team building – ProCRNA

Feel the Burn

By Thomas Davis, DNAP, MAE, CRNA

Follow @procrnatom on twitter

Last week a headline in the Linkedin daily update caught my eye; Millennials are experiencing job burnout at a high rate. My initial gut response was; “Really? You are too young and it’s too early in your career to be burned out.” When I stepped back and considered the topic, I realized that burnout is not tied to advanced age or a person’s position in the chain of command. “The physical or mental collapse caused by overwork or stress” is the full-blown Webster definition of burnout, and it can happen to anyone at any stage of his/her career, including millennials.

I recall talented athletes from my youth with parents who thought that with a little more effort, their kid would be wearing Olympic Gold. Even after Betsy upped her gymnastics practice to four times per week and Jason increased his swimming to two-a-days, neither made it to the Olympics. Both young people longed for high school graduation, not for the diploma, but for the termination of the unreasonable expectations for achievement. In short, what began as fun turned into a physical, mental obsession that took its toll and left both individuals flat, weary, and burned out.

Employee burnout is real, unrelated to age or years of experience and the affect can be devastating to both the employee and the employer.

Young workers are fresh out of college, excited to start a career and eager to pay off student debt. Most intend to pull their weight on the team and want to earn respect for ability and tenacity. What they find is a workplace that welcomes their enthusiasm by piling on the long hours, offering advancement by combining two jobs into one, and frequently offering inadequate support. Many young workers are running out of the energy that got them hired in the first place.

Burnout arises from unrealistic expectations and can happen when production pressure becomes excessive. Sometimes the burden is placed on the individual by the organization and other times the individual places unrealistic expectations on him/herself. Either way, as the burden becomes unbearable, the victim breaks internally and does one or both of two things: He/she pauses to refresh and/or moves on to a different job. Writers at Workplace Strategies for Mental Health identify the following as personal perceptions or actual causes of professionals becoming burnout victims.

Expecting too much of themselves
Never feeling that their work is good enough
Frequently feeling inadequate or incompetent
Feeling unappreciated for their work efforts
Working in a role that is not a good fit

Pushing employees beyond their mental or physical limit has consequences. In addition to fatigue, stress and anger/irritability, other health issues may develop. For the employee, high blood pressure, heart disease and type 2 diabetes are correlated with burnout as well as alcohol and substance abuse. Consequences for the employer include high employee turnover and the financial cost of filling vacant positions. Overall, there is a loss of productivity and a general deterioration of morale among the work group.

Extinguishing burnout is a shared responsibility and there are actions that both the worker and the leader can take to cool the embers.

What the worker can do

Ultimately, it’s up to you to monitor your stress level and make changes before falling victim and externally acting out at work or internally developing a physical illness. The Adult Health Department at the Mayo Clinic offers you these suggestions for assessment or prevention.

Evaluate your options both with your current job and finding a new employer.
Seek support from co-workers, friends, family or professional counselors.
Engage regularly in a relaxing activity such as yoga or meditation.
Exercise consistently to help you better deal with stress.
Value your sleep and let it restore your well-being.
Develop friendships with one or two colleagues at work.
Become mindful of your activity, energy, and feelings every moment.

Creating a culture of burnout is opposite of creating a culture of sustainable creativity…This mentality needs to be introduced as a leadership and performance-enhancing tool.

~Ariana Huffington

What the leader can do

There several behaviors that can be incorporated into your leadership style to take the fan off the flames and prevent the fire. Combined, all will elevate team morale, boost productivity and improve employee retention.

Provide clear expectations and ensure that they are understood by workers.
Make sure that expectations are reasonable and align with priorities.
Furnish necessary resources including the training required to meet expectations.
Enforce fairness in reasonable work hours including sending people home on time.
When overtime can’t be avoided, mandate that those who work extra hours are given time off to recoup.
Utilize mentoring and professional development to create a sense of personal value for the worker.
Strongly encourage breaks at work away from the workplace.
Encourage friendships and social support among the group.
Provide a sense of purpose by linking employee tasks to the greater mission of the organization.
Encourage physical activity by planning stretch breaks at work, encouraging gym memberships, and arranging group activities away from work.
Encourage employees to use rather than save their vacation time.
Know your team and adjust your leadership to a style that fosters collaboration.

