The ChallengeJ. Lynn Jones is a VitalSmarts veteran. An elementary school principal for sixteen years, he became a certified trainer in Crucial Conversations and used those tools to help his school boost achievement. When he was promoted to director at the Nebo School District in central Utah, he added a certification in Crucial Confrontations. He taught both courses to most of his 600-person staff and also offered them to other administrators, teachers, and support staff in his district. But his biggest challenge in his expanded role was a persistent one. He was responsible for special education in the district and focused particularly on the special education teachers in its twenty-seven elementary schools. These are the instructors who give extra help to mainstreamed students with learning disabilities. And they didn’t have a history or culture of being accountable to progress their students. "We had a number of veteran teachers who never had high expectations, and the kids never performed well. The teachers used the excuse that ‘these kids have disabilities’," he said. "In the end, we weren’t seeing good instruction and we weren’t seeing good results." Of about sixty teachers, Jones was comfortable with only five or six of their results. But because he was not a career special educator, he lacked immediate credibility to shake things up by himself. About the same time he came to this realization, he added another VitalSmarts certification to his credentials: Influencer Training. The Results: Read our case study to learn how J. Lynn used Influencer Training to boost literacy rates and double the number of special education students released into the regular school system. Related posts: Success Story: Crucial Conversations Training Improves Nurses’ Ability to Address Disruptive Physician Behavior Case Study: Influencer Training Helps Tennessee Health System Achieve 100% EHR Adoption Case Study: Influencer Training Helps Retailer Save Millions and Prosper in Economic Recession

ABOUT THE AUTHOR David Maxfield is coauthor of two New York Times bestsellers, Change Anything and Influencer. READ MORE Dear Crucial Skills, I work in a busy, growing medical office with five support staff, and I share duties with a coworker who just turned seventy and has been with the clinic since it opened. We don’t have an office manager, so the clinic owners expect us, as peers, to come up with policies and procedures for the front desk, solve problems, and strategize on improvements. My coworker resists every suggestion of change or improvement to the front desk area and refuses to use the computer unless she has to. When I try to suggest changes in a nonthreatening manner, she gets very hostile and attacks me personally, and I no longer feel safe talking to her. The owners are aware of the situation, but they won’t address it. I want to see the clinic continue to grow but frankly don’t see how that can happen if the front desk doesn’t keep up with the times. Stuck in the 90s  Dear Stuck, You’ve just described an incredibly messy, complicated, and value-laden problem. There isn’t likely to be a simple or easy-to-implement solution. Let’s begin by identifying the different issues that are involved. You don’t have an office manager, so your team of five organizes its own work and handles any disagreements. One of your coworkers resists changes and improvements. This coworker becomes hostile and attacks you personally. This coworker is seventy years old and has been with the clinic since it opened. The owners are aware of this situation, but haven’t addressed it. The clinic is growing and the front desk needs to keep up with the times. I think we can break this problem into two parts based on who could take action to solve it. One problem is with your coworker—her resistance to change and her personal attacks. A second problem is with the owners—their unwillingness to take action. I would focus my efforts on the owners for a couple of reasons: I don’t think you will reach an accommodation with your coworker until they make their position clear. The owners have more options than you do for creating new solutions. In any case, I think they need to step up and take responsibility for the situation. Determine What You Really Want. Before you talk with the owners, decide what you want in the long-term for yourself, for the owners, for the clinic, and for your coworker. I’ll guess that you want the clinic to continue to grow, the front desk to keep up with the times, and a fair distribution of work within your team. Find Mutual Purpose. What do you think the owners want? I bet they want many of the same things you do, plus a couple more: They don’t want to have to get involved in personnel issues and they want to show loyalty to a loyal employee. Can you buy in to these five goals? Do you think the owners will as well? Agreeing that a high-quality solution will achieve all of these goals will take you a long way toward crafting a solution. Make It Motivating. There is a good chance the owners don’t share your view of the problem. They may see it as a personality clash, while you see it as a productivity issue. Take the time to describe the situations that occur, and the impacts they have on the clinic’s ability to function. Avoid personalizing these issues. Remember, the owners are prone to dismiss your concerns if they sound like personality differences. Stick to the facts as they relate to the clinic’s ability to grow. Make It Easy. Give the owners time and space to discuss possible solutions among themselves. Don’t press for a "simple" solution—one that could sound to the owners like you win and your coworker loses. Remember, the owners may want to reward your coworker’s loyalty as well as maintain a healthy workplace. This will take some consideration and creativity on their part. Yeah, But. There are several ways this conversation can go wrong. I’ll anticipate a couple. What if the owners still refuse to get involved? Here is how I would read this outcome: they want to protect your coworker, they don’t want to get involved in a personnel issue, and they think you can work it out on your own. That’s the story I’d tell myself, but I’d want to check it out with them. Ask them whether you are reading them correctly. If that is their position, then you need to ask yourself whether you can live with the results. It may mean redefining the roles within your front desk team. Your coworker may need to stick to her preferred jobs, while the rest of you work more flexibly. It may appear unfair on the surface, but maybe she’s earned it. What if the owners ask your coworker to change, but she doesn’t? What if she becomes even more hostile toward you as a result? The ideal is that peers hold peers accountable. However, peer accountability requires that leaders back them up when the going gets tough. Since you know this scenario is possible, discuss it with the owners in advance. They can’t just ask your coworker to change; they need to support her and hold her accountable. They need a plan—who will do what by when—and a way to follow up. Good luck with this tough situation. Have other readers resolved a similar situation? I’d love to hear what worked for you. David Related posts: Uncomfortable Conversations with a Coworker Coworker’s Personal Life Control Freak Coworker

ABOUT THE AUTHOR Al Switzler is coauthor of four New York Times bestsellers, Change Anything, Crucial Conversations, Crucial Confrontations, and Influencer. READ MORE   Dear Crucial Skills, I was recently promoted to supervisor within a highly stressful telecommunications center. My entire team has complained about another employee’s personal hygiene and said that the offensive odor and unsanitary conditions of the employee’s workspace are so bad that it contributes to a hostile work environment. In the past, this was handled ineffectively and has now become a disciplinary situation. I know I need to hold this conversation, but because it is such a sensitive issue and the employee is otherwise a spectacular employee, I am at a loss as to how to begin the conversation. Please help! Dreading B.O. Conversation  Dear Dreading, What do we do when someone’s behavior negatively affects others and they don’t seem to know it or can’t seem to change? In addition to body odor and cleanliness, this behavior could include things like inappropriate dress or language, too much small talk, and smoking in incorrect places. All of these behaviors create gaps—the difference between what is agreed upon or expected and what is actually happening. We can endure small, infrequent gaps and hope they go away, but when the gap is serious and when it is a pattern—as it is in your situation—what do you do? Here are a few strategies. Clarify two kinds of expectations. The first expectation is reviewing or discussing expected behaviors and the reason behind them. When you are first promoted, or when there is a new team member or a new quarter, take the opportunity to meet and talk about the few expectations that will help your team work together effectively. This might include talking about past gaps that have hindered the team or the work. For example, you might want to talk about proper dress and grooming standards. The reason for this is that customers have expectations, managers and employees have expectations, and these expectations make it easier to work in close quarters as a team. I suggest that you never work on more than three or four behavioral expectations as a team—these should be important issues your team struggles with most. The second expectation is really important: when someone sees a gap, talk about it. Ask each team member to agree that when someone falls short of expectations, those who see it will privately, politely, and professionally talk to him or her. You won’t get angry or gossip; you’ll talk. The reason is that when we don’t talk about a gap, we lower the standards of the company and we increase the probability someone will get offended, gossip will run rampant, and team morale will go down. As a team, identify gaps and solve concerns before they become real problems. Give the person the benefit of the doubt. We teach people who face a gap to ask themselves, "Why would a reasonable, rational, decent person act this way?" By asking that question, you avoid jumping to conclusions or making assumptions that can move you to make wrong diagnoses. It also prevents you from beginning your conversation in a way that says in essence, "I have held court in my head and found you guilty. Can we talk?" Such a beginning is not helpful and makes you part of the problem. You want to start the conversation by sending the message that you are observant, inquisitive, and caring. You want to be part of the solution, not part of the problem. You do this by helping yourself understand that until you talk about it, you don’t know—you are only guessing. In your case, maybe the person has started taking a new medicine, or maybe his or her house burned down and he or she is living out of a car. You don’t know. Give yourself the opportunity to do a real diagnosis and to maintain the relationship. Discuss gaps early. Identify the gap when it first appears, then find a safe time and a private place to talk. Over the years, we’ve talked about the skills for beginning an accountability conversation or "the hazardous half minute." And we know that if you begin correctly, you are much more likely to find a solution. In Crucial Confrontations, we teach that you should first describe the difference between what is expected and what has been observed then end with a question. For example, if an employee came in late you could say, "I just want to clarify that working hours start at 8:00 and I noticed you came in today at 8:25. What happened?" You should say this in a way that is nonjudgmental. If the person is wearing too much perfume or cologne, you might begin with, "One of the expectations we have is that we will work together in ways that makes it pleasant for others. I have noticed that your cologne is very noticeable, and I’m hoping you can wear less of it. Can we discuss this?" Let’s assume the person says "yes" and we have caught it early. If they disagree, that is another problem. If you don’t discuss it early, the problem lingers. Coworkers gossip and don’t invite this person to lunch. Another employee calls the person names behind his or her back and one person lets a sarcastic comment fly. Now trust and respect have diminished. Gossip and hurt feelings have increased. Why? Because nobody spoke up early about the gap. Trust the process. If you begin your conversation in a way that says you are not judging, and that you are observant and caring—both about the standards and about your colleague—you are well on your way. In a private place, at a good time, after you have your head and heart in the right place, and if you had previously clarified expectations as I described above, you might say, "A few weeks ago, we all agreed to a dress and grooming standard that would help us serve our customers and work well together. This is a bit awkward for me to say, but I’ve noticed that when you come to work you have a body odor that is noticeable. I don’t know what’s going on, but I’d like to talk about what’s going on and what could be done to meet the expectations." Your purpose is clear in your words and in your behavior. If you didn’t have a clear expectation, you would substitute the first sentence by saying something like, "I think it’s important that everyone come to work in alignment with certain dress and grooming standards." Notice what should not be said at this point. For example, don’t say that others have complained to you. Share that information only if the person says it’s just your opinion. Don’t use inflammatory words like stink, stench, or reek. And certainly don’t use the indirect approach by anonymously leaving a bar of soap on the person’s desk. Over the years, as I’ve discussed the idea of bringing up a tough subject in front of large groups, I’ve asked participants to raise their hands if they have ever had to talk to someone about a "body odor" issue. Hundreds of hands have been raised, most often accompanied by audible sighs and shaking heads as people reflect on many bad experiences. Then I asked how many should have spoken up but didn’t. Many more hands go up and I can see many more negative reflections. You are not alone. I hope this advice will help you feel more motivated and able to step up to the conversation and help an otherwise spectacular employee. I wish you the best,Al Related posts: Confronting Late Employees When Your Employees Won’t Talk to You Giving Feedback to Defensive Employees

