Embracing Civility

The REAL Healthcare Reform!

Tag: conflict resolution (page 1 of 2)

Drill Down to Basics

basic-needs
I heard the yelling long before I saw the resident and her Aide struggling their way to the dining room.

I was sitting in a small med room just off the dining room in the locked Memory Care unit of an Assisted Living Facility.

The Aide seemed to have everything under control, so I waited and listened.

The resident was agitated.  The Aide spoke in a soothing voice.

The resident started ripping off her clothes.  The Aide gently re-routed her to a bathroom for privacy.

The resident screamed profanities from the bathroom.  The Aide waited patiently with her.

The resident tried to hit the Aide.  The Aide stood at the door and asked her co-worker to “bring the tray.”

A breakfast tray was handed off to the bathroom.

I could hear the Aide calmly say through the resident’s shrieks and screams, “Here’s your bacon.  You love bacon.”  And, “Oooh, you have a biscuit this morning.  Wanna try a bite?”

The cursing and shouting slowed, and then stopped.

A few minutes later, a quiet (and fully dressed) resident and her Aide emerged from the bathroom and sat down at a table to finish breakfast.

When the episode was over, I couldn’t help but think about this commercial!

In the old days, this type of resident behavior may have resulted in some sort of restraint.  Today, most healthcare environments are restraint-free.  That means we need to have more creative solutions!

In this case, the Aide used a method I call, “Drilling Down to Basics.”  The idea is that when a resident becomes agitated or combative, there’s a good chance that one of his or her “basic needs” is not being met.  The basic needs are hungry, thirsty, tired, lonely or in some sort of pain.  So the caregiver identifies the basic need that is not being met and meets it!

In this case, the resident was hungry.

As the episode resolved, the mood in the room returned to normal and everyone went about their business.

But that’s when I started thinking about how this may relate to incivility and dealing with difficult co-workers or your own difficult behaviors.

The resident in this scenario had Alzheimer’s disease which made it nearly impossible for her to express her needs.  People without AD can’t use that excuse!  But it’s possible that the same dynamic is in play.

I can’t speak for other people, but I know for a fact:

  • I’m grumpier when I’m hungry. 
  • I’m shorter-tempered when I’m tired. 
  • And I can be downright mean when I’m in pain. 

And to make matters worse, it’s difficult be objective about yourself and connect these behaviors to your own basic needs that are not being met.

So here’s my challenge to you:

The next time someone is being rude, mean or raging-on irrationally, remember the Aide in the Memory Care unit.  Stay calm.  Speak kindly and gently.  Remain patient.  Then try to get to the root of the problem.

Offer to get the person a snack.  Suggest they take a break, if possible.  Ask her if she’s feeling okay.  There’s a good chance one of these suggestions will hit her right where she needs it.

If you find yourself being rude or irrational, be your own Aide.  Step back and assess your own basic needs.  Take care of yourself.

pitcher2

When Sympathy is Not Enough . . .

All of us at Embracing Civility are honored to have Corey Anne Rotella, CNA, lend her very special voice to our blog as a regular contributor. Corey has worked on the frontlines of long term care since 2008. As she states, “Sometimes, you pick a career and sometimes a career picks you. In my case, the latter is true.”  (You can read more about Corey below.)

Here, Corey shares her thoughts on the importance of empathy in healthcare:

judy garland2Even before becoming a nursing assistant, I considered myself to be a sympathetic person, capable of feeling great sorrow for those in less fortunate circumstances. I would think, “Those poor homeless, sick, or emotionally disturbed people. How very sorry I feel for them!” Such feelings of sympathy tugged at my heart—but not for long. They moved quickly to the back burner, replaced by the routine of my own daily life.

The hard truth is that those fleeting moments of sorrow were really about ME. I had no idea what the people in those situations were going through, emotionally, mentally or physically. I only knew that it was far worse than anything that was happening to me. I realized that, in my sympathy, I was wishing I could pull them up to my level–without having any real understanding of their current struggles.

That’s the trouble with sympathy…
it’s all about the sympathizer.
That’s why the feelings fade.

