HIERARCHY: My New Thoughts

 

Hierarchy, the word, has always been a bad word in my mind. The very definition goes against my grain. The hierarchical structures of businesses & government have always made me bristle; I’m sure those around me could see the steam emitting from my ears.

 

         Definition of hierarchy    

plural

hierarchies

1:  a division of angels

2a:  a ruling body of clergy organized into orders or ranks each subordinate to the one above it;

especially:  the bishops of a province or nation

 b:  church government by a hierarchy

3:  a body of persons in authority

4:  the classification of a group of people according to ability or to economic, social, or professional standing; also:  the group so classified

5:  a graded or ranked series a hierarchy of values

I can live with a “division of angels”, classification by “ability”, ranked values, & maybe professional standing (that one depends on circumstances); but, as a general ‘better than you’ idea because of economic or social standing, or formal education I take exception.

I recently heard information that caused me to rethink & compare hierarchy characteristics to leadership characteristics. In every situation, someone is going to be better at something than the rest of the group & that will change as the situation changes. Furthermore, I recently learned “there are some things in this world that can be done better by you than by anyone else”.

 

 

I firmly believe everyone is a leader. A leader in one situation, however, is not necessarily a leader in another situation. I suggest you examine your numerous roles. In which roles are you a hierarch, a leader, a student, or a follower. I have decided to look at hierarchy the same way I look at leadership even though I do not see them as synonymous; there are similarities that allow us to use similar criteria for examination. This means that there will be some hierarchs & hierarchies we need to question, those who do not concern themselves with the best interests of others; we need to be discerning & discriminating when deciding who to follow & who to accept as teachers.

 

photo courtesy of CWALLACE

 

Unless you are self-employed you will have a hierarchy at work. Sometimes we grow to resent or distrust one or more of the people in our work hierarchy; when this happens, it might be time to find a new workplace. Do not let yourself be poisoned by distrust or resentment. Know your values & live your values. However, it might also be a good idea to look within: be open-minded, nonjudgmental, & seek to understand. As always “do no harm”.

I never thought I would see hierarchy as anything other than negative. But, as I have said in the past, the more we learn the more aware we become of how little we know. Hierarchy, on my terms, isn’t so bad.

 

 

 

 

 

BREATHE!

from Creative Commons

 

We all do it. We rarely think about it. Most of us do it pretty much the same. There are

differences though – through the nose, through the mouth, quietly, noisily, using the

chest, using the abdominals, fast, slow, deep, shallow. Nurses and doctors listen to your

chest to hear the sound of your breath in your lungs. There are a lot of different sounds

there; crackles, wheezes, sometimes it even sounds like a washing machine, and

sometimes there isn’t much sound or even none at all.  Are you doing it right? Are you

getting the most bang for your buck from your breathing?

chest to hear the sound of your breath in your lungs. There are a lot of different sounds

there; crackles, wheezes, sometimes it even sounds like a washing machine, and

sometimes there isn’t much sound or even none at all.  Are you doing it right? Are you

getting the most bang for your buck from your breathing?

there; crackles, wheezes, sometimes it even sounds like a washing machine, and

sometimes there isn’t much sound or even none at all.  Are you doing it right? Are you

getting the most bang for your buck from your breathing?

sometimes there isn’t much sound or even none at all.  Are you doing it right? Are you

getting the most bang for your buck from your breathing?

 

Teaching us to breathe is a waste of time:

we all do it all the time.

 

But, is it really a waste of time? What happens to you if you don’t breathe properly?

Why is breathing important? We need to get oxygen into our bodies and carbon dioxide

out of our bodies to keep us alive. Our cells need oxygen.

 

How to Breathe Properly

The above link has some interesting information.

Below are the differences between proper and improper breathing

Proper vs. Improper Breathing

Proper Breathing

Effects pretty much every part of the

body. It oxygenates the body, revitalizing

organs, cells, and tissues.

Improper Breathing

Can cause problems for many systems in

the body, including the immune,

circulatory, endocrine, and nervous

systems.

