great things about this conference.

(reviewed by AK) Good overall value, I’ve attended several encore meetings, would like to see more new lectures added into
The mix.

Legend in Leadership: John C. Maxwell

By Thomas Davis CRNA, MAE, Lt. Col (ret)

Follow @procrnatom on twitter

 

“Leadership is not about titles, positions or flowcharts.

It is about one life influencing another.”

~John C. Maxwell

 

Maxwell

 

John C. Maxwell has bestowed a lasting gift to those in leadership positions throughout the world by his commitment to developing leaders at all levels of the chain of command.  Born in 1946, John Maxwell is the son of a minister who followed his father’s call to the cloth, earning a bachelor’s degree at Ohio Christian University and a master’s degree from Azusa Pacific University.  While working as a pastor, he found that his greatest gift to society lay in leading others to discover their true talents.

 

John and his brother Larry are the co-founders of EQUIP, a non-profit organization that is founded on the premise “We believe that every person is born with the potential to influence others.”  The organization is based on Christian values and has taught over 5 million people in 126 countries techniques to motivate and empower one another.  Maxwell’s style of leadership coaching is based connectedness and the development of interpersonal relationships which create a synergy and makes everyone a better person.

 

John’s success with his approach to leadership coaching has grown into a multi-million-dollar organization that offers books, articles, seminars, and keynote speaking to audiences worldwide.  With sales topping $18 million for copies of his 12 books and having written countless articles, John Maxwell has established himself as a legend in leadership development.

 

Reviewing the lifelong work of John Maxwell reveals that his highly successful approach to leadership is built upon five essential elements – Vision, Values, Relationships, Attitude and Communication.

 

Vision    “Great leaders always seem to embody two seemingly disparate qualities. They are both highly visionary and highly practical.” ~Maxwell.    Effective leaders can visualize what their workplace would look like if collaborative teamwork opened the door to peak performance. Leading a team starts with being able to see the end point and relentlessly working to get there.

 

Values    “The respect that leadership must have requires that one’s ethics be without question. A leader not only stays above the line between right and wrong, he stays well clear of the ‘gray areas.'” ~Maxwell.  Values provide an essential navigation tool for guiding a team.  Aligning personal and organizational values will establish the standard for behavior that is acceptable in the workplace and forms a basis for decision-making.

 

Relationships   “The bottom line in leadership isn’t how far we advance ourselves but how far we advance others.” ~Maxwell.  Productivity moves at the speed of relationships and in John’s own words, “interaction fuels action.”  Maxwell describes 5 levels of leadership and at level 2 the leader connects one on one with each team member.  Those who make the effort to connect with others open the door to two-way relationships that produce unexpected rewards.   “The rewards leaders give are counterbalanced by the results that their people give in return.” ~Maxwell

 

Attitude   “The leader’s Attitude is like a thermostat for the place she works. If her attitude is good, the atmosphere is pleasant, and the environment is easy to work in. But if her attitude is bad, the temperature is insufferable.” ~Maxwell.  Attitude is contagious and how you show up each day is quickly perceived and copied by members of your team.  Per John Maxwell, “people hear your words, but they feel your attitude.”  Be a leader and set the tone for your workgroup.  Leverage your position and exude the attitude that will elevate your team.

 

Communication   “If you really want to be an uncommon leader, you’re going to have to find a way to get much of your vision seen, implemented, and added to by others.” ~Maxwell.  The key to communication is delivering information in an open and transparent manner and then listening to feedback that it generates.  In his book, Everyone communicates, few connect, Maxwell reinforces the importance of listening to understand the other person as a way of broadening diversity of thought.  “As a leader, you will never get ahead until your people are behind you.” ~Maxwell

 

Now in his 70’s, Maxwell’s lifelong commitment to leadership development has earned him the status of being a legend in leadership.  His books, seminars and leadership coaching has directly touched the lives of millions of leaders and indirectly touched the lives of those they supervise.  In the words of John Maxwell, “leaders stretch with challenges, followers struggle with challenges and losers shrink from challenges.”  Follow Maxwell’s five essential elements for effective leadership and become a legend in your own workplace.

Tom is a noted author, speaker and mentor.  Contact tom@procrna.com for information about the 4-part values-based leadership webinar series.

The Listening Leader

The Listening Leader

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

follow@procrnatom on twitter

 

listening

 

Leaders who listen are positioned to build productive teams.  According to the Harvard Business Review analysis of employee engagement and productivity, employees are 31 percent more productive with 37 percent higher sales on average when they are happy or satisfied.  Building a happy, satisfied team of employees is multi-faceted and based on the worker’s perception of being valued and respected.  At the core of feeling valued and respected is the perception of being heard by leadership, that “my opinion matters.”  Ergo, effective leaders listen.

 

Writing in Inc.com magazine, author Samuel Edwards offers 6 tips for enhancing employee satisfaction.  At the top of the list is listening.  Edwards emphasizes the importance of listening when he says, “By listening to your employees, you show that you respect their opinions and truly value them as part of the organization.”  The same can be said of the importance of listening to your clients as evidenced by the 2013 report issued by CMS that indicated 6 in 10 patients stated that they were not listened to or respected.  Satisfaction is enhanced by Value and Respect.  Sound familiar?

 

In a recent Prosynex on-line webinar for CRNA leaders, we discussed listening as a powerful tool for leaders who are intent upon building a productive team and preferred workplace.  We had a stimulating dialogue regarding the levels of listening, after which, we reviewed techniques for improving listening skills.  Below is a summary of our discussion of the three articles covered in the webinar.

 

Team members seek the attention of the leader and want to share personal or professional thoughts with the expectation that they will be heard; but, if the leader’s mind is elsewhere, both people walk away empty.  In our first article from the Black Swan group, Derek Gaunt notes that there are 5 levels of listening:

Level 1   Listening for the gist   The listener’s mind is elsewhere while the person is talking.  The listener may nod and say, “ya, ya” as the person talks but very little is absorbed.  If the listener is texting or checking email while talking, the speaker is tuned out.

 

Level 2   Listening to rebut   The listener is actively preparing a reply as the person is talking.  The listener is more intent on defending his/her point of view than learning about the issues motivating the talker.  The listener learns nothing new and the talker walks away feeling invalidated.

 

Level 3   Listening to logic   The listener is aware of both the words that are being spoken as well as the logic driving them.  Without the need to be defensive or rebut the talker, the listener is able to learn new information and gain insight into the speaker’s point of view.

 

Level 4   Listening to emotion   The listener is aware that many issues emerging to the surface are triggered by emotion.  Moving beyond the logic of the points being made allows the listener to observe body language and voice inflection that may reveal any underlying emotions, such as fear or anxiety, at the core of the concern.

 

Level 5   Listening for the greater world view   The listener walks away with an awareness of the foundational values that the speaker.  During the conversation, the speaker may leave clues about whether he/she is liberal, conservative, religious, financially responsible and many other basic personality traits.

Our consensus during this part of the Prosynex discussion was that “most leaders tend to listen at levels 1 and 2.”  But, by semi-consciously tuning out, or consciously rebutting a speaker, the leader shows disrespect and misses a valuable opportunity to connect with team members.  Avoid assuming a defensive posture and move to the preferable next step of listening by attentively tuning in to the logic behind the other person’s words.  Effective listening is respectful and empowering for both parties.

 

We pursued this pithy discussion by reviewing 6 tips for becoming a more effective leader as suggested by author, Glen Llopis, in Forbes magazine.

  • Show that you care. Have a physical presence with your team and take an active interest in their concerns.  When people talk to you, give them your full attention and never allow yourself to be distracted with mobile devices while listening.
  • Engage yourself. While you are interacting with your team, ask members for their opinions.  Many people wait until they are asked before sharing.
  • Be empathetic. Problems affect people on a personal level and an emotional one.  Commonly, issues are either triggered by emotions or the issue triggers an emotion.  Either way, learning to sense the subtle non-verbal signs that accompany a person’s words will increase understanding and reinforce the perception of being heard.
  • Don’t judge others. One of the quickest ways to cut off dialogue is to tell the other person that he/she is wrong and why.  If you don’t have all the facts, pre-judging ensures that you won’t get them.  Listen attentively even if you think the other person is wrong.
  • Be expansively mindful. Put the other person’s words into the context of their environment, personal background and emotional state.  Imagine how you would look at a problem from the other person’s point of view.
  • Don’t interrupt others. Just like being judgmental, interrupting will shut the other person down.  You know what you know, and nothing new is learned by interrupting and stating your point of view.  Resist the urge to be the expert leader and be the expert listener and learner instead.

 

The giants in leadership agree:  Employee happiness and sense of self-worth affects their commitment to the job and ultimately, productivity.   It is no accident that effective listening will enhance scores in 6 of the 12 identified on the Gallup Q12 employee engagement survey.  Effective listening is at the core of effective leadership.  Show each member of your team that he/she is valued; be a listening leader.

 

Tom is a noted author, speaker and mentor.  Contact tom@procrna.com for information about the 4-part values-based leadership webinar series.

