Patients come and go – it’s who you work with that makes all the difference

I had the most incredible day today. I started out my day with the intention of smiling at everyone I passed, searching out opportunities to encourage and engage, and the mission to learn something new about someone I worked with.

And Did God deliver! What an amazing day with some of the funniest, most intelligent people I’ve come to know. When God gives you those blessings of having a “slower” day in the Emergency Department- you take it and run with it and use the time to enjoy each other. I laughed and laughed like I haven’t laughed in a long time – and it made me remember the wise words of one of my favorite nurses at my first nursing job. “Patients come and go, it’s all about who you work with that makes the job.” This sentiment was coming from the coolest skateboarding, former trash man, father of two, most positive nurse I’d yet to come across. Today made me remember why I met two of my best friends at my first job and why I so desperately seek the same kind of connection and belonging in my current role. Belonging is something we all inherently need – to be known and loved for who we really are – even in our workplaces. Never underestimate this level of connection – it is the reason people stay at a job and the reason people leave. It’s the reason you have “good” days and “bad” days for no other reason than whom you work with that day.

Be that person people want to work with. Be that person that is a breath of fresh air when you walk into your assignment, your cubicle, your desk. Be someone’s lifesaver today – and the reason they want to keep coming back. Know someone more deeply today and let someone know you more intimately too. It’s scary to let yourself be known when we are so pressured to be professional at all times – but vulnerability has gotten enough press to be a goal to strive for, especially in the workplace. Authenticity and connectedness is what can bring you true joy and satisfaction even in the most dire of circumstances. If you have any decision in hiring – screen for people who love people and are a pleasure to be around. Be the person that is a pleasure to be around and call out the positive traits in your colleagues to encourage more of that good stuff – don’t let it go unnoticed- it’s far too important.

Featured post

How to become a High-Performing and Effective Team

Team Effectiveness Paper

                                             Selected Model Alignment

Selected Team Effectiveness Model

The Hackman Model of Team Effectiveness presents five concomitant conditions within its framework, including; being a real team with clear boundaries and a stable membership, having a compelling direction with clearly defined goals that each member is motivated to achieve, having a supportive structure that helps to accomplish goals and organize tasks effectively (as opposed to roadblocks such as one member needing to approve the work of twenty people), having the proper organizational context with enough resources, information, backing and support, and finally, having the availability of expert coaching and mentoring to help guide through any issues that may arise (Valdellon, 2016; Hackman, 2004).  This model for effective teams maintains the idea that above all else, the five aforementioned conditions must be present for effective team performance (Hackman, 2004).

            Model Alignment with High-Performance Teams

A high-performance team consistently delivers excellent results to their stakeholders, matures into a more capable team overtime, and continuously enables team members individual growth and capabilities (O’Neill & Salas, 2018).  Hackman’s model aligns with this definition of a high-performance team on multiple levels.  The condition of being a real team with consistent membership allows for consistent results to be achieved as well as for refinement in processes over time.  Refining team processes is part of learning and improving, and an interest in learning is part of a high-performing team’s culture (Forbes Coaches Council, 2016).  Having a compelling direction drives the team to strive for continued excellence.  A supportive structure conducive to teamwork processes diminishes unnecessary frustrations and allows things to function smoothly and easily.  Working within an organizational context that provides adequate resources, easily accessed educational information, peripheral support and cooperation from others allows a team to flourish.  Competent mentoring and coaching is a crucial part of developing maturity within team members and the team as whole, in addition to helping individuals continuously stretch themselves and achieve their full growth potential (Hackman, 2004).

Leader’s Role in High-Performing Teams

A leader’s role in high-performing teams is multifaceted.  Leaders of a team must have task skills, people skills, and diagnostic skills (Thornton, 2017).  Without a strong leader’s guidance a team can easily stray from the tasks at hand and lose their vision and focus for the future (Kehbila, 2011).  A leader must first lead themselves and model the behavior that is desired from team (Wing, 2005).  Creating and keeping a clear vision of the future at the forefront of a team is a large part of leading a high-performance team (Harkins, 2014).  Communication to the team is an integral part of leading a high-performing team.  Over-communication and transparency helps to foster the all-important characteristic of trust, which is the foundation of all high-performance teams (Forbes Coaches Council, 2016).

