Latest / Nurse Leadership Dumpster Fire / Building a Strong Team of Nurses
Transcript
- speaker-0: Hey everyone. Welcome to the Nurse Leader Dunster Fire Podcast. ⁓ we're here today to talk about something that ⁓ we've noticed a lot of leaders do, and I think that we've had to figure out on our own as well. But the issue is not setting a clear shared vision with your team and how that could be hurting your team. So if you're a nurse leader now, ⁓ and do you have, do you know why you're doing this? Do you know how you're aligning with your organization? Or you just kind of showing up every day and doing the things and hoping for the best? Well, that's probably not going to get you very far. Because the truth is if you haven't done this crucial step, you're likely gonna keep spinning in the hamster wheel with no end in sight. So hopefully this this podcast video will be helpful to you because ⁓ our goal is to just help nurse leaders be elevated and to create help make your team more successful. Yeah. So why do you think that this is important, Teresa? speaker-1: ⁓ setting a vision helps your staff know why they're doing what they're doing. That's a good start, right? Like why do I come to work every day? Obviously to get a paycheck. But what people want to be connected to something bigger than themselves. So how do you create that environment within your own job? speaker-0: Okay. That's yeah, yeah, yeah. Yeah, true. So I've noticed, I've seen a couple of managers do this where they haven't really set that vision and they don't really have a clear understanding about why they're doing this and how they're aligned with the bigger picture. And their staff don't really know what this message is either. And what seems to happen in those teams is that you've got those couple of employees who have a really loud voice, as in they're always telling you. what they think and their opinions and what they're mad about. And because if you're not setting that leadership tone, that person will become your leadership tone. So like this is just like a dog pack. Okay, guys. So bear with me. If you have a group of dogs and one of them is technically the oldest and should be the senior dog, but you have another dog who's like more demanding and like I'm gonna make it this way, that's where the rest of the pack is going to follow. And that's what happens on your unit is you're This person, these people who have their own agenda and they may not even understand what they're doing. Cause what I like to tell tell people a lot is your leader, whether you're leading with a positive influence or negative influence, everyone has their own leadership skills. And if you allow that person who's kind of got that negative spiral talking about all the things that they're mad about and and creating that toxic work environment, that's how that really takes off. It's because the leader hasn't really set that vision. speaker-1: There was and sometimes you have to tell that person what they're doing. I remember we have ⁓ we had a informal leader. That's the word. It took forever. Sorry, got there. So you have your informal leaders, and that's what she's talking about. The your informal leaders that are on the unit that can shift the culture. So not just you as the leader, but you have to take that and decide. So we had one guy who speaker-0: Okay. speaker-1: He sometimes has this like c thing where he likes to just vent and talk about all the things he sees could be different and how things could be better. And but he comes to work, he might vent a little bit, he doesn't actually care. He knows that he likes his job for the most part. He knows he's gonna keep coming back. And he understands that sometimes within systems there are these issues that can't be solved quickly. So he gets that. What he didn't know is when he was venting out loud. To other people, they didn't understand that. They didn't have the same background as him and the same experiences as him. And so what I noticed is that his comments were bleeding into other people and getting them mad and making those people angry. And so I pulled him aside and I just said, Hey ma'am, do you know that when you're doing this, you're actually creating a negative environment? Cause these people don't understand. They're they're thinking that we're doing something bad or wrong. Yeah. Rather than understanding it's a systematic issue that We're working towards fixing, but it's not something we have the power to control. So now we have a bunch of angry people a and nothing we can control. Yeah. speaker-0: I think and this is like a people thing too. It's not just in leadership and it's not just in ⁓ healthcare. Right. So my son, he was in we put him in this program. It was called a Waldorf program. And so it's like low tech, really high focused on teamwork and relationship. And so it was interesting because they paid way more attention to the behavior of the kids than any other school setting I'd I'd seen us be in. And my son, because he's my son. He has kind of a cynical, dark sense of humor. And ⁓ he leans into sort of like a little bit of like a depressive image, I guess. ⁓ and so so he was in like sixth grade and he was the new kid in this school. These kids have been together for probably their whole lives. Like they start in a class and they stay in that class until they get they graduate basically. And