AANA – Page 4 – ProCRNA

Hidden Jewels

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

Follow @procrnatom on Twitter

“I start with the premise that the function of leadership is to produce more leaders, not more followers.”

~Ralph Nader

Wouldn’t it be great if every person you hired already possessed 100% of the skills that are needed to be successful on your team? Perfect candidates do exist; however, searching for those hidden jewels is costly both in terms of time and money. A better option is to look within the existing team and develop their many concealed talents. Here are some reasons to make professional development a priority in your workplace.

Increased Performance. Your work environment is constantly changing as are the demands of the job. Delivering state of the art service requires ongoing education to keep up with advances in technology as well as the knowledge base. Just as your lawn mower blade needs sharpening every spring, peak performance of your staff is dependent upon constantly sharpening professional skills.
Increased engagement. In a preferred workplace there is someone who cares about your professional development. Ensuring that every person on your team has a plan to grow professionally infuses energy and loyalty while increasing engagement of the individual.
Increased retention. You can’t afford NOT to value professional development because it is linked to employee retention. Staff turnover carries an excessive cost both in money and morale. When expenses related to recruiting, hiring, credentialing and onboarding are considered, it may cost 1-2 times the annual salary to replace a licensed healthcare provider. In addition, team morale sags when a respected person departs, and the team is tasked with picking up the extra workload.

Discussing professional development with your employee at the annual performance review builds the expectation of opportunities for personal growth. Without follow-through, the discussion becomes a forum for hypotheticals and promises, and the disappointment that follows erodes morale. Professional development must be more than empty words at a once-a-year discussion; it must become a way of life that yields results for your team. Here are some ideas for infusing individual growth into your team members.

Professional meetings National and State meetings of professional groups are an excellent way to learn about innovative technology and to get updates on current research and best practice protocols. In addition, the gathering of professional peers creates a rich environment for networking. As the schedule permits, encourage your team members to attend.
Online meetings and courses Computer-based learning is an inexpensive alternative to attending meetings in person. Live, interactive webinars allow you to meet online with a group of peers, receive instruction and then have a live two-way discussion with the group. In contrast, pre-recorded webinars are accessible 24/7 but lack the opportunity for interaction. Many Universities offer coursed online that will lead to an advanced degree. For those geographically tied or too busy to travel, computer learning is a viable option. Be proactive and ensure that your team members can opt to use continuing education money to take advantage of online courses.
Mentoring Teaming up with an experienced person who has expertise in a specific area of interest is a practical way to expand skills. Whether your team member desires to update technical skills, practice public speaking, or improve professional writing, there is a qualified person in your organization who will help. Use your network of colleagues to find the right mentor for your team member.
Change jobs for a day A fun and straightforward way to add tools to a workbench is to spend a day working in a different area within the organization. Affirm your team members by helping them expand their professional network by facilitating a job swap for a day.
Professional social hour Set up a social hour for others who share your professional credentials and include people from other organizations. An informal gathering provides the opportunity to exchange information and increase your contacts. Continue by hosting other social events at intervals throughout the year.
Create an individual plan Don’t wait for your boss or your organization to put your future on a platter and serve it to you. Develop your own plan to increase your knowledge, skills and connectedness with others in your profession.

Increasing the skills and knowledge base of your team members is an expenditure of time and money, and a venture into professional development that will yield a high ROI. Professional development is economical and teaching new skills to existing team members pays for itself by providing an increase in productivity and savings from reduced staff turnover. Your organization includes many people with talents yet to be uncovered and cultivated. Among them is a hidden jewel who already exists on your team, ready and willing to be discovered.

Special thanks to my wife and editor, Liz Sanner Davis.

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

Build a preferred workplace. Join Tom and a group of healthcare leaders for the values-based leadership webinar. Click here for information.

