Toxic Tornadoes: Poisonous People Preparedness

June 5th, 2015

It’s tornado season. Just as storms brew up in uncertain weather and leave destruction in their wake, the aftermath of a toxic attack from a colleague can devastate even the most centered leader. My coaching clients have reported a surge of passive-aggressive and out-right nasty behavior recently—prompting this spring coaching column. That knife in the gut or stab in the back can be painful–but re-framing and understanding their behavior can help you become more proactive, with steps to heal after the attack and prepare to avoid the next.  After all, these colleagues would not have attacked you if you weren’t the strong leader that you are; it just wouldn’t be any fun for them!

1.  Know why people act mean.  As Richard Rohr says, “You can take it as a general rule: If you don’t transform your pain you will always transmit it.” Attacks come from a wound within that person.  When you are targeted by someone’s venom, active responses as outlined below will help relieve yourself of the poison. Don’t relive or perseverate on nastiness.  Don’t let this person’s toxicity control you or sap your confidence.

2.  From an attitude of curiosity, reflect on what might have precipitated this instance of toxic behavior?

  • If the person is a kind individual that normally does not “have a nasty bone in their body”(I’m channeling my mother here), then it is reasonable for the leader to ask them the coaching question privately “What is going on right now that would have caused this situation to occur or for you to say what you did?”
  • If this individual is normally nasty because of their own issues and they treat everyone this way, then you can choose one of several options. Please note: If you do not address the behavior, lack of follow up makes you an easy target for the next tornado.
  • Make them aware their behavior and ask for them to change their manner of communication.
  • Send them to the Employee Assistance Program or recommend a therapist.
  • Fire them if their nasty communication is an established pattern. Research indicates that toxic behavior affects the team’s ability to communicate and contributes to errors while undermining patient safety.
  • If you are not able to urge this person toward new job horizons due to their place in the organizational chart, then think about ways to avoid them. You have better things to do than deal with toxic energy.

3.  If you as a leader advocated for what you believed was best for patients and for your community—and your behavior thwarted a toxic person or their goals, good for you! Call out their behavior privately“I understand that it was difficult for you and your department that ____ and also I did this for our shared goals. We all look good as a team if our community health improves.”

4.  Perhaps something you said made a colleague lose face and your nicer twin might have avoided a public thrashing. If so, apologize that you made “X statement” that would have been better said in private.

Most of us have buried woundedness that can escape with certain triggers.  With that in mind, do your best to resolve an attack with the steps above, and then let it go.

For additional leadership coaching contact Ruth Hansten RN MBA PhD FACHE at 360.437.8060 or  Follow Ruth at @Rhansten on twitter, and visit our website at or

This Blog entry  was first posted on LinkedIn Pulse on May 29,2015.

The Curious Coach’s Questions: Coaching Skills for Healthcare Leadership

April 29th, 2015

Curiosity and Open-Ended QuestionsThese vital competencies should headline skills labs for healthcare professionals with the dual intent of enhancing their own abilities while developing others.

Our quiver of leadership skills is incomplete until we add coaching inquiries, delivered from a true attitude of curiosity, allowing us to learn together with those we lead:  patients, clients, employees, coworkers.  Precious moments spent to ask for input may seem wasteful in a pressured environment, especially when directives could be delivered more quickly.  However, the time allocated to ask, listen, and understand will ultimately save future problem solving efforts and increase personal engagement.

Too often, we assume we understand the motivations of individuals in our lives, when in fact, knowing the rationale behind their behavior will offer new perspectives as to how they think and prioritize.  Fully appreciating their thought processes will also allow us to help them reason through any gaps or potential pitfalls, assisting them to fully understand their own tendencies and patterns.

Let’s explore an example of the benefits of a spirit of curiosity and open-ended questions.

You are a Curious Coach type of healthcare manager.  Two additional personnel were added to staffing for the Saturday day shift and you have been nastily notified by the CFO about this budget excess.  Rather than charging forward and delivering an ultimatum to the weekend staff about adhering to the budget guidelines, a coaching stance would recommend the following set of questions:

Begin with inquisitiveness and an open mind, rather than an anxious or blaming intention:  “Please tell me about what was happening last weekend.”  If that question doesn’t lead to information related to staffing issues, continue with: “I heard about the additional RNs on Saturday, and since I wasn’t there, I am curious about what thoughts went into staffing decisions over the weekend…”   And wait for a response.

How will the Curious Coach reply to different responses?

1.  Inappropriate Use of Resources Response

If the response is “Gee it was Nurses Week!  We had a potluck planned; and we deserve an additional couple of staff to make it an easy day because we are tired and upset!” then there are several options for further questions: “Yes I know it’s been busy with unexpected patient deaths –And people are heroes for working on holidays and Nurses Week” But after acknowledging the need for support and relief, add “what are some other ways that we could support our team instead of using our staffing budget dollars when they are not needed for patientsWe can’t continue to use staffing for that purpose.” And wait for a response, and/or explain the budget situation if necessary. A subsequent and more directive question could be “Would you bring our need for a break or stress relief to our unit-based council to decide on the best ways to approach this need? 

2.  Clinical Planning Response

If the response is “We had 2 dying patients and families disagreeing over end-of -life treatment so we had to prepare for codes, and/or ICU transfers, AND we were slammed with 6 ER admits at change of shift” then a reasonable response is “Thank you for the great patient-family centered foresight! I’m wondering what or who else was missing?  In the future, what other people or professionals could we use to help us during these kinds of challenges on the weekends or even at admission? What could we do to prepare for this kind of situation in the future?”  The team can begin some longer term problem solving to garner extra support for critical end-of-life treatment and patient care planning on weekends.

Now, Curious Coach, aren’t you glad you approached your colleagues with respect and support instead of being contaminated by the CFO’s irritation? An immediate directive response is rarely needed except in case of emergency.  Maintaining an accusatory stance or pre-judging a team member’s motivations or decision-making capabilities would not serve to educate or change behavior.  Curiosity brings a leader to understand the true rationale for decisions, and helps trace healthier paths for decision-making within a transformative team environment.

For additional coaching tools and questions, consult Ruth Hansten’s most recent of her seven books:  The Master Coach Manual on at

For more information about your own leadership coaching, or developing an internal coaching program, email, or 360.437.8060,,

(This Blog Posting has been previously published on LinkedIn Pulse, 4/29/2015 by Ruth Hansten)

A Cure for Leadership Loneliness?

March 20th, 2015

A Cure for Leadership Loneliness? 

An unanticipated surprise in my first leadership role was the unwelcome abrupt detachment from my former collegial teammates.   Jettisoned from the warm cocoon of a backup group, I was seen as a “suit.”  I discovered that my new supervisor was a limited confidant because she was simultaneously judging my abilities with unrelenting concern. (My leadership style was decidedly less autocratic than existing corporate culture.)  My search for a supportive and helpful person to discuss my role and responsibilities led me to lateral colleagues.  I was soon disappointed to recognize that those individuals could not be completely trusted because we were competing for limited resources and respect. Even though I hunted for a mentor, no one within the organization stepped forward to partner with me to focus on my work or my professional advancement with loyalty, caring support, frank feedback, or sponsorship. 

Recent studies about female job advancement and pay equity show ongoing gender disparity and also highlight a gap in mentorship and sponsorship opportunities for women.  Leaders, especially females, frequently lack a specific advocate guiding and cheering them forward.  (See Healthcare Dive for an informative overview:

Healthcare leaders make numerous decisions each day while charting the course for their units, departments, and organizations.  Healthcare leaders’ abilities affect the organization’s and employees’ vitality as well as the health of the communities that they serve.  These important roles mandate effective assistance, reinforcement and encouragement. 

Solitary reflection about our performance can feel isolated and desolate. Without a thinking partner to actively listen, ask probing questions, and make observations, an executive can miss important progress, ignore danger signs, overlook potential growth opportunities

A leadership coach, whether internal or external, will perform the role of your own special active listener, fulfilling the requirements of behind-the-scenes confidant and supporter.  Confidential discussions, observations, feedback, education, challenges, questions: all of these are the potential strategies the coach uses to help the leader learn, grow, and achieve her goals. 

McNally and Luken’s research related to the efficacy and return on investment for coaching found that 100% of 64 healthcare leaders felt more competent and confident post-coaching, and over 50% were more likely to stay in their positions, with significant benefits achieved in comparison with program costs. (Leadership Development: An Internal-External Coaching Partnership. McNally and Lukens March 2006 Journal of Nursing Administration 36:3).

Leaders that affect the lives of so many people and communities deserve a trusted professional beside them to listen, encourage, measure progress, and help establish optimal strategies to achieve their goals. Collaborating with a coach can help transform the loneliness of leadership into a partnership for personal growth, professional effectiveness, dynamic progress, and vital engagement.  

 For more information about your own leadership coaching, or developing an internal coaching program, email, or 360.437.8060,,

Or visit to review the Master Coach Manual

4 Benefits of Developing a Coaching Culture

February 17th, 2015

4 Benefits of Building a Coaching Culture:

If your ultimate vision is of an organization brimming with superior thinkers and doers, teams of people inspired with joy and resolve toward their common purpose, then begin developing a coaching culture. Once basic required skill competencies have been assured, a team is ready to be coached.

Effective coaches learn to ask open-ended questions, helping their teams discover through guided queries and feedback rather than using a 19th century assembly-line approach of task check-lists and intensive management scrutiny.  In a coaching culture there exists a shared expectation and respect that individuals possess the ability to think through possible actions. Undergirding the concept of coaching is a respect for our colleagues and their ability to stir up their personal freedom to perform and to choose their course. Shared decision-making and creative inspiration replaces employees biding time waiting to ask for instruction or approval.  When leaders learn to coach, they learn to pause, wait, and listen, rather than always providing expedient answers.  They learn how to ask questions that truly develop the individuals on their teams, rather than stultifying them with pat answers that could impede creative new strategies.  Leaders that have spent the time and effort learning how to coach, teaching their teams coaching competencies, list these benefits:

  • A coaching culture saves time (ultimately),
  • Coaching organizations may reduce employee turnover,
  • Using coaching skills makes leadership roles less stressful,  more fulfilling, and
  • Coaching-competent teams promote the odds of goal achievement.

1)  A Coaching Culture Ultimately Saves Time:  When employees have been coached themselves and learn to coach others, this saves teams time.  On behalf of the leaders, not having to stop and “tell” everyone what to do, how, when makes for effective and efficient use of their energies.  A coaching culture means people have been trusted to make good decisions by guided inquiry rather than waiting, suspended in time, for managers’ instructions.  Leadership efforts can be placed on promoting steps toward the strategic plan instead of day to day “putting out fires” because knowledgeable employees have felt empowered to make necessary improvements at the point of service.

2) An Organization with a Coaching Culture Experiences Improved Employee Engagement:  Every leader would like to reduce employee turnover of the preferred kind of employee:  those stars that choose to think clearly and grow, learn, adapt, and work toward the shared organizational vision. People that have been coached know that their leaders value and trust their ability to think and to find the answers, and are confident that they are respected.   Personnel that perceive the freedom to act within shared values and mission-connected guidelines rate their autonomy highly in soaring employee engagement and tenure.

3) The Leader/Manager’s Job is Easier and More Fulfilling: Your management/leadership role is less stressful if team members and colleagues see themselves as powerful people able to influence changes in their workplace.  In  healthcare coaching cultures, team members serving at the point of care conduct themselves as assured professionals.  The same attitudes, competencies, and skills learned in coaching education and practice are those that lead to effective interdisciplinary teamwork and shared governance.   Effective team members are coached to self-manage, developing self-awareness, recognizing their internal locus of control as they gain knowledge and skills.

4)  Coaching Organizations Develop Higher Probability of Strategic Plan Achievement:  Patients and families that experience care from competent calm experienced professionals are more satisfied, and better apt to understand and follow care instructions.  What potential patients (all of us) wouldn’t want to be served by those that enjoy their work and can make professional decisions with alacrity, thereby increasing efficiency efforts?  Workforces ready to reflect, develop, make decisions, offer and receive feedback, are energized to work effectively toward shared goals, and raise the odds of success.



What does it take to develop coaching skills?

Being coached yourself is the best first step. Contact Ruth Hansten for information, at, or 360.437.8060.

There’s Treasure Buried in this Leadership Habit

February 5th, 2015

Rich rewards can be reaped by incorporating reflection into your leadership routine.  Any resistors out there?  Full disclosure demands that I state that I am a reformed, recovering Instant Decision-Maker Just-Do- It You-Can-Have-it-All Diligent Worker.  I grew up in a home with 2nd generation immigrants just off the homestead with the belief that if you worked harder you would be better off in Oh So Many Ways. No one sat to consider outcomes or options or to review, because we believed,  if you did sit then certainly the farm and your family would suffer.  As a single working mom I incorporated immediate streamlining of all tasks and processes with costs/benefit analysis as effective brain training for hospital administration, but also useful for rapid fire decision support regarding PBJ sandwiches QD versus a housecleaner twice a month. (Housekeeper acquired.)  Brisk efficiency and instant analysis (minus even momentary reflection) won.

Doing the tasks took over;  the chaos of immediate needs and adaptive changes were overwhelming.  But I was lacking the leadership moments necessary to ask critical thinking questions such as:

  • Are we achieving the results we would like? If not, why not?
  • What outcomes can we celebrate?
  • What’s working and what’s not working?
  • What could we do differently if we were to deal with a similar issue again?
  • What recommendations should be incorporate into our future work together?

Healthcare personnel (interdisciplinary teams) in departments I led were pausing for several minutes toward the end of a work session, to evaluate care outcomes, celebrate, and determine what they would recommend the team would do differently if they were to have a similar assignment.  I noted improvement in teamwork and critical thinking development, but I had not integrated reflective practice with regularity into my own leadership life. My business coach encouraged me to stop, sit, and reflect just for 2 minutes to start. Even one minute was too hard for me; I found myself manufacturing “to do” lists in my brain rather than evaluating outcomes and processes, thinking about course corrections, deciding on next steps.  I discovered I was repeating similar gaps and missteps because of a constant task work=value ethic.

How can you carve out the time for answering the crucial leadership questions about what you can celebrate and what you want to change? The benefits are numerous:

  • Consider course corrections before it’s too late to change the momentum
  • Avoid repetition of mistakes.
  • Streamline next steps due to clarity of intended outcomes and plan going forward.
  • Take deep breaths and/or put your feet up. (Health benefits!)
  • Celebrate the impact of what you do=immediate mood lift.
  • Reflection is essential for critical thinking development.

In the Master Coach Manual, we provide tools to help you stop and reflect on the onsite processes that improve clinical outcomes.   www.Hansten.com;

We recommend refection as an integral practice for coaches and coachees alike.  Contact us at for information about being coached or creating a coaching culture., or visit