Celebrating women

Last week was a week for celebrating women, with International Women’s day on Thursday and Mother’s Day (here in Ireland) on Sunday.

I had a wonderful Mother’s Day. As a mother, I adored being the focus of lots of gorgeous expressions of love from my children. Breakfast in bed, hand-made cards and showers of kisses and cuddles made me feel a lovely warm glow. As a daughter, I enjoyed trying to make my own mother feel special too, by letting her know how much she means to me, offering small gifts and a card as expressions of love and by spending time with her and the extended family. It was a really lovely day; one which I have tucked carefully away in my brain to be retrieved when I want to think about the high-points of my life.

International Women’s day felt a bit different. I saw adverts for lots of events organised to celebrate the day … women’s breakfasts, lunches, dinners, coffees, drinks, discussions, fora, online groups … you name it. Anyone who knows me, knows I’m a great one for celebrations. Last Thursday however, the celebrations didn’t feel right and I partook in very few. I would even go so far as to say that the idea of many of these events made me feel uncomfortable.

My discomfort arose from the gender imbalance at many of these organised events. Generally, Women’s Day events involve panels of women speaking to audiences of women about women. They are often sold as fora in which women’s issues are discussed and progressed – such as women on boards, women in politics, women in business, women in power… all of which are noble causes. At these types of events, the conversation generally centers around the under-representation of women in these areas and the need to achieve greater gender-equality. I don’t disagree. However, I can’t help feeling that a gender-skewed event is a somewhat ironic approach to the gender-equality issue. In fact, if I’m honest I think it’s a  bit counter-productive.

We need action from both men and women on the issue of gender equality and, if anything, we need to work harder to engage the opposite gender when we’re trying to progress the cause of one, rather than exclude them. We need meaningful debate and focused collective action. I suggest that if we are going to achieve gender equality, we need to start from that position of equality, not by perpetrating the very inequality we seek to conquer.

The event in which I was most interested was that of my employer, the Royal College of Surgeons in Ireland who, much to their credit, fielded a gender-balanced panel of high-profile speakers, with three female and three male contributors. It was the only gender-balanced event that I saw, although of course that’s not to say there weren’t others. Unfortunately the event was scheduled to take place one week ahead of International Women’s Day, and ultimately was cancelled due to the Beast from the East (For international readers, that was the name of the weather system that blew in from Siberia bringing blizzards with it!). It was a shame that it didn’t go ahead, as I believe more gender-balanced discussions are needed.

I’m fortunate that I’ve never experienced a situation where I felt my gender created any advantage or disadvantage for me. I have benefited from the support of many men and women along the way, in my career and in life more generally. Gender equality is an important issue, and never one to forego a celebration opportunity, I celebrated international women’s day in my own way this year:

I called my Mum and Dad, and thanked them for raising me in an environment where my gender was never considered an issue;

I rang the principle of my old secondary school and thanked him for the school’s ethos of creating the right conditions for girls to flourish, and for ensuring that  gender was never considered an issue (which is an impressive feat in an all-girl school!);

I bought flowers for each of the team in work and thanked them for the role they play in supporting the women in their lives;

I thanked my husband, for his role in creating an equal partnership between us;

I called some of the people who have really supported me in my career, and let them know how much their support meant to me and how they need to keep up the great work for others;

I spent time talking about the topic of gender with my children. Their views on the topic are refreshingly untainted and I enjoyed the conversation and learnt from it;

I made an conscious effort to encourage women I met, particularly those at an early stage of their journey;

I unregistered myself from the Women in Pharmacy facebook group because they decided to restrict men from joining the group;

and I marked International Men’s Day in my diary, so that when the time comes, we can celebrate men too!

These gestures, small though they may be, were my way of celebrating the day and trying to make a difference in the world. Finally, although the celebrations have passed, I’m attending an event this evening, with an all female panel and, most likely, an all female audience … because it’s important that I try to understand this issue from other perspectives too!  🙂

Reflect to prosper

My last gesture to mark International Women’s Day is to prompt you to reflect on the issue of gender equality. How do you contribute to this agenda? If/When you see gender inequality, what do you do about it? And is there more you could do, today, to contribute to a future where nobody feels excluded or overlooked because of their gender?

