Thursday, March 23, 2017

Understanding Preferences and Personalities

PERSONALITIES

After taking the test on the 16 Personalities website, results indicate my personality type is INTJ. Some of the traits of this particular personality include calm, rational, reserved, and independent. It is interesting to note these descriptors are similar to those I mentioned last week when discussing how others describe me. While I think the overall description is accurate, I know I work to overcome some of the tendencies, because the situation at hand requires it. For example, it is more my style to address the issue at hand than it is to deal with the emotions of the situation. My coworkers and family can vouch for the fact that I do not have a lot of time for tears and drama, but instead I prefer to fix the problem. Working in an ICU can require that kind of objectivity at times. There are other times, however, when a sympathetic ear and a compassionate touch are needed, and I try not to ignore those situations, even though I am much less comfortable dealing with them.

Another mom and I were co-leaders of a Girl Scout troop for several years, and we were as different as two moms could be. I looked up the opposite of INTJ, which would be ESFP, and it described her quite well! She was very social, creative, nurturing, and supportive, and she had all kinds of fun ideas for our group of girls. She did not always appreciate my organized nature or request for more specific details. During one memorable discussion, she asked me in a perturbed tone, “Do you always have to be so practical?” I suppose laughing was not the supportive response…

In the big scheme of things, however, I think the two of us working together as leaders was a good situation for the troop. My ideas were not nearly as creative as hers were, yet she did not have the organizational skills to follow through with her plans. Instead, my co-leader came up with excellent suggestions, and I planned a way to make them happen. While we sometimes would be annoyed with each other, we both appreciated that the other helped fill in the areas in which we were lacking. Together we were a great team!




INTROVERTS and EXTROVERTS

Susan Cain’s TED talk about introverts and extroverts describes the differences between the two groups and suggests the world needs both. As a life-long introvert, I can identify with the need for alone time to regroup and recharge my energy. I think both personality types have much to offer, and the challenge for me is to help direct the energy of the extroverted team members or attend to the introverts need for solitude in a constructive manner.

As a CN, I will sometimes task an extrovert with a project or something that can channel their initiative, such as taking a new piece of equipment around the unit and making sure everyone is familiar with how it works. As a QI director, I try to match skills and personalities to the needs of the projects we are working on. Extroverts can be a great help when it comes to generating buy-in from the rest of the staff. On the other hand, introverts are easier for me to work with, because I can relate to them.  I know the quiet nurse or CA may have an untapped well of capabilities, and I am definitely going to tap into it to help them grow and to benefit our unit simultaneously.

I am more likely to suggest a QI project that allows a nurse to choose her level of participation, meaning she can do as much or as little as she desires. For example, she might agree to join a committee and attend a few meetings, then gradually begin to offer ideas or take on some of the work that needs to be completed. This approach is less threatening, and often people begin to contribute more as time goes on and they feel more comfortable. On the other hand, a more extroverted person might offer to be the project lead!  I think of extrovert or introvert as a guide to help me determine some of the abilities of the person and perhaps a way to fine-tune my approach to working with them. Both personalities have needed qualities!



CONFLICT RESOLUTION

Differences in personality can affect every aspect of life including the manner in which we deal with conflict. Some people may avoid it at all costs, while others seemingly create it wherever they go. Conflict can create negative emotions, and people handle it differently.  While one person may sulk or even leave the room, another may have outbursts or speak negatively with others about the situation. As a common element in most relationships, however, it is important to find healthy and productive means of dealing with conflict. As an INTJ, conflict is particularly uncomfortable, because it means I must engage with people who are exuding all kinds of energy, and it is exhausting!  On the other hand, if I have a planned response to potential clashes and controversies, my INTJ personality is better able to handle it.





Jeff Muir defines conflict as the expression of an unmet need, and he lists three steps for dealing with it:
1. Determine if the need can or cannot be met
2. If it can be met – resolve
    If it cannot be met – negotiate a resolution
3. Conflict management if unable to resolve

Dana Casperson suggests two steps to use in negotiating a conflict:
1. Don’t hear the attack
2. Develop curiosity

I agree with these recommendations, and I have seen them work. A patient advocate gave a talk to our CN group several years ago.  She said her standard way to approach an upset family is to introduce herself, pull up a chair, sit down and say, “How can I help?” In doing so, she does not “hear the attack”, because she is entering into the conversation with no preconceived ideas about the issues.  She is also is developing curiosity to truly hear what need is being unmet. I think this approach is also acceptable to many personality types because it allows for whatever kind of response the person wants to give. By offering to help, the stage is set for negotiation and resolution from the beginning. I don’t remember anything else from her talk, but that one tip has served me well many times.

INNOVATION

Jeremy Gutsche compares innovators to hunters, and he likens everyone else to farmers.  A farmer, happy with the crop from one year, will repeat the steps to obtain a similar result the next time. He describes the farmer mindset as complacent, repetitive and protective. A different approach, which has the potential to return different and better results, is that of the hunter.  A hunter is insatiable or never satisfied with the status quo.  The hunter is also curious and willing to undo the current process in order to develop a better one. While the hunter is not always successful, the constant search has a higher likelihood of discovering something completely new.

