What's This Episode About?
This week on the podcast, Dr. Andy Roark and Stephanie Goss are tackling a mailbag letter from a practice manager who is wondering how to handle an issue with a veterinary technician's safety. This team member is a wonderful veterinary technician, who is generally well-liked by the team. They seem to have one habit that gets them into (sometimes BIG) trouble. They put themselves into situations sometimes that are unnecessarily risky – trying to do jugular blood draws by themselves, for example. The rest of the tech team has nicknamed this person “Cowboy” and while they can sometimes get things done super quickly, they have also been bitten, scratched, exposed to zoonotic things – all unnecessarily in this manager’s opinion. The team has protocols in place that include having help so this manager is at a loss for how to address the situation, get this cowboy tech to slow down, and be safe. Let’s get into this…
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Episode Transcript
This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.
Stephanie Goss:
Hey everybody. I am Stephanie Goss. And this is another episode of The Uncharted Podcast. This week on the podcast, Andy and I are tackling another question from the mail bag. You guys have been on fire lately, and this one is no exception. We got an email from a manager who is struggling with a team member who is phenomenal. They have been a great fit for the team, but there's just one slight problem, which is that they have earned themselves a nickname with the team, and that is the cowboy. So let's get into this and find out why this person has been nicknamed the cowboy and what we can possibly do about this situation, because I think this will be another episode where hopefully, you love Andy's nickname for me, as much as I do. And you are wondering, “Are they talking about my practice?” Let's get into this.
Speaker 2:
And now, the Uncharted Podcast.
Andy Roark:
We are back. It's me, Dr. Andy Roark and Stephanie “Mamas Don't Let Your Babies Grow Up To Be Cowboys Or Girls” Goss.
Stephanie Goss:
That might be one of my favorites that you've ever done.
Andy Roark:
We don't do enough Willie Nelson, Stephanie Goss, mashups. Stephanie “Blue Eyes Crying In The Rain” Goss, Stephanie “Whiskey River Take My Mind” Goss. Oh, it's an untapped well that's just been unlocked.
Stephanie Goss:
I love it. It's amazing. How's it going?
Andy Roark:
It's good. It's good. It was great to see you in person just a few days ago.
Stephanie Goss:
I know.
Andy Roark:
And to get to catch up. And man, VMX was great. I really had a good time and I was really happy to be there.
Stephanie Goss:
It was so awesome. It was so great to just see our friends and colleagues and just be in the same space as people, which was also overwhelming. I'm pretty cautious and we live in a pretty small bubble in terms of our interactions and stuff, and so I was having a lot of anxiety before going, but I will tell you, I think the folks over at NAVC did a great job. Everybody was pretty respectful of wearing their masks in the conference space. It was crowded, more crowded than I was expecting, but not in a way that I felt panicked or overwhelmed because then when you're in Florida and you're going out and about and doing other things, I felt a lot more crowded in other spaces outside of the conference.
Stephanie Goss:
So I think those guys definitely deserve the applause and the kudos for putting that together the way that they did because it went really, really well. I was really impressed. And it was good to feel that energy that you get watching some of your lectures and hearing people engage and asking questions, and just that excitement that comes with live in-person. CE was just so fun.
Andy Roark:
Yeah. I'm glad we got to talk about how great it was because I don't get to talk about how great it was because I came home and my wife has had children who have been snowed out at school, in a virtual school since I left. And she's like, “How was it?” And I was like, “It was awful. I wish I would've been home with you and the children and inside.” I'm like, “It was amazing, but I'm not going to tell you that.”
Stephanie Goss:
“I'm not going to tell you.” I was thinking about them actually, while we were gone, because I saw on a social media, your wife's preparation post as she got ready for snowpocalypse to hit where you guys are in South Carolina. And I was curious how it actually went and if they got the predicted disaster level snow.
Andy Roark:
Oh, it actually happened, yeah. They did, they got like five inches of snow, which is a lot in South Carolina, really crazy. Everyone got to watch on social media for Orlando as my wife's set up a generator in the snow.
Stephanie Goss:
Because she's badass like that.
Andy Roark:
And social media was like, “Ooh.” They would look and they would see her with pink cheeks, pulling the rip cord on social media, and then they would slowly turn and they would look at me with my mojito and-
Stephanie Goss:
Sitting by the pool in Orlando.
Andy Roark:
… my place tree ice mask.
Stephanie Goss:
Yeah. I love it.
Andy Roark:
Oh man. I love you honey.
Stephanie Goss:
I am excited for our Willie Nelson episode today because-
Andy Roark:
Let's do it.
Stephanie Goss:
… we have got a good cowboy one. It's funny, this question came up in a manager group that I'm in, and I reached out to the person who posted and asked them, I said, “Hey, this struck a chord with me because I have been in your same shoes. I've been the manager who's been supervising someone like this on my team, and I know that I'm not alone. Would you be okay if we talked about this on the podcast?” And they were like, “I think that'd be great because I'm at a loss for what to do, which is why I reached out to everybody.” So I think, again, this is going to be one of those episodes where people are like, “Are they talking about my clinic?” Because I think a lot of us have been there.
