Difficult Conversations Podcast
Lessons I Learned as an ICU Physician
Episode 154 | September 7, 2021
Be The Leader Nobody Wants To Leave
President and CEO of the Baird Group
Welcome to Difficult Conversations with Dr. Anthony Orsini. Nursing leadership is a topic that we’ve discussed more than once on this podcast and we’ve learned the importance of true leadership and how it can negatively or positively affect not only the culture of the hospitals, but also the wellbeing of patients and nurses. My special guest today is Kristin Baird, a nurse and former healthcare marketing executive. She is the Founder of Baird Group, a consulting firm that helps healthcare leaders create cultures where patients want to come for care, where physicians want to practice, and where employees want to work. She is the author of five books and hundreds of articles on culture leadership and patient experience, and today we will be discussing her flagship learning course called, Be the Leader Nobody Wants to Leave- 8 Transformational Skill-Builders for Busy Leaders. She is a highly sought-after speaker where she pushes leaders to think differently about their roles in culture and engagement.
We start out with Kristin talking about the appalling nursing turnover numbers in long-term care and home care, and the two reasons people are leaving. Dr. Orsini and Kristin share stories about how people crave recognition and not more money. Kristin dives into talking about culture and leadership and how they are related. She mentions a phrase, “What you permit you promote,” and explains the difference between permissive and being flexible. Kristin tells us about her learning course, Be the Leader Nobody Wants to Leave and explains each of her 8 Skill Builders. Kristin explains “Listen with your eyes as well as your ears” because so much is revealed by the nonverbal communication. We find out if anyone can learn to be a leader and how Kristin believes if people have the desire and are coachable, then wonderful things can happen. She shares advice to someone who is interviewing for a nursing leadership position. Also, Kristin explains how hospitals and businesses can invest in training for leaders and elaborates on how you just want to prove return on investment for anything you do. In 2025, 75% of our global workforce will be Millennials, and Kristin talks about how they bring a fresh perspective. We end with Kristin sharing the most difficult conversation in her family that was severely botched by a doctor and what it has taught her. Don’t miss this!! If you enjoyed this podcast, please hit follow, and download all the previous episodes.
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Kris Baird (1s):
You look at what does turnover really due to that patient relationship and the confidence that the family or the patient has in the caregivers. So there’s that, but then there is a huge financial implication. Right now, the data shows that the average nurse turnover costs in the organization, $44,000 and the average hospital, is spending between three and $6 million on turnover every single year. And so when you look at that and you think about, well, why are people leaving? And to have two of the main reasons that come up is their leader and the culture.
Welcome to Difficult Conversations Lessons I Learned as an ICU Physician with Dr. Anthony Orsini, Dr. Orsini is a practicing physician and president and CEO of the Orsini Way. As a frequent keynote speaker and author, Dr. Orsini has been training healthcare professionals and business leaders, how to navigate through the most difficult dialogues. Each week you will hear inspiring interviews with experts in their field who tell their story and provide practical advice on how to effectively communicate. Whether you are a doctor faced with giving a patient bad news, a business leader who wants to get the most out of his or her team members or someone who just wants to learn to communicate better this is the podcast for for you.
Dr. Anthony Orsini (1m 32s):
I am honored today that the Orsini Way has partnered with The Finley project to bring you this episode of Difficult Conversations Lessons I Learned as an ICU Physician, The Finley project is a nonprofit organization committed to providing care for mothers who have experienced the unimaginable, the loss of an infant. It was created by their founder, Noelle Moore, whose sweet daughter Finley died in 2013. It was at that time that Noelle realized that there was a large gap between leaving the hospital without your baby and the time when you get home. That led her to start The Finley project, The Finley project is the nation’s only seven part holistic program that helps mothers after infant loss, by supporting them physically and emotionally, they provide such things as mental health counseling, funeral arrangements, support, grocery gift cards, professional house cleaning, professional massage therapy, and support group placement.
Dr. Anthony Orsini (2m 26s):
The Finley project has helped hundreds of women across the country. And I can tell you that I have seen personally how the Finley project has literally saved the lives of mothers who lost their infant. If you are interested in learning more or referring a family or donating to this amazing cause please go to the Finley project.org. The Finley project believes that no family should walk out of the hospital without support. Welcome to another episode of Difficult Conversations Lessons I Learned as an ICU Physician. This is a doctor Anthony Orsini, and I’ll be your host again this week. Nursing leadership is a that we’ve discussed more than once on this podcast, as I’ve had the privilege of interviewing Lori Gunther from Synova Associates, then more recently, Dena Carey from Virginia hospital center, both discussed the importance of nursing leadership and how it can negatively or positively affect not only the culture of the hospital, but the patients and the nurse’s wellbeing.
