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Managing the Stress of Change by Guest Author Sharyn Mosca

Wednesday, September 23rd, 2009

Close communication helps during changing times

As a leader, you probably have discovered the number 1 stressor for leaders is “trying to do more with fewer resources and do it faster”. Perhaps your organization is downsizing, or under pretty stringent budget cuts. Perhaps that open job position you had, suddenly was taken away, and on hold indefinitely. Oh well, you say. I guess we will have to figure out how to “do without”. As a leader, not only do you need to manage change from a business perspective…you also have to manage the reactions of your staff going through the change. Certainly, a complex set of expectations.

Firstly, Put On Your Own Oxygen Mask
As we have heard so many times, while preparing to take off on a flight, we need to put our oxygen mask on first, before attempting to help others. The oxygen mask involves taking care of your own concerns through private discussions with trusted friends, family and advisors. Do I know how I feel about this change? Am I supportive of it? Confused? Threatened? Leveling with yourself and bouncing concerns off others is a very healthy start. “Stress is simply the adaptation of our bodies and minds to change; and change, as we noted, is about the only constant left in the workplace.” Peter G. Hanson, M.D.

Step Up Your Communication With Your Staff
This is the easiest yet hardest thing to do. Didn’t we just say we are going to do more with less? I don’t have time for much of anything, let alone wandering around to talk to staff. The issue is, there probably is not better place to be than discussing, sharing ideas, and keeping the channels of communication open and authentic during change. Start with one on one discussions, “How are you feeling about this latest change? “ Do you have any ideas on how we might pull together on this one?” Asking if there a better way to organize our work to deal with this resource or issue can yield hugely helpful ideas that just may bring the team to new levels of trust and cohesion. Make it a regular part of doing business to talk about change at staff meetings, and create a culture with your group that discusses the “what we do, with the how we do it”.

Emphasize That With Change… Learning Happens
Stay vigilant with your staff on the importance of learning through all the change. Ask them to keep a “learning diary” to record all the new situations that the change evokes, and what new skills, strategies or process improvements occurred as a result of dealing with the change. Short term you might get some skepticism, but 6 months from now, the new learning’s become very evident. Encourage your staff to consider what type of development they could use to meet new job duties or tasks. If budgets are tight, think creatively on how the development might happen. Job sharing? Rotation? Find a mentor? On the job classes by a resident expert? On line learning? The most beneficial outcome of rapid change is that it forces us to deal with new situations. Change masters are aware of this and learn from the experience. Make it a point to ensure each staff member has learning or professional development goals included in their performance plan. The more energy spent on developing through the change…the better.

Take Time…to Take a Break
We all need time to pause and refresh…even if it is busy. Create some “timeouts” like pizza once a month on a Friday or “bagels on Monday’s”. Create a loose agenda that serves more to just use the time to catch up with one another. Early in my career, a neighboring supervisor (not my own) regularly brought in baked goods for his staff. Coffee breaks were enjoyed with these goodies, and this simple gesture was admired and envied by surrounding departments. Who would ever think that something so simple would be this long remembered? In times of change, it is comforting to know that “we” have some rituals, and “we” can stand together and meet any challenge. The best change masters create teams that stick together during good times and bad.

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Tags: change management, leadership, stress management
Posted in Business skills, Communication skills, Personal observations | No Comments »

Using technology to make patient care safe by Pat Iyer

Monday, September 14th, 2009

A recent issue of Healthcare Informatics provides hope that technological advances can improve patient safety. One of the most significant barriers to care delivery is communication. Nurses, says Turisco, are often placed in the middle of the communication loop, where they constantly receive and place calls to physicians, pharmacy and lab, all while trying to tend to patients. Fran Turisco is research principal in the Waltham, Mass.-based Emerging Practices Healthcare Group of CSC (Falls Church, Va.) “So the issue is how you cut out some of the middle men in these communication loops,” she says. “And how do you shorten the time frame between when a nurse needs to talk to someone and when she actually gets to talk to that person, then either make a care decision or figure out what needs to get done next.” Nurses act as the hub in the wheel, and communicate with every other department in a healthcare facility. This communication is vital but time-consuming.