 

Boat-rockers: conforming and rebelling at the same time

I’m currently participating in the School for Change Agents. It’s an initiative from the Horizons Group of NHS England, which is led by the fabulous Helen Bevan (@helenbevan). The website declares:  If you’ve been frustrated by having to navigate stifling hierarchies to get the changes you know are needed, or criticised for being a dissenter, disruptive or even divisive, then The School for Change Agents is for you. Whilst I haven’t been frustrated or criticised in those ways, I admire Helen Bevan greatly, and am finding the School to be really thought-provoking.

Change agency is defined by the Horizons Group as the power, individually and collectively, to make a positive difference. It is about pushing the boundaries of what’s possible, mobilising others and making changes happen more quickly. They define a change agent as someone who is actively developing the skills, confidence, power, relationships and courage to make a positive difference. It often involves breaking rules

Change agents are often seen as rebels or boat-rockers.  These aren’t always perceived as good things, particularly within well-established organisations. There is no point in being a rebel, if people perceive that you are working against them. There is no point in rocking a boat to the extent that you fall out! To be effective in facilitating meaningful change, one needs to be able to rock the boat whilst staying in the boat. Helen Bevan paints a lovely picture of people who have the ability to be different and fit in at the same time. She describes how boat-rockers are capable of conforming and rebelling simultaneously. As she puts it, “in order to have the space to rebel we have to conform to the things that other people think are really important“. In other words, in order to effectively challenge the rules, you need to be able to play by the rules.

Playing by the rules and challenging the rules simultaneously is not easy. It’s often the case that people become so frustrated by lack of change that they rock the boat too much and end up falling out of it themselves! Once you fall out of the boat you lose the ability to influence it’s direction of travel, and you can become quickly disillusioned and pessimistic. The most effective boat-rocking is created by those who can simultaneously contribute to and challenge a system and who can remain optimistic while doing so. They somehow manage to get the balance right, with a net result of influencing positive change.

I recently read the book “A Force for Justice”, by Michael Clifford (https://www.easons.com/Buy/a-force-for-justice), which tells the story of a man who seemed to get the balance right. It strikes me that whistle-blower, Sergeant Maurice McCabe, seems to have been a particularly effective boat-rocker, managing to challenge poor practice within the police force in Ireland whilst remaining within the system as a committed member of the force. Acting as a whistle-blower whilst remaining committed to the wider system is a difficult balance to achieve, particularly around people who have a vested interest in maintaining the status quo. However, if you can manage to strike the right balance, you can instigate significant change for the better.

My experience is that people often find it difficult to get the balance right. Either they comply so much with the rules that they find them impossible to challenge, or they challenge them so much that they find them impossible to keep. Neither approach is helpful when trying to drive meaningful change. The School for Change provides thought-provoking content which is helpful to anyone interested in striking the right balance in the interests of making a positive difference. It also provides access to a network of like-minded people who can  provide the support required to get the balance right.

Reflect to prosper

Have you ever encountered people who adhere to the rules so much that they couldn’t imagine challenging them? How effective were they in initiating change?

Have you ever encountered people who seemed to consistently challenge a system and didn’t seem capable of working as part of that system? How effective were they in initiating change?

Could you be a change agent who gets the balance right? Could you develop the skills, confidence, power, relationships and courage to make a positive difference?

If so, you should consider joining the School for Change at http://theedge.nhsiq.nhs.uk/school/ . The school is currently in it’s third week (of five) but you can catch up on previous weeks by watching the recorded webinars, hosted by the fabulous Helen Bevan, Chief Transformation Officer in the Horizons Group, in the NHS England.

 

Don’t let perfect be the enemy of good

I’m pretty guilty of being a perfectionist. That doesn’t mean that I do things perfectly. Rather, if I’m going to do something, I do it as perfectly as I can. It’s a habit that has served me well throughout my life and career. I’ve gained a reputation as someone who values quality and I enjoy producing great work.

Whilst this tendency towards perfectionism helps me to produce great work, it often stops me doing good work …. or even “good enough”  work. When I arrive at the “good enough” mark, I usually keep going, trudging past the “good”  and “better” marks (the words “you could do better” echoing around my head), with my sight set firmly on the unattainable “perfect mark” until I run out of steam, usually somewhere between the “good” and “great” marks.  I hate stopping at “good enough”.