Dr. Anthony Orsini (3m 22s):
My guest today as taking those concepts in a topic of employee retention too, the next level, Kristin Baird is a nurse and former healthcare marketing executive. She is the Founder of Baird Group, a consulting firm that helps healthcare leaders create cultures where patients want to come for care where physicians want to practice and where employees want to work. She is the author of five books and hundreds of articles on culture leadership and patient experience. Her flagship learning course, which we’ll be discussing today is called Be the Leader Nobody Wants to Leave: eight skill Builders for Busy Leaders is earning international accolades for increasing employee engagement and retention by building a central leadership skills.
Dr. Anthony Orsini (4m 5s):
Kristen earned a bachelor’s of science and nursing from the university of Wisconsin, Madison and a master’s in health services administration from Cardinal Stritch university in Milwaukee, Wisconsin. Baird was appointed by the secretary of health, to serve as an advisor to the national health service. She is a highly sought after speaker for state and national conferences where she pushes leaders to think differently about their roles in culture and engagement. Well, Kristin, thank you for taking your time out of your busy schedule for joining me. I’m excited about this conversation where it’s going to lead us. And I think the audience is really going to get for a real treat today. So thank you, Kristin.
Kris Baird (4m 44s):
Yeah. I mean, one of the things that has just really it’s been a gut punch, I think for the entire industry is grasping where we are with turnover right now. And when we look at the bureau of labor statistics data, it’s one, half to two times somebody’s annual salary to replace them. Well, when I started researching turnover, I was just appalled to see what the numbers really looks like. And when you are looking at healthcare across the nation, it’s around 16%, which is troubling enough, but then when you drill down into different segments, like long-term care, you know, that it’s become accepted, that they ranged between 45 and 50% turnover.
Kris Baird (5m 37s):
And you look at homecare, you know, with the aging boomers, we need more home care than ever. And the turnover there is that 65% and you stop and think, you know, I just mentioned home care in long term care. Those are the relationships you develop with your caregiver because they’re not as episodic is the acute care. And you look at what does turnover really do to that patient relationship and the confidence that the family or the patient has in the caregivers. So there’s that, but then there’s a huge financial implication. Right now, the data shows that the average nurse turnover costs an the organization, $44,000 and the average hospital, is spending between three and $6 million on turnover every single year.
Kris Baird (6m 32s):
And so when you look at that and you think about, well, why are people leaving? And two of the main reasons that come up, is their leader and the culture,
Dr. Anthony Orsini (6m 43s):
Most people would think it’s money. It’s not money, right?
Kris Baird (6m 47s):
No, money doesn’t come in at the top of it is not typically money. And just an interesting story, when we go into organizations and we do focus groups, we’ll talk to the frontline people and we’ll say, you know, what inspires you to do good work? And they will almost always speak from the heart. You know, I want to make a difference. I would want my mother treated this way. I would want my grandma treated this way. So they speak from the heart. And then we asked leaders, what inspires you to do good work? And the leaders will say the same thing. You know, I believe in what we do. I want to do what’s best for our patients. But then we ask another question that is pivotal in this whole equation.
Kris Baird (7m 32s):
We asked them, what do you think inspires your staff to do good work? And so often they say money. And when you hear that and you realized the staff is saying heart and their speaking wallet, then the manager who has that belief, isn’t going to go out of their way to really work on engagement, to work on, you know, giving recognition and reinforcement and creating a culture because they think I can’t change the budget.
Dr. Anthony Orsini (8m 4s):
Right. I think when, when people get a raise or the money is great, you know, everybody loved, like where can I buy in how I can move to a bigger apartment? But I think the raise really symbolizes is the money symbolizes that recognition. You know, when I was young, my father was a police officer and then he went into the private sector, worked in the security and banking. And I remember maybe being a junior high student and my father coming home, all excited because he got a promotion and they couldn’t wait to tell her my mother he got a promotion and my mother who’s, you know, her jobs to pay the bills, right to make sure that the supermarket makes sure they don’t run out of money. And my mother’s says, well, how much money did you get in?
Dr. Anthony Orsini (8m 45s):
He said, Carol, their not giving me any more money, but I got a promotion. She looked at him and said, but I need to pay the bills. And so the point of that conversation is that my father was excited. Not because of the money because he got recognition, right? I mean, that’s what you really crave. Right?
Kris Baird (9m 3s):
That’s normal people do crave recognition. And so often we’re speaking two different languages. You know, we have one person that says, I don’t feel we need to give recognition. That’s their job. And yet we ask people all the time, you know, what inspires you? What gives you that extra surge of wanting to do better. And it’s usually recognition. I can’t think of a time anybody has ever said it’s when I get more money, it’s usually the recognition.
