Decisions at 16,000′
It’s been a month or so since I’ve blogged, primarily due to workload as I’ve taken on a new, interim role in NHS Orkney, as explained in my last blog. There’s been a couple of blog idea bubbling around in my head that I’ve wanted to share, but never quite put ‘pen to paper’ (or should that be fingers to keyboard?). Even as I write this I’m not sure whether to write about an idea I discussed with @docherty_e this morning as we sat in Glasgow Airport, or to write about the ‘difference’ – a blog I’ve already started. The ‘difference’ relates to my role as an executive member of an NHS Board and what is different to the role I perform in my substantive post as an Associate Nurse Director.
As I write this I’m at 16,000 feet looking out of the window at Aberfoyle far below, it’s decision time!
The decision – customer care
This morning I arrived at Glasgow Airport at 09.30hrs for my flight to Kirkwall, 90 minutes early: LoganAir check-in had four operators on duty and approximately 10 – 12 people in the queue (so not overly busy), having reached the front of the queue I moved forward when requested – “where are you flying to”. No good morning, no how are you today – “ID” – “have you got any of these items in your hand luggage?” All this while looking down at her screen – efficient and getting through the work! I asked if it was possible to get two seat together, for my colleague and I – we usually use this time to discuss the week ahead, areas that need addressed and basically as an extension of the working day – “your seat’s already allocated” pause “and Mr Docherty has already check in.” Hmm, the text I got from him 20 seconds earlier said he was waiting for his transfer bus at the off-site car park, of course he might be wrong and didn’t know nowhere he was!! I didn’t venture an opinion.
Let me look and see
I compared this to two other events, one last week and another one this morning.
- At one of the other desks an older couple were progressing rather slowly with the process of finding their photographic ID, the check-in operator didn’t rush them, however she also processed another passenger, via a side door, who was in the priority queue, while never losing focus on the older couple in from of her. The priority passenger was dealt with quickly and efficiently, he appreciated the extra attention he had received, the older couple were not rushed or made to feel they were a bother.
- Last week, arriving at check-in there was a fairly large queue (for LoganAir) of around 30 to 40 people. I arrived at the head of the queue and was called forward “good morning sir, where are you travelling to today” – “do you have your photographic ID please” – “on the front of the desk there is a chart, do you have any of those items in your hand luggage?” I asked if it would be possible to have a seat beside my colleague – “let me look and see what I can do, is he here at the minute?” - “no problem sir, I can give you seat 12C & D, I’ve just allocated that for Mr Docherty when he arrives”.
Not doing wrong might not be enough
Today’s flight is 75% full, last week it was 100% full and check-in was three times busier, which left me wondering – what was the difference? These three employees of Loganair each displayed different aspects of customer care. All three of them did their job, they were efficient and effective, they each carried out their duties safely, yet for one the person-centred, caring perspective was missed completely. It made me reflect on how we deliver healthcare on a day to day basis. My current area of responsibility spans nursing, midwifery and allied health professions – as I sat in the airport I wondered how many of our team today would be like last week’s check-in operator or the one on the ‘priority’ desk? How many will get though their workload today in an efficient manner, but never actually look at or consider the person in front of them? Which one do you aspire to be – are you efficient and effective, do you carry out your role as a task, or do you care about making it the best experience the person in front of you can have.
The check-in person this morning did nothing wrong, however I didn’t leave that check-in desk feeling important or valued – the outcome will still be the same, I’ll get to Orkney just after lunch time …………
………………. but I know which one I hope will be on duty next week when I arrive at the airport.
Will your patient’s look forward to seeing you at their next clinic or home appointment or the next time they are in your ward?
Will it be an experience characterised by care and compassion or will it simply be an efficient experience?
Begin with the end in mind
I recently was given the opportunity to work in an other health board area in a senior leadership role. It was easy to understand this role as a leadership one as the post directly managed only a handful of staff, and yet it’s impact should be felt on the greatest number of staff working in the Board. What was less easy was to understand what impact I could have in only three months (the length of my secondment); for me the important aspect of this dovetails with my last blog and my re acquaintance with Covey – Begin with the end in mind.
What was the end I had in mind, what did the Chief Executive have in mind and what would the individuals within the teams I would be working with have in mind.
Week one was hectic, there were people keen to meet me (which was nice), meetings that had to be attended, papers that had to be read. The Chief Executive drafted my objectives for the three months secondment (based on our conversations), and I was all set. However, my role as a leader demands more than what can be captured in a set of objectives.
If you don’t know where you are ..
In some ways the opportunity I’ve been given is to support others as they travel towards their destination – that’s a privilege and a responsibility. That said however, this involves individuals and teams knowing where they want to be, the destination, the shared vision. It involves ‘starting with the end in mind’ – what is the passion of the individual clinicians (as its mainly with clinicians I’ll be working), what do they truly want to deliver every day they come to work? Are each one of us focussed on the individual in front of us, the next person who will walk through the door. For each of us, it’s important to have a vision, to understand our personal/professional values, to understand our impact.