A hands-free voice activated badge in use at University Hospitals Case Medical Center in Cleveland, leadership addressed the problem by rolling out hands-free communication systems from San Jose, Calif.-based Vocera in the NICU. The technology enabled clinicians to call for assistance or answer pages by using a voice recognition button. With the badges, which run on the hospital’s wireless platform, nurses can call for help or communicate with colleagues across departments. This innovation addresses the ongoing issue of placing calls to others, and being interrupted when the call is returned.

Bar-code technology is gaining ground as a way to reduce medication errors. The medication is scanned at the bedside and verified as being correct for the patient, whose arm band is also scanned. The system catches errors at the point of administration, the last step before the medication enters the patient.

Another common theme in patient safety is workflow issues. A number of organizations are addressing the problem by deploying patient flow systems to provide nurses with improved visibility of both bed availability and patient status. With these solutions, instead of making several calls and chasing down charts, nurses can look at a screen to find out what rooms are available, how long patients have been waiting to see a physician, and when patients need to be turned.

When I was a nursing quality assurance coordinator, we tackled the seemingly simple issue of getting beds ready after a discharge. The backup of patients in emergency departments, medical surgical units, and recovery rooms waiting for a bed has important quality of care issues. One of the biggest selling points for patient flow systems, according to Turisco, is the ease of use factor. “It’s one of these technologies that you almost think is too good to be true because it’s not that hard to install. You can configure it in a short period of time to do exactly what you want.”

Here are the take home messages:

The proliferation of wireless technologies in the hospital setting has significantly impacted the way nurses deliver care.
The primary goals chief information officers are looking to achieve in implementing wireless technologies are to improve communication, workflow efficiency and patient safety.
Organizations that have successfully implemented wireless technologies have had nursing leaders involved in every key step of the process.

Read more about 10 common errors and what is being done to make patient care safer here.

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Tags: technology and patient safety
Posted in Communication skills, Patient safety | No Comments »

Watch Handshakes When Negotiating by Greg Williams

Tuesday, September 8th, 2009

What can you learn from a handshake?

When you negotiate, the handshake sets the tone of the negotiation. Handshakes convey nonverbal messages, which can give valuable insight into the character of the other negotiator. Consider what occurs in the 2 to 5 seconds when you shake someone’s hand. Do you take into account his or her grip? Is it firm, soft overbearing, or almost non-existent? What about your handshake—does it convey warmth, sincerity, or that of an antagonist? Below are handshake illustrations and the nonverbal meanings they carry.

Firm handshake: Conveys the intent of sincerity. Be cautious, it can also conceal the attempt of deceit.
Overbearing/bone crushing handshake: Could convey overcompensation for someone’s lack of self-confidence, or a desire to give the impression of control over the other negotiator.
Limp handshake: Usually given by people unsure of themselves, or at least in their current environment.
Four-finger handshake: This occurs when one person grasps the four fingers, rather than the whole hand, when shaking hands. Women who shake the hand of men are the ones who typically use this style of handshake. Since women have smaller hands then men, it’s one way a woman can send the signal: “I’m in control, or will try to be, in this negotiation.” If a man uses this style of handshake, he’s usually thought of as a wimp.
Two handed handshake: This occurs when one negotiator engulfs the other negotiator’s hand in both of his. This handshake can convey dominance or sincerity, warmth, and camaraderie. Take note of what occurs early in the negotiation to determine what the meaning of the handshake was and continue to observe the direction in which the negotiation flows.
Free hand on elbow handshake: This is a sure sign that the negotiator whose free hand is on the other negotiator’s elbow is sending the signal “I am in control”. If both negotiators use the same handshake, they’re both sending the same nonverbal signal of their attempt to gain control.
Free hand on shoulder handshake: This is an attempt to gain even more control than the handshakes described above. This style of handshake is displayed by placing the free hand on the shoulder of the other negotiator, while shaking his hand. If the first negotiator uses any of the above handshakes, the ‘hand on shoulder’ style of handshake will send the signal of ultimate dominance.

