We All Need to Slow Down

We All Need to Slow Down

Michael B. Grossman, DM, MSN, RN, NEA-BC, CNML 

Hummingbird Yesterday my daughter made a slow motion video of Lucy, her Rhodesian Ridgebacks puppy. I was  fascinated to discover that they don’t run like a horse, but more like rabbit; in terms of their back legs push off together. So I did a search on YouTube and apparently that’s where their energy comes from, which is also the way cheetahs and greyhounds run. Anyway, while viewing slow motion video’s I came across this one of hummingbirds, which I found interesting in terms of the concept of we need to slow down to appreciate our lives and work. When we’re always going at 100 miles an hour we miss a lot of life. If you can slow down for 2-minutes, check it out: Hummingbirds in Slow Motion

https://www.youtube.com/watch?x-yt-ts=1422411861&x-yt cl=84924572&v=Fouo6GKGBIM

What Happens When We are Constantly in High Speed 

            There are 1,440 minutes in a day. It doesn’t seem like taking 2 minutes to watch a video is that much time, when you put it that way. Likewise there are 168 hours in a week. Seems like a lot of hours, eh? But, when you start to break it down in terms of all the stuff we have to do, those 168 hours go pretty quickly. There are 720 minutes in a 12-hour shift, yet 60% of nurses are too busy to take a 15-minute break. They are willing to risk their license and own health by working fatigued, because they are too busy to take a 15-minute break. As an ethics professor I discuss the evidence based literature around 12-hour shifts and fatigue and what I have discovered is that most nurses are just not aware of the literature, because they’re too busy to slow down and read it. A colleague of mine told me recently, you know Grossman you’re the only one talking about 12-hour shifts. Nobody else sees it as a problem. See that to me is the problem. When we’re going at 100 miles per hour because we’re late for work, we don’t have the time to look over at the gas gauge and see that it’s almost on empty! Have you ever done that and then ended up stranded on the road and take an hour or two to get help…

The Impact of High Speed Change

White Water Rafting Peter Vaill (1996) is generally credited with introducing the concept of white water change in organizations. Vaill’s concept was that change in organizations has become like white water rafting, where we’re not even done with one change when another one gets piled on, like traveling through the rapids. Eventually, as Kurt Lewin (1997) suggested organisms can’t take anymore change and just shut down. Lewin called this re-freezing. My daughter’s puppy does this when we play fetch. After she chases her ball 15-20 times, she just shuts down and can’t do anymore. Even if I try to reward her with a treat, she’s just frozen and lays down on the sofa exhausted. Many nurses say they don’t get tired working 12-hour shifts. They say the work fuels their adrenalin and they actually become more energized, as long as they keep moving. But where is the point where they collapse? Is it 14 hours? 20 hours? Is it doing five 12’s in a row? The body, physically and emotionally cannot go on endlessly. Eventually it refreezes.

William Bridges (2004) another noted authority built his change model on the theories about grieving. When people are grieving loss they go through several overlapping phases of denial, anger, bargaining, depression, and finally acceptance (Kubler-Ross & Byock, 2014). Often a funeral serves as the time to slow down and incorporate what has just happened. The funeral often provides the time for reflection and symbolic closure of that chapter in our lives. Think of how often you leave a funeral making the promise to be a better person, spend more time with your family, and tell people how much you appreciate them. But, how quickly do we get back to our extensive to do list?

When organizations go through change they follow these same patterns. Most organizations are changing so quickly today there is no time to pause and reflect on what’s happening, let alone to review the evidence based literature on any particular topic. Like my daughters exhausted puppy most of us are so exhausted we can’t listen to one more speech about how this new program is going to revolutionize healthcare. However, Bridges message is that endings are more important than beginnings. Someone who just lost a loved one is not ready to appreciate the virtues of their death. Their focus is on how they’re going to live without their loved one. Likewise when the Joint Commission (2011) sent out a sentinel alert about the dangers of fatigue related to 12-hour shifts, the typical nurse couldn’t even listen because all she can think about is Oh no, they’re going to take away my 12-hour shifts. How will it fit everything into my workweek? How will I find a babysitter if I have to go back to working 5 days a week? What about my second job, and school? They are too busy to slow down long enough to hear the warning that 12-hour shifts don’t need to go away, nurses just need to take their breaks and the risk of fatigue disappears (Smith-Coggins, et al, 2006).

Pausing Long Enough to Listen 

            Years ago a friend of mine was going through a career crisis and could not decide what to do next. It was in the summer and he realized not many organizations were hiring anyway. So he decided to just take 3 weeks off to reflect. By reflect he meant not doing anything concrete, so he could actually reflect. Ken Blanchard (1988) told and interesting story about a guy he had take a train from California to Chicago to meet with him to discuss a major decision. He told the man to book a berth on a train and not read or speak to anybody for the 3 day journey. Just reflect on the topic. Basically he encouraged him to slow down. Einstein suggested that his greatest discoveries did not come from working endlessly in the lab long into the night. Instead he said his best ideas often came from putting down the research, taking a break, and then the ah ha insight would happen in the shower or out in his garden. Jim Loehr (2004), psychologist for the US Olympic team teaches athletes that the secret to peak performance is not managing your time as much as managing your energy by working in 90 minute blocks of time, followed by strategic breaks to rest, meditate, do yoga, or just pause to reflect. It makes sense when you think about it.

Don’t Wait Till It’s Too Late

             I once had a nurse give a patient the wrong unit of blood. She was in a hurry and violated the hospital policy by picking up two units of blood, for two different patients at the same time. She was trying to save time! Another nurse asked a charge nurse if she was reading an order correctly. The charge nurse was too busy to slow down and listen to what she was saying. That patient died. Mary was rear ended at a traffic light by one of her co-workers on the way home after working a 12-hour shift, that had morphed into a 14-hour shift. Her co-worker fell asleep at the wheel. A plane crashed in France a couple of years ago because both the pilot and co-pilot had fallen asleep and the autopilot computer landed the plane, but someone still had to put on the breaks. So the plane coasted off the runway. People died. I can go on and on with stories, but the bottom line is this:

The most valuable result of all education is to make you do the things

you have to do, when it ought to be done, whether you like it or not.

It is the first lesson that ought to be learned. And however early a

man’s training begins, it is probably the last lesson that he learns

thoroughly (Thomas Huxley, 2001).

Why must we experience tragedy pause, reflect, and develop our personal meaning and approach to life? Try something today. It will take you just 30 minutes. Go to a co-worker at the beginning of your shift and offer to relieve them for a 30-minute break in the middle of your shift. Agree to take their patients. Then ask if they will do the same thing for you. Don’t take your break with anyone. Just push yourself to do some quiet reflection. I worked at a hospital in California last year that had a beautiful contemplation garden. You may not have that, but perhaps you can put some quiet music on your phone and listen to that for 30 minutes, in a quiet spot with earphones. Give it a try, don’t try and make a value judgment. Just take 30 minutes out of the 10,080 minutes you have this week. Think about slowing down the hummingbird in your mind and see what you come up with. Afterwards, you might even end up telling someone how much you appreciate them.

For further information go to: http://www.nurseleadershipbuilders.com/Dr. Michael Grossman, DM, MSN, RN, NEA-BC, CNML has over 35 years of nursing leadership experience and is a nursing leader, consultant, academician, and career coach. As a professor in the graduate schools of nursing at both University of Phoenix and Walden University, he specializes in healthcare ethics, leadership development, career coaching, mentoring, teambuilding, motivation, change, communications, and dealing with “difficult” people. He also teaches nursing leadership certification review courses and time management for busy clinicians. He can also be reached at 610-331-8470 or Mike@NurseLeadershipBuilders.com

References

Blanchard, K., & Peale, N. V. (1988). The Power of Ethical Management. New York:

William Morrow and Company.

Bridges, W. (2004). Transitions: Making Sense of Life’s Changes, Revised 25th Anniversary Edition. Cambridge, MA: Da Capo Press.

Huxley, T. H. (2001). Collected Essays of Thomas H. Huxley. Bristol, UK: Thoemmes.

The Joint Commission. (2011). Health Care Worker Fatigue and Patient Safety. The Joint Commission Sentinel Event Alert(48), 1-4.

Kubler-Ross, E., & Byock, I. (2014). On Death and Dying: What the Dying Have to

Teach Doctors, Nurses, Clergy and Their Own Families. New York: Scribner Publishing.

Lewin, K. (1997). Resolving Social Conflicts: And, Field Theory in Social Science.

Washington, DC: American Psychological Association.

Loehr, J., & Schwartz, T. (2004). The Power of Full Engagement: Managing Energy, Not

Time, Is the Key to High Performance and Personal Renewal New York: Free Press.

Smith-Coggins, R., Howard, S. K., Mac, D. T., Wang, C., Kwan, S., Rosekind, M. R., . . .

Gaba, D. M. (2006). Improving Alertness and Performance in Emergency Department Physicians and Nurses: The Use of Planned Naps. Annals of Emergency Medicine, 48(5), 595-604.

Vaill, P. B. (1996). Learning as a way of being: Strategies for survival in a world of

permanent white water. San Francisco, CA: Jossey-Bass.

 

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Nursing is the Most Trusted Profession and We’re Talking About 12-Hour Shifts?

Nursing is the Most Trusted Profession and We’re Talking About 12-Hour Shifts?

Michael B. Grossman, DM, MSN, RN, NEA-BC, CNML

Tired Nurse   In 2001 Alan Iverson, a player for the Philadelphia 76er’s basketball team gave an infamous speech after his coach disciplined him for not showing up at practice (http://genius.com/Allen-iverson-practice-press-conference-annotated). Iverson’s argument was that he should be judged on what he does on the playing court, not practice. Iverson said he didn’t agree with the coach that as the team leader he had a responsibility to be a role model to the other players, including attending practice. Iverson suggested that as long as he performed at his best during the game that is all that matters. It reminds me of a classic nursing argument: Suzie’s a good nurse, she just doesn’t get along with people.