When she first met her husband, Patty Loeffler was thin, active, and the picture of good health. But nine years into her marriage, Patty found herself 100 pounds overweight and a perpetual yo-yo dieter. She had joined and left Weight Watchers so many times that she was embarrassed to even consider going back. And yet, she knew she needed to make a big change. That’s why in 2012, she made the resolution to simply "get healthy"—and the timing couldn’t have been better. In March 2012, Patty enlisted in Influencer Training by VitalSmarts. Already a Crucial Conversations certified trainer, she was excited to learn the Six Sources of Influence model for changing behavior. When prompted to identify a change challenge to which she could apply the model and principles, she selected her "get healthy" initiative. Shortly after, she received the newest book from VitalSmarts, Change Anything, which helped her further apply the Six Sources of Influence to her personal goals. Patty started her "get healthy" change plan by identifying two vital behaviors that proved to be instrumental to her success: 1. Make a plan. Patty found planning to be essential. She not only planned her healthy meals, but also where she would go if and when she ate out. She learned where all the healthy restaurants and meals were in the city so she would never have to make a last-minute unhealthy choice. 2. Weigh daily. By weighing herself daily, she found that she could stay on top of her weight loss and most importantly, quickly get back on track if she started slipping. Patty used all six sources of influence to help keep her vital behaviors, but she attributes the majority of her success to social motivation and ability. She says the social influence that was missing from her past diet attempts meant the difference between her success and the years of failure. Patty recruited her husband and son to join her in her goal to get healthy. Like Patty, her husband also had a history of failed weight loss, and as a result, was pretty reticent to participate. But after Patty begged him, he agreed and they made a very serious commitment to each other that they would see the plan through to the end. When Patty’s son came home from college that summer, she also recruited him to participate, and together the three found success in applying the model from Influencer and Change Anything. The Six Sources of Influence Patty identified to help keep her behaviors included: Personal Motivation - Patty hung her skinniest jeans on her closet door which served as a daily reminder of what she looked like and how good she felt when she first met her husband. The jeans also reminded her that at the age of 53, her window of opportunity to change was closing as she may only face more health issues in the future. Personal Ability - A key part of Patty’s plan included a nutrition program called Ideal You sponsored by her employer. At first, Patty was skeptical this would be just another failed diet plan, but this program taught her skills to control her diet with higher protein and lower carbohydrates and fats—skills she never learned before. There was also a phased approach which began by limiting her diet in the beginning and slowly adding in healthy foods as she learned to get her intake under control. The program also taught her effective strategies to maintain her weight loss. Social Motivation and Ability - Patty and her husband faced every part of their weight loss journey together. They started by publicly announcing their diet at her daughter-in-law’s birthday party. This public proclamation lead to support from her entire extended family. Her husband also did most of the shopping under their approved dietary guidelines and they began exercising together and spent less of their time together watching TV or eating out at unhealthy restaurants. Patty also garnered support at work. She teamed up with a few coworkers who also had a goal to get healthy and they spearheaded a transformation of their entire team. For example, they stopped bringing in unhealthy food to celebrate events and when they ate out together, they went to healthy restaurants. Patty’s family and friends never made her feel bad for wanting to choose healthy meal options. On the contrary, many actually thanked Patty for her example and motivating them to make their own healthy choices. Patty also attributes much of her success in beginning an exercise regimen to the help of personal trainers who reintroduced her to exercise and how to do it effectively. Structural Motivation - Instead of falling into old habits of rewarding herself with her favorite foods, Patty started going to the spa and treating herself to massages, manicures, and pedicures when she hit her weight loss goals. She was also really motivated to change by shopping for cute clothes she couldn’t fit into previously and the money she saved from giving up expensive and fattening fast food meals helped to offset the expense of a new wardrobe. Patty was also motivated to stick to her new diet because it was a plan she paid to be part of and she didn’t want to see that money go to waste. Structural Ability - Early on, Patty decided to chart her weight loss. This strategy helped her to see her long-term success—which was a tremendous motivator during the weeks of plateau. She also changed her surroundings. She brought exercise equipment out of storage and placed it in her family room. She also got rid of all the junk food in the house. She even made changes at work. For the first time in her career, she began to use the on-site personal trainer and fitness center provided by her employer. Results By using the change plan found in Change Anything, Patty shattered a long history of failure to lose weight. In just nine months, she lost an impressive 102 pounds. And, as it turns out, her weight loss impacted her life in even more immediate ways. After discovering a life-threatening illness months into her get healthy initiative, doctors told her that losing the weight was the best thing she could have done and possibly even slowed the progression of the disease thus allowing it to be discovered and treated at an early stage. Patty wasn’t the only one who experienced such dramatic success. The social influences she learned about in Change Anything really made a difference not only for her but also for her husband and son. In the end, Patty’s husband lost 80 pounds and her son lost 100 pounds, proving that with the right plan, you really can change for good. Related posts: Change Challenger Terri has lost 21 of 50 pounds Bobby Robbins: Lost 12 of 50 pounds…and counting Success Story: Nebo School District Uses Influencer Training to Improve Student Performance

