On The Edge: Nursing in the Age of Complexity

1. On The Edge: Nursing in the Age of Complexity The AIC Fractal Linking Purpose, Power and Process Control Influence Appreciation William Smith wesmith@odii.com Daniel Pesut dpesut@iupui.edu Cynthia Hornberger cynthia.hornberger@washburn.edu

2. On The Edge: Nursing in the Age of Complexity The AIC Fractal Linking Purpose, Power and Process • Fractals are patterns within patterns. • They are nature’s super-efficient way of organizing. • They can produce extremely highly functioning organization by iterating very simple patterns through multiple levels to produce very complex forms. • The complexity is produced from very little information and a parsimonious use of energy. • The results are often astoundingly beautiful. • AIC is a fractal that builds a highly effective organizing process from a pattern built on three power relationships: • Appreciation—openness, lightness, spirit, yin • Influence—relatedness, energy, heart, yin/yang • Control—closure, strength, body, yang • This pattern can be used at any scale from a 15 min. problem-solving session through design addressing the most complex issues of our time. • How many such patterns of three within three can you see in this slide? • (See last slide for answer.) Control Influence Appreciation William Smith wesmith@odii.com Daniel Pesut dpesut@iupui.edu Cynthia Hornberger cynthia.hornberger@washburn.edu

3. On The Edge: Nursing in the Age of Complexity: The AIC Fractal Linking Purpose, Power and Process Control Influence Appreciation William Smith wesmith@odii.com Daniel Pesut dpesut@iupui.edu Cynthia Hornberger cynthia.hornberger@washburn.edu

4. Purpose of Presentation • This Power Point is designed to give those who did not attend the previous conferences a brief background in the AIC concept and its introduction to Nursing so far. • We bring you up to speed by taking the main points of Liana’s September presentation and using the AIC Fractal pattern to show how they can be organized both as a leadership model and a framework for action. • We then show the results of an AIC Mapping Process applied to the discussions carried out in the 2010 Transforming Nursing Conference. The results give an Appreciation of the Nursing Culture and show its preparedness to implement the kind of ideas presented by Liana. Control Influence Appreciation

5. What is the AIC Fractal • Every purpose no matter how big or small creates three power fields: • a Control field that consists of everything you control relative to achievement of that purpose • 2. an Influence field that consists of everything outside of your area of control that you can influence relative to achievement of that purpose Conscious Purpose • 3. an Appreciative field that consists of everything that affects your purpose but which you cannot influence or control Control Influence Appreciation Unconscious Purpose

6. On the Edge ConferenceMaine in 2009 • This relatively simple use of the AIC Fractal occurred impromptu at the end of the conference. Faculty, students and administrators attending an optional session on AIC decided to put it to immediate use. • Their purpose was to obtain a successful launch of their program by involving all faculty, staff and students present in the process. Conscious Purpose • In just over an hour they were able to: • gain everyone's perception of the ideals and realities they brought to the program • have a discussion of priorities and what factors would support and oppose them • draw some key lines of action about how they would address them • create a degree of excitement and a greater sense of purpose Control Influence Appreciation Note: This simple use of AIC to bring people together around purpose and action is one of the most common uses of the AIC Fractal. Unconscious Purpose

7. On the Edge ConferenceSpokane in 2010 • The results of this experience were so positive that AIC was chosen to address the most relevant and complex issue the organizers could think of at the 2010 conference. They chose the issue of Transforming Nursing Education. • Such complex issues require the next more powerful level of AIC in which we engage not only the organizer’s power to accomplish their purpose but each of the stakeholder’s purpose and their power to support and oppose each other. We now have multiple organizations with no one in control. Conscious Purpose • The next level of organization requires more understanding of the AIC fractal as the power relationships within an organization and between the organization and its environments. Control Influence Appreciation Unconscious Purpose

8. The AIC Fractal • Your power consists not only of what you want to control, influence and appreciate but how that fits with others’ reactions to the exercise of your power. • Others can use their appreciation, influence or control to counter or support your exercise of power. Conscious Purpose • The more you are aware of your power relative to that of others the more “power-full” you are relative to the achievement of your purpose. Control Influence Appreciation Unconscious Purpose

9. THE AIC FRACTAL AS POWER RELATIONSHIPS Your power relative to others is symbolized by capital A, I and C A-a A Others’ Appreciation Your Appreciation I I-a Your Influence C-a C Others’ Influence Your Control C-c C C-i C I-c I I-i I A A-i A A-c Others’ Control The others’ Power relative to you is symbolized by the small a, i and c

10. THE NINE AIC POWER RELATIONSHIPS THAT MAKE UP THE FRACTAL A-a I-a C-a C-c C-i I-c I-i A-i A-c

11. THE NINE AIC POWER RELATIONSHIPS THAT MAKE UP THE FRACTAL A-a I-a C-a C-c C-i I-c I-i A-i A-c We now have nine possible power relationships that can be accessed through any purpose. Our preference for and use or lack of use of these powers determines how well we achieve our purposes.

12. Levels of Purpose Every level of purpose creates these same nine power relationships. Ideals A-The most open possible level of purpose (Global) Values I-Jointly shared purpose (External) Conscious Purpose Goals C-Closed purpose (Internal) c-The need behind a goal Motives Emotions i-The reaction to value differences Unconscious Purpose Instincts a-Basic human drives Similarly every level of subconscious purpose creates the same nine power relationships

13. Levels of Purpose Ideals Values Conscious Purpose Goals Motives The more we are aware of our levels of purpose and the power that they create the more “power-full” we can become. The following chart illustrates an organizing process for creating and maintaining such awareness. Emotions Unconscious Purpose Instincts

14. Means → a i c Learning Relating Doing Ends ↓ Relate Diplomatically To Our World A Global I External C Internal Open to Our World Form Policies for Our World Engage Stakeholders Appraise Priorities and Relationships Develop Strategic Options and Models LEADERSHIP Monitor Performance Practice Team Working Agreements AIC as an Organizing Framework

15. a i c Learning Relating Doing A Global I External C Internal We can now view Liana’s presentation on the Future of Nursing through this framework to better understand the leadership and organizing processes necessary to implement the recommendations. We can also understand the cultural preparedness of the Nursing Profession as revealed in our AIC Mapping process completed at the 2010 Conference. LEADERSHIP AIC as an Organizing Framework

16. GLOBAL INSIGHT AND IMPACT Diplomatic Global National Presence A-i Enlightened Human Global Approach A-a Policy Design Educational Reform A-c Health Committees Appraisal of New Partnerships And Forms of CollaborationI-a Strategic Partners New Models I-c LEADERSHIP I-i Team System New Information on Practice C-a Best Practices C-c C-i PATIENT BASED SERVICE

17. Transforming Nursing Education The Results From The 2010 Conference All Individual And Group Preferences for (AIC) Ends and (aic) Means. A-a I-a C-a C-c C-i I-c I-i A-i A-c

18. Nursing’s Fractal Pattern of Purpose and Power LEARNING RELATING DOING The Preferences for (AIC) Ends and (aic) Means produced this Fractal pattern. . IDEALS GLOBAL VALUES EXTERNAL GOALS INTERNAL This pattern is then passed through a digital program that interprets the results

19. Our Ideals Our Ideals As nurses, we believe that it is possible to achieve anything. This belief resonates through all our other ideals, values and goals and shows in a very energetic, interactive way that our colleagues find infectious. This belief helps us hold true to our underlying principles and the higher meanings that guide our profession. We strive to be open and flexible. We like to be sure we are working on the issues that really matter. OmnipotenceI-c Wisdom A-i TruthA-c A Fuller Version is available at: http://www.plexusinstitute.org/resource/dynamic/forums/20110309_161836_17724.pdf

20. Our Values Our core value is political in that we understand that others have different interests, and we constantly try to take their interests into account. We engage energetically with our stakeholders, and we also expect them to engage equally with us. We support this engagement with spiritual values that link us to the highest levels of purpose of the whole of healthcare and its community. We want to be an authentic voice in the strategic dialogue on health care issues. As we engage with our stakeholders, we are concerned about being treated as equals. We know what we want, but we also want to be sure that all others have an equal chance to influence education and healthcare. PoliticalI-i SpiritualA-a AuthenticC-i

21. Our Goals Our primary goal is the quality of care we provide, which includes understanding how that fits into the larger picture of healthcare. Our direct involvement in patient care gives us an advantage in seeing how the whole system functions. We are confident that we will carry out our commitments and will achieve our goals, and we fully expect our colleagues to do the same. We are quite assertive in commitment to our goals and thorough in appraising any conditions that could affect their achievement. We focus on producing value from the relationships we have with patients and all those affecting their care. We remain open to identify potential positive and negative factors that could affect implementation of those values. QualityC-a OperationsC-c EvaluationI-a

22. How We Appreciate Our Whole Situation (Mindset) At this stage of our development as a profession we are very self-aware and use that awareness to create harmony in our world of healthcare. We are disciplined in the pursuit of our ideas and their application to education, nursing and healthcare. However, we need more support and agreement from others in healthcare and the community in order to continue our quest. We sense that quality is not reaching the standards we aspire to, but we continue to work hard and stand our ground though we feel unappreciated. Our instinct is to get out. However, we continue with our work. We tell ourselves that we don't care, and we hide our true feelings. Our means for managing the tensions that arise between our ideals and the provision of quality service are more than adequately met by our willingness to engage as equals with others to negotiate difference—our core political value. PoliticalI-i OmnipotenceI-c QualityC-a

23. Politics: Developing Our Influence As we have already seen our core value is political, so effective influence comes relatively easy to us. There is no change necessary. We should, however, become less focused on the principles—or truth—involved in our diplomacy and more willing to be open to influence to consider a wider range of possibilities. In negotiating options we should think less about the work itself and more about the quality of the agreements reached. Note :The recommendations for change try to keep the ends, the large (A), (I) and (C) the same and make changes only in the means, the small (a),(i) and(c), so increasing influence is achieved by increasing the amount of influence means (i). PoliticalI-i Wisdom A-i TruthA-c PoliticalI-i AgreementC-i OperationsC-c

24. Execution: Developing Our Control At the policy level the model suggests that we become a little more open. It asks us to consider a wider use of ideas, people and resources for implementation—for example, from outside of Nursing. At the strategic level our emphasis on the political process is just what is required and requires no change. At the operations level it suggests that our learning process be much more focused on operational results rather on resolving difference of values that arise. Note: These relatively small changes end up giving us an ideal use of the maximum possible range of balanced ends and means A-a, I-i and C-c. PoliticalI-i Wisdom A-i PoliticalI-i EnlightenmentA-a OperationsC-c EvaluationI-a

25. Individual Takeaway for All of Us It doesn’t matter whether by personality we are (A), (I) or (C) types. We can all be healed (made whole) By choosing to use (a) (i) and (c) means equally.

26. REFERENCES A fuller version of the Appreciation http://www.plexusinstitute.org/resource/dynamic/forums20110309_161836_17724.pdf Background on AIC use in the on the Edge Conferences. http://www.plexusinstitute.org/members/forums/posts.asp?group=69372&topic=208766&DGPCrPg=1&hhSearchTerms=&#Post208766 The Creative Power: Transforming Ourselves, Our Organizations and Our World. Routledge, 2009.

27. © William E. Smith Ph.D.wesmithic@odii.comwww.odii.com GraphicsDeborah BarbeeBarbee Graphics barbee.deborah@gmail.com

28. On The Edge: Nursing in the Age of Complexity: The AIC Fractal Linking Purpose, Power and Process Green arrow, triangle A Red arrow, triangle I Blue arrow, triangle C Sky A Sea I Earth C Three Triangles within triangle Three dots Yellow A, Red I, Indigo C Three letters AICThree shades Light A Medium I Dark C Three Circle Three Colors Yellow Center C Dynamic Arrows I Black Whole A William Smith wesmith@odii.com Daniel Pesut dpesut@iupui.edu Cynthia Hornberger cynthia.hornberger@washburn.edu And many more depending on how macro or micro you want to look….