Us versus Them and Being in the Middle

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Us versus Them and Being in the Middle

• Strategies for Collaboration

Mary Henrikson MN, RNC Chief Operating
Officer Sharp Mary Birch Hospital for Women San
Diego, CA mary.henrikson_at_sharp.com
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WE
connectedness
unit cohesiveness
collective persona
when put together they come to life
collective sense of mission
the group
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US

Them

WE
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US

• Belonging of or to same group
• Like characteristics
• Same opinion
• Anyone who is not a them or a they

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THEM

• Anyone who is not an us
• Opposite of us
• Opposing reasons for being an us
• Anyone who has power over you

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MIDDLE

• Neither an us nor a them
• Dont belong to group in question
• May find yourself supporting one group to the
  other
• Can be most or least comfortable
• Can be most or least respected
• Can be loneliest

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WE
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An Evaluation of Outcome for Intensive Care in
Major Medical Centers Knaus, W. et.al., Annals
of Internal Medicine, 1986

• Did not find
• Differences in technical capability
• Differences in severity of APACHE Scores
• Differences in ratio of deaths when hospital was
  teaching or not
• Differences in administration of the unit

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An Evaluation of Outcome for Intensive Care in
Major Medical Centers Knaus, W. et.al., Annals of
Internal Medicine, 1986

• In comparing outcomes of 5030
• patients from 13 hospitals, we found
• important differences between predicted
• and observed deaths for all pts. These
• differences appear to be related to the
• interaction and communication between
• physicians and nurses.

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Nurse/Physician Collaborative Practice Improving
Health Care Quality While Decreasing Costs
Lassen, A. et. al, Nursing Economics, 1997

• Better clinical outcomes
• Better continuity and consistency in care
• Enhanced nurse/physician relationships
• Significant cost savings
• Diminished parental anxiety and confusion

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Collaboration

• A process of working with one another on a
  literary, scientific, or artistic endeavor.

• Cooperating with the enemy.

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Collaboration attributes

• Shared decision making
• Responsibility
• Accountability

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Anger
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Collaboration?
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Us versus Them
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Culture of Collaboration
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Creating an Environment of Collaboration
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Creating an Environment of Collaboration
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Creating an Environment of Collaboration
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Creating an Environment of Collaboration
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Creating an Environment of Collaboration
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Creating an Environment of Collaboration
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ALWAYS Believe in the Power of the Team!

• Managers---develop attitude!
• Everyone has value
• Each position is critical
• Each person deserves your respect and gratitude

TEAM
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ALWAYS Believe in the Power of the Team!

• Staffbe willing to participate!

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Communicate!Communicate!Communicate!

• Do it often and use different forms
• Verbal
• Managers Round with purpose
• Staff Talk to your managers

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Communicate!Communicate!Communicate!
Managers are not mind readers!
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Communicate!Communicate!Communicate!
When you talk with your manager about a
problem, come with a solution!
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Communicate!Communicate!Communicate!

• Do it often and use different forms
• Verbal (continued)
• Leaders Develop a style that encourages
  questioning, dissent, contrary views from
  yours.

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Quietism the sin of silence
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Communicate!Communicate!Communicate!

• Do it often and use different forms
• Verbal
• Staff Give your managers feedback!

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Communicate!Communicate!Communicate!

• Do it often and use different forms
• Non-Verbal
• Staff If you want to be in the knowREAD the
  information!

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Communicate!Communicate!Communicate!

• NO secrets!
• Financial
• Patient Feedback
• Turnover rates
• Productivity
• Pt. Satisfaction
• Scores

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Provide and Attend Education

• When You Know What to Do, and How to Do It, You
  Can Do It!

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Provide and Attend Education

• Skills for collaboration
• Conflict Management
• Provide feedback
• Team player
• Run a meeting
• Make a presentation
• Deal with difficult people
• Project management
• Peer interviewing

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Expectations and Behaviors for Collaboration

• Trust and Respect
• Take a Risk
• Problem Solver
• Consider the bigger picture
• Go the extra mile
• Suppress victim mentality
• Have fun
• Say Thank You

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Expectations and Behaviors for Collaboration
Trust
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Expectations and Behaviors for Collaboration

• Trust and Respect
• Keep promises commitments
• Choose the harder right over the easier wrong
• Never lie
• Dont have secrets
• No sniping

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Expectations and Behaviors for Collaboration

• Trust and Respect
• Be Fair
• Hold people accountable
• Be open to feedback
• Apologize when warranted

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Expectations and Behaviors for Collaboration

• Be willing to take a risk

Dont put something down until youve picked it
up.
IDEA
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Expectations and Behaviors for Collaboration

• Become a problem solver versus a complainer.

• Consider the bigger picture
• Analyze how a situation is connected to the total
• Ask questions
• Managers provide details

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Expectations and Behaviors for Collaboration

• Avoid the victim mentality

• Go the extra mile

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Expectations and Behaviors for Collaboration

• Have fun!

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Expectations and Behaviors for Collaboration

• Reward, recognize and say Thank You

Very Good!
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