The Sim Cafe~ Interview with Dr. Renee Thompson

Dr. Renee Thompson is the CEO & Founder of the Healthy Workforce Institute and works with healthcare organizations to cultivate a professional workforce by addressing bullying, and incivility.  Renee has authored several books including, “Do No Harm” Applies to Nurses Too!, and Enough! Eradicate Bullying & Incivility in Healthcare: Strategies for Front Line Leaders. Renee is one of only 26 nurses in the world who have achieved the prestigious certified speaking professional designation and in 2018 was recognized as one of LinkedIn’s Top Ten Voices in Healthcare for her contribution to their global online healthcare community. Renee has a Master’s degree in Nursing Education and a Doctorate of Nursing Practice from the University of Pittsburgh.

Website: https://healthyworkforceinstitute.com/

Youtube: https://www.youtube.com/results?search_query=renee+thompson+nurse+bullying

Innovative Simsolutions: https://innovativesimsolutions.com/ 

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Transcript

Intro: 0:05

Welcome to The Sim Cafe, a podcast produced by the team at Innovative Simsolutions, edited by Shelly Houser. Join our host Deb Tauber as she sits down with subject matter experts from across the globe to reimagine clinical education and the use of simulation. So pour yourself a cup of relaxation. Sit back, tune in and learn something new from The Sim Cafe.

Deb: 0:39

Hi, welcome to another episode of The Sim Cafe today. We, we are truly blessed to have Dr. Renee Thompson, Dr. Thompson, would you like me to call you Dr. Thompson?

Renee: 0:50

Oh, please call me Renee.

Deb: 0:52

Okay, thank you. So Renee, why don't you tell our listeners about yourself?

Renee: 0:57

Sure. Uh, well, I always like to tell people first I'm a nurse. I've been a nurse for a little bit more than 30 years, and I've pretty much done everything you can do as a nurse. I mean, from the bedside, I was an educator. I worked for a managed care company. I, uh, worked for a home care company. I was an executive, I was a frontline manager and you know what, Deb, I, I got to the point where I realized I, that it didn't matter where I worked or what role I had. I swear there was always another group of nurses who made it their mission to make my life difficult. And I just thought, you know, working in healthcare is hard enough without your coworkers making it harder. And so it's almost been 11 years now. I took a leap of faith. I quit a really great job that I love to start my own company with the intention to really do something about bullying and ins civility in healthcare. And so now I am the CEO and founder of the healthy workforce Institute. So that's a little bit about me.

Deb: 2:03

Thank you. So do you wanna share with our listeners why you got into that?

Renee: 2:09

Absolutely. You know, uh, well, I, I did some, there's a couple of reasons. One is, and I didn't realize this until really just a few years ago, but as I said, you know, I, I realized that didn't matter where I worked, what role I had. There were always, always people who made it their mission to make my life difficult. It all came together in a moment when I was the, the last job that I had, where I worked full time for an organization, my title was director of academic service partnerships. So I was responsible for all things related to the student nurse experience, the new nurse experience. So I developed a nurse residency program. We looked at the preceptor program, certifications, advanced degrees, really professional development for the system. And there were, we had about 10,000 nurses and I was doing all these focus groups with student nurses and new nurses about what they needed to feel that they could easily transition into professional practice. And I, cause I was building a residency program and I really thought that they would give me, oh, we need more time to focus on these and those skills. But Deb, all they wanted to talk about was how the other nurses bullied them. And it reminded me of my own experiences and somebody in the room said, well, that's just the way it is in nursing. And I had an out of body experience and I thought, wait a minute, this is not okay. And in that moment I decided enough is enough. I had to do something about it. And then, um, it was a few years ago when somebody was asking me, why do I do this work? And I had done some core values work, uh, a while ago where you try to identify what your core values are. You know, lot of people say family and health and all these things. Well, one of my top three values is kindness. One human being to another human being, independent of fill in the blank. Okay. And so this goes against everything I am as a human being, you know, when somebody's deliberately cruel to another human being, I, I just don't understand. And so I had to do something about it.