Dr. Anthony Orsini (9m 31s):
One of my favorite quotes is the worst thing that can happen to a business’ is when their most passionate employees goes silent. The people want to be heard. And I’m going to ask you how we can fix that, you know, later on down the line. But I think that’s a common misunderstanding what makes a good leader. And so a lot of that is communication. So you speak a lot about culture and leadership. And you mentioned before that they are related what comes first, the chicken or the egg, is it the poor and leader that makes the poor culture, or is it the poor culture that brings on the poor leader?
Kris Baird (10m 10s):
Yes. Okay. So let me just kind of start in the beginning, which, you know, I don’t know the chicken or the egg , let me just start with the definition. And so when we talked about culture, there’s all of these scientific definitions of a culture that are very flowing pros. I’m going to give you the down and dirty, straight talk culture is how we really do things around here. So you can put anything you want on that mission, vision value of plaque, the hangs in the boardroom, but real culture is how things are really done around here. And so you cannot separate leadership from that because so much of the culture is dictated by leadership.
Kris Baird (10m 54s):
And there was a Gallop study on that long ago that said 70% of culture is directly attributed to leadership. And you stop and think about just one pat phrase, What you permit, you promote. What you permit, you promote. So you can say in your mission, vision values statement, this is what we stand for. This is who we are. This is what we value. But when you come into an organization and this is how things are really done around here, it is very much about how the leader interacts with their people, what expectations they set, how they communicate, how they hold people accountable, how they built the ownership, a sense of ownership, all of those things come right back to the leadership.
Dr. Anthony Orsini (11m 49s):
Yes. And to be able to communicate and build a relationship. Because one of the things that I see a is a frequent mistake, is being inflexible, right as the leader, but not valuing, we’ve talked about it before or not value your people. I’ve seen in the hospital, setting that even in the business where you have an employee who says, you know, my life circumstances have changed. She may be your best nurse, or what are your top nurses? And then now I can’t work Tuesdays anymore. Or, and now I can’t work Thursdays. And the poor leader will just say, well, I can’t help you. If I do that for you, I’ll do that for everyone else and be inflexible. And then what happens is you lose her.
Dr. Anthony Orsini (12m 29s):
So how do you balance that? You know, I don’t want a permit things, but I need to make sure that I keep my employees. I don’t want to be so inflexible then that I’m losing good people.
Kris Baird (12m 40s):
There’s being permissive. And there’s being flexible. Now, the example you gave a logical human being would hopefully be flexible and meet people where they are in lead with empathy, you know? Oh, wow. Things have really changed at your household. You know, I’m sorry to hear that. Let me see what I can do to help. And rally the team, get the team to talk about how can we support one another. I remember when I was a new nurse leader and there was all of this discussion about hours and schedules and so on. And I pulled everybody together and I said, look around this room, where are all working mothers?
Kris Baird (13m 21s):
And most of us have kids. I mean that they were ranging from newborns to, I think the oldest might have been in junior high, that it was just a circumstance where we we’re all, you know, with the young families. And I said, look around there is going to be a day when Sally, when you’re kids are sick and you are going to need to lean on somebody and you know, Lisa, you’re going to have a situation too, how can we create an environment where are we all feel supported? And we want to work and we want to be here together. And so people really rally instead of being inflexible, where I take everybody has to do this schedule.
Kris Baird (14m 3s):
We really work together to make it a reasonable work environment. And it was completely foreign to every nurse in the unit. They had never had anybody even ask their opinion before.
Dr. Anthony Orsini (14m 16s):
Yeah. I see that inflexibility as a, an issue, even when the physicians are making their schedule, a physician A says, I can only work to three to 11 shift in a Physician B says I hate the three to 11 shift. I liked to work for a seven to three shift If you let them switch, everybody’s happy. But you see some leaders that’ll go, Nope, everybody’s going to work the same amount of shifts. Why let’s try to make an environment where people want to come to the work where it fits into their lives. And I guess COVID made that even more important, right? Cause now people have all this sudden their children or not going to school. So how do you deal with that as a leader or that, that you really gotta be flexible. I would imagine.
Kris Baird (14m 57s):
So you have to be flexible. And over 2 million women left the workforce during COVID because the bulk of the home responsibilities and the family responsibilities fall to the woman and you look at healthcare is predominantly women. And so if we can not learn to be flexible, we’re dead in the water. And what’s what’s the definition of insanity, doing the same thing over and expecting different results. We have got to be flexible. And especially since we have five generations in the workforce right now,
Dr. Anthony Orsini (15m 32s):
Wow, I didn’t think of that.