According to Hackman, the main work of team leaders is to make sure the five conditions are present that were identified above (2004).  In addition, effective leaders know how to extract the most significant performances in the most important times and help lead the team to their full potential (Hackman, 2004).  Emotional maturity and courage are two more characteristics outlined by Hackman as essential to leading a high-performance team (2004).  Courage comes in many different forms.  Leaders must be willing to show vulnerability to their team, which helps create psychological safety, opens the door for feedback without fear of retribution, and creates a safe place for disagreement and conflict resolution.  A high-performance team is guided by their leader to handle conflict in a constructive way and must be adept at different conflict management styles (Healey, 2018).   These attributes of a leader contribute to a shared sense of accountability, both for the leader and for team members.  When there is accountability for projects, deadlines, tasks and behaviors, the team functions as a motivator to all its members since no one wants to let their team down.  Commitment to each other can typically prevent an outlier or weak link but if need be the leader must be willing to address subpar performance in order to demonstrate a commitment to excellence to the rest of the team (Harkins, 2014).

An integral part of leading a high-performing team is picking the right team members (Wing, 2005).  One must seek to develop opportunities for each team member to excel and be challenged by building their confidence and recognizing their unique contribution.  A good leader of a high-performance team is energized by other’s successes and celebrates what team members are able to do individually and together.  Fostering an environment of positivity and encouragement allows people to learn from each other’s successes and failures and spur one another on in the face of difficulties.  High-performing team leaders help the team rise to the occasion when unexpected hiccups occur and finds ways to energize the team by framing all situations through a learning mindset.

One of the most difficult things for many leaders to master is the art of listening.  Among the most valued team characteristics is active listening, least valued; talking and offering information and opinions, and most lacking; active listening (Brock, McAliney, Ma, & Sen, 2017).  While communication from the leader is needed in a high-performing team, more importantly is the communication from team members to the leader.  Listening without fear of what one will hear must be a skill that is actively honed by a high-performance team leader.  Open dialogue, the need for debate and flexibility in viewpoints is highly valued by team members and necessary in building an environment of trust that is so pivotal to achieving high-performance results (Brock et al., 2017).

Successful Group Work in School

The literature makes it clear that there must be a designated leader in order to guide a high-performing team (Kehbila, 2011).  In order for group work to be successful in the context of school, the team must have a leader, preferably with as many of the characteristics mentioned above as possible.  A clear goal must be defined in the initial planning stages and formation of the team and clear roles assigned with deadlines and clear expectations.  Trust must be established as a given from the start of a group project and everyone must be willing to be held accountable to whatever responsibilities they were assigned.   There must be a clear plan outlined and accepted by all the team members and each student must show respect to one another in all interactions.  Continuous improvement must be an embraced part of the group project process and differing opinions need to be freely shared without fear of hurt feelings and conflict escalation (Thornton, 2017).

Hackman’s five conditions of team effectiveness (2004) can be achieved in group work by having a real team (easily established by already assigned team members), a compelling direction can be a good grade wanted by every member of the team, an enabling structure exists through the electronic platforms available, such as Zoom, Collaborate or Google Docs, a supportive context exists by the very nature of being in school and having the support of the professor and library resources etc., and finally expert coaching and guidance is available through professors, counseling, academic advisors and department chairs.

Application to Work

These same principles can be easily applied to any team created in a hospital setting.

What has your experience been in working with a team?  Either in school or at work?

References

Brock, S. E., McAliney, P. J., Ma, C. H., & Sen, A. (2017). Toward more practical measurement of teamwork skills. Journal of Workplace Learning, 29(2), 124-133. http://dx.doi.org/10.1108/JWL-07-2016-0069

Forbes Coaches Council. (2016). 13 Characteristics of a high-performing team (and how leaders can foster them). Retrieved from https://www.forbes.com/sites/forbescoachescouncil/2016/10/14/13-characteristics-of-a-high-performing-team-and-how-leaders-can-foster-them/#289e2474394a

Hackman, J. R. (2004). What makes for a great team? Retrieved from https://www.apa.org/science/about/psa/2004/06/hackman.aspx

Harkins, P. (2014). 10 Leadership techniques for building high-performing teams. Retrieved from http://www.linkageinc.com/leadership-development-documents/files/content/10-Leadership-Techniques-for-Building-High-Performing-Teams.pdf

Healey, B. J. (2018). Principles of healthcare leadership. Chicago, IL: Health Administration   Press.

