EP 70: Leadership Q&A with Renee: Your Questions, My Answers

CB_70 – Renee Solo 10: Audio automatically transcribed by Sonix

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Dr. 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.

Dr. Renee Thompson:
Hi there! Welcome back to another episode of the Coffee Break podcast. Okay, it's a new year, as you know. And, of course, as all new years start, we have an opportunity to tweak and enhance and improve and just really get better. And so it's podcast enhancement time. I am really excited about making some changes to the podcast. It's really based on what's been happening out there. So, let's just say I've only been hosting this podcast for about a year and a half. I feel like I'm still a baby podcaster, and I'm learning and changing things as I go along. And so I thought, okay, going into this new year, what enhancements do I want to make? Well, there's a term used in marketing and it's basically the market doesn't lie. If you want to do something to serve people, if you want to build a business, if you want to sell products, you have to listen to what the market is telling you. And here's what the market is telling me.

Dr. Renee Thompson:
You want answers to your questions about how to deal with certain behaviors over and over and over again; whether I'm doing a webinar, some type of in-person event, even all the coaching that I do, leaders are always asking, how do I deal with fill-in-the-blank? So, I am excited to let you know that starting January with this episode, we're going to have a monthly Q&A with Renee. And what this will be is an opportunity for me to answer some of those questions that you have been asking me. Now, keep this in mind. We will have an opportunity for you to actually submit questions that I can then review and choose to answer on this podcast. But I have a collection, I could probably write a whole book on Q&A, you know, situations that leaders have shared with me and wanted help to solve. So today, I'm probably going to do about three questions, depending on how long it takes me. Because, you know, if you know me, you know I can be a long talker.

Dr. Renee Thompson:
All right. The first question I'm going to answer today came from a reader who said, I have an employee who's been with the organization for a long time. She has always been disruptive but tends to hover under the radar, if you know what I mean. Never doing anything extreme that HR is willing to take action on. Okay, that's a whole other conversation. However, she gave me some examples. She hijacks meetings for her own self-interests. She argues everything and is a chronic complainer. She told me that most of her team has kind of gotten used to her, and they just deal with her. They don't let her affect them, you know? They avoid her antics and just kind of like, yeah, that's just the way she is, which is not good. However, they haven't succumbed to her negativity, which she told me was. She's noticed that she's taking some of the new people under her wing, and now some of these new people are starting to act like her. She's like, what do I do?