The thing is, “great”, and “perfect” come at a price, and with increasing pressure on resources – time, money, energy – it’s a price I can’t always afford. It’s just not in the budget. Rather than cut my cloth to measure however, and do a “good enough” job, I give up before I even start. If I know I’m not going to have the time to do something the way I’d like it to be done, the temptation is not to do it at all! And that’s where perfect becomes the enemy of good – because ironically, sometimes in the pursuit of perfection you’re left with nothing.

For current and future employers, let me be clear! I’m obviously not talking about my work here! 🙂  That, I always do to perfection! Instead I am talking about all those little jobs that I never start because I’ll never do them to the standard I want. This blog is a perfect example. I’ve hummed and hawed for months now about writing my next post. I’ve started a few different posts and then abandoned them because they’re not quite hitting the standard that I’d like for myself. They’ve been fine… good enough… but not great or perfect. So I abandoned them. What I’m left with is a few “good enough” posts that never see the light of day and an empty blog-space awaiting the “perfect” post … with a growing gnawing certainty that I’ll never be able to the produce the “perfect” post. And so, for me, “perfect” became the enemy of “good”. 

The answer? Sometimes “good enough” is good enough; particularly in issues of low priority. Five people have asked me about the blog over the past week…. and I realised that I just need to get back to it and be happy enough with “good enough”. 

Thanks to those of you who gave me the nudge!

Reflect to prosper

Do you ever let perfect be the enemy of good in your life? Are there areas where “good enough”  could be good enough? Is there anything you can do to reset expectations? Or are you of the view that if a job is worth doing it’s worth doing well?

Doing the right thing

24th September 2017

This day last week was a great sporting day in Ireland, with the All-Ireland senior gaelic football championship final taking place between  Dublin and Mayo.  (For overseas readers, if you want to know what gaelic football is, look here for an overview. And if you think that’s mad, then watch the overview of our other national game, hurling, here! Contrary to what these clips depict, lots of women play the games too!)

The All-Ireland football final is to the Irish what the Super Bowl is to the Americans …  a big sporting event. Over 82,000 fans are packed into Croke Park Stadium and, this year, over 1 million people watched the game on TV, making it the most watched programme so far this year. So you can imagine, it’s a lucrative weekend for the national broadcaster. Advertisers battle to get their brands in front of viewers, planting subliminal messages which will later sprout and grow into choices that pay dividends.

My brain doesn’t offer a particularly fertile environment for such seeds. Like many Irish parents, with a never-ending to-do list, I usually spring up during advert breaks, making the most of a few bonus minutes to get another little job done … putting the roast in the oven, making sure the uniforms are dried… you get the idea. So, as usual, I didn’t even see the advertisements during last week’s match. However, my attention was captured during the week when I saw someone on social media expressing concern that two of the half-time premium advertising spots had gone to pizza companies.

Advertising pizza during the half-time of an All-Ireland final is a genius idea on the part of the pizza companies. The match will be over about 5 or 6 o’clock in the evening. If we order pizza now, we’ll have it for when the match is over and we don’t have to bother with making dinner. Brilliant. But… and sorry to be boring here … not brilliant for our health. I have no problem with pizza or pizza companies (I very much like pizza in fact!). I don’t want a nanny state where we have curfews on when pizza adverts can be aired. I have no problem with broadcaster sales teams whose job it is to sell to the highest bidder. I understand how the world works and I understand my responsibility as a parent in being alert to subtle efforts to influence family choices. In my reflection on this issue, I seek not to find fault or assign blame. Rather, I’m curious about the dynamics of the situation.

In an ideal situation, I’d like to see some prime time advertising spots, such as those at half-time in an All-Ireland final, to be used for society enhancing messages and balanced with commercial spots which don’t promote unhealthy behaviours. I think of all the challenges our society faces in terms of obesity, cancer, mental health, road safety, suicide prevention … the list goes on. Could important societal self-care messages be “sold” during premium spots? I doubt that government agencies or patient-charities can afford such rates and I doubt that broadcaster sales teams will make their targets if they don’t make the most of every sale. In short, I doubt there is a feasible business case that could support my suggestion. But maybe we shouldn’t always need a business case to do the right thing. A friend sent me this article during the week, with that exact title!

