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SECTION 3: WORKING WITH OTHERS
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Scenario 2: Sam and Chris Sam and Chris worked closely on a project, Sam, as a clinician and Chris as an educator. Out of work they enjoyed one another’s company and had high mutual respect, but when it came to the project work, it was another story. Chris was a planner and liked to know what they were going to do in advance. Often drawing up a schedule for the work that needed to be done, Chris enjoyed being on top of the work and found it difficult if there were last minute changes imposed. Sam had evolved a way of working that meant that until deadlines became urgent, they did not really register. A very busy clinician with interests in many associated fields, Sam was excellent at dealing with crises and last-minute alterations. Whilst both working personalities were required for the project, the two found that it became increasingly difficult to tolerate the other’s ‘foibles.’ Sam wondered why Chris would become tense and rigid when something was changed just before a meeting or a course; Chris wondered why Sam never looked at the notes until they were actually in the meeting or course and then changed them. Surely if Sam looked at the notes before the meeting, they could agree the change together? Both felt that the other was sabotaging their work, and the relationship they had developed. |
Working with others is an essential skill in healthcare. However, the skill to work effectively with everyone we meet is a rare one. There will always be people we find easier than others, and this can impact our work.
Sam and Chris in scenario 2 are not unusual. They enjoyed a good relationship and had respect for each other’s work. Both spoke highly about the other. However, one day they began a new piece of work together, which caused a particularly tense situation when Sam refused to look at the planning notes and, on the day, changed everything as they went along.
Working with others effectively requires us to understand our working patterns and preferences and those of our colleagues which may be very different. Some of us are ‘people focused’ and prioritise our work around those with whom we come into contact, whether that is patients or colleagues. Others are ‘task focused’ and prioritise the tasks they must do (Ehman 2011). Often, we can be both and when things are running smoothly, we do manage to maintain equal attention to both aspects of a job. However, when we feel under pressure, we tend towards one focus or the other. So, Sam was a classic people focused worker. Adapting last minute to the needs of a group or a patient were second nature, whereas Chris was task driven under pressure, liking to plan ahead as an insurance policy, knowing that even if there were last minute changes, having a plan made for feeling more secure. Sam liked relying on wits; Chris wanted to rely on a plan.
There were other differences in Sam and Chris’s personality types at work too. They had previously completed Myers Briggs Type Indicator questionnaires and were opposites in terms of the ways they took in information, gained energy, processed and produced decisions and prepared for work. In their own working areas, they were comfortable with the ways they worked and had evolved ways of working that fitted with their preferences but thrown together for this project exposed these differences.
Many of you will have had an opportunity to access Myers Briggs through the workplace. If you have not there are abbreviated versions free online (Humanmetrics 1998-2016).
Brief Overview of Myers Briggs Type Indicator
Developed by Katharine Cook Briggs and Isabel Briggs Myers, the MBTI is based on Carl Jung’s theories that people experience their worlds using four psychological functions – sensation, intuition, feeling, and thinking – and that one of these four functions is dominant for a person most of the time. Each person is said to have one preferred quality from each category, producing 16 unique personality types, or sets of preferences. Whilst there are questions of independence, bias, and conflict of interest around the research underpinning this system, it can be a useful way of thinking about the approaches we take to making sense of our lives.
The following link will provide an overview of the MBTI types:
https://upload.wikimedia.org/wikipedia/commons/1/1f/MyersBriggsTypes.png
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Reflection 1 of 2 Reflect on a working relationship you have struggled with. If you have done the Myers Briggs Type Indicator you might want to think about the different preferences, you and your colleagues have. If you have not done it, you might want to consider the different ways of working in terms of:
This can be done individually or in small groups. If in small groups, please share thoughts. |
Why is it important for us to work well with our colleagues?
Positive working relationships have consequences for both the work we do and how we feel about that work. If we want to feel like we are contributing valuable work, we need to ensure that we can work with our colleagues who want to do the same. It is helpful to remind ourselves that very rarely does anyone get up in the morning with the express intention of going to work to annoy or hurt someone else. Most of us are trying to do our best, because it makes us feel good if we do.
Job satisfaction, teamwork and collaboration are all positively influenced by our working relationships. In an ideal world we would all love our jobs, feel worthwhile, like everyone we encountered, and communicate openly and honestly. In the real world some of these features of working life are compromised by interpersonal and communication problems, time pressures, resourcing issues and emotional issues.
Building effective working relationships
Understanding our work personality and those of others can help us to understand behaviours and preferences, but understanding is only part of the solution. There are several trusted techniques for maximising relationships at work, and we can all consider and work on these.