the teacher called me up one day and she's like, Hey, so Your son is hanging out with these other kids and he's got sort of this like depressive vibe and like cynical, I don't know, maybe angry sort of energy going on. And it's kind of creating a negative impact on the kids around him. And she's like, so your son, he does not he it's not like his identity, it's just like a thing he's doing. And she knew that. She's like, he he can like play around with this like depressive imagery, you know, like this is kind of like a a a thing I'm trying out. But he pops back out of it and he stays positive and you know, it doesn't affect him like internally. But she was like, But the kids around him, it is affecting them. And they're starting to have like these negative emotional responses. And it was super interesting. So, you know, like you that just reminded me of that when you were talking about that, of how, you know, just in group settings, if you're not careful, one person might be setting a tone for the group. that you didn't intend. And so if you're the leader of that group, you need to be really aware of that dynamic. And maybe you can just like pull that person aside and say, hey, you're actually creating a negative dynamic on the unit. And maybe they didn't even realize it and they just need to like snap out of it. ⁓ so, but yeah, when you don't focus on that leadership skill, you know, some of the things that can happen with that person is then you might see more gossip. Descent, you might have drift, which drift, guys, is like when the somebody like takes an easy shortcut to do a task, and then another person takes a shortcut, and then they're like, ⁓ everyone's doing it that way now. And they just like abandon the best practice or whatever the policy says because it seems to be the norm. So if you're not setting that tone, if you don't have that vision that everyone's bought into and it's clearly articulated and strong. Then you're gonna start seeing a lot of these problems and you're gonna be like, what's happening on my unit? So that's why I wanted to talk about some of that. And I think in some of our other episodes and in our YouTube channel, our our regular YouTube videos, we've talked a lot about trust. ⁓ and so when you don't have a leader who's setting that tone, you can get something where your trust is gonna be low. And if you guys have ever heard of Just some guy named Stephen Covey. He wrote a whole book about this and it's a whole concept. ⁓ but the this the concept is called the speed of trust. And he says that ⁓ trust is a measurable economic driver, not just for a social virtual ⁓ that accelerates speed and decreases costs in business. Trust is built on character, integrity, intent, and competence, which is capabilities and results, acting as a performance multiplier. So what that is he's trying to say here is. ⁓ if you have a high trust environment, you're gonna have people that buy in on all subscribe to the correct pathway and you're all gonna be working on this thing together, like as like little cogs in a wheel functioning very highly together. If your trust is low, people are gonna be off doing their own things and you're not gonna have control of the direction that your unit's going. speaker-1: So, how do you actually set a clear vision? Do you guys even know? Or is that why you're tuning in today? Like, you may first want to spend some time focusing on your why. This is a concept also created by another person, Simon Sinek. You can go find read your book, Find Your Why. He has a YouTube channel about how to do it. We also did a video on finding your why. And before you can find your why, you also need to work on identifying your core values. So we have a YouTube video on ⁓ identifying. How do I stay true to my values as I advance in leadership? So it's talk about your values and then your why. And you have to know these things to help yourself create a s a speaker-0: A vision. So yeah, you gotta first identify your values, go check out our video on values, and then you gotta figure out how to identify your why, check out our video on why, and then you can start talking about how you create your personal vision and the vision that you need to create with your team. speaker-1: So the thing you want to do is identify what the highest functioning teams you've worked on have in common. What are those common themes that you see? And what kind of vision do you want to create for your team if you don't know that yet? Like what was the culture like? Did they support each other? How did they create that culture? What did they do differently that hasn't been done? Did they support learning and embrace mistakes? How did they ⁓ support the team function? Yep. speaker-0: How do they communicate with each other? Is your team able to ⁓ give feedback to each other in a respectful and productive way? Or are they all being passive aggressive and talking about each other behind their back? That's a key indicator. But your higher functioning teams that do have a clear vision, you're more likely to see the first version, which is that they can give each other feedback because they're all trying to level each other up and they all understand that they're working for a bigger mission. Yeah. speaker-1: So then what differentiates those high performing teams from other work groups? Like what did that look