I have been around the block enough times now to realise that “doing the right thing” doesn’t always make financial sense. I believe that everyone has a responsibility to contribute to the society in which we live. We can’t wash our hands of the country’s challenges and lament that government doesn’t do enough to save us from ourselves. There is no convincing business case for me that justifies getting up in the middle watching of an enjoyable football game to put on a roast for dinner. It would be easier, nicer, more enjoyable to stay curled up on the couch with my family whilst phoning in a pizza order for dinner. It comes at greater inconvenience to me to prepare a home-made, nutritious meal, but I do it because I believe it’s the right thing to do. It’s just annoying that the rest of the family sits salivating over a more-attractive looking pizza on the adverts, making my dinner look boring by comparison!

I don’t know what other adverts were shown at half-time last Sunday. Maybe the pizza adverts were balanced with public awareness messages. Maybe the national broadcaster does reserve prime time spots for public awareness messages that support important national priorities. Maybe I shouldn’t write about things if I don’t know all the facts. For me, the LinkedIn comment prompted an interesting reflection and, on a personal level, made me realise that I need to be aware that subliminal messages are being conveyed to my family all the time from a world that seems increasingly obsessed with commercial and financial success. At a more general level, it raises the question of how committed we are, as a society, to doing the right thing. Making the right choice the easy choice is one of the building blocks of health promotion. Last Sunday, a pizza would certainly have been the easy choice!



Can you identify times when the right choice conflicts with the easy choice? Do you ever find yourself making decisions that aren’t the “right thing” for our society, but which support the accepted norms in our world? It’s worth taking some time to reflect on whether this might be the case. Sometimes just becoming more aware that tensions exist is the first step to figuring out how to manage them.

 

Rumination Vs Reflection

September 9th 2017

I haven’t blogged for a few months. People have been in touch asking me why I’ve stopped. Some assume that I’ve taken a break for the summer, others assume I’ve grown bored of it and others still wonder if I’ve received a negative response to a blog that upset me. Those who know me see that I’ve been busy and assume that I don’t have time for blogging any more.

None are these hypotheses are true.  It would be convenient to pretend they were. It would be easy to lament how a busy life has robbed me of the time to reflect.  Poor Time …  the reliable scapegoat, always covering for other, more deeply-buried reasons!

Have I been busy? Yes. Has someone upset me? No. Have I run out of things to say? No.  The Truth?  Over the past few months, for a few specific reasons, I unwittingly slipped from reflection into rumination. It wasn’t intended. It just happened. I didn’t even realise it was happening.  Every time I sat down to write a blog, I realised my brain was going around in circles in a most unproductive and disconcerting way. It never felt right to share anything that I wrote.

I’ve had a chance to reflect on what prompted this shift…. maybe it can be the topic of a blog for another day. Not now. But irrespective of what triggered it, I find it interesting to compare the processes of rumination and reflection.

If you look for information on the difference between rumination and reflection, you’ll find plenty. Generally, it’s accepted that whilst the processes may seem similar, they can lead us to completely different places, like two trains pulling out of a station at the same time, heading in opposite directions.

Rumination involves thinking about something deeply, often in a repetitive way. Whilst it enables us to consider an issue from many different angles, it can cause us to get sucked into the issue. We can end up going around in circles that don’t lead anywhere. If accompanied by negative thinking, it can result in a self-perpetuating cycle of negativity and stress. Whilst the process of reflection usually results in some type of forward momentum, rumination can cause stagnation.

Believe me, you wouldn’t have wanted to read my ruminations over the past few months. I was going around in circles, churning the same issues over and over again. It became tedious, frustrating and repetitive. It felt like a broken record, a scratched CD, a download hanging in cyber-space.

By reflecting on the past few months, I have identified the triggers that caused me to slip from reflection to rumination. I’ll be avoiding those in future! Somewhat ironically, reflection has clarified the difference between the two processes for me, which no amount of rumination could have done. I now appreciate that some people may mistake rumination for reflection, and, if that’s the case, I can understand why they would be unconvinced of the benefits of reflection. Through reflecting on the past few months, my thinking had subtly, but significantly, changed and I am no longer wandering around with a headful of aimless, glum thoughts.

It seems to me from what I’ve seen and what I’ve read, that lots of people might be stuck in ruminative cycles. What do you do? Do you have a tendency to dwell on things, to get stuck in a rut of repetitive thinking? If so, think about the possibility of stepping off that train, crossing the platform, and stepping onto a train that’s going in the opposite direction.

