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Renee Thompson:
Plants thrive and grow in a peaceful, nourished environment, right? Well, it's the same with human beings, but what if that environment is not so peaceful? What if it's toxic? Welcome to Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. In this podcast, you'll get practical, evidence-based strategies to help you cultivate and sustain a healthy and respectful work culture by tackling an age-old problem in healthcare: bullying and incivility. I am your host, Dr. Renee Thompson.
Renee Thompson:
Hi everyone! Welcome back to another episode of Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. I am your host, Dr. Renee Thompson, and I'm happy to be with all of you today. And today, I am flying solo. Yep, you get just me today. I actually like to mix things up, sometimes you'll just get me, and other times, we'll have a fabulous guest leader on the show.
Renee Thompson:
So today, it's just me, and what I wanted to talk to you about today are the common mistakes leaders make when addressing disruptive behaviors. Now, I've been working with healthcare leaders for over a decade, and I've noticed a pattern, a pattern of mistakes, and trust me, I've made every one of these mistakes, too. You may recall that as a frontline leader many, many years ago, I inherited a department of disruptors. I had never seen people actually, professionals, okay, so-called professionals behave in ways that were just, I can't think of a better way of saying it. I was embarrassed by their behaviors, and I spent the majority of my time either putting out fires, being a referee between two of my employees, or unfortunately, apologizing to my patients and sometimes their family members for their bad behavior, and that's one of the reasons that I do what I do. I had no idea I was making these mistakes. Well, now I do. And what we going to talk to you about today are there are five common mistakes I have noticed leaders make, and today I'm going to actually focus on three of them.
Renee Thompson:
So the five are: addressing someone's bad behavior once, addressing someone's bad behavior at a staff meeting, you know, you've done it, ignoring someone's bad behavior because they're so clinically competent, waiting before you start a documentation trail, and not involving HR earlier in the process. We're going to explore the first three on today's episode, but you can get a handout, a resource that actually goes over what we're going to talk about today, and it gives you some details, some strategies for the last two. You can find those in the show notes after this airs.
Renee Thompson:
Okay, let's start. Mistake number one, addressing someone's bad behavior once. It's a psychological reality that all human beings avoid pain. We're designed this way, it's part of our survival mechanism. Well, for many of us, confronting someone about their behavior is painful. So what do we do? We don't confront them. And let's say you realize now that that's an issue. Like you really need to, as the leader, confront someone's bad behavior, so you build up the courage. You may have gone through one of our programs, and you learned all the scripts of what to say, and you may have written everything down, and you were fully prepared. You, finally, you sit down, you have that conversation with your employee, and you did it. You had the conversation, you talked to your employee about their behavior and how we're not going to tolerate this anymore. Okay, this is what I expect of you when you say, shoot, I am done. You might pat yourself on the back. You may have promised yourself an adult beverage later, not saying don't do that occasionally when I've had a rough day, but you're done. You had the conversation. You think, I had it, I'll never have to have that conversation again, and that's the mistake. Thinking that one conversation changes behavior. Unfortunately, for most people, especially people who have been behaving badly for a long time, it doesn't, it's just the beginning. We understand why you do this. It's uncomfortable, we avoid pain. Here's what you should do. You have the conversation, and then you say to that employee, you and I are going to touch base now once a week to do a little check-in to make sure that you fully understand how I'm expecting you to behave here, okay? And then do that, schedule 15 minutes with that employee once a week. And what you're going to do in the meantime is observe. How is that employee acting? You know, depending on what the behavior was that you told them, okay, no more of this yelling, maybe criticizing, maybe, you know, cursing. I don't want to see this anymore from you. You're going to try to do a little bit of Intel so that when you meet with that employee, you can say, you know, people have said that you've actually been stepping up this week, and you've been helping people, even people that maybe you haven't helped in the past, or I haven't heard you drop the F-bomb, this is great, or all right, let's talk, you and I had this conversation, but yet you've been behaving this way again. The key in all of this is that one conversation won't change someone's behavior. You have to have ongoing conversations. Now, you will get to the point where you're going to say, all right, you're improving, you're doing well. Let's meet every two weeks and every three weeks and every four weeks or, you know what? We're not going to play this game. And you may need to performance-manage that person out. But the key is, plan on having more than one conversation.