To increase your chances of having a strong hand when negotiating, take note of what your handshake and that of the other negotiator conveys. If you can accurately discern that meaning, you’ll gain insight into the other negotiator. From the outset of the negotiation, you’ll have a huge advantage over the other negotiator … and everything will be right with the world.

The Negotiation Tips Are …

There’s a lot of value in being able to convey and perceive the hidden meaning of a handshake. Since a handshake communicates so much information, become astute at determining the real meaning of the handshake.
To gain advantages when negotiating, learn the meanings of handshakes and use that knowledge to enhance your negotiation outcomes.
Understand a handshake can convey hidden and manipulative meanings. A savvy negotiator can use the handshake to set the stage for a negotiation, that will cast her in the light by which she wishes to be viewed. Be aware, it may not be her real persona.

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Tags: handshake, Negotiation skills
Posted in Business skills, Communication skills, Trial lawyer skills | No Comments »

The Top Ten Tips for Utilizing Time More Efficiently by Guest author Natalie Gahrmann

Wednesday, August 26th, 2009

Time is a priceless treasure. Treasure every moment you have and remember that time waits for no one. You cannot make six minutes out of five just because you managed your time effectively. Each day you are given the gift of a new day, 24 hours. Utilize it the best way possible and don’t let it slip through your fingers. You cannot ever replace lost time. You can’t buy time or save time; you can only spend time…once it’s spent it’s gone!

1. PRIORITIZE
Determine what’s truly important to you. Schedule those items and activities first and then schedule everything else around it to the extent you can (noting some things are scheduled at precise times and there is less flexibility). Don’t cancel the important (not urgent) activities for any reason.

2. PLAN
Planning is a crucial skill when you want to accomplish something. However, it’s often the first thing forgotten when things get hectic and busy. Planning magnifies time by providing direction and enhancing productivity. Life is simpler and easier when planned out.

3. DELEGATE
Anything you’re doing that could be handled by someone else could be delegated. If you look at your time in terms of dollars you can compute how much your time is actually worth. Then, you may be more willing to delegate the more routine tasks, chores, etc. and free your time and energy for your top priorities and high-level work.

4. SET GOALS (HAVE STRONG INTENTIONS/A VISION/DIRECTION)
Establish specific goals on a daily basis to help you decide what you want to achieve with your time and to set targets that will lead you to achieving them more regularly. Setting goals may be very effective at raising your self-confidence by focusing on progress. In addition to having increased performance levels, goals will keep you more highly motivated.

5. STRUCTURE YOUR DAY
As individuals, we all have peak performance times. Learn when it’s your best time for greatest productivity, quiet thinking, exercise, etc. and arrange your day accordingly to maximize your personal advantage. Each person has an ‘ideal’ work style that operates as a function of who they are, their body and personality type. Begin to understand and honor that style in you and you’ll be more effective as a result.

6. VALUE YOUR TIME
If you demonstrate by your words, actions and commitments that your time is important to you, others will recognize how you value your time and will show more respect of it. On the other hand, if you don’t value your time, don’t expect anyone else to. By valuing your time, you are in essence valuing your self. One important thing to remember is that the only way others will respect your time is if YOU respect your time.

7. REPLICATE YOURSELF
No, you cannot actually duplicate yourself or add more arms and legs but the fact is, you can find someone who is just as good as you in a given task. You can also automate or systematize some of your routine tasks. Replication is about increasing your results without expending more time and energy.

8. GET ORGANIZED
Have a place for everything both in your office and in your home; it pays off in less wasted time searching for something you just can’t seem to find. Over the years, studies have shown that people working with a messy desk or work area spend an average 1.5 hours per day looking for or being distracted by things (at just minutes at a time!) In addition, create a (centralized) list of what you want to get done. Manage the activities and projects you can control; clearly distinguish between what is and is not actionable. You can also group activities that can be done simultaneously or on the same trip out. The key is to focus on about 6 activities you wish to accomplish at the start of each day and to keep your list manageable.

