::VitalSmarts - Get Newsletter::

==========================================
CRUCIAL™ SKILLS REMINDER
June 8, 2005
Volume 3, Issue 22
==========================================

IN THIS ISSUE

1. Quote of the Week
2. Tip of the Week
3. Live Interview with Coauthor Kerry Patterson
4. Announcing Our Contest Winner
5. Q&A: Overly Zealous Employee
6. Send Your Questions
7. Where Can I Learn More?

------------------------------------------
1. Quote of the Week
------------------------------------------

“Years ago, I tried to top everybody, but I don’t anymore. I realized it was killing conversation. When you’re always trying for a topper you aren’t really listening. It ruins communication.”

– Groucho Marx

------------------------------------------
2. Tip of the Week
------------------------------------------

Learn to Look for Your Own Style Under Stress

How effective are you at dialogue? Your friends and coworkers might be able to tell you how skilled you are. They watch you all the time, so they know your gifts as well as your shortcomings. But what about your perspective? Do you “work and play well with others”? When under stress, do you speak in a way that is heard and help others do the same? When you and your colleagues are discussing hot issues, does the information flow freely?

Knowing your own Style Under Stress will help you recognize your weak spots when it comes to stepping up to a crucial conversation. To find out your personal strengths and weaknesses, and to learn which skills you could use some work on, take the Style Under Stress test at

http://www.vitalsmarts.com/CrucialSkills/FreeStuff/SUS/Assessment.aspx

------------------------------------------
3. Live Interview with Coauthor Kerry Patterson
------------------------------------------

Don't miss Kerry Patterson LIVE on the “Business and Beyond with Will Matthews” Internet radio show.

You’ll get to hear the latest from Kerry and pick up ideas that will make you more successful and more effective right now!

When: Monday, June 20th, 2005

Time: 9:00AM Pacific, 10:00AM Mountain, 11:00AM Central, 12 noon Eastern (US)

Where: Go to www.healthylife.net and click the “Listen Live” button in the upper right corner to listen in.

------------------------------------------
4. Announcing Our Contest Winner
------------------------------------------

We're pleased to announce the winner of our “Has a Crucial Conversation Changed Your Life?” contest: Crystal D. Diggs, from Clearwater, FL.

Crystal won a Crucial Conversations Audio CD Companion and a signed copy of our newest book, "Crucial Confrontations."

Her full story is below. Thank you to all those who submitted stories.

Nursing Crucial Conversations
------------------------------------------

By Crystal D. Diggs

It was a Friday morning in the Trauma/Surgical Intensive Care. A very sick patient was admitted who needed immediate surgery. During surgery, he developed a severe reaction to a medication. The reaction caused malignant hyperthermia during which his temperature was sustained at greater than 104 degrees Fahrenheit. The sustained temperature caused the patient to then develop a condition in which muscle breakdown occurs rapidly. The byproduct of this muscle breakdown is myoglobin, which makes it difficult for the kidneys to function adequately, leading to acute renal failure.

This patient’s laboratory indicators of kidney function had already shown signs of deterioration. Being a superuser for continuous renal replacement therapy (CRRT), I knew that we needed to begin therapy on this patient as soon as possible in order to spare his kidneys any further damage. I called the chief resident and suggested that CRRT be started and supported my suggestion with every indication of why the patient qualified for this treatment. He agreed and asked me to consult a nephrologist who could order the treatment.

I met with the nephrology resident and gave him the data to support my request. He closed the chart and said “There is no indication for what you want.”

I stood up to the doctor and proceeded to cite the research that indicated the best treatment for this patient. He said, “We will not be starting dialysis, period.” The nephrology resident left the unit.

I informed the chief resident of this decision and he suggested I speak to the nephrology attending physician. In the meantime, the patient was continuing to deteriorate.

When the nephrology attending physician came to see the patient, I spoke with him about the indication for CRRT. He firmly stated, “no,” signed the resident’s progress note, and left the unit.

I again notified the primary service chief resident. He asked me to call the nephrologists back to explain to them that the primary service attending physician wanted CRRT started and if they would not do it, we would find a nephrologist who would. I immediately followed through with the request, and also asked for the attending physicians to speak to one another personally in order to decide what treatment would be best for the patient. Needless to say, the patient was started on CRRT that evening.