ABOUT THE AUTHOR Ron McMillan is coauthor of four New York Times bestsellers, Change Anything, Crucial Conversations, Crucial Confrontations, and Influencer. READ MORE Dear Crucial Skills, I’m the team leader of an increasingly dysfunctional team. Our tasks require a high degree of coordination and we often have to figure out what to do as we go. But we’re stuck in a pattern of arguing and disagreeing, and it derails our ability to get anything done. Lately, our aggressive debates and defensiveness are dragging us down. Members seem to think it’s more important to be right and prove others wrong than it is to get our work done. Can you help? Despairing  Dear Despairing, Sometimes in our teams and relationships, we slip into bad habits. It’s hard to trace how these problems developed, but it’s easy to see the negative and sometimes hurtful outcomes these problems cause. I consulted with an executive team that seems similar to the team you describe. In one of the first meetings I attended, a director shared his ideas about solving a problem. "I think we ought to do options ‘J,’ ‘K,’ ‘L,’ and ‘M’" he said. Another director aggressively jumped in, "I disagree!" he said. "We’d be fools to do ‘M,’ we’ve got to do ‘P,’ not ‘M.’" A heated argument ensued. Afterward, I spoke with the disagreeing director. He agreed with the other director about proceeding with options ‘J,’ ‘K,’ and ‘L.’" It was only option ‘M’ that he disagreed with. Imagine that. He agreed with three fourths of the other’s view, but the first words out of his mouth were, "I disagree!" This is the verbal and emotional equivalent of picking up a shield and drawing a sword. This response almost guarantees a fight. I’ve seen this same mistake made in personal relationships as well. What’s needed to change your team’s behavior is a focus on purpose and the teammates’ agreement to use a few skills: Share the facts first. You might say something like this: "I’ve noticed we seem to have more arguments and disagreements that lead to blockages rather than progress. For example . . ." Then share several specific examples that are obvious to everyone. Propose a Mutual Purpose. "I strongly suggest we all operate toward this Mutual Purpose: We achieve our team results in a respectful, efficient way." Define "respectful" as listening to each other, not labeling each other or each others’ ideas, and not interrupting each other. Give specific examples from recent team arguments. Such examples might include words like "stupid," "unworkable," and "ridiculous." Define "efficient" as letting details pass that are unimportant and not getting "hooked" into arguments or debates that are unproductive. Say, "Each of our comments and responses should take us closer to solving a problem or building a productive option." Explain that you shouldn’t expect perfection, but that you should actively make an effort to accomplish your Mutual Purpose. Share the ABCs of response. These skills help teams create more productive behavioral patterns. Here’s how they work. When someone makes a statement, do not ignore the comment or respond with disagreement. Rather, respond with A, B, or C, as explained below. The ABCs of Response A- If you agree, say so. You might simply say, "Mike, I agree with you that . . ." If you agree with some of what was said, respond by identifying what you agree with. Consider the example used earlier of the disagreeing director. Instead of saying "I disagree," he should have said, "Mike, I agree that we should do ‘J,’ ‘K,’ and ‘L.’" B- If you agree and want to add to it, build on their idea. "I agree we ought to do ‘J,’ ‘K,’ ‘L,’ and ‘M.’ I also think we should do ‘R.’" C- If you disagree with what was said, don’t attack, criticize, or disagree. Rather, compare your opinion. This is often best done by first paraphrasing the other person’s idea, then sharing your own. By laying both ideas side-by-side, everyone can compare and contrast the two ideas. For example, "Mike, you think we should do ‘J,’ ‘K,’ ‘L,’ and ‘M.’ Is that right? I think we should do ‘R,’ ‘S,’ ‘T,’ and ‘V.’" By responding to comments with the ABCs of Response, you acknowledge others’ comments and minimize defensiveness. With ideas out in the open and treated with respect, people can now compare, contrast, and build to get to the best solutions and the most effective decisions. We are now creating a dialogue and using it to get results and strengthen relationships. Using the skills of creating a Mutual Purpose and the ABCs of Response, the executive team I worked with had what the CEO referred to as "an amazing metamorphosis." Within three meetings, with the CEO giving gentle reminders, the team became more disciplined and productive. Each team member reported the change as an improvement and said he or she did not want to go back to the former way of doing business. As your team focuses on results in a way that strengthens relationships, you improve your effectiveness in the dialogue of today and pave the way for improving the dialogue of tomorrow. All the best, Ron Related posts: Violated Agreement A Boss’s Drinking Problem Responding to False Accusations

ABOUT THE EXPERT Steve Willis is a Master Trainer and Vice President of Professional Services at VitalSmarts. READ MORE So it doesn’t happen all that often, but when it does it usually takes me by surprise. It’s every facilitator’s fear—the inappropriate comment. They come in lots of shapes and sizes, ranging from overly personal to highly offensive. I remember a train-the-trainer session where a prospective trainer’s opening line was, "So Adam and Eve were in the garden." I thought for sure this was a joke. He got to the end and said, "And that’s how crucial conversations skills could have prevented original sin." Not the punch line I was expecting. We all fear and dread over-shares and inappropriate comments, but what’s the best way to handle them in the moment? One thing that’s worked for me is to use a contrast of sorts: thank the person for being willing to share, and clarify what’s appropriate to share in this setting. What do you do in these types of situations? Comment below to share your ideas. Related posts: From the Road: Mind the Gap From the Road: Do You Know Where Your Participants Are? From the Road: Insights From Just down the Street and around the Corner

ABOUT THE AUTHOR David Maxfield is coauthor of two New York Times bestsellers, Change Anything and Influencer. READ MORE Dear Crucial Skills, We are looking for meaningful ways to recognize our nursing staff in our busy, stressful ICU. In our last employee satisfaction survey, we scored low in "recognition." We know from Influencer that external rewards aren’t always the best way to motivate people. We would like to find ways that would encourage staff to grow and have internal satisfaction for doing a great job with their patients, families, and other staff. Other than external rewards, how can we meet our staff’s need for meaningful recognition? Managing Motivation  Dear Managing, Your question is relevant to every leader. It’s common for hardworking, productive, and dedicated staff to say they don’t get the recognition they deserve. If not corrected, this feeling can undermine their commitment, engagement, and performance. Leaders need a variety of ways to recognize performance and show appreciation. 1. Don’t resort to using money as a motivator. Personally, I like money. I endorse the view that, "Money may not buy happiness, but it sure makes misery more comfortable." The challenge is that money often plays the role of de-motivator. If you don’t think your pay is fair, then it’s hard to stay motivated. But, if you do think your pay is fair, then you stop thinking about it and its power to motivate fades. Leaders need to establish fair pay, but they shouldn’t rely on fair pay to motivate. 2. Use rewards in moderation and in combination. This is the guideline we introduce in our book, Influencer. Rewards work best when they a) aren’t so large that they become the only reason for acting; and b) are combined with personal and social motivators. The merit badges scouts earn are a nice example. The badges themselves are just bits of cloth or tin. They are very moderate in value. But they work in combination with both personal and social motivation. They recognize hard work and a worthy accomplishment, something to be proud of—personal motivation. And they create an occasion for family and friends to cheer the scout’s success—social motivation. When rewards are too large and not used in combination with personal and social motivators, then all eyes are on the rewards and the rules for winning them. You see people cheat and game the system. They may even lose track of the personal and social reasons for their actions. Here is a scary example. A hospital had made rewards and punishments a big part of their hand-hygiene program. A nurse manager saw a nurse put her hand under a hand-sanitizer dispenser, but nothing came out. The dispenser was empty. The nurse continued into the patient’s room and began to work with the patient. When the manager pulled her aside the nurse said, "I did my part. It’s not my fault the dispenser isn’t working." This nurse was so focused on the rules, she failed to remember patient safety and the intrinsic reasons for having clean hands. That is the danger of rewards that aren’t used in moderation and in combination. 3. Make the invisible visible. This is a skill we teach in Crucial Confrontations and Crucial Accountability Training. Have you ever looked back at a tough day—a day spent coping with emergencies, interruptions, and switches in priorities—only to wonder what you’ve actually accomplished? This is the rat race, right? You know you’ve been running all day, but you aren’t sure you’ve gotten anywhere. Many of us experience this frustration, and I bet nurses who work in Intensive Care Units (ICUs) experience it more than most. Here’s why. Patients who are in ICUs are among the sickest in the hospital. In fact, they are usually so sick that, even when they are healthy enough to be discharged, they don’t get sent home. Instead, they are sent to another unit in the hospital, one that deals with less critically ill patients. Often ICU nurses don’t get to see or experience the positive end to the patient’s story—the patient’s leaving the hospital and their happy families welcoming them home. Work to fix this situation by creating ways for your ICU nurses to see and experience their accomplishments. I’ll suggest a couple of ideas, but I bet you and your staff can generate far more. Involve your ICU nurses in post-discharge calls to patients. Most hospitals are now implementing some kind of post-discharge call to patients. Research shows these calls improve patient satisfaction, reduce medication-related problems, and result in fewer return visits to emergency rooms. These calls can also be a powerfully motivating source of feedback for nurses. I’m not suggesting that your nurses have time to make these calls, though that would be great. Most hospitals already have specially trained staff who make these calls. Have the people making these calls meet with your nurses to share outcomes, or meet with the phone team yourself and then share outcomes with your ICU nurses. Create regular opportunities for your nurses to see the human impacts of their hard work. Solicit feedback from patients’ family members. Often, ICU patients are so sick and sedated that they hardly remember their ICU experiences. But their family members sure do! Most are overwhelmingly grateful for the wonderful work ICU nurses perform and would be happy to share. Find ways to get family members’ feedback—solicit notes, ask family members to record a message that can be shared, or have family members attend a routine meeting. Tighten links to the units that accept the patients you discharge. Involve staff from your internal customers—the step-down and medical-surgical units that take your patients when they no longer need to be in your ICU. Ask them to attend regular meetings, so they can share how they, their patients, and their patients’ families have been impacted by the work your ICU nurses perform. 4. Use crucial conversations to reduce de-motivators. Ask yourself whether there are leaders, physicians, or staff members whose actions undermine morale on your unit. Sometimes you can identify a handful of individuals who are rude, dismissive, or disruptive in ways that counter the recognition others provide. I’m not suggesting that these people should ever sugarcoat bad news or provide less than honest feedback. But you may ask them to be more constructive by focusing on facts, allowing room for dialogue, and showing respect. I hope these ideas give you a few additional ways to recognize your staff. However, none of these can substitute for your own genuine appreciation for their work. Make sure you spend time rounding every day, noticing all the right things they are doing on the job, and removing barriers so they can do even more. Please let me know what you try and how it works. David Related posts: Motivating Others to Take Action Before & After: I Felt Like a Nurse Again by Gaylen T. How to Influence Accountability

What’s New in the Second Edition of Influencer? New subtitle Updated statistics, facts, and figures New research and case studies from organizations like KIPP, Menlo Innovations, Fundación Paraguaya, and others Skill applications gleaned from six years of Influencer Training "Act Like An Influencer" stories: twenty-five vignette examples of real influencers New focus on the three keys of influence: 1) Focus and measure, 2) Find vital behaviors, and 3) Engage all Six Sources of Influence Now available in paperback, hardcover, and e-book Win a copy of the new edition. Watch, comment, and share our video of author Joseph Grenny discussing the power of the influence model to change behavior at our local TEDX event. We’ll select twenty-five people to receive a FREE copy of the brand new second edition. You’ll receive one entry in our drawing for every action you take (watching, commenting, and sharing). Enjoy! Related posts: Special Announcement: Meet the UnAccountables—Introducing the New Crucial Accountability Companion Course Influencer Institute: Introducing the Influencer Institute—And a Call to Action! Special Announcement: Introducing the NEW Crucial Conversations!