Fuels energy production Mental fog
Improves focus and concentration Dizziness
Eliminates toxins Numbness
Strengthens the immune system Anxiety
Improves bowel function Chest pain
Reduces stress, tension, and anxiety Digestive problems
Increases feelings of calmness and

relaxation

Irritable bowel
Can lower blood pressure Neck and shoulder pain
Increases metabolism, aiding in digestion

and weight loss

(Karen Lee Richards. http://www.healthcentral.com/chronic-pain/coping-162182-5.html)

 

Courtesy of Curtis Wallace

 

I regularly use breathing to give me a boost when I am starting to droop in the afternoon

or early evening. At other times, I use breathing to relax and lower my heart rate. I also

encourage my life-coaching clients to breathe properly. Breathing deeply so that your

abdomen expands is one good way to ensure you are getting oxygen to the lower lobes of

your lungs; they are sometimes a bit short-changed. Give some different breathing

techniques a try.

 

Click on the link below and try the breathing exercises.

Three Breathing Exercises from Dr. Weil

 

from Creative Commons

 

 

 

 

 

What if…

What if you could have anything you wanted just by thinking about it?

 

What would your thoughts be? Would you think about money, a big house, not having to work, meeting your dream person?

What thoughts are in your mind now? This house is a mess. I’m out of shape. I’m too fat. I don’t have enough money. I’ll never get a job. I can’t pass the test.

How do you talk to & treat yourself? Often, we are not very kind to ourselves “I’m such an idiot. I always make such a mess. I’m not smart enough. I’m too slow (old, fat, dumb).” We would never speak like that to anyone else. So, why do we talk to ourselves that way?  We tell others to take it easy. “You better stay home from work, you are sick”. But, do we do it ourselves “I can’t stay home, I have too much to do.” “I have to cook a big meal every night: my family expects it.”

What do you expect of yourself & of others? I have high expectations of myself. I also have fairly high expectations of others. “Yes, I am often disappointed because my expectations are not met.” Sometimes I don’t share my expectations of others with them; they should know what is expected.

Why am I asking all of these questions?

Well, what if…

  • you were grateful for what you do have?

Appreciation & being grateful put a person into a more positive frame of mind. The negatives are pushed away. You feel happier when you think of good things.

  • you started to have positive self-thoughts?

I can have anything I want. I am beautiful. I deserve love & acceptance. I am doing my best. Tomorrow, I will do better than I did today. Praise yourself for your accomplishments: I did well on that test or project; I ate healthy foods today; I increased my daily steps from 5,000 to 7,500.

  • you talked to yourself & treated yourself at least as good as you expect others to treat you, or as you treat others?

Stop saying negative things to yourself. Ask for help. Could your family help you with dinner? Maybe family members could take turns preparing dinner? One night a week, dinner could be something easy to prepare or prepared. Or, maybe you could order in one night a week? Stay home from work when you are ill.

  • you lowered, or at least made, your expectations more reasonable?

We are often harder on ourselves than on others. Make sure your self-expectations are reasonable & doable. Don’t expect more of yourself than you would of others. Be as tolerant of yourself as you are of others if expectations are not met; so long as the best has been done.

I guess it isn’t good to not share expectations: after all, how can I expect anyone to meet my expectations if they do not know what those expectations are?

What if you were kinder to you? You just might be on the road to being happier & more satisfied. Consider giving these suggestions a try; you just might fly.

Choose the Law of Attraction: Think Positive

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Choices, choices, choices: there are so many choices we have to make.  Have you ever come home from work & you decide to go out for dinner with your partner?  Your partner asks “Where do you want to go?”  You think for five seconds & say “I can’t make another choice today; it is just too hard.  You choose.”    So often we hear people, especially on TV say “I had no choice?”  Well guess what “We always have a choice”.  Sometimes our options are pretty bad (think about any election, not just the most recent); but, nonetheless we choose.  Not choosing is making a choice; something to remember.  The apathy of choosing to go along with what others decide will still produce consequences for you.

Choice is a huge topic; I’m going to focus solely on the choices we make for ourselves.  An overarching choice we all have, that affects all our other choices, is the choice to think positive or negative.

What thoughts are flowing through your mind right now?

Close your eyes for just one minute: what thoughts did you have?

  • Why am I sitting with my eyes closed when I have so much work to do?
  • I need to make a dentist appointment.
  • I wonder how the kids are really doing in school?
  • Is my boss happy with my work?
  • I need to wash the floor.

Are your thoughts generally positive or negative?  Think hard on that one?  How often do you get frustrated or angry when driving, shopping, interacting with your spouse or children, thinking about work, thinking about your weight?  How often are you happy or excited when you think about your spouse or children, your work, your weight, going for a walk, spring, spending time outdoors, your pet(s), or a vacation?  Whatever your answers; the choice is yours.