Stephanie Goss:
It's a clinic that has a technician who has been a great addition to their team, they put a lot of pressure on themselves, they have a lot of high expectations for themselves in terms of their skillset. And this technician has been doing some things that the manager feels like are putting them at unnecessary risk, like trying to do jugular blood draws by themselves. And some of the rest of the tech team have nicknamed this person the cowboy, because they are trying to do so much by themselves. And the team's perception is that this person is trying to prove something to them.
Stephanie Goss:
And this manager's like, “I feel like I need to talk to them, A, just about how to ask for help. B, talk about clarifying because it is not in our protocols or policies for team members to be doing something like a jugular job by themselves,” for the exact reason that they put this forward, which is that in the time period that this person has worked with them, they have been bitten and scratched and had their own health put at risk by their interactions with their patients because it has not been super safe. And so they were like, “I feel like they really need to slow down, and I'm wondering, has anybody had this type of employee and what worked in terms of addressing it with them?”
Stephanie Goss:
And like I said, it really resonated with me because I have more than once worked with this person in was just like, this was a hard one, I struggled with it as a manager. So I'm excited for you and I to go through this one today.
Andy Roark:
Yeah. I like this a lot. This is a classic management trap, and I see it already. And I think this is a great question, and I appreciate the person who let us take a crack at it. I think the trap is, and we're already seeing this here, is focusing on the idea that, I need to talk to this person about how to ask for help, or that this is going to be a process discussion, because neither of those things address the underlying issue here. I'm not saying you can fix it every time, but I'm saying your only hope of fixing it is recognizing what drives this behavior, discovering it, digging it out, and then fixing that underlying problem, which is generating the cowboy mentality and the cowboy actions.
Andy Roark:
The cowboy actions are rarely the problem themselves, they're generally a symptom of some sort of psychological position this employee has put themselves in. And if we can reset that vision, then we can often change that behavior. But it's a whole lot easier to talk to the underlying problem so that this behavior goes away than it is to hold people accountable, reprimand, or coach them out of this specific behavior. So I like that a lot. Let's go ahead and get in a good head space for this. You ready?
Stephanie Goss:
Yep. Sounds good.
Andy Roark:
So let's talk about why this happens. Why do we see this type of behavior, when we see these people who are just going above and beyond to do things that are unsafe or risky to get it done? There's a number of reasons. And so I'll give you a couple of them that pop into my mind. Generally, it's not not knowing how to ask for help, that may be it, but usually, it's not it. It's also usually not about not knowing or understanding the policies, it's usually about tribal status, which is, I want to be perceived in a certain way by the team. And when I say that, it plugs a lot into self-worth and insecurity.
Andy Roark:
People who are willing to take risks with themselves and their health are often insecure of their position in the team. They want other people to think that they're valuable or that they're really good at their job. And they're like, “I'll take this risk to try to prove to people that I'm willing to do this.” And so there's insecurity there and they question their self-worth, “If I don't do these things, then they won't see value in me.” There's identity in doing things that others can't or won't do. “How do I fit? What's my role in the team? I'm the one who gets it done. I'm the one who will do the things that others' won't do or that they can do.”
Andy Roark:
These people get positive reinforcement for these behaviors. So as a manager, we were like, “You did a blood draw by yourself? Are you crazy?” On the floor, people get these raised eyebrows and like, “Wow, that went really well.” And they get these subtle, “Boy, you really are a cat whisperer to be able to do that. Wow, you really are fast. You get things done.” And they're feeling their emotional bucket, and the risk they're taking are not good risks, but there's a bad habit of us to go, “Wow, that was crazy. Boy, you jump in when other people would stand wait.” And they get positively reinforced for these behaviors that are ultimately in the long term, really problematic.
Andy Roark:
There's a thing called present bias, and present bias is the idea of like right now in this moment, the good thing is to get this case done. The long term view is, honestly, in the long term, the best thing is for me to stay safe and healthy and to maintain our standard of care over the long term. But right now in this moment, when we're behind schedule and people are waiting up front and all the exam rooms are full, just get this thing done. That is the immediate pressure that people feel, and so they often fold to present bias of, do the thing that's right in front of you that will give you immediate gratification or immediate pat on the back and discount the long term detriments of this immediate behavior.
Andy Roark:
I see that driving it. Are there other reasons? There can be. Like I said, these are just the main personal drivers that I see. It's possible that people have real self-identity issues or self-worth issues and things, and that's beyond what we're going to get into as their boss or their employer or their colleague. But those types of issues are generally what drive this more so than an understanding or a lack of understanding about policies and how to get help.
Stephanie Goss:
Well, I think the last reasoning for me is one of our biggest challenges in veterinary medicine, which is that the people that I have worked with have been this kind of team member, they go rogue or they cowboy or cowgirl, have often come from high pressure, high stress environments that very much exist in the present bias, whether it's a high volume hospital, ER environment where they're on nights and there is minimal staff, so you learn how to do a lot more with less, or shelter medicine where cost is a concern, and so you often have more of a skeleton crew because that's what the funding and the budget supports, those kind of environments.