Employee burnout is a very real equal-opportunity threat. Both the high school swimmer doing two a day workouts and an ICU nurse working 4 twelve-hour shifts per week (and being kept over at the end of the shift) can easily perceive that the work is never ending and whatever they do is not enough. Whether it’s a monster workload, a paucity of resources, or sense of being overwhelmed and isolated, burnout is a constant threat best addressed by frontline leaders who are directly linked to the team. Sometimes, the quick solution can be as simple as showing you care by providing resources and giving compliments where appropriate. The long-term remedy, however, must involve an emphasis on physical and mental well-being while instilling a sense of purpose and worth in each worker.

What was once thought to be the consequence of being in a job too long is now known as a threat to workers at any age or stage of their career. The cure for burnout starts with self-awareness within the employee and a commitment by leadership to create a climate where the workload is reasonable, resources are available, and employees gain a sense of self-worth from the work they accomplish. Look beyond the crisis of the day and treat workers today in a manner that leaves them fulfilled and wanting to return tomorrow.

Tom is a noted author, speaker, leadership developer and dedicated clinical anesthetist. Contact tom@prosynex.com to book a speaking engagement.

Visionary innovation

By Thomas Davis, DNAP, MAE, CRNA

Follow @procrnatom on twitter

Visionary leaders are hot commodity. How can you go wrong with a leader who can see into the future and position an organization to stay one step ahead of the competition?

In 1995, Jeff Bezos saw the potential of the internet marketplace and visualized a virtual bookstore that would be open 24/7 and could deliver reading material either in print or online with the click of a mouse. Naming the company after the famous South American river, Amazon books was established and rolled out from the founder’s garage in Seattle. The Bezos vision expanded via the kindle reader eventually developing into the shopping market that we know today as amazon.com.

The creator of Amazon was not lucky nor was he unique. There are other leaders in business and industry, including healthcare, who share the traits of a forward-thinking individual. In working to build a better future for the clients they serve and for themselves, the more successful leaders are able to strike a balance between creative thought and observable action. They listen keenly to clients and co-workers and use emotional intelligence to learn what people really want. They establish a desired end point, formulate a plan, and work relentlessly until the goal is achieved. They favor innovation, accept responsibility, and regard a setback as a learning experience. “…glad we don’t have to do that again.” In some cases, new technology must be created to address a need but at other times the leader with an eye to the future finds new applications for existing technology. Bezos did not invent the internet or the bookstore; however, he did foresee that readers would flock to the convenience of online access to any book in print with immediate delivery to a mobile device.

CRNA inventor

Diane Miller is a pediatric CRNA and inventor whose life was changed by her inner drive to develop a playful way to initiate general anesthesia for pediatric patients. Motivated by an experience inducing anesthesia on Zeke, a 4-year old “frequent flyer” with PTSD from previous anesthetic inductions, Diane felt compelled to develop a lighthearted induction technique. Rejecting the decades-old tradition of “cyclo-brutane” used on fighting children, Diane developed the Pedia device for induction of anesthesia. Widely accepted by young children, it resembles a balloon with a whistle and makes induction of anesthesia entertaining for the pediatric population. Pedia has been awarded a patent and has been cleared by the FDA. The Pedia device is a game changer for pediatric induction of anesthesia and I predict it will quickly become the standard for our industry.

Diane’s story and device are featured on the pedia web site

Point of care ultrasound

Ultrasound imaging can identify the gender of an unborn child, determine the size and shape of a tumor or locate nerves prior to placing regional anesthesia. However, the device comes in size extra-large and it frequently isn’t available where the patient is located. These handicaps opened the door for Dr. Jonathan Rothberg to introduce an ultrasound system that did not require transport of a cumbersome machine to the patient’s bedside. Rothberg selected a team with whom he shared his vision and together they worked tirelessly to create the butterfly point of care ultrasound device. The device uses a standard sized ultrasound probe with quartz crystals and, uniquely, connects to a smart phone, pad or other mobile device to display the image. The probe can be carried in a holder on the individual’s belt and literally anyone with a modern phone can keep a personal ultrasound system at their fingertips round the clock.

