“I don’t think it’s too profound: We all do better in a supportive environment”, states Dr. Lucian Leape, a founder of the national patient safety movement and a health policy analyst at Harvard School of Public Health in 6/18/12 Boston Globe interview with Karen Weintraub. In the article, “Healthy Doses of Respect“, Dr. Leape advises, “If you want happy patients, you want a happy workplace. The needs of the workforce have not really been a top agenda for the leadership of many health care organizations”.
As a Registered Nurse with over 25 years of experience, it is validating to hear a physician leader talk about the importance of respect and to associate the lack of it with high rates of injuries among nurses, mistakes by sleep-deprived doctors, and tendencies to not fully inform patients.
Thank you, Dr. Leape for your clear and progressive position that seeks to value healthcare workers and consumers. From a nurse’s perspective, having enough staff, time, and training along with supplies, equipment and technology designed with nurse input are all examples of respecting the work we do and the safety of our patients.
In graduate school I studied organizational behavior, emotional intelligence and group dynamics and recall being profoundly moved by Douglas McGregor‘s theories about human motivation and management. In his book, “The Human Side of Enterprise” published in 1960 he examined theories on behavior of individuals at work, and formulated two models which he calls Theory X and Theory Y.
I remember being particularly struck by how the assumptions of ‘Theory X’ leaders resonated with my work experiences as a nurse, teacher, waitress, cashier and a variety of other employee roles over the years. Consider Dr. Leape’s concerns about respect and the lack of it evident in McGregor’s model depicting a philosophy where leaders who believe in ‘Theory X’ assume that people:
- Have a genuine dislike for work.
- Must be prodded, coerced, or threatened in order to be productive because work is so unpleasant.
- Prefer to be closely supervised.
- Avoid as much responsibility as they can.
- Have little ambition.
- Seek security above all else.
Such leadership is common in many employment settings and yet the repercussions in healthcare can mean life or death. Perhaps there was a time in human history where controlling leadership was critical for survival, but it is an old way of being.
One of the biggest challenges that nurse, physician, and administrative leaders face is to balance the importance of developing collaborative teams, empowering patients, and ensuring action-based critical clinical interventions.Respect for self and others is a key leadership imperative.
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