Dr. Renee Thompson:
There's actually two parts to this. I'm only going to focus on one part. The part that I'm not going to focus on is, how do you deal with somebody like that? Okay. That hovers under the radar. Maybe I'll do that the next time because it happens so often. But how do you deal with someone who, you know, is starting to influence other people towards badness? I'm going to answer this by sharing another example, and this is an example that I have heard from so many people. And doing the consulting work that we do has shown up frequently. Let's say you work in an organization where you are very unionized. Okay. This is what I've learned about leaders. They feel like they have to walk on eggshells. They're afraid to say what they want to say because if a union rep hears them, they're going to get reported. And you know, they're going to file complaints and all this stuff. So, the leaders tend to be like, cautious. Oh, I don't know if I could say that because it might be turned against me. So, I'll give you a specific example, and it's not the example. It's the principle of the solution that I'm going to share that's going to apply to this first question in any other that this happens, any other situation where it's the same. So I was doing consulting, and there was an incident, a really significant incident that's confidential, I won't share. Well, the union got involved. And what ended up happening was there was almost mutiny with the staff because they were listening to the union side of the story that got manipulated by certain people in that department who didn't have all the correct information but acted like they did, and they started spreading these rumors and it spread like wildfire. And so even the quote-unquote good employees started joining this group of people, you know, in this sort of mutiny situation. And when I talked to the leaders who actually stood there and listened to one of their nurses share a part of the story that this leader knew was not correct. Like, that wasn't the facts. It was the opposite. And I said, well, what did you say? She said, well, I didn't say anything because, you know, I didn't know if I could, I didn't know what I should say. And I'm like, oh my gosh. Okay, we got to talk about this. Here's the deal. If you have a disruptive employee like this manager does who hovers under the radar and for whatever reason is still there, or if you're in a heavily unionized and you have a very strong union rep who is was twisting things and gathering their posse. Whoever's voice is louder will influence people, okay? Just think about that. This disruptive employee is complaining, arguing, hijacking meetings, all of that. Pulling these other employees under her wing. Talking, talking, talking. This place is a mess. And this is the fourth leader. You know, whatever they're saying behind the leader's back, you as the leader have to counter that with positive messaging, with getting really clear on what the facts are by overcommunicating. And what I shared with this manager who reached out and asked me, this is I said, okay, she has a really small team. I do one-on-ones with my employees, and I said, okay, here's what you do. Those new employees that you do one-on-ones with double the time you spend with them. If you do a 30-minute one-on-one, 15-minute one-on-one, double it. Spend more time with them because it's about influence and whose ever voice they are hearing will influence them towards goodness or towards badness. And it's based on, I'm sure you've heard this. Mirror neurons that is always mimicking what we see. And so the more you're around people, certain people, you start to behave like them. So she has these new employees who are starting to behave like this disruptive employee. So what she needs to do is she needs to address the disruptive employee. We know that. But she then needs to be that voice of positive influence to those new employees. And just like I said to the leader when they were dealing with that incident, you know, strong union, where I said, it is your ethical responsibility to tell the truth and to create a situation where you're scared to tell the truth. That goes a little bit deeper, but you have every right and responsibility to say, time out. That's not what happened. These are the facts that I can share. There are other pieces of information that I cannot share because it's confidential. But please know that did not happen. That is not accurate. And when somebody is even sharing things stories with you, you know what happens with stories. Even take a step back and then ask them, how do you know that this is true? Well, somebody told me, how do you know what they're telling you is true? So I just, if you look at the principle behind this, you need to be a positive influence in your department, Especially if you have an employee or employees who were negative and disruptive. It's again, whose ever voice is loudest is the one who ultimately influences other people. So, ramp up your positive influence. Meet with them more often. Let's go back to the hijacking the meeting. And I said to her, say, time out. We're not going to have this conversation at the meeting. I'll put it on the parking lot. We can discuss it later, like you need to take back control. Okay. Because some of these people, you've given them the control. You need to take it back. And so even by you doing that, you're sending a message that that's not okay. That's not professional behavior. You don't interrupt and hijack a meeting for your own benefit. When they're being very negative, if you're there and they're being negative, you need to say, hey, time out here. You know, this sounds very negative. You know, is this a complaint or a concern? And I've given a lot a lot of scripts on that. But I'll just wrap this up by saying again, whose ever voice is loudest is the one who will have the greatest influence. Your voice needs to be there in multiple ways, okay?

Dr. Renee Thompson:
All right. Here's another one. Somebody reached out and basically told me that they have an employee. She's been there for five months. She works the night shift, like 12-hour night shift. This manager has had several other employees reach out that this new, and she's a tech, she's a support staff PCT. She has an attitude. She does not receive delegation well. There is a big blow-up. You know, this is one of the incidents where the manager had to interview everyone. This tech was very defensive. She blew up. The manager gave her a verbal warning. And this tech screamed at her in her office, screamed at obscenities. She had an assistant nurse manager who was there, who was witness to this. And the manager. I remember her telling me, she said I was scared, like I didn't know what she was going to do. I mean, she was verbally abusive recently. Like, this is where it came to a head and she knew she had to do something. She had two complaints from patients that she experienced during rounding. So she was rounding on her unit, and two patient complaints about this tech. One patient said that this tech told her, you need to get your ass on the chair. Can you imagine? She actually said that to a patient. You need to get your ass on the chair. And then this tech said, you know, I get myself in trouble with my mouth. She confronted her again. She raised her voice and basically said, everybody's twisting my words. You'll be hearing from my lawyer. This tech complained to the CEO that she's being bullied in her department, got HR involved, and now this manager is afraid that she's going to get in trouble, that they're going to be sued, and all that good stuff. So that was where it was when she and I talked. Okay.