Stephanie Goss:
I have seen people grow up in those environments and they're doing what they have always done, because that's how they learned. And there are so many things in veterinary medicine where we get trapped in that hole. And so I think that it very much ties to your point of present bias. They are very much probably thinking about it from, “Let's get this case done and over with,” because that is what they know, and that's what feels comfortable. They may know that they should ask for help, but getting the case done and over with, “Oh, I could do this by myself and just move on.” It's very easy to put that pressure on themselves.
Andy Roark:
Yeah. I agree with that. I think that's a great point, but what you talk about positive reinforcement, when you are trained and you're told, this is how you do it, and then you do it and they go, “Great job today, you did well,” that's the positive reinforcement part coming back in, is, this is a behavior that has gotten praised in the past, and now… I think most of us struggle, especially if we can came up this way and there's years of a positive reinforcement structure to be like, “Oh, I'm in a new place, and what got me positive reinforcement before doesn't get it for me anymore.” That's not something that you discard and then put back on something else like you're changing jackets?
Andy Roark:
We have been trained and wired that way. Honestly, think about this, and you've heard me talk about this a lot. And I say, humans are simple animals and I don't care how smart you are, how many degrees you have, you're a simple animal. And think about people that you know who have… We'll make it simple, think about dogs that you know and they have been trained to do something. And then think about how much it takes to untrain them from the behaviors that they have had, where they have been positively reinforced, where there's been a stimulus and a response. And again, people are different, they are smarter than dogs, of course, but we still have that same internal wiring of how we're trained and how we respond to repeated positive reinforcement.
Andy Roark:
And again, this is about every human being, I don't care how smart you are. I believe that that's how we're made. And so when you think about the difficulties of untraining behaviors in pets that have been positively reinforced, it's hard, and it's hard in people. I think going into it with that headspace of like, “This is what we're up against,” I think that can help set really clear, realistic expectations of how we get through this, because we can get through it, but it's not a switch. Really think that that's critically important as I think a lot of people think, when they see stuff like this, “I'm going to go tell this person that they have to stop doing this,” and then they'll stop doing it.
Andy Roark:
And maybe they will, maybe if they are showing up and they're like, “This makes me uncomfortable, but I really need to show out for the rest of the team,” then maybe I can have a conversation with them. But if it is something that is how they've been in the past or how they were trained, it can take a while. And so I would go in this hoping that this is a feedback conversation, but expecting that it's going to be a coaching conversation, which is probably going to take more time. And if I think that, then I'm not disappointed when the behavior doesn't immediately go away.
Andy Roark:
So I think a lot about, how do we reach this person? And the answer is compassion. And I think this gets us into the right head space to have the conversation. If I go and say, “Look, you're putting yourself at risk, you're putting your team at risk, you're putting the patients at risk. You're not delivering the quality of care that we deliver.” Now, I'm hitting this person in ways that really hurt.” I don't want to be told that I'm not taking good care of patients or that I'm putting my team at risk. Those are heavy accusations. And most of us are not in an emotional place to be able to take that kind of criticism, even if it's true.
Andy Roark:
We don't want to hear that, it is painful and it hurts too much. And so we get defensive. We say, “You guys don't know what you're doing.” We put up walls to keep ourselves safe, and that's just the human animal. And so if you want help this person, you can't go after them with negative feedback and pointing out the problems necessarily with what they're doing. We'll have that discussion, but we're going to do it very much in a way that is kind and that is caring. The people who often struggle with this are often panicking inside. They're trying to do everything that they could do.
Andy Roark:
And people who risk their health or that push the boundaries like this, they often feel like they have something to prove or that they're in a position where taking your time and working with a team is not available. It reminds me a lot, we've been watching a lot of Incanto at my house and that song on Surface Pressure that Luisa sings. And if you haven't seen Incanto, you should see it. It's so good. And honestly, it's a happy, fun song and it almost makes me cry when I hear it, because I see it so often in others and in myself. But basically, it's this character who has this super human strength and she does everything for everybody, and she sings a song about how strong she looks on the outside, but how the whole time she can't make any mistakes, she can't let anyone down, she's terrified, she's not going to be strong enough.
Stephanie Goss:
She's carrying that weight.
Andy Roark:
“I have to carry this weight for everyone else because I'm the strong one.” And God, it resonates so strong, and it is so amazing. But I've been thinking a lot about that. But that's what I see when I see the cowboy in some ways. And again, I'm generalizing, but boy, there's a lot of Louisa cowboys out there who, they'll get it done, they'll take this risk. But on the inside, they're really stressing about their own value and what worth they really bring. We've all been insecure and we've all been worried about how other people look at us, so I think that's the pathway to engage in these types of conversations.