You don’t have to be an inventor to foresee uses for existing technology as evidenced by anesthesia leaders who have quickly adopted the butterfly system to enable immediate ultrasound images of their patients. In addition to the obvious use of facilitating nerve blocks, the system is being used to assess gastric volume, vascular access, ventricular movement, pulmonary fluids, bladder retention or other conditions where an image could alter the anesthetic plan. Those boarding the butterfly bandwagon appreciate the flexibility that comes with having immediate access to ultrasound images and forecast improved patient outcomes due to information gained by this creative device.

More information can be found on the butterfly web site.

Some think of visionaries as having a crystal ball while others picture the mad scientist busy inventing things in the workshop. Although there may be a touch of truth to each stereotype, the truth is that most visionaries are ordinary people visualizing extraordinary things in order to solve both ordinary and extraordinary problems. Their mantra is, “We can do better!” and their work ethic is indefatigable. Sometimes, a new product will emerge, and other times new uses will be found for existing technology. Jeff Bezos developed an online marketing system that has changed the world economy; Diane Miller developed a playful way to induce pediatric anesthesia, and Dr. Jonathan Rothberg put real time ultrasound imaging into the hands of every healthcare worker. Now it’s your turn. Use your visionary skills to discover resourceful ways for making the new technology a standard of care in the workplace. Identify a need, imagine the best possible outcome, develop steps to get there, communicate your plan and work relentlessly until your goal has been achieved. When the new standard has been set, you will join the ranks of visionary leaders.

Tom is a noted author, speaker, leadership developer and dedicated clinical anesthetist. Contact tom@prosynex.com to book a speaking engagement.

Micromanagement; A lens on leadership

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

“Train people well enough so they can leave, treat them well enough so they don’t want to” ~Richard Branson

Control is a funny thing. It’s necessary and can improve results when the boss wields it, but it is oppressive and demoralizing when you’re on the receiving end of the heavy-handed version. Keeping the boss informed as a project is tackled is one thing but having all the small parts directed is quite another. Unfortunately, many well-intended supervisors become over-zealous while attempting to produce exact results, crossing the line from coach and encourager to micromanager.

Micromanaging is the enemy of both collaborative empowerment and creative thinking and can have devastating effects on a team. Writing in Careeraddict.com, author, Chris Leitch lists the following as consequences of micromanagement.

Employees develop more health problems
Staff turnover is increased
Productivity is reduced
Personal relationships suffer
Job security is questioned
Progress is slowed
Teamwork is destroyed
Morale is lowered

Clearly, micromanaging blocks any attempt at creating a preferred workplace and must be avoided; yet Market Watch reports that over 50% of employees feel as if they are micromanaged. Keeping out of the micromanagement swamp starts with self-awareness and a sincere desire to release the creative energy in team members. Not sure whether you are a micromanager? Try the online self-evaluation offered by The Workzone.

Managing by “control patrol” is a sign of insecurity and often originates from fear; fear of losing control, fear of project failure and fear of not being viewed as the authority figure in charge of the team. To escape the fear, a leader must develop a keen sense of self-security that is clearly evidenced in the way he/she interacts with the team. Leaders who are secure in their position seek to gain stature through the empowerment of others. Author Goeffrey James offers the following insight for those who want to abandon the micromanaging style of leadership:

Rethink your role as a leader. Visualize yourself as a leader who is meant to guide and develop your team rather than a boss charged with controlling behavior. View your team members as the capable and competent people they are and individuals who desire is to meet your requests and serve the organization while developing their own personal skills.
Delegate projects. Assigning responsibilities to others eases the burden of leadership and sends an important message that you trust your team. When you delegate, make sure that the assignee understands the goal, the parameters within which he/she must work, and the timeline for completion. Agree on checkpoints that keep you in the loop then set the boss’s binoculars aside and trust that the team will come through on the project.
Ask how he/she plans to proceed. As the project or assignment takes off, remember that the goal is to go from point A to point B. Anticipate that someone else may solve the problem differently than you would, allow the individual to select the route and be okay with it. The intent is to bring the project to closure, not to dominate the process.
Establish reasonable check in via email. Check in must be appropriate for the complexity of the task and the experience of the person assigned to complete it. Requiring a person to check in more than necessary does not convey trust in the person’s capability and implies that you don’t trust your own decision to assign him/her the job. Limit yourself to checking in once a week by email so as not to intimidate the person you delegated for the project. Keep the tone cordial and collaborative.
Focus on developing others and giving them credit for their work. Micromanaging and empowering are polar opposites and mutually exclusive. The best and quickest way to change your reputation as a micromanager is to re-direct your attention to developing others. Be a thinking partner as well as a support system for team members who seek additional responsibility and have the desire to learn new skills.

