EP 34: Strategies for Resolving Workplace Conflicts

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Intro/Outro:
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 the Coffee Break podcast. Wherever you are listening or watching, I hope you're having a great week. For me, it's the weekend, okay? Today is Saturday, as I record this, and I was on the road this past week, so that's why I'm using today to get caught up to get some recordings done. But don't feel bad for me because I'm going to the beach tomorrow. The beach is my happy place, and when I'm home, the weather is nice. I live in Tampa, Florida, so the weather is usually nice, so we go to the beach. So my reward for working hard today is sitting at the beach tomorrow and maybe opening a nice bottle of red wine when I get home. Okay, so this is something that I discussed during the last webinar that I did in April, and I talked about it again at this retreat that I just did when I was on the road. It just keeps coming up, and so we're going to talk about this issue today. Dare I say that, let's say you have an employee who is yelling, cursing, refusing an assignment, and screaming and huffing and puffing down the hallway or maybe getting physical with a coworker; dare I say that's easy to address? You have policies about that, especially if it's overt behavior that everybody witnesses and can describe the same way. You've got some pretty good documentation, but that's not what we're going to talk about today. Today, we're going to talk about an issue that so many leaders deal with every single day, and that's dreaded, "he said, she said." Yes, we are going to tackle the, "he said, she said," because these are not easy to address. The issue is even for me, I teach how to address bad behavior, and I wish I had some type of magic recipe or formula for you to do one, two, three, and you will always know who's telling the truth and be able to resolve it, but it's not that easy. However, I do promise you by the end of this episode you're going to walk away with at least a few strategies and some tools to get better at addressing the dreaded "he said, she said". Okay. Let's say you're in a situation where one of your charge nurses barges into your office and is complaining that, let's call her Kim, one of your nurses just refused to take an admission, or maybe it's an assignment. It doesn't really matter. She goes on and on. I am sick of it. She is always refusing, and she gives me a hard time every time I give her an admission. Well, you go, and you talk to Kim, and you find out, wait a minute. That's not how it went down. Kim tells you, I don't know what she's talking about. She actually said to me, do you want to take this admission, or do you want to take the other one? And what now is she coming to you complaining about me? You know, she's always trying to get me in trouble. And then she gives, you know, ten other things that this charge nurse does to her, and now you're caught in this. Who's telling the truth here? Did the charge nurse clearly tell her, Kim, I have an admission for you? Or did she say, hey, do you want this admission, or do you want to take the next one? And then what ends up happening is they both bring all this other baggage to the conversation, to the complaint, and you're stuck in the middle. So, I'm going to give you a few strategies that will help you to at least have a better sense of who's telling the truth. The first thing I want you to think about is your own bias. Okay, we all have a bias, and here is a human issue. I call it my; whoever gets to mom first is believed. Okay, let's say you have two kids. So, I have two daughters. When they were little, if Katie came to me complaining about something that Kourtney did or something that happened that was Kourtney's fault, I talked to Kourtney, and Kourtney would tell me a whole other story. I tended to believe Katie first, even though, okay, it may have been; Katie was lying from the beginning, trying to get her little sister in trouble. It's something that happens in the brain. Whoever tells the story first, that's your default. That's what you believe. And then, when someone else shares a different version, it's like your brain is comparing it to what it heard first. So be mindful of that. When you hear this from the charge nurse, you're going to tend to side with that story. You're innocent until proven guilty. And I use this a lot, especially when, let's say, you have an employee who's been behaving badly for decades, and you finally decide that you're going to sit down and have an honest conversation with them; you're going to tell them, okay, look, you may be clinically competent, but you're nasty. You're not going to say that the way you're treating people was not okay. You're going to give examples before you have that conversation. You better tell your boss that you're going to have the conversation, and you better tell HR because what tends to happen is if this is the first time you're having a conversation with this employee, they tend to go to HR and complain that you're bullying them again. Whoever gets to HR first wins. So, just be careful of your own bias. Now the other thing that tends to happen is that we get sucked into the drama. Your charge nurse didn't just focus on Kim, who refused an admission. No, she went on and on. She gives me a hard time when I have to give her an assignment, and then she might go off on a tangent and tell you all the other bad things that Kim does. And likewise, on Kim's side, it wasn't just the admission. Kim goes into a barrage of other things that this charger says to her, so what you have to do is weed through all of