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Bill Klaproth: (Host)When it comes to building highly reliable cultures, why is listening often a crucial factor? And why is it such a necessary component? Well, let's learn why reliable leaders listen with Amy Trueblood, director of nursing professional practice and staffing support services at the University of Missouri Health System. This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. Amy, it is so great to talk with you, thank you for your time. So, let's start here. Why is listening and relationship-based communication and leadership, a necessity to creating highly reliable cultures?  

Amy Trueblood: (Guest)Thanks, Bill, for the question, and thanks for having me on it's a great opportunity to talk more about the subject I'm passionate about. Listening and relationship-based communication is really important for highly reliable cultures and for leaders within highly reliable organizations, because high reliability is all about safety, quality, and efficiency through five principals that Weick and Sutcliffe gave to us in there book managing the unexpected. And those are a preoccupation with failure, reluctance to simplify explanations, situational awareness or sensitivity to operations, deference the front line expertise, and commitment to resilience, all of which really require strong listening skills and an ability to build relationships with people as human beings, to hear what their concerns might be, to hear more about the true story and to really be able to make changes that will be meaningful and address the issues that we're trying to face in order to create safe quality and efficient environment.

Host: Well, this is really interesting. So. You know, a lot of people may think of leadership is I'm going to tell you what to do and you're going to do it. This sounds like I'm going to listen to you. They kind of seems counter to what a lot of people might think leadership is. Why is listening such an important component of this?

Amy: Listening is really critical and there's such a growing amount of research or literature support around how listening can impact both the patient and the employee experience. Really connecting all of us through a human connection and what our presentation we'll talk through is how patients have received listening. And also, how we can make that jump to how leaders might be able to utilize those same principles when dealing with their staff around listening. It's important because we need to enter situations with an open mind. Meaning, we need to leave all of our preconceived notions behind and talk through a situation with either a patient or an employee to really try to learn where were the failure point, if there were any, what's the real story there. Dig deep into a root cause of what's happening and really tried to put in practices that will help to change that for both our employees and our patients.

Host: Okay, so speaking of patients, how do they perceive listening, how do they fit into this equation then?

Amy: Thank you for that question, because until recently, I honestly would have had to say, we're not really sure entirely, but thankfully my colleague, Dr. Nancy Luce studied this very thing in her doctoral work and part of her results are presented in our presentation as well. And what she noted was that as the patient's in her study, had some emergent themes to what helps them see and perceive listening from caregivers. He bucketed into themes of making a connection with them, which we know is really important to connect as a human being. Help put the patient at ease by following through, anticipating what their needs might be and demonstrating empathy, and then ensuring that they're safe and sharing their questions are answered and allowing them opportunity to speak on their own behalf. She has some really fascinating things about what patients experienced as having not been listened to as well, that, our audience will get during our presentation. But really found that specific behaviors identified for the first time that can really help us as leaders help our nursing staff connect better with their patients and help them understand that they have been listened to. And what specific behaviors that might look like so we can actually target some real practice and behaviors that will help change that experience for our patients.

Host: And that experience is so important. I love some of the things you just said. They're trying to develop a deeper connection. Helps put the patient at ease, right? When you're treated with empathy, you certainly feel better at that point, you're not as stressed out, and then, of course, you talked about safety too. We've all been to the doctor. And when you speak to the doctor, you want to feel like you're listened to, and sometimes it's like, are you listening to me? I mean, that can be very stressful so I can see how making sure that a patient, making sure that they feel like, wow, I've really been listened to. This nurse really cares about me and understands what I'm going through and is trying to help me.  I can see here that really has benefited is that, right?

Amy: Is, it has huge benefit and probably more interesting in a lot of cases is how patients described when they were not listened to and the concerns that are really genuinely occurring for patients in clinical environments, such as feeling like they weren't believed that the providers,  nurses, physicians or others feel like they,  come forward already having the answers. And so, we do spend some time also talking about, approaching situations with any person. With a sense of curiosity and a sense of humility, knowing that you have something to learn from every person that you encounter. And our patients feel like they have things that they can teach us, whether it's just about them or their clinical circumstance and they're saying things that we may not always hear if we approach thinking we already have all the answers for that particular situation.

Host: Yeah, that is a great point. So, what can nurse leaders do to model really good listening behaviors as an example, to the staff, they lead.

