Many of us were taught to not talk back in school. That also applied at home for me. When I was in the first grade, I got popped on the bottom with a slat from an orange crate when I sassed my father. He ran a grocery store and I wanted two packs of 25 cent Blue Horse paper so my notebook would be thick, like the ones the older children on the bus had. He said, “No.” I said, “Well, if I can’t have two, I don’t want any.” Then I sashayed back into the store to put them down. He was waiting for me when I came back. He happened to be taking apart an orange crate.
I don’t think many parents paddle their kids anymore. In fact, I’ve overheard disagreements where both parents and kids yell at one another with a nasty tone. Neither approach is effective in the adult work place.
I taught doctors how to deal with disruptive behavior last week during the program to become a Certified Physician Executive. I always read recent articles on the subject to get ready. I found one in the PEJ by Joseph Grenny, head of Vital Smarts, the group that wrote and teaches Crucial Conversations. Not only did he discuss how to confront a physician who was behaving inappropriately, he also said an essential part of the change process is teaching nurses and others who are lower in the medical hierarchy to speak up. Grenny gave an example of a response a nurse could give to speak back respectfully. I shortened his version because I don’t think I would remember all of it in the pressure of being yelled at:
I am not trying to challenge your expertise. I know you are a good doctor. I apologize if you found my approach disrespectful. I will work hard to address you as you deserve. And doctor, I must ask the same of you. When I shared my concerns about the patient, you raised your voice, you rolled your eyes, and you spoke to me harshly. That doesn’t work for me either. May I have your word that you will not address me that way again either? (Adapted from PEJ Nov/Dec, 2009, “Crucial Conversations,” p. 32).
When angry words are flying, I tend to think of what I wish I’d said an hour, a day, or a week later, but I think this kind of response is worth memorizing and keeping in your repertoire to pull from when things get heated.
It would be a new world in healthcare if everyone had the nerve to call out inappropriate behavior and to talk back firmly and respectfully when spoken to in an ugly manner. I know we all fear for our jobs and many carry fears from childhood, but it is worth thinking about how to say what you mean in a calm, confident voice when someone yells at you. Here’s some food for thought: If someone has yelled at you before and didn’t get a response, they will probably do it again. So be prepared for next time: Write out what you wished you had said, learn it, and say it next time.