This topic really resonated with me, as I have found myself restless at times with our current projects.  While most things need ongoing measurement and oversight, it is easy to get complacent and spend the time on routine tasks. A recent conference I attended sparked some new ideas for using cell phones to streamline some processes in our unit, but implementation would require big changes to the usual organizational stance on such technology. An interesting idea to investigate!  I appreciated the task list given at the end of the talk, which included exploring curiosity, thinking about relationships in a new way, and not giving up.  I do know from experience that sometimes you have to bring up an idea multiple times with many different people before someone finally starts to really listen and think about your proposal.  This talk has inspired me to think more like a hunter!



SYSTEMS THINKING

Systems thinking is an approach to problem solving that requires looking at the entire system, as well as the manner in which the individual system components are related and have an impact on each other. This type of thinking is necessary in a large organization such as a hospital, where, too often, work is done in each department with little thought of how it affects those in other areas. When a problem occurs, it is necessary to consider the “big picture” in order to avoid solving one issue while creating other problems. Systems thinking can also help identify relationships and forces throughout the organization that may not have been known or understood prior to the investigation.

One example of a systems approach to problem solving is the Donabedian Model, which has three components: structure, process, and outcome. Examining elements of each component ensures a thorough investigation of an issue before starting the problem-solving process.  By looking at all organizational factors and relationships, it is much more likely that the necessary information is available to enable a satisfactory solution.



An example could be an ongoing problem with surgical site infections. The high infection rate is an outcome measure, but the cause of the problem, or the best type of intervention, may not be obvious. A systems thinking approach would consider what process and structural elements contributed to the outcome. Structural information gathered could include such things as the number of surgeries done each day, the number of OR rooms, the staffing, the credentials of the surgeons, the supplies and equipment used in the OR, and so on. The processes considered could include how the patient is prepped for OR, how instruments are sanitized, the manner in which OR staff prep before entering the surgical suite, and the process for administering prophylactic antibiotics.

Gathering all of this information gives the team an overall view of how the entire system fits together. Armed with the big picture, it is possible to hone in on issues that may not have been apparent during the initial discussion and consider a wider variety of interventions. It is worth noting that personalities and interpersonal conflicts can be pertinent to systems thinking, because both are elements which can define a culture and have an impact on processes.

FINAL THOUGHTS

O’Grady and Malloch discuss the evolution of our culture from the Industrial Age to the Technological or Information Age in their book, Quantum Leadership. We are in the midst of this change, as organizations are comprised of a multigenerational workforce with employees at all stages of transition. In my own institution, I work with some nurses who are completely befuddled by “cutting and pasting” in a Word document, and others who can trouble shoot a computer, cell phone, or any other piece of technology with little apparent effort. The setting is ripe for conflicts and personality clashes if not handled correctly, but some of the webcast speakers suggest these events should be embraced as a means of resolving issues and achieving growth. Furthermore, letting anger and resentment go unresolved can create team dysfunction.

The authors also suggest an effective leader will consider differences as part of their systems thinking, using their findings to develop a means of aligning the individual strengths and values of the staff with the goals of the organization. In other words, the leader should figure out the best way to present information in order to help employees understand the need for change and to gain their buy-in. Part of motivating change, however, includes allowing people to help create the change.

Those most affected by a change must be part of the change process to ensure the solutions chosen are reasonable and sustainable in the “real world”. Often those most affected are the direct caregivers such as nurses, therapists and CAs. Asking for their input when making decisions is clearly a new way of thinking for many leaders, but one which is certainly needed.

Change can be a challenge for so many reasons. Involving all stakeholders in the decision-making from the beginning offers the best chance of achieving employee investment in changes that reflect and meet organizational goals. In order to accomplish this task, an effective leader is willing to give up some of the control and allow others to be involved in problem-solving. This type of leadership is based on equity, team building, and relationships rather than a hierarchy in which the manager is in control. This type of leadership also creates accountability and ownership, both of which are of great value to the organization. While it is not easy to sit back and let others take the reins, the results can be well worth the temporary discomfort.



References

Breakthrough Marketing (Director). (2013). Conflict resolution [Video file]. Retrieved from https://www.youtube.com/watch?v=KY5TWVz5ZDU

Dawn, I. (2013). Introverts - Extroverts [Web log post]. Retrieved from https://uminntilt.com/2013/03/05/introverts-extroverts-change-takes-courage/

INTJ Personality: An Overview. (2016). Retrieved from http://www.personality-central.com/INTJ-personality.html

Porter-O'Grady, T., & Malloch, K. (2015). Quantum leadership: Building better partnerships for sustainable health. Burlington, MA: Jones & Bartlett Learning.

Shi, L., & Singh, D. A. (2015). Delivering health care in America: A systems approach (6th ed.). Burlington, MA: Jones and Bartlett Learning.

TEDx Talks (Director). (2015). Conflict is a place of possibility [Video file]. Retrieved from
https://www.youtube.com/watch?v=WfQeH3092Sc

TEDx Talks (Director). (2012). The power of introverts [Video file]. Retrieved from https://www.youtube.com/watch?v=c0KYU2j0TM4

Trendhunter (Director). (2015). Better and faster [Video file]. Retrieved from https://www.youtube.com/watch?v=VFshvhzcCVw




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