Coffee Break_Episode 8 _Renee Thompson: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
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 there! Welcome back to the Coffee Break podcast. As you probably figured out by now, bullying and incivility happen because they can, and it really takes dedicated leaders like you to do something about it. And that's what this podcast is all about, giving you the strategies, the actions that you can take to finally stop the cycle of bullying. In honor of Bully Prevention Month, yes, if you're listening to this when it airs, this is October, it's Bully Prevention Month. This sounds maybe weird, but at the Healthy Workforce Institute, this is like our Christmas. This is where we feel that we have permission to talk at nauseam about bad behavior and how healthcare executives, leaders, and their teams all need to be part of the solution. So in honor of National Bully Prevention Month, today I'm going to share with you nine strategies that you can implement to actually improve your culture and reduce that disruptive conduct. Okay, all right. Let's say you're an executive, and you get some data. Maybe it's your employee engagement scores, maybe some other type of survey. And what you find is that you've got a bullying culture. Maybe you see that a lot of your new graduate nurses are quitting, and they're telling you it's because of bad behavior. What do you do about it? You say, well, that's just the way it is here. I certainly hope you don't say that. Or do you take responsibility and do something about it? And today, we're going to talk about what doing something about it really means. I do want to just remind you, I always like to say, why is this so important? Why are we talking about culture when you've got other big issues that you're dealing with, and that's staffing issues and financial issues? There's a lot out there challenging, especially our executive healthcare leaders. Why culture? Isn't it like, oh, the nice to have and not certainly a need to have? Well, studies after studies after studies, especially recent studies, show that culture is actually more important than anything else that you're doing in your organization. One of my favorite studies that really sums it all up for us, and it should for you too, is the McKinsey report, came out in November of 2022, that basically showed the number one cause of burnout and turnover is bad behavior. Your people aren't going down the street for another $2 an hour. They're going down the street because of how they're being treated by their coworkers, and that's why this is such an incredibly timely and important conversation to have. And what I want to share with you is what I've learned over the last 12 years doing this work. All right, you get this information, it shows that you've got a bullying problem, whether you believe it or not. Data, I always said data doesn't lie. What do you do? Well, here's what some healthcare leaders have done. You try to tackle it alone. You just try to fix the problem. I had a leader reach out to me, and what had happened was two years before, their executives pulled all their managers, all their directors together, and they said, we have a bullying problem here. People are leaving, now go fix it. Go hold your people accountable for their behavior. Bye! And that was it. Well, they reached out to me two years later because they weren't able to fix it. You can't just go and tell people to solve the problem without equipping them with the skills and tools that they need to actually do just that. Here's something else, it's a mistake. There's something else that does not work. And I've been a part of this too, where you just hire someone like me or somebody on my team to do a workshop, and then you check a checkbox, and you say, okay, solved the problem. We actually brought somebody in who's an expert, and they did an in-service, or they did a workshop. We're good. Yeah, that doesn't work. A one-and-done when it comes to culture does not work. And we're actually at the point with our company that it's rare that I'm willing just to do a one-and-done, because I almost feel guilty. I don't want to take your money. Now, some people will learn, and they will execute, but it's not sustainable unless you give continued knowledge and skills and support and all of that, and it's very common that organizations do this. Here's what does work, and I'm going to talk and spend the rest of my time with you today, really talking about what I call, it's not a technical term for this, it's our trifecta approach. It's actually the framework that we use here at the Healthy Workforce Institute to completely transform culture in an organization. You have to, first you have to strengthen your organization. You have to equip your leaders, and you have to empower your employees to be a part of this. And I'll never forget, I was having this conversation with a chief medical officer in an organization where we were doing consulting there and really looking at transforming the whole culture. When I was explaining this to him, he said, Oh, so this is like your top-down, bottom-up, and everything-in-between approach. And I thought, man's brilliant. Exactly. That's exactly what this is, a top-down, bottom-up, and everything-in approach, in-between. You can't just bring leaders into a conference room and say, okay, how are we going to fix this culture here? You have to empower your employees to be a part of it. So the nine strategies I want to share with you today are related to those three buckets, okay, as part of that framework. If you look at strengthening your organization, and I'm just going to give you three strategies, there are others, but these are more broad or general strategies. First of all, when we go into an organization, we always ask to look at your policies. What is your process for addressing disruptive behaviors? I cannot tell you how many times I've sat with managers, and I would say, okay, what's