Every time I hear nurse’s argue about how 12-hour shifts are an acceptable practice, I think of Iverson’s argument. But, before we continue take a moment to think of your own reaction to this topic? Are you defensive? Are you concerned about what you would do if 12-hour shifts went away? Are you thinking you would leave nursing if you couldn’t work 12-hour shifts. So, before you stop reading just take a few minutes to hear my arguments, as I am not suggesting 12-hour shifts go away. There is another solution, which we will discuss later.

There has been extensive research on the perils of 12-hour shifts without breaks since it was first identified as a factor in 90,000 estimated patient deaths per year due to medical errors (Institute of Medicine, 2000). Today, it is estimated that 400,000 deaths occur per year in healthcare due to preventable errors (James, September 2013). Those are staggering numbers! When nurses and physicians were administered a driving test at the end of a 12-hour shift without breaks their cognitive ability was equivalent to someone who was clinically drunk (Smith-Coggins, et al, 2006). The State of Washington took this issue so seriously they appointed a commission to look at nurse schedules and fatigue (Ellis, 2008). The Joint Commission has formally addressed the dangers of 12-hour shifts twice, once suggesting it was a factor undermining a culture of safety (Joint Commission, 2008) and then again in specifically addressing the issue of health worker fatigue and calling for every hospital to have a plan of correction (Joint Commission, 2011).

The Nursing Reaction to 12-Hour Shifts

        I teach health care ethics at the graduate school level and have discussed the ethics of 12-hour shifts over the past 60 semesters I have taught. The topic raises a lot of emotional reaction and invariable several students give Iverson-like reactions in which they essentially argue that: We’re talking about 12-hour shifts, not taking care of patients, not all the unethical things going on in health care, we’re talking about 12-hour shifts. I go out there and die for my patients. I work 12, 13, 14 hours and never leave my patients side. I work five or six 12-hour shifts in a row and go to school full-time, and am raising 3 kids. I don’t take lunch break, I don’t go to the bathroom, I work overtime and never leave my patient’s side. But, you don’t talk about that. No, you want to talk about 12-hour shifts causing fatigue. What about the fact that nursing was just rated the most trusted profession by patients? What about that fact that I’m taking care of my patient? What about the fact that I care enough to never leave my patients side no matter how tired I am? But we’re not talking about that. We’re talking about 12-hour shifts. Not my nursing care, not my dedication, not that we don’t have enough nurses. We’re talking about 12-hour shifts, how silly is that?

What’s the Real Issue?

            There clearly are advantages to 12-hour shifts. Most nurses prefer them. Most nurses believe it provides them with a more balanced life and the ability to get a second job, go to school, raise children, or just have an extra 4 days off ever week. But the ethical question is whether 12-hour shifts, without breaks are safe for patients? No matter how much nurses like 12-hour shifts we cannot ignore the safety concerns?

If you were on the witness stand following a serious patient error that occurred in the 11th hour of a 12-hour shift, could you prove you were not fatigued? More important would the jury believe the argument that you prefer 12-hour shifts and didn’t believe you were tired that night? What if the prosecuting attorney presented research evidence that nurse who don’t take breaks on 12-hour shifts are equivalent to being clinically drunk (Smith-Coggins, 2006). What if the prosecuting attorney asked how your organization addressed the Joint Commission Sentinel Alerts around nurse fatigue (2008, 2011)? What if you said, well my adrenalin kicks in when I’m tired and the prosecuting attorney brought in a physiologist who said adrenalin sends blood to your limbs and away from your brain so critical thinking is impaired when adrenalin kicks in. Meanings when your adrenalin kicks in you are even more likely to cause a patient error.

What Happens When We Take the Time to Listen?

Ironically, in recent years Allen Iverson admitted his tirade about practice was an emotional, defensive reaction to his feeling criticized in public. Is that why nurses react to the question of fatigue and 12-hour shifts? Research has suggested that when people do not totally understand a topic they are not really capable of addressing the topic (Ehrlinger, Johnson, Banner, Dunning, & Kruger, 2008). In the 1970’s nurses defended smoking cigarettes right at the nurses station, because the research on second hand smoke was still too new and not fully accepted. Kuhn (1996) suggested all change is resisted the more closely people are tied to the history. From a change standpoint resistance to transitions is rarely about the virtues of the new innovation, but about what people are giving up (Bridges, 2004). Rogers (2004) suggested that only 15% of people are early adopters of any new innovation. Think of the adoption of electronic books. Ten years ago all you heard was but I like the look and feel of a book. Rogers suggested 34% of people are late adopters and need to watch others adopt the innovation before they test the water. This week my mother in law bought my wife a Kindle. I find it significant that an 85-year-old woman took years to accept the Kindle technology, then discovered the convenience and passed it along to her younger daughter. Finally 16% of people are laggards, according to Rogers. They will never adapt to change and are still talking about the convenience of paper charts. But that’s a topic for another time. So is there a solution to 12-hour shifts?

A Simple Solution

            Thomas Huxley (2001) suggested that the most valuable result of all education is to make you do the things you have to do, when it ought to be done, whether you like it or not. It is the first lesson that ought to be learned. And however early a man’s training begins, it is probably the last lesson that he learns thoroughly. Perhaps that explains why we learn by failing and must experience things to develop our personal meaning and ethical approaches to life. But does another patient need to get hurt for us to realize we need to do something about 12-hour shifts and nurse fatigue?

            One of the problems with any change is that change is more about loss than it is the transition. Indeed the issue around electronic books was the loss of that multi-sensory experience of sitting on the sofa and turning the pages of a good book that you could see, and feel, and smell. Nothing like the smell of a new book or a newspaper fresh off the presses with a good cup of coffee at the kitchen table. Covey (2013) suggested that communication does not take place as long as you are trying to push your view on the other person. Highly effective people first build trust and then seek first to understand the other person’s viewpoint. So here’s my viewpoint: 12-hour shifts do not need to go away. Smith-Coggins, et al (2006) found that when nurses and physician’s took an adequate break during their 12-hour shift they were as alert as when they arrived at work 12-hours earlier. There was no impairment of cognitive ability if they took an adequate break. So, can we change this discussion from doing away with 12-hour shifts to how can we make sure nurses get adequate breaks so they are not fatigued? Let’s change the topic of the conversation, then have an effective conversation about how to come up with a win-win solution so nurses get adequate breaks and 12-hour shifts don’t need to go away.

Dr. Michael Grossman, DM, MSN, RN, NEA-BC, CNML has over 35 years of nursing leadership experience and is a nursing leader, consultant, academician, and career coach. As a professor in the graduate schools of nursing at both University of Phoenix and Walden University, he specializes in healthcare ethics, leadership development, career coaching, mentoring, teambuilding, motivation, change, communications, and dealing with “difficult” people. He also teaches nursing leadership certification review courses.

For further information go to: http://www.nurseleadershipbuilders.com/

He can also be reached at 610-331-8470 or Mike@NurseLeadershipBuilders.com

Reference

Bridges, W. (2004). Transitions: Making Sense of Life’s Changes, Revised 25th Anniversary Edition. Cambridge, MA: Da  Capo Press.

Covey, S. R. (2013). The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change. New York: Simon & Schuster.

Ehrlinger, J., Johnson, K., Banner, M., Dunning, D., & Kruger, J. (2008). Why the

Unskilled Are Unaware: Further Explorations of (Absent) Self-Insight Among the Incompetent. Organizational Behavior and Human Decision Processes, 105(1), 98-121.

Ellis, J. R. (2008). Quality of Care, Nurses’ Work Schedules, and Fatigue: A White

Paper. Seattle: Washington State Nurses Association.

Geiger-Brown, J., & Trinkoff, M. (2010). Is it time to pull the plug on 12-hour tours:

Part 1 The evidence. Journal of Nursing Administration, 40(3), 100-102.

Huxley, T. H. (2001). Collected Essays of Thomas H. Huxley. Bristol, UK: Thoemmes.

Institute of Medicine. (2000). To Err Is Human: Building a Safer Health System.

Washington, DC: National Academies Press.

James, J. T. (September 2013). A New, Evidence-based Estimate of Patient Harms

Associated with Hospital Care Journal of Patient Safety, 9(3), 122-128.

Joint Commission. (2011). Health Care Worker Fatigue and Patient Safety. The Joint

Commission Sentinel Event Alert(48), 1-4.

Joint Commission. (2008). Behaviors That Undermine a Culture of Safety. Sentinel Event Alert(40).

Kuhn, T. S. (1996). The Structure of Scientific Revolution. Chicago: University of Chicago Press.

Rogers, E. M. (2004). A Prospective and Retrospective Look at the Diffusion Model. Journal of Health Communication, 9(1), 13-19.

Smith-Coggins, R., Howard, S. K., Mac, D. T., Wang, C., Kwan, S., Rosekind, M. R., . . . Gaba, D. M. (2006). Improving Alertness and Performance in Emergency Department Physicians and Nurses: The Use of Planned Naps. Annals of Emergency Medicine, 48(5), 595-604.