9. BECOME FULLY FOCUSED IN THE MOMENT
By focusing on what you are doing you permit yourself to get absorbed in the activity, be more relaxed and increase your creativity. Fact is, when you allow yourself to become totally focused on what you are doing at the moment, a freer flowing momentum occurs and you actually get the job done faster and easier. Be deliberate in how you use your time. Make the present perfect rather than splitting your attention.

10. ELIMINATE TIME WASTERS
Yes, we all have them in our life—interruptions, distractions, poor planning, ineffective behaviors and attitudes, over-commitment, etc. Rather than letting time control you, take control of your time and your life by incorporating some of the tips listed above. Take personal responsibility for creating stronger boundaries and communicating them to your colleagues, bosses, significant others and family.

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Tags: Priorities, Productivity, stress management, time management
Posted in Business skills, Communication skills, Priorities | No Comments »

Cultural Competence and Attorneys by Pat Iyer

Monday, August 24th, 2009

Do you have cultural competence?

The United States possesses an incredible melting pot of cultures. Spend a few hours in a major airport, as I did today, and you’ll see an interesting variety of dress and behavior.

Those of us who function within the medical legal arena need to have cultural competence. Within the healthcare framework, healthcare providers are expected to understand and effectively respond to the cultural and language needs of the patient. This requires us to value diversity, identify and overcome our biases, manage the dynamics of differences, and adapt to the diversity and cultural contexts of individuals (US Department of Health and Human Services, 2000). Attorneys have the same requirements.

An attorney may represent a client from a radically different culture. Client behavior must be viewed within the context of that culture:

Is the client extremely deferential to the attorney and staff and reluctant to ask questions? Demanding and asking for updated information on an ongoing basis? Affected by a language barrier?

What effort do you make to get to know the patient and his or her culture? Do you have bilingual staff? Do you know how to obtain a translator? What signals do you send to clients that you are interested in learning about their culture? Do you know how the lawsuit has affected the client’s role as parent, spouse, or employee? Do you understand the values of the client? Has a physician or nurse defendant suffered a diminished cultural status as a result of becoming a defendant? How have the immigrant’s goals been affected by an inability to work? Does an injured plaintiff have beliefs about what kind of healthcare is likely to restore him to health? For example, I recall a Vietnamese client who taped coins to his back to reduce back pain.

What information about the client’s cultural background is appropriate to share with a jury? How will the jury view this information? How can the behavior of the client be made understandable to the jury so they possess culture competence?

Send us a comment. What challenges have you experienced in representing a client from another culture, and how did you overcome them?

What are these?

Tags: attorney skills, communication, cultural competence
Posted in Business skills, Communication skills, Trial lawyer skills | No Comments »

How is the Economy affecting Jurors? by Pat Iyer

Monday, July 27th, 2009

Gently question jurors during voir dire

The Aletheia Institute sponsored a webinar on June 24, 2009 that addressed this question from the perspective of five jury consultants. These are the takeaway points I gained from listening to this program.

Data from 200 trial consultants shows that 8 out 10 people think the economy is bad. A person who is pessimistic about the future is less likely to award high damages to a plaintiff. Older jurors are less pessimistic. Pessimistic and concerned jurors are frequently ineffective jurors and may be more critical of the plaintiff, accepting the stereotype of the plaintiff as a greedy person. Focus group data shows that jurors still judge the plaintiff more harshly than they do the defendant.

Those who are most personally affected by the economy are least likely to volunteer this information. Attorneys who are permitted to do voir dire with jurors should approach this question gradually. Draw jurors about by asking two follow-up questions for each topic, using such questions as: “How so?” “Please say some more?” “What else?”

Jurors are more willing to help someone who embodies social norms. Attorneys should make their client – plaintiff or defendant – appear as normal as possible.

Jurors may not be receptive to arguments of future wage loss unless the person was horribly injured. Given layoffs, the defense attorney may raise the argument – “How do we know this person would have kept this job, and that these future wage earnings are valid?”