While I am a great believer in having a vision, an understanding of where you want to be, it is also important to know where you are. If you don’t know where you are, how do you know which way to go? Think of it as a road map. You might know the destination but without a starting point you are unable to determine the direction you need to head, where should that first step fall. Once we have accept where we are, good and bad, we can determine the steps needed to achieve our goal.
Pushing down or pulling up
Booker Washington said “There are two ways of exerting one’s strength: one is pushing down, the other is pulling up”. Leadership isn’t about pushing others down, it’s about pulling them up.
I recently read a blog by Todd Neilson about Leaders in ‘beta’ being a mixture of ambition with humility (beta refers to the IT term of things being in testing stage). He noted that it was ok for leaders not to know everything, this reminded me of Hawkins and Smith four stages of leadership – experimentation, the leader needs to understanding that it is ok not to know everything. Stage two starts with accepting that as a leader you are always in beta mode, always learning always testing. As you put that testing, learning and self reflection into action the next stage is evidenced by experience accumulation, you start to gain confidence in putting into actions the things you have learnt. Full leadership is more difficult to achieve, but people who have moved into this phase are obvious by their actions, they focus less on what they can get out of a situation and more on what they can put in, the outputs are more important than their person accolades. Their motivation is ‘what is the difference I want to make’, Covey described this as one of his four basic needs- To Live, To Love, To Learn, to Leave a Legacy: not the legacy of self serving obsession of fame, but rather the difference that the leader supports others to achieve, even when they are no longer there. Hawkins and Smith describe Eldership as the final stage in the development of a leader, many do not get there. The feature of this leadership stage is a detachment from the difference the leader can make and a focus on what has to be done, creating an environment for others to achieve. In this respect it follows a similar theme to Greenleaf’s concept of Servant Leadership. The perspective of:
- - caring for others
- - being mentor minded
- - having the passion to develop others
- - being the compassionate collaborator
There have been few times in my personal leadership journey when I can reflect with any certainty where I am in relation to the stages described. However I am confident that my role, over the next three months, is not about me, it’s about creating the environment for others, it absolutely isn’t about pushing others down, it’s about pulling them up.
This role I’m in is about Eldership, it about supporting others to ‘be all they can be’, to help set their path for the future.
It’s about finding leaders, but it’s also about finding followers - concepts that are not mutually exclusive, although the wisdom to know when, to be which at what point, can in many circumstances be elusive.
Whatever else, I’m looking forward to working with many new colleagues.
Sharpen the saw
A couple of unrelated (in space and time) but interesting things happened last week, firstly my daughter took a feng-shui approach to one of the rooms in her flat – to be honest, I’m sure this was more accurately described as picking things off the floor: however let’s not be unkind. For the purposes of this blog the relevance lies in her discovery. As she tidied her academic books and related resources she came across a manual she had been given and used on a course she attended – Covey’s Seven Habits of Highly Effective People.
The opportunity to ‘sharpen the saw’ had presented itself to me and I wasn’t about to pass on it. Over the next two days I read the handbook, alongside my own copy of Covey’s book, which provided a more in depth explanation.
There was an unmistakable relevance and challenge for me in Covey’s work as I reflected on my impact and influence as a leader :
- was I always ‘proactive? (habit 1),
- did I always ‘start with the end in mind’? (habit 2),
- did I ‘always put first things first’? (habit 3).
After some self review I think I’m pretty good with habit 2, I use this as a guide in my day to day work, it has a synergy with my belief in having a vision and working diligently and enthusiastically towards it. As a leader having a vision is critical, without it how can you expect anyone to follow you? Perhaps more accurately how can you truly expect high calibre followers to follow you – people who will challenge you, who will rise to your challenges, who have as their driving principle ‘excellence’? A leader without followers …..?
Quadrants of activity
On the whiteboard in my office I have Covey’s four quadrants of activity as a frequent and ongoing reminder to engage with habits 3 – put first things first. The diagram has been there for some time, and, rather like the habit itself it would benefit from being rewritten and refreshed – an early task I set myself for Monday (yesterday) morning.
When considering my activities I aim to keep them above the line, when I don’t manage to achieve that I know I’m not always putting first things first and that pro-activity is perhaps slipping a little.
Post Interview feedback
However this blog isn’t simply about a refreshed encounter with Covey, it’s also about the second ‘event’ I referred to in the opening paragraph. It’s relates to a meeting with a new and emerging leader and one specific aspect of the conversation. The meeting was focused on post interview feedback – an activity I highly commend to everyone, whether successful or unsuccessful in a job interview. Indeed those that are successful at job interview quite possibly have as much to gain from this feedback as those that were not, it’s an area we would do well to consider in terms of staff development and supporting people into new posts. However, I digress.