 

 

 

Everything I Know About Developing People I Learned From My Puppy

Everything I Know About Developing People I Learned From My Puppy

Michael B. Grossman, DM, MSN, RN, NEA-BC, CNML

                                                                  Dogs are known as man’s best friend. This year, nurses were once again voted the most honest, ethical, and respected Lucy Monkey V2 (Riffkin, 2014). A misbehaved dog can impact people’s impression of dogs, just as nursing’s respect can quickly be erroded if people lose trust in nurses to be completely focused on the patient’s safety and well-being. Lucy is my daughter’s puppy, an adorable Rhodesian Ridgeback. They are also known as the Lion Dog as they were bred for hunting lions in Africa. They are a combination of a loving cuddly family coach potato dog, with an incredibly defiant attitude toward certain things they feel strongly about. Basically they won’t back down on certain issues, including a lion! In many ways Lucy reminds me of some of the more strident employees I have worked with: strong in their beliefs on certain topics, but incredible loyal, engaged, and great team players if they are treated with respect.

Studies have shown that 100,000-400,000 preventable medical errors occur every year in the U.S. (Institute of Medicine, 2000; James, September 2013). Unfortunately, people often do not know what they don’t know. Nurses and physicians have resisted make the changes needed to improve patient safety (Ehrlinger, Johnson, Banner, Dunning, & Kruger, 2008). A puppy doesn’t know what it doesn’t know and can’t learn on its own. Puppies need guidance from their owners to learn the acceptable behaviors to live in society. The following article is about the 10 most important rules I have learned from training a puppy; that can be incorporated in employee development.

  1. Consistency-Everyone needs consistency. Nobody likes a boss who changes the rules. People and puppies perform their best when there are clear goals, rules, and rewards for the expected behaviors.
  2. Praise is Good-Ken Blanchard (1999) suggested your goal as a leader should be to catch people doing things right. Rath (2007) found that people perform best when their work is based on what they are strongest at doing. Lucy is a hunting dog, a hound. It’s what she loves to do. She loves to find things. Why not encourage that?
  3. Sometimes You Need Discipline- You can’t totally focus on rewards. Sometimes Lucy has to be told not to climb up on the kitchen counters. Likewise employees need rewards, but also need to know the clear boundaries of what is acceptable behavior. Sometimes the boss needs to point out which behaviors are unacceptable. Mission Statements, Visions, Goals, and Rules of Conduct excellent for making expectations clear, and reinforcing the acceptable behaviors.
  4. It Needs to Be Clear Who the Leader is-Dogs are pack animals and there is a clear pecking order as to who the pack leader is. Pure democracies are not effective because someone needs to make the final decision, especially at critical times in any organization. There are times for urgent decisions and in an emergency someone needs to be in charge and make quick decisions, not put it to a vote for everyone’s input. A puppy needs the pack leader to tell it not to run out into the street and when it’s time to go potty!
  5. Freedom With a Short Leash Till You Know the Rules-Situational Leadership is based on the concept that people need high direction when they are in a new situation they have never experienced before (Blanchard & Zigarmi (1999). A nurse orienting to a new field needs clear direction on how things are done, not asked to figure it out by trial and error. Puppies need clear direction and boundaries of acceptable behavior until they understand the rules to being a socially acceptable dog. They can’t figure this out on their own.
  6. Defiance is Unacceptable at all Times-Respect for authority is essential to living in society and having effective work teams. But, leaders also have responsibility to provide clear expectations, an opportunity for employees to do their best, provide recognition, listen to their opinion, and encourage their development (Buckingham, & Coffman, 1999).
  7. Getting Along With Others Means More Play Time-Puppies need to learn that good behaviors are rewarded with more play time. Teamwork (or the lack of it) has been show to have a direct relationship to patient mortality. Basically if a team does not get along well, patients are more likely to die (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002). Effective teams work and play together well. Puppies need to know how to socialize with other dogs. It can be the key to survival in certain situations.
  8. Intermittent Reinforcement is More Effective Than Constant Rewards-Your puppy doesn’t need a treat every time they perform. In fact according to behavioral psychologists, intermittent reinforcement is more effective than constant rewards as the subject never knows when the reward is coming. Leaders need a proper balance between rewarding every behavior and providing feedback and rewards at key moments in time.
  9. You Can’t Be Constantly Working: Breaks Are Important to Effectiveness-Puppies never want to take a nap; they’re afraid they’ll miss something. But when puppies get tired, they become irritable, tend to nip, bite, and become uncooperative. Puppies also need to learn to take breaks to potty or they have accidents in the house. Fatigued nurses are more likely to make mistakes (The Joint Commission, 2011). Nurses are especially prone to trying to do everything themselves and studies have shown that as much as 60% of nurses do not take breaks and are under the impression that it is best to be with the patient at all times (Ellis, 2008). There is increasing concern about compassion fatigue of nurses who work in stressful situations for long periods of time (Hooper, Craig, Janvrin, Wetsel, & Reimels, September 2010).
  10. There is No Prouder Moment Than Being Complimented-Everyone loves positive feedback be they a human being or a puppy. People are more engaged when they work for a winning organization, with co-workers who are committed to quality, and receive praise frequently for good behavior (Buckingham, & Coffman, 1999). Nobody wants to go to a dinner party and hear horrible stories about their place of employment, just as nobody wants to be worried about people visiting their home for fear of an unmanageable dog.

Summary

 We have an epidemic of patient errors in this country and something needs to be done to correct the situation before the respect of nursing and the entire medical profession is further eroded. Some basic principles of training have been presented with suggestions to applying them to improve employee engagement, teamwork, and patient outcomes.

 References

Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002).

Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA, 288(16), 1987-1994.

Blanchard, K., & Zigarmi, P. (1999). Leadership and the One Minute Manager:

Increasing Effectiveness Through Situational Leadership. New York: William Morrow.

Buckingham, M., & Coffman, C. (1999). First, Break All the Rules: What the World’s

Greatest Managers Do Differently. New York, New York: Simon & Schuster.

Ehrlinger, J., Johnson, K., Banner, M., Dunning, D., & Kruger, J. (2008). Why the

Unskilled Are Unaware: Further Explorations of (Absent) Self-Insight Among the Incompetent. Organizational Behavior and Human Decision Processes, 105(1), 98-121.

Ellis, J. R. (2008). Quality of Care, Nurses’ Work Schedules, and Fatigue: A White

Paper. Seattle: Washington State Nurses Association.

Hooper, C., Craig, J., Janvrin, D. R., Wetsel, M. A., & Reimels, E. (September 2010).

Compassion Satisfaction, Burnout, and Compassion Fatigue Among Emergency Nurses Compared With Nurses in Other Selected Inpatient Specialties. Journal of Emergency Nursing, 36(5), 420-427.

Institute of Medicine. (2000). To Err Is Human: Building a Safer Health System.

Washington, DC: National Academies Press.

James, J. T. (September 2013). A New, Evidence-based Estimate of Patient Harms

Associated with Hospital Care Journal of Patient Safety, 9(3), 122-128. doi: 10.1097/PTS.0b013e3182948a69

The Joint Commission. (2011). Health Care Worker Fatigue and Patient Safety. The Joint Commission Sentinel Event Alert(48), 1-4.

Rath, T. (2007). Strengths Finder 2.0. New York: Gallup Press.

Riffkin, R. (2014). Americans Rate Nurses Highest on Honesty, Ethical Standards.

from http://www.gallup.com/poll/180260/americans-rate-nurses-highest-honesty-ethical-standards.aspx

Dr. Michael Grossman, DM, MSN, RN, NEA-BC, CNML has over 35 years of nursing leadership experience and is a nursing leader, consultant, academician, and career coach. As a professor in the graduate schools of nursing at both University of Phoenix and Walden University, he specializes in healthcare ethics, leadership development, career coaching, mentoring, teambuilding, motivation, change, communications, and dealing with “difficult” people. He also teaches nursing leadership certification review courses. For further information go to: http://www.nurseleadershipbuilders.com/ He can also be reached at 610-331-8470 or Mike@NurseLeadershipBuilders.com

Feel Like You’re Not Appreciated at Work?

I Did All the Work: Why Did They Attack Me?: Scapegoat Theory in the Workplace

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The purpose of this book is to identify the dynamics of scapegoat theory, a form of lateral violence. This book is purposefully less than 150 pages. The intention is for you to get an overview of the best body of knowledge about scapegoating, to identify your strengths, and areas you would like to learn more about. You will find a list of references at the end of the book, which will help you on your journey to being more effective in avoiding being scapegoated.

Click to Purchase

We Won: But Does it Matter How We Won?

We Won: But Does it Matter How We Won?

Michael B. Grossman, DM, MSN, RN, NEA-BC, CNML

Referee & Cowboy     This week an important NFL playoff game was impacted by a referee’s mistake. As typically       happens in a situation like this the winning teams fans said, who cares we won, and the losing teams fans questioned the credibility of the sport. The former Commissioner of the NBA, Howard Stern said that he was concerned about controversy in basketball, whether it was real or not as it impacted on the overall integrity of the sport. One of the great questions asked this week was how will this weeks winning team feel if their team loses next week due to a similar referee mistake? Which brings us to the issue of credibility and integrity in all parts of society today. We have a challenge in the work place and as a nation in terms of the morals, norms, and rules we adhere to. Is anything acceptable as long as you win? In the following article we will look at the long-term implications of who cares how we won.

In the End it All Comes Down to Credibility & Integrity

As an ethics professor I have my classes explore the concepts of credibility and integrity through reviewing cases in their workplace and society at large. Deontology is an ethical process for decision-making built on moral rules and unchanging principles. The foundation of deontology is a concern for right and wrong, survival of the species, and social cooperation. From an ethical standpoint, humans should always be treated with respect and integrity and not just a means to achieve something. Human life should always have value. We should always tell the truth, and the foundation of an ethical society is to first do no harm (Morrison, 2011). Some of the contemporary issues in our society, beyond sports speak to these larger ethical issues:

  • Is it acceptable to torture our enemies in the interest of national security?
  • Is it acceptable for our enemies to use children as human shields and bombs in order to win their war?
  • Should the police be above criticism if they are trying to protect themselves from harm?
  • Do people have the right to protest if they feel they have been treated unjustly?
  • Should businesses follow ethical standards or is anything permissible as long is the business makes a profit?