Connection

Make the connection

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

follow @procrnatom on twitter

In 2013, the Centers for Medicare and Medicaid services released a scathing report stating that 6 in 10 patients felt that they were not respected or heard by their healthcare providers. Even though most patients reported having received competent medical care, the majority felt a disconnect between themselves and the healthcare system. Similarly, one characteristic of an undesirable workplace is that workers sense that their opinions do not count and feel separate from the chain of command. Whether you are a patient or a worker, feeling part of the whole is essential for a successful relationship. Here are some principles for connecting with others that can be useful in both your personal and professional life.

Ask questions. There is something exceptional about every person you meet, and you will seldom discover their hidden interests unless you ask questions. As healthcare providers, we are trained to ask about symptoms that will guide the treatment we offer; however, we are less skilled at discovering the individuality of the person presenting with the problem. By asking patients about both symptoms and concerns, we open the door to connecting with their personal life and the implications of how their disease will affect relationships in the family and at work. Showing equal interest in the person and the medical condition is the first step to forming a meaningful relationship that will validate your patient as a unique individual.

Be a great listener. Asking questions is meaningless unless you unless you are focused to hear the answer. When listening, hear the words and try to understand the emotional meaning. A patient may describe an ache or pain while the real concern is that he may not be able to continue in a job or recreational activity. After actively listening, restate the perceived anxiety by saying, “I sense that you are concerned about…” When people feel that you understand on an emotional level, a common bond forms that validates the person as an individual and gives them a sense that you care.

Develop a Starbucks mentality. In old movies based in small town America, a local enters the store and the storekeeper knows the person by name as well as the details of his family. The customer feels welcome to be there and the attendant has a “customer is right” mentality with a desire to satisfy the customer. At Bux they welcome you as you enter the door by saying, “Welcome to Starbucks, what can I get started for you?” At Sams they refer to customers as “guests.” It’s part of customer service training at Bux and Sam’s to connect immediately through a warm welcome. Though healthcare is far from being a country store, interacting with a friendly, down-home attitude creates a personal link with patient and employee alike.

Discover areas of commonality. Finding and discussing common interests with another person is a wonderful way to establish unity. As you ask questions and concentrate on answers, you will discover similarities with the other person. Acknowledging shared values and areas of interest exposes you as a real person beyond your position as a healthcare provider. Be careful NOT to one-up the person by making your experience more important than theirs.

Acknowledge anxiety. Patients seek healthcare either to address a specific concern or to maintain their current health. Both scenarios carry anxiety; those with a problem fear the implications and those who are currently healthy fear the discovery of an unknown health problem. Assume that all patients are anxious and listen with empathy. Let the person know you are willing and ready to discuss both their medical condition and their concern about the consequences.

Be a friend. In a professional relationship, you do not need to become a BFF but it is important that the person views you as being genuinely friendly with an honest interest in their wellbeing. Establish a specialized relationship by encouraging the individual to tell you something that interests them on a personal level. A favorite question that I often ask is, “Tell me something about yourself that is not on your medical record.” Suddenly, the person fees as if he is more than someone in need of medical treatment, he is a real human being with a life of his own. Make it a goal to know the patient well enough to introduce her to a co-worker without reference to the medical condition. “This is Mary and when she is not with us, she cares for her grandchildren and loves to tend her garden.” By asking my favorite question I learned that my 63-year-old female patient was a pool shark. Another former patient was top 10 in table tennis in the State of New York. Each person, whether patient or colleague is unique and interesting.

Regardless of your position in healthcare or elsewhere, connecting with clients and colleagues is the key to success. Unlike finding a cure for cancer – a monumental task requiring years of research and a huge investment of resources – the perception of patients not being respected, as identified by CMS, can be cured today by healthcare providers who are focused on connecting with everyone they encounter. In fact, connection IS the cure.

Special thanks to my wife and editor, Liz Sanner Davis.

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

Build a preferred workplace. Join Tom and a group of healthcare leaders for the values-based leadership webinar. Click here for information.

Receive in Kind

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

Follow @procrnatom on twitter

“No kind action ever stops with itself. One kind action leads to another…A single act of kindness throws out roots in all directions, and the roots spring up and make new trees.”