 

 “I strongly believe in the law of attraction.

When I am in a positive mood, I attract positive situations;

vice versa, when I am in a bad mood, more negative things seem to happen”.

Dr. Mario Lehenbauer-Baum

 

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You might not believe in The Law of Attraction; & that is okay.  Sitting & thinking (dreaming) about what I want hasn’t gotten me anywhere; I was taught that hard work is the way to success.  However, I see lots of people working very hard & not getting ahead, not achieving their dreams.  I was very scared when I quit my job as a salesclerk to go back to school to become a nurse.  I had two small children to support & I hadn’t been the best student in high school. But, despite only having a grade 11 education, I made the choice.  I decided I would succeed.  But, I also knew I couldn’t do it alone.   I asked for help from the people I knew loved & supported me, including my ex-husband.  They all assisted me & helped me through my two years of school.  I am very grateful to have had such support.  Though I didn’t know it at the time, I now recognize the choices I made empowered The Law of Attraction & how my positive thoughts helped me to succeed.  I had to work very hard, & sometimes I wasn’t thinking positive; sometimes I cried because it was so hard & I didn’t know if I could make it – but, I pushed those thoughts aside.  I am so glad I did.

Dr. Mario Lehenbauer-Baum stated “I strongly believe in the law of attraction. When I am in a positive mood, I attract positive situations; vice versa, when I am in a bad mood, more negative things seem to happen”.  He goes on to say that circumstances don’t change immediately.  Our now experiences are a result of thoughts & actions taken over the last several years.  I encourage you to follow the link above & read more about The Law of Attraction.

 

like attracts like

 

Think Positive!  Have a positive outlook?  For me that is something like taking a placebo – I don’t care the placebo isn’t a real drug, so long as it works & makes me feel better.  If thinking positive can fool my brain & make me feel good; then I am going to think positive as much as I possibly can.  What do you need to make you feel better?  Could a change of thought or attitude make you feel better?  Would you be willing to give it a try?  I’m all in to try this out.

Can you think positive all the time?  Of course not – remember you are human & that means you are not perfect. Don’t be too hard on yourself.  But, if thinking positively makes you feel better for even a short period of time I think it is worth a try.  This beautiful video came across Facebook today about  Spreading Positivity.  I am sure just watching will bring joy to your heart.

A choice I have made is to give people the benefit of the doubt; sometimes I have gotten hurt, but overall it has served me well.  As a university assistant professor I told my students; “I trust you to not cheat, to be honest; I am not naïve though & I have life experience; so, if you choose to cheat or be dishonest I will not ignore it & there will be consequences”.  There are consequences for all of us, regardless of what choice we make.  I am not perfect by any means – I get angry because I have not bothered to think of the other person: I have blamed others for the way I feel i.e. you hurt me; when I know I can only be hurt if I allow others to hurt me.  Yes, your behaviour surprised me & destroyed my perception of you.  I will grieve for a while; because the vision I had of you was shattered.  But, it was my image, not yours; so I need to get over it.  The positive thought – I had a great time, I have learned, & now I move on to the next adventure of my life.

 

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What you think about is what you get.  That is the Law of Attraction.  I encourage you to think positively.

I am happy, all is good

I also encourage you to take a moment & read The Desiderata

 

 

 

I’m so busy, I hardly have time to breathe!

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Does this sound familiar?

Joe: “How are you?”

Busy as usual, not even time to take a breath.  How about you?” Jane says with pride.

“The same” Joe proudly responds.

Why are they both proud of this?  What has happened to bragging about the time you have for family, fun, golf, travel, or just plain reading?

Are you rushing from one activity, one task, to another?  How much do you have on your plate?  With all the things you are doing, do you see what is happening around you?  What about those changes you have been trying to implement at work; are they actually taking place, but you just haven’t noticed, or have they been totally ignored & you haven’t followed up?  What is happening with your spouse, partner, children – do you really know?  Of course you know, all activities are on the big home calendar that everyone uses so the family knows who is where & what each member is doing.