Amy: Yeah, that's a really important question and a really important aspect of this work that we're really just beginning and the dialogue that we are seeking to start through this opportunity. And that is to make the connection between the human desires of both patients and employees, and what our patients have told us, looks like listening to them. In all likelihood though, not having been studied tremendously, at least by us is our employees would want those same types of behaviors. So, the question becomes wouldn't our employees also want to be treated as a human, have their leaders make a human connection with them, perhaps approach them with curiosity. Approach situations, with compassion and empathy for the employee. And so the discussion that we want to start is how can we, as leaders demonstrate exactly those same behaviors to our employees in hopes of them understanding and learning what that experience is and then knowing how to perform those behaviors with their patients as well. And so we, spend some time talking about some barriers to that too, and that oftentimes whether we're dealing with a patient or an employee, or really any other human, we have some preconceived notions that we need to set aside in order to be able to listen and really identify with that person as a human being. There are so many examples of that within healthcare, and we want to be able to show leaders, just some simple things that they might do changing some words they use to refer to their employees or, starting some simple icebreaker connection point during every meeting. Those types of things to really start to connect with employees and have that experience for the employee be so fulfilling and understanding that they are listened to and there's a human connection with their leaders in their organization. And then they're able to demonstrate that with their patients as well.

Host: So when a floor nurse feels heard from the nurse leader above her she's more likely then to make that honest human connection with the patient that he or she is caring for them to, it kind of follows right down the line, is that a way to look at it too?

Amy: Absolutely, that's exactly right. That's the connection that we want to make in the Bayer nursing leadership community so we can start to infuse these cultures within all patient care environments.

Host: I'm just curious, you said in your last answer, you're gonna showcase words you can use with, someone can use with their employees. I don't want to give away your whole session here, but can you just give me a brief example of switching out words and examples of that in a conversation or a situation and how that's beneficial?

Amy: Sure, just as one example and this is more about, all of us as humans have a tendency to generalize some behaviors based on some perhaps labels or, words that we've used to describe people. So even just thinking about the terms we use based on someone's generation, for instance. And there's, a lot we know about that, and it is fascinating, the differences and the similarities between generations. We just touch on the question around how does identifying a nurse, for instance, I'm a member of gen X. So, I'll use that as an example. How has people's impressions or what you might term an implicit bias around generation X. How does that impact how they approach me with curiosity or how they, understand what it is that I'm saying or what have they made up about me already prior to an encounter. And those are the things where we want to think about why can't I just be Amy and not Amy gen X nurse and all the things that come with that. And so how do we help people understand, yes, there might be some tendencies generationally within each individual there's a lot of characteristics that make that person unique and their viewpoint comes from that frame. And so how do we help discover what it is that's unique about each individual person to develop strong relationships with them. That's just one example of the things we'll discuss.

Host: Yeah, that's really interesting. we're all just humans and when you can remove those labels, I'm sure it makes it easier to make that honest, authentic human connection. It sounds what you're striving for. So, Amy, can you tell us about your session briefly and what attendees can expect?

Amy: Yeah, absolutely. So, just as I said, our intention is to start a dialogue that we feel is really important amongst nursing leaders. And we always want to connect to the why on that. And the why for us is really in that all of us are trying to provide high quality, high, safe, highly, reliable environment. We're trying to be those types of leaders. And this is a look at one aspect of that to say, can we expand our thinking on high reliability, to more of the experience and communication relationship building within our organizations or within our department. And then once we have identified, we believe we can, what might that look like? In one example, and we know listening to be critically important to the patient's experience, to safety, to quality care being provided. And so, we look. in-depth at Dr. Luce's research, what she found from patient's about listening, which we touched on here a bit. And then get into the conversation about how do we as leaders put this into our worlds with our staff and patients, and then spend a lot of time talking about the barriers to that. Highlight some of those words, some of those bias point that we might be able to flip the script on and turn the table and look at those things differently. Maybe stop using some words that we've used before to describe either patients or employees and open up our, frame on how we see them and try to get into who they are as a person and how we can connect with them.

Host: Right, now that really makes sense. Well, the session, Highly Reliable Leaders Listen, check it out. I know you're going to like it. Amy thank you so much for your time today we appreciate it.

Amy: Thank you, Bill, very much. You have a great day.

Host: That's Amy Trueblood and for more information please visit AONL.org and if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Today in Nursing Leadership. Thanks for listening.