11. Fun is good
“…in our haste to seek the
American dream, we‟ve
sucked the
fun, passion,
and creativity out of the
workplace.”
◦ Instant replay
◦ Disco inferno night
◦ Lowest attendance record
◦ Labor day
www.RxForSanity.com
12. Melissa McCants, College of Charleston
Athletic Department (& former Veeck
employee)
Mark off a large athletic field in squares,
raffle 300 spaces for $100 each, and bring
in a cow. Wherever the „chip‟ fell
determined the winner.
Gallon of “Holy Cow” ice cream to owners of
squares visited at least 15 minutes
All-you-can-eat oyster roast $25
After $10,000 prize for bingo, netted
$30,000 for scholarship fund
www.RxForSanity.com
13. Cow Bingo
College of Charleston Athletic Department
300 spaces for $100 each, $10k prize
Gallon of ice cream if cow lingers 15 minutes
www.RxForSanity.com
16. Fun is good (in healthcare too)
Fun/satisfaction in
medicine=transition to health
From patients to partners
◦ Patient Ed and Assignments
Stool diary
◦ Snaps for good efforts for health
www.RxForSanity.com
17. You treat a disease, you win,
you lose.
You treat a person,
I guarantee you, you'll win,
no matter what the outcome.
~Hunter Patch Adams
RxForSanity.com
27. Disease of the month
Body art- sharpies, bottom décor
Ownership of their health- Nona‟s book
Cartoon book
Butt Meddler, butt-ons, joke books
RxForSanity.com
37. 2100+ MD & RN executives
◦ 67% nurses
◦ 68.9% hospital setting
97% “experience behavior
problems with docs and nurses”
◦ 12% note increase in last 3 years
Problems occur:
◦ Daily 9.5%
◦ Weekly 30%
◦ Monthly 25.6%
38. Yelling
Degrading comments & insults
Cursing
Refusing to work together
Refusing to speak to each other
Spreading malicious rumors
Inappropriate joking
Trying to get someone disciplined unjustly
Trying to get someone fired unjustly
Throwing objects
42. Bullying behavior in medicine
Attack upon competence & reputation
Personal attack
Attack through work tasks
Hutchinson, Nurse Researcher 2008
43. My reputation was damaged by false
allegations
My achievements and contributions were
ignored
My abilities were questioned
I was given work above skill level and refused
help
I was denied development opportunities
44. I was ignored
I was belittled in front of others
I was watched and followed
I was blamed
I was publicly humiliated
I was threatened
45. My work was excessively scrutinized
I was allocated the heaviest workload
My work was organized to inconvenience me
I was given demeaning work below my skill
level
46. My work life was made difficult
I was excluded from receiving information
My work was organized to isolate me
48. VHA Survey
◦ 2562 respondents, 1615 nurses
◦ 37% “Nurses are leaving the hospital as a result of
disruptive behavior”
If +, average number of nurses 2.5/year
Rosenstein The Physician Executive; 2002
49. Knaus 1986 Ann Int Medicine
◦ 5030 patients in 13 ICUs
Differences in death rates related to interaction and
communication between nurses and MDs
Shortell 1994 Medical Care
◦ 17,440 patients in 42 ICUs
Group
culture, leadership, communication, coordination, c
onflict management abilities
Lower risk-adjusted length of hospital stay
Lower nurse turnover
Higher technical quality of care
www.RxForSanity.com
50. The worst behavior problems aren‟t the most
„show-y‟
◦ “It‟s the everyday lack of respect and
communication that most adversely affects patient
care and staff morale”
Fear of questioning attitude
◦ Better teamwork leads to fewer OR errors
OR is most common site for adverse events to occur
47.7% -50.3% of AEs for surgical patients
Johnson PEJ; 2009; Catchpole Ann Surg 2008
51. VHA Survey: 102 hospitals, Jan 2004- March
2007
◦ 4530 participants, 2846 nurses
67% agreed disruptive behavior was linked
with adverse events
◦ 71% medical errors
◦ 27% patient mortality
Rosenstein Jt Comm J Qual Patient Saf 2008
65. First, get centered
Second, establish who you are wiling to be in
the moment
◦ Select three, and if you can get the other party to
commit to three…)
RxForSanity.com
68. Cultivate non-resistance
◦ Martial arts, yielding
◦ Don‟t tense up!
