Quote from John Freeman on October 7, 2020, 5:39 pm

100%. Looking forward to the summary! :)

Quote from John Freeman on October 7, 2020, 7:26 pm

Something that I understand better: there was a deceased child a few years ago because my colleagues thought he had a benign viral infection and sent him home. He later died in the car.

So the whole institution is still traumatized with this case I believe. They don't talk about it of course, for cultural reasons: mistakes are shameful, etc. Fixed/conservative mindset. So I have empathy for them as it ruins one's carrier because then there is a trial for a few years and then everybody is scared of making a mistake.

However, I think that once more it proves the mediocre management/leadership. I think that's why they gave more power and teaching to nurses than to junior doctors. As of course, it's the junior's doctor fault so the scapegoat is found. Yes, it's their fault (along with the supervisor) and yes it's a good move to make new systemic policies to improve safety.

What's unhealthy is that they should talk about it to every new batch of resident. Instead of the ghost of the child literally looming over the institution. I'm very sad for this child and his family and the professionals involved. However, I think people have not yet a mature attitude of dealing with these kinds of event. In this case, death of a child in a rich country. This is not tolerated.

That is once more an argument to have an open and transparent culture. Everything that is unsaid is exactly this: unsaid. So the group cannot learn from the mistakes of previous members and are more likely to repeat them. Increasing control is not an effective solution in the long term as it does not build more trust and therefore does not allow people to talk openly about what they could improve and should be cautious about.

That is why I think I have a role to play in medicine. They don't have an engineering approach to things. They try and I think for people not trained in engineering they do an "ok" job at it but I can see they don't have the right mindset. Doctors are not trained to build systems. Engineers are.

So I think that these kind of mistakes actually stems from:

1. Bad training
2. Bad leadership/management
3. Bad control systems
4. Bad luck: there will always be something that will slip through the system, no matter what. There will always be plane crashing and car accidents, no matter how many systems you put in place.

So by increasing control, you actually increase the fear of making a mistake in subordinates, which removes the self-confidence people have and make them more prone to make errors I believe.

Also, the people who got into trouble were the resident, direct supervisor (does not want to do clinical work anymore) but not the medical chief officer. So, there is also a problem of accountability on the higher levels here.

That is a very important component of social intelligence at work: finding out what is the specific history of your institution that will shape its culture.

Quote from Lucio Buffalmano on October 7, 2020, 9:18 pm

Great message, John.

I added "investigating your organization's history" to the "Basics of Workplace Power", and quoted you here:

Quote from John Freeman on October 7, 2020, 7:26 pm

That is a very important component of social intelligence at work: finding out what is the specific history of your institution that will shape its culture.

 

Quote from John Freeman on October 7, 2020, 10:01 pm

Thanks!

Quote from John Freeman on October 10, 2020, 8:27 pm

I’m a little proud of myself today as I defended a nasty power move.

It was coming from one of the nurses who cannot stand her job anymore. I was talking about a patient whom we could not stitch because he was too agitated.

Her (while she was not doing any kind of work BTW): it’s because he saw you that he’s crying. (Implying that I scare kids, which is kind of an insult in our field and in general, which I don’t BTW: Kids love me. She was also trying to make me the laughing stock.)
Me (detached and calm): he was crying before I came in.

Her: ....

I’m happy because it shut her mouth good and the group of nurses was floored by my answer.

So it shows that the power of detachment helped me to choose the best answer: in this case being factual.

It also shows that Jocko’s answer to haters work: keep working. I post below the video.

P.S.: that’s what I understood today. Some of the nurses that are nasty/mean are the ones that would like to change profession but feel they cannot (of course they can but that requires moving their ass!) so they’re bitter. Now I’ve overheard 3 of them explicitly saying they would like to change jobs. I have empathy for them but it does not give them the right to abuse coworkers because they’re unhappy.

Dealing with haters:

Quote from Lucio Buffalmano on October 10, 2020, 9:33 pm

Nice one, John!

Also notice how her actions clearly show how she's uninterested at doing a good job.

It certainly doesn't help the kid/patient to frame the doctor as an ogre who makes children cry.
It makes the kid feel uncared for, an out-group member in a group that is not interested in helping him out, and now the person who's supposed to take care of him is being framed as someone who makes children cry (obviously he doesn't process that consciously, but the effect is the same).

She was more interested in making fun of others and/or gaining some scraps of power, rather than even remotely doing a good job.

If you wanted to bridge towards also helping the kid out, it could have been an option to go something like this:

You: (detached and calm) he was crying before I came in.
(slight pause)
But I can see he's such a good kid, I think he might even stop soon. And he knows we are here to take good care of him (sits next to him, pats him on the back). Do you like the Avengers (pulls out an action figure)?

Overall, thumbs up!

Quote from John Freeman on October 10, 2020, 9:55 pm

Thanks! Actually the kid was in another room. I was in the "command center" with a group of nurses and we were discussing how to deal with the situation. So it was just a swing at me for no other reason that power-scalping. The child was not even in the room with us. It as a power move pulled on me in front of the group of nurses. That was the dynamics: me and a group of 5-6 female nurses.

Quote from Lucio Buffalmano on October 10, 2020, 10:02 pm

Got it.

Then it was 100% pure effectiveness :). Well done, John, happy about that.

Quote from John Freeman on October 11, 2020, 7:12 pm

Thanks!