Apologies can be unsatisfying

My boss came to me yesterday afternoon and asked how the morning had gone. Then he held out customer service card where one of my colleagues in another department had written a negative response about me.

Frustrated with what I perceived to be this person's inability to solve the problem, I grabbed the patient's ID out of his hand so I could pull up the online records. I immediately knew this was a mistake, but I didn't apologize. I wish I had. Instead, I softened everything from that point on, explaining everything I was doing and trying to be as helpful as I could be, hoping this person would see the grabbing as an anomaly.

He didn't.

So I told the boss I planned to apologize to this person.

Today, after the mad rush, I stopped by the lab. The technician immediately recognized me and ushered me into an office. It wasn't what I expected. I had actually planned to apologize in front of others so they would know I respected this person and that I was acknowledging my role in behaving badly. But, this must have been what he wanted and needed.

I told him I was sorry. I shouldn't have done what I did and I wouldn't do it again.

I asked him why he had submitted the comment card instead of talking to me. He said, "I wanted to bring it to your attention. I wanted to make sure you weren't treating your junior sailors this way."

I then asked him why he didn't call me on my behavior at the time. "I recognize there is a difference in rank," I told him, "but if you were justified, as both of us know, then what was the point of not calling me on it there in front of those junior sailors? Wouldn't that have been a more powerful example of how to role model behaviors for those sailors?" Truth should be able to speak to power.

He didn't seem to understand what I was trying to say. "Would you like me to do anything else? Do you need anything else from me?" I asked. It didn't seem nearly enough. Perhaps the apology and my presence were all he wanted and that would suffice, but for me, it was very unsatisfying.

I talked to my boss this afternoon and told him I apologized to the lab technician. I also explained that it didn't help me; I knew I was wrong, but the apology didn't meet MY needs. I didn't know if it was the inequality in status or the cultural differences, but I needed something more.

I have a problem with trying to speed things up and can adopt a tone of voice that irritates people or suggests condescension. I suggested to my boss that perhaps I could ask my colleagues to help me identify when I'm getting to close to the edge by using some code word to help me step back from the situation and regain control of my feelings and actions.

"It could be helpful," he acknowledged. "That's the principle behind 360 degree evaluations." But he left it up to me to broach the topic with my subordinates. So that's my plan for tomorrow as I begin my trek toward a more mindful workplace.

Leadership Tied to Maturity and Receptiveness

So I spent my lunch hour composing an email response loaded with what I thought were leadership newsletters, books, and articles, along with the observation I was not a great leader. I also stated I did not have to be the expert; I only needed to know who was and to let him or her shine. I read it through several times to make sure there were no errors, that nothing could be miscontrued or misunderstood, and sent it off, full of hope that everything would be made as new as I wrote in one sentence: a clean slate to start again.

I sent the email at 1244. I received a response at 1250. Six minutes. And the response? Ma'am,
Noted. Thank you for your time.

In my mid-to-late 20's, I might have had my own image tied into what and how I wanted to be perceived by others. Maybe I would have responded with the same speediness, the same acerbity, the lack of depth and gratitude. And maybe that's my error---in thinking she would be grateful.

Well, maybe someday she will be. I can hope.

A Little Like Dying

I've known for a few months now I will be deploying. Pretty much in denial for the first few months, I was able to tolerate this and, because of the chaos and uproar at work, almost welcomed the respite from the Beltway drama and politics.

That changed as I got my anthrax shot (which laid me low) and I avoided a smallpox vaccination because of some mysterious dermatitis on my collarbone. All of a sudden I have less than 28 days left on this side of the world, no childcare plan in place yet, and overwhelming grief that I have not been able to accomplish all I set out to do in my assignment as the department head of surgical nursing.

In leaving for the unknown with hopes of returning, I understand my grief is due to changes beyond my control. I won't be returning to this same position. I can't; someone else will have stepped in to take the helm. So what will I do when I come back? Will it be as challenging? Will I like it? Will it be---dare I say--fun?

I've been keeping in touch with one of my JG's in Kandahar who has excelled and is over half-way through her deployment. "What do you want to do when you get back?" I asked, hoping she would want to stay and provide leadership and expertise on the unit.

"I'd like to go to the APU or PACU," she wrote. "I've been working on the wards and assisting with trauma, which can be rewarding but draining. I'd like a break."

So, I asked her if she'd considered becoming an OR nurse; would she have time to shadow a nurse there? She'd have the opportunity to provide attention to detail, work as a team, and monitor patient safety. "It provides some distance from the patient," I suggest.

As an Individual Augmentee (IA), I am plucked from my workplace and sent alone (mostly) to meet up with other individuals to form a tribe of providers to do a job far away from our families and support networks.

I've had lots of people ask me over the past two weeks: Are you okay?

"Yes," I say. "I think so."

Sparta Humor Very Similar to Healthcare Humor

The Spartan Sense of Humor by Steven Pressfield is very similar to that found in First Responders and Healthcare Workers. I love what he writes:

["T]hey’re not jokes. They’re not meant just to raise a laugh. Yet they’re funny, they’re on-point. Second, they don’t solve the problem. Neither remark offers hope or promises a happy ending. They’re not inspirational. They don’t point to glory or triumph–or seek to allay their comrades’ anxiety by holding out the prospect of some rosy future outcome. They face reality. They say, “Some heavy shit is coming down, brothers, and we’re going to go through it.”

That could be said about a lot of workplaces right now...

Use Your Peripheral Brain

Today was a Command Urinalysis. Usually, that's not a problem, just an inconvenience. However, my name was on the list, I had requested this morning off due to another appointment, and the instructions on the Command Urinalysis list stated that a memo attesting to the individual's unavailability for this random urinalysis was insufficient. Members needed to provide copies of special liberty chits, memorandums, and leave or TAD paperwork.

Incredible. The one morning I am not at work, all bedlam breaks loose. The LPO, instead of requesting assistance from more experienced officers, directs his junior enlisted to generate a special lib chit for me and backdate it. Not a good idea. Besides, officers don't routinely route special request chits; they generally draft memos or letters requesting time off. The fact of the matter is, this wasn't an incident that would require written notification.

So, my LPO decided his brain power was sufficient for responding to this situation. If he had been on "Who Wants to be a Millionaire," he probably would have lost his opportunity to win. Steven Shapiro has a better answer and one this LPO can employ now and for future emergenices.

Typically, "Who Wants to be a Millionaire" allows you to use all your accumulated knowledge to answer questions of increasing difficulty and esoterica. You may finally get to a point where you can no longer weed out obvious distractors and have exhausted your personal information fount. That's where consulting others comes in handy.

Phone-a-Friend only works if your friend is more knowledgeable than you. In the Navy, people who are consulted by others are usually Sea Lawyers. That is not a popular moniker.

In Fifty-Fifty, two of the answers are removed. However, if you have no answers or you know that the answers you do have are probably not right, this option doesn't help.

Ask the Audience is a little better, but again, it relies too heavily on the knowledge of the crowd. As with 50-50, if you don't know your options or you know what you do have is not correct, asking your audience won't be helpful.

Finally, Ask the Expert. This is what I told the LPO to do for future problems. For one thing, consulting with someone who has considerably more experience will provide a lot more viable options. Also, the expert will tend to have more rank and authority to take the heat or to run interference for him.

In healthcare, many medical and nursing students have notecards, crib sheets, or PDAs to scribble the information they need at fingertip notice and they refer to these bits of data as their peripheral brains. In the business world, they call it networking---using people (and their collective knowledge) to find answers and get ahead.

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.

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.