ABOUT THE AUTHOR Al Switzler is coauthor of four New York Times bestsellers, Change Anything, Crucial Conversations, Crucial Confrontations, and Influencer. READ MORE   Dear Crucial Skills, How do I deal with passive-aggressive behaviors like someone agreeing to do a task then "forgetting" to do it, dragging his or her feet, or deliberately doing it incorrectly so he or she won’t be asked to do it again? Tired of Passive Agreement  Dear Tired, If you live or work with or near other people, at some point other people will let you down—they’ll miss a deadline, fall short of a standard, or just do something wrong. So your question about dealing with this behavior is universal. I’ll offer a few suggestions that are more generic and then get specifically to the challenge you face. 1. Speak up. Some people hope that if they are patient, the problem will go away, even if the problem is reoccurring. They hope that time will cure the issue. While people are waiting and not speaking up, their silence is generally interpreted as acceptance or agreement. My first bit of advice is to speak up. It might be that the task or assignment is harder than it need be. Speaking up can send a message that the task is important and that you want to make sure nothing gets in the way. 2. Speak up while keeping it safe. The key components of safety are Mutual Purpose and Mutual Respect. Remember to avoid jumping to conclusions or losing your cool. This step requires that you avoid showing on your face or by your tone of voice that you have held court in your head in advance and found the person guilty. You want to convey that you’ve observed a gap and that you want to figure out what’s going on. The way you stated your question causes me to remind everyone to give the other person the benefit of the doubt before speaking up. Think: "Could this situation be more complicated than I assume?" 3. Speak up about the right topic. This step focuses on your specific problem. In Crucial Confrontations, we teach CPR, which stands for content, pattern, and relationship. CPR is a strategy to help you find the right issue. Talk about content if this is the first occurrence. For example, "JC, you agreed to have the report in by Tuesday at 2:00 p.m. and I didn’t receive it until Wednesday at noon. What happened?" The first and second times can be accidents, so you should talk about the content—the specific issue or behavior. By the third time, the issue or behavior has become a pattern and you should address this pattern. For example, "JC, the last three weeks you’ve turned in the Tuesday report on Wednesday. What’s going on?" When JC says that the computer broke down yesterday, you can say, "I’m interested in what happened this time, but I’m more interested in the pattern of missing the deadline three weeks in a row." This allows you to then diagnose the motivation and ability issues that can get in the way and close the conversation by reaffirming the commitment to deliver the report. Follow up by asking if there are any other reasons why JC could not get the report in by 2:00 p.m. on Tuesday. Excellent performance begins with clear expectations. And now to relationship. In your case, you need to have a relationship discussion. It might sound like this. "JC, you’ve committed to turn in your report by Tuesday at 2:00 p.m. each week and you’ve missed this deadline three out of five times. We’ve had several discussions and you’ve told me there was nothing getting in the way of you doing this. I’m now thinking that I can’t trust that when you make a commitment you will keep it. I’m not sure why this is happening, and it is certainly affecting our working relationship." This is the time to discuss the possibility that JC is forgetting, dragging his feet, or simply trying to get the task reassigned. Based on JC’s response, you may have to start progressive discipline. And for those who are thinking that this is not quick or severe enough, I chose a topic that I thought could allow a bit of patience. Other performance gaps would require quicker, tougher responses. Over the years, we’ve coached people in situations that lingered and festered. When we asked, "Have you spoken up?" they respond "Of course." "About what?" we ask. The answers too frequently reveal that they spoke up about the easy not the hard, about the simple not the complex, about the content not the pattern or relationship. When you speak up about the right topic, you send a message that the task is important, that you are interested in finding any barriers that make it more difficult than it needs to be, and that it is so important that you’ll make sure the task will be completed. Sometimes, a relationship conversation will focus on the fact that you have to hold these conversations so frequently and you need to see high performance without repeated conversations. In summary, make sure you do the first two steps, and then always talk about the right topic. When you do, you are more likely to find a lasting solution. I wish you the best,Al Related posts: Holding People Accountable Holding Clients Accountable Holding a "Charmer" Accountable

Last week, we announced the release of the second edition of Influencer: The New Science of Leading Change. For a sneak peak of the book, download the first chapter now. This new edition includes: New subtitle Updated statistics, facts, and figures New research and case studies from organizations like KIPP, Menlo Innovations, Fundación Paraguaya, and others Skill applications gleaned from six years of Influencer Training "Act Like An Influencer" stories: twenty-five vignette examples of real influencers New focus on the three keys of influence: 1) Focus and measure, 2) Find vital behaviors, and 3) Engage all Six Sources of Influence Now available in paperback, hardcover, and e-book WIN A COPY: Enter our drawing to win one of twenty-five copies of Influencer by watching Joseph Grenny discuss the principles of influence at our local TEDX event. To enter, watch the video, leave a comment, and share with others. (One entry per action taken. Winners will be selected and announced June 5.) Related posts: Special Announcement: Introducing the Second Edition of our Bestselling Book, Influencer: The New Science of Leading Change August Newsletter Drawing Winner! Influencer Institute: Introducing the Influencer Institute—And a Call to Action!

ABOUT THE AUTHOR Joseph Grenny is coauthor of four New York Times bestsellers, Change Anything, Crucial Conversations, Crucial Confrontations, and Influencer. READ MORE Dear Crucial Skills, How does one escape the addictions of pornography, drugs, alcohol, etc? I’ve been told that even if I’m able to finally get to the point of remission, I’ll always be an addict and never completely escape. It’s a hopeless message, but I sense truth in this and fear I’ll have to fight it the rest of my life. Do you have any advice that can help me in my lifelong battle against addiction? Signed, Struggling  Dear Struggling, I have great news for you. While in some cases there might (and I stress MIGHT) be some element of truth to the statement, "I’ll always be an addict"—that statement doesn’t mean what you think it means. The implication of "always an addict" in your note is "I’ll have to fight the rest of my life." That’s the part I can immediately reassure you is absolutely not true, but hang on for a moment and let me get to that point in its time. First, I want to be clear that my coauthors and I are not addiction experts. We study human behavior, so we have opinions about the state of research on issues like addiction recovery. That is not our specialty nor do I have training in addiction recovery. With that said, I will share some opinions on your question. • Will you always be at risk of returning to your addiction? There’s a good chance you won’t. Many people with addictions recover in a way that never affects them again. One of the most dramatic evidences of this point is a major study funded by the U.S. Government in 1971 as tens of thousands of heroin-addicted soldiers were returning from Vietnam. Military officials were terrified that a healthcare crisis would ensue as their systems would have been overloaded with those suffering the effects of addiction. But the crisis never happened. Well over 80 percent of those returning, who were classified as seriously addicted, discontinued drug use after coming home—forever. • How long does it take? I’ll answer this briefly but will refer you to the chapter on addiction recovery in our book Change Anything: The New Science of Personal Success for a fuller description. Our work shows that habits change when all six of the sources of influence that shape our habits change. Period. Now, that process can take a while, but understanding those sources of influence helps you recognize that there are discrete actions you can take to move the process along and to understand what work remains. This also explains why so many of the returning soldiers changed so quickly. All of these sources of influence were organized in a way that promoted addiction when they lived in Vietnam. When they returned, for many of them, all six sources changed. So they did, too. • If you’re one of the 20 percent rather than the 80 percent, does that mean a lifetime of struggle? Absolutely not. Even those who continue to feel vulnerable to relapse will tell you that year by year, maintaining the life patterns that keep them "sober" (I use that term generically) become not just easier, but pleasurable. Here’s the good news I promised you. Please read these sentences over and over and over: The way you feel today about your addictive behaviors can feel entirely different just a few months from now. You can literally come to hate what you currently love. You can—and will—come to find loathsome those things that seem irresistible today. Let me elaborate on this last, and most important, point. Our emotions often lie to us. When we experience an emotion (let’s say I’m feeling angry at my daughter) it comes with two embedded lies—it feels true, and it feels permanent. It feels true in the sense that I have a profound conviction that I am totally right and she is totally wrong. My emotion is my evidence that I am right. All of us have had the experience of feeling that way, then getting a little more information and perspective, and having the emotion pivot 180 degrees. We feel remorse, or empathy, or love—whereas seconds earlier we couldn’t have imagined feeling different. Similarly, the emotions feel permanent. We believe the way we feel about something is how we will always feel. For example, I cannot imagine not craving a cigarette. Or being stimulated by pornography. Or getting out of control at the sight of chocolate. Or losing my temper when criticized. Yet, when you talk with those who have realigned the sources of influence in their life, they’ll often use words like "disgusted" when they think about those behaviors today. But don’t trust these other people. Test this proposition against your own experience. Have you ever felt even momentarily different about an addictive habit you struggle with? Have you had moments when you felt no temptation at all? In fact, you felt revulsion for the act? If so, you know already that change is possible. The challenge is working through the process of change until those temporary feelings become the norm. If you want to see a powerful example of this shift, watch this video. It’s a fascinating experiment done by the Thai Ministry of Public Health. A young child approaches people who are smoking in public with a cigarette in her hand to ask them for a light. The smokers are horrified at the thought of this child picking up this habit. Every one of those approached began lecturing the child, citing compelling reasons the child shouldn’t smoke. After listening patiently for a moment, the child would hand them a card with a phone number for smoking cessation services, and ask, "Then why do you smoke?" Researchers observed the smokers after the child walked away. Almost every one of them dropped their cigarette. All retained the card with the phone number. Calls to the help line increased 40 percent on the day of the experiment. Now, this doesn’t demonstrate permanent change, but it shows that feelings can change. That’s the point. In this case, it was temporary. But people who were feeling compelled to smoke moments earlier were suddenly disgusted at the thought and stopped. You need not fear a lifetime of struggle. You may need to be conscious of maintaining the six sources of influence throughout your life, but you’ll want to do it. You’ll derive pleasure from the new life. Your feelings will change. Just keep up the good work. The way you feel today is not the way you will feel a year from now. Warmly, Joseph Related posts: Change Anything: Overcoming Addiction-Part Two Change Anything: Overcoming Addiction Overcoming Career-Limiting Habits