your process? When you have an employee who is bullying other employees or who is being extremely disruptive, clinically competent, but their behavior is incredibly disruptive, what's your policy? What's your process? And they look at me like I have two heads. They don't know. But then I'll talk to the directors. Do your managers know what your policy is? Oh, absolutely, they know. No, they don't. And the issue is with policies, too, is sometimes they're so prescriptive, or they're so vague that you can't hold anybody accountable for them. And they're not communicated very well. And so one of the things that you can do, strategy number one, to strengthen your organization is to create clear policies and a process to actually identify what bullying is, what it's not. It's not harassment or discrimination, okay? We have legal definitions for those terms. But when it comes to bullying, incivility, workplace violence, how are your policies written, and are they communicated well to your team? The second strategy is really to provide initial and ongoing skill development related to behavior. What we find is that, in general, organizations don't have anything built into their orientation for new employees. They don't have anything annually for their employees to remind them that the way we treat each other here is just as important as the care services that we're providing. There's nothing for their leaders that actually take a look at culture, and how to establish a healthy work culture, and how to address disruptive behaviors, especially for new leaders. So what we recommend is that you incorporate some type of education, initially, when you have new employees and then ongoing. And I'm just going to tell you this now because I don't want to forget, but I'll have some links to some resources for you in the show notes after this episode airs. So you can just check out, because I have some examples and some things that you can do. The third strategy under that umbrella of strengthening your organization, and I'm going to tell you, if you're only going to do one thing, and this is free, okay? Do this one thing. I would add Healthy Workforce as a standing agenda item in every single meeting. Think about it at the executive, if you have an executive leadership team, you should have it on the agenda, Healthy Workforce. Your directors' meetings, your managers' meetings, your education meetings, your staff meetings, your huddles, add Healthy Workforce as a standing agenda item, and in that, when you get to that part of your agenda, talk about culture, talk about behavior. Hey, let's talk about the fact that we're getting a lot. We're getting an uptick in people sending in complaints about cursing and yelling and arguing and patient care areas. Whatever it is, that's where you talk about culture. Hey, I just read this article on gossip. Does gossip happened here? Where does it happen? How does it show up? Is this something that we want to work on as a team? Or you can use this to actually recognize employees, recognize leaders for being a role model for a positive, a healthy work culture. Hey, shout out to Jane, who went out of her way to help Brian. He was new, and he wasn't sure how to do the whole payroll system, so she stayed after and helped him, shout out to Jane. You want to use it as an opportunity to really reinforce that culture matters in your organization. Now, I'm going to caution you. When I started doing consulting, and we were meeting, we created this executive team, one of the executives said, How do we make sure this doesn't become another flavor of the month? Great question. Once you put Healthy Workforce as a standing agenda item and all of your meetings, it can never come off. You understand? Like once you say culture is important, you cannot remove it because something else more important is now taking its place. You can shorten it, maybe you give it ten minutes, and today, you can only give it two minutes. Okay. But the first time, you take it off the agenda because something else more important showed up, now you've made it one more thing. And one more tip on adding Healthy Workforce as a standing agenda item, you don't have to call it Healthy Workforce. I mean, that's part of the name of my institute, but I named my institute that way for a reason. You always want to label things and name things in the direction that you're going. I've gone into some organizations, and they want me to help them with their anti-bullying committee, or their bully prevention committee. I'm like, No, can we change the name? You might want to call it Healthy Work Culture, you might want to call it professional work culture, positive work, whatever it is, but always make sure that it's spun in the direction that you're going to, because people will respond to that better than if you call it something negative. You know, again, my company, the Healthy Workforce Institute, it's not the anti-bullying institute because our goal is to help organizations like yours cultivate a healthy, respectful, professional, and kind workforce. So under strengthening organizations, we talked about your policies. We talked about making sure that you include some type of education related to bullying and incivility initially for your new employees and then annually, at least annually, ongoing. We actually recommend more than that, but I'll tell you the minimum that you have to do, and we talked about incorporating healthy workforce as a standing agenda item in your meetings. The second part of our framework is equipping leaders. We actually spend the majority of our time working with leaders to help them address disruptive behaviors and hold people accountable for professional conduct. This is where you're going to get your biggest bang for your buck is making sure that those leaders are equipped with the knowledge, skills, and practical tools that they need to actually address bad behavior. And what we have found in organizations is