After being on the therapy for a week, the patient became more stable, continued to produce urine, and was able to switch to hemodialysis--and his mental status continued to improve daily. The patient’s wife was a nurse and witnessed the proceedings of this crucial conversation. She thanked me for being her husband’s advocate and standing up for what I believed to be best for him.

As a nurse and a member of AACN, I have vowed to speak and act boldly against unhealthy work practices. I value the passion that has been ignited by nurses who vowed to take a stance, not just for nursing but for our patients.

------------------------------------------
5. Q&A: Overly Zealous Employee
------------------------------------------

Dear Authors,

I've recently promoted a person to be my assistant who is a very capable, gung-ho type. He has plunged himself into his new responsibilities with an inordinate zeal and is now micromanaging folks who are not his direct reports. He has an advisory role with them but no line authority. He also has a habit of moving ahead on things without informing me, sometimes in areas that I would prefer that we do nothing.

I know he is doing all this to please me. I'm sure that in his own mind he is doing everything he can to be helpful and make my life easier. Unfortunately, it is making me uneasy about several things. I feel as if he is exercising prerogatives that belong to me. I'd like to get him to defer to me more, but I do not want to dampen his enthusiasm or make him feel that he is not appreciated. He does bring a dimension to our work that makes us all better. What do you recommend?

Signed,

Too Much of a Good Thing

-------------------------

Answer by Kerry Patterson, coauthor of "Crucial Conversations" and “Crucial Confrontations”

Dear Too Much,

Congratulations on having such a lovely problem. Working with a person who is trying his best, taking initiative, anxious to please, and inclined to take action is a pleasant break from the traditional challenge of getting people to embrace any one of these desirable characteristics. Of course, what has you worried is that your direct report often demonstrates too much of a good thing. Showing concern, when taken to the extreme, transmutes into micromanaging. Taking initiative mutates into overstepping his bounds. Taking charge ends up feeling like stealing away important parts of your job. So, as you rightfully ask, how do you have him demonstrate the “right amount” of each of these positive qualities? Equally important, how to you talk to him without killing his enthusiasm?

First, don’t take an indirect route.

You’ll be tempted to start your conversation with a big “Yeah but.” “I love your enthusiasm, but it’s not working for me.” “I’m glad you’re taking initiative, but you’re showing too much.” When you take this two-step approach you first give (love the . . .) and then immediately take away (hate the . . .). This technique can feel too much like “sandwiching”: “That’s a cool new tie, but did you have to embezzle from the company? Nice shoes.” People hate this thinly-veiled technique.

So, don’t mix praise with problem solving. When you mix the good and the bad, people never hear the praise. Besides, sandwiching kills subsequent instances of genuine praise as people wait for the other shoe to drop. Go strait for the problem. People appreciate a direct approach.

Don’t succumb to your temptation to talk about “too much of a good thing.”

You have a number of different challenges here and you might want to discuss them all. Worse still, you might want to sneak them all under the single title of: “You’re trying too hard” or “You’re too enthusiastic.” This approach rarely works. First, there are too many separate problems in your example to put them under a single banner. Second, you can’t talk about “too much of a good thing” without either discouraging or insulting the other person. Everyone knows that too much of any thing is bad. That’s why it’s too much. What the other person needs is advice on recognizing the boundaries. What is the right amount of the specific quality and when do you know you’ve stepped over the line?

Besides, telling people, “I appreciate _______, but it’s too much,” often comes across as patronizing. Beneath the surface of a “too much” message lies the hidden statement: “Yeah, you’re enthusiastic, but so is a puppy dog.” Nobody likes to be told that they’re a naive rookie who is trying too hard. It’s humiliating.

Do pick one problem and focus on it alone.

To avoid sneaking up on the problem or piling on too much material, pick one specific problem at a time and talk about it and nothing more. As I suggested earlier, all of the elements you identified don’t fall under a single category. For instance, micromanaging people who don’t report to him and taking too much responsibility himself are likely to be very different problems that stem from very different root causes.