Many people describe the “worst boss I ever had” as the controller who managed everything and everyone through a telescopic lens. If your team has trouble with high turnover, low morale or other consequences associated with micromanagers, consider the possibility that you may be one. Turn the lens on yourself, loosen your white-knuckle grip, embrace the concept that there is more than one way to achieve a goal and more than one person who can do it. Ironically, by releasing authoritative power, you strengthen personal power and emerge as the recognized leader of a loyal and productive team.

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist. Contact tom@prosynex.com to book a speaking engagement.

Find the right boss

By Tom Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

The blog-o-sphere is clouded with management and leadership articles about how to attract fabulous applicants, how to build an elite team and what it takes to retain the top performers. On the flipside, there is a paucity of information to guide workers who are searching for the right job with the best boss. Unfortunately, highly qualified workers are sometimes wooed into joining a team only to find that they have hitched their wagon to the wrong horse. The Balance Careers writer Susan Heathfield affirms the importance of finding the right boss, noting that that working for a poor boss is the most common reason given by a person who leaves a job. People don’t leave jobs, they leave bad leaders. In fact, having the right boss may be the single most important factor related to happiness and success in a position. When you hit the job market, be an informed shopper who avoids chasing pay and benefits. Focus your search on finding the right boss.

Chief Technical Officer at Dailymail online, Oleg Vishnepolsky writes, “Choose a boss, not a job. A boss that supports you, trusts you and believes in you will make a great difference in your career.” That sounds simple and would be if only you could go online and click “order” and “submit.” Ordering a boss from Amazon is not possible, yet, there are a few things that you can do as you apply and interview for your next job. Adopt the mindset that you are interviewing them just as they are interviewing you and take responsibility for your future.

Start your search by doing your homework and reading blogs regarding the common traits of a great boss. From the articles, make a list of traits that satisfy your own requirements. If your list parallels the essentials identified by others, it will include some of these items:

Communicates effectively with a pleasant personality
Has a vision
Makes decisions based on shared values
Sets expectations and provides resources
Provides timely feedback
Demonstrates honesty, transparency and respectfulness
Cares about each worker on a personal level
Values the perspective that each person adds to the group
Is focused on team development
Has your back, cuts you slack while maintaining standards
Is a working partner who provides mentoring and professional development
Makes the workplace enjoyable
Recognizes and rewards superior performance

The list is followed by the search. Stumbling on Happiness author Daniel Gilbert gives a comprehensive, evidence-based review of how people perceive and react to various situations. Based on solid research by behavior scientists, he concludes that one of the best indicators of whether you will like something are the reviews of others whom you trust. So, ask questions of someone who knows your next boss. Is the person happy at work, fulfilled by his/her job and would he/she recommend the job to a best friend? According to Gilbert, it is likely that your experience, good or bad, will parallel theirs.

After talking with people who know your next boss, your quest continues during the application/interview process. If you detect a heavy presence of red tape and bureaucracy as you apply, don’t expect it to be any different once you are on the job. Be certain to read the job description carefully, looking for key words related to teamwork, collaboration and professional development. Read the mission, vision and values of the organization and determine if they are reflected in the job description. If not, they are just words on a web site and are not part of the corporate culture.

At some point during the interview you will be asked whether you have questions and that is the opening that will allow you to learn about the leadership style of your next supervisor. Have a list of written, open-ended questions that will get your next boss talking about him/herself and your future colleagues. IMPORTANT: Word your questions in a manner that does not make the person defensive. Asking, “How do you…?” or, “Why do you…?” is personal and may generate a cautious answer. Instead, “Tell me about…,” or “How does the organization handle…?” gives a platform for the person to spill the beans without being put on the spot. NOTE: if someone other than your next boss does the interview, it is a red flag that you will have a supervisor who is isolated and does not connect with workers. Listen carefully as the person answers. Dialogue that is “I” oriented with the leader describing all the wonderful things that he/she has accomplished is a red flag. Empowering Leaders who elevate their workers and create preferred workplaces will respond in terms of “we” while crediting the team for accomplishments. It is a particularly good sign when your next boss names people on the team who played an important role in implementing a plan or achieving a goal. Here are a few questions to ask when you interview