The pearl in the oyster

Last week I wrote about the importance of getting the balance right between negative and positive interactions to maintain healthy relationships and to flourish. The concept of needing a certain level of negativity in life was mentioned, which can seem like a rather odd proposition. It’s certainly not a new
concept. Without the wicked stepmother, so many princesses would never find their prince (although I do wish fairy-tales would change the record sometimes!), without the “bad-guy” the “good-guy” wouldn’t triumph. The juxtaposition of good and evil, of positive and negative, is widely accepted. But leaving fairy-tales and extremes aside, how does the balance of positivity and negativity work in our lives?

I think this issue is neatly addressed in the animated movie “Inside out” (yes, I know it’s a kid’s film, but it’s brilliant!) where the main character, Joy, discovers to her surprise that sadness is a necessary part of life which ultimately enhances our experience of joy. As inconvenient as it is, sadness is a necessary part of the rich tapestry of a life well-lived. If you haven’t seen “Inside Out” I would suggest having a look! The portrayal of the inner dialogue going on in both the Mum and Dad’s brains at dinner is hilarious!

When faced with a negative situation or irritant, I try to remember the pearl analogy. Pearls are formed as a defense mechanism against an irritant, such as grit or sand. The oyster’s natural reaction is to cover up the irritant with layers of the same nacre substance that is used to create the shell. This eventually forms a pearl, a thing of beauty which would never have existed without initial irritation. This reaction is exploited by pearl farmers, who purposefully insert irritants to oysters to promote pearl formation. I’m not suggesting going out in search of irritants to insert in my life, but I will frequently seek out people who will provide the grit needed to initiate development of a pearl of an idea. Also, when I come across unwanted irritation or unwelcome grittiness, I try to remind myself that this may be starting point for something more meaningful and that it may serve as a useful prompt for reflection. If nothing else, you just need to have something to tell yourself on tough days.

Can you look back and identify sources of irritation which ultimately led to something better? Rather than trying to eliminate irritations from your life, are there other approaches you could use? Have you inadvertently ended up with some pearls?

The magic relationship ratio

Well, the concept of supportive challenge from last week didn’t seem to gain much traction! In fact, for the first time in my (short) blogging history there was almost radio silence from readers. I found this interesting and it led me to … reflect! 🙂 This time on the balance required between positivity and negativity.

Previously I have written about the importance of positivity and the importance of relationships and trust. John Gottman brings these two concepts neatly together by focusing on the importance of positive interactions in maintaining trusting relationships, though his magic relationship ratio. He proposes that a ratio of 5:1 positive:negative interactions is required to maintain positive relationships. That means that you need five positive interactions to counteract one negative interaction. Although this concept originated in analysis of marital relationships it has since been shown to be valid in lots of types of relationships, including those in the workplace. Maureen Gaffney, in her book Flourishing, refers to this as the Flourishing Ratio where she proposes that for every burst of irritability, every tense exchange, every negative thought and feeling of disappointment, there has to be five times as many positives.

This is a principle that I now try to bring to all aspects of my life… how I treat my family, how I interact with my colleagues and friends and, probably most importantly, how I talk to myself! I don’t always achieve it but I do find that conflict in relationships is much more easily resolved where there is a sufficient cushion of positivity.

Note the fact that the magic ratio isn’t 5:0. A certain amount of negativity is needed in the world. In fact Maureen Gaffney maintains that appropriate negativity has an important role to play in flourishing. Yet many of us shy away from it.  Sometimes, however, shying away isn’t an option.

With this in mind, I was reminded of a publication which I read a number of years ago in the International Journal of Pharmacy Practice entitled Who do you think you are? Pharmacists perceptions of their professional identities“. The researchers interviewed 43 pharmacists about how they perceived themselves in the context of their professional identities. It’s an interesting article and could lead to a whole raft of different blogs! But one particular point stood out for me which is related to this topic of the magic relationship ratio. One pharmacist, described their approach to difficult conversations as follows…

“a lot of the time you’re potentially going up to doctors and saying, you know ‘I disagree with what you’ve prescribed here’, you have to be able to put that across in a friendly way, without sounding like you’re constantly nagging them, otherwise you don’t have a very good relationship with them”