Kotter, for a change

By Thomas Davis, CRNA, MAE, Lt. Col. (ret.)

  Follow @procrnatom on Twitter

managing change

 

     “Change is the only constant in life.”  

– Herculitis, Greek philosopher (535 BC – 475 BC)

We know that change in the workplace is unavoidable and that it can sometimes be painful, making people cling tightly to the secure comfort of status quo.  Savvy leaders know that modifying and implementing new policies or guidelines is inevitable and to make the changes less difficult, they find ways to rally the team.

Writing in the Forbes.com blog, author, Larry Alton, agrees with the Greek philosopher and recommends addressing change head on.  Culture evolves based on relationships.  Therefore, to achieve a successful rollout of a new policy or plan, it is essential to build an energized team of individuals who can accept variation and take the lead during implementation.

John Kotter, professor emeritus at the Harvard Business School studied both the necessity for and the resistance to change.   In his book, Leading Change (1996), the Kotter 8-step model for managing change is presented as a thinking framework to smooth the process of making modifications in the workplace.  Repeatedly and successfully used in business, industry and healthcare, the Kotter model can be applied to just about anything that requires transformation.  Here is an example of how we used this dynamic, interactive model to improve the workflow at our ambulatory surgery center.

One of the myths that our ASC embraced is the belief that every female patient who is not post-menopausal must have a pregnancy test before receiving anesthesia.  Being a fast-paced GI center with rapid patient turnover, any delay caused by waiting for a urine specimen slowed the work flow and ultimately caused subsequent patients to experience delays.  Many of our patents have zero likelihood of being pregnant and the drugs we use pose no risk to the pregnant patient, therefore, many on our staff felt strongly that it was time to change the policy. A grassroots movement was emerged and we were well on the way to fulfilling the requirements of the first step on the Kotter model:

  • Create urgency Often when things don’t seem to be quiet right, the initial response is “somebody ought to change that” and the sentiment quickly progresses to “we gotta fix it.”  At our ASC, Doctors, CRNAs and nursing staff all complained about delaying cases while awaiting a pregnancy test.  The concerns of the staff were reinforced by negative feedback from patients when they were solicited to evaluate their experience at our center.  Specifically, evaluations from patients expressed dissatisfaction with the ASC due to the required pregnancy test.  ASC staff and managers sensed urgency to change the policy and we collectively agreed that we WILL address the issue head-on and take corrective action.
  • Form a powerful coalition There is strength in numbers.   When building a coalition to support a proposed change, it is important that all stakeholders are on board with the new plan.  Building a coalition involves gaining consensus among your peers who share your view point as well as from collateral professionals who look at the same problem from a different perspective.  Our coalition of stakeholders included doctors, nurses and support staff; all of whom were included in the development of the new policy to modify our current practice.  Patients were the ultimate stakeholders and, although we took their feedback seriously, we did not include them in revising the policy.
  • Create a vision Having identified the problem, we clearly knew what we didn’t want:  Unnecessary testing that slowed the workflow without adding value to the process.  We turned our attention to what we did want:  A policy that maintained patient safety, facilitated workflow and elevated patient satisfaction.  After a “best practice” review of the literature to ensure that we were on solid ground, our efforts were rewarded when the new plan was developed to support our goal.
  • Communicate the vision  Before implementation, the new plan was shared with every worker at the ASC through email and informal discussions.  The sense of urgency already in place from step 1 smoothed the process of sharing the plan with the entire group.  The ASC team quickly embraced the vision that would improve workflow and patient satisfaction.
  • Remove obstacles There were very few obstacles for our proposed change.  Knowing that involving stakeholders would increase buy-in, we reduced potential resistance by making sure that everybody was kept informed.   In addition, we made sure that everybody knew that our new policy was in line with safe practice.
  • Create short-term wins This was a change to a local policy and it did not have a big impact on the organization, so the sense of achievement was confined to our workgroup.  We gave recognition to those who were instrumental to developing the plan; however, the nature of the project did not warrant a major celebration.
  • Build on the change The Institute for Healthcare Improvement (IHI) recommends the plan, do, study, Act (PDSA) model for improving a plan.  The PDSA model involves implementing a pilot plan, evaluating the results, modifying the plan and re-implementing a better version which, hopefully, will produce even better results.  Our plan improved the overall workflow by eliminating mandated pregnancy testing and had the collateral effect of improving patient satisfaction.  Success with this project motivated us to look at other workflow issues and seek ways to make further improvements.
  • Anchor the change in corporate culture “That’s the way we’ve always done it,” does not mean that it’s still the best way, nor does it mean that we must to continue a non-productive practice.  Our new corporate culture includes the knowledge that grassroots initiatives are received in a positive light and that change can be initiated by any person in the organization.

Eliminating the need for every female to receive a pregnancy test before undergoing anesthesia is only one example of the use of the Kotter model for introducing and managing change.  What is the greatest need for revision in your organization?  Take time to pre-plan and practice the Kotter model when change is required.  Apply it chronologically, one step at a time.  It will be self-defeating to build a coalition before creating the sense of urgency or trying to implement a vision without first developing a plan.  Embrace transformation and proactively use Kotter’s model to reach your desired outcome.

Heraclitus observed that change is inevitable, but he did not say that change is a bad thing.  The great philosopher also said, “You could not step twice into the same rivers; for other waters are ever flowing onto you.” Today, one thing that has not changed over time is that the only constant is change.

Tom is a noted author, speaker and mentor.  Contact tom@procrna.com for information about the 4-part values-based leadership webinar series.

Mentoring; Connect for Winning Results

By Thomas Davis CRNA, MAE, Lt. Col. (ret)

Follow @procrnatom on twitter

 

Mentoring

“We make a living by what we get; we make a life by what we give.”

— Winston Churchill

For many healthcare workers, an ideal job includes working within an environment where individuals are valued, creative thinking is welcomed and professional development is enhanced.  Effective mentoring addresses those essentials and more.  This ongoing cultivation of relationships in the workplace connects less experienced workers who have a need and desire to expand their abilities with more experienced people who have knowledge and a willingness to share.   Mentoring offers an opportunity for two people to connect one-on-one in a relationship that promotes personal growth for both individuals.

According to Wikipedia, an engaged employee “…is fully absorbed and enthusiastic about his/her work.”  Mentoring enhances employee engagement which, in turn, increases productivity and job satisfaction.  In the still highly-regarded 1996 Gallup Q12 employee engagement survey, 6 of the 12 items on the survey could be improved by an effective mentoring program.  From both personal experience as a leader and a review of the small business literature, here are some of the advantages that arise from connecting people in a relationship designed to boost personal and work skills.

  • Promotes professional development
  • Connects mentee with someone who is interested in his/her advancement
  • Stimulates personal/professional growth
  • Creates a sense of accomplishment
  • Teaches self-discipline
  • Expands professional network of colleagues

The Journal of Applied Psychology (2004, Allen et al) published a report identifying additional tangible advantages that were gained by those who had a mentor in their workplace,

  • Greater overall career success
  • Increased compensation over the course of the career
  • More promotions than non-mentored peers
  • Higher job satisfaction
  • Greater loyalty to the organization.

Establishing a relationship that benefits both the mentee and the mentor requires preparation and commitment from both individuals.  Whether you are the well-informed advisor or the neophyte learner, these two components are essential for the partnership to work.

Start with self-assessment   Before entering a mentoring relation, take time for introspection and think about what you have to offer as a mentor, or what you need if you are the mentee.  Are you a good match for the other person?  How much time can you commit to the mentoring process?  Why do you want to be a mentor?  Mentoring demands sincere effort to connect with and elevate the other person; it is never a platform for self-promotion.

Establish expectations   Having common expectations aligns both people in the mentoring relationship and clarifies up front what each person has to offer and what can be expected from the other. Establish and agree on the amount of time and the level of preparation needed from each person before commencing the mentoring process.  To be effective, mentoring is more than casual conversation over a cup of coffee.

Make it personal    In addition to sharing information, take a personal interest in the other person and include things that are important to him/her as an individual.  A good mentoring relationship can produce a friend for life.

Be a thinking partner   All too often, the mentor assumes the role of an authority and eagerly tells the learner how to think and do the assigned task.  Avoid being an authoritarian task-master by assuming the role of thinking partner and use your experience to guide the learner to an “aha” moment.

Share your network  Those in a mentoring role often hold a more elevated position in the organization than the mentee, and/or have been with the organization for a greater length of time.  Introducing your mentee to those whom you trust for advice expands his/her network of connections and establishes resources for future projects.  Conversely, the mentee who is lower on the chain of command has a network of trusted colleagues at the grass-roots level.  Working with a mentee may give the mentor insight into frontline issues that have not yet made it upward through the power structure.

Mentoring is an opportunity to create a two-way relationship that validates the mentee and provides a sense of fulfillment to the mentor.  Having someone in the workplace who cares about you as a person as well as your individual professional development is a win-win in which both parties will grow by becoming more engaged, more creative and better informed .  If you are an experienced worker, share your knowledge willingly with those who will become the future leaders in your organization.  If you are new to the job, seek a mentor to help you learn about the company culture and provide guidance to ensure your future success.  Effective mentoring produces lasting connections and winning results.