Why is this position open? This is a question to ask “trusted others.” If it is due to expansion or retirement, that is fine and you will be told; however, if the void was created by people jumping ship, after you sign on, you will quickly learn why they left.
What is the greatest achievement of your team in the past year? This indicates whether the job is ho-hum, day to day routine or if there is a vision and shared goal. It also gives you one more opportunity to listen to the leader taking credit or giving it.
How does the organization handle staffing shortages? A supply of local per diem workers that cover vacations can be healthy; however, if a significant number of shifts are filled by expensive locums who were imported from other parts of the country, it indicates that the team is having difficulty hiring new members locally and leadership may be the reason.
What is your favorite part about leading this team? Listen and you will learn about the person’s basic leadership style. Is the focus on command and control or is it on empowerment and professional development?
A year from now I’m at my first annual performance review and I have had an exceptional year; describe it. Listen to the response and discern what is most important to your new boss. Some will emphasize compliance with policy and high production numbers. Others will talk about professional growth and the important contribution that you make to the team the organization. In the middle are those who describe managing the status quo. You know which to choose.

Some people go through an interview and get lucky, happening into an job in a supportive workplace; others roll the dice during the process, hopeful that the job works out but ready to move on if it doesn’t. A lot of preparation is required for both interviewer and candidate in the process of learning about each other. As part of the prep, acquiring the attitude that you are choosing your chief will position you to weed out poor bosses and sign on with a real leader who wants to hire and promote the best and is the best.

Tom is a noted author, enthusiastic speaker, committed leadership developer and superb clinical anesthetist. Contact tom@prosynex.com to book a speaking engagement.

Older workers strengthen the team

By Thomas Davis, CRNA, MAE, DNAP candidate

We respect our elders. There is wisdom that comes from experience, and I am not going to stop learning from wise counsel. ~Marcia Fudge

Our baby boomers are aging, our healthcare needs are increasing, and our shortage of nurses and other healthcare providers is expanding…an unhealthy situation. Concurrently, many highly qualified healthcare providers who have reached retirement age are not quite ready to throw in the towel. Keeping experienced, qualified people on the job adds depth and diversity to the team and reduces the shortfall of workers needed to meet the expanding demand for healthcare services.

Arlene Donovan, Forbes.com contributor, confirms that seasoned workers add value to a workgroup. “They possess years of experience, have industry knowledge and are committed collaborators.” In addition, many older workers have a calming and unifying attitude based on their ability to withstand the battle-scars of past achievement. Blending the wisdom and experience of older workers with the knowledge and enthusiasm of younger workers creates a diverse workgroup uniquely positioned to meet the challenges posed by the expanding patient population.

Efforts to broaden the age range and retention in the workforce must go beyond making all capable workers welcome to remain. It must include active recruiting to bring experienced people back into the workforce. Many who have recently retired are having second thoughts and would welcome an opportunity to rejoin a team, even if part time, but feel too old to apply for a job. Reaching out to mature workers opens the door for their return to the job.

Glassdoor.com, author, Jacqui Barrett-Poindexter, highlights several characteristics of mature workers that make them valuable team members.

Problem solving With decades of experience, veteran workers have overcome challenges and deadlines, have a network of connections in place, and know the most efficient way to bring a project to completion. Along with adding insight, in stressful situations they have a calming influence that that generates confidence.
Perspective Seasoned workers know that not every project is urgent and not every deadline is firm or realistic. By drawing on experience, they are able to discern the difference and when to focus on urgent tasks prior to addressing other issues.
Knowledge Older workers may not have the same knowledge base as younger workers who recently completed advanced degrees, but, as described in the March 24, 2019 procrna.com blog, there is a big difference between knowledge and wisdom, and both are important. Where older workers lack textbook knowledge, they win the prize for perceptive common sense.
Capacity to grow/learn. It is a myth that older workers are set in their way and resist change. To the contrary, older workers have spent a lifetime implementing change and know how to do it. Today’s workers who are in their 60s and 70s were the activists of the 1960s and 1970s who spearheaded the civil rights movement and attended Woodstock. The hair may be gray, but the spirit remains.
Mentoring. Older workers want to share their stories and ensure that those who follow in their footsteps have the benefit of their experience. Older workers tend to be willing mentors who are eager to leave a legacy through the work of the next generation.