like? Kind of take that time to think about what did success look like and what did what I don't want to work for or have in my area? And what was the difference? And how do I make sure I set that tone to be ⁓ the the vibe that we're looking for? Cultivating the high performing team ⁓ and creating that. There's an article. By AONL, American Organization for Nursing Leadership. It's called Cultivating High Performing Teams. ⁓ and you may wanna check that out and get some more ideas on how to get that and tie it all together so you can work towards creating the team. And it needs to be a shared vision. So we're gonna go continue to explain how to get there. speaker-0: And so w just a snippet from that article of something that I that we pulled out from that was a statement that said, what differentiates a high performing team from other work groups on these teams is that they are described as being goal-focused individuals with specialized expertise and complementary skills who collaborate, innovate, and produce consistency superior results, displaying a high degree of trust and mutual respect. These individuals are fully committed and hold each other accountable at all levels. So That's a nice summary of everything we just tried to say. It was much more less succinct and yeah, efficient than than our rambling circling. So good job, AO now. So the next thing that you want to try to think about is ⁓ identify, you know, we're talking about those specific skills and expertise. So identify your team's specialty skill sets and who on your team is good at what. So what does your unit specialize in? Most of us have a specialist unit. If you're a med surge unit, this might be just a free-for-all. You guys do everything. You get all the all the dumpster fires every day. But at the same time, you still have a scope. You know, you have a patient that, you know, you're going to take a patient within these parameters. You're not going to take the patient who actually needs to go to the ICU or the patient who's crashing and crumping, ⁓ or actually should just go to a long-term care facility. So you do have a scope. So what is that? You know, are you a labor and delivery unit? Are you a neurology unit? Do you work in an emerging department? What are those high risk, low volume skills that your team needs to be proficient in? It's also useful to look at what are your key performance indicators, your KPIs that your facility and your unit are watching. If you're an inpatient unit, you're probably looking at things like CLABSIS and CODIS and ⁓ pressure injuries. If you're an outpatient clinic, it might be turnaround time for patient visits. It might be ⁓ lab response time, it might be patient satisfaction, vaccine rates. I mean, we've got falls going on everywhere. The list is endless, but know what those indicators are because this should all be part of your vision, because your vision should help you address all of these pieces. And then make a list of all those items ⁓ that makes your unit and your organization unique and consider how that will align with the vision, how those things align with your personal vision and the vision of the organization. So you first have to kind of understand what is my personal vision. What is the specialty of the unit and what is the organization's vision? speaker-1: Exactly. So then as she just mentioned, you've got to look at your organization's vision. You need to understand the higher vision that you're working for. Because if you try to create a vision that doesn't align with that, you're going to be just doing this and it's not going to your team isn't going to be successful. You've done all this work, put all this effort in, and they're not in alignment. ⁓ most often when you're looking at visions, so you wanna pull up your s your location's mission and vision statement. And how do I wanna make sure that I'm in alignment? So We have some examples that we pulled just from the internet. You can Google this. ⁓ we've got the University of Utah Healthcare System. And it has to become integrated, comprehensive, and high-performing academic health system guided by patient-centered care and superior experience, innovation in research and education, generative financial stewardship. ⁓ and then we also have another one from the Mayo Clinic. And that one is gonna be transforming medicine to connect and cure as the global authority in case in the care of serious or complex disease. We got UCLA. speaker-0: Mm-hmm. So that one, ⁓ again, this is a very succinct one. Is their mission is to heal humankind one patient at a time by improving health and alleviating suffering and delivering acts of kindness. And then we also just grab the VA because that's where we happen to work right now. We are not affiliated with the VA for this podcast or YouTube channel, just as a side note. ⁓ but the VA's mission, just slightly different sounding, is to empower veterans through partnerships that move beyond treating illnesses, aiming for optimal health. And offering a positive world class healthcare experience. So, like Teresa said, it's a really good idea for you to go find out what your organization's vision is. And if you don't already know, you should find that out because you can't really align your vision with yourself and your team's vision by without knowing what that greater good is. Because we should all be sort