It’s like those memes you see on Facebook: “Can I get a thousand likes for this child with cancer?” Or, “Repost this picture of an injured animal; otherwise you support animal abuse!”

Messages like these fly through the internet at a dizzying pace, forgotten in days, if not hours, and replaced with something else that MUST BE RE-POSTED. While it is a nice to know that people do care about others, this “sympathy” does nothing to enact lasting change.

Sympathy is a good beginning, but it doesn’t run deeply enough to foster the kind of understanding that we can use to ultimately heal one another. That’s why, in healthcare, sympathy by itself is a useless emotion! In this field, we have to meet people where they are rather than attempt to pull them “up” to where we are. To accomplish this, we need empathy.

Empathy is the ability to walk in another’s shoes. It is a skill, and like any skill, it requires both thought and practice. It takes time to develop but the value of empathy in every walk of life cannot be overstated.

But how can a young, healthy person possibly understand what it’s like to live with Alzheimer’s or cancer? How do you walk in the shoes of someone living with mental illness or who is facing a terminal illness?

The most honest answer is that we can’t. Not exactly. But we CAN relate. Every one of us brings our own unique set of experiences to each situation. For example, I don’t know what it’s like to live with Alzheimer’s disease, but I do know what it is like to feel as if I am not valued. I do know what it’s like to feel scared. I do know what it’s like to need help and not know where to turn. Someone living with Alzheimer’s is probably feeling all of those emotions.

I am able to use my own experiences to identify and relate to their troubles. I can apply what helped me through my difficulties to help them with theirs. So, where sympathy is passive (you feel it and move on), empathy is active, creative and helpful.

There is no “one size fits all” solution to everyone’s problem, but the ability to genuinely empathize with others opens the door to solutions.

Empathy is equally important when engaging with co-workers.

One of my favorite parts of working in healthcare is the diversity. We interact with people from a variety of educational, cultural and economic backgrounds—and we all bring something different to the table.

Things run smoothest when we can all relate to and understand each other without prejudging or making assumptions. Unfortunately, prejudging and making assumptions about others is prevalent in the healthcare field, and patients suffer because of it.

Look around at your team. Can you be more helpful and understanding to the new girl who speaks English as a second language? What about the older nurse who is burned out and crabby? Can you imagine the pressure that doctor feels? And someone in billing just lost her husband to cancer.

It’s not enough just to feel sorry for these people. EMPATHY is the only thing that helps. Empathy creates bridges and bonds. It helps people feel safe. It fosters an environment where everyone feels supported and valued.

Whether you work in housekeeping or perform brain surgery, empathy is a skill everyone can improve upon! We must all remember that (regardless of our differences) we have all experienced the same emotions and we are all working towards the same goals. If we can do this, then we can achieve a more productive, healthier, and happier work environment.


Here’s more about Corey Anne Rotella, in her own words:

Corey2“At first, I worked in the housekeeping department at an assisted living facility until I could afford to take the state test. Then I moved up to CNA. I also have my Medication Aid certification, but my heart is on the floor, where I can interact, observe and care for my residents.  My priority is taking time with my residents so that they know they are valued as human beings.  At the end of the day, don’t we all need to know that?

What I love most about my job as a CNA is that every single lesson I learn at work can be applied in all areas of my life.  A lifelong chronicler, I began to fuse my two passions and write about my work experiences, my perceptions and the issues that we all face in the healthcare system–patients and workers alike.

Survey Results: A Disturbing Trend

shockedOkay, remember that survey we started a few weeks ago dealing with bad bosses? Well, after weeding through hundreds of responses, we narrowed down a disturbing trend.

Here are the results:

I have (or had) a bad boss . . .
44% said Right now <~~~ Not too shocking.
31% said At my last job
25 % said A while ago
0% said Never

The problem with this supervisor is (or was) his (or her) . . .
31% said Incompetence <~~~ An expected response.
25% said Mean or thoughtless comments
19% said Lack of professionalism
13% said Other
6% said Absence (never around when needed)
6% had No response

What I did (or will do) about it . . .
38% said Talk to my Supervisor’s boss <~~~ Completely normal action to take.
19% said Talk to my Supervisor
13% said Talk to my co-workers
13% said Look for another job
13% said Quit
4% said Nothing

Did your actions solve the problem?
99.35% said No <~~~ Wait. What? Now this is DISTURBING!
Less than 1% said Yes

Nearly no one felt like their actions solved the problem. That’s just discouraging and . . . um . . . depressing.

When I realized where the results were going, I started to scour the web looking for experts who gave “the best advice” for handling a bad boss.

I found experts who said, “just quit.” But how does that solve the problem? It just leaves the bad boss in place to torment others.

I found experts who said, “You must go to HR.” Really? And that solves what?

I looked in our own book and found the section titled When It’s Not You It’s Your Supervisor, which I posted along with the survey. It’s good advice, but I kept looking.

shocked2Then, I found something that KNOCKED MY SOCKS OFF!

Alice, a CNA who writes for a blog called CNA Edge gave this advice in a recent post:

“. . . there is a freedom in having poor leadership. It means we either learn how to become leaders ourselves or we let the system beat us down.  We learn to not just survive in these impossible situations, but thrive. We excel, when they treat us as disposable, we rise above the sniping and backbiting and keep moving forward.”

“If enough of us do this, consistently and not just when it’s easy, we will become an asset that anyone with any sense will be loath to lose. And we will be doing this on our own terms for our own reasons. We will lead by example. If we do that, eventually we will have a voice that people will not be able to ignore.”

I love Alice’s advice because it reminds us that the only thing we are REALLY in charge of is ourselves. It’s probably safe to assume that NOTHING is going to change your bad boss until he or she is ready to change.  But you can change the way you deal with the crappy situation!

Can you take Alice’s advice and find the
“freedom” that comes with having poor leadership?

Will you step up and take the lead?

How can you be the best example of leadership
when the actual leaders are blowing it?

It’s a BIG Deal!

dealThe Deal of the Day is here again!
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  • Engaging classroom activities.
  • Enlightening PowerPoint presentations.
  • Thought provoking discussion questions.
  • Simple tips for improving participation in discussions.
  • Presentation tips to keep your organized and energized.
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This deal is too good to pass up!  Click her to ORDER NOW!  The deal ends at midnight tonight.

Survey: Tell Us about Your Bad Boss!

bad bossAt some point, just about everyone experiences
the agony of a bad boss.

But what do you do about it? Sometimes it helps
to know what others do in the same situation.

Take this short survey.
It’s completely anonymous!
We’ll gather answers and post results in about a week!

While you wait for results . . .

If you’re dealing with a difficult supervisor right now, there are a few things you can try to make the situation a little less frustrating.  Here’s an except from The REAL Healthcare Reform:

When It’s Not You…It’s Your Supervisor!

Resolving problems with a “boss” can be tricky, especially if that person has the power to make your job difficult (or make it go away). 

Here are some tips for getting along with your supervisor, even if you don’t always see eye to eye:

  • Review the expectations.  Make sure that your priorities match what your supervisor expects of you.  You’ll never measure up to your supervisor’s expectations if you don’t know what they are!
  • Remain professional.  Remember that you are there to provide care to your        patients—not to make friends.  As a professional, your goal is to get the job done and carry out your supervisor’s instructions.
  • Don’t expect to change others.  If you work for a “difficult” supervisor, there is probably nothing you can do to change his or her behavior.  The only thing you can control is your own attitude about that person.
  • Take a deep breath.  If a supervisor criticizes your performance, take a deep breath and look at the situation objectively.  Did you really do your best?  Keep in mind that constructive criticism gives us an opportunity to learn and grow professionally.
  • Keep emotions out of it.  If a supervisor confronts you about something, remain calm.  If you let yourself react emotionally, the situation can turn into a “war” where you and your supervisor are fighting about who is right.  Instead, simply say, “I understand.  Thank you for the information.”  Or, try asking for advice and ideas about how your work can be improved.
  • Be careful about complaining.  It may be tempting to complain about your supervisor to your co-workers.  But, be careful!  You may wind up being labeled as a chronic complainer instead of a team player—and your negative comments about your supervisor may get back to him or her and can be used against you.

What’s your solution? Feel free to tell us your
“bad boss” story in the comments below!

Scrubs Magazine Explores Toxic Nursing Relationships

The Fall 2013 issue of Scrubs Magazine began investigating the growing problem of incivility in the healthcare workplace.  We were interviewed and our Self Awareness Quiz was included in an article called “Build Emotional Resistance.”

We’re happy to see Scrubs Magazine is taking it even further!  The Spring 2014 issue covered examples of toxic relationships. And now, their website has even more for you to chew on!

5 articles you can’t miss on toxic nursing (via http://scrubsmag.com/)

Feeling like someone at work is out to get you? Dealing more with politics than your patients? Are you a new nurse who can’t get anything right…at least, if your coworkers are to be believed? You might be in a toxic work environment. In the Spring…

Continue reading

“OMG, She’s Driving Me NUTS!” 8 Ways to Deal with a Difficult Co-Worker

difficult

You come across all kinds of different people in your job!  And different people have different personalities!

Your “personality” is a combination of all your mannerisms,
quirks and behavior patterns that make up your character.
It’s what makes you “You!”  How you see the world, your
attitude, thoughts, and feelings are all part of your personality. 

Personality is usually formed at an early age.  We take cues from our family, friends, teachers and other influential people.  We try out different attitudes and behaviors and we stick with what works!

  • People with healthy personalities are able to cope with normal stresses and have no trouble communicating their needs and forming relationships with family, friends, and co-workers.
  • People who tend to be “difficult” when faced with stress may have trouble communicating their needs, forming relationships, or getting what they want out if life.

Getting along with all kinds of people (with a variety of different personalities) is part of your job.  That means, whether you like it or not, you have to find a way to handle people with difficult personalities.

HERE’S THE HARD TRUTH: No matter how hard you try, you will NEVER change other people!

The key to dealing with difficult people is changing the way you react to the situation!  Your attitude and communication skills will make all the difference!

Here are 8 things you can do when faced with a difficult person at work:

  1. Keep your cool. If someone is yelling at you, crying or complaining loudly, try standing still, looking directly at the person…and waiting.  This gives the person a chance to get all their anger out.
  2. Don’t be the “floor show.” If a co-worker wants to squabble in front of the team, you might also try saying, “I want to hear everything you have to say, but not here where it might disturb others.  Let’s go somewhere private.”
  3. Take ten.  Remember that old “rule” about counting to ten?  It really does work.  The next time you feel angry or upset with a coworker, breathe slowly and count to ten—before you speak.  You’ll feel better about the way you handle the situation.
  4. Be the boss. Don’t allow other people to control your moods.  If you do, you are giving them tremendous power over you.  So, if you’re in a good mood, don’t let someone else’s grouchy attitude bring you down.
  5. Focus on actions. When dealing with a difficult person, focus on the particular behaviors you don’t like…rather than just labeling the person.  For example, instead of saying, “You’re always so rude” try saying, “I feel hurt when you ignore me.”
  6. Be your own cheerleader. The next time you have to work with a difficult person, give yourself a little “pep talk.”  Tell yourself, “I’m ready for this.  I can handle whatever happens today.  I will not get upset, no matter what.”
  7. Play it back in your head. If you saw a videotape of yourself from a recent confrontation with a difficult person, would you be embarrassed by your own behavior?  If so, how would you like to see yourself behave?
  8. Save your strength. Don’t waste your energy trying to change people who behave in a difficult manner.  Instead, work on changing the way you react to their behavior.

HEY TRAINERS AND EDUCATORS! Here’s an activity from the Instructor’s Manual for “The REAL Healthcare Reform Civility Training Program.  Use this activity to practice ways to resolve common work related conflicts.

Download the Activity!

 

Your Next Staff Reward Just Got More Affordable!

giftLooking for an innovative way to reward and inspire your team? It’s probably safe to assume they have enough pens, key chains, water bottles and canvas tote bags!