What is the Next Generation Learning From What They See?

The founding fathers of the United States where primarily Mason’s, a secret fraternity grounded in the belief in a higher power and committed to creating a nation based on freedom of speech, equality of people, and separation of church from government, so people of any religion would be free to practice their beliefs. The founding father’s believed that it mattered how we conducted ourselves, and it was important to teach our children ethical principles. Cohen (2008) suggested that what you accept is what you teach the next generation, your employees, and society in general. There have been many challenges and changes to the constitution, but through it all, the resounding theme has been the way we win does matter. In 1864 a group of nations met in Geneva, Switzerland and established a set of humane rules to govern conduct during all future wars. We need rules, laws, and principles to guide our conduct as human beings even in wars, if we truly believe that the way we win matters. There were many questions asked after the stock market crash in 2007? Why weren’t their better laws in place to protect us from this? What are the boundaries of ethical business behavior? How do we protect the average citizen from personal harm?

Ethics in the Workplace

Nursing was again voted the number one profession in terms of ethical standards. Members of Congress came in last at only 7% credibility (Rifkin, 2014). This is a tribute to nursing, and a sad commentary on our government leaders. Yet few people are aware that the third leading cause of death in the United States is preventable medical errors, estimated to be as much as 400,000 patient deaths per year (James, 2013; Institute of Medicine, 2000). Yet even fewer people are aware of nursing’s role in patient errors. The majority of nurses work 12-hour shifts and do not take adequate breaks. Despite numerous studies and recommendations from the American Nurses Association and The Joint Commission to fix this problem, nurses continue to resist addressing the issue of worker fatigue and the resulting patient safety issues (Geiger-Brown, & Trinkoff, 2010). What are the ethical implications of this behavior and how will it affect the credibility of nursing when this information becomes public knowledge like it did with bankers and our government leaders? Most conflicts of interest are around perception of wrongdoing, more so than actual wrongdoing. It is important that we consider our behavior and how it looks to outsiders.

What are we Teaching the Next Generation? 

Today we have massive problems with cheating, bullying, and unfair competition in our schools, organized sports, and on the playground. Parents often ask, where are our children learning these behaviors? Nurses accuse the younger generation of being selfish and not team players. Yet, they are learning it from us and the comments we make when a team wins a game in an unfair way or nurses sacrifice patient safety for their own convenient schedule. Children learn when they see their parents cheat or use influence to get their children into the right school, or playing on the best team. Children learn from what they see on television, in books, and movies when cheaters do get ahead in life and when how we win is less important than winning. It is time for us to honestly and objectively look at our behavior and ask ourselves what we are teaching our children, and the next generation of nurses. How would you answer the question if a patient asked: Am I safe here? What are you doing personally to reduce patient errors?

References

Cohen, M. H. (2008). What You Accept is What You Teach. Minneapolis, MN: Creative Health Care Management.

Geiger-Brown, J., & Trinkoff, M. (2010). Is it time to pull the plug on 12-hour tours: Part 1. The evidence. Journal of Nursing Administration, 40(3), 100-102.

Institute of Medicine. (2000). To Err Is Human: Building a Safer Health System. Washington, DC: National Academies Press.

James, J. T. (September 2013). A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care Journal of Patient Safety, 9(3), 122-128. doi: 10.1097/PTS.0b013e3182948a69

Morrison, E. E. (2011). Ethics in health administration: A practical approach for decision makers (2nd ed.). Sudbury, MA: Jones and Bartlett Publishers.

Riffkin, R. (2014). Americans Rate Nurses Highest on Honesty, Ethical Standards. from http://www.gallup.com/poll/180260/americans-rate-nurses-highest-honesty-ethical-standards.aspx

Dr. Michael Grossman, DM, MSN, RN, NEA-BC, CNML has over 35 years of nursing leadership experience and is a nursing leader, consultant, academician, and career coach. As a professor in the graduate schools of nursing at both University of Phoenix and Walden University, he specializes in healthcare ethics, leadership development, career coaching, mentoring, teambuilding, motivation, change, communications, and dealing with “difficult” people. He also teaches nursing leadership certification review courses. For further information go to: http://www.nurseleadershipbuilders.com/ He can also be reached at 610-331-8470 or Mike@NurseLeadershipBuilders.com

Looking for Some Career Advice?

What’s Next? Create Your Dream Job With a Plan B

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What’s Next? Create Your Dream Job With a Plan B is a great way to take a fresh look at your career. The ten chapters unlock the key factors to creating your dream job. This book is direct, yet comprehensive enough to cover all the essential elements to finding a new job or passion in your current work. You can read the book in less than 2 hours and spend as much time as you like working on the exercises to figure out What’s Next for you.

Click to Purchase

Passion: Finding What Energizes Your Career

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Do you ever look at a successful person and wonder, “why can’t I find a job like that and be successful?” Every one of us is capable of living out our dreams. This book will help you map out your dreams in a step-by-step approach and to successfully achieve your goals to find passion in your work. Passion can be just finding a different way of approaching your current work, so that it is more meaningful. It all begins with finding something you are passionate about. When you look at successful people in any walk of life be it business, the arts, sports, or health care, the one consistent characteristic is that successful people love what they do. They wake up in the morning and cannot wait to get to work and jump into the day’s activities. You can achieve your dreams too, but in order to achieve them you must map out a plan.

Click to Purchase

Thinking About Getting a Doctorate: How to Choose a Program

Choosing a Doctoral Program
Michael B. Grossman, DM, MSN, RN, NEA-BC

     I am often asked for advice on what doctoral program to enroll in. There are so many choices today for doctoral education it is almost like buying a car. Somehow you need to narrow your focus: do you want a sports car, a family vehicle, something that is economical, or something luxurious? Sometimes it is easier to catch people early in their educational journey when they have already explored the question of what they want in a doctoral program. But, if that’s not your situation, now is as good a time as ever to begin the journey. As they say, Today is the first day of the rest of your life. So, let’s begin looking at what’s next for you. A variety of authors have suggested that it is useful to have friends in your career journey that provide support, guidance, feedback, and hold you accountable to the goals you are setting (Ferrazzi, 2009, Ibarra, 2003, Rath, 2006). I follow a similar process for choosing a doctoral program to the approach I recommend for finding a new job in my two earlier books (Grossman, 2011a, 2011b).

Figuring Out Which Doctoral Program is Right for You

     People often need to do a little career planning before choosing a doctoral program, as a lot depends on what you want to do career wise with a doctorate. Once you figure what is next for you (Grossman, 2011a) and what you are passionate about (Grossman, 2011b), it will become clearer what path you want to take in terms of doctoral education. One question you need to decide is if you want to take a traditional approach or the road less traveled. Early in my education I was a psychology major and the graduate school I was looking to attend preferred people without an undergraduate degree in psychology. You read that correctly, they did NOT want you to have an undergraduate degree in psychology. They said they wanted people with varied backgrounds who brought that perspective to the field. Some of my favorite nursing professors had doctorates from outside of nursing, which I thought made them very interesting and contributed new ideas to the field of nursing. Of course you need to be comfortable with doing that. I don’t mind when people snub their nose at me because my doctorate is not in nursing. I think I bring a lot of valuable insights to the field I love; nursing.

Hermenia Ibarra, PhD (2003) did some interesting research about organizational dynamics and individual role transitions. Broe (2012) replicated her research showing how leaders transition to different careers. Both of their research is very interesting in that they debunk some of the conventional wisdom in leadership practice. Ibarra and Broe based their work on the results of qualitative studies of over 30 people who made career moves and the formula, which is somewhat counter intuitive to conventional thinking. Their suggestions are very much in line with my own experience in coaching people to make career transitions. Briefly Ibarra’s theory (with Grossman comments in italics) is:

  1. Take action; don’t just think about what’s next. (Actually this is the foundation of cognitive therapy: push the patient to take  action, rather than rehash why they think their mother didn’t love them when they were four years old. So you need to talk to people with doctorates and interview at some doctoral programs).
  2. Try different things in protected environments (e.g. With a career move I recommend people try development programs, action learning, pipelines to working in other areas, short term assignments to different units, projects, task forces, shared governance committee work. It is possible to try out a doctoral program. You can usually take a course or two at the university before enrolling in the program).
  3. Don’t try to look for one thing, that is the essence of you. Instead find a bunch of ideas and test them (e.g. Grossman always says, “create a vague vision and then test out jobs or assignment that have those attributes rather than find THE perfect job.” This same principle applies to doctoral programs. There may not be one perfect program, but one that provides the flexibility to achieve your dreams. I had an interest in organizational dynamics, leadership, and the challenges of working with emotionally difficult people. I was able to achieve all those objectives with my doctoral program).
  4. Build in a transition period (e.g. William Bridges, 2004 Neutral Zone concept), rather than jumping right into a new position. So try some things like part-time jobs or temporary assignments (e.g. again, see if you can take a couple of courses before formally enrolling in the program. Even if you do enroll in a program, and find you don’t like it, you can switch to a different program).
  5. Shift your network-Don’t focus on the tasks of the new job, but on people who do the kind of work you’re thinking about. Ibarrah says to never, ever expect your boss or the workplace to be invested in your transition! (This is complicated by the old saying, “You can’t be a prophet in your own land.” It is very difficult to make a school decision based on input from the people in your own environment. The people in your own environment may be worried that going back to school means you are going to eventually leave or get promoted. They may give you biased suggestions like, “Why do you need more education?” Find some people with doctorates from outside your environment and seek their advice and support).
  6. Don’t look for a BIG BANG to hit you over the head…ideally the transition is slow, with mini-steps and psychological transitions occurring every day! (What’s nice is if you have worked on a Plan B, you can refer back to it when you are having a bad day and feeling discouraged with your current work).
  7. Take time to step back and reflect. But, keep the breaks just long enough to reflect, put it all in perspective, and get right back to changing (Here’s where a coach can be useful in reminding you of your goals and keeping you on track).