 

Tom is a noted author, speaker and mentor.  Contact tom@procrna.com for information about the 4-part values-based leadership webinar series.

Legends in Leadership: W. Edwards Deming

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

Follow @procrnatom on twitter

Deming

Edwards Deming was an impactful thinker in transforming post WWII Japan into an industrial power that would challenge the rest of the world for a share of the international marketplace. Deming did not have a background in business or economics; rather, he was a statistician who knew how to gather and interpret information. Immediately after the war, the US government sent Deming with a group of advisors to assess the damage and to assist in the post-war rebuilding of the country.  When the Japanese business and manufacturing communities needed advice, Deming evaluated the numbers and shared what the statistics revealed.  Based on the willingness to take advice from Deming, the Toyota Corporation jumped to world prominence.  From the work of this America statistical thinker, the Toyota style of management emerged and has been adopted by many healthcare organizations throughout America.  Here are some lessons and suggestions for implementation from this month’s Legend in Leadership, W. Edwards Deming.

  • Have a purpose  Before you embark on a project, Deming advises taking time to identify what it is that you are trying to accomplish.   Most large organizations have a vision for the success that they are working to achieve.  Aligning your team with the vision provides a sense of direction to guide decision-making.  In addition, your team can create its own vision with the proviso that is in alignment with that of the organization.  Once established, constantly remind your team of their shared goal and when a project arises, develop a plan that moves your team and your organization toward achieving the vision.
  • Stop inspecting Inspection creates a focus on defects and shifts attention away from the goal of zero defects.  In healthcare, many safety initiatives spend too much time discussing the problem and not enough time discussing ways to create a new workflow that is free of glitches.  Rather than inspecting, spend the time looking forward with the intention of designing a system in which it is not possible to create a defect.
  • Eliminate complacency Whatever is done today may not be effective tomorrow.  Don’t bask in success; instead, remain aware that victory is temporary and motivate your team to constantly seek ways to improve the quality of the service that you provide.  With the desire to consistently make things better, you establish a dynamic environment wherein creativity is encouraged, and the team stays one step ahead of competition.
  • Promote staff development Foster education and self-improvement among your team to build knowledge, improve skills, and further engagement.   Mentoring provides a unique opportunity for both the mentor and the mentee as ideas are shared through two-way dialogue and the networks of each person are expanded.  Often, a coaching/authoritarian style is effective in mentoring relationships.
  • Be a leader Deming advises, “don’t supervise, be a leader.”  Connecting one on one with each person on your team satisfies the requirements for Maxwell’s level 2 leadership; however, going to the front and working shoulder to shoulder to increase team productivity earns respect and takes you to level 3 leadership.  Stop telling others what to do, be a working partner and show them the way.
  • Work collaboratively    At the heart of Deming’s teaching is collaborative work in an environment free from fear of fall-out.  Within the Toyota model, barriers between work teams are torn down and people talk directly to those with the information that they need rather than sending messages through established conduits.
  • Make quality job one  Coming full circle, the purpose of the organization must include delivering a product that is free from defects.  Quality must be at the front of each team member’s mind and the basis for creating a process that ensures safety, satisfaction and maximum outcome for each of our clients.  At each team meeting, openly discuss the reason the company exists, what it is trying to accomplish, and the role each person plays in achieving the goal.

 

Seventy-five years ago, W. Edward Deming disregarded the wisdom of Harvard Business School and recommended a plan for manufacturing that he knew was statistically correct.  At the heart of his plan was collaboration among workers and a focus on the desired outcome of delivering a defect-free product.   Follow his sage advice and adopt a motto that continues to survive the test of time:  We deliver healthcare defect-free.

Tom is a noted author, speaker, educator and clinician.   Join Tom the second Tuesday of each month on the Leadership journal club webinar

What’s in a brand name?

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

Follow @procrnatom on twitter

Branding

“Rebranding generates enthusiasm and brings attention to an existing operation

that may be taken for granted.”

The morning news grabbed my full attention with this announcement:  Dunkin donuts is doing away with donuts.  “What?” I screamed silently.  “No more Bavarian cream filling or toasted coconut crunch?  How could they do such a thing?”  The reporter went on to explain that the company (relax, everybody) will not stop making donuts but will be dropping the word “donuts” from the company name, logo and advertising.  The intent is to rebrand and give the company a fresh look while opening the door to promote a line of drinks that will compete with the Starbucks grip on the grounds. The purpose of the press release was to make me visualize Dunkin Donut coffee.  Rebranding works.

Dunkin’s announcement comes only a few months after the media blitz surrounding the rebranding of IHOP to IHOB – International House of Burgers.  The pancake giants “want the world to know that they also have a great menu for lunch and dinner.”  Even though it was a hoax, the announcement certainly got the public’s attention as people all over the country flocked to IHOP for an IHOPB.   Weight Watchers is in the less startling process of rebranding as they plan to rename themselves WW with an emphasis on wellness rather than strictly on weight loss.  Branding works and when a company wants to renew enthusiasm for their product, they regain attention by rebranding.

A recognized brand serves many purposes and collateral benefits within a crowded marketplace.

  • Recognition Established brands stand out and are known for the product they deliver.  When you pull off the highway and see McDonalds, Starbucks and Shell gas, you immediately know who they are and what they provide.  Branding promotes consistency thus removing doubt and uncertainty.
  • Credibility Attached to an established brand name is the appearance of expertise.  When I was at The Johns Hopkins, we treated a global patient population most of whom were attracted to the JH brand and the expectation of proven excellence tied to the name.  Branding expert, Lisa Cron, notes that good branding increases revenue because clients are willing to pay at a higher price and are more compliant with making payments.
  • Loyalty Branding promotes loyalty both from the customer base and from employees.  Established quality brands attract the top applicants who perform at a higher level.  Good people providing a quality product for a recognized company creates a loyal customer base.
  • Culture Brand identity promotes a company culture of excellence and collaboration.  Workers who feel pride in and loyalty to a known brand will develop a loyalty to the company and embrace the company culture initiated from the front office.  Branding lets both clients and employees know what the company stands for and forms a basis for acceptable behavior.

 

Brand your Workgroup

In healthcare, we are not BK or Mickey D’s; however, a recognizable brand identity for your healthcare team offers some of the same advantages as those in the business world, namely consistency, collaboration and a loyal customer base.   One simple suggestion to develop a team brand that yields big results is for your team adopt to a motto or tagline that represents your team’s shared values.  For example, the Cleveland Clinic has kept their name but updated the corporate motto to reflect their collective values; “We are all caregivers.” To create or update your healthcare team motto or tagline, bring the group together and review the organization’s mission, vision and values.  Discuss the purpose of your team, for example, I work in a busy GI clinic where we pride ourselves in the service we provide for patients, gastroenterologists and referring physicians.  Challenge your group to establish a motto that will both inform clients and remind one another of why the team exists.

Sample mottos and taglines

  • A personal relationship with medical excellence
  • Exceptional people, extraordinary care
  • Changing the way you receive healthcare
  • A passion for putting patients first
  • A Transforming, Healing Presence

 

Once your team has established its identity, treat it as your brand and use it to tell the public about the excellent service they will receive from your team.

Market your new brand

  • Posters Create and hang posters with your team motto in common areas where they can be viewed by both patients and staff.
  • Business cards Make business cards with your team motto on one side and a place on the other side for the care giver to write his/her name, freely giving cards to patients and their family members.
  • Buttons Make campaign style buttons with your team motto and encourage your team members to wear them prominently at team meetings, department parties, state meetings and healthcare fund raisers.
  • Messages/Memos Make a template on your signature block that includes your team motto ensuring that every message you send is a reminder of the purpose of your work.
  • Signs at work stations  Attach your motto to the base of every computer on your unit as an ongoing reminder to staff members.

 

Literature arising from today’s business community reinforces the importance of having a recognized brand to attract customers and standardize the product delivered by workers.   Whether branding for the first time or rebranding to renew interest, you can create advantages for your workgroup by developing a team motto and tagline, advertising it and then using it to promote team identity, collaboration and consistency.   Creating or recreating consumer familiarity takes time but soon enough your patients will become just as confident about the expectations of care that they will receive from your team as you are about the Pike’s Place with a shot you pick up on the way to the Hospital.  Brand your team for success, and in the meantime, I think I’ll pick up a Dunkin dozen…just in case.

 

Tom is a noted author, speaker, educator and clinician.   Join Tom the second Tuesday of each month on the Leadership journal club webinar.

Get the most from your professional meeting

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

  Follow @procrnatom on Twitter

prof meetings

Professional organizations of every description tend to favor autumn for gathering their respective flocks and commonly select popular locations for their meeting.  You survived the heat and the extra shifts that were required to cover your colleague’s summer vacations, now it’s your turn to enjoy a well-earned break by attending a national or state meeting of your profession.  Pre-planning for the Meeting Season positions you to learn more, make more contacts and get more enjoyment during your time away from home.