Before you order your next trinket or doodad, ask yourself if any of those giveaways ever really made a change. For example:

– Did your customized water bottles ever reduce costly medical errors?

– Did the pens and key chains increase employee retention?

– Did the canvas tote bags improve client satisfaction or enhance your organization’s reputation?

Chances are good that your answers are “No, no and no!” So, why keep doing it?

Instead of the typical gimmicks and giveaways, make your incentive dollars count!  Give a gift that shows just how much you value your employees, your clients and your organization.

Head over to In the Know for Today’s Deal of the Day!!!

TODAY ONLY, you can get an amazing deal on 24 copies of “The REAL Healthcare Reform: How Embracing Civility Can Beat Back Burnout and Revive Your Healthcare Career” to give as your next incentive gift!

By giving “The REAL Healthcare Reform” to your team, you will

  • Encourage civility,
  • Promote healthy teamwork,
  • Enhance your team’s communication,
  • Decrease your turnover rate,
  • Improve client care, and
  • Reduce costly medical errors.

That’s a valuable return you won’t get by giving t-shirts or tote bags!

The Deal of the Day at ITK!

CTP package

If you’ve been waiting for our complete Civility Training Program to go on sale, then today is your day! Head over to ITK for the deal-of-the-day on the Civility Training Program for 12 Learners.

The package was custom designed for organizations with 12 or fewer employees.  You’ll get 12 copies of the book, “The REAL Healthcare Reform” (read sample pages), and 1 copy of the Companion Instructor’s Manual (read sample pages).

Don’t delay! This deal expires at midnight tonight!

Living with Integrity and Broken Tacos!

tacos2

Family dinners with my kindergarten-aged twins are usually a raucous good time, and this week’s “Taco Tuesday” promised nothing less . . . until the taco shell broke.

Maybe I made the shells too crispy.  Maybe the meat was too moist.  Maybe Dylan was over-tired.  Maybe an offensive breeze knocked a kite out of the sky on Jupiter.

Whatever the reason . . . Dylan (the oldest by a minute) suffered a complete emotional breakdown at the sight of his exploded taco.  He bolted from the table and with the grace of a trained superhero, flew through the bedroom air and landed with a thud on his bed.  Face down. Sobbing. Convulsively.

“I don’t deserve to be in this family anymore!” He wailed.

“What the heck are you talking about?” I asked.

“I’ve been lying to you.” He confessed. Snot and tears soaked his pillow.

“I tell you every day that I was good in school and that I don’t get in trouble, but I dooooo. I get in trouble every single daaaaaaay.”

Hearing this confession simultaneously broke my heart and made me smile.  He just learned an important lesson about living with integrity.  And he learned it at age 5.  Wow!  I can’t help but be impressed.

Integrity can be a difficult concept to pin down, even for adults.  Most people think of it as honesty—or being able to tell the truth—but it’s even deeper than that.  Although Dylan’s confession was about telling us a series of lies, he could have gone on forever with the charade had it not been for his integrity.

Integrity is when your values match your behaviors.

Honesty must be a value my son just realized he holds.  And he realized that his behaviors did not match that value.  So the taco broke, the confession spilled and (after a long conversation about lying) his integrity was restored.

Fortunately, living with integrity doesn’t have to be so dramatic!  And you don’t have to wait until your taco breaks to figure it out!

Just think about the things that are important to you.  Family?  Career?  Reputation?  Self-respect?  Honesty?  Fairness?  Independence? And then think about all of the ways you behave (or want to behave) to reflect those values.

It’s not always easy to live with integrity. We all face distractions, conflicting desires and confusing motives. Dylan’s actions were motivated by his desire to use the computer. (Being “bad” in school usually leads to a loss of computer privileges in our house!)

What’s keeping you from living with integrity?

Does it really matter if you live with integrity? Why or why not?

What, if any, are the consequences of NOT living with integrity?

Do you think living with integrity is more important in healthcare professionals? Why or why not?

Let us know your thoughts! We love to hear from you!

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