During the conversation I was asked about one of the questions that I had posed at interview “what would you do on day one, if you were successful today?”. What was I looking for with that question, what answer was I expecting?
Seek first to understand
The simple answer is I wasn’t looking for a specific answer, it was a people question, I was trying to understand if the candidates had considered a future where they would be in that position, did they have a vision to share. If a candidate hasn’t consider what success might look and feel like, are they really in a strong position to influence an interview panel that they are right for the job? I know people will grow into a job, that people take time to develop and mature, but day one is also an important day, it can set your path for the future.
The second thing I was perhaps expecting (but also hoping to avoid) from that question was the rather clichéd ‘I’ll listen to people, hear what they have to say etc etc’. Of course listening is extremely important, we all need to practice it more, however I expect successful candidates to have an understanding of the role they are about to take on, as well as an understanding of what they are going to contribute to the role and, importantly, to be able to share that with their new team. This brings me to the dichotomy inherent in Covey’s fifth habit ‘seek first to understand, then to be understood”
As a new leader people will be looking for an indication of what impact the change is going to have on them, what will this mean for the services they provide. A new leader simply saying ‘Im going to listen’ is a disappointment for teams.
Day one is an opportunity to share the vision, Sinek in his Tedtalk (and his book) talks about the Golden Circle – Why, How, What – day one is a day to involve teams in the ‘why’, it’s an opportunity for the new leader to share their ‘why’, it’s an opportunity to inspire.
The ‘how’ is where listening comes in, we all need to listen to team members, we all need to feel we’ve been listened to.
As a new leader, or a leader of a new team, Covey isn’t encouraging us to inaction, he’s encouraging us to recognise the value in understanding your team, to get underneath their ‘why’, only then can the team move forward together with ‘how’ to address the ‘what’ that is needing done: remember however they also need to understand your ‘why’.
Last week I had the privilege to attend the Principles into Practice Network Awards and Conference - to be honest I get to attend a fair number of conferences, the question really is why blog about this one. Followers of my blog will notice of course that I blogged last week about a conference, however my purpose in that blog was to highlight the power and reach of Twitter, this is different.
The Mental Welfare Commission for Scotland, through their Principles into Practice Network hold this bi-annual event. It is there to celebrate innovative and good practice from services and projects across Scotland in exemplifying the principles that underpin the Mental Health (Care and Treatment) (Scotland) Act 2003. For ease these principles are noted in the table below:
- Respect for diversity
- Informal care
- Respect for carers
- Least restrictive alternative
- Child welfare
The conference opened with Lorraine telling us of her journey with mental illness, through the dark days of depression which she described as a Sunami sweeping over her, an overwhelming darkness where she lost hope. For me one of the powerful messages from her was her explanation of others hold her ‘hope’ for her, as she had lost it. One of the critical aspects of this is the ‘temporary’ loss of hope and of others holding it for her was the need to enable her to take back that hope as she progressed through her recovery.
In her discourse with the audience Lorraine (Renaissance woman) allowed us insights into how she “gained strength though vulnerability”
In her pictorial presentation she vividly described the fragile road she travelled, how creativity had given her a path of hope and a way to self reflect on her recovery. For absolute clarity, Lorraine was not saying recovery was the absence of mental illness, it was the ability to live well in the presence or absence of it. See http://www.hope4recovery.co.uk for details of Lorraine’s story.
“People outwith ‘art circles’ may not recognise or appreciate the immense value of art and creativity in recovery” – it seemed that lots of people agreed with that! Underpinning this statement from Lorraine is her explanation that creativity is one of the first ‘gifts’ we develop as children, is it therefore any wonder that if nurtured and encouraged that it should not be one of the first keys in the process of recovery – it’s not “just a nice hobby”. For those of us in health or social care services please take a few minutes to reflect on how (if) your service supports this aspect of a persons wellbeing.
At lunchtime I was near to tears, I went into the lunchtime film showing of ‘My Life’ a film made by Peter McMahon. Peter’s film explores the many way that he was bullied and ridiculed simply for because he had a learning disability. The film was a wonderful portrayal of how Peter rose above the bullies and engaged with a wide group of individuals and organisations. I was also immensely saddened as some of Peter’s contemporaries described how remained a feature of their lives.
Chilling aspect of the film were when Peter’s friends aid “most people have experienced being bullied because they had a learning disability’. The film has also some poignant moments of triumph – when Peter speaks on the local radio station, when he influences the local bus company to taking seriously what happens on their buses. Making the film meant that Peter. for the first time was really able to speak to his own family about it and thereby tap into the natural support that was there for him. A powerful film, made by a larger than life character.
The film is available for use for education purposes – if you are in education or work with groups of people where you think the message of respect, of embracing of ‘different’ could be enhanced this film can support your work.
Finally, it wouldn’t be me if I didn’t give you a few Twitter facts from the conference: