The Rule of Six

A 500-pound man was admitted to the cardiac floor of a local regional hospital last week. In one of my training programs at this hospital, some of the nurses on the obese man’s unit described how difficult it was to care for him.  They told their fellow classmates that the patient continually pressed the call bell. He would ask for water and as soon as that need was filled he would ask for ice or a pillow.

Demanding patients challenge nurses

These nurses ran back and forth into his room all day and into his first night at the hospital.  When comparing notes at the end of the shift, they determined that the man had not been alone all day due to the quick responses of the staff to his every need.

One nurse’s comments stood out to me as I asked the class to share what enabled them to stay responsive and positive with this assertive  patient.  She described the collaboration she builds with a patient when she is assigned his/her care. To start, she tells each patient  that her goal is to collaborate with them to help them heal. In the case of the obese man, she introduced herself and asked him if she could count on him to partner with her.  When he began to ring for her repeatedly, interrupting the care that she was giving to other patients, she began asking herself what could be the reason that the man was so demanding.  She told us that she considered the following ideas:

• He was scared to be alone
• He had lost his sense of control over his life so he needed to try to control things on his unit
• He might have had inattentive service during another hospital visit
• He was lonely
• He didn’t know any better about the ways to be your own advocate while in the hospital
• He had inadequate insurance coverage and knew he would owe a lot of money for his stay.  He was going to insure he got his money’s worth during the visit.

Not knowing if any of these ideas were true didn’t matter to this one nurse.  By considering what might be motivating the patient to behave as he did, she discovered empathy for him as well as more curiosity about his circumstances.  By not jumping to the conclusion that the patient was acting out inappropriately,  she stayed away from judging him and then getting impatient with the way he was trying to partner with her.

The Oneida Indian tradition has a name for the process the nurse used with this large cardiac patient.  It is called The Rule of Six.  This long-standing part of the Oneida world view represents the idea that for any phenomenon, behavior or event, there are at least six possible  explanations for it.

By CarbonNYC at Flickr Creative Commons

The Oneida believe that if you look for six explanations,  you will not lock into the first interpretation you land on.  When applied to our experiences with people, an automatic interpretation of someone’s behavior  is  often not accurate so the discipline of looking for other reasons for some behavior can widen our options for how to respond.

This nurse’s story highlights how the Rule of Six helped her to be quite agile with a demanding patient.  She was able to avoid frustration and to respond to him with continual compassion and interest.   I’m thinking that the Oneida tradition can help all of us to be more emotionally intelligent when dealing with the varied personalities on our teams and in our organizations.  Let us know what your experience has been using this technique.

Maddie

Making changes….a way to agility

Years ago I attended a workshop on change. The facilitator asked each participant to introduce themselves with some tidbit about their morning start-up routine.  Some reported they began with making a pot of coffee, others talked about showering. I recall saying that I reach for my glasses.

Through a day of exercises, we were challenged to think about the impact of  varying our routines.   What differences would show up in how we felt or what we observed if we changed the ways we moved through our day?

Taking a new direction hones agility

I was amused with some of the impact I experienced in the days following the workshop.  One day I took a new way to work and parked in a new section of the parking lot.  I found myself paying close attention to the road signs rather than my  typical automatic-pilot driving. I recall noticing some wooded park land for the first time and making a mental note to come back there for a picnic. When I arrived at my office, I felt more alert than usual. After all I had needed to keep on my toes to avoid getting lost! I felt accomplished and surprised at the same time.  I noticed how big a deal it was for me to change such a simple thing.  I wondered what else was I missing by approaching things in a routine way?

Tachi Yamada, president of the Global Health Program at the Bill and Melinda Gates Foundation, believes that people who have lived in many different places are more agile than those who have stayed in one town their whole lives.  Having the experience of  adjusting to something new convinces Yamada that a person will be able to thrive in the changing environment of global health.

So, what  is your relationship to change?  Are you agile when confronted with new challenges or new points of view?  What changes can you make in your life to increase your experience with needing to adapt?  Try the experiment of altering one simple practice you have in your life.  See what it opens up for you and then please tell us all about it.

Maddie

Pet Agility Sport

While exploring the attribute of agility, I discovered a another doggie sport! For fun, here are a few pet-inspired videos demonstrating successful (and not so successful) collaborations. Notice that each collaborator has a different motivation.