My husband & I have lived very busy lives for many, many years.  He continues to have a very busy life; but, due to health issues I have been forced to slow down.  When this first happened I was upset that I could not carry on with all that I was doing.  Friends said to me, “there’s always something good in everything; so there must be something positive for you in this”.  I agreed, but to be honest, it took quite a while before I found that being forced to slow down was actually a blessing.  As I slowed down I started to feel better physically & enjoy life again.  Now l just need to convince my impatient, curious self that I cannot say “yes” to everything I am interested in or want to do (I am learning, but am a bit slow at times).  I am learning I have to make choices & set priorities.  If I don’t take care of myself – physically, mentally, emotionally, & spiritually – someone else is apt to have to make those choices for me & set my priorities.  I don’t like being told what to do, so I must listen to my body (husband, friends, & physicians) & do what is best for me.  Doing what is healthy for me has actually allowed me to do many things I have been wanting to do for years – like writing a blog, offering life coaching, & writing a book.  And, I am finding time for my spiritual, mental, & emotional health in addition to my physical health.

What are you missing with your busyness?

  • Are you running the kids from one activity to another, but not having time to stay & watch them – unless you have your laptop with you so you can work?
  • Are you running from one activity to another but not really enjoying the activities?
  • Do you peak in on your staff & because no one tells you about a problem, you dash on to your next activity?

My husband is a diver.  He has often commented to me how many divers stop briefly, see a fish or two & then swim off to see what else is lurking beneath the waves.  He hangs out a bit longer, hovering silently in one spot & sees more fish & other underwater creatures that come to him, that come out of hiding when all is still.  What if we did that in our day-to-day lives?  Can you be still & silent for a minute.  Give it a try.  How hard was it?  If we can do this for a little longer what might we see & learn?

 

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I am doing my best to share what I have learned & experienced to promote self-care; especially self-care of my nursing colleagues through my blog, web-site, life coaching, & HeartMath®.  I have seen that what we are taught in nursing, about wellness being made up of physical, mental, emotional, & spiritual health is true. And, while we remember to take care of our physical health we forget the rest.  When did you last do something for your mental, emotional, or spiritual health?  What is that little inner voice of yours saying?  Are you sleeping well? Do you have too much stress and/or worry in your life.  Where do you get support?  Do you go to church, meditate, pray, or take time to reflect on your day, your life, or those things for which you are grateful?  Do you just sit outside & enjoy the beauty of our world? I challenge you to take just five minutes each day for one week, to sit outside still & silent; then reflect on what you saw, heard, & what you feel (maybe even write down your reflections).

I would love if you would share your experiences so we can maybe learn from each other.

 

NURSING TEAMS: WHAT IS A TEAM

 

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Team nursing and nursing teams are not the same thing.  Are either of them really a team?  What is a team?  For purposes of this blog I am using the team definition from The Five Behaviors of a Cohesive Team by Wiley:

A team is a relatively small number of people (from three to twelve) who meet on a regular basis and are collectively responsible for results. The team members share common goals as well as the rewards and responsibilities for achieving them. Not every group is a team.

(The Five Behaviors of a Cohesive Team™ Facilitator’s Guide, 2014, John Wiley & Sons, Inc.)

 

If you look at the above definition I guess, we could call team nursing a true team.  After all, it is a small number of people, who might meet on a regular basis (depending on work schedules), and the ‘team’ is collectively responsible for results (the safe care of a specific group of patients).

 

Now let’s tackle a nursing team, the group who work the same shift, with the same leader on a regular basis.  Of course there is always the casual staff, who may or may not be considered part of the team.  Again, a small number of people, who meet on a regular basis.  But, are they collectively responsible for results?  Each RN has his or her own patient assignment, as does each LPN, or nursing assistant.  As a ‘team’ are they all responsible for the safe care of all the patients on the unit?  Do they even know the answer to that question or know what is expected?  The charge nurse is certainly responsible for all the patients, and is the leader of the team.  That kind of makes one think that everyone is responsible for all the patients.  Wow!  That could shed a whole different light on how the ‘team’ works together.

 

Let’s look at Patrick Lencioni’s (2002) list of the dysfunctions of a team

  1. Absence of trust
  2. Fear of conflict
  3. Lack of commitment
  4. Avoidance of accountability
  5. Inattention to results

(Lencioni, P. (2002). The Five Dysfunctions of a Team. Jossey Bass, San Francisco)

 

Consider the above dysfunctions: how does your team rate?

