Co-Director, Center for Professional Health The Year of the Scientist: Balancing Health and Science Dealing with unprofessional behavior William H. Swiggart, MS Co-Director, Center for Professional Health March 2017

Conflict of Interest William Swiggart ….has NO financial relationships to disclose. 2

Goals The purpose of the session is to ... Identify disruptive behavior in self and others and to respond appropriately.

Objectives Participants attending this session will be able to: Define flooding and recognize flooding in self and others. Practice one communication technique to use with colleagues in the workplace. Practice one grounding technique.

Agenda Introduction / Handouts Flooding DRAN Resources Summary

Ground Rules Whose in the audience – MDs, Phd, RN, other allied health workers??? Create a safe environment for scientist to engage in discussion on challenges but more so solutions to the challenges.

Handouts Flooding test DRAN

Definition of Disruptive Behavior Disruptive behavior includes, but is not limited to, words or actions that: Prevent or interfere w/an individual’s or group’s work, academic performance, or ability to achieve intended outcomes (e.g. intentionally ignoring questions or not returning phone calls or pages related to matters involving patient care, or publicly criticizing other members of the team or the institution) Create, or have the potential to create, an intimidating, hostile, offensive, or potentially unsafe work or academic environment (e.g. verbal abuse, sexual or other harassment, threatening or intimidating words, or words reasonably interpreted as threatening or intimidating) Threaten personal or group safety, such as aggressive or violent physical actions Behavior or behaviors that undermine a culture of safety Violate Vanderbilt University and/or VUMC policies, including those related to conflicts of interest and compliance. Vanderbilt University and Medical Center Policy #HR-027, 2010

Disruptive Behavior Is Not An occasional “out of character” reaction of an individual Lack of perfectionism. No one is perfect Constructive criticism in good faith with the aim of improving patient care or education Expressions of concern about a patient’s care and safety Expressions of dissatisfaction with policies through appropriate grievance channels or other non-personal means Vanderbilt University and Medical Center Policy #HR-027, 2010

"Every system is perfectly designed to get the results it gets.” Systems "Every system is perfectly designed to get the results it gets.” BW Williams to accompany a talk delivered at the FSPHP Spring Meeting 2010

Topic 1 Flooding

Flooding “…this means you feel so stressed that you become emotionally and physically overwhelmed…” “Pounding heart, sweaty hands, and shallow breathing.” “When you’re in this state of mind…you are not capable of hearing new information or accepting influence.” *John M. Gottman, Ph.D. The Relationship Cure, Crown Publishers, New York, 2001, 74-78.

Flooding Take a test John M. Gottman, All Rights Reserved (revised 11/17/03)

Flooding - Scoring Scoring: If you answered “yes” to more than eight statements, this is a strong sign that you are prone to feeling flooded during conflict. Because this state can be harmful to you, it’s important to let others know how you are feeling. The antidote to flooding is to practice soothing yourself. John M. Gottman, All Rights Reserved (revised 11/17/03)

Flooding Things to do when you flood: Breathe Practice any mindfulness technique Step away from the situation: if possible go into the restroom

SKILLS TO USE WHEN FLOODING GROUNDING Categories exercise Judge versus describe Mindfulness with all senses Breathe

Topic 2 DRAN Practice one communication technique

Assertive Communication When asking for something, use the acronym – DRAN Describe Reinforce Assert Negotiate John Gottman, Ph.D. The Relationship Cure. Crown Publishers, New York, 2001, 74-78

Describe Describe the other person’s behavior objectively Use concrete terms Describe a specified time, place & frequency of action Describe the action, not the “motive” John Gottman, Ph.D. The Relationship Cure. Crown Publishers, New York, 2001, 74-78

Reinforce Recognize the other person’s past efforts It takes eight positive comments to compensate for one negative comment. John Gottman, Ph.D. The Relationship Cure. Crown Publishers, New York, 2001, 74-78

Assert Directly and Specifically Express your feelings Express them calmly State feelings in a positive manner Direct yourself to the offending behavior, not the entire person’s character Ask explicitly for change in the other person’s behavior John Gottman, Ph.D. The Relationship Cure. Crown Publishers, New York, 2001, 74-78

Negotiate Work toward a compromise that is reasonable Request a small change at first Take into account whether the person can meet your needs or goals Specify behaviors you are willing to change Make consequences explicit Reward positive changes John Gottman, Ph.D. The Relationship Cure. Crown Publishers, New York, 2001, 74-78

SPECIFIC PHRASES You may be right. Give me a minute, I’ll get right back to you. I know this may be frustrating, I want to address your concerns. Tell me how I can help you. Glad you are here. John Gottman, Ph.D. The Relationship Cure. Crown Publishers, New York, 2001, 74-78

The 8:1 Ratio Communication John Gottman, Ph.D. The Relationship Cure. Crown Publishers, New York, 2001, 74-78

Topic 3 VERITAS Event Reporting System

To access VERITAS, Click on Resources For Employees

Summary As a result of participating you should be able to: Identify the characteristics of flooding. Use grounding techniques to calm your mood. Use DRAN to improve your communication. Access the Veritas system.

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