Dr. Renee Thompson:
I want to focus on one key principle mindset solution. When things like this happen, when you have someone who is, for lack of a better way of saying it, misbehaving. You have to ask yourself, is this something I can train? Can I train someone to communicate more assertively? Communicate with honesty and respect, and maybe not aggressively. Can I train someone to give direct feedback instead of indirect, or triangulation, or gossip? Or is this a character flaw? So I'll give you another example. We were doing a live culture call that I do every month with our clients. And one of the managers was telling me she had a PCT who, the nurse said to her, hey, did you check this patient's blood sugar? I need to give insulin before the meal. And she says, yeah, I checked it. It's like, well, I don't see it in the record. It's like I checked it. She got a little testy, and she came back, and she's like, I don't see it. And then there was a blow up and she admitted that she didn't check it. She could check it herself. And the manager said, this is like the third or fourth time this PCT did something like that, where she said she did something and they find out that she didn't. What should she do? And I said, oh my God, you do not work with this person. This is a character flaw. You fire this person; you don't work with them. So I want you to think about that. Is this something you can train? Then train them. Give them a chance. But if somebody is screaming obscenities at you, tells a patient you need to get your ass on a chair, goes to the CEO complaining that you're bullying them. This is not anything you can train. This is a character flaw. You need to therapeutically extract them. Now, the issue sometimes is when you go to HR, we talk a lot about this disconnect between human resources and leaders. I've done episodes on this, and actually, I will link the episode I did about how to improve the relationship with HR in the show notes. Okay, I'll put the link there because it's really important. HR, I've seen two models. It's either consultative, I need your advice or it's I have to make the decisions. So, you have to first figure out your model and your organization. Which one is it? Are they there to consult with you and help you guide you, or do you need their permission or approval to do anything? Anything like a corrective action. So, regardless, this is what I told the manager to do. You go to HR, and you say, I want to terminate this employee. What do you need from me to make it stick? Because a lot of times managers will go to HR and they'll complain about an employee, but they don't really know what they want. First, I learned this once when I had an issue with somebody I had hired to install carpet, and it's just a really great framework to use. Anytime you're not satisfied with something, you've purchased a service that you've received, it's easy to just get on the phone and complain to them. You first have to stop and ask yourself, okay, I'm not happy. What do I want? Do I want a full refund? Do I want them to replace it? Do I want money? Like, what is it that you want? Because then you show up as someone who's serious, who's put some thought into this, that, you know, they're not going to say, oh, they're just, you know, complaining, and they're off the rails, okay, and that happened with me. I had carpet installed. They did such a lousy job. I mean, it had already buckled like the day after they were there. So I'm like, oh my gosh, I was livid because it took a lot for me to actually coordinate me being home and then putting the carpet in. So I thought, what do I want? Do I want my money back, or do I want them to fix it? And for whatever reason, I remember thinking they have to come back and fix it, and they have to continue to fix it until it's right. So when I called them, I'm not happy. This is what I see. I want you to fix it. I was very clear there was no room for hysteria. Okay? And I was serious. And they knew I was. And they came in and they fixed it, and it was okay. If you have an employee that you're struggling with, you first have to step back and say, what do I want? Do I want to put them on corrective action? Do I want to give them give them a chance to do some training? Some coaching, maybe. You know, it's just something that they need to work on. Or is this someone with a character flaw that I need to extract from my department? You have to figure that out first. Okay. Character flaw was the next one. Let's do one more.

Dr. Renee Thompson:
Here's a situation where someone reached out. There had been a yelling match between his LPN and a tech from another department. The tech apparently didn't do what she was supposed to do, and the LPN yelled at her in the hallway in front of everyone. So he said, I don't know if I should bring these two together. The tech isn't from my department. You know, I've talked to the tech manager and we were trying to figure out what to do. So he asked me, what should we do?

