The Last Word

No More Excuses! How to Address Pushback

Adapted from 101 Answers to Questions Leaders Ask by Quint Studer

How do we overcome resistance to senior leader rounding?
First, put criticism in perspective. I find leaders weigh criticism much more than the positives they hear. Dig for specifics. You may have 5 percent of staff who are speaking as if they represent the majority. Often, the complainers are the low performers.

Also, make sure managers are managing up the senior leaders by providing solid information about their departments. Senior leader rounding is successful because of the middle managers who know their staff best.

What if nurses don’t have time to make post-visit phone calls to patients?
Begin by asking one or two high performers to make five calls and time each one. (Typically they take two minutes.) This means you are asking nurses to spend only 10 extra minutes checking on their patients. Also, keep in front of the staff the actions you are taking as a leader to provide them with this time (i.e., a new copier on the unit to avoid time on another floor).

Eventually, when you make post-visit phone calls, you will get a clinical win. Perhaps an elderly man’s oxygen was not delivered or a parent explains that a child with a head injury has been sleeping for the last 10 hours. Nurses will get their arms around post-visit calls when they see that such calls make a difference.

How can I create a positive “ripple effect” as a new director of a unit when I’m the third or fourth unit director and staff is cynical?
Role model, role model, role model! Ask staff what they want the unit to be like. Have them describe what a good unit looks like to them. Then create a unit action plan to make this a reality. Get some quick wins and publicize them in a way that isn’t self-promotional, but informational.

Also, reward and recognize the behavior you are looking for in your employees. Likewise, don’t hesitate to make quick decisions about those with poor attitudes. (When a staff member brings up a problem, always ask for her solution before offering yours.) And finally, remember that perseverance is important. A cultural transformation that can be sustained won’t happen overnight, but it will happen if you stay the course.

How do we overcome resistance to common key words all employees are expected to use?
Rolling out key words is harder than developing them. Prior to asking staff to use them, be sure unit leaders are rounding on staff. If you haven’t connected to what the staff needs, then you won’t be successful hardwiring this behavior. (It’s important to build the emotional bank account first!)

Also, make sure senior leaders are behind the key words that are developed, and share success stories in using them at department meetings. It’s essential that leaders role model using the key words themselves.

In addition, be sure to ask employees for help in developing the words that work for their particular areas. And finally, look for people who are doing well and reward them. Ask them to share with your team why the key words make them feel better about themselves and the work they are doing.