Thank you to all those who entered our drawing to win one of twenty-five free copies of the second edition of Influencer by watching Joseph Grenny talk about the power of the Influencer model to change behavior at our local TED event. If you missed it, click here to watch the powerful transformation story of Jane, a young girl who grew up in poverty in the slums of Nairobi, Kenya. We had an overwhelming response, but the twenty-five lucky winners are: Arthur Johnson Jr. Chris Clark Chris Klenk Daniel Hiatt Deborah Carcutt Derek Applegate Elaine Rose Fidelia Herrera Roster Paul Pstivthnkn Kurt Ellis Lynda Sowell Lynette Vetsch Mauricio Soto Mnquaker Nicolas A. Reynolds Pat Hatcher Patty Skerl Randi Schmechel Rick Kotter Sharon Humphreys Sue Burge Dahl TJ Brensen Travis Cunningham Tyler Edmondson Vicky Smith If you won, please e-mail us at editor@vitalsmarts.com to claim your book. Related posts: Special Announcement: Influencer First Chapter Download Special Announcement: Introducing the Second Edition of our Bestselling Book, Influencer: The New Science of Leading Change

ABOUT THE AUTHOR Andrew Maxfield is director of the Influencer Institute, a private operating foundation that seeks to increase humanity’s capacity to change for good. Atilano, a new friend of mine in Mexico, smiles while he delivers bottled water from his bicycle to nearby homes and businesses. His is a small business by nearly every standard, yet it is a powerful component of his escape route from poverty. And it’s working. But that’s only half of the story. It turns out that there are several behaviors besides increasing income that lead a person to the outcome of a reliable financial surplus, and, eventually, to permanently improved economic conditions. Can you imagine what one of those behaviors is? You probably already know the answer—and it isn’t an exciting one. The behavior is: regularly write down every amount of money you take in and spend. People who make a habit (the intersection of ability and reliability) of regular financial record keeping know exactly how much they earn, exactly how much they spend, and can therefore take action if there is an imbalance between the two. Our work with small business mentoring organizations in Latin America verifies this fact: their very poor clients who start small businesses and keep daily financial records manage to escape poverty over time, sometimes rapidly. Those who start businesses but are sloppy with record keeping or neglect it entirely, may never get ahead—and often don’t. So here’s the rub, and it’s probably familiar: what if an all-important behavior is mundane? What if it’s dull, inconvenient, or psychologically painful? This is where we can all learn from Atilano. It’s true that the act of record keeping might be tiresome if you view it as taking away from income-generating work, family time, or whatever you’d rather be doing. But Atilano thinks of his kids and the example he’s setting. He reminds himself of the "why" behind the task. Believe it or not, he considers his ledgers a personal diary—evidence of his hard work and dedication to his family. Taken in that light, record keeping can be a celebration of sorts, a happy daily ritual. Can you think of a way to reconnect the task you routinely avoid to what you care about most? Can you link it to your values and vision and to people you care about? Finding the thread that links what you must do to the grander vision of why you do it can help drum up the motivation you need to do an unpleasant task. Of course, your personal motivation isn’t everything; you also need skills, tools, and social support—and those factors unquestionably contribute to Atilano’s successes. However, you and I can take a big step forward in our efforts to influence ourselves and others when we deliberately find meaning in life’s mundane but vital tasks. Related posts: Influencer Institute: Beating Poverty One Vital Behavior at a Time Influencer Institute: Introducing the Influencer Institute—And a Call to Action! Finding Fault with the Facts

ABOUT THE AUTHOR Kerry Patterson is coauthor of four New York Times bestsellers, Change Anything, Crucial Conversations, Crucial Confrontations, and Influencer. READ MORE   Dear Crucial Skills, A couple of my employees tend to get all the other staff in an uproar. They constantly turn people against each other and pick on the newbies. How can I address my employees’ tendency to "stir the pot" and help them recognize the harm they’re doing to our work environment? Mitigating Harm  Dear Mitigating, Thanks for this interesting and important question. We’re often asked how to give feedback to direct reports who act in ways that cause problems. Sometimes these challenging individuals are described as having "bad chemistry" with their coworkers. On other occasions, they’re labeled "hard to work with," "troublesome," or even worse. In this case, the individuals in question cause uproars, turn people against each other, stir the pot, and pick on newbies. As their supervisor, it’s your job to do something about the bad behavior. But what? At first glance, suggesting that the individuals in question cause an uproar or turn people against each other may sound like a description of what they do, when, in fact, these particular words describe the effect not the cause. They behave in some particular way to cause an uproar or turn people against each other, but it’s impossible to decipher from these expressions alone which from millions of possible behaviors they enact. If you expect the individuals in question to improve, they’ll need to change their behaviors—swapping out the old and replacing them with new. As a leader, you’ll need to adeptly describe, in detail, what they’re currently doing to cause an uproar and the other effects you’ve described. Describing behaviors requires an understanding of exactly what the offending parties do along with the ability to describe their behavior in a way that is crystal clear. You have to see what others actually do and then metaphorically hold up a mirror so they can see what they need to change. This can get complicated. When you suggest that the problem employees "stir the pot," the metaphor masks the actual actions they take. If you tell them they "stir the pot," they might know what you’re hinting at and change, but it seems unlikely. The same is true with expressions like "picking on newbies." You include a verb that hints of certain behaviors, but alas, also leaves a lot to the imagination. When I talk with people facing similar challenges and ask them to provide the behaviors (causes) behind the effects or vague conclusion they describe to me, they often can’t. Their conclusions are firm: "They constantly stir the pot." That part they feel strongly about, but when I probe for detail, they aren’t able to describe the behaviors the other person enacts. They remember their emotional reaction far more clearly than the actions that took them there. For instance, when trying to help a supervisor with a salesman who was "socially backward," I asked for a detailed description of what the salesman did. The supervisor explained that he was "a nerd, a geek—you know, a dweeb." The supervisor knew what he had concluded about the fellow, and was able to come up with synonyms, but couldn’t describe any actual behaviors. So I asked him, "The last time he did something you thought was nerdy, what exactly did he do?" "He looked like he had no confidence in what he was saying," the supervisor responded. (Also a vague conclusion.) "And what made him appear unconfident to you?" I continued to probe. "He stared at the floor. He started a sentence three different times. He spoke in a low voice. The minute the person disagreed, he backed off even though he was correct . . ." and so forth. At last, behaviors the other person might be able to recognize and replace. This is what the salesman needed to hear and correct. Most of us use shorthand negative adjectives along with vague outcomes when talking with others because such simple expression often works for us. "Quit teasing your brother!" you bark to your son. He knows exactly what he’s doing and what to do instead. He knows because you’ve told him before—focusing on his actual actions. "Yes, I know you said his new shirt was cool, but you said it in a sing-song tone and rolled your eyes—and that appeared insincere." You’ve described several versions of "teasing" to your son, so now when he does it, you can address it in shorthand. However, with direct reports, where we don’t have a long history and the specialized code that comes with it, we need to carefully observe others in actions, take note of the actual behaviors that aren’t working, share those in a direct and non-punitive way, check to see if they understood us, and then talk about replacement behaviors. I’m assuming you’ve watched your direct reports in action and have a whole list of undesirable actions they take, so you’re ready to hold a discussion in a way that will be helpful. Start by holding separate conversations—one with each employee. Privacy is essential. Select no more than one or two of the areas you’d like to talk about. You don’t want to overwhelm the other person. Start by describing the undesirable behavior and what you’d like to see instead. Share three or four example actions and take special care to focus on their behaviors, not your conclusions. Share actions you’ve personally observed—hopefully recently. Open the conversation for questions. Ask the other person if he or she sees it differently, and jointly develop a plan of action. Obviously, there’s a lot that goes into such a feedback discussion. Today, I chose to focus on one element that can turn a painful and vague discussion into a helpful feedback session. Focus on behaviors. Become skilled at both observing and describing them. Know the difference between a behavior and a result or conclusion. Help the other person see what he or she is doing, not merely what you think about him or her. Kerry Related posts: Finding Fault with the Facts Confronting a Coworker’s Temper Tantrums Confronting Destructive and Manipulative Behavior