After exposure to headlines about corporate wrongdoing, jurors are more receptive to the idea that people do bad things in their own self-interest. Attorneys should consider conducting a focus group on a day in the life video, but day-in-the life videos are not right for every case. Some things may be better left to the juror’s imagination.

The Aletheia Institute Trial Consulting Panel had 5 jury trial experts:
David Wenner, Esq (Arizona) has written and researched on the subject of OJB (Overcoming Juror Bias).
Phillip Miller, Esq (Tennessee) has done up to date surveying and research on the subject.
Eric Oliver (Michigan) is nationally known for his ability to select (or deselect) juries.
Katherine James (California) nationally recognized trial consultant, frequently invited to help lawyers and their clients.
Alan Blumenfeld is another nationally known litigation consultant who, with his ACT of Communication partner Katherine James, advises lawyers, experts and clients on better communication skills during discovery and trial.

Pat Iyer is a founding member of this organization. She will be appearing on a program on Wednesday, August 26, 3 PM EST: AI will hold our second Free Aletheian Hour with our MedicalSchool panel discussing “The Good, Bad & Ugly Pain Tests Used/Misused by Medical Experts.”

Interested in seeing this program? This free offer will end on September 1, 2009.

Event Title                “How Is The Economy Affecting Jurors”
Recorded Date         Wednesday, June 24, 2009
Go to www.remotecounsel.com

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            Password       3XZzb4

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Coming up:

On Friday, September 25 at 3PM EST, our EconomicSchool panel address – How to Make More Money and Save Time with New Professional Practices. For more information about AI, go to Aletheia Institute.

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Tags: defendants, focus groups, jurors, jury, plaintiffs, voir dire
Posted in Communication skills, Medical malpractice, Personal injury, Trial lawyer skills | No Comments »

Does the Plaintiff Possess Health Literacy? by Pat Iyer

Wednesday, July 15th, 2009

Plaintiffs are sometimes labeled as uncooperative for not following prescription directions, appointment slips and other written instructions. “Health literacy” is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health care decisions. People with low health literacy are less likely to understand written and oral health information and be able to navigate the healthcare system. Superimposed on depression, lost income, pain and other symptoms, low functional health literacy can sabotage the efforts of the plaintiff to obtain medically necessary treatment. Although health literacy affects people from all backgrounds, the problem is more acute in those who are older, non-white, immigrants, and those with low incomes.

Approximately 44 million adults in the United States are functionally illiterate and an additional 54 million have marginally better reading and computation skills. This information suggests that many injured people may have difficulty understanding prescriptions, informed consent documents, insurance forms, and patient education materials, most of which are written at a high school level. The recommended reading level for all health education materials is 5th to 6th grades.

Many individuals with low reading skills are loathe to admit to their deficits and go to great lengths to avoid admitting they have trouble reading. Often they cover this by saying they forgot their glasses. Healthcare providers should set up a climate that is shame free and does not make the person feel embarrassed or stigmatized. Healthcare providers can ask the patient to restate the instructions in his own words to help to determine if the patient understood the information. Simplifying language also helps. Healthcare providers can also limit the amount of information imparted to the patient, slow down, and take the time to talk to the patient.

Modified from President’s Editorial, New Jersey Nurse, May/June 2009

The plaintiff attorney who suspects the plaintiff client has difficulty reading can encourage the client to bring surrogate readers to a healthcare encounter to help with reading difficulties. Providing a videotape to cover key points on being deposed lessens the demand on reading skills. The attorney and legal nurse consultant can effectively communicate with low literacy clients by using the same techniques of slowing down, simplifying, asking for a repeat back of instructions, and providing simple, attractive materials. The client will feels he is being treated in a respectful, nonjudgmental and helpful manner will learn more and be better equipped to cooperate in the medical and legal system.