of funneling up to the higher productivity and Why does this organization exist? And who are the patients that are coming here? That's ultimately like what we're trying to align with. speaker-1: So next we want to take it and like let's put this together. How do we now create that vision, that shared vision with our team and going into the direction we want? So first make your personal vision, like we mentioned. Now that you have a clear picture of what's important to you and you've identified your values and you've got your why down, you kind of know what your unit's looking like, but personally you need to have those in alignment. So get now you're looking at the priorities of your unit and organization ⁓ making a couple lines of statements. So you're maybe going to even go ahead and use Chat GPT and AI. Yeah. Put down your values and whatnot and say, I'm working on developing this. Get it, get some ideas, run through s a few things. And then you want to take the opportunity to merge this. And how are you going to merge this and make it all together? speaker-0: Yeah. So this almost could be a video all by itself because ⁓ it's really about how you strategically plan a meeting to address this. ⁓ so if you're struggling with this, we also have a YouTube video about how to plan for a staff meeting. And that video will help you kind of prep for this. But you're gonna need to sort a strategic planning meeting with your team. And ⁓ you may have to do this over several meetings because the first meeting might just be Explaining the goal and where you are with your personal vision and what the other vision is. And you may have to say, you know, it might take a long time to explain all of those pieces. And then you might need another meeting where you say, okay, now we're gonna have the unit come up with the shared values and their shared vis, you know, the shared why, so that you can start getting to where you formulate that. And then you might have to do a third meeting where you say, Okay, we're gonna pull this all together. We're gonna look at our KPIs. We're gonna look at all those pieces and we're gonna actually start putting something down on paper. So ⁓ that is. speaker-1: Is another option for this if you're worried about meetings and staffing and you have patient care and all these other things and you're like, how the heck am I supposed to do this? Because that's a big concern for people. Like, let's be honest, staffing is a real problem almost all the time. Yes. And sick calls happen and people take days off and whatever, and they're allowed to, and we want to support that. If you have a unit-based council with your informal leaders, you can utilize that to help you work on this and then use them to go find out some of the details from some of the other staff that maybe can't come to these meetings or whatever and utilize that as a space as an option. Yeah. speaker-0: For sure. And another option, you know, there's a lot of like tools out there where you can all come in and sort of update data. So if you have access to ⁓ like a Google One, not Google, sorry, Microsoft OneNote or a Google Share Drive, you can start having that process and you can say, okay, I want everyone to go in there and and add your own flavors. And you can sort of like, so you might have one meeting where you explain the whole process and then you would have everyone come and add to it. And start working on that. And then you can do another summary of okay, we're gonna try this and then put that back out. It's gonna take you a long time because you wanna really make sure that you have that engagement from your team and you don't want to rush it so fast that people feel like they didn't get a chance to speak up. So, you know, and you're gonna do all you need to spend a lot of time explaining why we're doing this and what the ask is gonna be. Because again, this is all about a vision. So if you're not setting the vision for the meeting, they're not gonna understand what's going on. So you gotta really spend your time doing that. speaker-1: After you work together as a team and kind of identify what it is and you have your vision is stated and you and your team wanna decide, how do I disseminate this? What do I do with this information now? ⁓ what are you gonna do? You can do so many things. Yeah. speaker-0: I remember when we worked ⁓ in when we worked together, the ER that we were working with was doing a very similar thing. And they actually did theirs not just with nursing, they did it with the providers and the lab staff and all the people that also work in the ER. This wasn't just like a nurse's vision. This was a multidisciplinary vision. And they came up with a a statement. ⁓ and they even like pulled in some Latin and it was really funny and geeky and they had a sign made that they put at the entrance of the ER. So anyone that walked in could say, ⁓ this ER has this vision that they've created. So that's one way to do it. You know, you want to put it somewhere that, you know, your staff can be reminded about it. Somebody visiting from a another unit understands what this unit's about. And even the patients, so that they understand, like, what does this unit do? speaker-1: What can I expect when I come here? What what kind of treatment am I gonna get? ⁓ you can like like she said, banners, posters, ⁓ you can write it in different