- Show a genuine interest in people
- Spend time with people
- Balance your needs with the needs of others
- Be approachable
- Active listening
- Sensitivity to people’s feelings
- Developing trust
- Offer to help others
- Developing a supportive culture
Click the tabs below to reveal information on these techniques
In the arena of healthcare, the patient is often in receipt of much of the care and attention we give, but it can be invaluable to show an interest in all our colleagues. We can ask people questions about their holidays or weekends off and show that you see them as a person and not just a job title or role. Everyone is part of a team. Porters are often the first people a patient may meet when visiting a hospital and can guide patients to far flung areas in the sprawling campus.
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Example from a professional: Jan works on a consultancy basis and tells of one cleaner who regularly helps her to find people or rooms, who is always cheerful and reliable, asks how she is. When this person was having his appraisal, Jan happened to be passing and told his appraiser how integral he is to the work she does in that venue. “It was the only way I could think of to repay him for all the small acts of help he has shown me over the years,” she said. |
Healthcare has changed greatly in the way it functions over the last 20 years and one change means there are fewer opportunities to get to know colleagues. Many of us do not want to go out after work or can’t due to other commitments or the hours we work. This means that we might get less of a rounded picture of our colleagues. The occasional coffee, team dinner, or small group lunch can help us to understand our colleagues better. It also shows a commitment to them.
A little social time occasionally can build bonds that help when the pressure is on at work.
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Example from a professional: Pascal said, “I went to a conference with two colleagues. I was desperately hoping that I would not have to spend every hour of every day with them but was a little dismayed that our leader was not willing to have dinner with us, making an excuse that he had something else on. We tried to suggest a coffee to plan our workshop session, but he avoided that too. It may be that there is a perfectly good reason for this, but I just felt that he didn't rate me, didn't like me, or was unwilling to share.” |
We have all worked with people who are entirely focused on their needs, only call when they want something, and seem to engender a lot of work for others. This is a short-term strategy and will very often not serve them well in the long term. People are less willing to help such colleagues when needed and are more often likely to say no if they sense that they have given more often than they have received. “Give and take” is as important in working relationships as it is in personal relationships, and we should ensure that we manage to do that, especially with those with whom we work the closest. It might require some honest communication, which will be discussed later in this module.
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Example from a professional: Ali works in a busy clinical team of ten. Their work is fast paced and covers 19 hours a day with on call commitments. As a team they have experienced serious illness, close relative serious illness, bereavement, and a wide assortment of difficulties which impact on the tight rota. Ali is currently covering several extra shifts for three colleagues who are having significant family issues. However, he does this with acceptance as he knows that when it is his turn to need help, his colleagues will provide it. |
This requires us to put people at ease, and to be friendly, non-threatening and inviting. Sharing information with people can achieve this quickly. Of course, there are boundaries for everyone in terms of what it is appropriate to share, but letting people see who you are, and getting to know you is an important part of being approachable. Humility is often described as an under celebrated quality, and those who do admit to mistakes, share how they overcame errors or adversity in a humble way are often more readily accepted as colleagues than those who know it all or are enigmatic and aloof.
We know that listening is a key ingredient to good working relationships, but active listening is an art form that can be developed. When someone tells you something, instead of treating that piece of information as complete, it might sometimes be helpful to ask, “And then what happened?” or “I see, can you tell me more?” or even, “I understand”. Asking such questions with continued eye contact can help them to carry on. It has been documented that some of us use more conversation reinforcers: “I see,” “Really?” “Was it?” “Uhm” “Right” which encourage people to continue with whatever they are saying. In building relationships, it is important to listen to colleagues, and even if you think that they are the ones who should be doing more listening, when we role model active listening, it can positively influence others to do the same.
Levels of Listening
There are three levels of listening we can use. Read these descriptions and think about the different levels of listening you might use and who might use these different levels with you, and when.
Level 1. Level 1 listening refers to listening in sections, tuning into and out again, listening to some of what is being said but being more aware of oneself. Often at level 1 people are keeping quiet just to get a chance to talk. A listener at this level may be faking attention while thinking about what they can say next or thinking about irrelevant topics. The listener might have a blank expression and seem more interested in talking than in listening.
Level 2. At level 2 it is typical to hear what is being said but not really think beyond the obvious words heard. Level 2 listeners listen logically, focusing on facts but often remain emotionally detached from the conversation. Whilst at level 1 it is obvious the person is not listening; at level 2 the speaker may think they are.
Level 3. This can also be called ‘active’ or ‘empathic’ listening. Listeners at level 3 do not judge what the speaker is saying, but rather place themselves in the other person’s position and try to see things from their perspective. They are not easily distracted, pay attention to the total communication, including body language and are open to the speaker’s thoughts and feelings. These listeners display a non-judgmental attitude and neutral body language.