Ibarra and Broe’s work has huge implications for most fields, especially those that need a next generation of leaders. It also has huge implications for selecting a doctoral program. Frankly I don’t know many fields that have a surplus of good leaders and well educated people. The number one take away message for me is that people need coaches, mentors, and structured action learning experiences (LaRue, Childs, and Larson, 2004) in order to test their theories of what they would like to be in the future.

Why Can’t You Just Do the Work on Your Own?

     You can do a lot of the career development work on your own, but what is difficult is being objective about your strengths, growth needs, and holding yourself accountable. It is too easy to get busy with your current work responsibilities and slowly
the days, weeks, and months pass you by without any progress toward your new career or school decision. It is also hard to push yourself toward loftier stretch goals. Here’s where a mentor or career coach using a formal structured process is useful. Ferrazzi (2009) suggested it is a lot easier to be successful in life if you have other people help you. Ferrazzi suggested that good relationships are based on intimacy, generosity, vulnerability, and candor. A true friend helps you to build your dream, gives you honest/realistic feedback, and holds you accountable to achieve the goals you have set. That’s what he calls having your back. It is not always easy to find good friends like that. Tom Rath (2006) suggested that it is difficult to find one perfect friend who meets all your needs in life. Instead Rath’s research with the Gallup Corporation showed that most successful people have different friends for the different pieces of their life.
I have a network of friends in my academic career, other people who provide me with clinical support as a nurse, artist friends who support my cartooning career, and my sports fanatic buddies who I go to the ballgame with. Bringing this back to Ibarra’s work, you can not always expect the people around you to be invested in your progress. They may not want you to leave them alone in your old work environment, they may be jealous of your career success, and they may not want to take on the work you leave behind. Much of this is not conscious, but comes out in discussions with friends and work colleague’s. Which, is why Ibarra suggests you talk to folks in the field you envision yourself moving to, not the people in your current work environment. I was always interested in on-line learning, leadership, and organizational dynamics. Unfortunately I often asked the wrong people for advice. I spoke to my friend who had a traditional PhD. He said the hallmark of doctoral education was face-to-face interactions. I spoke to another friends father, who was a dean at an Ivy League College. He said on-line learning was just a fad. So, I dropped my dream for a few years, till I realized I was speaking to the wrong folks. Then I switched my approach and started talking to people with on-line degrees, who told me it was the wave of the future. I often sabotaged myself by talking to
people in my own organization who had left academia or consulting for the comfort of
working in an organization. What kind of advice do you think they gave me? You
guessed it, stay in the organization and not pursue a degree. The more I networked with with people in the kind of academia and consulting where I wanted to be, the more support and encouragement I received to take the leap.

Formalizing the Process

     One approach to choosing a doctoral program is to make it into a formal process like many people do with other important decision like buying a car or purchasing a house. Make a list of 5 questions and interview 5-10 people with doctorates. Here are some good questions to start:

  1. What was your goal in getting a doctorate?
  2. Why did you choose the program you went to?
  3. What did you like about the program you choose? What do you wish was different?
  4. I appreciate why you went to the program you went to. In my field what sort of doctoral program will be the most valuable in the future?
  5. What surprised you the most after you had your doctorate that you hadn’t thought about ahead of time?

Another approach is to hire a career coach, who will lead you through a formal process, and whose only investment is in having you be successful and find a new career or educational opportunity you feel passionate about. That structure can be very instrumental in exploring your strengths and building a business plan to make your next move. A good coach can also hold you accountable and remind you when you are making forward progress so you don’t get discouraged.

Dr. Michael Grossman, DM, MSN, RN, NEA-BC is a nursing consultant, academician, and career coach. As a professor in the graduate schools of nursing at both University of Phoenix and Walden University, he specializes in healthcare ethics, leadership development, career coaching, teambuilding, motivation, change, communications, and dealing with “difficult” people.
He can be reached at 610-331-8470 or Mike@Nurseleadershipbuilders.com

References

Bridges, W. (2004). Transitions: Making Sense of Life’s Changes, Revised 25th Anniversary Edition. Cambridge, MA: Da Capo  Press.

Broe, S. (2012). Leaders in Transition. U.S.A.: CreateSpace available on amazon.com.

Ferrazzi, K. (2009). Who’s Got Your Back: The Breakthrough Program to Build Deep, Trusting Relationships That Create   Success and Won’t Let You Fail. New York: Broadway Business.

Grossman, M. B. (2011b). What’s Next Create Your Dream Job With a Plan B. Bala Cynwyd, PA: Nurse Leadership Builders @ http://tinyurl.com/d47t4uo

Grossman, M. B. (2011b). Passion: Finding What Energizes Your Career (1st ed.). Bala Cynwyd, PA: Nurse Leadership Builders@ http://tinyurl.com/d47t4uo

Handy, C. (2002). Elephants and Fleas: Is Your Organization Prepared for Change. Leader to Leader, 24.
Ibarra, H. (2003). Working Identity Unconventional Strategies for Reinventing Your Career. Boston, MA: Harvard Business School Publishing.

LaRue, B., Childs, P., & Larson, K. (2004). Leading Organizations from the inside out unleashing the collaborative genius of action-learning teams. Hoboken, NJ: Wiley Custom Services.

Rath, T. (2006). Vital Friends: The people you can’t afford to live without. New York: Gallup Press.

Can Teamwork Be Mandated?

Teamwork seemed to be a consistent theme in the nurse to patient ratios debate. Clearly there is no evidence that patient ratios works (Buerhaus, 2010). We also know that the lack of teamwork increases patient deaths (Aiken, et al, 2002). So why not mandate teamwork. Make it a requirement that nurses must exhibit teamwork or they’re fired. It would eliminate bullying, lateral violence, eating our young, and nurses would gladly float to other units to help their colleagues who are short staffed. It would require hospitals to actively work on communication, teamwork training, and create systems for monitoring the effectiveness. What do you think?

Reference

Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA, 288(16), 1987-1994.

Buerhaus, P. (2010). It’s time to stop the regulation of hospital nurse staffing dead in its tracks. Nursing Economic$, 28(2), 110-113.

Does a BSN Matter?

Many nurse argue that a BSN doesn’t really matter as a nurse is a nurse is a nurse. I find this argument a bit confusing, because in most professions, education is seen as a good thing. Why wouldn’t education make someone a better nurse? In 1910 the federal government assigned this topic to a commission to determine what sort of education nurses and physicians should have. That commission said over 100 years ago that RN’s should have the same education as similar professions and should go to college to get their education (Flexner, 1910). Aiken, et al (2002, 2012) did a comprehensive research study that showed patient outcomes were significantly improved when nurses had their BSN. This became a standard for Magnet hospitals. It raises an interesting ethical question: Does the fact that you have a friend who doesn’t have a BSN and she’s a good nurse have more value than a comprehensive research study?

Reference

Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital nurse

staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA, 288(16),

1987-1994.

Aiken, L. H., Cimiotti, J. P., Sloane, D. M., Smith, H. L., Flynn, L., & Neff, D. F. (2012). The

Effects of Nurse Staffing and Nurse Education on Patient Deaths in Hospitals With

Different Nurse Work Environments. Journal of Nursing Administration, 42(10),

S10-16.

Flexner, A. (1910). Medical Education in the United States and Canada a Report to the

Carnegie Foundation for the Advancement of Teaching. From

http://www.carnegiefoundation.org/sites/default/files/elibrary/Carnegie_Flexner_Report.pdf

Suggested Books & Links

Welcome to my book list.

I love to read books and listen to audio recordings of books. I just find I need constant inspiration to navigate the waters of life. As C.S. Lewis once said, “We read to remind us we are not alone.” I need the inspiration that when life gets tough there is always hope, or as Winston Churchill said to the British Empire in the deepest darkest hours of WWII, “Never, never, never give up.”

All of the books on this list are easy to find at any book store or online website like http://www.amazon.com. Most of these authors are quite prolific but I’ve only listed one book to get you started. Don’t assume it’s their “best” book, that’s up to you to find out. Look up the author and see if they have another book that speaks to your interests. If you haven’t tried audio books, I highly recommend it, especially if you have a long drive to work. It’s a great way to use that time effectively. Not everybody likes audio books, so try reading or videos. You may also may find a lot of these authors do workshops you can attend. If you like audio books I highly recommend http://www.audible.com, a website where you can download books quite cheaply (and it’s legal).

Some of My Favorite Non-Fiction Authors

Welcome to my book list. I love to read books and listen to audio recordings of books. I just find I need constant inspiration to navigate the waters of life. As C.S. Lewis once said, “We read to remind us we are not alone.” I need the inspiration that when life gets tough there is always hope, or as Winston Churchill said to the British Empire in the deepest darkest hours of WWII, “Never, never, never give up.”

All of the books on this list are easy to find at any book store or online website like http://www.amazon.com. Most of these authors are quite prolific but I’ve only listed one book to get you started. Don’t assume it’s their “best” book, that’s up to you to find out. Look up the author and see if they have another book that speaks to your interests. If you haven’t tried audio books, I highly recommend it, especially if you have a long drive to work. It’s a great way to use that time effectively. Not everybody likes audio books, so try reading or videos. You may also may find a lot of these authors do workshops you can attend. If you like audio books I highly recommend http://www.audible.com, a website where you can download books quite cheaply (and it’s legal).