I agree with the idea that if you are must have this type of conversation, you should approach it in a friendly manner. However, as a pharmacist, if every interaction I have with a doctor is focused on telling him/her when they have made an error in prescribing, it’s unlikely to result in a positive relationship, no matter how nicely I phrase it! If I consider the magic relationship ratio, I need to have five positive interactions counteracting that negative one in order to maintain a good relationship. I never considered this when I practiced as a pharmacist. I contacted GP colleagues when there was a problem because a conversation was needed. I handled it as nicely as I could but, to be honest, I rarely, if ever,invested any thought into the importance of balancing those interactions with more separate, positively focused conversations. To be fair, my GP colleagues were always very professional and responded well but I do wonder now if I could have been more mindful of the relationships. With an increasing focus on inter-professional working in our healthcare systems, perhaps it is worth considering how we can achieve the magic relationship ratio across the resultant relationships.

 

Reflection time

 

Take a moment to consider your relationships with others. Do you always achieve the 5:1 ratio? Are there times when you’re not able to build up a cushion of positivity to counter the negative interactions? In these cases, is there anything you could you do to get closer to the magic relationship ratio?

 

Opposing views.

I am lucky to have a number of people in my life who provide me with a healthy balance of support and challenge. I meet lots of people who are willing to support me, which is lovely, but they often shy away from the edgy conversations. I also meet people who are willing to challenge, often in the adversarial sense of trying to ensure that their view dominates. Whilst I enjoy the debate and the challenge, these are often competitive types of interactions rather than ones designed to faciltate growth. It’s difficult to find people who are perpared to both support and challenge you in the interests of driving you to be a better version of yourself, so when you find them you should cherish them.

One of my fears with blogging is that I wind up in a self-perpetuating self-congratulatory cycle where I only hear from the people who like what I write. Everyone who has contacted me thus far has been quite complimentary and encouraging and I have been very grateful for that. However I’m not so naive to think that this means that everyone is positively disposed to what I’m doing. I am savvy enough to know that anyone who thinks it’s a pile of rubbish will simply ignore it and that most people will simply dismiss it as something that’s not doing a whole lot of harm but not necessarily doing a whole lot of good either. Therefore I was interested to seek out the views of someone who would give me their opinion straight up.

For me, one such person is a former boss of mine, Mary Rose Burke. This lady has taught me lots about myself and about the world more generally. She is independence and passion personified and is a brilliant role model for anyone trying to achieve a balance between family, work and life more generally. She lives her life authentically, thinks differently to most people I know and shares her insights generously. Therefore I was delighted to bump into her last week and was curious to know what she thought of my blogs.

Needless to say, Mary Rose didn’t disappoint. She provided some encouraging comments about some of the blogs before moving to a position of challenge. She queried the value of sharing self-reflection in such a public forum and whether it was really of any benefit to readers to be subjected to my internal musings. I was delighted to hear the counter position and asked if she would write a guest blog. It’s a testimony to Mary Rose’s patience with me that she obliged by writing a blog about why people shouldn’t write blogs! As she says herself, she’s a reluctant blogger. Her blog, here, raises some super questions, ones to which I don’t necessarily have appropriate answers. I agree with her view on the deeply personal nature of self-reflection and yet simultaneously also find myself agreeing with the likes of Brené Brown on the importance of vulnerability in our world. Yes, self-reflection ought to be a private affair, but I fear that we’ve made it so private that people don’t know how to go about it and don’t feel comfortable talking about it.

I’d love to hear your views. If you get a chance, read Mary Rose’s blog and lets have a proper debate about whether this blogging lark is of any value to anyone. Fear not, this is not going to turn into a match between two opposing views. Rather, it’s an opportunity to help shape my thinking on how I should approach blogging. Have I shared too much and ventured past the boundaries of appropriateness? Or is more vulnerability and open reflection what the world needs? Or is it an entirely irrelevant question in a world that has much more to worry about than what I think? Irrespective, I’m going to keep blogging because I find it a thoroughly enjoyable and relaxing thing to do…. but your views might influence what I choose to share.

Reflection time

Once again I find myself grateful for people like Mary Rose in my life, and fortunately I have quite a few of them around me. They keep me grounded whilst giving me wings. They pose the difficult questions from which so many others shy away. They challenge me to question what I’m doing without any expectation of compliance with their thinking.