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Self-assessment activity 1: Listening audit Read through the list of listening behaviours and think of a time you may have used this behaviour.
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Reflection 2 of 2: Do you struggle with listening to others? If so, why might that be?
What might be affecting your listening skills? How can you help yourself to be a better listener? This can be done individually or in small groups. If in small groups, please share thoughts. |
Even if you know you are not great at picking up on people’s emotions, it can help to ask people how they are occasionally. At particularly stressful times, people can feel cared about as a result of one genuine enquiry. The “Double Tap” enquiry as outlined in point 9 below, can be used sensitively here.
Speaking positively about people and following through on promises are two ways to develop trust. Gossip has a habit of finding its way back to the target even if not verbatim and speaking genuinely and positively about our colleagues can build trust around us. On the converse, negative comments breed mistrust of the person making the comments more often that the target of them.
We might feel we are doing people a favour by promising too much too soon but if we cannot deliver on it, people lose trust in us.
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Example from a professional: Zac told me that he never promises what he cannot deliver, and is conservative in estimating delivery time, so that he does not have to let people down. He is well regarded in his team. |
Be realistic here! There may be little opportunity for you to go out of your way to help other colleagues, but even small gestures help to develop working relationships.
Often several hands make light work too and teaming up to do an audit or planning a questionnaire can reduce the difficulty of the task as well as building better relationships.
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Example from a professional: “When Sanjay was asked to write up a patent information leaflet, I knew it would be a nightmare for him, he hates doing that kind of thing, whereas I quite enjoy it. I offered to do it and told him he could pay me back with the next job I did not like doing,” said Belinda. |
Frequently however, when we are feeling less effective, we do not seek help, as we blame ourselves. As colleagues, supervisors and professionals we should all work to develop a culture where we can all ask each other how we are doing, before the situation becomes as concerning as Minna’s was in scenario 1.
As we increasingly understand the impact of stress, burnout and moral injury in the workplace, we can support one another through a strategy called the “Double Tap” created by Dr Sammy Batt-Rawden. She suggests we ask colleagues who might not be quite themselves, “Are you OK?” and when we receive the stock answer, we check again. We can say, “Are you really OK?” or “Would you tell me if you weren’t OK?” or, her favourite, “Are you sure – you just don’t seem quite yourself lately.”
You can find Sammy’s TEDxNHS talk here: https://www.youtube.com/watch?v=VN9VwX2rUqk
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Scenario 2: Sam and Chris’s outcome Sam and Chris’s situation came to a head. On the day of the event on which they were working, both were anxious. Sam was worried that Chris would rigidly stick to the plan they had made, and not allow for flexibility according to the needs of the group. Chris was worried that Sam would change everything beyond recognition and the group would not benefit from something that was not thought through.
They muddled through the morning, each becoming more tense and more fearful, Chris sticking to the agenda and Sam interposing questions, comments and thoughts which were sometimes useful and sometimes tangential.
At lunchtime Chris decided to take the bull by the horns and sat in a corner with Sam. “Do you want to go through the afternoon’s plan?” asked Sam, looking exhausted. “Yes, but I thought maybe we could decide which parts we needed to stick to and which parts we could perhaps go a little off-piste,” said Chris, tentatively. “OK,” said Sam, brightening up. “You see, I am such a Judger – a Myers Briggs Judger,” said Chris, “I get panicky if I don't have a plan. But I saw from this morning that my plan is kind of cautious and that with this group we can maybe go a little off-piste and push them a bit…. you never know what we might get.” “I hate plans!” Sam burst out. “Not yours of course, well, I mean…. but it would be great to open them up a bit and see what they could come up with if given free reign. I know I can sometimes go off topic a little so do stop me if that happens…” “OK. Well, shall I start them off and then you could manage the – what, half hour discussion? And then I can always come in and close it down at the end?” “Fabulous!” beamed Chris.
Sam and Chris had already established a good relationship that was threatened by this project, and both were beginning to struggle with the other. The conversation over lunch showed a willingness to acknowledge the others’ viewpoint and preference, some sensitivity to how the other was feeling, some information sharing about themselves and an agreement to share the workload, and to trust one another again. The session went very well indeed, both felt they had learned from the experience and the next project in planning is taking a much more integrated approach. Because Chris had a framework with which to explain their differing styles, they were able to use a language they both understood to explain why they were acting as they were. |
What can be learned from this scenario?
- Taking time to know ourselves and our preferences especially when under stress can give us a language to use with others, as well as a way to understand others’ preferences.
- Skills for developing our relationships with others at work can be developed with awareness and practice.
- Work is always more enjoyable if we can get along with our colleagues.