~ Amelia Earhart

Kindness can change the entire culture of your workplace. The essential elements of a preferred workplace, including civility, mutual respect, and collaboration, are interwoven with the thread of kindness. The same level of thoughtfulness in the delivery of care to patients increases patient satisfaction. Kindness is contagious in the interactions of cohesive workgroups and can be the difference between staff retention and resignation. Take your team to the next level by doing catching acts of kindness that will quickly spread throughout your workplace and increase the effectiveness of your group.

Acts of Kindness. I recently worked in a busy suite of operating rooms where anesthesia providers pushed patients on carts or hospital beds from the pre-op area to the OR and then again from the OR to the recovery area. Many carts had defective steering devices and hospital beds were always heavy. Staff would make room for the struggling patient pusher to pass, then stand back and watch. Two newly hired people who noticed the difficulty of transporting patients, started helping direct carts around corners and through doors and within two weeks several others joined the practice. Within two months, with the simple act of assisting instead of watching, the culture of the entire work area changed. Not only did people continue to help one another transport patients, they started aiding in other areas as well.

Several Jewish CRNA friends in the mid-Atlantic region always volunteer for call on Christmas and Easter to enable their Christian colleagues the opportunity to be with family.

A nurse manager in the Midwest always greets patients and their families in the hallway and provides directions when needed. Despite being confined to a wheelchair secondary to an auto accident, she holds the door for people of all ages and gender, not just seniors…and does it with a smile.

My CRNA friend Sal and his wife Carol travel to Honduras to work as anesthesia provider and nurse one week every year. Augustine is a CRNA and friend who solicits other CRNAs to join him on mission trips.

James, a Chief CRNA in the Midwest, takes his office manager and one staff CRNA to lunch quarterly to reward each for their work, and to build a bond between the office staff and the frontline providers.

Michelle arrives early each morning, sets up her room and then goes room to room asking her colleagues if they need help.

Another chief CRNA, who began this practice long before the advent of Facebook, emails a personal Happy Birthday well-wish to each of his staff, and copies the group.

Kindness is contagious. An article in the highly respected APA peer reviewed journal, Emotion, describes a study done in a workplace where employees were placed in 1 of 3 groups. Those in the first group were assigned to perform designated acts of kindness for specific people in group 2. The third group acted as the control group for the study, neither offering nor receiving acts of kindness. The study revealed that those on the receiving end in group 2 were more likely to react by offering kindness to others. In the spirit of pay it forward, the thoughtfulness of a few spread rapidly and changed the culture of the work environment.

Kindness elevates patient satisfaction. Kindness affects the overall experience of our patients and their families as reported by www.winnipegfreepress.com with feedback from a Canadian patient by the name of Z. Soloman. Ms. Soloman’s experience is exactly the one all healthcare wish to provide. “Kudos to Victoria General Hospital for recruiting and retaining staff who treat patients with (such) respect and kindness. I rate my stay as 10 out of 10.” Ms. Soloman’s experience elevated her satisfaction and raised the hospital’s scores.

Give gladly and receive in kind! You can be a catalyst in changing your healthcare workplace to a culture defined by kindness just by being more attentive to the needs of others. Pay it forward by offering assistance when appropriate, or challenge yourself to perform several unsolicited kindnesses daily and watch the culture change. It starts with you.

“The greatest work that kindness does to others is that it makes them kind themselves.” ~ Amelia Earhart

Special thanks to my wife and editor, Liz Sanner Davis for contributing to this article.

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

Join Tom and a group of leaders for the values-based leadership webinar. Click here for information.

Stop It!

Stop It!

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

Follow @procrnatom on Twitter

Al Franken to resign… New York times

Moore says it (abuse) didn’t happen… The Daily News

Matt Lauer…axed New York Post

Over the past few months the headlines in the news have been filled with stories of abuse of power related to sexual harassment in the workplace. Victims sense that now is the right time and the support structure is finally in place for them to step forward and tell their stories and be believed. Many high profile perpetrators have been held accountable and the culture of the workplace is starting to change.