See The Uncooperative Plaintiff for more information

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Tags: health literacy, illiterate, Personal injury, uncooperative patients
Posted in Communication skills, Personal injury | No Comments »

On Challenging an Authority by Pat Iyer

Monday, July 13th, 2009

Challenges to authority save lives

A nurse sees a physician about to commit a grievous error. A resident watches an attending physician brush aside warning signs of a medical error. What factors go into challenges that may save a patient’s life? Malcolm Gladwell provides insights in Outliers. The author of The Tipping Point and Blink, Gladwell’s engaging writing is a delight. Here’s what I gained on this subject.

The concept of power distance is concerned with attitudes toward hierarchy, specifically with how much a particular culture (or group of professionals within that culture) value and respect authority. There are low-power distance index countries, like the United States, and high power index countries, like the Philippines. Here’s what we see in nursing: a nurse can be ignored or chastised if she challenges a physician from a male-dominated society where women are considered to be less than equal. On the other hand, a nurse from a society that puts physicians on a pedestal may be unable to challenge the decision making when needed.

How does this apply to patient safety and medical malpractice? And how can healthcare providers prevent those lost or ruined lives that result from medical disasters? How do we avert medical and nursing malpractice if those who speak up are ignored?

1. First, healthcare staff should be given the skills and the words to use to question authority. One of my job responsibilities in 1987 was to teach assertiveness skills to Filipino nurses. I recall the startled expressions on their faces when they realized they were expected to challenge physicians. This was not part of their training at the time. The healthcare culture must actively and visibly support the need to speak up. This is an incredibly threatening concept for those stuck in the high power distance mindset.

2. We can learn from the airline industry. Crew Resource Management concepts are being adopted by healthcare institutions. For example, according to Gladwell, many airlines teach a standardized procedure for copilots to challenge the pilot if he or she thinks something has gone terribly awry. They may say, “Captain, I’m concerned about…”then, “Captain, I’m uncomfortable with…” and if the captain still does not respond, “Captain, I believe the situation is unsafe.” And if that fails, the first officer is required to take over the airplane. Imagine nurses, residents, or others being taught how to telegraph their concerns in such a fashion. Nurses are taught to contact their nursing supervisor if a challenge to a physician is ignored.

3. I think there is another factor at work, which Gladwell refers to as “practical intelligence”. This includes things like knowing what to say to whom, knowing when to say it, and knowing how to say it for maximum effect. It is knowledge that enables you to read the situation correctly and get what you want. A person with high practical intelligence would know how to challenge another person’s actions or decision making in a way that would bring results. The nursing supervisor should embody these skills.

4. Keep in mind that healthcare medical disasters can happen just as quickly as a plane can plunge into the ocean. A bleeding vessel in the operating room, the incorrect administration of intravenous chemotherapy into spinal fluid, the fetus that shows signs of needing to be delivered right now- all constitute emergencies. The person with low power distance, communication skills and practical intelligence is in the best position to save patient lives.

5. Patient safety application:
The person who is a silent witness to the disaster, who is afraid to speak up and be a patient advocate, and the person who ignores those who question decision making may end up as part of the chain of a medical disaster.

6. Business application:
If you work within a law firm or legal nurse consulting firm, actively encourage your staff to speak up, to question, to point out problems. Listen to their concerns. You might be functioning with blinders on and not able to see an emerging situation. Thank those who are watching over your shoulder and serving as your safety net.

What are these?

Tags: challenging authority, crew resource management, medical negligence, Patient safety
Posted in Business skills, Communication skills, Medical malpractice, Patient safety | 1 Comment »

10 Tips for Managing Uncertainty by Guest Author Sharyn Mosca

Wednesday, July 8th, 2009

The times are daunting. It sometimes seems surreal that we slipped so far in our economic stature. Through the worry and uncertainty, here are some tips to keep you positive and sturdy.

1. You know this, but I am going to remind you that you know it…worry never helps anything. In fact, it usually blocks creative thinking and problem solving. There is an expression about worry: when you worry, you are paying interest in a debt you may not have. Place a card in front of your computer or other space where you spend most of your day. Write in large letters on the card:

I used to worry

It may take a while, but you will be smiling when you catch yourself choosing not to worry.

