If this is your first time joining this series, I would encourage you to visit the page dedicated to this series so you can start from the beginning. Please click anywhere in this paragraph to get full context.

Today we will discuss the most important thing in hospice. We are going to address what can possibly be the biggest cause of burnout among all hospice staff. Nobody can escape this dilemma. No matter what role you have in hospice, today’s subject will affect you. This is by far the biggest challenge. This can make hospice amazing or absolutely miserable.

Today we discuss our coworkers.

Workplace Conflict

This series cannot reach completion without discussing the relationship hospice professionals have with each other. This work is incredibly stressful. Working in hospice forces medical professionals to work with patients and families at the peak of their vulnerability. We are providing medical care while death is invading their lives. They are going to lose someone close to them forever. The sheer gravity of the situation has the ability to overwhelm anyone.

Something as simple as running out of disposable diapers can become a crisis. Someone is getting a phone call, and the person on the other end may be angry because the nurse forgot to leave supplies. To the hospice professional, this may seem trivial. To the family member, it means a late night trip to the store to purchase something hospice was supposed to provide. Now they have to find someone to sit with their loved one while they make a run to the store. It is even more likely that the after-hours nurse will have to make an emergent delivery and get an earful while they are there. They will spend thirty minutes taking the blame from someone they have never even met. If you are an on-call nurse, you have experienced this more than once.

This is just one simple example of how difficult this work can be. We can NEVER blame the family when we don’t meet their expectations. Doing so will heap more stress on them. As a result, we end up taking it out on our teammates. The stress of this work has to find an outlet. Unfortunately, it often results in conflict between hospice professionals. We feel pressure to lay blame, and we turn on each other.

1. Assume Positive Intent

A lot can be found online regarding this topic. Rather than regurgitate what I have read elsewhere, I will address this based on my own experience. This is something I have witnessed throughout my hospice career.

So, what does it mean to “assume positive intent?” It means to assume the other person’s intentions are honest. It is to assume your teammate has everyone’s best interest in mind.

This sounds easy enough, but it really is not very easy at all. We all bring our personal experiences to work with us. We have all had bad experiences in the past with relationships. We have been lied to, or we have been cheated on. We have watched coworkers at previous jobs steal from the company, or make up all kinds of fake excuses for their behaviors. We drag these experiences from one job to the other, and it causes us to judge our current coworkers based on previous experiences.

This is especially true when a decision impacts us in a negative way. It is easy to assume the move was made to intentionally cause us harm. We also tend to judge someone else’s mistakes differently than we judge our own mistakes. We can explain our own mistakes away because we know our intentions.

The next time one of your coworkers does something that confuses you or impacts your happiness, assume positive intent before calling them up to tell them how you feel about their decision. Chances are they really weren’t trying to make your life harder.

2. Listen – Validate – Communicate

Conflict is inevitable when dealing with people. It will find its way into our relationships at work. Let me share with you a strategy I have been using for years to help deescalate conflict. I use this in every area of my life. I use it with family, friends, my children, coworkers and patients.

Listen: I start by making sure the other person is heard. Sometimes, I’ll just ask, “Are you okay” to start the conversation. Most people just want someone to listen and understand where they are coming from. The more they are able to explain the situation, the more they will calm down. As we listen to them, we also begin to understand what is at the core of the problem.

Validate: Once I have listened well, I will validate their fears and concerns. This shows the other person they have been heard. Most of the time I am able to really connect with the other person after I have heard all their concerns. Listening well also may change my own perception of the situation. I can also learn how someone thinks or what causes them distress. That is valuable information to understand the person behind the frustration.

Communicate: After having listened and validated, this is my opportunity to share my own feelings or thoughts. For patients, I educate. For staff, this is my chance to work towards a resolution. I have found most people are a lot more receptive if we save the rules and correction for the end of the conversation.

The next time you find yourself in conflict with a coworker, would you consider trying this strategy? I think you will find some amazing success. You may even discover the two of you aren’t as far apart as it seems.

3. The Speed of Trust

A few years ago I read the amazing book, “The Speed of Trust.” The main theme of the book explains that the more you are able to trust those around you, the faster the work will get done. If you struggle to trust your teammates, you may want to pick up this book. Also, if you are not very trustworthy, you should pick up this book.

It hurts my soul to watch two people, whom I believe love this work, fight with each other. I catch myself trying to find ways to help them see how awesome the other person is. I’m not very sneaky, so everyone knows what I’m up to. I’ll say to myself, “I can’t believe these two people are fighting. They are both so awesome! They both love our patients. They both want to provide amazing care for our patients. Why are they fighting like this?”

I observe how miserable they both are due to being so untrusting of the other person. I watch this mistrust turn into a cancer between two amazing people. We should all be working towards building a culture of trust inside of our businesses. We can’t spend time pointing at everyone else. True change starts with us. Let’s all be the change we want to see in others. Let’s trust early and often.

4. Getting Burned

I’m a naturally trusting person. I spend most of my day assuming the people around me are working hard and being honest. I realize this is very high risk on my part. I have paid the price in the past for being overly trusting. I have found myself working harder and longer because I was assuming things that just were not true.

I refuse to become jaded and change my strategy. I watch others who are looking for work-place conspiracy under every bedpan, and I will just not live this way. If I get burned, I can still sleep well at night.

I have never been a very good desk jockey. Even when I was a hospice administrator, I found ways to help in the field and still see patients. One day I was out seeing a patient for one of my nurses. After the visit I called her to provide an update. When she answered I could hear her doing the dishes. I was out seeing one of her patients because she was so swamped for the day, and she’s at home!

The weight of this type of behavior is on that nurse. It is never my fault because someone was dishonest with me. It’s not my fault because I opened myself up to being treated poorly. The weight of bad behavior is on the person who is misbehaving.

5. Gossip is Poison

This section can be nice and short. If you like to talk about everyone to everyone, you are poisonous to your organization. If you run around and complain about your company to your peers, you are poisonous to your organization. Pot stirrers have no place in hospice. Complaining should always go up the ladder. It should never go down or laterally. You know it’s being done wrong if the person you are complaining to is powerless to make the changes you desire.

Hospice is a very complex and stressful area of medicine. Our most valuable resource is our teammates. Every one of use has a specific purpose and has equal value. There may be hierarchy in a technical sense, but not in a practical sense. All members of the team should be treated with equal respect and equal value. The home health aide is not “just an aide.” The office manager is not “just a secretary.” We all have to work together in unison for our patients to get the absolute best care possible.

Let’s be the kind of professionals who contribute to a healthy work environment. We can only do this by being intentional about how we conduct ourselves and how we interact with those around us. Let’s trust each other every chance we get. Let’s be willing to sit down with those we struggle to understand. Let’s assume everyone has the same goals for our patients. Let’s stop the gossip and negative talk. Let’s all take ownership of our company, and be the change we want to see in others.

Visit The Hospice Nursing Community for more assistance in avoiding hospice burnout.

James

James worked on-and-off as an LPN for over 20 years. In 2014 he completed a bridge program and became an RN. James became a hospice nurse in January 2015. He lives in the Kansas City area with his wife of over 30 years, 4 daughters and 2 sons in law.