Kehbila, A. G. (2011). Teamwork and its contribution to performance: Empirical field evidence. Journal of Marketing and Operations Management Research, 1(4), 313-322. Retrieved from https://search-proquest-com.ezproxy2.library.drexel.edu/docview/1701282939?pq-origsite=summon

O’Neill, T. A., & Salas, E. (2018, December). Creating high performance teamwork in organizations. Human Resource Management Review, 28(4), 325-331. http://dx.doi.org/10.1016/j.hrmr.2017.09.001

Thornton, P. B. (2017). Common characteristics of high-performing teams. Retrieved from https://trainingmag.com/common-characteristics-high-performing-teams

Valdellon, L. (2016). 6 Different team effectiveness models to understand your team better. Retrieved from https://www.wrike.com/blog/6-different-team-effectiveness-models/

Wing, L. S. (2005). Leadership in high-performance teams: A model for superior team performance. Team Performance Management, 11(), 4-11. http://dx.doi.org/10.1108/13527590510584285

Featured post

False Freedom

We are encouraged to “be yourself!” from early childhood whilst also being taught to conform to ‘normal’ societal standards. We are sold a false bill of freedom and I’m not buying it.

  • “Go for your dreams!” (As long as your dreams don’t make me feel like I’m not living up to my potential.)
  • “Go with your gut, follow your heart, be courageous and make things happen!” (But don’t make me too uncomfortable with your confidence or scare me with all you want to change.)
  • “Do you!” (Unless it makes me feel bad about myself.)
  • “You shouldn’t care what people think about you.” (Unless it’s me, because yeah, you should care what I think. And I think you are too x, y, z and way too c, d and e and you definitely are lacking in areas j, k and l. I just won’t say this to your face. But really ((person sitting next to me)), who does she think she is?!
  • Yeah, I know it all too well. I’ve been the perpetrator (when I believed a rumor and spoke out of turn) but I’ve learned the idiocy of my behavior and I’ve been the victim more times than I’d ever want to count and should have known better.
  • Some people don’t want to know better. So it’s hard for you to become better. It’s hard for you to become your best when the hands of complacency want to pull you down at every turn.
    • “You talk too much. You should always be talking and interacting. You aren’t focused enough. You are too focused. You are too hard on yourself. You could use improvement. There is no wrong decision. You shouldn’t have made that decision. Relationships are paramount. You get too involved. Be confident. You’re overly confident. You’re too insecure. You need to be humble. Be balanced. Be 110% committed. Do it yourself. Ask for help. You don’t have to know everything. You should really know much more than you do. Be ambitious. Don’t be overly ambitious. Be aggressive. You’re too aggressive. Be nice. You’re too nice.
  • Sometimes your best will never be enough. No matter what you do no matter how you perform or what you achieve it will never be enough. And for those people, I don’t have a good answer. They are the hardest to please but the ones you want the approval from the most – simply because they withhold it from you like a carrot on a string.
  • Well maybe that carrot is rotten and your barking up the wrong tree. Some people will never give you the freedom to be yourself and excel at your finest hour and you may find this out way too late in the game. Only once you’ve exhausted every resource and scoured down every avenue to get to your desired destination only to find out – it’s a dead end.
  • My wish for you is you see the signs before the dead end but if you don’t…and you find yourself face down in the gravel confused and bewildered, angered and so saddened – that you will pick yourself up and find your own true north.
  • People will lead you down the paths they want for you if you don’t lead yourself down the path you want for yourself. Beat up, used and abused is many the destination for those of us looking to please.
  • The only one who can cut off that invisible leash they’ve got you on is you. But first you have to realize it’s there – and believe me girl it’s there. Right there around your neck being pulled and tugged at by whoever you give away your power to. Trust your own intentions and make your own path because everyone will deter you even without meaning to – but you must mean to go where you are meant to go.
  • Face towards the wind and rain in your face – bloodied and bruised you may be but you’ll be YOU as you were meant to be. Across that finish line with tears in your eyes because you didn’t let your dream be minimized – in the eyes of the blind it’s a sign it’s your time only when you realize it’s your own path you have to find. Many people will be left behind just make sure it’s not you who’s been downsized. Don’t downsize your dreams don’t downsize your you this is all you’ve got left to do – you’ve been sold a fallacy and it’s hard for me been seen as me and not accepted but rejected. In the end we answer to ourselves and our God and not group think or the mob. False freedom is what you’ve been given but true freedom is for the taking – it may just be a lonelier road but I’m here for you – you’re not alone.
  • Rise above and let His glory be shown. Rise above and let His glory be shown. It may be lonely but you’re not alone. Remember you’re never alone.
  • Featured post

