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Tuesday, June 19, 2012

Can I Really Trust You?

This week I've been thinking a lot about those around me and how much I value the ones that are totally truthful. Over my career, it has been interesting to me that leaders sometimes surround themselves with people who continually tell them what they WANT to hear instead of the what they NEED to hear. As for me, I prefer to know the truth, the whole truth, and nothing but the truth. Where have I heard that before?....Oh yeah, the courtroom.

In one of my early management jobs, I went through a battery of tests administered by two Industrial Psychologists from Tulane University named Gig and Irv.  Following the tests, the gave me feedback on the results.   There were several deminsions on the tests that I showed very good balance on, but on one demension I was off the scale.  The two men looked across the table at me at said this will be a problem for you.  It's the "Honesty" scale.  I asked how could that ever be a problem to be honest.  Before the movie ever came out with Jack Nicholson saying the famous line "You can't handle the truth!".  Gig and Irv explained to me that in organizations, complete truth telling is not always valued.  At some level, people had rather not know certain problematic things that are going on, that are difficult to solve, or that involve those that are difficult to deal with.  There have been times in my career when I have heard Gig and Irv whispering in my ear, complete honesty will be problematic for you.

Complete trust on the other hand is required for teams.  Patrick Lencioni, in The Five Dysfunctions of a Team said that trust is the foundation of being a functional team.

The absence of trust is the biggest problem in dysfunctional teams.  According to Lencioni the main problem here is the tendency of group members to show vulnerability.  It is our tendency to show ourselves as invulnerable in the workplace.  A retreat to work on trust-building might work to expose some of those vulnerabilties.  Simple things such as discussing each persons Hopes and Fears for the teams future and discussing some personal things about each other that is likely unknown by other members of the group.

For the most part, healthcare is a team sport.  Consider the paramedic.  He or she must be able to trust their partner to watch their back on a gang shooting scene as they bend over to care for the patient.  The nurse on the floor must be able to trust the ER nurse to give accurate information in report. Rebuilding trust if failures occur in these areas if very difficult to do.  But it all starts with showing vulnerabilities.

If you decide to have a retreat to deal with trust, their are a variety of games and exercises that purport to build trust available on the internet.  A professional facilitator may also be able help to bring the group together.

One of my greatest successes was when I was assigned to supervise both the Inpatient units and the Emergency Department.  Historically, the Inpatient units are accused by the ED as holding empty beds and delaying taking new patients.  The ED is accused as being pushy and providing incomplete reports.  So, we brought both groups of Charge Nurses together.  Everyone introduced themselves giving professional and some personal information.  Following that, everyone participated in some group training on Communication as an inservice for Charge Nurses.  Then, they broke up into small mixed groups and rotated among stations to design new processes.  What resulted was better understanding between the groups, and the Inpatient Units began to "pull" patients out of the ED.  What a success when each group understood the other's issues and were able to see each other as trusted colleagues.

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