Friday, May 22, 2009

Wind Mills and Flail Exercises

I have two months left and it is hard to summon the strength to continue to rail against waste and indifference. Six months from now it will be as though I never set foot here. And you know what? I have come to the conclusion that having the military run hospitals is stupid because we have a new Commanding Officer every two years and the status quo has to be shaken up, corporate knowledge must be lost, and politics must be endured, because no CO ever gets ahead by continuing to do what his or her predecessor has done (even if it is succeeding wildly---which has not been the case, unfortunately).

I am aghast at the amount of corporate knowledge I have accumulated and the fact that I cannot possibly communicate all the information for one-of-one situations that have happened so someone else doesn't have to reinvent the wheel or undergo a flail exercise (FLAILEX). Quite frankly, I don't think I've truly amassed such founts of information so much as I've discovered my network of people who know or who know other people who know the information I need. The biggest problem with functioning where I am is being surrounded by people who feel they must know everything and if they don't know it, there is no one else who can possibly know what they need to know. It is silo-ization at its finest. [In 2002, Vicki Casey, program director of Information Highways, used the word "siloization" to describe the smokestack-like structures that promote knowledge hoarding, rather than knowledge sharing and collaboration.]

Case Study
The LPO needed to get a bile bag (don't ask) from the OR. He called us in the endoscopy suite and said the OR tech didn't know what he was talking about. Instead of telling the OR tech, "Look, is there someone else I can talk to?," the LPO calls us. And instead of the OR tech being creative and helpful, he stops at the "Dude, I have no idea what you're talking about. End convo."

The inability to think creatively is not limited to the enlisted ranks. I had another Division Officer approach me for information about wound care. I'm not an expert. I only read the labels (but I did sleep at a Holiday Inn Express last night). So I look through the Phone Book and call healthcare agency who accepts patients from our hospital. I ask to talk to someone about wound care. They transfer me to Sofia. Sofia walks me through the steps, I transcribe them, and I hunt down the products (unfortunately, we don't have a few, so I direct my Supply Petty Officer to order them). I give the instructions to the Division Officer, note the telephone number and name for her in case she has future questions, and make a mental note to bring my corpsmen up to speed on wound care supplies and information. It didn't take very long, maybe 15 minutes total, including a call to another hospital for their wound care specialist who wasn't due to work until later that afternoon.

Sunday, May 3, 2009

Overcoming Defensiveness Key to Better Workplace Environment

My LPO was being counseled by the Senior Enlisted Leader (SEL) for our directorate.
"Your problem is you're too defens---" was all he was able to get out before the LPO interrupted, saying, "No, I'm not!"

This occurred after he had already been brought in to my office to discuss progress on a self-improvement plan. In that discussion, the LPO could not get himself under control to stop talking, even after repeated and even rude requests to be quiet.

After his discussion with the SEL, he came to me and said he recognized he had a problem. "So if you see me bringing my hand to my mouth," he said. "That's my way of slowing myself down so I don't interrupt or respond right away."

I told him I was curious about when this defensiveness had started. "When I became a corpsman," he said. "People assume because I started out in another specialty, I don't have any medical knowledge." He pointed out several individuals, including the Department Head and a fellow surgical technician as culprits in minimizing his experiences and abilities. "Well," I said. "There are gaps in your knowledge and not everyone knows what they are. Isn't it better to assume you don't have an essential skill than to assume you do?"

In any case, I doubt his defensiveness just started when he became a corpsman. Argyris, a leader in adult education, believes defensiveness starts in childhood and is reinforced throughout life. However, he is taking positive steps to correct this behavior. As Jim Tamm, author of Radical Collaboration, says, recognizing defensive behavior is the first step. Dr Nathan Cobb, a psychologist and marriage therapist in Calgary, has a very good workbook on overcoming defensiveness. Although "How to Overcome Defensiveness" is directed towards marriage, my LPO admitted that he adopted a defensive attitude at home, too.

One of the important things I learned in our encounter that started this spiral was my own role. I chose to become angry when the LPO would not stop talking and, for that, I regret my responses. Ridge Training's Overcoming the Destructive Dynamics of Defensiveness could have helped me stop my inner Mr Hyde from erupting.

The second step is acknowledging the emotions that come with the awareness of defensiveness. In this case, the tenets of yoga (breathing) and Buddhism (mindfulness) are invaluable. The Miracle of Mindfulness by Thich Nhat Hanh looks promising. The link from YouTube provides mindfulness using movement.

This website provides information on using hypnosis to overcome defensiveness. I'll let you know how it goes.