Stephanie Goss:
Yeah, no, I agree 100% with that, because I think about the people in my career that I have worked with who have been this person, and I think about myself and some of my friends. I had some really good conversations at VMX this last week, but there was a few conversations with some really good friends who I look at and see as very confident people. And when you have that confidence, it's really hard to look at people like that and think that they could be insecure, but it is amazing to me when you have the comfort and the trust to be able to let your guard down and have those conversations. And I was talking with some friends and talking to them about how much I admired their ability to look confident.
Stephanie Goss:
Because I feel like in situations like that, I feel like I look as terrified as I am on the inside, on the outside. I don't look at myself as having confidence. And the conversation very much was, “Are you kidding me?” I know I can do it, and I'm still nervous. I'm nervous every time I do this thing or I face this fear. And so when I think about those people that I have worked with in my career who have been this person, I have had the pleasure of actually knowing them over time well enough to know that they, the confidence comes from that place of insecurity, of feeling like, I have to do it, or, the weight it is on me.
Stephanie Goss:
And so I think your analogy and your tie to Luisa, having seen that movie is a very good one, because I think that is really easy to feel like, “Well, I have to hold the weight of this, and so I can't let anybody see the pressure that I'm putting on myself to make this good.” But I think about the people on my team, and I would way rather work with someone like this who is, in this manager's word, a wonderful addition to their team, who is putting the high expectations on themselves. I would way rather work with that person as a manager and as a leader to try and get them to develop those self-awareness skills and get to the place where they feel like it's safe and it's okay to say, “Oh, maybe I should pause for a second and ask for help.”
Stephanie Goss:
I would really rather do that than work with somebody who has no desire, no motive, is on that opposite end of the spectrum of like, I have to really poke this person with a cattle prod to get them to do what I want them to do. Yeah, exactly.
Andy Roark:
Yes. But you're exactly right. Think about it as a spectrum. Would you rather work with a person who cares so much that they take risks that they shouldn't take, or would you rather work with someone who cares so little that they will not engage unless it is convenient for them? You know what I mean? Unless they're walked by the hand up to the engagement? No, give me the person who cares too much. But I'm going to work with them and try to get them to come down. We're going to this exercise and talking about this because when I get in the head space to have this conversation, I want value in this person, and I do not want to get lost that I see where they're coming from, and I see them, and I understand that this, that there are probably some reasons beyond a lack of policy understanding that are driving this behaviors.
Andy Roark:
And the last thing as we get into head space and start talking about putting these things together, are you safe to have the conversation? And you talk a lot about this. I feel like we left it off the list a lot recently, which is fine because we talk about it so much. But are you safe to have the conversation? Can you sit next to this person? And can you smile? It is not the right time to go and talk to this person when you're mad.
Stephanie Goss:
In the moment.
Andy Roark:
Let's just say that this has just overstepped and they've got big cat scratches down their arm. And you're like, “Look, we need to talk about this now.” Because they're feeling shame Or embarrassment from trying this thing. And so if they're insecure and insecurity's driving this and they just had a setback in front of the whole team, and now you are coming at them and saying, “Hey, we've got to talk about this.” You're making it worse and really pushing that insecurity monster into a corner. I don't want that. And so, can I sit next to this person? And if I can't, we may have to schedule this for tomorrow when we're going to talk about it. Am I assuming good intent? And that's why we had this big conversation in the beginning.
Andy Roark:
This person is not willfully ignorant, they don't disrespect you and the rules, they're not doing things their own way and bucking authority. They've got something in their mind that they feel like they have to prove, they don't think that they're worthy of respect unless they push the envelope and do things that other people do. They've got some weird value system that has been taught and positively reinforced in the past that they're working again. These people, like I said, the most important thing to remember is you're dealing with someone who cares so much that they're willing to put themselves at risk.
Andy Roark:
And that helps me to see them in a positive light, which is going to make this a better and easier conversation. F is, has this person been set up to fail. And do we have policies? Do we have protocols about how we restrain and how we handle? Do we do animal restraint, low stress, animal training? Things like that. Because if this person was trained somewhere and they came in and we said, “Get on the floor and go to work,” we set them up to fail.
Stephanie Goss:
Well, and I feel like this is one of those areas where, especially with experienced team members, that we as an industry really do need to own the F a little bit. I can think of my own career of so many times that I set team members up to fail because they were experienced and they had the skillset and they came in and I made assumptions because I knew their skillset, and I knew they had proven their abilities, that I was like, “Cool, go at it,” and let them loose thinking it would be condescending or it would be like I was questioning their abilities if I sat down with them and said, “Hey, this is how we do this here. This is our protocol. This is our process.”
Stephanie Goss:
And I think that that's assumption that a lot of us managers can make, is when we do have experienced team members come on board, it is equally important to have that training process and go through the things with them to reaffirm that their skills actually are what we think that they are, but also just to integrate them into our culture. This is where we really have to, before we point the finger at someone else, we have to look at the fingers pointing back at us and say, “Hey… “And maybe this manager did this as part of their onboarding process, I don't know.