Attracting older workers to apply for a position in your organization should not be a daunting task. It is a myth that the long-serving people who join, or rejoin, your group will try to steal your leadership position or demand a higher level of pay. Experience from the business community has revealed the opposite; older workers want to share their experience, but they do not want the responsibility of being the boss nor do they expect top dollar in the pay check. Whereas younger workers are attracted to pay/benefits, school districts and flexible hours, older workers are working because they want to and are attracted by things that make them feel valued. When recruiting older workers, appeal to the following:

Competitiveness Senior workers who wish to remain in the workforce have been the innovators of change throughout their careers and even though they are no longer leaders, their competitiveness remains. Their desire to achieve will lift the performance of the team.
Wisdom The transfer of knowledge into action requires the judgment, foresight and prudence that older workers have accumulated over the span of a career. Your elders know how to get the job done.
Place in life Mature workers are at a place in life where they are neither harried by the schedules of their children nor encumbered by leadership responsibilities. Appeal to their needs by offering flexible work schedules that allow them to travel, visit their children and grandchildren or pursue the other activities that keep them in shape for continuing to work.
Flexibility Appreciate and place value on the flexibility that older workers offer the collective welfare of the team as they fill schedule positions that are difficult for younger workers who are raising young children. You’ll find that the grandparents on your team who have been there, done that, will help out where others cannot.

Baby boomers ARE aging, and their health needs ARE changing; and, they bring balance to the ever-expanding need in health care. Engage with the gray-haired and tie-dyed who still want to work and you’ll rediscover what, sooner or later, you will experience…decades of wisdom based on experience, a wonderfully collaborative spirit, and the dedicated dependability of those who truly want to help build the bridge to a healthy situation.

Tom is a clinical anesthetist, noted author and requested speaker.

Boost your credibility

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter

Would you have faith in the information that you received from a person for whom you had little respect and trust? Even if you gave the person the benefit of doubt, you would be likely to view the information with skepticism and validate the report before fully it. That is because respect and trust go to the heart and soul of being believed. Whether you are starting to climb the professional ladder, or reaching down to assist others with their ascent, when you’re dealing with others, your personal credibility will either enhance or kill the results you achieve.

Business is conducted at the speed of relationships and credibility is the gatekeeper that will makes or breaks the deal. Forbes.com contributor, Victor Lipman, reinforces the notion that credibility puts spurs to the process of making a deal. For example, at one point, Warren Buffett’s company sought to make a 23 billion-dollar deal that normally would take months, or even years, for lawyers to complete. Based on the personal credibility established during previous deals between Mr. Buffett and his counterpart, both parties felt secure that the other was working honestly and in good faith. As a result, the monumental deal was completed in a few short months.

In the movie The legend of Bagger Vance, Rannulph Junuh, played by Matt Damon, is the local favorite locked head to head in competition with the two greatest golfers in the world. Having trailed for much of the match and now tied with the pros, Junnuh hits a ball into the rough. “He has a chance to win the match on the final hole but has the integrity to call a penalty on himself when his ball moves after he tries to remove a loose impediment.” (wikipedia). A young boy and eager fan implores him not obey the mandate, saying, “But nobody saw it move.” Junnuh replies, “I saw it.” Honesty and integrity provide credibility, and Rannulph Junnuh had both. Sometimes personal integrity leads to an immediate loss, but it always creates a long-term winner. You will have to watch for yourself to see who finally wins the match; however, the young golfer’s high ethical standards set a precedent that would build a foundation for honest dealing beyond the golf links.

Follow the example from Bagger Vance and build relationships like those of Mr. Buffett by focusing on behavior to boost your credibility. Incorporate the following behaviors into all your interactions and establish yourself as an honorable trusted person in all that you do.

Be honest. The call for honesty appears so often in self-help articles that it is almost a meaningless cliché; however, without honesty there can be no trust and without trust, there is no credibility. A retired used car salesman whom I’ll refer to as Pompous Patient, told me, “If a used car salesman told the truth, he would never sell a car.” Do you want to do any kind of business with a person who is a professional liar? In your leadership transactions, move beyond mostly honest and establish a goal of totally honest. Admit your mistakes and assess yourself a penalty when needed. Total honesty also involves refusing to turn a blind eye and proactively holding those around you responsible for following established standards.

