Concluding Insights

 

   

21^st Century Leadership

At this current stage in my life, I fit into numerous roles: mom, wife, daughter, sister, nurse, co-worker, friend, etc. In my professional career I am the Team Trainer, Patient Safety Nurse, High Reliability Organization Lead, and Change Management Lead Practitioner. Many titles in my professional life, but all lacking any authority because I’m not officially “in charge” of anyone. In the 21^st century it is now essential and a necessity to understand how to lead others without having designated authority. People want to follow those they feel authentic trust from. These types of influential leaders are self-aware, have well intentions, and are consistent in their commitments, deadlines, and behaviors. Authentic trust builds strong relationships that are reciprocated back. In turn, leaders can lead, and followers will follow, all without official authority and designation (Russell, 2012).

Before becoming a nurse, I worked in retail management and felt inauthentic to myself. Sure, I loved fashion and shopping, but I hated having to push people to purchase items whether or not I was on commission. In a Ted Talk regarding trust, Sinek pointed out that we’re intelligent beings and can usually tell when someone is working on commission, and we begin to not trust them (Simon Sinek, 2019). It makes complete sense to me that I never connected with that line of work because I wasn’t being my true self and allowing others to trust me. When I’m trying to influence those around me, they will feel safe to innovate and think beyond the box. It has been shown that one of the greatest barriers to innovating is people themselves. People can become fearful of leaving their comfort zone along with all the existing and known processes that go along with it (Albert et al., 2020). 

Emotional Competency and Interpersonal Interactions

Trust can be built by those who are emotionally competent. I have always felt that being honest and humble goes a long way, especially in my current role. Today I had to reach out to numerous service lines regarding sustainment of previous RCA actions and outcomes. It was very tedious, and honestly felt a little silly. I was anxious that people would get mad because they’ve already reported out its completion. Our regional oversight wants to ensure sustainment of these actions and outcomes, so therefore passing down the task to us. Once I was honest and humble with the service lines, they completely understood why I was asking them for this repeated information. I felt that I could build a stronger interpersonal working relationship with them this way, versus just sending an email without further explanation. At first, my fear, was that they wouldn’t “trust” that I felt they completed their actions and outcomes in the first place. In order to be a good leader, you must be able to facilitate optimal communication that allow the fostering of mutual respect through therapeutic interpersonal relations (Albert et al., 2020). I’ve mentioned my current boss before and feel that her high emotional competency and interpersonal skills has allowed her to become successful with her staff. There are things that are beyond her control, and it can get frustrating at times, but her honesty and humility in it all makes you feel that she truly is trying her best. As a “stuffer” in the workplace, I have learned that I tend to gravitate towards ignoring anger, minimizing, and pretending that I’m not really angry (Ingram & Johnson, 2010). This would lead me to also believe that I am less impulsive with my emotions and am a rather patient person. Studies have shown that people with low impulsivity are more often associated with the emotional competence of the ability to cope with problems and emotions (Joshi & Husain, 2019). A leader may be bombarded with a vast array of staff throughout their workday. Though it may not be the best to internalize all situations and “stuff” it all down, I’d imagine it’d be wise to not spew out the anger or emotions in front of the staff they supervise. Once composure is gathered, then a calm and professional conversation can occur between both sides. 

         

Influence and Promote Change

I really enjoyed the comparison of how influence and change is much like getting an elephant to move. I feel like in the coming months my team and I will be moving an elephant through a ginormous muddy mess as we prepare for our shift towards our new electronic health record system. I need to remember that the technical aspects will happen, and that I am in charge of the people side of the change. I must use the rational side of this new product and major change to find the bright spots that will guide us to our destination. My team and I must remember to use scripted critical moves to ensure standardization and sustainability as we move through old processes and adapt to new workflows. The elephant represents the emotional side that is the resistance from the people who will have to experience the change to our new electronic health record. I must motivate this elephant by growing the people and finding out what motivates them to change. This will allow the change to shrink and not seem so daunting. The situation represents the path and journey we will be on. As the change management lead, I can only tweak the environment so much, but I can emphasize the need to build habits that will establish a solid foundation and sustainability. Through the entire change process, I must rally our team and keep positive (4-H iGrow Video Resources, 2014). If the people see and feel that I believe in this change, they too, will follow! 

 

I found the Three Myths to Behavior Change to be enlightening and plan to use it in my practice as we embark on the new electronic health record. The first myth is the belief that education really changes behavior, but the key is that the information must be tangible through how the change is being presented. It is recommended that humans respond better to a possible loss of something versus a gain. People are more likely to change if there is a risk to losing something as compared to gaining something that might be of little importance to them (TEDx Talks, 2013). This has been evident in my place of work regarding unsigned notes and lost patient encounters. This was not being tracked by senior leadership for the last three years. We got a new Associate Director a few months ago and he presented its importance in a way very tangible to us. He noted that every lost encounter and unsigned note represented dollar bills that we were not being reimbursed for care we provided to our patients. He made note that as a facility we have all these projects we want to take on, along with large equipment purchases and dozens of new positions to be filled. He explained that if we could capture these lost encounters and unsigned notes, we would then be reimbursed, thus have more money for these construction projects, equipment purchases, and employees!  Since the start of the fiscal year, we have been able to flatten the curve in lost documentation! I truly believe that his messaging made an impact on its importance. He also catered his messaging to his audience, something that is also emphasized to combatting the myth of education being the key to behavior change (TEDx Talks, 2013). There is a big difference in changing the behavior of service chiefs regarding lost encounters as compared to how the message is delivered to the patient facing ward clerk who is scheduling the patient’s upcoming appointment. Our Associate Director made sure to tweak his messaging in a way that was understood at varying levels along with how it directly impacts their line of work.

