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16 December 2011
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One conversation at a time

I don’t know exactly who coined the phrase that leadership is an activity that takes place “one conversation at a time”. It may go back to before 2000 when Susan Scott was already developing her idea of Fierce Conversations[1]. Her eponymous book, published in 2002, certainly pushes forward the idea of achieving success one conversation at a time. Since then, a Google search reveals, one-conversation-at-a-time has had a pretty viral spread, and is to be found on multiple websites in different contexts.

Popular, does not, of course, mean wrong. We need to remain mindful of the importance of the conversations we have as leaders, because aside from the influence we seek to have, we can also be sure the people we converse with will be watching and listening carefully. What is she telling me? What does he really mean? What does this say about how the organisation is doing and where it is going under his leadership? What does it mean for me? Can she be trusted? Did he say that deliberately, or was it some kind of slip of the tongue?

Greg Dyke, the former Director General of the BBC, makes this point powerfully. Leadership, he says, “is about the stories that are told about you” [2]. He reminds us that we do have some control over what those stories will be, and that we need to remain alert, as leaders, to what others will narrate about our actions. We can’t, of course, be oppressed by that fact, and as Goffee and Jones have pointed out, to have real traction as leaders we need authenticity (among other attributes). But by remaining mindful of the conversations that we and others will have, with us and about us, we can seek to make every interaction count; with those we manage, our peers, and even our bosses.

A colleague recently told me a story that is so simple, and packed with a certain kind of leadership, it just has to be told.  His Specialist Registrar has a distinctive habit, unusual among doctors; for every patient that she sees on her ward round, she pours a glass of water and gives it to the patient (for readers in questioning mode, we are assuming this is only when medically appropriate). She even does it on consultant ward rounds behind his back, when my colleague is busy addressing the rest of the team or is moving on. Simple, practical, humane….and it doesn’t stop there. On arriving at one patient, the ward round ran into difficulties…..the patient did not want to be examined by the doctor, thank you very much; they wanted a wash, which the nurses had not supplied. Undeterred, the doctor gave the patient a wash instead, naturally getting lots of useful clinical information at the same time.

Those actions can be seen just as that; as actions. But if they touch us enough to trigger a sense both that they should be emulated and be narrated, of course they then become acts not just of compassion, but also of leadership. They point the way towards behaviours we should all seek to enact. They provide something worth following.

Another great story was told to me without the teller, I think, necessarily even realising what a powerful thing he was saying. Dan Bowen is a PICU nurse at Birmingham Children’s Hospital and is part of the team there that delivered nearly 95% flu vaccine uptake among the Trust workforce last year. This is a level of uptake that has elsewhere largely been achieved, in countries like the USA that lead the way in healthcare worker flu immunisation, through compulsory vaccination. In the NHS we do not have mandation to fall back on, making the healthcare worker seasonal flu immunisation campaign a major leadership challenge. How to influence staff, with variable levels of engagement with the organisation’s multiple agendas, to undergo the inconvenience of the flu jab for the greater good? What, in particular, to do about “resisters”, as one so easily can lapse into calling the group who, no doubt for many different reasons, have not yet been immunised?

Dan and I were discussing mandation as a strategy and he mentioned that whenever this comes up, he defends the rights of staff not to be immunised even though he passionately believes having the flu shot is the right thing to do. So much so that when two members of staff turned up in the flu clinic, having been “sent” for the jab by their manager, he refused to immunise them, sending them away because they had been coerced.

A week later, they were back of their own free will. It’s hard not to believe that Dan’s personal and enacted commitment to participative leadership and consensual action was not part of what brought them back, and is likely to bring them back year after year in future.

Both stories are about strong and evident values, with a dash of the courage of one’s convictions to turn beliefs to action. Leadership may not always, or even often, be that easy, but sustaining our energy for complex struggles might at times need no more than having the right kind of conversations, or telling the right kind of stories. Perhaps we should all make a little more time to notice, to listen, and to tell stories that really count?

 

[1] Scott, S. 'Fierce Conversations: Achieving Success in Work and in Life, One Conversation at a Time', Viking, 2002.

[2] Dyke, G. speaking to Management Today, 3.11.09 http://www.managementtoday.co.uk/news/935797/greg-dyke-leadership-storie...

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About the author

Anthony Berendt's picture

Anthony Berendt

Tony has worked at Medical Director level in acute Trusts since 2004 and he is particularly interested in organisational dynamics; their influence on individual, team, and organisational behaviours and performance; and the role of leadership in creating healthy organisational cultures.

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