that, oh, they don't do a good job making sure that their leaders are equipped. So I'm just going to give you a few tips because, again, I could, probably should do a whole podcast episode just on leaders, but I'm going to give you three. First of all, make sure that you're providing some type of training for your new leaders. This is what we're seeing. This is the trend right now. A lot of organizations, if you look at how many of them because we've done the studies, you take a look at how many of your leaders are new. There are some organizations that 50% of their leaders are brand new to leadership, and many times, they only have a few years experience. You're throwing all this at them that they have to learn, and they're trying to do the budget and the payroll and the staffing patterns and all of those things. You must help them to know how to address disruptive behaviors as part of their leadership onboarding program, because that's what they need help with the most. And a lot of times we've talked to so many of them, it's so uncomfortable for them to say, confront one of their employees who has been there for 40 years, especially if they're new and they're young. You have to make sure that you're equipping them. We say this all the time. I was a staff nurse yesterday, and today, I'm your boss. Ooh, That creates a whole other dynamic, and if you're not helping them, what ends up happening then is they don't succeed, and then they quit, too. And we don't want that to happen. So make sure you're equipping your newest leaders. And then the second strategy and equipping leaders is to make sure that you're providing them with ongoing skill development. What we recommend and if you've already added Healthy Workforce as a standing agenda item, and so every single leadership meeting, you're talking about it, but then minimum, we recommend quarterly deeper dives into the topic of culture, into the topic of bullying, incivility. My favorite way to work with a client other than consulting is, we'll say, okay, Q1, we're going to focus on addressing bullying, incivility. Q2, we're going to focus on developing assertive communication skills with your team. Q3, we're going to resolve conflict, and Q4, we're going to focus on how to develop an emotionally intelligent team. I swear, if everybody in healthcare right now just had higher level of emotional intelligence, most of our problems would go away. And so that's where you've got this ongoing, they know every single quarter they're going to be doing a deep dive in a topic related to culture. So that would be what I would recommend for you. And then please, please, please, when you have a manager who comes to you, and we talk a lot about building a stronger relationship with HR, that's actually part of our strategy, that member said, I have a lot of strategies, that's another one that I didn't really talk about. But if you have a manager who wants to terminate a toxic employee, please help them. I cannot tell you how many conversations I've had with leaders who have said, I've done my due diligence, I've documented, I've done everything, and, but my organization won't let me terminate them because of, Fill-in-the-Blank. And this is where I actually tell the manager, go to HR, and say, my goal is to terminate this employee for these reasons. What do you need from me to make it stick? Now, I know some of you are working with a very strong union, and there are some adds, another layer of complexity. However, you have to consider the organization as a whole and that department as a whole. One of my favorite quotes of all time is from Perry Belcher, who said, There's nothing that'll kill a good employee faster than watching you tolerate a bad one. If you have a manager who wants to terminate a quote-unquote, bad employee, please help them, please support them. Okay, and finally, we take a look at the third part of our framework, that's empowering your employees to be a part of the solution. And we do this in lots of different ways, but here are just three of them. First of all, you have to raise awareness of disruptive behaviors. We see more disruptive behaviors in healthcare than in any other industry in the world. And one of the reasons, because we've normalized bad behavior. We've normalized deviant behaviors to the point where we don't even notice it. We just say things like, well, that's just the way she is, or that's just his personality. He's a really great nurse. Or if you need anything, like don't go to her. She doesn't like people very much. Don't take anything she says the wrong way. Don't take it personally. We justify someone's bad behavior because of how competent they are, how long they've been there, sometimes it's how much revenue they bring into the organization. So when people are working with some of these, we've justified their behavior for so long that we don't even notice it, that's what happens, they don't even think it's a problem. I just interviewed somebody for a podcast who said that when she started working in her department, there were people who would stand there and just curse and yell, and they didn't think there was anything wrong with it. And she's like, Time out here, people. Whoa, whoa, whoa. What is going on? And they looked at her like she had two heads, shocked that she thought that there was something wrong with that. So you have to heighten awareness of disruptive behaviors. And this is kind of a piggyback one. When we talked about adding healthy workforce as a standing agenda item, this is how you start heightening awareness, by starting to talk about culture, conduct, how people treat each other, talk about the eye-rolling, the exclusion, the silent treatment, the cliques. But you have to heighten awareness first before you can ask people to actually adapt their behavior. And I say this all the time, You can't expect somebody to adapt their behavior if they're not even aware of their behavior needs to be adapted. And so you've