Stephanie Goss:
But I know that for myself and for many of my fellow managers, we can all think of times where we have put an experienced person and let them loose because we knew their skillset, and yet we're doing them a disservice and we're doing the team a disservice when we don't take the time to have a training process for them the same way we would for an assistant who came in and who had the zero experience, or a tech just out of school that didn't have a whole lot of on the floor experience prior to going to tech school. So I think that this one is a really important one, and it's often one that we can overlook.
Andy Roark:
Yeah. And then E in SAFE is the end result. What is the end result that you want? I don't want this person to apologize. I'm not trying to get them to say that they made mistake. I want their behavior in the future to change, I want them to be safe and I want them to practice the standard of care that we practice, but I don't want this, again, to be a punishing thing, I don't want it to be a painful thing. I want it to be a growth thing. Yep. That's what I want. And so that's the end result that I'm looking for.
Stephanie Goss:
I love it. Should we take a quick break here and then jump into some action and steps?
Andy Roark:
Yeah, let's do it. Hey, Stephanie Goss, you got a second to talk about GuardianVets?
Stephanie Goss:
Yeah. What do you want to talk?
Andy Roark:
Man, I hear from people all the time that are overwhelmed because the phones never stop ringing, and I'm sure you hear from these people as well like, “Our caseload is blowing up and the doctors are busy and the phones just don't stop.”
Stephanie Goss:
They never stop. That is a true story.
Andy Roark:
I'm amazed by how few veterinarians know about GuardianVets. This is a service where you have registered technicians who can jump in virtually and help you on the phones. You can flip a switch and GuardianVets can jump in and take some of the load off the front desk and they can handle your clients and get them to book for your appointments and give them support. And it really is a godsend.
Stephanie Goss:
Pre-pandemic, it was amazing to me how many people hadn't heard about it for after-hours call help, but at this point, I can't believe how many people don't realize that they are offering help during the daytime as well, which I would think right now is a huge benefit to practices because everybody is shorthanded, everybody is drowning in phone calls. And so we talk about it, we've talked about GuardianVets, lot on the podcast. And every time we do, we always get somebody who says, what is that?
Andy Roark:
Guys, if you're not familiar with GuardianVets, if you think that you could use some help on the phones or up the front desk, check them out. It's guardianvets.com. And if you mention our podcast, me and Stephanie Goss, you get a month free. So check it out. guardianvets.com.
Stephanie Goss:
Hey everyone, it's Stephanie and I just want to jump in here for one quick second and make sure that you know about a couple of things that are coming up that you may not want to miss. Andy and I just kicked off our Strategic Planning Workshop series. We've been doing this at the top of the year, every year for the last few, because it gives us a chance to talk about how do we set the team up for success when we look ahead at a coming year? We've done the first session already by the time this comes out, but you can still join us for the remaining three. We're going to be talking about setting vision, mission, talking about values with our team and really living and breathing it versus something fancy that just goes up on our wall.
Stephanie Goss:
We're going to talk about loading the bus, getting the right people in the right seats and forward. And then we're going to talk about KPIs and what do we need to look at from a numbers perspective to smartly manage the practice. And also, how do we get our team bought-in to that? So you can join us for that. And then the other thing I want to make sure you don't miss is we have a class coming up on February 17th. It is a workshop that is being led by my friend, Dr. Adam Little. This is a workshop that Adam did for us previously at an Uncharted Event. And we heard so much great feedback about this that I wanted to figure out a way to bring this to you guys virtually. And Adam rose to the challenge that I am super stoked about this.
Stephanie Goss:
You're not going to want to miss it. It is called What Vet Med can Learn from Improv. And Adam is going to be talking about how to learn, how to take the fundamental foundations of improv and apply it not only to comedy, but to life and practice. So how do we learn to think quick on our feet and be more comfortable with what is often the uncomfortable or the unexpected? So that workshop is kicking off on February 17th, registration is still open. You can find out about these and more at unchartedvet.com/events. And now back to the podcast.
Andy Roark:
Let's get in some action steps.
Stephanie Goss:
Okay.
Andy Roark:
All right. One of the big reasons I wanted to bring up the safe conversations in the head space is because it's critical in our first action step. And the first action step is cliché, start with why. It's easy to bring this person in and say, “You got to stop doing that. You did this thing and it be caused a problem.” Now, if that happens, if this person has done something one time and was a bit cavalier then just saying, “Hey, when you put yourself at risk like this is, this the outcome or this is what can happen. Please don't do that again.” And as simple feedback, it takes 10 seconds. You look them in the eye, you smile at them and you just say, “Hey, can I talk to you for a second?”
Andy Roark:
When you do this, you put yourself at risk, you put the team at risk, we don't live our values, we don't deliver the patient care that we have set forth to deliver. Can you do that differently next time for me, buddy? Thanks, man. You're the best. And that's it. That's the whole conversation. That's that quick feedback and it's just done. If this is a pattern behavior, and we're seeing this person, especially if they have a reputation of the cowboy, this is not a one-and-done feedback on a specific behavior. This is about the pattern of behavior. And so we need to talk about why, we need to talk about why do you want this person to stop?