Russel Ackoff, Ph.D. – Re-creating the corporation: A design of organizations for the 21st century. Ackoff is a very prolific writer on the application of systems theory. A former professor at the Wharton School. Look for his articles as well as his books. He really makes you think about why we do some of the crazy things we do in organizations.
Idealized Design-if you’ve ever participated in one of my team interventions you’ve probably heard me talk about the concept of idealized design. Here are the details behind the approach.

Angeles Arrien, Ph.D.The Four Fold Way-An expert in the cultural anthropology of the Native American Indians. If you have participated in a Medicine Wheel exercise with me and want more information, this is the book.

Mitch Albom-Tuesday’s With Morrie. My friend Andrew Shoyer said to me, “Michael thank you so much for this book. It’s been 20 years since my wife died and I’ve always been puzzled by the meaning of life since then. No one has ever come back to tell us what happens after we die, but Morrie, in his story of courage and faith gives us a glimpse and beautiful perspective from a special man as he approaches his own death.” This is one of the most touching, beautiful, inspiring books I have ever read.

David Baum- The Randori Principles. David is one of the most entertaining and informative consultants I ever worked with. We hired him in the early 80’s to do a series of workshops on humor in the workplace. He taught me how to eat fire, literally. I have the pictures to prove it. But along the way I also learned some great lessons about organizational dynamics and life in general. Much of his philosophy is found in this text.

Valerie Malhotra Bentz & Jeremy Shapiro-Mindful Inquiry in Social Research. If you’ve heard me talk about my dissertation, a phenomenological qualitative study and want to read more about the research method this is an interesting book on the topic. The authors tie the research methodology to eastern philosophy and the practice of mindfulness. A nice companion to Moustakas’s classic text on phenomenology (see below).

Ken Blanchard, Ph.D.-Leadership and the One Minute Manager: Increasing Effectiveness Through Situational Leadership. Blanchard’s practical and easy to read parables on management are a great start in the world of management literature. They’re a quick read but have a great deal of the depth to them. Situational leadership is a tremendous model for how different people need different approaches, the basis behind contingency theory. There are some questions around the validity of Blanchard’s theories, which I would be happy to discuss.

Peter Block, Ph.D.-Stewardship: Choosing Service Over Self Interest. Block is today’s leading writer on stewardship and employee empowerment. Must reading if you’re into shared governance. Look for his audio tape The Right Use of Power, it’s brilliant.

John Bradshaw-Healing the Shame That Binds You. John is a wonderful lecturer and prolific writer. His lecture series are often on PBS. He is a psychologist and a former Christian Monk who does a brilliant job of explaining psychology and spirituality in a very down to earth manner that is easy to relate to. I especially enjoy his lectures on families.

Patti Breitman & Connie Hatch-How to Say No Without Feeling Guilty : And Say Yes to More Time, and What Matters Most to You. There are several authors who have written books on this topic. I find there are a lot of nurses who struggle with this. It’s not surprising given that we are care givers and want to help, not set limits. There are some great tips on how to say things in a way that avoids your feeling guilty, things like, “Sorry but I have a personal matter to attend to tonight.” If they ask what the personal matter is, respond, “It’s personal.” Also see Manuel Smith’s book listed below.

William Bridges, Ph.D.-Managing Transitions. Here again, if you’ve attended my lecture on change, this is the basis for a lot of that information. Fast reading and lots of helpful hints on how to survive major change.

Marcus Buckingham & Curt Coffman-First Break All the Rules: What the Worlds Greatest Managers Do Differently. The authors work as consultants for the Gallup Survey Organization and reviewed over 80,000 interviews with managers from all types of companies. They debunk some dearly held notions about management, such as “treat people as you like to be treated”; “people are capable of almost anything”; and “a manager’s role is diminishing in today’s economy.” “Great managers are revolutionaries,” the authors write. “This book will take you inside the minds of these managers to explain why they have toppled conventional wisdom and reveal the new truths they have forged in its place.” The four keys to becoming an excellent manager: Finding the right fit for employees, focusing on strengths of employees, defining the right results, and selecting staff for talent–not just knowledge and skills. A very enlightening book. I give it five stars!

Marcus Buckingham & Donald O. Clifton, PhD-Now Discover Your Strengths.
This book introduced the Strengthsfinder assessment, which psychologist Donald Clifton developed. It’s a wonderful tool for assessing your passion and what strengths bring you energy. The book entitles you to take the on-line assessment. An updated version Strengthsfinder 2.0 is available by Tom Rath.

Joseph Campbell-The Power of Myth. Campbell was one of the foremost authorities on comparative religion. He looked at the universal themes that occur in all religions. If you want to understand more about other religions this is a great starting point. Look for his series with Bill Moyers, it’s often on PBS and is available on audio and video cassette.

Richard Carlson, Ph.D.Don’t Sweat the Small Stuff…and it’s all small stuff. Well the title says it all!

Julia Cameron, The Artists Way. Are there some things you used to enjoy doing, and just don’t get around to in the busy serious business of life? Maybe you played an instrument, did artistic work, sports, or just visited with friends. Would you like to recapture the spirit of those times? Julia Cameron’s book is a 12 week course in which she guides you through a series of exercises that look at these issues and leave you with tools to capture your creativity, the vein of gold in each of us. Heck I found out I was a cartoonist!

Kim Cameron & Robert Quinn, PhD’s- Diagnosing and Changing Organizational Culture: Based on the Competing Values Framework. This book thoroughly explains the Competing Values Framework, a contingency theory based on four major schools of leadership. This is a much more academic approach to Hersey and Blanchard’s concept of Situational Leadership. Basically we should have a single style of leadership but a combination of skills based on the situation. Also see Quinn’s Deep Change listed below.

Peter Checkland, Ph.D. – Systems Thinking, Systems Practice: Includes a 30-year Retrospective. A wonderful academic review of the various forms of systems theory. Not as practical and down to earth as Senge, but a wonderful retrospective review of the body of literature on systems theory.

Jim Collins, Ph.D.-Good to Great: Why Some Companies Make the Leap and Others Don’t. A wonderful research based review of excellent companies who have been successful over decades. How do they do it? He explains it.

Sonia Choquet, Ph.D.-The Psychic Pathway. Sonia is a fascinating lady and a graduate of Julia Cameron’’ workshops. She found her gift is her intuition and Julia helped her to write this book that explains ways to cultivate your intuitive side. Sonia is a wonderful story teller and this book is a really fascinating look at a side of each of us we don’t talk about much. If you’ve ever had the experience of feeling in touch with another person you should read this. I won’t say anything more.

Deepak Chopra, M.D.-Quantum Healing. A traditionally trained U.S. endocrinologist, former Chief of Medicine at Tufts University. Deepak took a trip back to his homeland, India and was introduced to the world of Ayurvedic Medicine. Skeptical at first, of “alternative” medicine he learned more about and has written many books on this topic as well as on Eastern Religion. Very down to earth explanations of Eastern philosophy.

Ann McGee-Cooper, Time Management for Unmanageable People. Do you have trouble sticking to a schedule? Time management courses are usually taught by compulsive, detail oriented people who love check lists and daily planners. If you are a right brained creative person who struggles with doing it all, this is the book for you.

Kenneth Cooper, M.D.-Aerobics. The Godfather of the whole exercise movement. Dr. Cooper says you don’t have to exercise to the point of exhaustion. His research shows you exactly how much exercise you need for optimal cardiac conditioning.

Steven Covey, Ph.D.-The 7 Habits of Highly Effective People. If I gave you this list I probably don’t need to tell you about Dr. Covey. As you can see I do a lot of this type of reading. Covey is the best at putting it all together in a way that everybody can relate to it. As he says, “common sense, but not commonly practiced.”

Ram Dass [Richard Alpert, Ph.D.]-Experiments in Truth. This is my favorite audio tape of Ram Dass, as it’s a compilation of some of his greatest talks. He’s also written several books but I find him to be an exceptional motivational speaker combining Eastern Philosophy with traditional Western psychology. A Jewish, Buddhist, Stanford trained clinical psychologist who gives a funny, touching, and spirited perspective on integrating the message of Eastern religions into Western culture.

Peter Drucker, PhD- The Essential Drucker: The Best of Sixty Years of Peter Drucker’s Essential Writings on Management. Yes you read it correctly he has been writing for 60 years. He is the granddaddy of contemporary leadership authors. You don’t want to be caught saying, “I’ve never read any Drucker, who’s he?” This is a wonderful compilation of his works.

Wayne Dyer, Ph.D.-Your Sacred Self. Dr. Dyer has been a prolific writer and speaker for over 25 years. I especially enjoy his work in the past few years since his wife’s cancer was cured by Deepak Chopra and he became more spiritual.

Betty Edwards-Drawing on the Right Side of the Brain. If you wish you were artistic but don’t think you have the talent read this book. Edwards breaks down art into simple lines and curves. It’s how my favorite art teacher taught me. But, she also discusses the psychology behind why we think we can’t draw and how you can quickly overcome it. Try it you’ll surprise yourself. It’s a different approach to the problem than Franck takes, but if you read both books you’ll soon be drawing like an expert. There are a few other books on drawing I’ve listed here if you want to learn more and I highly recommend The Artists Way by Julia Cameron.

Frederick Franck-The Zen of Seeing. If you think you have no artistic ability, Dr. Franck will have you drawing in an hour and producing works of art within a day. A brilliant piece of work I was given by my friend Frank Champagne 20 years ago. Franck is in his 90’s and I’m not sure he still does his live workshops, but the book is still an excellent way to learn how to draw even if you think you can’t draw beyond a stick figure. It took me five years to get into his class and was well worth the wait.