Dr. Renee Thompson:
All right, here's the deal. Let's talk about mediation, when to do mediation, and when not to do mediation. And my good friend Randy Kern, he's the mediation expert. I've interviewed him on my podcast, and I'll put the link to his interview in the show notes. All right. Mediation works really well when there's conflict. It does not work well for one-time incidents like this, because it was a one-time incident and absolutely is the worst thing that you can do if it's a bullying situation. Because if you bring the bully and the target together, well, let's just say you've just given the bully more ammunition, okay? So you have to ask yourself, is this bullying, or is this conflict? If it's bullying, no mediation. If it's conflict mediation. And I want to give you an example. And it's so funny. We had our big company retreat recently, and my best friend Kimmie, I've known her since the third grade. We've been best friends since the third grade. She always has to come to my house because we invite everybody to my house. So we always have to check her schedule first so that she can be here. And she always ends up spending a week here with us, which is really great because I love, love, love my best friend because she cooks okay. She's in the kitchen. She makes sure everybody is well fed and well hydrated because I am not, as I'm not quite the party planner that she is. So, that's why we bring her in. We were talking about the fact that she and I both love to do jigsaw puzzles. And I'll go to her house, and I'll see if she's working on a puzzle. And sometimes, you know, when she's at my house, you know, we'll work on one. We have a very different approach to jigsaw puzzles, so we both start the same way. You got to do the frame first, got to do the frame. But then what I do is I pick a certain image in the puzzle, and then I find all those pieces that I think are part of that, and I build it. What Kimmie does is she, after she does the frame, she organizes all the pieces by colors. So, if there are pink pieces, she puts them all together, blue all together, you know, dark all together. She has a different approach to puzzle building than I do, but we end up with a finished puzzle. That's conflict. I can't say to her, you're doing it wrong, Kimmie. Okay? You're doing the puzzle wrong. You can't organize your colors. That takes way too much time. It's what she does. Just like she's not going to say to me. Renee, you're doing it all wrong. You got to organize your colors. We end up at the same place. That's conflict. So if you have two of your employees who have a different approach to how things are done, as long as it's evidence based and they're ending up at the same place, that's conflict. Do mediation. Okay. It works when it's a one-time incident like this LPN in tech, do not do mediation. And what I suggested was, he needed to talk to his LPN, and the other manager needed to talk to her tech about their behavior. And what I said to him was you need to have the conversation with her that goes like this. Okay, I, okay, I understand what happened. This is what I heard. Even if she was right. Okay, we know this. Sometimes, people are right. Even if she was right, the way she handled it wasn't. So that is just a counseling and a coaching. It is having that conversation with that LPN, saying, let's talk about what happened. And I love starting a conversation that way. I heard this happen. Let's talk about it. I want to hear from your perspective. And then, you know, listen to them and then remind them again. It doesn't matter if they're right. It's how it was handled that wasn't right. And how could she handle it differently in the future? Because if you don't have that piece of the conversation, then how are people really going to learn? It's okay if the next time, if I'm in a situation where something wasn't done right, how am I going to address it? Am I going to stand in the hallway screaming and yelling at them? No. Maybe I'll pull them aside and say, okay, walk me through what happened. This wasn't done. Is there a reason? Because I always like asking that. Is there a reason why this wasn't done? You know, Mr. Rossi's blood sugar wasn't checked. Was there a reason? There may be a reason. Somebody may have been in the middle of a code brown. And, you know, somebody's pulling out their Foley catheter-like you just don't know. Can you tell with those examples out quickly because they've happened? You have to ask the questions and act with curiosity. But in a situation like this, it's being very clear this was the way it was handled, was not okay, was not professional. Now, there was another piece of this that I reinforced. He and this other manager talked about this, and it wasn't a, your employee did this, my employee, blah, blah, blah. There's no competition here. There's no right and wrong. Because, you know, we say this a lot. Leaders complain about the people in their department all the time, but nobody else better complain about them. Okay. I've shared this many times. I'm the oldest of five kids, and actually, all of my siblings were together just a few weekends ago to celebrate my big birthday. And we're all over the country, and it was a surprise. It was just amazing. You know, having my siblings all together, we haven't been all together in eight years. And it's funny, we were so close growing up, and we're still close. We just don't see each other as often. And I can remember my brother Jerry is only ten months younger than me, and he and I would pick on my younger siblings all the time because, you know, that's what kids do. We would pick on them, but nobody else better pick on them. It's the same thing. Or it can show up in departments where you complain about your employees, but nobody else better complain about them. We need to stop that because you're all on the same path. You're all dealing with the same issues. So what I reinforced to this manager was to say to that other manager, look, if any of my employees ever treat your employees in a way that's disrespectful again. Yes. Please come to me first, and I promise I'll do the same for you because you guys are all on the same path. You're all dealing with the same issues. So instead of attacking the other department or accusing or criticizing, just recognize that, oh my gosh. Yeah, I've experienced that too. And how do we work on this together, okay? You know what? Let me do one more quick one. This question has been asked of me numerous times, actually included in my keynote that I do on bullying and incivility my workshops that I do. People ask me, what's the difference between bullying and incivility? Okay, if you look at behaviors, yelling, cursing, exclusion, gossip, arguing, if you look at, you know, stabbing people in the back, silent treatment, withholding information, all of the behaviors, all of those behaviors could be either bullying or incivility.