According to our recent poll, social networks are becoming increasingly hostile, with 78 percent of users reporting rising incivility online and two in five blocking, unsubscribing, or "unfriending" someone over an argument on social media. Specific findings include: 76 percent have witnessed an argument over social media 19 percent have decreased in-person contact with someone because of something they said online 88 percent believe people are less polite on social media than in person 81 percent say the difficult or emotionally charged conversations they have held over social media remain unresolved Social media platforms aren’t the problem, it’s how people are using them that is causing a degradation of dialogue that has potential to destroy our most meaningful personal relationships. Here are five tips for communicating both candidly and respectfully on social media: Check your motives. Social media hasn’t only changed the way we communicate, it has modified our motives. Ask yourself, "Is my goal to get lots of ‘likes’ (or even provoke controversy)?" or "Do I want healthy dialogue?" Replace hot words. If your goal is to make a point rather than score a point, replace "hot" words that provoke offense with words that help others understand your position. For example, replace "that is idiotic" with "I disagree for the following reasons . . ." Pause to put emotions in check. Never post a comment when you’re feeling emotionally triggered. Never! If you wait four hours you’re likely to respond differently. Agree before you disagree. It’s fine to disagree, but don’t point out your disagreement until you acknowledge areas where you agree. Often, arguers agree on 80 percent of the topic but create a false sense of conflict when they spend all their time arguing over the other 20 percent. Trust your gut. When reading a response to your post and you feel the conversation is getting too emotional for an online exchange—you’re right! Stop. Take it offline. Or better yet, face-to-face. For additional advice, including ten things NOT to do when communicating via social media, download our free e-book, "When Crucial Conversations Go Social: How to Handle Heated Discussions via Social Media." Related posts: Antisocial Networks? Hostility on social media rising for 78 percent of users Antisocial Networks? Crucial Applications: How to Hold Slacking Coworkers Accountable

ABOUT THE AUTHOR Joseph Grenny is coauthor of four New York Times bestsellers, Change Anything, Crucial Conversations, Crucial Confrontations, and Influencer. READ MORE Dear Crucial Skills, I was recently elected leader of a 30,000 person district in Kenya and my leadership is under threat. For the last three weeks, we have had constant rainfall here. There is water everywhere, rivers have burst their banks, crops have washed away, most roads and bridges have been cut away, and several school buildings and homes have been blown away. Quite a number of deaths have been reported in the process, and most families’ homes no longer offer a good environment for living, as water is oozing through their ground floors. Soon, a malaria outbreak will follow as a result of mosquito bites. Too much water means crop failures and is the beginning of real hunger! Some begin to question or threaten my leadership. What immediate solution can you give me to lead under such a situation? Signed, Leadership Crisis  Dear Leadership, Kenya is a second home to me. I have met some remarkable leaders in your country from whom I’ve learned a great deal about human influence. I am happy to hear of your concern for the people you have been asked to serve. I have some very strong opinions about what you need to do to make a difference and solidify your support at this critical time. In times of threat, people need to know two things from their leaders: You care about my problems. You are competent to help. When people believe these two things about you, they trust you. If people trust your motives and your ability, you have their support. Now, that’s easier said than done. When everything is broken, what do you do first? How do you show your concern when 1,000 things need attention? If you go to work on five of them, those who feel the most pain about the other 995 will think you don’t care. Furthermore, if you try to work on too many things, you will squander your finite resources while making little progress—thus undermining trust. So what can you do? When Ellen Johnson-Sirleaf was re-elected as president of Liberia, the country was in a precarious situation. But she did three things that influenced trust in a remarkable way: 1. Go on a listening campaign. Be visible. Be accessible. Listen a lot. Empathize. Do your best to develop a theory of which problems you should address first. This step must not take so much time that people see you as politicking rather than taking action. However, it is crucial not just that you understand people’s concerns, but that they believe you understand. 2. Prioritize. Having listened deeply, set a small number of concrete and time-bound goals. When President Johnson-Sirleaf finished her listening campaign, she announced some very specific commitments she would complete in the first 150 days. If your community is smaller, you may want to set a tighter timeframe—perhaps seven-day, thirty-day, sixty-day, and ninety-day goals. For example, President Johnson-Sirleaf committed that within 150 days, her administration would: Put 6,000 young people to work on road maintenance and beach clean-up projects. Open 150km of feeder roads, linking thirty communities in two counties. Open 150 new sanitation facilities. Complete eleven reinforced concrete bridges. Open seventy-five community wells in three counties. Be sure you only make commitments you have the resources to keep. People will understand that you can’t do everything. As you announce these commitments, you are defining the terms by which people will begin to trust you. If you have listened well, and choose things people find important, they will let go of those things you have not committed to do and calibrate their future trust for you on the terms you set. 3. Go public. The next thing President Johnson-Sirleaf did was make weekly progress reports to the country on her commitments. This accomplished two things: 1) it put pressure on those whose job it was to deliver these commitments; 2) it built trust as people saw steady progress over the 150 days. Every week, Liberians were reminded what they could (and could not) expect from their president. And they learned that she had the leadership competence to fulfill her commitments. Within 150 days, three-fourths of the commitments had been met. Not a perfect record, but far better than people had seen from previous administrations. If you listen well, prioritize carefully, and go public with both commitments and progress, you can demonstrate to your community that you care about their concerns and that they can trust you to deliver. I wish you the best in your leadership and service. Thank you for caring enough to put yourself in such vulnerable circumstances at such a crucial time. Warmly, Joseph

ABOUT THE AUTHOR Cathy Parsons is a nursing practice consultant at St. Joseph’s Health Care London, and a Master of Applied Positive Psychology graduate, University of Pennsylvania, Philadelphia. Practice changes are an everyday reality in the life of a healthcare provider. Clients, patients, and residents are more knowledgeable and expect care that is evidence-informed. All change creates some kind of emotional response. If the recommended change challenges staff members’ long-held assumptions and cherished beliefs, it may create frustration and moral distress. It may feel like the research negates years of tradition. For example, one of our units recently reflected on best practices for reducing patient falls and use of restraints, and practice changes have required a significant shift in staff behaviors and attitudes. Don Ewert, Coordinator, Veterans Care, and I recently collaborated on ways to enhance the success of practice change by using an approach grounded in principles from VitalSmarts’ training. We used the skills from Crucial Conversations to achieve the organization’s vital behaviors of speaking up, holding each other accountable, and asking for help whenever concerned about safety, quality of care or service, and/or quality of work life. Getting unstuck begins with our awareness of discomfort with the practice change. Our emotional response helps us to gauge whether we have a difference of opinion about the desired change, or whether we fear the stakes are high (maybe I won’t be able to do it). Starting with Heart reminds us that those promoting the practice change and those who put the change into practice usually have good intentions. By suspending judgment, admitting our biases, being open to new possibilities, and recognizing the role of Villain, Victim, or Helpless behavior, we Master Our Stories so that we can be fully engaged in the change process. Stating Our Path requires us to share our views while also staying open to hear and consider others’ stories. During this step, Learning to Look for behaviors of Silence or Violence ensures that everyone continues to contribute to the Pool of Shared Meaning which is key to successful change. As we discover the Mutual Purpose of the change, we are more likely to show Mutual Respect when there are differences of opinion. This, in turn, makes it safe for dialogue to continue. The term evidence-informed practice requires us to Explore Others’ Paths—including research on the subject, experience of the healthcare provider, and especially patient, client, and resident preference—this does not have to be an either/or choice! It also means that we prepare care providers with the skills and tools to successfully adopt the change. This is how we strengthen a person-centered approach to care in body, mind, and spirit. Our Move to Action includes implementing and evaluating the change. The success of the change is assessed from the perspective of the patient, the care provider, and the care environment processes. Our vital behaviors help us to evolve the implementation process as we speak up about problematic aspects of the change, hold each other accountable when we see members of the team not modeling new behaviors, and ask for help when we feel unable to support the new practice. Ultimately, the way to enhance quality of patient care, build positive team relationships, and foster a shared and inclusive approach to practice change is grounded in the outcomes of these conversations. Related posts: Vital Behaviors for Entrepreneurs Guest Post: 7 steps to evolve a culture from control to trust How to Find Vital Behaviors