The second myth was that attitudes changed once the behavior was changed. Instead, it is recommended to set behavioral expectations. I loved the example of using the light switch. As children our parents set the example of turning off the lights in order to conserve energy. If they didn’t practice what they preached, more than likely we would have also left lights on (TEDx Talks, 2013). This behavioral expectation is evident with any new processes within our facility. In order for the frontline staff to buy-in to the new change, they have to see that their direct supervisor is mirroring the new process in order for it to be successfully sustained.

The final myth was that people already know what motivates them. In actuality, social norms play a huge role on our behavior. The example used was how the street musician is more successful at receiving spare change if he planted a friend in the crowd to drop a few dollars every once in a while. Just simply having money in the bucket was not enough to feel the social pressure from the crowd as compared to seeing others around you dropping money in the bucket (TEDx Talks, 2013). Seeing others do something makes it become a social norm to do so. 

Conflict Resolution

My need to create trust in my workspace aligns with how I mange conflict. I tend to avoid and accommodate others, but I do so to protect the working relationship. As I mature in my career, I am learning that I must remember to be vocal about my needs, too. This way I don’t become resentful if my projects or aspirations get overlooked. It is recommended to let the other party know what is being given up in order to resolve the conflict (Riasi & Asadzadeh, 2015). This allows the other party to realize the value and worth that is being sacrificed this time around. This prepares the future of the relationship, thus allowing the other party to accommodate the needs next time around (Riasi & Asadzadeh, 2015)!  

Innovation in Healthcare Delivery Systems

Complexity science understands that systems and processes are not like machinery. You cannot simply break apart the pieces and replace them with new parts. Everything is intertwined together, therefore one change impacts the other in a ripple effect (Albert et al., 2020). Our facility has taken great strides to weave systems level thinking into our work lives. Our Patient Safety department asks incident report investigators to look at the error as a system and see if there are system level fixes to mitigate the error from occurring again. When leaders are asked to use this type of lens, they are more likely to not place blame on the individual and look at how the process could be fixed.   

Transformative Leadership

I am intrigued by the transformative leadership theory as I journey along my career. This type of leader enables and encourages individuals throughout the organization to innovate and build upon their potential. Part of this is integrating the commitment and values of the organization to drive positive outcomes. Transformative leaders are able to create personal relationships and have humility and resolve (Caldwell et al., 2008). I do feel that my personality, ability to manage conflict and anger, allow me to build trustworthy working relationships with my peers and senior leaders. I look forward to looking back on this blog twenty years from now in order to reflect on how my career shifted and grew! 

4-H iGrow Video Resources. (2014, September 25). The Elephant & The Rider [Video]. YouTube. https://www.youtube.com/watch?v=-XYxudAQk5w

Albert, N. M., Pappas, S., Porter-O’Grady, T., & Malloch, K. (2020). Quantum Leadership:

            Creating Sustainable Value in Health Care: Creating Sustainable Value in Health Care.

           Jones & Bartlett Learning.

Caldwell, C., Voelker, C., Dixon, R. D., & LeJeune, A. (2008). Transformative leadership: an ethical stewardship model for healthcare. Organizational Ethics : Healthcare, Business, and Policy : OE, 4(2), 126–134.

Joshi, R., & Husain, T. (2019). Effect of impulsivity on aggression and emotional competence. IAHRW

International Journal of Social Sciences Review, 7(3), 342-346.

Ingram, C., & Johnson, B. (2010). Overcoming Emotions that Destroy: Practical Help for Those Angry Feelings That Ruin Relationships. Van Haren Publishing.

Riasi, A., & Asadzadeh, N. (2015). The relationship between principals’ reward power and their conflict management styles based on Thomas–Kilmann conflict mode instrument. Management Science Letters, 5(6), 611–618. https://doi.org/10.5267/j.msl.2015.4.004

Russell, N. (2012). The Titleless Leader: How to Get Things Done When You’re Not in Charge (1st ed.). Career Press.

Simon Sinek. (2019, October 29). 2. Trusting Teams | THE 5 PRACTICES [Video]. YouTube.

TEDx Talks. (2013, March 20). Three Myths of Behavior Change - What You Think You Know That You Don’t: Jeni Cross at TEDxCSU [Video]. YouTube. https://www.youtube.com/watch?v=l5d8GW6GdR0