Cultivating Trust as a Healthcare Leader—Part II

Cultivating Trust as a Healthcare Leader—Part II Posted By:
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What do trust and trustworthiness really mean? How can we really establish ourselves as trustworthy leaders in healthcare for our colleagues and patients? While trust is essential for every professional (and personal) relationship, it is an amalgam that can be difficult to define in a universal sense. In my previous post, I discussed ability, benevolence, and integrity as key predictors of a leader's ability to gain trust and foster a sense of trustworthiness, with a focus on healthcare leaders and the relationship between manager and subordinates. Researchers John Gottman and Brené Brown offer another perspective on building trust.

Are broad sweeping gestures needed to build trust? Not necessarily. Gottman, who has studied couples and relationships for more than 40 years, says, "trust is built in very small moments." However, just as trust can be built in small moments, it can also be broken in just as short a time. In our roles as healthcare leaders, we should remember this—simple moments and gestures, such as giving a patient ample opportunity to ask questions, or noticing when your coworker is overwhelmed and offering a hand or an ear, can foster a relationship with trust.

Researcher Brené Brown has explored trust extensively; her podcast "The Anatomy of Trust," will keep you thinking long after it has concluded. In the podcast, Brené defines trust through the acronym "BRAVING" (Boundaries, Reliability, Accountability, Vault, Integrity, Nonjudgement, Generosity).

I'll focus here on 3 of these: Reliability, Accountability, Nonjudgement.

Reliability, like trust itself, is not a one-and-done phenomenon. It is a pattern of behavior of you keeping your word. Each small moment you have, you should follow through with what you say you will do, not overpromising or underdelivering. When you offer to cover a shift for a colleague, do it; when you tell a patient you will follow-up by the end of the day, do not assume that doing it first-thing tomorrow will build the same foundation of trust.

Accountability, simply stated, is owning our actions. When we make a mistake, accountability is owning the mistake without excuse and giving a sincere apology. Brown takes the idea of accountability one step further, emphasizing that it goes both ways—I can trust you if you own your mistake and apologize, and if I make a mistake you allow me the courtesy to do the same.

Nonjudgement also follows this bidirectional path: You can have a problem or issue, be struggling with it, ask for help, and not be judged by me—but for trust to really be fostered, I should not feel judged by you in the same situation. If you feel a little uncomfortable with that part about you yourself asking for help, you are not alone. As healthcare providers and leaders, it can be especially difficult for us to ask for help. In our relationship with patients, it is so ingrained in us that we are the ones helping them. This can carry into our relationships with colleagues; perhaps we believe others may view us as being less effective or having some kind of weakness if we ask for help. However, Brown underscores if others are not given the opportunity to reciprocate the help we have given them, a bidirectional and strong trusting relationship does not exist. Furthermore, if we judge ourselves for needing or asking for help, we inevitably judge others when they need it or when we provide it to them.

Establishing and building trust and trustworthiness is a continuous discipline and something we need to work on every day. "The Anatomy of Trust" podcast is a wonderful starting place for thinking through the many facets of trust and trustworthiness. Mindfulness with our words and actions is key; and remember the small moments may be where we can have the most impact.

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Filed under: Practice Management/Career , NPs & PAs

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