The Challenge The staff at St. Joseph’s Health Care London didn’t talk to each other. Yes, they exchanged words, but when problems were serious and emotions were involved, many side-stepped core issues. Not only was this behavior unproductive and disrespectful for employees, it was potentially dangerous for patients. The organizational development staff identified a training course that might help, especially in the interests of their main concern, patient safety. They also knew they needed an executive champion who could persuade busy physicians and nurses to participate. So they approached Dr. Gillian Kernaghan, a veteran family practice physician who was then the hospital’s Chief Medical Officer. She agreed something needed to be done. "Only 50 percent of meetings were productive," remembers Kernaghan, who is now the hospital’s President and CEO. "We had a lot of ‘Groundhog Days,’ where we talked about the same thing and didn’t find common purpose or get to actions that were agreeable." Kernaghan describes an environment where people wouldn’t speak up and sabotaged decisions that were made in the real "meeting" that happened in the hallway after. "People pushed through their agenda by using power words like ‘patient safety,’ ‘evidence-based,’ and ‘family-centered,’" she says. "The implication was, ‘If you disagree with me you’re obviously not patient centered.’ Essentially, others couldn’t speak up because they felt shutdown." She also observed the initiatives that grew out of those limited discussions were less effective, leading to "rework" and "I told you so" comments even though people hadn’t spoken up in the first place. "We needed to not only teach people to be nice to each other, but we also needed to get results by teaching them how to follow up and follow through," she says. "We knew that if we could transform the way we communicated, our staff would be happier and more productive, and ultimately, our patients would be safer." So when she was asked to champion physician training that purported to address those needs, she agreed, knowing that in order to be an effective voice, she had to be "integrally involved." So she registered to become a certified trainer of Crucial Conversations. The Results: Read our case study to learn how Dr. Gillian Kernaghan used Crucial Conversations and Crucial Accountability Training to earn accreditation with exemplary standing, improve employee satisfaction scores, and see a significant improvement in holding others accountable. What St. Joseph’s employees have to say: Read this guest post to see other ways employees at St. Joseph’s Health Care London have used Crucial Conversations and Crucial Accountability Training to change their culture. Related posts: Success Story: Crucial Conversations Training Improves Nurses’ Ability to Address Disruptive Physician Behavior Case Study: Influencer Training Helps Tennessee Health System Achieve 100% EHR Adoption Success Story: Nebo School District Uses Influencer Training to Improve Student Performance

ABOUT THE AUTHOR David Maxfield is coauthor of three New York Times bestsellers, Crucial Accountability, Influencer, and Change Anything. READ MORE Dear Crucial Skills, I am struggling to regain my supervisor’s trust. I have made some errors—of omission, mainly—and have been written up. There are some extenuating circumstances such as an ill parent and my own depression and anxiety, but the bottom line is that my supervisor expects me to do my job. She is micromanaging me now—searching for errors. I am afraid of losing my job, so I am always looking over my shoulder, wondering what she will find next. Fear and anxiety can create more mistakes, and I’m afraid I’ve created a dangerous pattern. What else can I do to regain her confidence and trust and get out from under the microscope? Trying to be Trustworthy  Dear Trying, Thanks for your brave question. You’ve already avoided two mistakes that keep many of us stuck. You’ve accepted that you aren’t perfect, and you aren’t blaming others for your problems. You are taking responsibility, and that puts you on the right track. I think I can help. Examine your story. You are telling yourself a very anxiety-provoking story—that your supervisor has you under a microscope, searching for errors, with the intent of firing you. Are you sure this story is correct? Interrogate your story by asking two questions: "Do I really have all the facts I need to be sure my story is correct?" and "Is there any other story that could fit this same set of facts?" In particular, ask yourself whether you are misreading your supervisor’s motives. We humans tend to see the worst, rather than the best, in others’ motives. This bias is so common that psychologists have given it a name, the fundamental attribution error. What if you are wrong about your supervisor’s motives? What if your supervisor is rooting for you to succeed and sees her micromanagement as "helpful coaching"? Clarify your intentions. It’s also possible your supervisor has misread your motives, so make them clear. Draw a line between your past errors and your new situation. Sometimes, an apology can be a good way to draw this line and make it clear that your motives are aligned with hers. In addition, do your best to remove any lingering doubts your supervisor might have about the extenuating circumstances you’ve described. Explain how you’ve resolved or stabilized them so they won’t undermine your work going forward. Take the initiative. Act as if your supervisor is providing helpful coaching, and become the eager learner who is striving to reach perfection. When she searches for errors in your work, tell yourself she is trying to help and make an effort to learn from her. Use these times to ask her about her priorities, and to offer your help. Use this period to hone your craft and become the very best at your job. Trust comes from sacrifice. Here is the hard part. Meeting the requirements of your job won’t be enough to create the trust you want from your supervisor. Personal trust comes from going "above and beyond" what is required—from making a personal sacrifice to showing your support for your boss’s goals. Often, this sacrifice is of time, effort, or other priorities. For you, it might mean volunteering to do a job nobody likes to do, spending extra time on a task that needs to be done, or getting up to speed on a skill that’s difficult to master. Work to create a reputation for doing more than what’s required. I hope these ideas are helpful. Do other readers have ideas that could help? If so, please share your ideas in the comments below. David Related posts: Rebuilding Trust After Layoffs Regaining Work/Life Balance Approaching a Hard-to-Please Boss

ABOUT THE AUTHOR Joseph Grenny is coauthor of four New York Times bestsellers, Crucial Conversations, Crucial Accountability, Influencer, and Change Anything. READ MORE Dear Crucial Skills, How do you hold your peers accountable when you don’t have the support of their supervisor, or in some instances the support of your own supervisor? I work with a person in a cross-functional team who is disorganized (he loses things on a regular basis and asks me to resend things), unprepared (we show up for a meeting and he’s still setting up equipment so we have to wait to start the meeting), and shows up to meetings late or doesn’t show up at all. Sometimes, when I come into his office, he is working on a project for his personal company, but he continues to complain that he has too much work and can’t get our projects done. Because of the workflow, I field a steady stream of complaints about him where I’m literally left saying, "What do you want me to do? I’m not his boss." I’ve tried discussing things with him directly and I’ve tried discussing things with his supervisor, but no one will hold this person accountable and I’m not allowed to. What do I do? Out of Ideas  Dear Out of Ideas, You’re off to a good start. I’m impressed that you have attempted to directly address the issue with him and with his supervisor. Nice job. To help you think about any remaining options, let me suggest five levels of influence you can use when dealing with problem peers. Use them in order. In other words, don’t move to #2 until you’ve effectively attempted #1, and so on. 1. Content. The first time you have problems, present them immediately and directly to the individual involved. Don’t wait for it to happen again. Don’t wait until it really ticks you off. Do it right away. Remember also to do it skillfully—create safety, master your stories, etc. For example, the "content" conversation you might have would address "You did not send me the report by Wednesday as you committed. What happened?" 2. Pattern. When it is clear that a pattern is emerging, you must have an entirely different kind of conversation that leads to different kinds of solutions. Many people misunderstand pattern conversations. They think it simply means addressing, "You failed to get me the report on time the last four weeks in a row" as opposed to, "You got the report to me late again this week!" This is true. You must be sure to raise the right issue, but you must also be sure the agreements you come to at the end address the true nature of the pattern. For example, "I’m sorry, I have been really irresponsible. I will do better next week. I promise!" is insufficient. You must stay in the conversation longer to understand what general causes there are and to develop solutions you believe will address those general causes. For example, if the person is disorganized, what will they do to get more organized? If they are overcommitted, how will they manage that? If they see this as a low priority task, what will change next time? If the only thing that changes is they want to avoid another crucial conversation with you, you’ll get temporary motivation but nothing sustainable. Be sure to solve the pattern problem. 3. Relationship. This is also a conversation you have directly with the individual. Notice we’re at influence level three and we haven’t had to involve anyone else yet. However, the nature of the conversation changes each time. At this level, you are no longer trying to solve the pattern. Rather, you are discussing ways to restructure the relationship around it. The person has repeatedly demonstrated an inability and/or unwillingness to keep prior commitments. At this level you must say, "I need a different way of working together—one that does not put you on my critical path. I want to be clear that this isn’t the way I want it. I would much prefer to work in the way we have attempted, but if conditions change to restore my trust, let’s go back to that relationship. However, until I have that trust, here is what I will need to do . . ." Relationship problems are often solved by developing new boundaries or roles that work for you. The key is that these new boundaries must be explicitly shared with the other person—not simply taken behind his or her back. For example, we often start doing others’ work as a workaround to their weaknesses without letting them know we are doing this. That is acting out rather than talking out the problem. Influence level three is candidly discussing with them the steps you will take to ensure you have control of your destiny. For instance, if part of the problem is someone’s abusive behavior, this could include letting him or her know that until you see changes you will not have contact with him or her. Relationship conversations are often the level at which you must involve other stakeholders—the person’s boss, your boss, HR, etc. But again, you must let the person know that you have exhausted your options and will need to be honest with those who have responsibility to address the concerns—or who may be affected by them. 4. Upward Influence. Level four is sometimes needed as part of level three. Let’s say the person on your cross-functional team was responsible for logistics and you are at the point of using other resources to get that done. You should now hand the influence problem over to the person who should own it next—your coworker’s boss. Don’t do it in the form of blame or to vilify the person. In fact, do it gracefully, acknowledging that you may be part of the problem in a way you weren’t aware of and are open to feedback if the person’s boss discovers something you had not seen. At the same time, let him or her know what you’ve attempted to do to solve it and why you need to take the steps you’re taking. If your boss will be affected by the actions you are taking, you may need to involve him or her as well. Once again, be careful that you are not engaging in gossip or trying to undermine the other party. Check your motives. Simply let others own the part of the problem they need to own, while taking steps you need to take. Let them know the natural consequences of the problem—without overstating them—and why your response is necessary for your own quality of work life and results. 5. Renegotiate Work. The fifth level of influence is needed if the problem persists and your coping strategies fail to help you ensure a reasonable quality of work life as well as control over your results. If this happens, you may need to have a "relationship" conversation with your boss. Perhaps your boss and others have failed to address the accountability problem with the other person in a way that continues to cause problems for you, you may choose to ask for a different assignment, more organizational distance from the individual, or reduced commitments on your shared project. You may say, "I can continue to work with Jack, but I will need more flexibility on our deadlines due to the unpredictability of his contributions." Sometimes, the best way to influence your boss or others in leadership positions is to help them experience the consequences of the problem you are facing. Busy people don’t like to take on new problems, so it’s often the case that when you share your accountability concerns they minimize them by avoiding thinking about them in more visceral ways. Level five lets them experience it more palpably as you communicate what you will need in order to work in this low accountability reality. None of the above advice is a magic pill—it is simply the logical process you need to pursue in order to take responsibility for your own life and your own results. If you do so in a 100 percent respectful and 100 percent honest way, you will have far more influence than you might think. And if things don’t improve to your satisfaction, you must take responsibility for either accepting a situation you can no longer influence or removing yourself from it. I wish you all the best. Joseph Related posts: Holding a Slacking Coworker Accountable Holding People Accountable Holding a "Charmer" Accountable