First the fabulous performance so that you understand the goal

But, as with collaborations,  it doesn’t always go that smoothly!

Dogs are initially trained with doggie treats but cats have a different motivation:

A fun toy and a willing owner! I have to go and try that on my kitties!

What motivates you?

If you’re hooked and want more of an explanation of the sport follow these links:

http://www.vidilife.com/video_play_13549_Dog_Agility.htm

Why We Love Cats and Dogs – Video: Cat Agility Show | Nature.

Debbie

Motivations in Collaboration

We’re often asked if collaborative partners have to be motivated by the same things — or at least have the same end goal in mind for the collaboration. We think that the answer to that is No, not necessarily.

by melilab at Flickr Creative Commons

We have interviewed many people about their collaboration experiences. One question we asked is “What criteria do you use to choose a collaborator?” One person, whose job is facilitating community collaborations,  said she looks at her organization’s “ethical manner of doing business and the directives that are given to us. I usually look for alignments in collaborators mission, values and purpose. So I probably won’t collaborate with a gun association. However, I might if it were to prevent gun injuries. You have to do a balancing act. What is it that we can both wrap our arms around? Look for the points that you can all agree on.”

So even though it can be nice to share similar motivations and goals, the overall goals of each party don’t have to match. It is important that the end goals are not at cross-purposes.

Another example is when my husband brought disparate political parties together to identify and collaborate on the initiatives where they agreed.

Have you been agile enough to collaborate with people who have different motivations and end points?

Watch for our next blog post to see a fun exploration of collaborators who have different motivations.

Debbie

Collaborative Agility Case Study

“I think they will hear the message differently if it comes from you,” said my client.

The message she hired me to bring to the leaders in her dispersed healthcare organization — “Effective teamwork can create better results.”

My client is known for living this message herself but at this annual leader retreat she wanted to bring more emphasis to the critical need for her staff to think beyond their location or function to effect the care for patients.

Taking advantage of the premise that the outsider can get away with ideas that insiders can’t, I suggested that we create an interactive format to the retreat where people were working in teams and reflecting on their experience.  This was a significant change over the business-like retreats held in the past and my client wondered aloud  whether her organization would resonate with it or judge the activities to be too game-like.  After all, they all had been quite serious students earning advanced degrees in their specialty.

I could feel my client’s dilemma.  She wanted to spearhead a successful event AND she wanted to ignite some new energy around teamwork.   To her credit, my client decided to jump into the new interactive approach.  The risk she took was a testament to the degree of agility she has as a leader.  She changed an approach for a desired result.  This agility has been labeled,  “Situational Leadership”  by Ken Blanchard and can be further studied in his newest book, Leading At A Higher Level.

Last Wednesday was retreat day.  The assembled group took part in a round robin ice-breaker, “Knot the rope” team exercise and simulations devoted to teaming. The energy in the room was high throughout.  Some of those who my client least expected to be energized by the team-building activities rated the day with high marks.   People typically known to be hesitant in large groups were seen as leading.  Some who usually are out-spoken took leadership from others.  Agility abounded.

When have you purposely placed yourself in a new situation and adapted to it?  When have you delegated a task in order to help someone’s flexibility develop?

Being Agile

During this year’s winter Olympics, the highlight for me was watching the figure skater, Kim Yu-Na of South Korea. The agility she displayed as she skated to win a gold medal was both breathtaking and awe-inspiring.  Not only did she show her well-trained body’s flexibility but her life story demonstrates how adaptable her spirit is as well. Click below to see her in action.

Video Library Player:  A Nation Awaits Gold in Figure Skating

Like Kim Yu-Na, collaborators need to be agile.  Websters defines agile as 1) marked by ready ability to move with quick easy grace and 2) having a quick resourceful and adaptable character.  In business, one doesn’t need to learn how to do a triple lutz jump but it is vital to know how to quickly adjust to and build on the numerous points of view on any project or team.  If you are able to influence and be influenced, you avoid the ineffective spinning that comes from people talking at one another.

Collaborative Agility is demonstrated when we change how we relate to someone in order to better communicate.  It occurs when we can reframe a problem into an opportunity.  We are agile when we don’t have an answer but improvise  with others until a path becomes clear.

In the next few blog entries, we are going to look in more depth about the value of agility in collaboration.  You can begin thinking about the value of agility in your collaborations.  We’d love to know some of your stories.