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Managing Through Work Style Differences in Healthcare
Professionals
““Why Working With Why Working With You Is Driving Me You Is Driving Me
NUTS!”NUTS!”
Terry S. Johnson, APN, RNC, MN, CLECTerry S. Johnson, APN, RNC, MN, CLECNeonatal Nurse PractitionerNeonatal Nurse PractitionerFounder, Lode Star Enterprises, Inc.Founder, Lode Star Enterprises, Inc.© Lode Star Enterprises, Inc.© Lode Star Enterprises, Inc.
Disclosure Statement• In addition to any clinical practice, education
and consulting services I provide– I am currently on the speaker's bureau and/or
consult with these industry partners• Prolacta Bioscience and Abbott Nutrition Health Institute• I receive financial reimbursement for those services
• Images & photographs used in this presentation come from publicly accessed sources
• I will make no recommendations for any off label use of any drug or medical device
• I am honored to be here with you today
Interpersonal Work Skills• "Simplexity"
– Why Simple Things Become Complex and How Complex Things Become Simple
• The science of redefining how we look at the world and using that new view to improve our work and lives
• “Simplexity” Interpersonal Issues in Nursing– Reality of Work Stress in Nursing
• Work Style Differences
• Communication Style Differences
• Intergenerational Influences
Klueger, J (2008). Simplexity: Why Simple Things Become Complex and How Complex Things Can Be Made Simple. New York, NY: Hyperion.
Interpersonal Work Skills
.
Dorothy DelBueno, 1980, Work Competency
Interpersonal Work Skills
• Nature of Work Place Conflict– Substantive Aspects
• Conflicts of Work Styles• Conflict of Communication Styles• Conflict from Intergeneration Influences
Conflict of Work Styles
• Why Do You Do That?– Comes from being “different”– “Hard Wiring” around tasks– Exists on a continuum – Expressed in work variables– Influenced by stress– Information & tolerance help
People
Socially Cautious Socially Assertive
People
• Socially Assertive– Increased need for people at work– Likes working with a crowd– Work is a social event– Emoting, feelings matter– Focus on the task….responds to people– “How are you doing?”– Gathers the troops
People
• Socially Cautious– Decreased need for people at work– 2 people at their bedside is a crowd– Work is work– Shares feelings rarely and selectively– Focus on the task….tolerate the people– “If you would quit talking so much….”– Retreats into a fortress
Environment
Stable Environment Dynamic Environment
Environment
• Stable Environment– Values routine, pattern and order– Systematic approach– “We’ve always done it this way!”– “That’s nice….now go away”– Conformity is everything!– Things are carved in stone
Environment
• Dynamic Environment– Values and seeks change– Flexible approach– “Whatever gets the job done!”– “I’ve been thinking….”– Just do it!– Written on an etch-a-sketch
Time
Monochronic Polychronic
Time
• Monochronic– Tends to compartmentalize tasks– Loses focus with interruption– Accused of being anal-retentive– Methodical– Low level of involvement with their work– “It’s done, copied, stapled, collated and I sent
it to you by email, snail mail….”
Polychronic
• Polychronic– Engages in multiple tasks at once– Stimulated by interruption– Accused of being disorganized– Impulsive– High level of involvement with their work– “It’s on my desk somewhere….”
Completion
Bottom Line PerfectionisticBottom Line Perfectionistic
Completion
• Bottom Line– Independent standards about “done”– Things change depending on the
circumstances– Results over form– “That’s what the next shift is for!”– “Get it done, we can clean it up later”
Perfectionist
• Perfectionist– Exact, concrete standards about “done”– Worship the 3 P’s -
• Policy• Procedure• Protocol
– Form is everything– “I can’t leave this like this!”– “There is only one way – the right way!”