Kris Baird (15m 34s):
And there are a very different mindsets among those generations. I mean, you go all the way from the traditionalist all the way down to the gen Zs and what is important to a traditionalist or a boomer is very different than, and X, millennial are Z. And that flexibility is huge. And if we keep going at a problem with this rigidity, we’re never going to be able to solve the whole turnover issue.
Dr. Anthony Orsini (16m 3s):
You referred to several times when you were in a nursing leader and I, and that’s clearly your background then how you came up. So tell us a little bit about that. So after you graduated nursing school and, and how you move into leadership, why you decided to move into leadership and why you decided to take those lessons that you learned then to where you are now, where are you you’re teaching or other leaders?
Kris Baird (16m 23s):
I absolutely love being a nurse. I’m very passionate about the work that nursing does. And my clinical background really was, well, I worked my way through college as a nursing assistant in open heart unit, which gave me an amazing experience. But then I also worked in med surg and then critical care. And I was one of those people who had a family and I thought, oh gosh, you know, a public health looks pretty good for that hour. So I did public health and then went back to the hospital for a while in obstetrics and then worked in a community outreach education. So I was all about reaching the community and had an affinity for marketing. And so I started doing some of that work too, and then this guy named Quint Studer,
Dr. Anthony Orsini (17m 7s):
Who are we all love? Well,
Kris Baird (17m 9s):
He was a marketing director at the time. He hired me to be the ask a nurse manager. So asking the nurse was a triage and health information hotlines, but it was how it is in marketing. And so aye, all of a sudden had this job where I could be that nurse leader, but also keep my fingers into the marketing and business development. And he promoted me to marketing director. And then I went on to other organizations working in marketing and business development, but I’ve always had an affinity for leadership and culture and really asking why I was that kid that said and why all the time I was that kid.
Kris Baird (17m 54s):
So I always could see, wow, we can do better than this. We can make this a better organization. Let’s ask people what they really want. You know, so I’m a natural researcher, qualitative research. So my master’s thesis was on patient perceptions of quality in clinical settings. And at the time this was the early nineties and I was doing my thesis research. And I can’t tell you how many doctors would say to me, well, Ms. Baird patients, aren’t qualified to gauge quality. And I would say, well, you know, they don’t know that they’re not qualified, so they’re doing it anyway.
Kris Baird (18m 36s):
So let’s ask shall we? so they had really was my foray into the patient experience and culture and leadership. So they all kind of melded together and I am truly blessed to have, have the journey that I’ve had. Right?
Dr. Anthony Orsini (18m 50s):
Yeah. And then you go on in you, right. Your five books. And to really start to teach more and more leaders how to lead, but I want to really get into the learning course. I love the name, Be the Leader. Nobody Wants to Leave eight skill Builders for Busy Leaders. So tell us about that course. And I think everyone’s asking right now, what are the eighth Skill Builders? So maybe tell us a brief history of brief synopsis of that, because I think that’s such a great course. I think I mentioned this to you last time I’ve had leaders or bosses as a physician that if you said anything bad about him or her, I would smack you a slap.
Dr. Anthony Orsini (19m 30s):
You like so loyal to her that I don’t care what you say. She was the best ever. And then I’ve had leaders where I’m like, oh my God, this is just miserable. I got to get out of here. So this is something that’s near and dear to my heart. And I’m frustrated that in business and in medicine that we don’t always have the best leaders. So tell us about the course and how we can maybe learn from it.
Kris Baird (19m 51s):
Yeah. I’d love to first, let me say that. One of the reasons we don’t have the best leaders is that we have really good intentions when we promote people from within, we see this potential, we see the raw potential in, let’s say, as a nurse or a physician or a, a, a tech. And we say, oh, we need a new manager. We need a, a leader in this area. You know, you’re a really good nurse. Why don’t you step up? And so we create this environment where we’re trying to reward somebody like your dad, you know what you were talking about with your dad. And we want to give them and say, Hey, we really trust you. We want to elevate you.
Kris Baird (20m 31s):
And then we, we abandoned them that they have a great skillset for working on the frontline, but they don’t have a leader skill set. And the more I dealt into that, the more I saw that, oh my gosh. I mean, everything from hiring right down to the crucial conversations and being able to coach a lot of it is communication. And so we’ve been offering workshops and trainings for the last 25 years. And what I wanted to do is I want them to take the best of the best in the most, you know, hard hitting pieces of all of those trainings and pull them together.
Kris Baird (21m 11s):
You know, because as I talked to these nurse leaders across the country, they were constantly saying, Hey, it’s leadership, it’s culture in the two are inextricably linked. So I started to look at all of the things that were the biggest gaps in the research. And I started at the very beginning and I thought, all right, let’s start from hiring. Let’s hire for fit. So that’s one of the skills that we really teach in your thinking, yeah. Hire for fit. But you wouldn’t believe how many people take this course. And some of them are long-term leaders who say, oh my gosh, I realized now I’ve been winging it.