Viktor Frankl, M.D.-Man’s Search for Meaning.  In the deepest darkest hours of his imprisonment in the Alshwietz concentration camp Frankl discovered the last ultimate freedom, the ability to choose how YOU want to interpret what is happening to you in life. Dr. Frankl survived the experience by finding a purpose in it all. As a psychiatrist he felt the need to survive so that he could explain it all to the world and help future generations to understand how we can find meaning in life’s tough moments. This is a good companion book to Martin Seligman’s work on learned optimism.

Robert Fritz-The Path of Least Resistance. Why is it that we have self destructive behaviors? What holds us back? What motivates visionary leaders? Fritz worked with Peter Senge on a lot of his theories. You know that little thing cartoon I show about Vision vs. Current Reality and the man pulled in different directions by rubber bands? That’s from Robert Fritz!

Marshall Goldsmith, PhD-What Go You Here Won’t Get You There How Successful People Become Even More Successful. Goldsmith is the #1 executive coach making $250,000 per client per year! In this book he gives all his tips for how he coaches and how executives can be successful.

John Gray, Ph.D.-Men Are From Mars Women Are From Venus. My favorite author on male-female communication issues. Very entertaining and thought provoking, especially on tape or live!

Jack Hamm-Cartooning the Head and Figure. People often ask me how I got into cartooning and is there a good book to get started. First of all I think it helps to have some traditional art training to understand thinks like space, depth and proportions. I would recommend Franck’s book on the Zen of Seeing (see above) even if you feel you have no artistic skills at all. I highly recommend Betty Edwards book, she’ll have you drawing works of art in no time. As far as cartooning there a lots of books out there but this is like my encyclopedia of figures. When I can’t figure out how to capture something I pull out Hamm’s book for 100’s of great examples.

James Hoopes-False Prophets: The Gurus Who Created Modern Management and Why Their Ideas Are Bad for Business Today. Hoopes is a historian and traces the history of modern business from a historical paradigm. He describes the shift from an agricultural society to factories during the industrial revolution in the late 1800’s. Hoopes suggests that the only models we had for management were the military and slavery, which shaped the future of modern management in not such good ways in his opinion.

Institute of Medicine Committee on Quality in Health Care- Crossing the Quality Chasm: A New Health System for the 21st Century. A landmark book written in 2001 that describes what’s wrong with health care and makes some suggestions for how things need to change in order to be consistent with other businesses that need to pay attention to quality and safety.

Susan Jeffers, Ph.D.-
Face The Fear and Do It Anyway. It’s funny how our anxiety paralyzes us in some aspects of our lives yet in other areas we just face our fears and do it anyway. Dr. Jeffer’s explains why and how to overcome your fears.

Bill Jensen- The Simplicity Survival Handbook: 32 ways to do less and accomplish more. Jensen has done some very interesting research on the complexity of today’s workplace and how we can make communication simpler. He practices what he preaches in this easy to ready book that’s chock full of interesting tips like keep your E-mails to a few sentences that focus on what you want your recipient to KNOW, how you want them to FEEL and what you want them to DO.

Spencer Johnson, Ph.D.-Who Moved My Cheese. Dr. Johnson was the co-author of The One Minute Manager and wrote this amazing little book on ways to deal with change in your work and in your life. The book is amusing and a quick read but the message is very, very deep. If you struggle with change or working with people who whine and complain and aren’t motivated you’ll find some helpful information in this book.

John Kabat-Zinn Ph.D.-Wherever You Go There You Are. I love this title, it’s so true, and you can’t get away from yourself so you better learn to love yourself. Kabat-Zinn is the founder of the Stress Reduction Clinic at the University of Massachusetts Medical Center and teaches mindfulness as a way of life. A practicing Buddhist he gives a simple explanation of why meditation is important and how it can be cultivated as a stress reducing technique in our hectic lives. His guided meditation tapes are a great introduction to meditation.

Rodger Kamenetz-The Jew and the Lotus. In 1990 a group of Rabbi’s traveled to the East to meet with the Dali Lama, spiritual leader of Tibet. In the late 40’s the Chinese killed over one million Tibetan people many of them monks and exiled much of the nation to other parts of the world, much as the Egyptians did to the Jews 2000 years ago. Along the way the Rabbi’s learn as much about Judaism as they do Buddhism. A fascinating piece of work. If you are a Jew who struggles with spirituality I’d also highly recommend his later book Stalking Elijah. It’s all about his struggle with formal religion.

Mathew Kelly-The Dream Manager. This book introduces a fabulous concept around employee engagement. Kelly suggests that companies hire career coaches to help employees achieve their dreams. His premise is that by showing employees you care, they care about your organization. It’s really the premise of servant leadership, but Kelly shows a practical approach that any company can institute.

Thomas Kuhn PhD-The Structure of Scientific Revolution. This landmark book was written in 1962 but Kuhn traced his theories back to the 1940’s. It’s an incredible description of how change takes place in science and is the basis for many of today’s theories on change. Kuhn suggested that the more people are tied to the history the more resistant they are to changing, but a new generation comes in, takes the change at face value and says, “Hmmm makes sense to me.” Think about this if you are still playing CD’s or worse yet tapes and don’t have an Ipod.

Rabbi Harold Kushner-Why Do Bad Things Happen to Good People; How Perfect Do We Have To Be? Rabbi Kushner lost a son at an early age. He learned a lot through that experience and shares his wisdom on why bad things happen in life and how to get through the bad times in these two books.

Patrick Lencioni-The Five Dysfunctions of a Team. Lencioni has written several books, but this is my personal favorite. One example is that teams need to have robust debates about what to do next, but once the debate is done they need to choose a direction and all march off to that plan. Dysfunctional teams continue to debate the issue after the decision has been made, and then fail to hold each other accountable for why they’re not sticking to what was agreed to.

John Maxwell-The 21 Irrefutable Laws of Leadership. Maxwell is a very prolific writer and speaker. He is very down to earth with a very practical and principle based approach to leadership. Very Covey-like in his approach.

Clark Moustakas PhD-Phenomenological Research Methods. Arguably the definitive text on this qualitative research method. It is the approach I used for my dissertation so you may have heard me speaking about it and wish to read more. Also see the Bentz text listed above.

Bob Nelson-1001 Ways to Reward Employees. Nelson works for Ken Blanchard and suggestions there are 1000’s of ways to reward employees beyond just money. One of his theories is that anything given across the board becomes an entitlement and not a reward. A reward must be based on specific behavior and timely. A good compliment can be more rewarding than a bonus, if done right.

Ikujiro Nonaka & Toshihiro Nishiguchi-Knowledge Emergence: Social, Technical, and Evolutionary Dimensions of Knowledge Creation. I know sounds pretty heavy, it is.
This is a major work on how people acquire knowledge, especially around things that are tacit, not easy to describe. I often refer to them so I list this reference for those of you who want to read some heavy material.

Suze Orman, The 9 Steps to Financial Freedom. Do you struggle with your personal finances? What you just rather avoid the whole topic? Most people feel that way, but Suze helps you to understand where those feelings come from and has some good exercises on how to overcome those fears and take personal control of your situation.

Barry Oshry PhD- Seeing Systems: Unlocking the Mysteries of Organizational Life. Oshry is one of the most interesting authors I have come across in recent years. An amazing perspective on organizational life. This is the Tops-Middles-Bottoms theory I often refer to. If you can find one of his experiential workshops to attend it will be a life altering experience for you. You will never see organizations in the same way again.

Og Mandino-The Choice. Og Mandino was a very prolific motivational writer who passed away a few years ago. His books are kind of like a spiritual, motivational, twilight zone that always leaves you with a warm feeling when you’re done.

Kerry Patterson, et al- Crucial Conversations: Tools for Talking When Stakes are High. This is a wonderful text for scripting difficult conversations written by a consulting group hired by the Association of Critical Care Nurses to help improve communication and team dynamics. Also see Stone’s similar book Difficult Confrontations below.

M. Scott Peck, M.D.-The Road Less Traveled. Peck is a recovering alcoholic psychiatrist whose brilliant insights on life are useful to anyone, whether you have an addictive personality or just have to relate to others who do.

Tom Peters, Ph.D.
In Search of Excellence. Who can say they’ve never heard Mike Grossman say, “Well you know what Tom Peters always says….” Peters is a charismatic, energetic speaker who exhausts you just to watch him. His life’s work has been looking at what makes companies excellent. Look for him on PBS or get a live lecture on tape[not him reading his book!] He’s amazing to watch and really makes you think about what makes for a quality organization. This was his first book decades ago and he’s written many since. Just pick out the one that resonates for you. His message is usually the same, “Listen to the people on the front line. They know what’s wrong!” Peters work is a good companion to Oshry’s work on why leaders don’t listen to their employees.

Tim Porter-O’Grady-Quantum Leadership A Resource for Healthcare Innovation. Tim is one of the most prolific nursing authors over the past 20 years. The fact that he’s also a graduate of the same doctoral program as me means that a lot of the things I talk about HE talks about in this book. It’s a nice, practical, down to earth book on the future of healthcare from a system’s theory perspective.

Robert Quinn, PhD- Deep Change Discovering the Leader Within. Robert Quinn is the Dean of the University of Michigan School of Business and a very prolific writer. He is the co-author of the competing values framework methodology you may have heard me discuss. This is an easy to read and very thought provoking book about the deep changes that need to take place in organizations to avoid a downward decline.