Bullying is a less sensational form of harassment that plagues the American workplace and it can have equally devastating effects on workers. In some cases, the designated leader is the bully with a heavy hand that is used to micromanage, complete with stiff consequences for offenders. In other cases, the weak leader turns a blind eye while the dominant team member abuses co-workers. Regardless of who is doing the bullying, a culture where abuse exists is toxic and will ruin the morale and productivity of the entire group.

Every system is perfectly designed to produce the results it gets.

We think of a bully as the tough guy who controls the playground by punching the little guys in the nose. The same schoolyard abuse in the workplace is more expansive and includes any activity in which one person asserts his/her dominance in a manner that is harmful or demeaning to another person. With bullying, there is repeated, abusive behavior which usually involves threatening, humiliating or intimidating. Here are some examples.

Spreading rumors, gossip and innuendo
Making personal threats
Sabotaging work
Withholding necessary information
Removing responsibility without cause
Making pointed jokes about the person or their family
Belittling the person’s work or opinion
Constantly criticizing
Establishing impossible guidelines to ensure failure
Tampering with personal property
Direct verbal attacks or unverifiable accusations

In addition to creating potentially devastating psychological tension, the monetary cost of bullying can be immense. When bullying is allowed, productivity drops not only by the victim but for other team members who fear being the next victim of the bully. Now there are multiple victims, many of who will find another employer as soon as they are able, creating a staff shortage which in turn, requires the organization to spend time and money recruiting and training replacements. Equally costly is keeping an unfortunate victim in place who is not financially able to leave and continues to show up every day like a zombie with little productivity to show at the end of the day. As a master bully gains power, he/she will form a team of gangstas that taint the reputation of the workplace making it increasingly difficult to attract qualified applicants for the increasing number of openings. Without adequate personnel, per diem and locum employees must be hired at huge expense. Permitting a pervasively oppressive work culture is downright costly.

Behaviors that are repeated will become habits and habits define who we are.

The onset of bullying is often insidious and the first negative behaviors may be barely noticeable. However, aggression builds on aggression and as the bully gets away with demeaning behavior he/she will push the limits of civility until reigned in. The first and most crucial step for eliminating bullying is for the designated leader to establish a zero tolerance for any and all harassment in your workplace. Here are some ways to convert your environment into a bully-free zone.

Stop Enabling. Turning a blind eye or rationalizing that the bully is just having a dreadful day ensures that the problem not only continues, but grows. When bullying is present, do a quick self-assessment and determine ways in which you or others on the team have enabled the situation. Frequently, enabling takes the form of remaining silent and not getting involved. You don’t have to be a terminator to stop an intimidator. You just need the courage to address what everyone sees.
Commit to accountability. When bullying is seen or reported, it must be addressed ASAP. The need to dominate has an emotional component and bullying may be a manifestation of the person’s fear and insecurity. As soon as possible have a private discussion with the offender and focus on engaging the thinking brain rather than pouring kerosene on the already smoldering emotional brain. Review the observed/reported behavior with the person and make them think by asking the following questions:
1. What was your desired outcome?
2. How did your behavior advance your goal?
3. How did your behavior affect the team?
4. How else could you have approached the situation?
5. How does your behavior support our goal to be a workplace of choice?

The person may acknowledge the behavior and agree to stop it or he/she may deny it. Either way, he/she knows that you know and that you are expecting specific changes in behavior.

Build civility. Team meetings and retreats are perfect venues for discussing common values and generating enthusiasm for the development of a preferred workplace. Freely discuss the core values of the organization and guide a discussion that links them to collaborative teamwork. Openly call it what it is – abuse, intimidation, harassment, bullying – and challenge the team to adhere to zero tolerance for incivility of any sort.

As with other forms of abuse of power in the workplace, the time is right to stop bullying your fellow teammate. Just stop it! Heighten your awareness, confront offenders quickly and engage your team in building a community of collaboration. Civility is one key component of a preferred workplace. Demand civil behavior from yourself, your teammate and your leader because behavior that is repeated becomes a habit and habits define who you are.