Deb: 4:23

Excellent. Excellent. And when I first asked you about doing this podcast, you said, well, I really don't do simulation.

Renee: 4:32

Right? I'm like, well, I don't do sim!

Deb: 4:34

But I think you are doing simulation. You're doing it in unique ways. So why don't you about how some of your training, which was essentially simulation training, right? Uh, changed an organization or a culture?

Renee: 4:50

Um, well, to your point, my first thought was, yes, I, I don't do simulation and the traditional sense of simulation, but then as you reminded me, most of what I do is really in a stimulated form. And, and it's because I am well known for my simple practical tools skills to address disruptive behavior using scripting. And this is where I always say, people don't know how to address bullying and incivility because they don't know what to say. They don't how to say it when to say it. And that's where I really have been able to help organizations reduce incidents of disruptive behaviors is because I'm big on scripting. And I'll, I'll give you some examples cuz I think, oh my gosh, I have so many examples of success stories, uh, working with, uh, an organization out in, uh, California. There was a department, um, that was incredibly dysfunctional. There was this war between the staff, the employees and the leaders and the, the leader, the first conversation I had with her, cuz we were gonna start doing this work together. First conversation I had, she cried. She said, I walk into the break room and my nurses walk out. When I walk onto the unit, everybody turns and walks the other way. I, they complain about me constantly, never to my face, but they, um, you know, call the compliance hotline or they'll put in some type of incident report. And she said, I I'm trying. I just, I don't know what to do. And so here's what we did. I worked with the leadership team and give, they gave them very practical strategies and scripts to use when people are acting out. Okay. And it's not just to address disruptive behaviors in the moment, although that's, you know, part of it, but it's also, how do you cultivate good behaviors, professionalism, respect. And we, I gave them a lot of, and we did some role playing when I'd have my calls with them. We'd say, okay, here's the situation? How do you handle it? Okay. If you're in that situation, how would you handle this? Which to your point is really simulation. And from there then we empowered the employees and we started working with the employees. So what do you do at two o'clock in the morning when you ask your coworker for help and your coworker said, I'm not your mother, go look it up yourself or just completely ignores you. And that's where we were able to identify, cuz we do a lot of surveys. We have a validated tool to show them, these are the way disruptive behaviors are showing up in your department. The most. So silent treatment is a big one. Oh my gosh. I think if anyone on the healthcare team isn't willing to speak to anyone else. Okay? That stops the flow of information. And when we stop the flow of information that affects someone's mom or child or you know, partner, so working with them, giving them the skills and tools and scripting and how do you deal with certain situations ended up transforming this department into a department that they have the highest morale scores, highest engagement scores, people scores. So, um, this, the leader actually sent me a video a couple of weeks ago of her staff, her employees coming together to celebrate each other for, you know, helping each other, giving each other feedback, helping each other to grow. It was just phenomenal. Like I cried, you know, the leader cried, we all cried felt, but, and I I've had that situation so many times, but that's the one that really stands out to me.

Deb: 8:44

Well, and I think you bring up up a great point. One of the things that when I did teaching, I would always pull up a triangle and I'd say, if the triangle's going up, you have one is trust. One behavior is respect and the other one is appreciation. And when you have that, your clinical outcomes are gonna go out up. But if you conversely have a, a hero, a rescuer and um, uh,

Renee: 9:13

Victim!

Deb: 9:13

Victim, yeah. If you have a victim, a hero and a rescuer, you're gonna have clinical outcomes are gonna go down and you, you know, that you could feel absolutely. Just like you said, you, you could taste incivility in a restaurant.