Andy Roark:
And it's not because it's a violation of our policies, although that's part of it, but I can say, “I worry about you, I want you to be here, I don't want you to be injured. I don't think it makes you look good. When these things happen and you end up getting bitten and go into urgent care, that's not good for you. And we lose a great technician off the floor.” I'm going to talk about their longevity and their profession. I'm going to talk about the example that they set for others and others look up to them. I'm going to talk about the impact on patient care. I'm going to talk about legal liability of the practice and say, “Hey, I know you to don't mean this, but you put us in a really hard spot because we can end up getting sued. If people say how we work or sure or there's workers comp problems or things like that.”
Andy Roark:
So there's a lot of reasons why this is not a good idea. It has nothing to do with, I don't believe you are that good or things like that. I want to validate the value of their worth outside of these reckless behaviors. You are valuable, we want you here. And this is me really to trying to speak to that idea of a lot of times, these behaviors come from insecurity. And so I want to validate this person, I want to provide them the security so that they can stop doing these reckless things. But if they feel insecure and pushing themselves beyond what is ideal, we shall say, if pushing the something beyond what is ideal is the way that they try to show their value, and then I just take that tool away from them without fixing the underlying problem, now I have this insecure person who felt like the one thing that they could do to show their value has been stripped from them.
Andy Roark:
And they're going to leave, they're going to push back, they're going to find something else that tries to demonstrate their value, and that may not be a healthy behavior. I want to address the underlying problem, which is, “Hey, we want you here, we like you here. Everybody likes you, you are well established. You don't need to do these things.” And so it works, that validation, that big part of the starting, it works in combination with explaining why we're having this conversation.
Stephanie Goss:
I think that piece is so important and it's amazing how big of an impact. It's so simple, but I will tell you in my own personal experience after bumbling through it, eventually got through trial and error on my own, got to the place where it was like, “Look, I think that you're amazing technician. These are the things that you do so well. I don't need you to do jug draws by yourself, I need you to be whole and healthy. And when you have to miss days of work because you got bit and are on antibiotics and the doctors told you to stay home for three days, that's what I don't need. I need you here.” And then leading into how do we solve the problem together, but it's about, “Look, this is what I do think is great about you.”
Stephanie Goss:
And it was amazing to me how simple and powerful the words of, “I don't need you to do this thing.” And then calling out the behavior, what a radical difference that made in turning on the light bulb for that person. Because if they are feeling insecure, they are probably coming at it from a place of, to some degree of, “I want to be needed. It's nice to feel needed.” And when you can do that thing that nobody else is willing to do, or that gets the race eyebrows, that is often them wanting to feel needed in that way. And so hearing, I “I don't need you to do that, these are the other things that you do that are amazing and fantastic. I need you to do more of that.”
Andy Roark:
Yeah. It's not wrong to just ask them as well. We've made a number of assumptions here, but ideally I'd like those assumptions to be validated. So asking questions of, tell me, “Tell me honestly, why do you do that? Why would you put yourself to risk like that?
Stephanie Goss:
Seek to understand. Yeah.
Andy Roark:
Just help me understand what you're thinking here. And that's a very open-end question, and a lot of times remember, they're not going to say, “It's because I'm insecure. And I question myself worth on the team.” They're not going to say that.
Stephanie Goss:
But they may tell you, “Well, at my previous hospital, this was how I was trained, this how I learned and we needed to get stuff done. And it just seemed to be the most efficient way. So that's the way I've always done it.”
Andy Roark:
Or they'll point out to you legitimate concerns that they have, that taking risks that they're taking is not the appropriate response, but there is a reason that they are doing and they may say, “Hey, look, we are not moving efficiently and there's other people who are standing around that. I am trying to pick up the slack and set an example to get those guys to get engaged. And yes, I know I push too hard, but that is why I'm doing these things alone is because people are standing around.” And so then what I would say is you have a different management problem on your hands.
Andy Roark:
And if that's true, then the agreement is, “Hey, look, you're going to stop taking these risks and I am going to get on board with motivating these people and figuring out how to get those things done, because that should not be happening.” And that may be empowering other people, it may be protocols, it may be whatever it is, but I don't want to… You know what I mean? I think we should start talking as if there would be no legitimate reason for this, but sometimes people, again, not the right course of actions, but sometimes we make a poor choice in response to a very legitimate problem. And so again, this is a way of me relieving that pressure to try to coach this person back to where they need to be.
Andy Roark:
We got to do positive reinforcement on the safe and the responsible behaviors. You and I talk a lot about building culture, that's our sweet spot, it's where we live. It is really hard to police culture. It is hard to catch people not doing culture and get them in trouble. The better play in these things is it's positive reinforcement. Positive reinforcement got this person into these behaviors, positive reinforcement is going to get them back out, just like we talked about retraining pets. I'm not going to negatively reinforce my way out of something that they were trained to do, I need to use positive reinforcement to coaching, to grow them. And that's it. So are we positively reinforcing safe behavior, responsible handling, teamwork, collaboration, things like that? How do we do that?