that and focus on the issue at hand. It was all about the admission. So, get really clear on what the issue is. In this case, the issue is that the charge nurse gave Kim an admission, and supposedly, Kim refused it. Okay, all the other stuff is just drama. So do not get sucked into that vortex of drama. Forget about all of that other stuff. The next thing I want you to think about, you can usually tell when someone is lying or, let's just say, exaggerating the truth when they speak in generalities. So, let's say the charge nurse says she refused this admission. She's so lazy. She never, she always gives me a hard time, and just as all that general, versus, I walked into the documentation room where Kim was sitting. I asked her to take the admission, and she said I had just been admitted, give it to someone else. Jerry and Tina were in that room, too, and heard it. Do you see the difference? She's lazy. She always gives me a hard time when I walk in. This is what I said. This is who was in the room. You can tease out if someone is exaggerating, telling the truth, or lying based on the specifics they share with you. So again, look for general versus specific information that can really be helpful to you. The next is to talk about whether we should bring them together to mediate. Is this the mediation situation, or are you going just to let it go, or are you going to deal with it individually? So what are you going to do? First of all, I am not an expert on mediation. My friend Randy Kern is, and I interviewed Randy. We did a podcast episode. It's episode number seven. We'll have the link to that episode in the show notes, and he talks about his approach to mediation. It was quite shocking when he shared his approach to mediation. And it works. I was like, whoa, okay, so basically, he says, you put two people in a room, and you tell them, we're not leaving this room until we resolve this, and you let them. They can curse, they can yell, they can scream, and they can do anything. But so that you know, we're not leaving here. If we're here all day, we're here for six hours. You're not leaving until we resolve this, and you have to listen to the episode. It's actually pretty amazing. I know this as a bullying and incivility expert. You first have to decide if this is a conflict. Is this a, "he said, she said," or is this a bullying situation? Let's say this has happened before, where the charge nurse is fine with everybody else. It's just Kim she has a hard time with. Maybe it's other things that this charge nurse does to Kim. So is it just Kim? So is their target. Is the behavior harmful? Maybe she has set him up to fail in the past. And has it been repeated? If you think or even suspect that one of the people is bullying the other, please don't ever bring them together in mediation, okay? Mediation does not work when it's a bullying situation. All you will do is give the bully more weapons to use against their target. So first think in terms of whether this is a bullying situation or is this just like I said, "he said, she said," it's a conflict situation. When you bring them in to let's say you decide, that's it. I have to get to the truth here. Bring them in together. Tell me exactly what happened. There are a couple of tips that I want you to know that will help you actually engage in that conversation. There are some techniques you can use. I always start by establishing common ground. We want the same things. We want to work in a department. We want our culture to be respectful. We want to treat each other with respect. As professionals, we want to deliver the very best care to our patients, whatever that is. Establish common ground, and if you can include them in that initial conversation, include them. What's important to us here? Why are we here? So, go back to your purpose. Maybe it's a labor and delivery department. Why are we here? And get them to say to take care of moms and their babies. Okay, to treat our moms and our babies like they're our family, okay, whatever that is, to provide the very best care. You always want to start by establishing common ground because, in a way, it disarms them a little bit. Look, we want the same thing. You also want to set some ground rules, okay? When one person is talking, the other person can't talk. You actually have to be quiet until they're finished. And there are some techniques that you can use. You probably heard of this. You can use the talking stick. I actually did this with my daughters when they were, I think, in their early 20s. They were living together, which was not good, and they really had some conflict with each other. And so I went over to their apartment and brought a I think we used a wooden spoon as the talking stick. I said, okay, Kate, when you have the stick, you can talk. And I said, Courtney, you can't talk until Katie gives you the stick. And we did this. And it was actually not easy because they wanted to overtalk each other, but, uh-uh, ground rules. Whoever has the stick is the only one allowed to talk, and they only hand the stick over to the next person when they feel that the next person heard them. So you don't have to get that elaborate. But basically, just say I want to hear your side and the other person's. You're not allowed to say anything until they're finished. Now I want to hear your side, okay? So this is a, like I said, a "he said, she said" conflict situation. That mediation works really well. The key here, then, is it's not about deciding who was right, who was telling the truth. That's great if you can figure that out. However, what's more important is to set expectations for future behavior moving forward. This is