Dr. Renee Thompson:
What makes it one or the other is asking yourself these three questions. Is there a target? So let's say somebody always gives us one person the worst assignments, criticizes them any chance they get. Looks for reasons to find fault in them. Drills them like a drill sergeant during giving report. But they're fine with everyone else. They've targeted that person for behavior to be considered bullying. There has to be a target. It can't just be a mean to everyone. There has to be a target. It could be one person or a small group of people. It could be like all the new people. It could be the night shift. Okay. If you're day shift, or it could be the day shift if you're night shift. But there has to be a target. The behavior has to be harmful in some way. So when we look at the spectrum of behaviors, things like eye rolling, is that harmful by itself? Not really. It's, you know, not nice, but not really. If I'm spreading false rumors about you, telling lies about you, if I am openly criticizing you in front of other people trying to get you in trouble. Find fault. If I withhold information and you look stupid in front of people during rounds, if I withhold information, that might affect the patient. So you're looking for harm here. What's the harm in someone's behavior? And then finally, it has to be repeated over time. It can't be one time I get testy with you in a crisis situation.

Dr. Renee Thompson:
So, if we even go back to that LPN tech situation, that yelling, was that bullying? No. Okay. Because it was a one-time act of aggression. It was a one-time incident that we know of. If this LPN is always attacking this tech every time she sees this tech, now the tech is in a different department, so chances of that happening are slim. But hey, I'm giving you that opportunity. You have to see this behavior repeated over time. So when an employee comes to you and say, I'm being bullied, you say, okay, is there a target? You know, are they the only one being treated this way? And you could even say, are you the only one being treated this way by this person? Ask the question. Or have you seen this person act this way with other people? Where's the harm? What's the impact? And you may need to figure that out because they might not realize it. And then, have you seen this behavior before? Has this happened before? Bullying is very different than incivility, but I want you to remember it can be the same behaviors. It's just with bullying there's a target. The behavior is harmful, and it has to be repeated over time. Here's some sort of good and bad news. The good news is, if you can actually identify that someone's bullying, you got policies for that, it's actually easier to address.

Dr. Renee Thompson:
The bad news is, if it's incivility, not so easy. Incivility is culture. And your culture didn't get this way overnight. It's not going to change overnight, but it can change. But you have to take an active approach to that. And what we work on mostly here at the Healthy Workforce Institute is incivility, because that's what's pervasive. Bullying is not as pervasive as people think it is, because people have a different definition for bullying. I had one person years ago who said to me, my hospital is bullying me. Said the name of the hospital. I said, okay, what did your hospital do? This was pre-COVID. And she said, I don't want to get the flu vaccine, so they're making me wear a mask. I said, all right. Are you the only one they're making wear a mask. Well, no, that's not bullying. That's actually evidence-based. Okay. That's policy process. Whatever. You have to get really clear because a lot of people say they're getting bullied if they don't get the schedule that they want. That's not bullying. Unless you're the only one who doesn't get the schedule that they want. So, as a leader, it's important for you to get crystal clear on what bullying is and what it's not okay. This wraps up our first Q&A with Renee. Again, you can expect to have one of these episodes once a month. Not sure what week of the month I don't want to lock myself in.

Dr. Renee Thompson:
It's whenever I can actually get things scheduled and recorded, but I hope they're helpful. We will have a link for you to go ahead and click on if you want to enter a question for me to answer on the podcast; I would love that. I just want to thank you for being here. I know you're busy, and I'm grateful that you carved out time out of your busy life to spend with me, trying to learn how to cultivate and sustain a healthy work culture. If you like this podcast, can you please write a review? We're doing a campaign to get more reviews, and it's looking a little, I don't know, it's like our reviews are starving. Okay, we don't have a lot of reviews, but yet people reach out to me all the time saying, oh my God, I love your podcast. Write a review for me, please. Okay, give it a rating, and then share this podcast with others. Again, thank you for everything that you do to cultivate and sustain a healthy work culture. We'll see you next time. Bye!

Dr. Renee Thompson:
Thank you for listening to Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. If you found this podcast helpful, we invite you to click the Subscribe button and tune in every 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 us at HealthyWorkforceInstitute.com. Until our next cup of coffee, be kind, take care, and stay connected.

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