Kris Baird (21m 51s):
I’m trying to make this match. And I’ve been going into this, these interviews winging it, or I’m rushed, or I don’t have a clear sense of what is a good fit for my team and what is a good fit for our organization. So helping them to define that. So there’s hiring for fit. Then the, the conversations that keep people engaged. And so we call that one in mastering the state interview. And so how do you recruit people? And so you have to know how to have these conversations and it’s not a drive by, Hey, Tony, how’s it going? That’s all nice and friendly, but it’s not going to make you feel engaged in value.
Kris Baird (22m 35s):
So learning to sit down and have the conversation with you about what makes a good day at work, how can I help you have more of those? What might make you dread coming to work? How can I help mitigate any of those situations? You know, when was the last time you thought about leaving? What was the circumstance around that? What could I do differently? So helping the person to know how to have those conversations, I think back of this dentist, one time being kind of a smart Alec, he goes, you don’t have to brush all of your teeth, just the ones you want to keep. So I always think about that when I’m thinking about you don’t have to do stay interviews with everybody. It just, the ones that you want to keep.
Kris Baird (23m 17s):
You know, I love that. So thinking about that as re recruitment, talking with people about managing expectations, because most of the time we don’t manage expectations until somebody fails to meet them. And then we stop and think, huh? I wasn’t clear. So a lot of that has to do with communication. And then there’s coaching, mentoring, modeling, you know, managing how do you do those things on a day-to-day basis to make sure that you’re creating the culture that you really want to create? So there is a heavy emphasis on coaching, how to have conversations with people, crucial conversations, if you will, but you know, looking at how do you look at somebody’s behavior, what they produce, how they interact with other people and then diagnose which level, are they fully engaged, somewhat engaged or disengaged based on those criteria.
Kris Baird (24m 16s):
And then once you can spot the level of engagement, now we teach you how to coach to that level so that you can coach them up or coach them out. And we get really good results from that. The other thing we talked about to Tony is, is recognition. So we spend some time on that or how to give meaningful recognition, how to connect to purpose. For me, I’ve always had this strong connection to purpose in healthcare. But as leaders, you’ve got to a two-prong responsibility, one is seeing yourself as the leader, what’s your connection, there, why do you want to be a leader, helping them to articulate that?
Kris Baird (24m 58s):
Why did you choose this? You know, what fills your cup right now? The second point of that is now that you’ve got all these people here, how do you help them connect to purpose? How do you look at their job description and tie it back to the mission, vision values? How do you help this person to see that they are making a big difference in the organization?
Dr. Anthony Orsini (25m 21s):
So you talked about these conversations that you’re having with each employee. You could have those conversations, but if the employer doesn’t really think that you are listening than what’s the point. I have been in situations before, I’ve heard this before, when you know, you are hiring a new nurse, are a new physician or new business person. Then you asked three or four of your colleagues’ to where you are, nurse leaders is to interview them. They all interviewed the person. And then the boss’ pics who he or she want’s any way. And then after a awhile you go, are you asking me in your opinion, what do you think have that person we’re, we’re thinking of hiring where the, what I’m thinking deep down inside his what’s the difference, you’re not going to listen to me anyway.
Dr. Anthony Orsini (26m 1s):
So those stay conversations. We had someone on this podcast, a captain, Mike Abrashoff people’s say to me all the time of my wife says that you’re always talking about you’re podcast. And the reason why I think I do that is that over the last 50 episodes, I have learned so much from my guests. And so many things in life hit home that when things happen, I’m like, oh yeah, well, you know, here’s a story about Kristin Baird. And she mentioned that and I had a podcast. And so I’m doing that again. So for my audience, but Mike Abrashoff is so I would really recommend going back and listened to his podcasts interview because he’s amazing.
Dr. Anthony Orsini (26m 41s):
He was a graduate of Annapolis finished at the bottom of his class. When it was time to give out a ship, they gave him literally the ship that was the worst ship in the Navy. Year in year out was the lowest performance. And Mike turned this from the lowest to the top ship in one year. And one of the things that he did was sit and make sure that he had an interview with every single one of is hundreds of sailors. And then my favorite story, he has the sailor, or what can we do to make things better? And the sailor was very shy. Didn’t want to say anything. He said that to the sailor, and you’re not leaving until you give me a suggestion. And the sailor said to, do you know, why we paint the ship every six months?