Deliver results. It’s easy to volunteer and say yes when someone is needed to tackle a project; however, saying yes puts your integrity on the line. Credibility is established when the task comes to fruition in a timely manner and achieves the desired outcome. Protect your reliability by refraining from over-promising and treat all tasks, large or small, as opportunities to deliver results. When you agree to perform, keep your word and deliver.

Be transparent. Credible people have the courage to share information, both good and bad, to those who have a need to know. Trying to shield those around you from bad news is a losing proposition. When you’re the messenger of bad news, put it into context by discussing the reasons behind the decision. Eventually, people always learn the truth and if you have not been forthright, they will have good reason to doubt you in the future.

Be consistent. Human beings, including your colleagues, thrive on routine and are more relaxed and trusting when the behavior around them is predictable. By making certain that policies, procedures and rules are known by all and equitably applied, predictability is reinforced. When administering discipline is required, it must be appropriate for the offense and be meted out evenly to every offender.

Be principled. Situations change but guiding principles remain constant. What are the principles that you stand for and guide your deciaion-making? If you need your consciousness raised, go to jamesclear.com to review a list of values, select 5, and practice, practice, practice. Your credibility is enhanced when others observe that consistent, principled behavior is who you are and not just something you do.

Lead by example. Imagine yourself with impeccable credibility and then be the person you visualize. It’s easy to want or intend to be honest, trusted and credible, however intentions do not change reality. Personal credibility can only be present when people know your integrity not by what you say, but by what you do. Your behavior is being observed and will determine the reputation that you create for yourself.

Credibility is a visualized, rehearsed, observed, taught, role-modeled behavior that, lucky for leaders, can be learned. It is often said that we are who we are when no one else is watching. If you consistently set high standards for yourself no matter who’s in the audience, you will earn the reputation of a straight-shooter with whom people want to do business. You will garner respect and trust, the key components of credibility.

Tom is a noted author, speaker and team builder

Plan for success

By Thomas Davis, CRNA, MAE, DNAP candidate

Follow @procrnatom on twitter for leadership motivation.

“Without continual growth and progress, words such as improvement, achievement and success would have no meaning.”

~Benjamin Franklin

Keeping the workplace relevant involves updating goals, re-defining the workflow to provide better service to clients and staying ahead of competitors. Establishing new team goals that leverage new technology while reflecting social change, positions the organization to remain relevant in the foreseeable future. A positive spinoff of new team goals is the energy and enthusiasm that is injected into the team as the status quo is shaken when the group challenged with a new task. The time and effort spent assessing current priorities, anticipating future trends and establishing new goals will revitalize the team and paint them as the face of leadership in the organization.

Start with a comprehensive assessment. Review the team goals that were established a year ago and note which were achieved, discarded or ongoing. Goals that have been achieved deserve a high five and can be crossed off the list. Items that slipped off the radar screen and were not achieved deserve to be re-assessed. If they are no longer relevant, cross them off the list, however, if it’s a should do that lost momentum, move it back to the active list and create a plan to ensure completion. Ongoing goals merit a progress report and tweaking of the plan to ensure that the goal is achieved.

Develop a written list. Following your assessments, develop new goals for the upcoming year and put them in writing. A written list will organize your thoughts and give you something concrete to publish for others to review. Include all pertinent goals that remain from the prior year along with the modifications needed for successful achievement of the objective. Next, anticipate the new priorities needed to align your team with the greater goal of the organization and add them to your forecast. Following completion, prioritize and notate the items on your written list.

Clarify your goals. Teams suffer when a leader’s vision for the future is vague; people are most productive when they know exactly what is being requested of them, the resources that are available and the timeline for completion. Goals should be written in language that is specific, measurable and attainable and each should include a timeline with milestones to mark the team’s progress. Once the list has been presented to the team, each person should know exactly what is expected and their role in the plan.

A bonus for establishing and clarifying goals is the opportunity for mentoring. During the progression of self-reflection, the review of old goals and establishing new ones, invite one or two of the up-and-comers on your team to participate in the activity. Mentees benefit from being included in the discussion and learning the process of uniting a team with the greater goals of the organization. In addition, you will benefit from the insight provided by subordinates who view the workplace from the grassroots level.