Do you have people in your life who’ll challenge you supportively? If and when they do challenge, can you accept that challenge with a spirit of gratefulness or do you find yourself engaging in combat? Defending your position is a natural inclination but sometimes it’s useful to just listen and hear what’s being said. This touches on the topic introduced in last week’s blog (Teamwork: The importance of trust), where we introduced Patrick Lencioni’s hypothesis that fear of conflict can prevent teams from reaching their potential. A fear of conflict or an unwillingness to have challenging conversations stifles growth, creativity and trust. Willingness to voice, and hear, oppossing views enables growth and strengthens relationships. It’s a topic to which I have no doubt we’ll return, particularly in the context of team development.

In the meantime, thanks, Mary Rose, for your reluctant blog! And thanks in advance to those of you who take a moment to share your thoughts on the subject.

Teams: The importance of trust

26th May 2017

This week I had the privilege of working with colleagues in the School of Pharmacy in the Royal College of Surgeons, Ireland (RCSI), the Bill Gatton College of Pharmacy, East Tennessee State University and the Irish Institute of Pharmacy to explore the topic of inter-professional collaboration and team-based approaches to patient care. This involved a day-long masterclass in RCSI on Wednesday and a number of other “fringe events”. As part of the programme of fringe events, I found myself in the studios of Raidió na Life, hosting a podcast where pharmacy and medical practitioners from Ireland and America shared their reflections on the concept of team-based approaches to healthcare (You can hear the recording here). It was a great experience. It was my first time to host such an event, which was a learning experience in itself, but more importantly it resulted in a rich and meaningful discussion which I think will prompt lots of reflection on how we could improve healthcare delivery in Ireland. My thanks to Prof. Reid Blackwelder, Dr. Brian Cross, Dr. McKenzie Calhoun, Mr. Paddy Byrne and Dr. Kieran O’Driscoll for contributing so authentically to the discussion and for sharing their reflections and insights. I believe that more conversations like this, forward-looking and positively-framed, are needed in order to start changing the order of things.

Given that we were considering team-based approaches to healthcare delivery this week, it’s not surprising that the topic of teamwork featured strongly in our discussions. Anybody who knows me knows that I am passionate about this topic! In fact, a number of readers have been specifically asking if I could share reflections on teamwork as part of my blog. It’s impossible to distill my thoughts about teamwork and effective team leadership into one blog-post, so I propose to dip in and out of the topic over time, reflecting on different aspects of teamwork as they arise in my day-to-day life. In light of the discussions about teamwork over the last week, today seems like an opportune time to start that reflection.

I have had the privilege of working with some fantastic teams over my career to date and I am lucky enough to be currently part of one of the best teams in which I have ever worked. Like most people, I have also worked in quite dysfunctional teams. Therefore, it’s easy for me to reflect on what I think differentiates a good team from a not-so-good team. With a great team around you, the impossible becomes possible. It’s where the magic happens.

During the past week, and most notably in the podcast discussion, it is clear that strong relationships are important in teamwork. Whether you are working within a structured and clearly-defined team or you find yourself thrust into situations where you need to collaborate with others informally, relationships are considered a vital ingredient to good teamwork. In my opinion, this can be distilled down even further to one essential ingredient: trust. Without trust, the magic just can’t happen.

The Collins English dictionary states the following in defining trust: “If you trust someone, you believe that they are honest and sincere and will not deliberately do anything to harm you.” Upon reading such a definition, it makes complete sense that you need trust for a team to work well together. The absence of trust would suggest that there are concerns regarding honesty, sincerity or intentions. How could a team perform effectively, let alone flourish, in such an environment? How could any meaningful relationships be established?

The interesting thing about a really powerful team is that you don’t necessarily have to like everyone in the team in order to have trust. In my experience teams are most powerful when they are made up of people who are quite different to each other, each bringing something unique to the table. In a truly effective team there will be potentially opposing views of the world and there will be healthy tension between different perspectives on how things should be done. In a flourishing team there is room for this to happen. Where there is trust, no-one feels threatened.

Patrick Lencioni, author of The Five Dysfunctions of Team, positions trust as the foundation on which all great teams are built. He further differentiates between types of trust: predictive trust and vulnerability-based trust. Predictive trust is where you know someone long enough to be able to predict what they’ll do. You trust that you can anticipate their response to situations.  Whilst useful, this isn’t the type of trust that makes teams great. Vulnerability-based trust is, predictably enough, the trust that comes about when people on a team can be vulnerable with each other. When this type of trust is in place, people can ask for help, they can admit their wrong, they’re willing to provide feedback on potentially difficult issues and they’re willing to hear that type of feedback about themselves. Team members are willing to have conversations in a spirit of honesty, sincerity and good intention and are met, in-turn, with reciprocated honesty, sincerity and good intention. When people can be vulnerable, it changes the dynamics of a team completely, making it unstoppable.