Renee Thompson:
All right, mistake number two is addressing someone's bad behavior at a staff meeting. One of the leaders that was in an organization where we were implementing our consulting, our culture change system, contacted me. He said, I need your advice. I'm about to go into a staff meeting, and here's what I plan to do. I just want to make sure that this is the right way of handling this. And he told me, and it was in like a radiology department, and he told me that he wants to bring up at the staff meeting about the importance of coming into work on time because he has some people who show up late 20 minutes every single day. And I said to him, okay, how many people are showing up late? And he said, 2. How many people are going to be at your staff meeting? He said, 25. All right, here's the deal. If it's only 1 to 3, people, never address it at a staff meeting. I know why we do this. We do this because it's easier for us, we don't actually have to confront that person. We just say, hey, everybody, it's important that we all come to work on time. And you may even have some explanation for why and the impact and all of that. Here's the problem. Everyone in that room knows you're talking about two people, but you don't have the courage to say something to those two people. You will lose credibility as a leader if you have that conversation in a staff meeting. What you should do is meet with each person who shows up late or whatever the behavior is individually and say, yeah, we're not going to play this game anymore. Now, for somebody coming in late, I always like to give the benefit of the doubt and start the conversation by saying, I've noticed that, it's a nice script to start with. I've noticed that you've been coming into work 20 minutes late for the last 27,000 days. Okay, whatever it is. Is there a reason for this? Is there a reason that you're consistently late? Because there might be. Just consider having that conversation and don't walk in and say, you're late all the time, and we can't handle this anymore. But again, open up the door to a conversation. Just don't do it at a staff meeting. Now, if 50% of your staff are coming in late, well, then bring it up at a staff meeting. But remember, you do not use a staff meeting to address 1 or 2 people's bad behaviors. You will lose credibility as that leader.
Renee Thompson:
All right, the third mistake that we're going to talk about today is ignoring someone's bad behavior just because they are so good at what they do. Wow, this is a big one right now, especially if you're listening to this, I'm not sure when you're listening to this, but we're in a major staffing crisis, and leaders are afraid to confront anyone because sort of the mindset is, well, a bad nurse or a bad tech is better than no nurse, and that is faulty thinking. My favorite quote of all time right now, this is like ranked number one, is from Perry Belcher, who said, there is nothing that will kill a good employee faster than watching you tolerate a bad one. We avoid confronting someone's bad behavior when they're so good at what they do. They have the most tenure in your department. I just read a study that shows 70% of the nurses right now working in hospitals in a department have less than two years experience. I get it, you want to hang on to that nurse who's been there for 30 years, but what you have to do is think in terms of the long-term impact it will have on your entire team if you ignore someone's bad behavior just because. You know, it's one of the reasons that we see more disruptive behaviors, more bullying, and incivility in healthcare than in any other industry is because we've normalized deviant behaviors. We ignore people's behaviors, we justify them. Usually, we'll say, oh, he's a great nurse, but. What does that mean? Or, think about some of the physicians in your organization who bring in a lot of revenue, but they behave so badly that they have numerous complaints about them, but yet nothing is being done. We have to stop justifying disruptive behaviors just because somebody is clinically competent or brings in revenue, or who has been there for decades. And what we need to do instead is confront their behaviors, just pull them in. And you can even acknowledge saying, look, I get it. You're our most clinically competent nurse. You are the most competent respiratory therapist we have in this entire organization. However, your behavior needs to change, and it's no longer okay or acceptable for you to be behaving, and be very specific on what they're doing. I've seen a lot of these very competent employees. They actually come in, if they don't like the assignment, the charge nurse gave them, they change it, they just make their own assignment, and they think they and they can get away with it. You need to stop letting them get away with it because they're so good at what they do.