 

When I look back on my rather long career as an RN I remember variations of how many of the dysfunctions were present.  Of course some colleagues were trusted, others weren’t; with some conflict was definitely feared, but not with everyone; accountability was definitely individually based, and there was great variability.  As for results, I think everyone was working toward the same goal; keeping all patients alive and safe.  However, I am not sure everyone cared about every patient on the unit; if the patient was not assigned to you then that patient was not your responsibility.

 

It was my first solo shift in a new ICU and I had been scheduled for the first break.  Shortly after I should have left for that break the nurse with whom I was covering came and asked “are you ready to go for your break.  “No not yet”, I replied.  She responded with “If you don’t get away on time for this break, then I don’t get away on time, and all our breaks for the rest of the day will be messed up”.  I was so afraid of her that of course I skipped my break so she could go on her break and keep us on schedule.  I certainly didn’t want to ruffle any feathers, or ask for help so that I could get going.  There might have been a little absence of trust at this point too.  I continued to work with that RN for most of my career and once I got to know her, I became comfortable asking for help.

 

I think nursing teams would be much happier and work much more efficiently and effectively if they were true teams.  Of course that is not easy to accomplish.  First the leader must buy in and that goes beyond the charge nurse to the unit manager.  Think about it?  A healthy work environment where there is trust, no fear of conflict, commitment, accountability, and attention to results sounds like a place I might want to work.  Of course this wouldn’t be on just some shifts, depending who was on; but, on every shift.

 

I recall one ‘team’ I worked with, again in an ICU (different hospital).  I arrived for my night shift and one of my colleagues told me that I couldn’t care for the patient I had been assigned because she wanted that patient, and I didn’t have enough experience.  I went along with this, as I didn’t really care and she was much more experienced than I was, so fine.  One of the other nurses came to me later suggesting that I had been bullied and not treated with respect.  I had not thought of this myself, but when mentioned, she was right.  I guess I had let myself get into a mode of just thinking that is the way things are, so accept it.  Maybe she could have stood up for me at the time, seeing as I hadn’t stood up for myself.  But, all around a good lesson.

 

I encourage everyone to read Patrick Lencioni’s book, The Five Dysfunctions of a Team; it is a good story laid out in the form of a fable.  I also encourage all nurses to urge their charge nurses and unit managers to take the steps to develop a cohesive team.  I am positive that the results of having a cohesive team will be rewarding.

Conflict: The Role of Nurse Leaders

 

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We are surrounded by conflict.  Teenagers & parents are frequently in conflict about curfew time or dating choices.  Husbands & wives have conflicts related to finances, raising children, where to vacation, whose job is more important, whether or not to move, or how to squeeze the toothpaste tube; the list is close to being limitless.  Then, there are conflicts at work.  Workplace conflict is generally caused by poor communication or poor ability to control emotions.  Obviously, lots of areas for professional development.  However, not all conflicts need to be negative; in fact, some conflict is good.  No, I have not lost my mind.  I’m going to focus on work conflict.  Productive conflict is necessary for strong, healthy relationships (Patrick Lencioni).

The type of conflict that is good is where people do not agree, discuss the differences, & weigh pluses & minuses during decision making.  Being nasty to one another is not good conflict & needs to be overcome – we are adults: learn to be respectful of others & their beliefs, or preferences.  But, how do you have good conflict?  First, you have to establish trust; I have already written a bit on trust, the foundation of a cohesive team (Patrick Lencioni).  Trust needs to be established prior to even thinking of encouraging conflict.

Conflict doesn’t mean that someone has to be right & someone else has to be wrong.  It doesn’t mean holding grudges, or not speaking to someone, & it definitely does not include bullying.  Conflict must focus on ideas & concepts, & must avoid mean-spirited accusations or personal attacks (Patrick Lencioni, p. 202).  Conflict means you have to act like an adult – I think – sometimes adults don’t act in a way to be recommended.  But, I think you know what I mean.  Politeness, respect, no yelling, no swearing; but, that does not mean you cannot be passionate.  But, you must keep an open mind.  “Seek first to understand” Stephen Covey; is a good phrase to remember & to heed.  What does the other person mean, think, & why?  Sometimes when you understand these things you will find you are not so far apart.

When planning a change someone needs to share all that could go wrong.  Someone needs to think about how to prepare for what could go wrong, & try to prevent errors.  Someone also needs to be able to share all the positive things that the change will contribute to the work environment.  Conflict is an opportunity to discuss new ideas, to use imagination, & creativity when change is about to occur.  Change is inevitable; but, conflict often goes hand in hand with change, so why not make the best of it & ensure the change will be positive & successful.