 

Organize

Prior to travel, spend your google time discovering venues that you will enjoy.  For some, activities such as hiking, biking or walking is appealing, whereas others may prefer dining, shopping or shows.  Every community is unique and history buffs, amateur archaeologists and bird-watchers may find something of interest if they look.  Whatever your pleasure, research what is available in the community and make reservations for the things that enhance your travel experience.

 

Well before the flight, confirm your hotel and reserve transportation for arrival at and departure from the destination airport, review the meeting agenda and download the meeting app if there is one.  During flight, spend your time reviewing information regarding the meeting and local community to ensure that you take full advantage of both.

Some attendees are sponsored by employers and must submit documents for reimbursement while others pay out of pocket and need documents to claim a tax deduction.  Either way, pre-planning allows you to submit documents seamlessly.  Here are some proven tips for organizing your travel:

  • Use your phone to organize information that you will want at hand while traveling. Upload flight information and boarding passes as well as the customer service phone number for the airline that you are using.  Use the note pad app to store the address and phone number of the hotel where you will be staying…it simplifies the process when you get in a cab.
  • Use your computer to set up a folder specifically for the meeting in your documents section. The folder can have sub-folders for travel, lodging and daily expenses and personal expenditure.  When you first book your flight and make hotel arrangements, put receipts in the folder.   At the hotel check-out, request an email receipt and when it arrives, save it in your meeting folder.  Excel has several pre-made templates for spreadsheets to collect travel expenses such as meals or Uber fare; download and use to simplify tracking reimbursable expenses.

 

Socialize   

Your professional meeting offers the gratification of renewing acquaintances with former classmates and coworkers along with the networking opportunity to meet national leaders and those who are recognized in education, innovation or leadership.  A meeting can also provide fertile ground for expanding your network of peers.  Socialize at gatherings and extend a hand to the people who have names that you know, opening your vision to connect with new people who may add depth to your network.

Members of many professional organizations have created user groups on social media. Meet those whom you connect with online by posting a time and place for the group to meet in person and interact with one another.

 

Customize

Hello and a hand shake is a social start, but the real value of networking is being able to connect in the future.  For starters, plan to exchange your contact information with those you meet by having business cards readily available.   To avoid losing the stash of newly acquired cards, create a business card photo album on your phone to capture and store information that will enable you to initiate future contact.  Once you’re back in your hotel room each day, take a picture of each business card you wish to keep and drop them in your card album.  Add yourself as a contact on your phone and then quickly exchange information by sending your contact information directly to those you meet.

 

Optimize   

Prior to the meeting assess your personal interests and educational needs, then peruse the agenda and make sure that you attend the sessions that are most beneficial to you.  When two sessions that capture your interest are held concurrently, enlist a friend to attend one talk while you attend the other and then compare notes later.  Look around and try to sit with new people who you have just added to your network.

Optimize the time you spend with vendors by first assessing your department’s greatest needs for equipment and seek out the vendors with the products that you need.  The larger the meeting, the more eager vendors are to introduce new equipment and the latest updates to existing devices.   Sign up for samples and demonstrations and if you make a must-have discovery, collect vendor contact information for follow-up after the meeting.

 

Summary

Whether your autumn plans include a national meeting, a state gathering or both, your return on investment will be enhanced with a little pre-planning.  Beyond earning continuing education credit, a live meeting provides a wealth of opportunities to connect and grow professionally, and to have a great time doing it.

 

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist. 

 Join the online Leadership Journal club the second Tuesday of each month.  Click here for information.

Pharm to Table: Direct Marketing Works

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

Follow @procrnatom on Twitter

 

“Tell your doctor to order Clearfast two hours before your surgery,” implored the radio messenger.  The audience listened raptly to claims that this potent preop drink, “… speeds recovery and promotes a better outcome for consumers…” than their less fortunate peers who suffer from the traditional 8-hour fast enforced by many anesthesia providers.   The narrator continued by telling listeners that downing the drink 2 hours before surgery would be calming, provide a feeling of being hydrated and nourished, reduce postoperative infection and promote a comfortable recovery.   I was shocked to hear a manufacturer bypass the collective wisdom of anesthesia providers and speak directly with future patients and encourage them to buy a product that would enhance recovery after surgery.  After all, isn’t it our job to do preop teaching?

 

As evidenced by the number of medications being marketed via TV, radio and social media, direct marketing works.  Pharmaceutical companies spend millions of dollars every year on direct marketing campaigns for one and only one reason; selling directly to the consumer works.  As healthcare providers, we must learn from the business community and use direct marketing techniques to promote our individual practice as well as the status of our profession.  Writing in Becker’s Hospital review, author Nick Ragone notes the importance of direct marketing and the use of technology to connect directly with future patients as well as the use of mobile devices to make access to care convenient, accessible and personalized.

 

Regardless of whether you are marketing your personal skills, your profession, or the organization where you currently work, Laura Dyrda (Becker’s ASC Review) offers suggestions for direct marketing your healthcare services.

  • Direct mailing  Snail mail may feel “so yesterday” but we still have postal service.  A colorful, thoughtfully formatted postcard will catch the eye and advertise your group.  A short newsletter outlining the ways in which consumers benefit from your services will attract a percentage of those in need.
  • Attractive and interactive web site  By necessity, direct marketing is a brief encounter with a potential client that may leave questions unanswered.  Marketing should link people to a web site that is visually appealing and functional in every area, Including quick links to frequently asked questions and an interactive area for questions and answers.
  • Social media It is not enough to have an award-winning web site; a presence on social media is needed to augment your direct marketing.   Link your web site to social media and increase the number of potential clients that you capture.
  • Write an article for a local rag or mag  Newspapers have a health column and trade magazines are always seeking human interest stories.  Put on your creative cap to assess the needs of your community and write an article to address local hot topics.
  • Send a monthly newsletter  Newsletters allow you to present your information in greater detail.  Always keep the newsletter relatively short and very interesting to build a cadre of readers who look forward the next installment. Newsletters can be delivered via regular mail or via email with a link to a blog page on a web site.
  • Conduct a local charity event Your group is placed in the spotlight and you can develop trust with the local community when you successfully sponsor an event to benefit a local charity.  Pick your cause, design an event to promote the charity and do the work to make it a success.  In my local area, CRNAs recently promoted our profession by sponsoring a blood drive.  Last year the group did a children’s book drive to benefit the pediatric area of the hospital.
  • Talk to civic groups Local groups such as Rotary, Lions, or VFW have monthly meetings and are always seeking local experts to enlighten the group on a variety of subjects.   Select a healthcare-related issue and give a talk to a local civic group.  When the group or an individual in attendance needs the services you provide, they will seek you.
  • Support community events  Many events in your local area can only happen with the assistance of people who volunteer their time to provide support.  Local running events need teams of people to man the water stations.  Health fairs need booths of eager healthcare workers to assist in health assessment.   Career day at the local high school is dependent upon local experts entice students to take an interest in their line of work.   All donations of time, energy or money help make it happen.
  • Hang signs in waiting rooms Working long hours behind closed doors limits visibility and the opportunity for others to truly appreciate the valuable services provided by skilled advanced practice professionals.  During CRNA week, rather than hanging signs in the lounge, hang them in patient waiting areas.  “Wanted” posters picturing the CRNA or a healthcare worker of the month and his/her outstanding contribution can be simultaneously consciousness-raising and amusing while marketing the profession.

 

Pharm to table marketing works.  When it’s implemented judiciously and in the right spirit, you are rewarded with a positive return on the resources invested.  In a connected and mobile society, patients are not geographically tied to a specific area or provider; they are free to shop for services and select the provider who best serves their needs.   Direct marketing has taught patients to request preoperative hydration as a means of improving outcome and direct marketing has the potential to build a population of patients who request Nurse Anesthesia to accompany their drink.

 

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist. 

Be an Awesome Boss

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

Follow @procrnatom on Twitter

 

 

The distinction of being a great boss is a recognition that you cannot give to yourself; however, members of your team are constantly observing your behavior, judging you through their eyes and are the ones to bestow the honor when appropriate.  Those whom you supervise may not be able to name your leadership style, but they know first hand how it affects them on a personal level.   When you connect with your team in a way that conveys respect and promotes the development of each member, they take note and respond in kind.  For example, the heartfelt accolades that my recent patient gave to her boss.

 

While waiting for an overbooked doctor to arrive and start a procedure, I passed the time talking with my stressed patient in hope that pleasant conversation would allay her anxiety.  She told me about her work at a restaurant and then mentioned that she worked for the most fantastic boss that she could imagine; “She is so amazing that I would do anything that she asked.”  “What makes her a great boss?” I asked.  Grateful for the distraction and eager to reply, the patient enthusiastically answered with details.  “She likes me as a person, wants me to do well, and she shows me a better way of doing things without criticizing me or complaining.  She listens to me and wants me to be the best I can be.”  Wow, under stress and on delay, my patient gave a great tribute to a person who is not only a boss but clearly changes the lives of people on her team.