Renee Thompson:
So as a recap, let's go back to the first one. We talked about addressing somebody's behavior only once. Remember, if you're going to sit down and have a conversation with an employee about their behavior, see it as the first of several conversations about their behavior. I always say for some people, the way they've been behaving, especially if nobody's confronted them, it's become a habit. How many of you know people who curse all the time, and it's out of habit? The first time somebody says, hey, it's not okay to be cursing, like, oh yeah, you're right, I'm going to work on that. Well, chances are they're going to curse again that day because it's become a habit. So you have to recognize that, that a lot of times they need that reinforcement, that reminder and a recommitment from you as the leader that, no, we're not going to tolerate this anymore. The second mistake is addressing somebody's bad behavior at a staff meeting. Just don't ever do that again. If you have 1 or 2 employees who are misbehaving, pull them in separately. I wouldn't pull in the three people who show up late all the time and have a group discussion. This is an individual conversation you want to have with that employee. And then the third one is ignoring their bad behavior because they're so good at what they do. We have to think in terms of short-term, okay, we know we're in a staffing crisis, but also long-term impact of the decisions that we make on a daily basis with our employees, and it's easy to just focus on the short-term. What I'm asking you to do is instead focus on the long-term impact this will have. We know right now new graduate nurses are leaving within their first two years. The first year it's 40% of them leave, by the second year, it's 63%. And it's not because they're going next door for $2 more an hour, they're leaving because of how they're being treated by their coworkers. Again, I want you to think about the long-term impact it has in your department when you ignore someone's bad behavior.
Renee Thompson:
All right. Well, those are three mistakes and strategies on what you should do instead. I hope you found that helpful. And we have an entire resource guide for you, again, that includes all five common mistakes and what you should do instead. And you can find that in the show notes, that will be available as soon as this podcast airs. All right, as we wrap up, I always ask my guests, What book are you reading right now? So I grabbed my book, and right now, I'm reading Tribe of Mentors by Tim Ferriss, and I'm not even quite halfway through. As I was getting ready to actually launch this podcast, I listened to other people's podcasts, which actually I've been doing for years now, and this book was recommended to me by our producer as a great way to look at the questions that you ask your guests. And it's really just a collection of different podcasts that he has recorded and how a lot of his guests answered. And I just found it fascinating. So what I usually do is I read every morning for about a half an hour, and at the end of that period of time, I will read 3 or 4 of those excerpts from his podcast in that book. So it's probably going to take me a long time to get through it, but I find it really helpful. That's what I'm reading.
Renee Thompson:
And the book I recommend for all leaders, and I mean all leaders, is a book by my dear friend and colleague Joe Mull called Employability: How to Ignite Commitment and Keep Top Talent in the New Age of Work. I've known Joe for a long time, and he has such a great writing style. He does a nice balance of evidence and story, and what's happening out there, and practical strategies. This is all about how to actually engage your employees and keep them in today's, let's just say, challenging world. I read this, and I said, oh my gosh, this is probably one of the best books that I've read. So if you're in a leadership role, I highly recommend this book. I will have a link to this book in our show notes too. And speaking of the show notes, you can also just get access to our show notes by hopping on our website, HealthyWorkforceInstitute.com/podcast. I want to thank you for listening and doing your part to create a healthy, respectful, and kind work culture. We'll see you next time.
Renee Thompson:
Thank you for listening to Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. If you found these practical strategies helpful, we invite you to click the Subscribe button and tune in every other week. For more information about our show and how we work with healthcare organizations to cultivate and sustain a healthy work culture free from bullying and incivility, visit HealthyWorkforceInstitute.com. Until our next cup of coffee, be kind, take care, and stay connected.
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