What do you do when you don’t agree with your leader?   Well, unless the leader/boss is dishonest, unethical, devious, or abusive you need to hang in & find a way to get along.  Stephen Covey, & Kouzes & Posner suggest “Seek to Understand”.  Of course we know this is easier said than done.  However, disagreeing with your leader/boss, or co-worker is an opportunity for you to develop your leadership & communication skills; after all there will always be someone with whom we do not agree.  Kouzes & Posner (2006) suggest that serious conflict gives you the opportunity to learn: to learn about yourself.  Considering that you cannot change anyone other than yourself, it is a good idea to learn about yourself.  Additionally, being open minded, non-judgmental, & respectful are characteristics you might also want to develop.

Nursing includes conflict.  Conflict with other nurses, with physicians, with other members of the healthcare team, with patients, with families, & with anyone else with whom you have contact.  Dealing with conflict is barely touched on in nursing education.  Nursing leaders need to be responsible for guiding nurses to communicate effectively, to learn to work as a team, & to deal with conflict in a constructive manner.  According to Patrick Lencioni (2002), one of the hardest things for leaders is “the desire to protect members from harm” (p. 206).  Encouraging healthy conflict requires members to develop coping skills.  As hard as it might be for the leader to not step in to resolve the conflict, he or she must allow the members to come to a resolution on their own.  This is a big, ongoing job for anyone.  However, the nursing leader, or any leader, must work with employees to establish what is & what is not acceptable behaviour.  Mike Myatt, Feb. 22, 2012 referring to conflict writes “It is essential for organizational health and performance that conflict be accepted and addressed through effective conflict resolution processes”.

Nursing leaders who are in formal leadership roles, such as unit manager, often have so many meetings to attend they have very little time to lead professional development.  If that is the case, maybe it is time to consider bringing someone in to do such training.  Maybe one of the nurses has an interest, or additional education, in team building & conflict resolution & would be willing to lead this professional development.  Regardless of how it is done, learning how to deal with conflict effectively is necessary.  Remember, conflict can be good.  Nursing leaders must learn how to model this practice & encourage good conflict within their teams.

References

Lencioni, Patrick. (2002). The Five Dysfunctions of a Team. Jossey-Bass, San Francisco, CA

Myatt, Mike. (2012). Five Keys of Dealing with Workplace Conflict

http://www.forbes.com/sites/mikemyatt/2012/02/22/5-keys-to-dealing-with-workplace-conflict/#4ffef0ac15a0

 

 

 

LEADERSHIP & TRUST in NURSING

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Trust is a key component in all relationships.  Have you ever trusted someone only to have that trust broken by catching that person in a lie?  Or, had someone make changes related to the project you were assigned to lead, while you were away & not informing you?  How about sitting in a meeting & hearing an announcement about the project you were leading with no advance notice?  Other examples include someone taking credit for your work, someone making an error & not owning up, cheating, lying, or talking behind your back, just to name a few ways trust can be broken.  I’m sure somewhere along the line in your personal or professional life you have had your trust broken.  Now ask yourself that tough question – whose trust have you broken?

The Merriam-Webster Dictionary defines trust as:

a: assured reliance on the character, ability,

strength, or truth of someone or something

b: one in which confidence is place

Synonyms could include: integrity, reliance, surety, faith, dependence, belief, hope, care, protection…

 Antonyms could include: lie, cheat, steal, deceive, trick, fool, irresponsible…

When I was teaching first year nursing students we discussed how to establish trust with your patients.  Maintaining confidentiality; doing what you say you will do, when you say you will (keeping your promises); being a patient advocate (standing up & protecting). If you don’t know an answer, say so, then go find out: admit your weaknesses, be honest.  Establishing trust with patients is not different than establishing trust with anyone, except that you might need to do it more quickly.  Also, remember, patients & their family members may be frightened & distrustful depending on past experiences with healthcare.  One of the things not addressed in any depth in nursing courses is building trust with co-workers, other healthcare professionals, or team building.

Patrick Lencioni (2002) wrote the following about the trust needed in teams

“trust is the confidence among team members

that their peers’ intentions are good, 

and there is no reason to be protective or

careful around the group.  

In essence, team mates must get comfortable

being vulnerable with one another” (p. 195).