 

The killer testimonial that my patient gave regarding her awesome boss mirrors the theme found in leadership/management books and journals.  In The 5 levels of Leadership, Maxwell (2011) states that level 1 leadership is conveyed with a title that identifies the individual as the boss but carries no clout beyond the title.  Level 2 leadership is dynamic and builds upon an essential connection between an engaged boss and willing workers.  In level 2 leadership, workers trust the inspiring leader and, therefore, they want to perform at a high level.  Maxwell reinforces the importance of one- on-one bonding between the leader and each team member by stating that at level two, “…people follow because they want to and not because they must.”  Being connected by having a sincere concern for personal and professional growth of team members creates a bond that elevates trust and loyalty.  My patient and her boss could be poster children for the maxim of Level 2 leadership; being mutually committed to one another works for them and it will produce a mindblowing transformation of your workplace when you follow their example.

 

Naturally outgoing people connect easily but where do people with a more reserved personality start?   The answer is simple; you start by making a commitment, learning simple techniques and then jumping in and gaining experience.  Building a viable link between yourself and your team requires spending time each day interacting with people and, validating them by practiced listening.   In an article, Did you know there are 5 levels of listening? author Derek Gaunt implores the reader to move beyond listening as a means to prepare a rebuttal to the other person; rather, train yourself to listen to understand both the meaning and the emotion behind what you hearing.

 

Make a commitment to do the following for 30 days and marvel at the response that you will receive from your team.

  • Have a positive presence. Make your team a priority and block space on your calendar to spend a minimum of 1 hour per day in casual interaction with your team.  A cheerful attitude and a sincere desire to learn about the personal and professional goals of everyone sends the message that you care about more than simply getting the job done.  Investing time in your awesome team delivers a persuasive message that each person is valued not only for their work but also for who they are as individuals.  As you gain a greater understanding about what motivates each team member, you are able to develop a valuable plan for professional development that will help each person meet his goals.
  • Learn to listen. In a hectic workplace it is easy to have your mind on other issues while listening to people and only get the gist rather than the full message that they are trying to deliver.  It is also common to feel as if you must defend the status quo and prepare a rebuttal while the other person is talking.  Effective listening requires that you leave your defensive position and focus on the other person, listen carefully, and actively seek more information.  Rather than digging in your heels, prepare a follow-on question that will encourage the person to disclose more details and increase your depth of understanding what they are saying; “Tell me more about…”, “What next?”, “What is your desired outcome?”, “If you were in charge, what would you do?” are all responses that show your interest and encourage the person to continue talking.

 

Like my patient’s boss, you can inspire productivity while transforming the lives of those you supervise by connecting, listening and empowering.  Transforming your leadership style and earning the “amazing boss” recognition described by my patient is neither a daunting task nor a natural talent.  It is a behavior that can be learned.  The process involves using the tested theory of spending time with your team and actively listening to their thoughts to learn what makes them tick.  Set Level 2 Leadership as a goal and start by committing to a 30-day journey to an empowered and collaborative workplace.

 

 

Maxwell, J.C. (2011). The 5 levels of leadership. New York, NY: Hachette Book Group. ISBN
978-1-59995-365-6

Gaunt, D.  (2018) https://blog.blackswanltd.com/the-edge/did-you-know-there-are-4-levels-of-listening

 

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist. 

Uncertainty; Survive and Thrive

 

By Thomas Davis, CRNA, MAE, Lt. Col (ret)

Follow @procrnatom on Twitter

 

“life is uncertain, eat dessert first”

Jim, the auto salesman, is dependent upon commission and never knows from month to month just how much money he will take home; Jim lives his life with worry about whether or not bills will be paid.  Fred, an OR nurse, works in a hospital where the number of surgical cases is dwindling, and he constantly worries about the dreaded lay-off.   Amanda, a Nurse Anesthetist, has just heard an unverified rumor that her group is in the process of being taken over by a larger anesthesia management company; Amanda fears that her pay and benefits will be reduced or that her job will be eliminated.  Francis is a parent and watches anxiously as her daughter leaves on her first date.

Living in world in which uncertainty is the norm causes many people to be distressed as evidenced by behavior that clearly driven by fear and anxiety.  In contrast to the safety and security that accompany stability, an aura of unpredictability arises from a situation in which the facts have yet to emerge.  Fear of the unknown results in subjective speculation that may leave some people feeling weak and vulnerable.  For those who worry about becoming victims, the mind quickly imagines doom and gloom scenarios that always end poorly; however, for others, uncertainty is linked to change offering an opportunity to alter of the status quo and thrive in the process.

Those who prosper and grow during times of uncertainty have learned to implement design thinking when faced with ambiguous situations.  Writing in Interaction Design foundation, authors Dam and Saing describe design thinking as. “…an iterative process in which we seek to understand the user, challenge assumptions, and redefine problems in an attempt to identify alternative strategies and solutions that might not be instantly apparent with our initial level of understanding.”  To implement design thinking, the individual must first investigate to uncover facts that are available rather than jumping to conclusions based on partial or faulty information, and then remain positive while visualizing a variety of potential outcomes.

Abandoning the natural tendency to link fear with uncertainty transforming to the development of a mindset that produces a better outcome is not difficult; however, it does require conscious effort.  In order to thrive while others are struggling to survive uncertainty, use the following habits to design a plan that works for you.

Control your Amygdala

The first step in flourishing during uncertain times is to quiet the emotional brain.  The amygdala is the area of the brain linked with fight, flight, or freeze and kicks in quickly during times of stress.  Once the amygdala is activated, stress hormones are released, and the emotional centers of your brain scream so loudly that the thinking brain is silenced (the amygdala hijack).  Be aware when you are stressed and rather than succumbing to a knee jerk, emotive response, challenge your thinking brain by assuming that the facts are not yet known and seek more information

Name your feelings

When apprehension produces anxiety, take a moment to explore your feelings and how they are connected to your stress.  Name the emotion you are feeling – fear, anger, genuine concern –  then ask yourself if the facts that are known justify your emotional response.  Determine other emotions that could be warranted if the initial information is not completely true and don’t forget to consider positive emotions such as joy, satisfaction or fulfillment.   By considering other emotions, you are also acknowledging that other outcomes may arise from the uncertainty.

Choose your response

After you’ve gathered information, acknowledged how you feel and identified a variety of outcomes that could emerge from the uncertainty at hand, use the facts, your personal goals and the available resources to develop a response that will promote your best interest.   When the outcome involves a group, make an effort to quiet the emotions of those around you and enlist them as allies in your plan to create the best possible outcome under existing circumstances.

Develop a contingency plan 

Despite your best effort, some situations really are as bad or worse than the rumors and it’s time for plan B.  which may involve moving on.  Developing a contingency plan has two advantages; it gives you a sense of being in control and it provides an alternative outcome.  Often, implementing a contingency plan and seeking employment elsewhere allows you to thrive in ways that were never possible in your current position.   Uncertainty can be a mixed blessing and force your hand in making a necessary decision.

Uncertainty is a certainty in one’s life both on and off the job.  We can never predict changes that will be thrown our way.  However, we can develop personal skills and design our own plan that will enable us to not only to survive, but to thrive.  Whether you are selling cars, putting patients to sleep or staying awake til your daughter gets home from her first date, take control and turn ambiguity to advantage.

 

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist. 

 Join a group of your healthcare colleagues in the on-line leadership journal club at 7:30 Central time the second Tuesday of each month.   Click here for more information.

Rejuvenate your team

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

 

My bicycle and I have been together for over a decade and many American and European miles have rolled under the wheels.   This professional grade aluminum specialized workhorse is my source of daily transportation to and from work as well as my weekend recreation partner and we know each other very well.  Over the past few months, the back wheel developed a wobble and the shifter lost its crispness; and finally, it would not shift into two of the gears.   Our relationship was becoming strained and my specialized Wunderkind needed to be rejuvenated.  A trip to the bike shop restored the function of my bicycle by replacing the shifter cables, giving it a good C&L (clean and lubricate) and mounting a newly trued back wheel, without the wobble.  Two resources – time and effort – infused life into the bike and now it works like new.

 

Many leaders have a long-standing personal relationship with their team similar to the one I have with my bike; however, like my bike the team may be losing its crispness and failing to function as it once did.  Investing a little time and effort to rejuvenate your team will restore your relationship, bring the wheels back into alignment, and improve the productivity of the group.

 

Writing in Psychology Today, author Robert Taibbi identifies three reasons that cause relationships to go stale over time; avoidance of conflict, work-centered relationships and work behavior that is based on routine.  The combination of the three factors creates a safe, secure and boring place to work where expectations are met however creativity and self-motivation are not rewarded.  Over time, workers resort to robotic performance of familiar tasks and lose the desire to excel; like my bike, the crispness is gone.

 

Shanking up the status quo and infusing energy into your team by re-defining your relationship with them starts with you.  As the leader, you create the environment and establish the energy level of the workplace.    Start your team renewal project by entering the workplace every day with pep in your step and a smile on your face and watch your team respond in kind by picking up the pace.  Once you have established a higher energy level, the stage is set for a team tune-up.   Continuing with his Psychology today article, Robert offers several suggestions for adding a spark to a relationship that is losing its luster.  Although the article is about marriage relationships, the concepts that he presents can be used to re-ignite your relationship everybody around you, including your team.