Stephanie Goss:
Yeah. I think one of the things that I tried that worked really well was coming at it from an accountability perspective. And so I had the conversation one-on-one with the person and was just like, “Look, I need you here and I need you safe. And what you're doing is not safe for you. And it's also not safe all the time for your patients either. And so I know that you care about your patients and I know that you would never want to hurt anybody. And let's talk about the risk.” And so then I said, “Okay, I need you to be accountable, not to me because I'm your boss, I need you to be able to be accountable to yourself because I know that you want to be here and be a part of this team.”
Stephanie Goss:
And so I opened up the door to having the conversation about, “Well, what would accountability look like to you?” And it caught me so off guard, but the very first time that I dealt with this as a manager, it was a veterinary assistant who was the cowgirl and we were having the conversation. And she said to me, “Maybe I could have a code word.” And I was confused so I said, “Well, tell me more about that.” And she said, “Well, sometimes I can feel myself going to go rogue and do the thing because I feel like it's just better, and so maybe I can have a code word for you or for somebody else on the team to ask for help, because saying, “Hey, I need your help with this,” when they're in the middle of doing something else, then I feel guilty because I feel like I'm pulling them away from their job and what they're supposed to be doing.
Stephanie Goss:
And it like lightning bolt moment for me because I realized part of why they were doing what they were doing was because they didn't want to inconvenience other people. And so to your point, it was a different management problem, but it gave me a starting place. And so we had a conversation one-on-one and talked about it and it was great because the idea came from this person. And then we moved out to have a conversation with the team as a whole and just say, “Hey, we've been talking about this and we want to set up some accountability for each other and protect each other.
Stephanie Goss:
“And so would it work for everybody if we set up a system where we had a code word, where if we see somebody struggling or trying to do something by themselves that they probably shouldn't that we're all if we use this code word,” and it was pineapple. “And if we say pineapple to somebody, that means, “Hey, either I need help or, hey, you need some help.” And we had to have a conversation about being okay with accepting that help in the moment even if we didn't feel like we needed it, but I will tell you, it was amazing how much of a difference it made, for your reason, which was it created the environment where we could reinforce the good behavior.
Stephanie Goss:
We weren't catching them, screwing it up and not asking for help again when they should have, but it created an environment where I could say, “I'm feeling like I just need to get this thing done and I know that I shouldn't rest. And so I'm going to ask for help, even if the other people are involved in something else, because they've given me permission to not feel guilty about it.” Or as a team member, this person has given me the okay to help them and say, “Hey Pineapple, let me let hop in and help you. What do you need? Do you want me to hold… ” and ask them for help in a way that felt very, very safe. And it was slow. It took changing the behavior, so it didn't happen very often, but I made it my job to pay attention to the situation.
Stephanie Goss:
And I was the one to be brave and call out pineapple and set the example for them. But slowly but surely, I watched them react to each other and develop that positive reinforcement with each other because not only were they doing it, not only were they calling each other pineapple, but it created the safety where they were like, “Hey, great job on that. Thanks for letting me help you.” And create that positive reinforcement and the group dynamic shifted when they saw the power in being able to help each other and support each other there. And it was such a great experience for me. And they haven't all gone like that. I've had go spectacularly sideways even when we talked about it as a team.
Stephanie Goss:
But I think your point of figuring out what that positive reinforcement looks and catching people doing good, but also figuring out without throwing someone under the bus, without making someone, the center of attention in a way that feels uncomfortable. How can I get the team to point out when we're doing things that are good? So if the rest of the team has given this person, the cowboy nickname, maybe it's having a team conversation, or maybe it's as a manager, having a separate side conversation with the rest of the tech team and saying, “Hey guys, I know that this has been a thing, I know you've all been joking about it. It really bothers me, and I really want your help. I need your help to fix this. Here's what I need.” And then ask them for help and get them involved in the process.
Andy Roark:
Well, that's the hard part with positively reinforcing your way out of problems, how often are you standing around this person when they do something? You've got to recruit, I'm not saying you have a team meeting where everybody's going to help Darrell, but I'm going to say to my head technicians, “Hey guys, this is what's going on. And this is the behaviors that I want to do. I'm not asking you to police Darrell, but I am asking you to pay attention and positively reinforce those behaviors.” And just gets a support system around who's there to say, “Yeah, hey, that was really great.”
Andy Roark:
Ultimately, whether it's in the first conversation that we have, or the ongoing feedback processes that we're talking about, for a lot of people, I'm really trying to get them to redefine their self-worth so that they don't see their value in this, but they still see value in themselves, or they believe that other people see value in them. And I need to talk to them about why I see value in them at this meeting and what their value to us is and how I appreciate them and how I want to keep them and why I want to keep them, but at the same time, I need people on the floor to also support that revision of what self-worth is.
