From Toxic to Healthy: A Productive Exchange

Sometimes, walking through the corridors, it hits you. Tension. It’s in the air. It’s in the body language. It’s in the tone of voice.

Its impact gets expressed in many ways:

• A domineering, controlling administrator criticizes others in public settings. Outcome? A crippling of creative thinking. Why bother?
• Nurses argue about protocol at the bedside of a dying patient. Outcome? Increased anxiety about the end of life for the patient, loss of confidence by the family, fractured treatment.
• A physician assistant leaves incomplete notes in the patient’s chart. Outcome? Potential patient harm; increased exposure to malpractice liability; extra time, effort and frustration required to provide the best care.
• Members of a surgical team don’t communicate – clearly or at all. Outcome? Compromised patient care.

One Key to High-quality Care

The healthcare industry is currently under a microscope. As if the pressure and demands of new technology, sicker patients, fewer employees and growing bureaucracy are not enough, everyone has become an instant expert on how to “fix” the system. It’s no surprise that healthcare workers may be feeling more tension or experiencing more conflicts. The system is changing.

One critical difference, however, between providers who consistently deliver high-quality care with high ratings for patient safety and those who don’t is how quickly and how effectively they acknowledge problems or conflicts and how they choose to address them. If not addressed early and productively, the outcome of these ignored conflicts can be detrimental — to physicians, staff, patients, families and the organization.

Take a look at the following descriptors. How would you assess the climate in your work group?

TOXIC ENVIRONMENT:

• sarcasm, mixed messages, guessing games
• time wasters such as backroom gossip
• redundant efforts or working at cross-purposes
• competitive people who need to be right
• avoidance or passive-aggressive behavior

OUTCOMES:

• cynicism, frustration, stress, burnout
• higher than average turnover = $$$$
• Inconsistent focus on patient-centered care

HEALTHY ENVIRONMENT:

• clear communication
• highly productive
• very efficient, focused efforts
• collaborative teamwork
• open and honest

OUTCOMES:

• positive-attitude energy; sustained support
• staffing stability, skills and experience
• consistent focus on patient-centered care

The Impact of Personal Style

Toxic environments are often fueled by our own, often unconscious, personal style of dealing with conflict. How do you address conflict?

• Turn a blind eye. Deny its existence.
• Hope it just goes away.
• Procrastinate. Push it to a lower priority.
• Use your position of power to mandate a solution.
• Empower those involved to discuss the issues and reach a mutually agreeable solution.

Choosing Healthy Habits Over Crisis

Resolving conflicts, whether personal or professional, takes time. But just like dealing with wounds, the earlier you do what it takes to start the healing process, the less the likelihood of infection. Acknowledge the problem, identify the issues, and solve it while it’s manageable. The longer you wait to address a conflict, the larger it gets, the more difficult it is to unravel, and the more time and effort it requires.

A Team Approach

Resolving interpersonal conflicts is similar to diagnosing and treating medical problems. When working with patients, you ask about their symptoms, the effects on their body, their quality of life, etc. You may run tests or talk to others in the family to understand what they are witnessing. Once you’ve collected “sufficient” information, you talk with the patient about appropriate next steps. If you recognize that your knowledge and experience is not sufficient to address the patient’s needs, you might seek advice or counsel from a respected colleague. The same is true of resolving conflicts.

Sign up to Attend SDCMS’ Jan. 18 “Workplace Harmony” Seminar/Webinar: This seminar/webinar will take place from 11:30 a.m. to 1 p.m. on Wednesday, Jan. 18. For further information or to sign up, please contact Serena Sauerheber at SDCMS at (858) 300-2779 or Serena.Sauerheber@SDCMS.org.