    Transformational Leadership

    A transformational leader needs your buy-in in order for the enterprise to be successful, which he or she achieves by casting a realistic and exciting vision for followers (Healey, 2018).  Notonly do you need to trust the vision of your enterprise leader but you need to know that you are valued as an employee and that your personal development is important to your leader and by feeling personally valued you will be more likely to carry out the necessary changes to move the vision forward (Healey, 2018).  I know this to be personally true for me as I have leaders above me whom I will give my blood sweat and tears for because I so strongly believe in the vision they have casted for our department.  Our enterprise leader is also incredibly charismatic and always challenging the status quo and pushing the enterprise further than any of us would have ever imagined.  This is an organization I want to be a part of because I believe in the vision of the enterprise all the way down to my leadership’s vision for our department within that enterprise.

    The biggest challenge in my work environment is the boarding of admitted patients within the Emergency Department (ED).  The staff we have work in the ED for a reason, we like the fast pace, we like to “stabilize and send,” (save their life then send them to their floor)  and “treat them and street them” (give required treatment then discharge as soon as possible).  While this might seem harsh it is what an emergency department is meant to function as.  Unfortunately, as we have acquired so many additional institutions and because every specialty is at our facility, everyone gets sent to us and literally the only patients ever sent out are pediatric patients (sometimes).  Amidst all of this acquiring there has been no increase in patient beds within our facility, in fact there has been a decrease.  Admitted patients are now staying in our ED for up to two days sometimes and we often carry 20-30 admissions at one time.  This in turn creates an incredibly long wait time as there is physically no space to put new ED patients since admitted patients are occupying them.  It is a terrible cycle that burns our nurses out, frustrates the admitted patients as well as the ones now suffering the longer wait times and it seems as if there is no end in sight.  Morale is low, we experience staff turnover and active disengagement and decreased productivity by employees because of this seemingly unrelenting problem.

    Stewardship was first introduced to me as a child when I would hear my parents talk about being good stewards of their money and growing up in church hearing sermons about how we are to be good stewards of what has been given to us, including our time and talent.  Stewardship regarding the challenge of ED boarding would be seeing your staff as the talent you have been given, which must be cared for and curated to best serve your customer, the patient.  Good stewardship in this situation is advocating for your nurses to be able to safely care for patients, advocating for patients that these wait times are unsafe and reminding the enterprise what our values are that are current situation makes it sometimes impossible to deliver the best possible care to our patients.  So often decisions made within healthcare institutions have been based purely on economics and to be a good steward of the nursing profession we must preserve the ethical values that are inherent to our profession and urge stakeholders to make decisions based off of a shared value base as opposed to purely profit (Milton, 2014).

    Transformational leadership is the way to tackle the problem of ED boarding.  We must be developing relationships with the surgeons that apparently are one of the root causes of our boarding by going to a seven day surgery model.  We must be willing to lose these highly sought after surgeons if there is not buy in because we want to operate from a place where there is buy-in from every level and everyone is working towards the same vision and goal, which is to be a part of something greater than themselves.  We must get the buy-in of inpatient nursing staff, that giving pushback or hiding beds is not a behavior based on our shared values.  Doctors must buy-in by discharging patients in a timely manner because they know their actions directly affect the entire enterprise.