Resistance is futile.
Non-resistance is fertile.
RxForSanity.com
69. Cultivate non-resistance
◦ Martial arts, yielding
◦ Don‟t tense up!
Only two sentences for you:
Tell me more.
then
What do you need?
~or~
What‟s missing for you?
RxForSanity.com
70. “attend to them with the ear of your
heart…”
~Prologue, Rules of St. Benedict
RxForSanity.com
83. 1920‟s study at Hawthorne plant, Cicero Il.
Increased lighting, shorter workdays, other
worker friendly fixes to improve
productivity
Boosted performance noted, but due to
changes in social environment, not physical.
Increased attention led to happier and more
effective employees.
www.RxForSanity.com
84. Gallop Organization 1998
Extensive interviews with highly productive
workers
◦ 5.4 million employees at 474 organizations
Developed 12 statements to measure
happiness with work=“engagement”
Sept ‟04: 29% engaged, 55% not
engaged, 16% actively disengaged
www.RxForSanity.com
86. Do you know what is expected of you at
work?
Do you have the materials and equipment
you need to do your work right?
At work, do you have the opportunity to do
what you do best every day?
In the last seven days, have you received
recognition or praise for doing good work?
Does your supervisor, or someone at
work, seem to care about you as a person?
Is there someone at work who encourages
your development?
www.RxForSanity.com
88. At work, do your opinions seem to count?
Does the mission/purpose of your company
make you feel your job is important?
Are your fellow employees committed to
doing quality work?
Do you have a best friend at work?
In the last six months, has someone at work
talked to you about your progress?
In the last year, have you had opportunities
at work to learn and grow?
www.RxForSanity.com
91. 360 degree feedback
1. Truth lunch:
Employee gets $25 to take manager to lunch at
location of their choice outside hospital for straight
talk and honest feedback
2. Twelve coupons for “Listening Time”
20 minutes to talk to you about anything
www.RxForSanity.com
94. Guidelines for your area
◦On time
◦Respect
◦Assistance
◦Lunch relief
◦Uniform selection
◦Come to leadership with
BOTH a problem AND
a solution.
www.RxForSanity.com
99. If you had a magic wand, and
could wave it over your
staff/patients/colleagues and get
them to do any one thing
differently, what would you
choose and why?
If the people in your office were
singing a blues song about their
job, what would they be singing
about EXACTLY?
RxForSanity.com
102. “Make a Change”
“Pass it on”
The “put-down, put-up bean jar” exercise
Are your staff suffering from O.R.?
◦ “Bell-Ringers”
“Give Up the Chip”
www.RxForSanity.com
103. Recognize Positive Behaviors
◦ NorthShore Regional Medical Center, Slidell Lo.
◦ Vote for awards for MDs with positive behaviors
and attitudes
◦ Congeniality, most compassionate, best
dictation, best teacher, best penmanship, best
bedside manner, best phone etiquette
Begin an epidemic of elevation in your
office or unit!
www.RxForSanity.com
104. How would you describe the working
environment in this unit?
How are staff recognized?
Is innovation valued here? If so, give me an
example of how.
www.RxForSanity.com
106. No matter how big or warm or soft your bed
is, you still have to get out of it.
~Grace Slick
Opportunity Hit List: Grow, stretch, & learn
Internal job fairs
Grow your own staff: CE eligible classes
Give good feedback, weekly or monthly
◦ Set written goals and deadlines
www.RxForSanity.com
107. 1. Build a flexible staff
Cross trained
Part time
Half shifts and 4-10 hr days
2. Address concerns re physical nature of job
Zero lift policy
www.RxForSanity.com
109. Newsletters
Thank you cards
Display accomplishments in unit
Spotlight and encourage their
volunteerism
“Caught Doing Good”
www.RxForSanity.com
111. Nomination by other staff
Nominee must be caught going
beyond job description
Outcome of action had positive
result in patient care
The result must further one of the
hospitals mission statements
www.RxForSanity.com
112. Improved working relationships amongst staff and
between staff and patients
◦ Enhanced job satisfaction and reduced
turnover of both nurses and MDs
◦ Reduced LOS and costs of health care
◦ Better patient outcomes
◦ And…it‟s more fun to be at work!
www.RxForSanity.com
