As a systems’ thinker and communication expert, I believe that in this moment of time we are seeing two complex adaptive systems that are interrelated and in chaos. One based on the old paradigm of relationships where having power over others is prevalent. This one is collapsing. Hard to tell because right now it is still very powerful as evidenced by Trump’s behavior and the large numbers of people who voted for him.
The other is a new system where having power with others, a collaborative approach to relationships is emerging and is evidenced by the even larger number of people who voted for Clinton. While I have faith in the emergent system and the huge number of people in the USA who believe in sharing power, equality, inclusion, democracy, and collaboration, I have no idea how long it will take for this system to become stable or the dying one to become impotent. Or how many will suffer along the way.President-elect Trump is a Theory X kind of leader! Click To Tweet
I see Mr. Trump as representative of the old dying, but still powerful kind of leadership. If you are familiar with Theory X and Y management styles, you’d recognize the former in his behavior and language thus far. Dominant and abusive, it is the kind of power that led to and sustains our toxic hierarchies. His behaviors along with the large number of people willing to overlook them, lack of ability to recognize them, and/or feeling justified in approving of them create dynamics like those we see in healthcare organizations where cultures of blame or bullying exist. It isn’t good for patient safety, staff morale, patient experience, teamwork, or quality improvement initiatives. We know this!
Some nurses will continue to be afraid to speak up, some will be punished for speaking up, horizontal and vertical violence will continue in places and all of these behaviors will be reinforced by Trump’s leadership. No doubt there will be additional suffering for patients, families, and all of us trying to provide safe, compassionate care.
What can we do?
Be assertive! Assertiveness, i.e. respecting self and others is especially challenging in the face of aggression. And it is key to forming this new collaborative system. I call upon all nurses who understand and practice assertiveness, those who are learning to be more assertive, and those who teach them to develop this skill to be vigilant.
- Speak up for any clinical concern you see or think you see.
- Speak up for your patients, your colleagues, and yourself to ensure compassion and respect.
- Find kindred spirits. Not to exclude others, but rather support you.
- Speak up against horizontal and vertical abuse every possible time.
- Validate others’ points of view even when you disagree.
- Use inclusive language and curiosity to help others feel safe.
- Keep yourself healthy in body, mind, and spirit. (It could be a long ride!)
- Help patients and families feel safe to express concerns.
- Share your stories with “Confident Voices”. (This can be your platform to share challenges and successes. email me if you have an idea or questions: firstname.lastname@example.org.)
These ideals will help you become part of the new system while contributing to safer, kinder care and a healthy career.
Also, I find comfort in Margaret Wheatley’s message to decide who you/we want to be in this world and create “Islands of sanity”. Not because it can stop the old system from collapsing, but just because it is the right thing to do. If you’re looking for more about this I recommend her book, “Lost and Found in Our Brave New World” and this 25 min vimeo for iopen.org.