Dr. Anthony Orsini (27m 24s):
And the captain said no, actually, I don’t know why he says it because the bolts that we used to tie down, the gun’s they rust and the rust goes down. And he is, I always wondered, how does the Navy I ever heard of a stainless steel and so on? So this is Sailor was responsible for the Navy changing all of their bolts, to stainless steel. And so I love that story. I tell it all the time. But as you were talking about these conversations, I thought you can do lip service as a leader. You have to have the communication skills and the nonverbal language to show the person that you are speaking to you, that you actually care when you’re listening to her.
Dr. Anthony Orsini (28m 6s):
And not everyone has that skill.
Kris Baird (28m 8s):
We always teach you listen with your eyes, as well as your ears. You know, that there’s so much that is revealed by the nonverbal communication.
Dr. Anthony Orsini (28m 19s):
Yeah. If you’re a multi-tasking, if I asked you a question and what, you know, what can I do to keep you here? And while you’re answering, I’m looking over at the, you know, email, I’m just going to stop speaking. So I wonder in your experience, I asked this question a lot, also, in your experience, can you take anyone or what percentage of people can you take? And even if you invested all the communication skills as they took your class, but they really want it to anyone learned to be a leader, or do you have to make sure that when you do that interview, that fit, that you identify the ones that are never going to be a leader,
Kris Baird (28m 54s):
Right? You hate to be a Pollyanna. I like to see the positive in people. I think that if people have the desire and are coachable, then a lot of wonderful things can happen. But there are people who I have coached who actually get into leadership positions. And as we’re talking about what fills their cup and what really drives them, they realize they don’t want to be leaders, that they are much better being one of the worker bees that they really don’t want that role. And that’s okay. We don’t all have to be leaders, but I think that the ones that do want to be leaders of the ones that they accept the responsibility in the title, they must do whatever they can to hone skills, to be the best that they can be.
Kris Baird (29m 46s):
And really we’ve got to help them distinguish between management and leadership. There are things that we do that we have to manage, but when we’re leading, we’re really trying to bring out the best in everybody who works with us. You know, we want everybody to reach their maximum potential and that’s, you know, maybe not for everybody.
Dr. Anthony Orsini (30m 9s):
So what is the best advice you can give to someone when they are interviewing someone for a Nursing leadership? So you are looking for an assistant nurse manager and you’re their nurse manager. What would be the best question or what are you really looking for a during that interview to see if this was a good fit?
Kris Baird (30m 25s):
Right? First thing that I would do is I would bring together the staff and I would ask them about from their vantage point, what makes a good leader and what would be a good fit? What are some of the values we have in our department that are non-negotiable. That as we’re trying to build the culture to be even better than it is today, what are the things that we must look for in a person? So how have the staff help you to identify those qualities. You mentioned earlier, you have these panel interviews and then the boss hires, whoever they want in any way. Well, there is a better way of doing that, and that is bringing people together to talk about what is an ideal fit, what are the characteristics that we are looking for?
Kris Baird (31m 14s):
And therefore, what are some questions that we should ask that are behavior based that we’ll get at that the best candidate. And so, for instance, you know, you need somebody who can manage conflict. So if I already ask anybody, you know, how are you at managing conflict? What do you think people are going to say? Oh, I’m really good. Okay. That’s easy. So we don’t ask it that way. We say Tony, tell me about a time where you had to work with a team that experienced conflict. Tell me about that. You tell me about it, then I’ll say, you know, what do you feel was your role in that situation in hindsight, what would you do differently?
Kris Baird (32m 2s):
How did the team resolve that conflict? And what about that worked well? You know, and like I said, you’re probing, you’re getting at really delving down into it. And that is a learned process. Or your first identify the quality’s, you have the team to say, okay, if this is the quality we’re looking for, what are some behavior-based questions that we can ask? And then how are we going to score the responses? Because there are people who come into interviews are very charismatic. They’re charming people, they win you over immediately. And then when you really look at how they answered the questions, if you have behavioral-based interview, you can really separate the wheat from the chaff by having a scoring system.
Kris Baird (32m 47s):
And so those are some of the elements that are often missing.
Dr. Anthony Orsini (32m 52s):
It really is so important to identify it. As you said, that starts with the intake. ’cause we often just say, especially when someone from outside of the organization, right now, we often say that we are going to hire the person who has the Ivy League education with the most letters after her name or the most letters after his name. And yet maybe it is not the best communicator. I think that the biggest mistake we made in medicine is the biggest mistake they make in business. And I would say you’re bridging the gap really once again. And there’s so many parallels between what I say, that the patient-doctor relationship to the nursing patient relationship, that business leader or employee relationship to the leader is all the same way.