the expectation moving forward because you can't address what has already happened. But what you can do is set expectations for future behavior. Now, it's easy for leaders to tell them what to do. This is what you're going to do from now on, okay? This is what you're going to do, but that's not helpful. Leaders tend to, and I'm guilty of this too, we tell people what to do all the time. Just do this. Just do that like we solve people's problems. That's what we think our job is. But if we keep telling people what to do, from now on, when she gives you an assignment, you're going to take it. If there's a reason why you can't, you're going to engage in a professional, respectful conversation, honest and respectful, and then come up with a solution. Okay, maybe it is that you take the next one, maybe the charts are set, and you realize that you had just discharged someone, or you just had a really difficult patient situation you had to deal with, and someone else was available to take the admission. Whatever that is, you're going to work it out as adult professionals, okay? It's easy for us to tell people what to do. Now, you could set some context for that and say, what would a professional do? What would somebody who's respectful do? How would they handle the situation? But really, what you want to do is say, how will you make sure that the next time something like this happens, you're going to respond in a professional way? What are you going to do? Because as long as we're telling people, they don't think, okay, that we don't give them an opportunity to think about how they will handle the problem. It's very similar to when an employee comes to you, and they're complaining, and they're complaining about anything right away. We go into solution mode, but sometimes, they need to vent. And I usually refer to it as: Are they looking for comfort? Do I need to vent to someone, or are they seeking a solution? I heard this recently at a conference where the speaker asked if they needed support or a solution. Because I'm going to tell you, a lot of us go right into solution mode. I want you to catch yourself doing that and take a pause and a step back and ask them, how are you going to make sure this doesn't happen again? As the charge nurse, how are you going to make sure we're not in this situation again? Kim, how are you going to make sure we're not in this situation again? They own the issue, not you. Your goal, your responsibility as the leader, is to set that expectation that we handle these situations as professionals. We make decisions first based on what's best for our patients and new admissions. What if that was your mother? Hey, what if that was your dad, your spouse, or your partner? Your child? We make decisions based on what's best for our patients and team. Maybe that charge nurse needs to assess the team to see who the best person is to get an admission, and then self is last. I know that's sometimes hard for people because right now, there's a big focus on wellness, mental well-being, and self-care. And I'm basically telling you that you come last. But you have to think about the role that we play in healthcare. Patients have to come first. We are serving patients. It's a selfless profession. Patients come first. Our teams should come second, and then we're last. I remember working at the bedside, but it wasn't that long ago, and I had just sat down and started to get caught up with my documentation, and the charge nurse called me out to the desk. And, you know, it will be bad when they say, I'm sorry. I was like, what? She said, but I have to give you another admission. And I said, Tracy, that's why I'm here. I'm here to get admissions. But my inside voice said, crap, I have to get an admission. I just had an admission. I had two discharges. I had a difficult family situation. I trusted that my charge nurse knew what everybody else was dealing with and that I was the best person to get that next admission. Sometimes that's not the case. So the charge nurse who is responsible for those admissions needs to really take a look at who is the best person. They have to think about the team, who's the best person on the team to get that admission, and then make an appropriate decision. But the bottom line with all of this is these, "he said, she said," they're messy. They're in the gray zone. It's not clear. It's not black and white. I wish they were. But there are some things that you can do to help minimize the, I would say, just the overall amount of time and energy that you spend trying to figure out, all right, who is really telling the truth here? And that is first to check your own bias. Then it's really important to take a look at it. All right. What is the issue? If you focus on one issue at a time and allow yourself to pay attention to all the other issues that they're bringing up, they will zing zing. This happened six months ago, and she did it. And that's just they're all distractions, okay? They're all distractions. Focus on the issue at hand. Think in terms of: are they giving me specifics or are they talking in generalities? Just like when you're an employee says, oh, you have favoritism? Okay, wait a minute. How am I showing favoritism? And they can't respond. They can't give you an answer. I just heard this from one of the leaders that I was working with, and they said the physicians were saying there are issues with nurses, so many issues with nurses. Can you tell me what one of those issues is? Just issues. I'm like, so somebody can't be specific. Then it is either they're just venting, or they're just frustrated. It depends on the situation; it should be a heads-up or a red flag