Special thanks to Liz Sanner Davis for editing and collaboration.

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

Join Tom and a group of leaders for the values-based leadership webinar. Click here for information.

Step It Up

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

Follow @procrnatom on Twitter

Regardless of whether you call them resolutions or goals, many people start the new year seeking self-improvement in both their professional and personal lives. Leaders hope to find ways to do a better job guiding and motivating their team and team members hope for professional development that will earn them respect and recognition for their work.

“Hope rarely enters into it. ‘Tis action moves the world.”

From: The Winter Sea by Susanna Kearsley

Whether your official role be leader or team member, here are some ways to convert hope into action.

Ask I recently worked at a clinic where OR personnel wore a color-coded paper hat – blue for staff, red for vendors and pink for students. A popular anesthesiologist with 30 years of experience who commonly served as clinical coordinator frequently opted to wear a pink student’s hat. When I asked him why, he replied, “I am a student and learn every day.” His commitment to self-improvement was contagious, setting the stage for everyone to learn. When working with him, there were no dumb questions so the entire team was able to benefit from his commitment to sharing knowledge. As a part of your personal professional development plan, learn from everyone you encounter during the day and freely share your knowledge so that others can learn from you. You will be amazed at the things they know about their jobs and a free exchange of information enhances collaboration. Over the years, I have learned things by listening to my anesthesia colleagues, anesthesia techs, OR nurses, and from housekeeping. Create a pink-hat environment in which all are free to exchange information without the fear of being belittled for asking the wrong question.

Listen to understand In the high stress healthcare environment people don’t want to make mistakes or be blamed for an undesired outcome. When issues arise, it is easy to default into the it’s-not-my-fault mode and build a wall that stops communication. Open your mind by assuming the other person has a valid point and then listen carefully to understand his concern.

Tactical Empathy is the ability to share someone else’s feelings while executing a plan to achieve a goal. In his book Never Split the Difference: Negotiating as if your Life Depended on it, Author Chris Voss uses the term tactical empathy to describe a preferred approach to listening. According to Voss, listening is more inclusive that just hearing words; tactical empathy includes listening to the emotion behind the words. After attentively listening, state the emotion that you sense and allow the other person to agree or clarify. For example, say, “I sense that you value teamwork and have concerns about our team.” Then be quiet and let the person respond. It is likely that the person will validate the emotion that you sense and shift their concern/anger from the problem at hand to a discussion of the underlying problem. If you are wrong with your assessment, the person has your attention and can provide additional information. Another way to show tactical empathy is saying, “I sense that you have a deep commitment to patient safety and fear that someone will be injured.” As before, listen to the response and open the door for additional information. The key is to detect to the emotion that is driving the words, state the emotion, then listen. You will add depth to your understanding by having the person describe the desired behavior they would expect if things were going well. When done, you will have a new perspective on the issue and the person will feel as if his/her opinion was valued and understood.

Be positive We are social creatures and our attitudes affect those around us. Develop the habit of approaching issues from a positive point of view. Instead of reacting to a situation, be proactive and view a problem as something that is temporary and correctable. Keep the desired outcome in mind, identify resources, and tap into the collective wisdom of your team. A We Can Do It Together attitude quickly spreads throughout a team and stimulates creative solutions.

You’ve already stepped up to the plate by being a leader, now step up your game. The New Year is here and it’s a great time to convert good intentions and high hopes to tangible action by changing your status quo. In a recent interview, investment advisor, Tony Robbins, suggested, “Leaders anticipate; losers react.” It’s impossible to know the details of the challenges that will arise in the upcoming year, but one thing is sure, you can’t anticipate all of them, and being a lifetime learner, effective listener and optimistic problem solver will position you for success.

Tom is a noted anesthetist, leader, educator and speaker. Join Tom and a group of frontline healthcare leaders in the Values-based leadership webinar series.