Dr. Anthony Orsini (33m 35s):
And it’s really based on two words, as far as I’m considering all the three words, loyalty, trust, and relationship, and that’s where communication comes in. How can we create those three things? We had Stephen Covey on the area and bringing in a previous podcast
Kris Baird (33m 49s):
Trust. Yeah. The speed
Dr. Anthony Orsini (33m 51s):
Of trust. Yeah. So that’s something that’s not a soft skill. Just kind of circling back to the beginning of my pet complaint. And yet I don’t think hospitals and businesses really invest enough in that, what can we do to make the people with the money, the bean counters as they call them invest in this kind of training for their leaders. So
Kris Baird (34m 13s):
You always want to prove a return on investment for anything that you do. Okay. So from the medical standpoint, I’m with you a, a hundred percent. So we teach engagement, empathy, communication, gestures of respect when done well foster the relationship that builds the trust. And when the trust is there, you have higher compliance. When you have a higher compliance, do you have better outcomes? So you can follow that whole thread through and say they are as an accountable care organization we wanna make sure that we have a, you know, so that’s one way to go to go another, his, to go the route, have turnover and say, look, if we can reduce turnover by 1%, it’s usually worth $306,000.
Kris Baird (34m 60s):
That’s the average, what would it mean to us? If we could reduce turnover by X amount? So his, sometimes you have to go in with that data in order to be able to, when the argument it’s often speculative and finance people, don’t like that. They want a guarantee and that’s not always possible. So you have to be ready with some case examples, you know, and it’s hard because of the whole industry has been hesitant to invest in this. And yet what’s the definition of insanity. We keep getting what we’ve always gotten. So let’s try and shift the course a little bit
Dr. Anthony Orsini (35m 40s):
Or moving in the right direction. I think the gen Z people, you spoke about the generations, whether it’s business or health care, that they don’t tolerate bad leaders, as much as we used to and our generation, they are stories have doctors throwing charts and, and nurses getting yelled at by their leaders. And it was, you know, I’m going to take it because I want my job, et cetera. I’m talking to more and more companies right now in the biggest topic right now is creating a culture of safety in a culture of inclusiveness in the gen Z people that are not going to tolerate that. There are just they’re, they’re going to leave their gone. Kristin is shaking her head no
Kris Baird (36m 22s):
So in 2025, 75% of our global workforce will be Millennials. That is a major shift. So the millennial and gen Z’s have a different perspective on things and they are not gonna tolerate. And so many have the millennials now or are moving into leadership positions. So I’ve been coaching a lot of millennial leaders, which is very exciting because they bring a fresh perspective. So you don’t, I hope that we’re moving in the right direction. I really hope that we are.
Dr. Anthony Orsini (36m 51s):
I really feel that we are in healthcare. We are, the whole patient experience is driving now possibles to put more emphasis on communication skills, building relationships with patients, because again, the millennials and the generation Z, I remember a very common phrase, but I was growing up as he’s a good doctor. He’s got a lousy bedside manner, but he’s a good Dr. So I’m going to go to him or go to her. Generation Z and the millennials are not going to tolerate that. You can be the greatest Dr. In the world, if you don’t have good communication skills that are going to find someone else. So it is moving in the right direction than millennials get a bad rap, but they are doing some really good things in gen Z.
Dr. Anthony Orsini (37m 32s):
And it’s making us more aware of culture in a, and I think, and your doing that too. So you’re work is amazing. Kristin, I don’t know if I warned you about this question before hand. I always finished with it, the same questions on every podcast. And when that is, what do you think is the most difficult conversation you’ve ever had? A, can you give us some advice on how to navigate that? And it doesn’t have to be personal. It could be a type of conversation, but lets leave the audience with some really pearls of wisdom on how to navigate the most difficult conversations.
Kris Baird (38m 3s):
Well, I’m not so sure that its the most difficult conversation I’ve had, but if I could stretch that out just a little bit, I am one of 10 children and we had this big, crazy loud family. And when I was four years old, my parents brought home. My younger sister and mom and dad both knew that something was not right from the very beginning. And she kept worrying. You know that all Patty is just not doing things like the other children. She doesn’t cry. My mom was very concerned and they brought her for all these batteries of tests that the university of Wisconsin and they were finally going to get the results.
Kris Baird (38m 45s):
And my parents sat down in this doctors office and he came in and he didn’t even sit down. And he and his arms crossed and his white coat and he said to my parents your daughter’s severely retarded and she’ll never sit up. You have to put her in an institution. And my parents were heartbroken. I mean they were devastated and both of them are educators. And so my father said, you know, I really believe we should just take her home and give her as much stimulation and opportunity as possible. And he said, no, she is your eighth child. There is no way you are going to give her the attention she needs.