for you that something is going on that deserves further conversation. Okay, so that might be with this physician setting time aside to say, hey, let's talk about this. You said there were issues with nurses. I want to get really clear on what those issues are because if I don't know what they are, I can't work with you and them. Because it's, you know, not a siloed situation, maybe take a look at how we can resolve these issues together. So, are we getting really clear on these specifics, or are they just talking in general terms? And then consider whether or not you want to mediate. Again, if it's a bullying situation, please do not bring them together. You will make it worse. But then set some ground rules for how you will interact with each other. Again, listen to the podcast episode where I interviewed Randy Kern. It's episode number seen. He will help you with mediation and dealing with conflict because he talks a little bit about that, "He said, she said," too. But then make sure that you lead with the expectations. And then how are you going to make sure that this doesn't happen again? Don't take ownership of this. It's their problem to solve, okay? And then, finally, I want to maybe go back to the beginning. There are some of these that are just drama. If they don't impact patient care, I don't know. I might pick and choose which ones I want to get involved in. Sometimes, it's just petty middle-school bickering between your employees. Now, I'm not saying ignore all of them, but think about your own energy and think about the impact that situation has on the overall function of your department and the relationships in your department. And it's okay sometimes to let something go. If you feel it's just some drama, use your time and energy to solve some of the bigger issues. And then one last thing. I mentioned this, and I'll repeat it. Sometimes, when you have an employee coming to you, do they want you to do something about it? Do they want a solution, or are they just venting? Was it comfort? Are they looking for comfort, or do they want a solution? And is it actually okay for you to ask them if you're telling me that this happened? Do you just want my support? I think support sounds better than you just want me to comfort you. Okay? Come here. Honey, I gave you a big hug, but that might not go over very well. How would you like me to? Would you like me to address this? Do you want a solution? Do you want to talk about how you can handle this situation? Because it shouldn't always be your responsibility to take care of these problems. You want to empower your team and your employees to handle these situations. So before you get into the "he said, she said," the vortex of these issues, take a pause and just ask yourself, when you're here from that first person, do they really want a solution, or do they just want my support? Is this a situation that's impacting my department, my patients, and my team negatively, and then make a decision? Whether or not you are going to get involved. And then I've given you some strategies to do that. Again, as I said earlier, it's not an easy situation to deal with, and it comes up so many times in so many different ways, and I'll end with this. A lot of times, for employees, it's all about who's right. I was right, he was wrong, or she was right. She was wrong. Remind them that it's not about who is right, okay? And all of these "he said, she said" situations. It is not about who is right. It is about what the right thing to do is. So we go back to the example when Kim refused to take an admission. What's the right thing to do there? Okay, from Kim's perspective, it's to take that admission and, again, maybe how the charge nurse delivered that information could be worked on. But I always try to take it back to, I don't know, the right brain. What if that was your mom? Would it be okay for a nurse to refuse to take that admission? What if that was your spouse, your partner, or your child? Would that be okay? It's not about who is right; it is about what is right. Okay, I hope that helps you and at least gives you some guidance on how you can tackle these "he said, she said," or as I call them, these tricky sticky situations. And in the show notes, I'm actually going to link to the webinar that we posted. You can actually get access to that webinar through our academy. Not only do I handle the he said, she says, but I handle how do you deal with cliques. How do you deal with having a strong union? Leaders face some other tricky, sticky situations when in their leadership role, but you can get access to those, and to learn a little bit more about how you can best handle them. Okay, if you like this podcast, can you please rate it for me and give it a rating from 1 to 5? Hopefully, you'll give me a five-star review. Just post a review and it's really easy when you go into where you listen to podcasts, if you scroll down, it'll show you the ratings and reviews and it'll say, write a review. Just click on that, write a review for me, and then share this with other people who might need to hear this message today. So when you do all of that, when you rate your review, and you share, that helps us to make some noise in a very crowded space right now. All right. So, I wanted to thank you, our listeners, for doing your part to break the cycle of bullying and incivility in healthcare. And remember, the way we treat each other is just as important as the good care that we are all providing. So keep fostering a healthy work culture, and I'll see you next time.

Intro/Outro:
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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