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Retreating stall: preventing team collapse

Retreating stall: preventing team collapse. Robin House, RN/CEN/CFRN/NRP Shane Turner , NRP/FP-C. Who Are We?. Background Not experts Origins of frustration. disclaimer.

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Retreating stall: preventing team collapse

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  1. Retreating stall:preventing team collapse Robin House, RN/CEN/CFRN/NRP Shane Turner, NRP/FP-C

  2. Who Are We? • Background • Not experts • Origins of frustration

  3. disclaimer • The views expressed by the speakers in this forum do not necessarily reflect those of Lifeforce or Erlanger health systems and are expressly the personal opinions of the presenters. All examples used portraying aviation, clinical, or personnel situations resembling actual persons living or deceased is entirely intended and available as public information. Identifying details may have been changed to protect the privacy of individuals. We have no financial disclosures.

  4. Aviation Analogy • Retreating stall as analogy • Signs/symptoms- recognition • High reliability organizations- do we make the mark? • Recovery maneuvers • Informal/embedded leadership • Empowerment

  5. Recognition .

  6. What are we doing here? Take aways Discomfort brings growth To make a change you first have to care You need to walk off from this thinking “am I this person?” Or if I know this person,…. “how do I help them recover?” Commit to doing work

  7. USAF PHOTO BY SSG J FLESHMAN

  8. High Reliability Organizations – Are we making the mark? • 1. preoccupation w/ failure • 2.reluctance to simplify • 3. sensitivity to operations • 4.deference to expertise • 5. commitment to resilience

  9. Serious HROs • -Air Traffic Control -planes landing/departing on largely human decision-surprising? Why? • -Extraordinary human beings? • -self discipline, cross accountability • -highly regulated/supported environment • disallows distractions

  10. Normalized Deviance • Texting or Personal electronics use at work • Procedural Intentional Noncompliance (PINC)

  11. complacency • *No calls in 3 consecutive shifts: • *Loss of focus • *Complacency on checklists/daily duties • *Complacency due to multiple low acuity requests • *Complacency with equipment check

  12. Organizational Killers • Goal Seduction- (disregard of safety in pursuit of goal- motivation toward unsafe behaviors) we can handle this/hospital destination • Situation Aversion (taking less safe course of action than normal to avoid inconvenient situation- motivation away from safe behavior) *seat belt use

  13. Fire Truck Magnet • shift change • Pressure: real or perceived, customer service, government • Use language directive then descriptive • Ex: Surgical Airway

  14. So you have a choice • Is it fun to own it? Not always • Is it your responsibility? • Do you want the responsibility? • then you get accountability • If you Don’t want it, get out of the way • Good Work ethic portable, contagious, infectious • be patient zero

  15. BE HERE NOW • Extreme ownership • Don’t be a tourist in a professional world • Are you an Imposter?

  16. Psychological Resilience • Training consistency • Repetition • Back to discomfort • Not everyone is going get a trophy, just like not every patient lives • It’s not a matter of if -but when- you have an emergency. if you have accepted mediocrity as your norm your chances of navigating that emergency successfully plummet.

  17. Changing Attitude (organization and personal) • Discipline • habits • Checklists breed accountability • It’s called work for a reason • Don’t be the soup sandwich • Doing the right thing is rarely the easy option

  18. Intent vs Execution • Why do people react in defense? • Pride, EGO-this a time and energy SUCK • ASK-Immediate safety concern? Will it change the outcome? • Normalization of excellence • Goal setting: somewhere is not a place, someday is not a time • objectivity- stop assigning motive

  19. Consequences • Rhetorical –what’s the realization if you don’t do them • in healthcare failure to rescue • Demolition of team, pt demise, employee suspension, termination, litigation, CRASH, DEATH

  20. Embedded Leadership

  21. Informal Leadership • -line personnel • -No title or rank • -High standards, intrinsic motivation, little regard for recognition • -Coming to work & doing a good job because that’s the right thing to do • -Right things are hard things • -Attempting to do it correct the first time every time

  22. Empowerment • Watch what you let inside your yard (circle of influence) • If you are thinking “I know this guy…. • how do I help them?” you’re an informal leader • If you’re enabling this person you’re as guilty as they are • YOU CAN STOP TEAM COLLAPSE

  23. “Performance oriented groups that do not make their members aware of these values [hard work, max effort] are really just trafficking in cleverly marketed leisure. This works because most underachievers are seeking an experience, not the pursuit of excellence. These individuals don’t want to truly challenge themselves to get better, they just want to be part of something.” ~ Aaron Barruga /SOFLETE.com

  24. Robin House RN/CEN/CFRN/NRP Flight Nurse - LifeForce 1- Cleveland, TN Shane Turner, NRP/FP-C /CCP-C Flight Paramedic- LifeForce 6- Andrews, NC Erlanger Health Systems robin.house@erlanger.org shane.turner@erlanger.org www.lifeforceairmed.com

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