After the goals have been established and clarified, organize a team meeting to present the new agenda positively, proactively and energetically. As described in Leader Reader 1, Authentic Lessons in Leadership, your leadership attitude during the roll-out sets the tone for the group and your enthusiasm creates an expectation for success. At the meeting, establish the importance for change, outline an overview of the plan, establish a timeline and identify key people to take charge of specific projects. A congenial team meeting that has been well-planned creates an atmosphere of shared responsibility wherein each person wants to contribute to the team’s success.

“Always plan ahead. It wasn’t raining when Noah built the ark.”

~ Richard Cushing, Catholic priest

Staying ahead of the times in the workplace can be challenging so take advantage of the changes that occur naturally with the passage of time. View social change as an invitation to renew and re-focus the priorities of your team. Like cleaning the closet and discarding old items to make room for the new, make an honest assessment of workplace priorities and remove the goals that have been completed or that no longer apply. Then boldly, confidently, and proudly introduce your team to the new priorities for the year. Your efforts will be rewarded as your team takes the lead and works with renewed energy to ensure that your clients and patients receive superlative service.

“Every minute you spend in planning saves 10 minutes in execution; this gives you a 1,000 percent return on energy!”

~Brian Tracy, author and motivational speaker

Tom is a noted author, speaker and team building coach.

Leader Reader 1, Authentic lessons in leadership is a practical guide that is loaded with tips for enhancing your leadership skills.

Legend in Leadership: John C. Maxwell

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

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“Leadership is not about titles, positions or flowcharts.

It is about one life influencing another.”

~John C. 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)

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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.

Step It Up

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

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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.

Be Thankful, It’s Healthy

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

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Thanksgiving is over but it shouldn’t be. A national day of reflection and giving gratitude is healthy for your mind and is also a great excuse to indulge in food, football and family. Likewise, in a preferred work environment, insightful leaders create a healthy environment for their team members by being grateful and thanking them publicly and privately on a regular basis.

Writing in his book The Upward Spiral, author and neuroscientist Alex Korb connects being grateful with brain activity that elevates your mood. The book goes on to offer tangible suggestions for alleviating depression. High on the list of mood elevators is the act of being grateful which triggers the release of dopamine in the hypothalamus and creates a sense of wellbeing. Even on a terrible day, the act of imagining things to be thankful for has the effect of elevating your mood.

Being grateful and giving thanks is as important in the workplace as it is in your personal life. During a chaotic and stressful, pressure-driven day on the frontline, stopping to reflect on the positive events of the day breaks the anxiety cycle and shifts attention from problems to achievements. In my book Leader Reader 1, Authentic Lessons in Leadership I recommend an end-of-day routine which includes reflecting on the activities of the day and giving thanks to those around you. The activity has the double benefit of increasing your sense of wellbeing and ensuring that your team feels validated and appreciated.

In a contribution to Forbes.com, career coach, Nancy Collamer, offers the following tips for giving thanks in the workplace:

Just say it. As you wind down the day, seek out people who have made a difference and give them a sincere thank you tailored to their contribution. Walking through the work area and shouting, “Thank you everybody!”Â has very little effect. Taking an individual aside and telling him/her “I really appreciate the work that you have done today.”Â, sends the message that you noticed and appreciated their effort.

Send an e-note. It’s not always possible to see everybody face to face at the end of the day to affirm their work. Sending a short email that thanks a worker for something specific that he/she has done is the next best thing to saying it in person.

Send a written card. This old-fashioned method of giving thanks takes time and effort but sends a powerful message that the person is recognized, appreciated and worth the energy required to send the card. Cards are appropriate when large projects have been completed or a person has sustained high performance over a prolonged period of time. To make the card even more effective, send it to the person’s home address.

Recognition, reward and a sense of being appreciated are all elements of a workplace of choice. Be grateful and give thanks to those around you to create a powerful double effect. First, you will receive the benefit of changes in your own brain that elevates your mood and gives you a sense of wellbeing. Second, you will reward those around you and take a step toward creating highly desirable workplace. An intended consequence of giving thanks is that it is contagious and those on your team will follow your example by thanking one another when they collaborate to complete a task.

Be thankful, it’s healthy.

Thomas Davis is a noted leader, educator and leadership coach.