Being vulnerable means team members need to be comfortable admitting mistakes, making suggestions, admitting weaknesses, skill deficiencies, & asking for help without having these held against them.  In nursing there is another layer to trust; in nursing we want to be able to trust that our colleagues will always do the same things in certain situations (i.e. code blue) every time: this is the reason patient simulations are used & are important in nursing & healthcare.

Building the vulnerability portion of trust can take time to develop.  As a nurse I remember there were some colleagues I would ask for help before others, & only a few to whom I would admit my weaknesses.  Admitting weaknesses, & asking for help can be very frightening, especially to new nurses.  The statement “nurses eat their young” has been around for many years, & my guess is that most nurses have experienced it at some time, yet it continues.  When I was a nursing student we were told about this phenomenon & vowed when we graduated we would never treat nursing students & new nurses with contempt, or disrespectful.  The leader has a large role to play to ensure that trust is developed & maintained among team members, & among teams.  When you think about this the circle of trust it is huge (Figure 1).  Old customs, habits, rituals, & cultures are hard to change; but in this case it would be well worth the effort.

 

scan(3)Figure 1: Circle of Trust

The many roles of nursing leaders must include changing the “nurses eat their young” culture.   What can the leaders do to introduce these changes & see them through to fruition?  Kouzes & Posner (2016) stated

“Trust is all about openness, and trust building involves

creating an environment in which people can be open and honest

with each other” (p. 163). 

One thing that I noticed during my time nursing was the absence of openness & honesty from management; often just an extension of how they were being treated by the executive.  Strong leaders are a benefit to any organization.  Time spent nurturing & growing those leaders is time well spent.  Nursing managers can develop the leadership skills of their direct reports by being open & honest; setting the example & not accepting any less from herself or others.  This said, every person can start to build trust in their relationships by being honest & open.  Sounds simple, but it is something that must be worked on every day; it requires a lifelong commitment to leadership development.

References

Kouzes & Posner (2016). Learning leadership: The five fundamentals of becoming an exemplary leader. Wiley. San Francisco, CA.

Lencioni, P. (2002). The five dysfunctions of a team (2002), Jossey-Bass, a Wiley Imprint, San Francisco, CA

Nurses! Self-Care is a Must: Stop Being Bullied by Your Workplace

As a nurse how many times have you told family members to go home?  Go home or you will get sick & not be able to help your loved one.  As a nurse, has anyone ever told you that?  Probably the closest you have gotten has been “don’t come near me & infect me with whatever you have”.  Nurses know that when they stay home sick they may not be replaced; therefore, colleagues will be left to pick up the extra work.  Working short staffed, you hope an extra coffee, maybe a chocolate bar or some donuts will provide extra energy to get through.  But, that only works for so long & then the next person gets sick & the cycle continues.  This is a familiar story that every nurse knows all too well.  You are not doing yourself or your colleagues any favours by continuing in this cycle of destruction.  As a nurse you are a leader: lead yourself by caring for yourself.

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As nurses we know what we need to do:

  • eat a healthy diet
  • get adequate sleep
  • be physically active
  • maintain a healthy weight
  • have a strong social support system
  • live in a healthy community
  • spend time with your family
  • make time for yourself
  • keep your brain active
  • embrace your spirituality
  • listen to your body

Of course this is easier said than done; the culture of ignoring self has been around for a long, long time. This is just the beginning; remember you are not selfish when you care for yourself.  If you do not care for yourself you will go from being a caregiver to someone needing care, & possibly be a burden to your family.  No nurse wants to be in that situation.

For two years I struggled with increasing fatigue, repeated sinus & other respiratory illnesses.  With prolonged physical problems, my mental status was slipping into the doldrums; I wasn’t depressed, but it was starting to seem that might not be far away.  I was prescribed time off work for ‘burn out’.  Though I felt much better after six months off, I did  not return to my previous state of health, & the amount of progress I made vanished within a very short period of time.  Eventually I was able to get back to work on a very restricted schedule, but within 4 months I had the same old respiratory illnesses, extreme fatigue, & body aches.  More time off, then a repeat of the same thing.  During this time – we’re looking at close to 2 years now – I was a slug at home.  I’d get home from work & collapes; no energy for anything.  My poor husband didn’t have much of a wife & was doing housework, shopping, & cleaning.