Tom Rath-Vital Friends. Tom Rath’s fascinating book on the value of friendships in the workplace is a combination of seventy years of Gallup surveys culminating in a database of 4.51 million respondents from 423,000 workgroups in 112 countries from 2002-2004 (Rath, 2006). Rath’s review of the literature on friendships suggested that friends can be the highpoint of ones day and that strong social relationships are the leading indicator of overall happiness (Kahneman, Krueger, Schkade, Schwarz, & Stone, 2004). Rath suggested we focus on the strengths of friends rather than their weaknesses, which is also consistent with other Gallup research regarding the value of focusing on employee strengths (Buckingham & Clifton, 2001). There is growing recognition of the importance of relationships in the workplace, as described in several recent popular books (Patterson, Grenny, McMillan, & Switzler, 2005; Patterson, Grenny, McMillan, Switzler, & Covey, 2002; Stone, 2000). Research in health care has also shown there to be a direct relationship between patient outcomes, relationships and teamwork (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002). Rath suggested that the gap between individual focus and fixing the entire group could best be addressed by focusing on improving relationships two people at a time, you and your vital friends. IF you haven’t noticed by now I REALLY liked this book!

Strengthsfinder 2.0-Tom Rath published this book after taking over many of Marcus Buckingham’s projects at the Gallup Corporation. The content is not much different than Buckingham’s original book and is based on the same Strengthsfinder on-line assessment. Buckingham is one of my favorite authors, but you can often pick up this version a little cheaper.

James Redfield-The Celestine Prophecy. Redfield’s controversial book heralds a spiritual revolution in the world. His somewhat amateurish fictional story line gets in the way of some really brilliant work based on his insights and experiences as a therapist. If you can’t get past the story I’d recommend his The Celestine Prophecy An Experiential Guide. It reads more like a textbook and he gives a lot of academic background to his theories. Also includes some good group and individual exercises. Try his meditation tapes too.

Anthony Robbins, Personal Power. Yes this is the guy on the infomercials. I know he looks a little too slick, but his information is very interesting. A practitioner of the Neurolinguistic school of psychology, it’s a very practical approach to moving through life by making changes in your behavior rather than trying to dwell on what got you to this point. Give him a try, it’s interesting stuff.

Hal Rosenbluth- The Customer Comes Second and Other Secrets of Exceptional Customer Service. Rosenbluth is the president of Rosenbluth travel and suggests that unless you treat your employee’s right they can’t be good customer service agents, which is why he suggests the customer comes second. Very logical down to earth suggestions.

Neil Salkind- Statistics for People Who (Think They) Hate Statistics. O.K. who can honestly say they love statistics. If you do then don’t read this book, but if you shy away from statistics this is a great companion to any text you are required to read for a course. Salkind’s also written a very traditional textbook on statistics.

Steven Sample PhD- The Contrarian’s Guide to Leadership. Sample is the Dean of Stanford’s prestigious school of business and has written a book that is similar to other non-traditional leaders. Much like Buckingham’s work First Break All the Rules, Sample suggests that the best leaders don’t follow the conventional wisdom but instead take a somewhat contrary approach, which is why there are so few great leaders. A very thought provoking book.

W. Richard Scott PhD-Organizations: Rational, Natural, and Open Systems. This is a classic book of management theory. Somewhat esoteric and not a practical how to book by any stretch of the imagination. But it is a landmark and required reading to understand the foundations of management theory taught on graduate school level. I often mention it so that’s why I included it in this list.

Martin Seligman, PhD-Learned Optimism: How to Change Your Mind and Your Life. Why do some people see life as a half empty glass and other’s are optimistic despite adversity and challenges? Seligman explains not only why it happens but how you can change your approach to life to stop feeling like a victim. Many other works have been written based on Seligman’s theories. A good companion book to Jeffers Face the Fear and Do it Anyway listed above.

Peter Senge, Ph.D.-The Fifth Discipline. If you haven’t heard my Senge routine you don’t know Mike Grossman. Senge brings systems theory to the world of business. His writing is somewhat dry, but his lectures are brilliant! It’s an incredible model, especially if you are involved at all in Continuous Quality Improvement.

Barbara Sher, I Could Do Anything If I Only Knew What It Was. Do you struggle with what to do next with your career? This book is the next best thing to working on a 1:1 basis with Mike Grossman to figure out what to do next.

Tony Schwartz-What Really Matters Searching For Wisdom In America. Tony hurt his back and went to see John Sarno M.D., and orthopaedic surgeon in N.Y. He found it that back injuries are not totally about your back. It’s also about anxiety, stress and life in general. Tony went on a journal of meeting with all kinds of interesting people who have been pioneers in the healing movement in this country since the 60’s. A writer for New Yorker Magazine, Tony’s stories are down to earth and quick reading. A great starting point for an overview of many of the authors on my list.

Bernie Siegel, M.D.-Love Medicine & Miracles. Bernie is an oncology surgeon at Yale. Twenty years ago he wondered why some people survived cancer and others didn’t. His insights also work for anyone who struggles with life, but they are a must if you or a loved one has been diagnosed with cancer.

Marsha Sinetar-Do What You Love and the Money Will Follow. Another book on finding your right livelihood. If you do what you love you’ll be so good at it, you can’t help but be successful.

Manuel J. Smith-When I Say No, I Feel Guilty. There are several authors who have written books on this topic. I find there are a lot of nurses who struggle with this. It’s not surprising given that we are care givers and want to help, not set limits. Smith gives some great tips on how to say things in a way that avoids your feeling guilty, things like, “Sorry but I have a personal matter to attend to tonight.” If they ask what the personal matter is, respond, “It’s personal.” Also see Patti Breitman’s book listed above.

Douglas Stone, Bruce Patton, Sheila Heen, Roger Fisher-Difficult Conversations: How to Discuss what Matters Most. This is a wonderful book on just what it says, how to conduct difficult conversations. The authors are associated with the Harvard Project on Negotiation and show how dialogues consist of describing what happened, the feelings behind it, and a re-expression of the situation given the new insights to arrive at a solution. Also see Patterson’s book on Crucial Conversations listed above.

Al Stubblefield-The Baptist Health Care Journey to Excellence Creating a Culture That Wows. Stubblefield took over the leadership of BHC after Quint Studer left to go on the lecture/consulting circuit and has kept the traditions of quality going. This is his perspective on how they are one of the nation’s leading hospitals for quality. A good companion book to Studer’s.

Quint Studer-Hardwiring Excellence: Purpose, Worthwhile Work, Making a Difference. Studer is probably the hottest consultant in health care today. Everyone wants to develop an evidence based, outcomes oriented, quality organization based on Pillars of Quality. A must read for anyone in healthcare.

Rabbi Joseph Telushkin-Jewish Literacy. The best down to earth explanation of anything you would want to know about the Jewish religion, people, history and culture. We read his explanations at every holiday dinner. A great review of the Old Testament too.

Peter Vaill, PhD-Learning as a Way of Being: Strategies for Survival in a World of Permanent White Water. Vaill is credited with first using the metaphor of white water to describe the chaotic, fast paced business world we live in today. This book just blew me away, one incredible insight after another. The pages of my copy are just covered with highlighter pen markings and notes.

Dennis E. Waitley, Ph.D.-The Psychology of Winning. Have you ever watched an athlete close their eyes and concentrate before they perform? They’re visualizing their performance. Waitley was the psychologist to the Olympic team and really explains the whole concept of how athletes use vision and guided imagery to motivate themselves to achieve success. Not just for athletes, these same techniques work in any part of your life.

Margaret Wheatley, Ph.D.-Leadership and the New Sciences. Some people find Wheatley a little “out there.” I love her work. She is a wonderful author who explains Open Systems theory and why organizations can not be rigidly controlled. I’ve heard her questioned about the practicality of her theories and she replied, “I’m a theorist, I’m not supposed to get into all the details.” She will really make you think about why change is so difficult, like trying to control the weather.

David Whyte-The Heart Aroused. A poet who has friends in Fortune 500 companies who struggle with their work. Whyte points out that these are not work dilemmas, they’re about the struggles of life that have been well described in great literature. He does this interesting technique of using poems and stories to explain our work struggles.

Marianne Williamson-A Return To Love. Marianne is the foremost authority on A Course in Miracles, a spiritual based program not tied to any formal religion but based upon love and kindness. I became interested in this a few years back when I noticed that so many motivational speakers had taken the course and highly recommended it. A Course in Miracles is a book [not written by Mariane] that you can walk through in years worth of daily exercises. If you are spiritual but struggle with the rituals and dogma of formal religion, give this a try.

Anthony E. Wolfe, Ph.D.-Get Out of My Life but first can you drive me and Cheryl to the Mall? If you have an adolescent at home you can relate to this title. I LOVED this book. It was funny and so on target. It also had some real practical advice for dealing with this difficult age group. If your kids are younger, start reading this now because it’s coming your way sooner than you think!

Andrew Weill, M.D.-Spontaneous Healing. Dr. Weill is a traditional western trained physician at the University of Arizona who became interested in complimentary medicine. He really explains what works and doesn’t work for the everyday problems that your doctor really doesn’t have an answer to. Must reading!

Ron Zemke, Raines, C., & Filipczak, B.-Generations at Work: Managing the Clash of Veterans, Boomers, Xers, and Nexters in the Workplace. This is the definitive work on age diversity and the impact of the different clashing generations on the workplace environment. A must read.

Dr. Michael Grossman, DM, MSN, RN, NEA-BC has over 30 years of nursing leadership experience and is a nursing consultant, academician, and career coach. As a professor in the graduate schools of nursing at both University of Phoenix and Drexel University, he specializes in healthcare ethics, leadership development, career coaching, mentoring, teambuilding, motivation, change, communications, and dealing with “difficult” people. 
He can be reached at 610-331-8470 or Mike@NurseLeadershipBuilders.com