 

Talk about the obvious

A new leader joins a team, makes observations, and asks, “Why do we do it that way?”   In a few short months, the same leader looks at the same workflow and says, “That’s just the way we do it.”   The first step toward rejuvenation of your team involves looking at the current level of performance and once again asking, “why do we do it that way?”   Open a dialogue with your team and openly share your observations about areas where your team has become complacent.  In an upbeat and positive manner, solicit feedback about the team’s reaction to your observations and welcome each person discuss areas where they feel the team could be performing better.  Focus on team strengths and build a consensus regarding actions that the team will take in the future to address the areas where the status quo is not creating peak performance.

 

Find common interests

Being members of the same team creates a common interest however it does not inspire and motivate individuals to develop friendships or to increase collaboration in the workplace.   Encourage team members to find common interests beyond the job and develop friendships that transcend the 7-3 work shift.  Every member of your team, including you, are unique people and have personal stories to tell.  Plan social time into your work day and value the time team members spend in the break room learning about special interests of their team mates.  Plan a quarterly social hour and include a few events every year that include families and friends of the workers on your team.  As team members take a personal interest in one another, collaboration and creativity increase producing a win/win for both the employer and the employee.

 

 

Create a vision

Teams are the happiest and most productive when they are working toward a common goal and sense that they are making progress.  Take the time to create a vision and share it with your group.  Alter your workflow to enable the achievement of the goal and then be liberal with compliments and thank you’s to show appreciation.  A new vision shakes up the status quo and upsets the monotony of the daily work schedule.  Working toward a new vision is much more stimulating and rewarding than just showing up and working.

 

 

Make relationships a priority

The Gallup Q12 employee engagement survey documents the importance of relationships in the workplace as evidenced by questions 4, 5, 7, 8, and 11 all of which explore workers connection to their boss as well as their co-workers.   Leaders of the most highly engaged teams of workers have learned the importance of building relationships and exude the attitude that there are no unimportant jobs or people in the organization.  Get to know your team members one on one and learn things about them that make them tick on a personal level and inspire them to achieve greater goals.  The time you invest in relationships will pay huge dividends as your team experiences rejuvenation.

 

 

My bicycle was performing poorly which strained our relationship and detracted from the pleasure of my morning commute to work.  Time, effort and some money corrected the problem and restored our relationship.  If your team is not firing on all cylinders or not working at peak performance, it doesn’t mean that they need to be traded in for a new model; you don’t sell a car because it needs new tires and a battery, nor do you throw away a bicycle because cables are frayed.   Make a commitment to  rejuvenate your relationship with the team and guide them to emerge stronger than ever.  Identify areas for improvement, challenge your team to leverage common interests and transform your workplace into a welcoming environment where people feel as if they are valued.

 

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist. 

 

Fixer-Upper Leadership

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

Follow @procrnatom on Twitter

 

In the popular HGTV reality TV show Fixer upper, Chip and Joanna Gaines work with buyers to select a run-down and under-valued home and then using vision combined with hard work, turn it into a showplace. The Gaines walk the buyers through three potential homes, all in need of repair.   Typically, the buyers are openly disappointed with the current state of the property whereas Chip and Jo look at the same mess focusing on the potential beauty that it could become.  The remodeling experts ask the buyers about features that are most important to them and listen carefully to preferences that are stated during the walk-through.  The show progresses with the buyers selecting a property, establishing a budget, reiterate the items that are most important to them, and then turning the project over to the experts for remodeling.  Midway through the project, Jo meets with the buyers, updates them on the progress and ensures that everybody agrees with the final design.  The show ends with the amazed buyers walking through the newly remodeled home in disbelief that it could be the same property that they selected weeks earlier.

 

In the reality of the work world, some teams are run-down, underproductive and in need of a leader who will transform the current workplace into an employment showplace.  Like doing a fixer-upper on a home, transforming a low-achieving workplace into an environment where people want to spend the day involves listening, developing a shared vision, leveraging resources and motivating team members to work hard to implement change.  Be a fixer upper leader and create a workplace where employees are stimulated, motivated and want to spend their day.

 

Establish your goal

Your team must share your vision as well as your commitment to make things better.  Encourage your team to share your vision by openly discussing the status quo, including the things that currently drain team spirit from the group.  Ask them to describe their ideal workplace and the behavioral changes needed to move the ball in that direction.  As in the TV show, listen attentively to reveal the most important needs and make a list of behavior changes needed to improve the morale of the group.  Next, tune in to the group’s order of preference.  After identifying 1-3 items for immediate focus, develop a plan and hold team members accountable for its implementation.

 

Identify your resources

Once the Gaineses have a solid vision for repairing the property, they quickly assess the resources at hand and make plans to obtain additional supplies that are needed.   Likewise, take the lead in the remodeling of your team and how they interact with one another.  Ensure that it has the resources needed to make the desired changes.  You may need to modify work schedules, implement a streamlined method for communication or even place an absolute ban on gossip in order to get the job done.  Do everything within your control to activate the priorities identified by your team.

 

Demo day

Chip’s favorite day on any project is demo day.  Everything that is not necessary for structural integrity is ripped out and carted off to make room for reconfiguring the house and to allow for a make-over.   To make room for your new way of conducting business, old thoughts and habits will have to be “ripped out and carted off.”  During demo, be prepared to rid the construction site of behavior and of things that prevent the group from achieving their collective goal.  Ultimately, the leadership goal is to guide your team to the promised land while keeping it intact.

 

Rebuild

Once the old thoughts and habits have been removed, the vacant space is fertile ground for new and fresh ways to conduct business.  Keep your hands on the wheel and make sure that the void you created draws in feelings of collaboration and commitment.   Remind team members frequently about their consensus of creating a preferred workplace and encourage only positive thoughts and creative energy to exist among teammates while on the job.  Implement a spirit of accountability in which shared responsibility creates positive outcome.

 

Give frequent updates

Keep your team members in the game by meeting with them frequently and openly sharing the overall progress.  Discuss both the areas in which the team is doing well and areas that lack progress. Routinely review the original goals, tweak the plan, and motivate individuals by sharing your anticipation of success.  Toward the end of the HGTV show, excitement grows as the project nears completion.  The children deliver food in preparation of Joanna’s all-nighter to ensure that the property is perfect for the grand showing the next day.  Likewise, as your preferred workplace becomes a reality, be inclusive and harness the excitement of team members by having them participate in the planning of a celebration in honor of the changes that have been made.

 

Celebrate success

HGTV Fixer Upper ends each show with a segment where the finished project is presented to the buyer.   The new residents of the house high-five in near disbelief as they walk through a structure that only vaguely resembles the structure they selected to recreate.  As part of your leadership, celebrate with your team when attitudes and behaviors have changed and your workplace has been upgraded to become a magnet for fully engaged workers.  Carve out time for a team meeting complete with treats and high-fives for those on your team who most aggressively pushed colleagues to a new and better place.

 

By challenging your team to fixer upper restoration, you no longer need to lead a team that’s at at the low end of productivity.  Choose a reconstruction plan and get consensus, develop a strategy that’s inclusive and hold one another accountable for implementation.   You too can restore, repurpose and lead a team that delivers the best possible service to clients and the organization.

 

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist. 

8 apps for High Tech Leaders

By Thomas Davis, CRNA, MAE, Lt. Col (ret)

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Today’s hip leaders require instant access to information and real-time communication with the team members and chain of command.  Churning the high-tech world to move even faster, young workers have thrown the communication books from the shelves while no one on the team has even heard of mimeographed memos.  Quick-learning youth may have the advantage over older workers who have survived the techno transition, but workers of every generation have come to rely on technology and the advantages that it offers.

 

Tech is the way we conduct our business and live our lives; to do otherwise denies reality.  You cannot survive as a leader without google and email; however, g and e are not enough to propel you and your team to all-star status.  Creative software developers have fashioned hundreds of app-based programs to support management, enhance communication and promote collaborative teamwork.  You can shine a light on your leadership and your team by using mobile device-based applications to conduct daily business.  The learning curve is short and the return on investment is high.

 

Communication

Email and texting offer real-time exchange of information and are ingrained into our interactions with one another.  Using email and texting as communication tools enables geographic freedom, removing the requirement to assemble a group to receive announcements.  You can streamline the process of group communication by using apps specifically designed to organize user groups, instantly delivering messages to the right people in an encrypted format that ensures privacy and meets HIPAA standards.

The TigerConnect app is a cloud-based clinical communication and collaboration tool…that is HIPPA compliant.  Enabling real time messaging among members of user groups, the app is expressly designed to be used in healthcare settings. The developer claims that the use of TigerConnect leads to shorter hospital stays, increased patient satisfaction, reduced readmission rates and improved team collaboration.  You be the judge.