2. Fear is so very consuming. Write down the fearful thoughts you have and put a positive opposite next to it. Some examples:

I am afraid I will lose my job. If I lose my job, I will find another creative way to generate income

I lost money in the stock market, how can I make it up? I may or may not make it all up. I am lucky I am sitting here, healthy, and writing about it.

3. Blame often follows fear. Try reciting this phrase when you find yourself feeling sad and wanting to blame:

“Most people are well intended. Most people make the best decision they can at the time they are making them.”

4. Misery would like your company. The fear, blame and shame game needs players to play. The next time someone entices you to play fear, blame or shame; say; “I pass this time. My head needs positive and creative notions to get me through the tough times.”

5. Some have it worse than you. Make a habit of donating a few dollars to a local food bank, homeless shelter or other charity. Giving dollars now, even when money is tight, is a joyous thing. You will never feel better about giving than when you really can’t afford to.

6. Listen more to others. Offer encouragement. Be the wise person that you know you really are. Most people respond, heal and rejuvenate with surprisingly simple kindnesses. Make someone’s day.

7. Share your feelings. Don’t hold them back, but also share with integrity. Naming emotions like’ “I feel scared or tense” and adding a positive spin, “but I also have worked through fear before with success” helps you perpetuate strength in yourself and others.

8. Learn through this experience. Keep a journal. Record your thoughts, feelings, victories and losses large and small. Sometimes the economic situation can seem so harsh until we view it with hindsight. I have a friend who lost his job on Wall Street, lost all his savings and can’t sell his house to downsize. His aunt became really ill, and he is with her almost daily helping her recuperate. Your journal will tell you someday what this time really meant.

9. Learn some more. Notice how you have changed. Are some things now more important than before? Are your priorities different? Note it in your journal.

10. Lastly, know that I know you are a talented, caring, fun loving, genuine person. You indeed will persevere and come out ok.

What are these?

Tags: keeping perspective, worry
Posted in Business skills, Communication skills, Personal observations | 1 Comment »

On Being Trapped by Pat Iyer

Monday, June 22nd, 2009

On being trapped in a garden

We have four elevated gardens on our property. They are designed to keep the deer and rabbits out, but yesterday, one of them kept a bird in. This photo, taken in late July last year, shows that they are open at the top.

My husband and I were going for a walk when we saw a little bird trapped inside this garden. The bird was at the ground level and was trying to escape through the holes in the wire wall. The state of panic the bird was experiencing preventing him (or her) from looking up to see the open sky. How to rescue the bird? If we opened the garden door to go inside, it would terrorize the bird. Instead, we opened the door to the garden and moved to the wall opposite the door, hoping the bird would move away from us, see the open door, and escape. The bird shot out of the garden at about 80 miles per hour.

Sometimes we feel trapped like this bird. We are caught up in a business crisis, problem or maze. We are caught up in a troubled business or personal relationship. We feel like we are beating our heads against the wall. The frustration mounts, and the ability to problem solve drops.

What we learned from this: Stop- take a breath. There are always answers out there. If you are fortunate, someone bigger and wiser than you will open the door. But you can’t give up. There are solutions you have not considered, and people you should turn to for guidance. Someone will assist. Keep looking for the answers until the door opens up or you lift up your head and see the escape route.

What are these?

Tags: business problems, feeling trapped, problem solving
Posted in Business skills, Communication skills, Personal observations | 1 Comment »

Medical-Legal Topics

Archive for the ‘Communication skills’ Category

Managing the Stress of Change by Guest Author Sharyn Mosca

Using technology to make patient care safe by Pat Iyer

Watch Handshakes When Negotiating by Greg Williams

The Top Ten Tips for Utilizing Time More Efficiently by Guest author Natalie Gahrmann

Cultural Competence and Attorneys by Pat Iyer

How is the Economy affecting Jurors? by Pat Iyer

Does the Plaintiff Possess Health Literacy? by Pat Iyer

On Challenging an Authority by Pat Iyer

10 Tips for Managing Uncertainty by Guest Author Sharyn Mosca

On Being Trapped by Pat Iyer

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