places, different things. You could speaker-0: put it in your email signature. You could put it on documents that you use for, you know, if you have like a newsletter, you could plug that on part of your new like as a your ⁓ logo, whatever. speaker-1: Another thing you can do is ⁓ if creating all these meetings and and all this is is really overwhelming, what you can also do is create a few variations of it and have them vote. Utilize that. You can use ⁓ another thing it we were talking about is like you have Microsoft Forms and you can put different things in there where they can do or you can do Qualtrics and do ⁓ survey monkey, whatever type of survey option you have. speaker-0: That's a good idea too. speaker-1: utilize the tools that are given to you and f see what people think. speaker-0: Yeah. And so then after you've done this, once you've come to your conclusion and you've done all that back work and you have your vision that's shared, now you want to make sure that you come back to this probably at least once a year. So you probably want to have a strategic meeting scheduled every year that you can reevaluate because with new staff and changing dynamics and you know, sometimes organizations change. Like I w started working on a surgical ICU unit and then They realized we didn't have enough volume. And so they combined our medical and our surgical unit. And that completely redefined what we were doing. And so, you know, we should have probably had we didn't have a vision at all. We were not doing any of this back when we were bedside nurses. But it would have been really helpful probably. It probably would have made it look go a lot smoother because there was a lot of infighting that happened when we did that. speaker-1: And we did ⁓ create a shared vision eventually. And it was very simple. It was to be the best ICU in the valley. ⁓ and at first, ⁓ when people saw that, they thought when we kind of were talking about it, because we hadn't had our meeting yet, to kind of finish disseminating how it what it meant. ⁓ they talked about, ⁓ we're the best unit in the hospital. I was like, no, no, no, the whole valley. Yeah. That's what that means, you know. And as we talked about it, we identified all and then we talked about those values of how you get there. And what we had another staff member create a visual to represent that. And it ended up being a tree because in order to become the best at anything, you have to have feedback loops and trees do that really well. speaker-0: Yeah. So the concept, because it's kind of a cool concept, is that it was about ⁓ how a tree in a forest is not just a tree in a forest. It has all of these other pieces around it. So you're one piece, you're your your unit, but you have all these other units that you're interfacing with. And so the way the concept was with the trees send their roots down and they send they have their own like neuropathways that they send to other trees. and to all the other plants around them. And then you have the decomposing cycle that's putting nutrients back into the roots. And how, you know, that really represents that you're a unit. There are multiple units in the hospital. There are other hospitals in the facility or sorry, the city, you know, you're not the only option that patients have. And so what's your relationship like with them? And are you working productively together or are you fighting with them? But the tree, the forest and tree was a really cool concept. speaker-1: In reality, the staff are also the trees. Because if I can't tell you when you're dying or or failing me and we can't communicate, then our relationship breaks down. Totally. Right? Or if I grow taller because I want more of the sun and I want more of the light and I overshadow you, how is that helping you? For sure. So and in order to maintain your your forest. you have to be able to communicate with each other as well. Yeah. ⁓ so just ideas out there. ⁓ if you guys have more questions about ⁓ how to create a shared vision, definitely follow a couple of our videos, like we said, the values, how to find your why, and then this podcast. And then we'll also put a YouTube video together that's a little shorter and just bullet points of how to do this. speaker-0: And ⁓ if you have experienced this or you are in a process of it, we'd love to hear what's going on with you in the comments. Please drop that down. And you know, if you've come to this conclusion, you've done all these things, then then the last step you need to do is congratulate yourself and the team because it's a big feat and it's worth it though. So congratulate yourself for that hard work. ⁓ but thanks for listening. We ⁓ hope that this was useful to you. Please like and subscribe if you want to hear more content. We've got some YouTube channel videos and we've got our podcast videos. ⁓ but we hope our mission is to really help elevate nursing leaders out there. speaker-1: Yeah, and you can find us on Apple and Spotify and any other area that you might have ⁓ podcast that you get your podcasts. And then for videos and shorter content you can head over to YouTube for those speaker-0: And you're also welcome to email us. We both have an email. Mine is cindy at ariinercircle.com and Teresa is Teresa at arinercircle.com. We'd love to go to the inbox. And ⁓ maybe you can come on to the podcast with talk about.