got to start opening the door to say, okay, this is how we really look. This is how you're perceived by other people, and start talking about it. And then the next strategy is really to engage your employees as partners. We've done a really good job with this. It's been so incredibly successful, and that's why I wanted to share it with you. With the consulting work that we do, we always work with the leaders first, but then we empower the employees to be a part of our implementation, and we actually identify employee champions, employees who get it, that culture is important, and are willing to partner with the leaders. So if you have shared governance, unit-based councils, if you have charge nurses or maybe it's respiratory, whoever, just engage them in any conversations you're going to have about culture, ask for their involvement. We just did somebody on my team, Dr. Mitch Cuzzi and I presented to a group of our certification clients, and we talked about eight essential skills of a healthy team. Actually, it was a healthy interprofessional team because we had physicians there, we had providers, we had nurse leaders there, and he talked a lot about collaboration. How do you get engagement and collaboration from the people on your team? Well, one of the ways to do that, very simply, is to ask for their input. Ask for their opinion. Hey, we've noticed that there's a lot of gossip in our department, and I think it's something that we should work on. I'd really like your input on this, because they may say, I don't think gossip is the big problem here. I think the cliques or the exclusion or fill-in-the-blank is more important. Okay, let's talk about that. You want to get their opinion, and there are ways that you can do this. I always like to use a little bit of scripting. We're actually going to put some of our scripts in the show notes for you. But I was thinking about how we could improve our culture, reduce gossip, whatever it is, and I thought about you because you're so good at, fill-in-the-blank. I'd really like your opinion on this, or I'd really like your input on this. I've noticed this, and it's a positive trait, and that's why I'd really like your opinion. Now, don't lie to people, okay? You can't use these to manipulate people, you know? Oh, yeah. I'm going to say, Oh, you're really observant, and you're always positive and honest. And if they're not, don't lie to people, but just say, I've always respected you as a surgical tech in this department, a nurse in this department, because you always come in with truly an intention to take care of, make decisions based on what's best for your patients first and then your team. I see you going out of your way to help people, and because of that, I want to work on this, maybe it's gossip or whatever it is, and I'd love your opinion. I'd love to get your input. Oh my gosh, if you're the leader and you say that to one of your employees, what are they going to say? Heck no. No, I don't want to be involved. They're more likely to be engaged because you want to empower your employees to be part of the solution. And then, finally, as I've said, I think in every single one of our frameworks, you have to provide your employees with ongoing skill development related to culture. Assertive communication. How do you help your employees learn the skills that they need to have honest and respectful conversations with each other? How do you give and receive feedback that helps your team to grow? How do you establish a culture of trust? How do you establish a culture of psychological safety? How do you resolve conflict? How do you develop emotional intelligence? Those are skills that they can learn, and those are skills that you should be learning too. It doesn't just come intuitively where you know how to give feedback to someone. No, there are skills that you can learn. So what we recommend is, monthly skill development for your team, and again, engage your employees as part of that. So those were the nine. So remember, the three frameworks is strengthening your organization, equipping your leaders, and empowering your employees, and I've given you three strategies for each. We actually have all of these strategies in a new resource that we have for you, it's actually called Nine Strategies to Improve Culture and Conduct a Guide for Healthcare Executives. You'll find the link to that in the show notes, where you can download it. Bottom line, if you really want to reduce incidents of bullying, incivility, and turnover, and burnout, it can't just be a, sign this code of conduct, when somebody is hired because, you know, signing a piece of paper doesn't work. If it did, I wouldn't have a growing company. It's a good start, but it can't be the only thing you do. You can't just bring somebody in to do a workshop on bullying. We know those things don't work. You can't just tell your managers, go do something about it. It doesn't work, I'm telling you. You can't check a checkbox when it comes to improving or transforming the way your people treat each other. Changing culture requires organizational support. You need to equip your leaders, and you need to make sure that your employees are a part of this. I will have a lot of resources for you in the show notes because, like I said, I can. It's National Bullying Prevention Month, and I'm excited to give you a plethora of resources that you can click, and you can download, and you can have at your disposal. One of my favorite things that other people say is, Oh my gosh, I love all the tools that I get that I can put in my toolbox for addressing these bad behaviors. So I just wanted to thank you for listening and for truly doing your part to address bad behavior and cultivate a healthy, respectful, and professional work culture. Thanks for everything that you do out there to make healthcare a better place. Take care. Bye!
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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