Whatsapp allows you to form user groups and share messages, documents and videos and to conduct group chats all in a format that bypasses SMS fees.  Using this app, you can connect with up to 256 people at once.

 

Efficiency

Day to day management of your team involves more than sending messages to disseminate information, and savvy leaders use technology to grease the process of dealing with daily chores.  Fortunately, cyber space has an abundance of programs to help you organize, remember and track vital information.

Google drive is available to every computer user with a google account.  You can store documents on google drive and make them available to your team.   By posting policies, procedures and work schedules on google drive, your team will have 24/7 access to anything you wish to share with them.

Inventory tracker is a handy app for those who have the job of ordering supplies and maintaining inventory levels.   You may be the one putting in the supply order or you may have delegated the task to a team member, either way, treat yourself and your team by using this app.

2do is a task organizer designed for mobile devices.  Just like the rest of us, you may still forget some task that “made the list.”  The 2do app is a safety net that allows you to use your phone to create a list of tasks, indicate the day that they are to be completed and set up reminders.

Clear todos is also a task organizer.  This app permits the creation of separate categories with each list having its own set of tasks.  Reminders can also be programmed on this app to jog your memory.

 

 

Team identity

Team identity provides your group with a sense of belonging to something important and a feeling of inclusion.  The internet provides a platform to unite your crew and a worldwide stage to showcase the talented people that you supervise.

Team websites are common, inexpensive and easy to create yourself.   Companies abound offering URLs, platforms and tutoring that enable people with basic computer skills to design and launch a website in one evening.  Click here for a link to a list of the top 10 website programs.

Youtube videos are another way to display your team in a positive way.   After opening an account with youtube, you will be able to submit video clips and then post the link on your team web site.  Instantly, members of your team have a visible presence in cyber-space and a platform to share their experiences with the public.

 

Our spinning, techno world offers possibilities that were not even imagined several decades ago.   Capitalize on the opportunities offered at this digital smorgasbord by selecting the apps that best serve the needs of team members.  Go all-in by implementing the technology that is expected by all of your workers, the young and the not-so-young, because no one is looking back.

 

If you’re feeling overwhelmed at figuring out how to meet the expectations of both your team and your employer, it’s useful to work with a leadership coach who has experienced challenges similar to yours. Feel free to contact me today to learn about the specifics of techniques to for developing a preferred workplace. Email me at tom@prosynex.com or click here to book your free introductory meeting.

 

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist. 

Surviving Mistakes

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

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All men make mistakes, but only wise men learn from their mistakes.

~Winston Churchill

Surviving mistakesMistakes, we all make them.  I have made them, so have you and so has everybody else.   Paul, the barista at Starbucks, makes an offensive tasting non-fat chai latte, dumps it down the drain, starts over and voila, problem solved.  Laurel, a candidate for congress, makes an offensive comment about immigrants, the media takes over and voila, her campaign spirals down the drain and drowns.  Minor mistake are no big deal, easily corrected, but major mistakes have launched world wars.  Most mistakes fall between the two extremes.  Leaders at all levels are faced with making daily decisions based on the available information as well as their personal bias related to the issue.    When the choice is spot on, high fives ensue, and the team celebrates success.  But if the option misses the mark, damage will result and damage control by the leader must begin.

Making an error in judgment doesn’t have to be a career breaker as evidenced by the ability of high profile people to recover from bad decisions.   The Ford Motor company launched a new line of cars and quickly the Edsel became the biggest flop in automotive history.  Later, Ford went on to launch the highly successful Mustang.  In 2012, Netflix CEO Reed Hastings perceived the trend for an increased demand for access to streaming videos and launched a plan to split the company into DVD and streaming divisions, each requiring membership and separate fees.  The public quickly rejected the new structure, balked at joining and caused the CEO to walk back the decision and remain with a single membership to include both DVD and streaming access to entertainment.

Although your goofs and gaffes may not get worldwide media attention, they can affect those around you both at work and at home, and as with high-profile leaders, if you can learn from your mistakes, you can recover.

 

Own it 

Looking good to your team and the chain of command is important and making a mistake can undermine your credibility as a leader; therefore, it is natural for you want the blame to fall elsewhere. Despite your desire to be blameless, others, review exactly what was said and done so they know who made the error, and if it’s your lapse, own it.  Denying your responsibility will further erode the respect of those familiar with the situation.  Put yourself back on the path to success by candidly recognizing your mistake and accepting responsibility.  As most politicians have discovered, projecting an attitude of, “I did it but it really wasn’t my fault,” does not garner respect or support from those around you.  “I made a mistake and it was my fault,” is a much better starting point when trying to recover from a bad decision.

 

Apologize

After owning it, the next step on the road to correcting the error is a sincere apology to those affected by your decision.  Choose your words wisely and focus on apologizing for your action rather than the way others reacted to the blunder.   Admit what was done was wrong and acknowledge the unintended consequences of the action, including any negative effect it had on the team.  People who apologize because others were offended instead of admitting personal fault, aren’t really accepting blame and will quickly lose both respect and support from those affected.

 

Correct the damage

Very few decisions are absolute and final.  In spite of the damage that has been done, with time, patience, and a good plan most damage can be repaired.   There are times when we kick ourselves and wish for a do-over because, in retrospect, a better decision was obvious.  In cases where the better decision was clear, walk it back, repair the damage and proceed with the correct choice.  In other cases where the answer is less obvious, involve the team in a group-think process to produce a better solution than your original choice.  If penalties are required, pay them and then move on/forward.

 

Learn from the experience

The harm caused by a bad decision creates an opportunity for personal growth that will position you as an expert who can help others who face similar challenges.   Damage control looks back on a situation and tries to fix something that has already taken place.  Instead, seek a type II solution that not only addresses your problem but also keeps others from making the same error.  Think of preemptive measures to update or change the current system and prevent a recurrence.  Again, involve the team in an open discussion, “What did we learn?” and, “How can we prevent this from happening again?”  Involving others in producing a permanent solution shows good faith in your desire to correct your judgment error and to learn from it.

 

Rebuild trust

Trust is foundational to a positive working relationship with your team.  You take the first step in re-building a trusting relationship by owning, apologizing and correcting the error.  The final, and by far the hardest part, is convincing your team or institution that you’re sincere and solid, all is well.

  1. DON’T compound the problem by making more mistakes.
  2. DON’T revisit the circumstances or the behavior that caused the mistake except as a reminder of what not to do or say.
  3. DON’T dwell on guilt and don’t allow yourself to feel shame or to be shamed. Get over it.
  4. DO use honesty and transparency when correcting the problem.
  5. DO encourage others to participate when selecting a new course of action.

 

Summary

Our world is composed of over seven billion people, each with independent thoughts and goals.   What may seem logical or obvious to you and support your personal point of view may be perceived very differently by others.  Leaders, followers and people in general all make mistakes in virtually every aspect of daily life and a few of those seven billion may occasionally take offense.   When it happens, and it will, face it head-on, focus on immediate resolution and continue a lifelong commitment to building trust.  And in your moments of reflection, always remember:  Your blooper is your problem; others’ reaction to it is theirs.

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist. 

Emotionally Intelligent Leadership

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

Follow @procrnatom on Twitter

Emotional intelligence is the ability of a person to be aware of and control his/her own emotions, to sense to the emotions of others and to handle interpersonal relationships in a manner that preserves the integrity of both parties.   Writing about emotional intelligence in Forbes.com, author Christine Comaford states that emotional intelligence accounts for 58% of your team’s performance regardless of the industry in which you work.  Clearly, the most effective leaders control their own emotions while boosting the self-esteem of those they supervise.  Conversely, leaders who lack emotional intelligence quickly undermine collaboration and demoralize individuals on the team.

A busy Gastroenterology center commonly schedules 12-18 cases per room per day and assigns patients an arrival time based on starting a new case every 20 minutes; productivity and efficiency are top priorities.  Today the outpatient endoscopy center has an irate patient in the waiting area; MaryJane arrived at the designated time and has been waiting 2 hours for her procedure to begin.  She demands to talk with George, the clinic manager and doesn’t hold back when unloading her anger about the excessive waiting time.  When the scheduled cases are completed, the stressed clinic manager assembles his workers to pass on the patient complaint and puts the blame on them for the delay stating, “If you were competent and knew your job, this would never happen.”  He went on to threaten the team with disciplinary action if things did not improve.  Having no control over the speed at which the physicians can complete a case, the chastised team members felt demoralized.

Leaders who lack emotional intelligence may alienate either an entire team or selected individuals through thoughtless comments.  In a similar event at the same center, a technician set up for the next scheduled case, however the patient brought into the room was out of sequence and was scheduled for a procedure that required special equipment.  The doctor entered the room at the same time as the patient, found the wrong equipment in place and became irate demanding that the technician be replaced by, “someone who knows what he is doing.”  The rejected technician left the room feeling completely devastated and defeated.