Whilst everyone in a great team needs to be willing to be vulnerable, Lencioni maintains that the only way to achieve this is if the leader goes first. If the leader can’t be vulnerable, then the other team members are unlikely to trust that they can be so. Lencioni maintains that leaders have to be willing to show their vulnerability before others will trust that it is safe for them to show theirs. Leaders must be self-aware. They need to understand their strengths and how they use those strengths. They must be insightful about their short-comings and how they address these. They must be capable and willing to admit when they are wrong. They must be open to receiving uncomfortable feedback graciously, before their team will trust that they should do the same.

Once the conditions are set at a leadership level, all team members then have a responsibility to step up and pay their part in cultivating a culture of trust. This means that they too must have self-awareness, they too must have insight into their short-comings and they too must be prepared to put in the effort that is required to maintain a trusting environment. Everyone must believe that all team-mates are acting honestly, sincerely and with good intention. Once the trust is established, it provides a strong foundation for everything else.

Self-awareness is a tricky issue. It makes sense that people should understand themselves and their impact on others, but I often find it lacking. This is often where I focus on efforts when I work with teams, either leading, being part of or coaching them. Once people understand themselves they are better positioned to understand others and this helps to build a culture of respect and trust.  I also find it easier for trust to flourish when people are able to have fun together.

Whilst I agree with Lencioni that good leadership is a key ingredient, what about those situations where a clear leadership mandate does not rest with any one individual? In the example of team-based healthcare, where a range of different healthcare professionals may be required to form spontaneous teams to plan the best approach for a particular patient, who is responsible for setting the tone? My answer is that you can wait for someone to come in and set the tone or you can be proactive about playing your part in creating the right environment. This is where you get to see leadership qualities displayed irrespective of rank or whether the individuals concerned have a mandated leadership role. This is where the practicalities of “who is in charge?” become irrelevant and “what needs to be done?” becomes a unifying goal. Once we start asking the right question, everyone can contribute to the leadership of the group by playing their part in creating an environment which will enable the team to flourish. As my American colleagues would say, don’t wait for a memo to instruct you to start creating trust! Just step up and play your part!

Establishing trust, whilst important, is only the first step to creating a great team. There are a further four elements to Lencioni’s model, which proposes that a team will not function optimally if there is a fear of conflict, a lack of commitment, avoidance of accountability and inattention to results. Each of these topics fascinates me, particularly the one relating to the fear of conflict, and I am sure I’ll be reflecting on each of them in future blogs. I’m also interested in exploring the concept of vulnerability because I’ve had some fascinating conversations about this in the last few days and am anticipating a guest blog next week which might stimulate some interesting reflections in this regard! So I know we will re-visit the topic of teams in future blogs. In the meantime, if you want know more about Lencioni’s model of teamwork, take a look at The Five Dysfunctions of a Team.

 

Reflection time.

 

 

Are you part of a team? Teams can be found in the workplace, in sports, at home, in communities, in social circles … essentially anywhere you have groups of people working on something together.

Reflect on your team experiences. Think about a time when you have been part of a fabulous team (I am hoping that you have experienced this at some stage!). Compare this to a time when you worked in a poor team environment (I’m assuming most people have experienced this!). Reflect on the differences between these two in the context of trust. Does it hold true, in your experience, that there are low levels of trust in poorly performing teams?

If you are currently working within a team where there is a trusting environment, cherish it and make sure you play your part in keeping it that way. Don’t become complacent and assume trust will just flourish. Like anything worth having, it takes constant work and care to ensure that it is maintained. The effort is worth it when you are part of a team where great things happen.

If you work within a team where there is a lack of trust, it might be worth reflecting on what you could do to start nudging towards a more trusting atmosphere. I’d be interested in any reflections you have on how this can be achieved.

As always, thanks for reading and I’m looking forward to some interesting exchanges over the coming week 🙂

And check here for the latest update from Cicely Roche, who is guest blogging about her Ontario trip!