In every organization, you’ll find renegades who break rules or fail to live up to their end of the bargain. We call these troublemakers "The UnAccountables." They create problems that are so stubborn they require extra vigilance. Watch our new video to see a showdown between one manager and his unaccountable direct report. To prevent showdowns like this from happening in organizations across the world, we’re pleased to announce the release of Crucial Accountability Training, the update of our popular Crucial Confrontations Training course. New features include: New and updated video-based instruction Streamlined content in a new flow that’s easier to learn and train Updated Crucial Accountability model Learn more about the course, watch more videos, and play our game to see how well you do when it comes to holding others accountable. Related posts: Special Announcement: Meet the UnAccountables—Introducing the New Crucial Accountability Companion Course Crucial Applications: What’s New in Crucial Conversations 4? Special Announcement: Introducing the Second Edition of our Bestselling Book, Influencer: The New Science of Leading Change

According to our recent poll, three in four employees quickly attribute their coworkers’ bad behavior to lack of motivation while only one in ten consider ability deficits. As a result, they avoid holding problem colleagues accountable, engage in costly workarounds, and perpetuate the very problems they detest. Those who think more generously and carefully about the cause for others’ misbehavior are far more likely to speak up. They are also more disposed to explore potential motivation and ability barriers to their coworkers’ performance, and often report success in resolving the issue. Here are three tips for holding coworkers accountable by correctly diagnosing their bad behavior: 1. Identify the right problem. When approaching your coworker, think "CPR" (Content, Pattern, Relationship). Our natural inclination is to talk content—the immediate offense. But if and when your coworker continues to behave poorly, it’s time to talk about the pattern of bad behavior. If the infraction continues, talk about the long-term damage the pattern is having on your relationship of trust and dependability. 2. Make it motivating. If the other person is able to do what’s been asked, but chooses not to, start by making the invisible visible. Talk about the natural consequences—both good and bad—he or she cares about. What are the effects of his or her behavior on other employees, customers, share owners, etc.? 3. Make it easy. If you find out the problem is not due to motivation, then it’s likely due to an ability barrier. Maybe your expectations aren’t realistic. Maybe you didn’t provide him or her with the right tools. Maybe he or she is constrained because of bureaucracy. Whatever the constraints, discover them and make changes. The goal is to make it as easy as possible for your coworker to meet the expectation. To view an entertaining video about unaccountable coworkers, access an online game to test your accountability skills, and learn more about our new Crucial Accountability Training, visit vitalsmarts.com/unaccountables. Related posts: Crucial Applications: How to Hold Slacking Coworkers Accountable Holding Peers Accountable Without Management’s Support Holding a Slacking Coworker Accountable

ABOUT THE AUTHOR Cricket Buchler is a Master Trainer. READ MORE How do I handle participants who do not appear to be engaged in class? It’s so easy to get triggered by participant behavior in class, believing the way she’s acting is proof that she’s not taking the class seriously or that he doesn’t mind that his problem behavior is negatively impacting those around him. I’ve learned to give benefit of the doubt up front. Need some help? Here are some ideas to get you moving in that direction: Not taking notes? They don’t have a pen. (This happens more than you think. Bring extra pens). Refuses to engage? They feel worried about exposing a sensitive issue with colleagues. Texting or leaving class a lot? Their managers could be pinging them with urgent issues they do not feel empowered to ignore. Having side conversations? They’re talking about their insights and all the ideas that are sparking for them in an effort to really put the concepts into practical context. Set expectations up front. Don’t underestimate the power of ground rules. Try asking the group for their help in building ground rules by saying early on to the group: "Have you ever been in a class that disappointed you for some reason? Consider your pet peeves in a training environment and let’s see if we can avoid hitting those triggers for each other. What advice would you offer each other to ensure the highest quality learning environment? Let’s build some ground rules together." I always pre-write my ideas on a flipchart. Then after the group comes up with their ideas I show them my list and add any additional ideas they come up with to it. Mine looks something like this:  Our Promise to Each Other Maintain confidentiality Return from breaks on time Silence phones/ Turn off computers Avoid texting under the table Avoid side conversations Take regular breaks (Ask, "If we pause every 1.5 hours, is it fair to ask that you reserve texting/emailing/calling for the breaks? Will that work?) Have fun!  After displaying the list of ideas I ask the group if they are willing to commit to this list of ideas saying, "Is there any reason any of you might have a hard time committing to these promises? Ok, then. So if we run into challenges with these, I’ll be sure to have a crucial conversation with you about that. And in fact, since this session is all about driving accountability, I’d like to challenge any of you to speak up to each other should anything be getting in the way of your learning. Ok? It’s a great way to practice what we’re learning in here!" Once you have permission to have a crucial conversation with them later, it’s easier to approach any issues that might come up. Speak Up Using Your Skills "I noticed you haven’t been writing. Are you having a hard time coming up with ideas?" "I’ve noticed you’ve returned late from the breaks this morning. Can you help me understand what’s going on? (when addressing a side conversation in front of the whole class) "Sara and Kate… Questions? Thoughts to share?" "I’m seeing that you’re on your phone in class. Something going on?" Use the Power of Tools and Space Display ground rules on the wall and refer back to it, checking back with the group to see how it’s going. Change where people sit each day. Move them around for exercises to break up chatty groups. Display the timer in your presentation software for breaks and tell them you’ll get started the second the timer dings. Always start on time. Download VitalSmarts viral videos from YouTube and display them after breaks to entice people back on time. Related posts: How do I handle participants who are quiet or who don’t participate? How do I respond to participants’ concerns about participating in training? What are some ways I can further participants’ learning after the training?

ABOUT THE EXPERT Steve Willis is a Master Trainer and Vice President of Professional Services at VitalSmarts. READ MORE I was recently reviewing a training industry report for 2012. There were all kinds of bar, pie, and other hunger inducing graphs serving up all kinds of information. It highlighted overall spending (≅ $55.8 billion), the average amount spent per employee ($1059), how many hours the average employee spent in learning and development activities (41 hours per employee), the types of training products and services (too many to name here), and even who was receiving training by level in the organization. Wading through all this data got me thinking about my own 2012 year in review: How many sessions I conducted, the number of organizations I worked with, the different countries I had trained in, and the mix of programs I delivered. And while all these numbers are interesting and useful, the number that caused the most meaningful introspection was the percentage of people who walked away from my sessions having had a meaningful (dare I say life-changing) learning experience. This last one got me thinking of what it would take to increase that percentage in 2013. What should I improve about the way I prepare for each session? Which delivery skills would be highest leverage to practice? Do I need to do more in order to master the skills from the programs I deliver? So I want to leave you with the question that’s been on my mind, "What will you do to increase the percentage of people who have a meaningful learning experience?" You have the opportunity to positively impact lives with each session you conduct. Now, go get em! Related posts: From the Road: So Much Training From the Road: The Importance of Propinquity From the Road: What Happens in Training, Stays in Training