    Transformational leadership would allow for this all to happen because all hospital employees, doctors, nurses, administration, clerical, environmental would all share the vision to create the best possible patient experience and expedite their actions because we are all working towards one goal of providing the best care to all of our patients and all of our staff.  The transformational leader models this behavior so that it can be emulated by others (Stone, Russell, & Patterson, 2004).  By providing inspirational motivation to all members of the team and by intellectually stimulating everyone around them to find innovative solutions to our shared problem, a transformational leader can do this because of considering the individual in all their relationships (Stone, Russell, & Patterson, 2004).

     

    References

    Healey, B. J. (2018). Principles of healthcare leadership. Chicago, IL: Health Administration Press.

    Milton, C. L. (2014). Stewardship and leadership in nursing. Nursing Science Quarterly, 27(2), 108-110. http://dx.doi.org/10.1177/0894318414522661

    Stone, A. G., Russell, R. F., & Patterson, K. (2004). Transformational versus servant leadership: A difference in leader focus. Leadership & Organization Development Journal, 25(4), 349-361. http://dx.doi.org/10.1108/01437730410538671

    Featured post

    Emergency Nurses Week! Day 2

    A huge issue in nursing at this time is nurse engagement and nurse burnout.  Day two of Emergency Nurses Week and the theme is “#EmpowerED.”  Giving nurses autonomy and empowering the nurse at the frontlines is a necessary piece of burnout prevention.  I came across this article and I am enthralled with the data and want to give it our enterprise leader in person!  Nurse engagement is so crucial to patient care and patient outcomes that it is imperative it be addressed now (Dempsey & Reilly, 2016).  That is how important we are to the success of a hospital and to healthcare worldwide.   Everyone always points back to money, but money is just a symptom, an easy thing to be measured and an easy thing to discuss (Block, 1993).

    Being recognized, fostering trust, valuing work-life balance, investing in our growth, listening without the intent to reply and caring for us, the caregiver are all parts of nurse engagement that I hadn’t quite thought of as in depth before (Dempsey & Reilly, 2016).  This data is only empowering me further and showing me in plain sight what I already know to be true in my heart and being – nurses are the backbone of the healthcare system and everything we feel and experience is valid.  We must mark this as a time in which to lead ourselves and in turn lead others through all we are learning.  I am on fire to inspire right now!

    References

    Block, P. (1993). Stewardship: Choosing service over self-interest (1st ed.). San Francisco, CA: Berrett-Koehler Publishers, Inc.

    Dempsey, C., & Reilly, B. (2016, January). Nurse engagement: What are the contributing factors for success? Online Journal of Issues in Nursing, 21(1), 1-11. http://dx.doi.org/10.3912/OJIN.Vol21No01Man02

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    Emergency Nurses Week! Day 1

    It is so easy to point at “the leader,” the ones above us as responsible for bringing necessary changes.  As nurses we are stewards of our profession and although it is not something we are accustomed to or something many of us would feel comfortable doing, we are the ones that must advocate for ourselves, our patients and our work environments.  Today is day one of emergency nurses week and as the theme was revealed “empowered,” I am deeply drawn into Peter Block’s writing on stewardship as his well-written wisdom seems to be before his time (Block, 1993).

    The nurses bill of rights (American Nurses Association, n.d.) and the components to a healthy work environment (American Association of Critical Care Nurses, n.d.) both can serve us well as empowered individuals.  Stewardship is choosing to be empowered, and empowerment in these cases would be to use the aforementioned tools in our daily work and bring attention to any practices that are outside of a healthy work environment or not in accordance with a nurses code of ethics.  The leader can be a steward by being committing to bringing these values into the workplace, even without the sponsorship of those above us (Block, 1993).

    References

    American Association of Critical Care Nurses. (n.d.). What makes a work environment healthy? Retrieved from https://www.aacn.org/nursing-excellence/healthy-work-environments

    American Nurses Association. (n.d.). The nurses bill of rights. Retrieved from https://www.nursingworld.org/practice-policy/work-environment/

    Block, P. (1993). Stewardship: Choosing service over self-interest (1st ed.). San Francisco, CA: Berrett-Koehler Publishers, Inc.