Andy Roark:
And we do that by celebrating the person when they do the things that are positive and healthy, self-worth, self-valuing behaviors and celebrating them for things that are good and sustainable as much or more than we need to catch the things that are not healthy or that are problematic, that we want to stop. The last thing I would say, and we talked about this the beginning, but I'll just hit it one more time. Coaching is a process. It is a process. We are talking about changing people, a lot of times we are talking about changing people who have long established behaviors, they have underlying drivers that are making these behaviors happen. Be patient, be kind, remember that this person is putting themselves at risk because they care a lot.
Andy Roark:
And that's the type of person we want to work with and we want to keep, but we want to keep them healthy, and we want to keep our practice safe and we want to keep our other people learning and growing in ways that are good and that we're proud of. But what we can balance those things, it just takes time. It's going to take more than one conversation. Make sure you're having positive conversations as much or more than you're having any negative conversation.
Stephanie Goss:
Well, and I think that's really important because I think it's an ongoing process, and I think your points are spot on. And I think we said in the beginning, this is not necessarily about someone not knowing the protocol or not knowing what your policies are. And I think the coaching piece a lot of times can be looked at as, “Oh, I'm going to do the positive and I'm going to do the supportive part of it.” And the accountability piece does get left out a lot. And so I think it's really important to say, “Look, you should not start with accountability.” There has to be the stuff that you and I just spent the last half hour talking about all of that has to be set up, and there has to be ongoing support. And you have to create the environment world where that person feels like they are trusted and have trust in you.
Stephanie Goss:
And if the behaviors, because as a manager, it is important to recognize, “I am in charge of the safety of the team. And if I have a team member who is being reckless and who is endangering themselves and their team members, there is accountability that has to be put in place. And so when you have a team member that is bitten, that is scratched, that gets the ringworm cases because they're not doing what they're supposed to be doing, those things, at some point, there has to be accountability for that. And so I think the important part for you and I is that is absolutely not where I would start this conversation. And when it comes to coaching, don't forget that accountability is a part of that process.
Stephanie Goss:
And so if you have had the conversation and you have had the follow-up conversations, and you're still having the conversation after having multiple follow-up conversations, then I think it's not about what they're doing, it's not about them being a cowboy, it's not about them being reckless. It's about their behavior is not changing and there does need to be accountability because at the end of the day, your patient safety, your whole team safety, their safety as an individual employee is your responsibility as a manager. And so don't forget that that piece should be a part of the conversation. I think it's really easy to be like, “Oh, okay, this, it's leaning into the people piece of it and the emotional and the touchy feely piece of it.”
Stephanie Goss:
And knowing that there does come a point where when behavior doesn't change, now you're not talking about the thing that they're doing or not doing that is the problem, now you're talking about the fact that they are refusing to change their behavior, and that can be unacceptable. And it is okay to discipline that process and have a process, whether you put them on a performance improvement plan or whatever your disciplinary process looks like in your hospital, but you should have that process. That's not the tool that you should reach for first in the situation, you need to do the pre-work.
Stephanie Goss:
But if you get to the point where you're four months in and this employee has still been bit five or six times and nobody else on the team has gotten bit, now it is perfectly acceptable, probably a little bit too late to be having that conversation about, “Look, this is continuing to happen, it's not happening to anybody else. Now, we're talking about the fact that your behavior is not changing and this is unacceptable and here's the accountability piece of that.”
Andy Roark:
Yeah. And you're not showing a willingness to change. And I don't have any reason to believe that you will change in the future. And now I am making decisions about the future based on the information that I have. But patterns are key, spotting patterns is really the heart and soul of management. Man, I heard the best quote today, you and I were there and we were talking to one of our friends and he said something like, “If you make the same mistake over and over, and over again, at some point it's not a mistake, it's your culture.” And I'm like, “Yeah, that's really good. It's totally true.”
Stephanie Goss:
Totally true.
Andy Roark:
That one is a great one.
Stephanie Goss:
Totally true.
Andy Roark:
All right, buddy. Thanks for doing this with me.
Stephanie Goss:
Yeah. This is a great one. Have a great week, everybody.
Andy Roark:
Yeah. Guys, take care of yourselves, be well, don't let your babies grow up to be cowboys. I can tell you my babies want to be a fashion designer and a paleontologist. So I think I'm going to be in the clear.
Stephanie Goss:
You're safe.
Andy Roark:
Yeah. See you. Take care guys. Bye.
Stephanie Goss:
Bye guys.
Stephanie Goss:
Well, everybody, that's wrap on another episode of the podcast. Thanks so much for spending your time with us. We truly enjoy spending part of our week with you. As always, Andy and I enjoyed getting into this topic. I have a tiny little favor to ask, actually two of them. One is, if you can go to wherever you source your podcast from and hit the Review button and leave us a review, we love hearing your feedback and knowing what you think of the podcast. And number two, if you haven't already, hit the Subscribe button. Thanks so much for listening guys, we'll see you soon.