Decision Making
Reflective ReactiveReflective Reactive
Decision-Making
• Reactive– You already know if you are– Decisions made in 3-10 seconds– Intuitive based over data based– “I have a hunch!”– Biggest fear is “no” decision– Will change decision as more information
becomes available
Reflective
• Reflexive– You’re still trying to decide if you are one– Decisions take time– Data based over intuitive based– “I need more information!”– Biggest fear is a “wrong” decision– Can’t decide….I’m still collecting data
Intra-Personal Stress
• Emotional aspects:Emotional aspects:
AngerAnger DefensivenessDefensiveness
DistrustDistrust ResentmentResentment
FearFear RejectionRejection
SS(Stimulus)(Stimulus) + + RR(Response(Response)) = = OO(Outcome)(Outcome)
Intra-Personal Stress at Work• “Communication problems are the
number-one cause of sentinel events.G. Porto, RNQRS Healthcare Event Advisory Board JCAHO Sentinel Event Advisory Committee
Sentinel Event Alert # 30
• Published July 21, 2004– 71 cases (now over 110 cases) of perinatal
death or permanent disability in a term, normal newborn
– Injury defined as
“ Any perinatal death or major permanent loss of function unrelated to a congenital condition in an infant having a birth weight greater than 2,500 grams”
Sentinel Event Alert # 30
• Maternal Characteristics– Mothers ranged in age
from 13-41 years– Over ½ of the mothers
were primiparas– Average gestational
age was 39 weeks
Sentinel Event Alert # 30
• Maternal Risk Factors– Lack of PNC (4%)– Maternal age (13%)– Previous C/S (11%)– Diabetes (4%)– Substance abuse (4%)– Placental abruption (8%)– Ruptured uterus (8%)– Breech presentation (6%)
Sentinel Event Alert # 30
• Delivery Risk Factors– Emergency C/S (49%)– SVD (46%)– VBAC (8%)– Vacuum extraction (21%)– Mid forceps delivery (13%)– Delayed C/S decisions (4%) – Failure to do indicated C/S (11%)
Sentinel Event Alert # 30• Root Causes Identified
– Staffing issues (25%)– Staff competency (47%)– Inadequate fetal monitoring (34%)– Orientation and training process (40%)– Physician unavailable or delayed (19%)– Unavailability of perinatal information (11%)– Unavailable monitoring equipment and/or drugs (30%)– Credentialing/privileging/supervision issues (30%)
Sentinel Event Alert # 30
• Root Causes Identified– Communication issues (72%)– Organizational culture (55%)
• Hierarchy• Intimidation• Failure to function as a team• Failure to follow the chain-of-command
Which Cortex Are You Using?
EpinephrineEpinephrine NorepinephrineNorepinephrine
CortisolCortisol
LanguageLanguage
MemoryMemory
Problem SolvingProblem Solving
Intra-Personal Work Stress
• Immediate Responses:Immediate Responses:
BreatheBreathe Minimize your speechMinimize your speech
Time outTime out Maximize your hearingMaximize your hearing
Walk awayWalk away Make eye contactMake eye contact
Speak slowlySpeak slowly Refrain from touchingRefrain from touching
Lower voiceLower voice Breathe againBreathe again
Resolving the Situation
• Response:
Deal With It!Deal With It!
Conflict of Styles
• Response:
Don’t expect spontaneous remission of different behavior!
Conflict of Styles
• Response:
Plan in advance –
you can’t wait for brilliance!
Conflict of Styles
• Response:
Avoid Triang-ling
The Rules About Styles• We’re all different and/or difficult some We’re all different and/or difficult some
of the timeof the time• It’s usually about how we process It’s usually about how we process
information – its not personalinformation – its not personal• When people are different and/or When people are different and/or
difficult we judgedifficult we judge• Judgment censors negotiationJudgment censors negotiation• Behavior under stress becomes Behavior under stress becomes
extreme!extreme!
Presenter
Terry S. Johnson, APN, NNP-BC, MN, CLECNeonatal Nurse PractitionerFounder, Lode Star Enterprises, Inc.
7709 Knottingham LaneDowners Grove, IL 60516
Phone: 630.881.2606Email: [email protected]