So, take a look at your list of laments, and pick the one area that has you concerned the most. Then identify the last incident or two where this problem came to your attention and focus on these incidents. To quote from a friend who I once worked with on a massive and wide-sweeping problem: “The best way to eat an elephant is one bite at a time.” So start small. For example, consider the problem with your direct report making decisions and implementing them without conferring with you. Point out the last time this happened. Explain that you would prefer to have been involved and why.

Remember, the biggest key to handling your problem is to work on the instances early on and use them as opportunities to clarify roles and responsibilities. Also, take time to praise the person when he does demonstrate a quality without crossing some line. This helps clarify the lines as well. In fact, try to offer up far more praise than anything.

Finally, as you do work your way into healthy discussions where you’re outlining exactly what you expect, as your direct report asks for more clarity, feel free to answer questions by explaining both what you do and don’t want. Take care to describe specific behaviors that are both recognizable and replicable. But remember, don’t pile too much on all at once and don’t unilaterally step up to a discussion with a big list in hand. It’ll be both overwhelming and discouraging.

Good Luck!

Kerry

--------------------

Find helpful skills for giving tough feedback and describing disappointed expectation in Chapter 7 (STATE My Path) of the book “Crucial Conversations: Tools for Talking When Stakes are High,” and Chapter 3 (Describe the Gap) of the book “Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior.”

------------------------------------------
6. Send Your Questions
------------------------------------------

Submit your question to the authors of "Crucial Conversations" and “Crucial Confrontations” at www.vitalsmarts.com/CrucialSkills/FreeStuff/AskAnAuthor/
Or e-mail it to questions@vitalsmarts.com.

We do our best to answer those questions that reflect the interests of our readers. For more about the authors of "Crucial Conversations," visit
http://www.vitalsmarts.com/CrucialSkills/Product/TheAuthors.aspx

-------------------------------------------
7. Where Can I Learn More?
-------------------------------------------

Web Seminars
-------------------------
Join the authors of "Crucial Conversations" and “Crucial Confrontations in a free web seminar as follows:

Crucial Conversations

- June 22, 1-2:15 p.m. (Eastern) (custom healthcare seminar)
- June 28, 1-2:15 p.m. (Eastern) (general overview)
- July 28, 1-2:15 p.m. (Eastern) (general overview)

Crucial Confrontations

- June 23, 1-2:15 p.m. (Eastern) (general overview)
- July 20, 1-2:15 p.m. (Eastern) (general overview)

For details about each Web Seminar and to register online, visit
www.vitalsmarts.com/Events/?s=All&c=Webinars

Open Enrollment Training
--------------------------
Crucial Skills Training offers intensive skills training in our principles and methods. For in-house training conducted by your staff or one of our professional facilitators, contact your VitalSmarts representative. Open enrollment courses are also available as follows:

Crucial Conversations:

- June 14-15, Dallas Ft. Worth, TX*
- June 21-22, Irvine, CA*
- June 21-22, Cleveland, OH*
- June 21-22, Minneapolis--Bloomington, MN*
- June 21-22, Washington DC--Arlington, VA*
- August 2-3, Denver (Greenwood Village), CO*
- August 23-24, Chicago, IL*
- August 24-25, Baltimore, MD

Crucial Confrontations:

- June 14-15, Irvine, CA*
- June 20-21, Detroit (Beverly Hills), MI*
- June 21-22, Greenwood Village (Denver), CO*
- July 12-13, Baltimore, MD*
- August 23-24, Dallas Ft. Worth, TX*

Additional course dates are available at
www.vitalsmarts.com/Events/?s=All&c=Training

*Trainer certification is also offered directly following most Training. For more information or to sign up, contact your VitalSmarts representative or visit
www.vitalsmarts.com/Events/?s=All&c=t

=================================================================

Questions, feedback, or information you would like to see? Send an e-mail to editor@vitalsmarts.com

You are receiving this newsletter because you expressed an interest in receiving updates from Crucial Conversations--either by signing up for the newsletter or by registering on the site and choosing to receive this reminder.

If we have sent this to you in error, or if you wish to remove your name from future communications, please click the link below:
http://www.vitalsmarts.com/unsubscribe.aspx?MSN=reminders

If you know someone who would like to be on our mailing list, have them visit www.crucialskills.com where they can sign up to receive information and access free resources.