Your reaction to stress matters and affects the performance of your team.   Emotionally intelligent leaders can challenge a team to correct a problem and have the group walk away feeling empowered and committed to resolving the issue.   If the leader lacks emotional intelligence, teams feel demoralized and defeated when faced with similar challenges.  Here are some tips for infusing emotional intelligence into your leadership style:

 

Tune into yourself 

As the gatekeeper of your emotions, be aware of the moment the gate starts to open and react quickly.  If something is not quite right and causes a little twinge of anxiety, trust that something is driving your gut feeling and don’t dismiss the emotion that you perceive.

  • What to do: Take a moment to identify your sentiment and put a label on it; “I’m feeling nervous,” “I’m feeling defensive,” “I’m sensing that I’m being unfairly blamed,” or “my GERD is acting up.” Putting a label on what you feel requires you to shift from an emotional response to one that is intellectual and diminishes the likelihood of a knee-jerk reaction that will add fuel to a smoldering fire.

 

Slow your reaction 

The emotional area of the brain, called the amygdala, kicks in when you are stressed and triggers a fight, flight or freeze reaction.  Unfortunately, when the emotional brain takes charge, the thinking brain shuts down and you may respond in ways that you later regret.

  • What to do: Take control by pausing when you first perceive that your emotions are being challenged; take a deep breath, count to ten and ask yourself, “What is my desired outcome?” or “What do I want?”  Continue the intellectual activity by clarifying facts asking questions to gain insight into the other person’s point of view.  This process quickly quiets your emotions by stimulating problem solving areas of your brain and saves you the embarrassment of saying or doing something that will require an apology.

 

Assess and leverage your resources

Leaders of collaborative teams never need to face a problem alone.  When challenges emerge, take a moment to assess your resources and utilize those that will help you resolve the problem.  Two of your most powerful yet frequently overlooked assets are your team and your positive attitude.

  • What to do: Approach a stressful situation with confidence and avoid dictating a quick fix or assigning blame until facts are known. Explain your desired outcome to your team and solicit their ideas for resolution.  Use your emotional intelligence to be inclusive and harness the creative power of your team rather than shutting them down.

 

Focus on the desired outcome 

Focus on the desired outcome in a positive and proactive manner that looks beyond the immediate problem at hand.  A type I solution fixes your immediate problem whereas a type II solution ensures that the problem will not recur for you are anybody else on the team.  In the case of the GI center, the goal was more than appeasing today’s irate patient; the type II solution involved realistic scheduling that reflected the reality of the patient flow.

  • What to do: Create a group-think environment, assume that your team shares your goal and use emotional intelligence to validate and implement their creative ideas. Those who work on the front line have personal knowledge of problems as well as solutions.  Tap into your team’s fountain of knowledge

 

Take control of your emotions and gain a sensitivity for the feelings of those around you.  This does not mean that you should ignore problems for fear of hurting feelings; instead, address every problem in a forthright manner that preserves the emotional integrity of the person you are correcting.  George could have brought the team together to discuss the patient flow problem, gain a better understanding of causes and create a solution that offered a feasible chance for success.  Had he talked to the team, George would have learned that the average time per case was 32 minutes and scheduling a new case every 20 minutes was a receipt for failure.  The first step toward staying on the timeline was to develop a realistic schedule that allotted enough time for each case.   Rather than working harder or more efficiently, the solution rested in creating a schedule that reflected reality.  Similarly, had the doctor in the second example been sensitive to the fact that the technician had set up correctly for the scheduled patient, he would not have launched into a personal attack on a competent worker.

Emotionally intelligent leaders know and control their own feelings while tuning into and uplifting those around them.  Elevate the productivity of your team by being sensitive the emotions that drive behavior.

 

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist. 

Manage Workplace Stress

Embrace useful stress; eliminate the rest

 

By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

Follow @procrnatom on Twitter

 

“We all have to be willing to deal with a certain amount of discomfort in order to see what we’re truly capable of.”

~David Taylor, Proctor & Gamble CEO

Stress is inherent in both our professional and personal lives.  Some types of stress are motivating and empowering whereas others are destructive and incapacitating.  Both the type of stress that you face and the way in which you respond are the determinants of the outcome.  Literature from the American Psychological Association describes the three most common categories of stress and offers insight into stress management.  Gaining awareness of the type of stress that you face and formulating a plan to address it will put you on solid ground for reducing anxiety in your life.

Acute stress

James is 12 years old and is all-in for little league baseball.  His hitting has improved, and he has mastered the skills needed for him to be successful playing second base; the coach sees him as a player with strong skills and a good sense for the game.  Today, the usual catcher is out with an injury and the coach selects James to move to a new position, one that he has never played before.  James feels the pressure.

Susan is an experienced Nurse Anesthetist and is a go-to person when her peers have questions about managing difficult cases.  Today, there is an urgent add-on open heart case and because of her strong skills, Susan is assigned to step in and provide the anesthetic.  Susan has not been in the heart room since her student days 6 years ago and she feels anxious.

Both Susan and James are experiencing acute stress (AC).  As described by the APA, AC is the most common type, it is tied to demands that are imminent or in the immediate future, and it occurs frequently.   Often, situations that create acute stress pop up unexpectedly and catch you off guard, knocking you out of your normal routine and comfort zone.

Solution

  • Retrain your brain. Move away from the fear of failure and focus on the opportunity that you are being given to develop new skills.  Enjoy the satisfaction of knowing that others respect your skills and selected you to meet the challenge…be glad, not mad.
  • Focus on personal gain. Anticipate that stressful situations will emerge frequently and welcome them as opportunities for growth rather than threats to your status quo.  Visualize a successful outcome look forward to the skills and self-confidence that you will develop from the experience.
  • Ensure that support is in place. To reduce your personal anxiety, clarify the resources, material and personnel, that will be in place to ensure your success.

 

Episodic Stress

Adam is the manager of the busy admissions area of a mid-sized community hospital.  He awakens half-rested every morning and quickly shifts into high gear, gets his boys ready for day care, scrambles to deliver them and then arrives at work on time.  Adam knows the importance of the admissions process and feels personally responsible for what happens in his office as well as for the flow of patients through the hospital.  When asked, he says yes to every request and lives his life sprinting from task to task; any unexpected challenge pushes him over the edge.

The APA describes Adam’s situation as episodic stress (ES) characterized by living a life of chaos and crisis in a rushed environment in which, if anything can go wrong, it will.  He is highly likely to become irritable and short-tempered, neither of which enhances the productivity of the team.

Solution

  • Track your stressors. Those who experience ES typically have type-A personalities and live in such a constant state of anxiety that they lose track of the source.  Keep a journal of your causes of stress and gain insight into chronic sources.  When patterns emerge, use them to anticipate your personal vulnerability and position yourself to proactively fend off the distraction before it occurs.
  • Set boundaries. Victims of episodic stress often say “yes” even if “no” is more appropriate. Think ahead and plan a response for requests of your time that transcend reason or your capability.  Acknowledging the request, state that you are too busy to accommodate and then refer the requestor to a colleague who may be able to help.
  • Allow time for recovery. You can’t be everything to everybody all the time.  To sustain your fast-paced and often over-committed lifestyle, you must embed personal recovery time into your daily schedule and it must be as important as the other things on your list.  Set aside time to read, shoot some hoops, meditate or go for a jog.  During your recovery time, push out all work-related thoughts and embrace the joi d’ vivre.

 

Chronic Stress

Betsy is a nurse in a community hospital in the small town where she lives and it provides her only professional opportunity without commuting 50 minutes to a larger city.  She dreads going to work because of the disorganized and often disorderly way in which her unit is managed.  Her sarcastic supervisor borders on being a bully and does not offer positive feedback.  Betsy’s daughter is acting like a knows-more-than-mom teenager, and as the established as the insurance expert in the community, her husband does not have the luxury of moving to another location.  Betsy is trapped in a life that is not fulfilling and she suffers from chronic stress.

Chronic stress (CS)occurs when a person does not see a way out of an intolerable situation.  Over time, the person stops expecting to resolve the situation, becomes disengaged, and accepts living with a feeling of hopelessness.

Solution

  • Change what you can. Betsy can’t change her location or her boss; however, she can assess her skills and find new ways to utilize them.  She is a nurse and has locked herself into nursing.  By finding a new application for her organizational and interpersonal skills used in nursing, Betsy may be able to find other non-nursing work in the community that will leverage her personal strengths.
  • Develop new habits. When the status quo is no longer working, identify new behavior patterns that will produce better results.  Repeating the new behavior frequently will quickly convert the behavior into a new habit.  Betsy can change the way she responds to her daughter’s sarcasm and eliminate or reduce the level of tension created by the teen-aged moments at home.
  • Create a support network. People who suffer from chronic stress feel as if they are in it alone.  Develop new friendships by participating in new activities that will give you something to look forward to such as starting a book club or volunteering to walk dogs at the local shelter.  Taking charge is empowering.

 

Stress is ingrained in the fabric of the world in which we live; however, there are ways to effectively identify and manage how it affects us personally.  In some situations, stress should be welcomed as an opportunity for personal growth.  Other forms of stress are obstructive or destructive and can be controlled or eliminated by developing awareness and implementing solutions.

 

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist. 

 

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