At about the one & a half year mark I finally got a diagnosis: I had an autoimmune disease (PBC) & it was responsible for the extreme fatigue.  Though I thought knowing the reason would help, & it did, mentally, it did not help my energy level, if I overdid I got quite ill.  This was distressing as I loved my job, loved being a nurse, but I could no longer work.  Unfortunately, I still couldn’t do much at home either, & was missing out on many of the things in life that I enjoyed.  If I had listened to my body & if I had taken better care of myself would it have made a difference?  Could I have prevented my autoimmune disorder, or could I have maybe felt better for longer?  No one really knows; &, that is the past & I am moving forward.

This is not about me, I’m doing ok & I have learned a lot; but, I hope my story inspires you to care for yourself.  I found out my workplace didn’t really need me.  My family managed, though they all had more work to do & none of them really needed that, especially because of me.  So what will you do?

My questions to you are these:

  1. Are you happy?
  2. Do you love your job?
  3. Are you happy with the amount of time you have for yourself?
  4. Are you happy with the amount of time you have with your family?
  5. Are you satisfied with your health?
  6. Do you feel you are missing out on anything?

You know what the answers should be: what changes do you need to consider?  How will you make these changes?

I believe every nurse is a leader; whether he or she thinks so.  But most important everyone must know thy self, must lead thy self.  Self-care is difficult: our culture puts so much pride in working too many hours, working too hard, not having time to eat well, or get enough activity, going to work when ill, not taking vacations, & not having time for self that we brag about these ‘hardships’.  I don’t think this makes much sense: do you?

What can you do?  Start with yourself, talk to your colleagues: can you support each other in a quest to be healthy & happy?  I am passionate about nursing & leadership: I hope to see the changes I have been championing come about in my time, but I need your help.  Let me see the initiatives demonstrating nurses caring for themselves.

“Be the change you wish to see in the world”.

-Mahatma Gandhi-

Trust

Using Trust to Build your Team

I recently watched the Indy 500 & the movie The Big Shorty.  As so often happens I learn things that probably were not the intent of the movie; & in the case of the Indy 500, I was reminded of something that I hadn’t thought about for quite some time.  The things that I learn are often related to leadership. guess that is to be expected seeing as I have spent so many years focusing on leadership.  Relationships, trust, & team work seem to be the leadership themes that jump out at me.

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Trust

Watching The Big Short reminded me a bit of another movie Wag the Dog.  The movies simulate some real life events; which I think makes them a bit frightening.  When I finished watching I had to ask myself “how much of what I see on the news is true?” & “who can we really trust?”  We certainly can’t trust government, banks, or other big business organizations, bureaucracies & many of the people associated with these bodies.   If you have not seen these movies I strongly suggest you watch them.  Watch with an open mind & ask yourself “what would I do?”, “what is the right thing to do?”  What would you do in circumstances similar to those identified in the movies?  Who do you trust? Can you be trusted?  What criteria do you use to determine whether or not a person can be trusted?  Trust is the foundation of so much that we do in life: relationships (personal & professional), business, teams, & even things as simple as driving – you trust the drivers of the cars coming toward you will stay on their side of the road.

Teams

If you have never watched an Indy or Formula One race I urge you to watch at least part of one.  Watch long enough to see what takes place when the car goes into the pit.  The team work & precision is incredible.  As I watched the Indy 500 my husband & I were shocked to see one of the pit times for fuel & changing four tires took a bit more than 13 seconds; way too slow.  Usually you see this at around 8 seconds.  This affected the driver taking him out of the first & second place he had been jockeying for with one other driver.  I am not pointing this out to blame or point fingers, but to emphasize how important team work can be.  The racing team includes the driver, the pit crew, & the engineers (& maybe more); every one of them is essential to win the race.

One of the things that is important in team work is trust.  Teams can’t really work well together if the team members cannot trust one another.  I need to be able to trust you to do as you say & I need to be able to trust you to be understanding & accepting when I own up to a mistake.  I also need to trust you will support me when I need help, just as I will support you.  I need you to listen & really hear what I am saying & know that if you have concerns about a plan or project you will voice those concerns & I will listen.  I might not change what I am doing, but I will take your comments into consideration. I need to trust that if you are upset with something I have said or done that you will come to me to discuss.

As a leader you are in a position to demonstrate trust & to work to build trust among those you lead (coach, manage, train).  Trust is the foundation of any relationship; personal or professional.  Trust can be lost in a second & once lost take years to re-establish: start by making sure you can be trusted.

 

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