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Messy moments: Everyone sniping

Blog
Article
Physicians PracticePhysicians Practice August 2023
Volume 1
Issue 2

Calming discord in your practice.

nurse thumb down | © jedi_master - stock.adobe.com

© jedi_master - stock.adobe.com

Scenario

Your practice providers and staff snipe at each other all day. Daily interactions are harsh or rude. People criticize and complain about just about everyone.

It’s awful to hear the squabbling all day long. So you close your door…

What do you want to happen here?
Transform the mean streets into a culture of cooperation

  • You want them to cooperate. That requires kindness and some generosity – whether they like each other or not.* You want them to know you expect this of them
  • You want them to see the benefits of a kinder environment. You believe that they'd enjoy working more in a kind, cooperative workplace. You’d like them to want to walk into work. You’d like them to stay!

*Kindness is a caring nature or attitude. It’s being good to one another. It’s different from being ‘nice’ – polite or trying to please others.

Create a providers-are-people-first culture of kindness

The inner game - Be intentional

  • Consider: How do show up in your practice?
    • Are you curt with co-workers?
    • Do you encourage questions or dodge
    • Would the people you work with say you’re kind?
  • How can you be kinder? What specifically might you do to show the kindness that you’d like to see in them?
    • Notice what you do and think when something goes wrong. If you tend to blame, think about what you’d really like to respond in a difficult moment. You know that systems cause most mistakes. Rarely is one person at fault.
      • How do you want all the people around you to feel?
      • You want them to work together to mitigate the problem and to be willing to prevent it next time.
    • How can you be kind so they all feel part of the solution?
  • Choose just one small thing you’ll do to respond more kindly. Be specific about how, when and with whom. Yet it’s so small you’ll never find a reason not to do it.
    • Do that one thing for at least 10 days. Ten days or more increases the chances significantly that it will become a habit.
    • The hard part is to remember in the midst of challenging, busy days. Choose a way to remind yourself.
    • Write a fast, micro-report. Just one sentence. Daily. How and where you were kind. Perhaps add where kindness was needed. Date it. Written reflections dramatically increase the chances you’ll remember in the moment before old habits jump in.

Everyone notices how you show up. They take their cue from you: leadership from the inside out.

Tips:
  • It’s important for this to be genuine. Look into people’s eyes. Take the moment to show them you see them.
  • It’s harder to show your internal intentions with remote workers. And virtual communications make it so much easier to treat people poorly. How can you be kind in Zoom, emails and texts?

The outer game - Show everyone how much better work can be

The aim here is to:

  • Make kindness the expectation and norm,
  • Reinforce your commitment to a kind work environment, and
  • Show how kindness helps everyone.

1. Compliment people publicly. Catch them doing something right. Even seems small things - like when someone steps up to offer help kindly. People – especially now – love recognition. If public appreciation proves hard to do, put a note in a provider’s box to say you saw them do X and the ways it affected you and others.

  • Over time people will see it’s expected. They’re willing to try it too.
  • Research finds that people appreciate small acts of kindness as much as large ones. Simply knowing that one is appreciated can trigger the psychological wellbeing without costing the organization substantial sums.

2. Make space for kindness in meetings. Even on zoom! Meetings are the most powerful venue to change cultures.

  • It used to be easy and quick to praise or thank someone when you saw them in the hallway. Now with an even faster pace and many people working remotely, moments slip by unheralded. Bring kindness into critical communications of all kinds.
  • Make specific space for appreciation and kindness in the meeting. Perhaps at the beginning, take 2 or 3 minutes in weekly meetings inviting everyone to acknowledge one another’s work. [Have an idea ready if no one wants to start!]

3. Ask: How am I doing? Talk to people in the practice individually. Tell them you want a kinder practice. Ask each if, how, where, and when they’ve seen you be kind. Ask how you might improve. Recap what you learned from each.

  • Almost always, the other person then feels comfortable asking, How am I doing? Respond candidly and kindly.
  • Check in with each again a few weeks later: How am I doing now?

Repeat: Do just one small thing: see above.

What does this do for you and your patients?

  • It’s good for your patients. Your people will communicate more about patients because they feel safer when they know they’ll be treated respectfully and kindly. Candor can replace unsafe silence.
  • It’s contagious. Just like toxicity. When people are treated kindly, research shows they pay it back… more widely. People feel more connected to others – a basic human craving. If improves people’s moods, morale and willingness to be kind. In fact, complimenting another feels better than receiving a compliment.
  • Kindness reduces stress and improves everyone’s experience. Research from Gallup and others shows kindness and appreciation correlate with
    • reduced burnout, greater employee mental and physical wellbeing,
    • greater generosity and collaboration,
    • higher employee satisfaction,
    • increased commitment to the organization
    • lower absenteeism and turnover,
    • higher quality work, and
    • increased productivity.
  • It increases your staff’s willingness to stay. Toxic behaviors make people want to hide and too often to leave entirely.
  • It reduces needless, time-consuming conflict. Care workplaces are rife with conflict: too often its destructive because it comes from people being rude or demeaning to one another. Leaders spend a huge amount of time on conflict fallout and repair. Reducing needless anti-social behavior saves everyone time and energy. Some conflict is inevitable – especially in complex, changeable and fast-paced conditions. The more conflict is instead about important ideas or practices, the likelier it will trigger learning and better outcomes.

Your practice’s providers may be suffering. Practices face big patient backlogs of patients who are sicker because of deferred care. Staff face more and more documentation. Many people are new and think they must figure it out alone. With workforce shortages, absenteeism, remote working and temps, everyone is being asked to do things they don't consider part of their jobs. They feel stretched thin. They are stressed – often to the point of tears.

In these turbulent clinical conditions, cooperation is critical. The workloads are too big and fast-paced for anyone to go it alone.

Kindness is essential. They must feel safe enough to ask questions and for help and to voice concerns.

This makes creating a culture of cooperation, kindness and respect a daily responsibility. Especially if you want your staff to stay.

What have you tried when your providers and staff are unkind?

Email me – I’d like to know!

Nance.goldstein@post.harvard.edu

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