     

    Employee Engagement

    Own it. Don’t blame your workplace or boss or coworkers, take a long hard look at yourself and figure out ways to get your mind engaged someway, somehow. Or your soul with surely shrivel up and die in a cubicle somewhere. Don’t expect to be engaged, engage yourself somehow and transfer that energy onto everyone you come across in your workplace.

    • Appreciate, appreciate, appreciate and say it, write it, make it known as soon as you think it. Don’t put it off – no one can ever be too appreciated.
    • I know it’s easy to blame the institution or the culture – well guess what – one person can change the culture one interaction at a time.
    • (I’m writing this for myself as much as for anyone else right now, by the way.)
    • Observe people’s love languages, how they receive and give love and try to match their language. Words of affirmation? Quality time? Gifts? (For more info on the 5 love languages see Dr Gary Chapman’s book).
    • Try not to get bitter by expecting things from your superiors or peers. Thank without condition. Help without the need for reciprocity. Give from a place of freedom.
    • Guard your time, heart and energy. As I’ve learned too well, burnout is always around the corner, especially with nursing and healthcare professions. Try to be wise about where, when and how you invest your time and energy so that you are still making time for your sleep, your family, your faith, your health – and hey maybe even once in a while some fun.
  • Don’t give up on trying to make a difference, just pray and ask for guidance on where your gifts and passions would best be put to use and eventually the path will become clear. And hopefully along the way, someone notices how much you care. Be vocal and clear about what your objectives are because sometimes people are too busy to see your efforts. Not to toot your own horn but to bring attention to the value that you bring to the table. Because you do bring a lot to the table and don’t let anyone ever tell you otherwise.
  • Own your own engagement cause ain’t nobody gonna come knocking on your door, asking if you’d like to feel more engaged at work. Own it and make it your own.
  • Credits to http://www.howtobeawesomeatyourjob.com for the guests and the insightful tips from each episode.
  • Depression Does Not Discriminate

    Mental illness does not see color or race; it does not see the zeros in your bank account or the likes on your social media posts.  Depression does not care about the size of your house, your waist or the letters after your name.  Anxiety does not see success or failure, the family you grew up in, whether city or suburb, what you had or had not.

    As the nation was rocked by the deaths of Kate Spade and Anthony Bourdain it brought much needed attention to a very real truth.  Depression does not discriminate.  Reach out to someone, anyone and know that you are not alone.

    The Blessing of Dementia

    I stood across the room from my father in awe and wonder. I watched from the kitchen as he was being interviewed by his long term care insurance’s nurse to see if he qualified as ‘bad enough’ to get full time residential care paid for by their company.

    As she interviewed him I couldn’t believe my ears as I listened to a man who never talked spit out story after story to this very gracious and patient woman. Us siblings always joked that my parents ‘popped out and they were 30.’ They never told us stories of their past like my friend’s parents did and we knew very little detail about their specific experiences. Maybe they were trying to protect us, maybe they were trying to move on themselves, but for whatever reason it’s just the way things were.

    Yet here is my father, friendly as could be, asking her about her marriage and husband and how they met, telling her (many, many times) how long he’s been married to my mother, reliving their 40th anniversary trip to Europe with a level of detail you could never get out of him in the past.

    As I’m standing there tears of joy and awe and confusion and sadness ran down my cheeks. This was all mixed in with a strange sense of relief, hope, and giddy cheerfulness that the father I never knew could now – through this horrible disease, become known.

    I couldn’t believe what I was experiencing. How gracious our God truly is. This horrible saga of discovering his dementia over the past 2.5 years, the sale of my childhood home, the expensive treatments that haven’t worked, the car accident that took his license, the job loss that took his pride, the disease that’s taken his brain and stolen away the husband my mother loved so dearly.

    But wait – God is a God of redemption and creates beauty out of ashes and is the healer of the broken hearted. I have found my heart being healed in places I’d forgotten were broken. Through my father’s filter being taken away by dementia, he has spoken his true heart to me about things that have happened and I have found healing. The stress that always wracked his entire being is gone – he’s free to be unapologetically himself and open his once so closed off heart.

    While this doesn’t negate what my mother is going through or the grief we’re all navigating, it does bring sweetness to the sadness.

    Dad, I like you better this way. What an incredibly unexpected blessing, the blessing of dementia.

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