Kris Baird (39m 28s):
She needs to be institutionalized. There’s no way. And my mom said, no, we have to try this. And he looked at him and said, well, go ahead. Some people feel they make good pets. Oh my goodness. My parents sobbed all the way home. And you seeing their grief and hearing this story over the course of my life, that was horrible news to get. But how it was delivered was absolutely it was unconscionable. And what it has taught me is that we have so many opportunities. We have so many opportunities in healthcare, whether we like it or not.
Kris Baird (40m 14s):
We are part of people’s stories every single day. And we have a responsibility to ask ourselves, what do we want that story to be like 10 years from now, 20 years from now, when their telling a story about their experience with us, what are they gonna say? And so that would be probably one of the most difficult conversations in my family that was severely botched. That has been pivotal for me in my life and in my career. And by the way, Patty did learn to sit up. She learned to walk and she went to high school, she got a diploma, she works a job. She lives independently.
Kris Baird (40m 54s):
So guess what my parents were right. And he was wrong.
Dr. Anthony Orsini (40m 58s):
Yeah. And as you know, I mean my presentation breaking bad news. That’s how I started. That’s really what I’ve dedicated my life to is to teach the physicians and nurses, how to have that initial conversation with breaking bad news. Because as you know, better than anyone, it can affect you adversely not only in the immediate time when you hear the news, but also studies have shown that the, how you receive that news kind of affect someone up the 30 years and we’re still counting. And so how many years ago is that? I don’t want to give you all right.
Kris Baird (41m 35s):
No, it was over 50 years. Honestly, I take that into my workshops. And one of the techniques I use is to look at an audience and say, I want you to think back to a time when a healthcare provider made an indelible impression on you, it could be good or bad, but just think to a time when a healthcare provider left this indelible memory or indelible impression and people share their stories and some are really good and some are really bad. But again, it goes back to, we have these moments in time, the small moments in time, where we get to make a choice about how we are going to deliver the news or how we’re going to empathize, how were going to engage with another human being at a time when they are most vulnerable.
Kris Baird (42m 29s):
And you see tens of thousands of patients on the course of your career, and you’re not going to remember them all, but guess what? They’re going to remember you .
Dr. Anthony Orsini (42m 38s):
Absolutely, and it’s to be fair or what I have found and my hate to say the decades of research and, and working. But this topic is its not just about to be fair to the doctors in the, nurse’s not just about telling them to be nice, right? Where to sit down, which is what we’ve done. We’ve failed them by not training them, how to do it and then told them to go do it. And I always say to my doctors, when I’m training them, would you read a book on how to do an appendectomy and then go do surgery? And this is what we’re doing for this really important communication skills to say, here’s a lecture, you know, I’m going to give you a quick acronym. Now go do it. So I think it’s human nature when you’re are very uncomfortable with doing a task, you rush it and you botch it.
Dr. Anthony Orsini (43m 25s):
And so I’ve dedicated my life to helping physicians start to think about this really important conversation as a skill that they can be really proud of. And I don’t wanna tell that person that their child is going to be developmentally delayed, but I know how to do it. And I know how to help. And here I go. And once we get there and again, this whole podcast is making a full circle. Now it’s all about communication. So that’s why I knew you’d be a perfect guest. So this has been great, Kris thank you so much.
Kris Baird (43m 56s):
Oh, it’s my pleasure.
Dr. Anthony Orsini (43m 56s):
What’s the best way for people to get in touch with you at the Baird group?
Kris Baird (44m 3s):
The best way is just to go to our website info at Baird, B A I R D hyphen group.com. Then you can send a message that way and we’ll get back to you as soon as we can, but we have our next cohort coming up. We start new cohorts of Be the Leader Nobody Wants to Leave Eight Transformational Skill Builders for Busy Leaders. We start them every eight weeks. So the next one is coming up in July.
Dr. Anthony Orsini (44m 31s):
Okay, great. And I’ll put that on, on the show notes so that we’ll able to find you so they don’t have to jot that down at media type. Thank you again. If you’ve enjoyed this podcast, please go ahead, hit follow up on your favorite podcast platform and download all the previous episodes. Cause I’m telling you, everyone of them is just as good as Kris and Kris has been amazing. I’m really a better person for knowing you, Kris, I’m excited about what you do and I hope that together we can keep pushing this communication and leadership training and make it better for everyone. So thank you so much, Kris.
Kris Baird (45m 5s):
Thank you. It’s an honor.
Dr. Anthony Orsini (45m 6s):
Well, before we leave, I want to thank you for listening to this episode of Difficult Conversations Lessons I Learned as an ICU Physician. I want to thank The Finley Project for for being in such an amazing organization, please, everyone who’s listening to this episode, go ahead, visit the Finley Project.org. To see the amazing things they are doing. I’ve seen this organization literally saved the lives of mothers who lost infants. So to find out more and go to the Finley project.com.
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