Renee: 9:26

Yes. And the food that you eat, I was saying, I, I read this somewhere. The, the chef said he wanted to get control of the incivility and, and his restaurant. And he said he can taste sensibility in the food. Like, Ooh, that's good because you can, it's palpable. You can tell when you walk into a department or you can tell when you go into an organization that bad behaviors are tolerated there. When people just act as though they don't care and they're just rude to each other. And in healthcare, when we act like that, that affects someone's life studies. After studies show this like hands down, we don't need the proof that instability and bullying harms patients. We have it, but it's just who, you know, who's doing anything about it. And, and that's why I decided to tackle.

Deb: 10:18

And that gets me into my next question. Where do you see this work going in the future? I know some of the simulationist that I've been meeting with wanna incorporate inability training into their work. So where do you see it going?

Renee: 10:31

Well, when I first started doing this work, I did a lot of speaking, you know, onsite, an organization would contract with me to come and do a day or two training. Usually we start with the leadership team. Then we train the staff. But the problem with that, it's sort of like a one and done, they would say, okay, we have a bullying and instability problem. Let's find an expert. They'd bring us in. And it was as though they were checking a checkbox to, and that doesn't change behavior. At least it doesn't sustain behavioral change. And, and I was getting to the point where I just didn't have the capacity. I, I was spending more times in hotel rooms and on airplanes and airports. Oh, the miles I racked up on the different airlines. Well, I decided to look at what are the trends in education and take a look at my company and sustainability and scaling. So we move to, uh, we have an online academy where, and this is where I think, uh, this type of training is heading where we don't just passively say, okay, we have a core scope, access, the course learn on your own. You're good to go. I, I think what works for us very well, that we've seen the most success and the future of this type of training and education is a hybrid model. So I just got off of a live call, 99 leaders hopped on who were in one of my online courses. So it's, self-paced five modules. They go through it, there, there are interactive things that they can do, but it's all asynchronous, but then hop on a live call with me. And I just have one of the leaders ask me a question about how to deal with the situation with one of her employees. And I gave her the scripts and we talked about this and 99 people on this call all receive that same sort of advice. So now they can take it back and apply it into their practice. And here's something else that we do with these calls, each organization that enrolls groups of their leaders, um, in this, on some of our, um, programs, we identify somebody from that organization who also schedules time with everyone to do a debriefing. And they talk about how does this apply here? And that's all sim you're right. That's what they do in simulation. You have the debriefing after. So we do the exact same thing, but we do it in a hybrid model. So you've got your asynchronous, you've got the content, but then you come together and you talk about it.

Deb: 13:06

Right, right. And I think you, you also, it's a shared mental model when you get the people who are in the, in the C-suites involved in it. And then everyone's is sharing the same playbook, right? The same scripts.

Renee: 13:21

Absolutely. And that's you bring up a really good point too. Um, one of the things that we started incorporating into the work that we do, cause we do a lot of consulting. I do more consulting now than anything. And when an organization and reaches out and they want some type of training from us, they wanna improve culture. We always make sure that we have the key stakeholders involved from the beginning because they need to support this. They need to protect time. They need to make sure that this, whatever we're teaching them is to be reinforced at the organizational level. It can't just be that frontline manager and their employees.

Deb: 14:02

Right. Right. Renee, what do you do in the situation where one of the C-suite leaders is the.....

Renee: 14:08

Problem?(laughter)

Deb: 14:10

Problem, yeah,(laughter)

Renee: 14:12

That never happened!! Yes.(laughter) It's very difficult. Especially if they're bringing in that there's some benefit to keeping them there. Okay. And we've dealt with this before, where there's somebody at the C-suite who either doesn't buy into it i s part of the problem. I always say, first of all, data doesn't lie. So what feedback o r are you getting about this individual? And if it's that, they're not buying into this, it's showing them the data. Like I said, data doesn't lie, but also there's gotta be a commitment that it doesn't matter what role you play. It doesn't matter if you're the C EO, IOF, OO, NO you kn ow, MO all the O's or the dietary ai d p assing trays or the housekeeper. Okay. That everybody needs to be held responsible for conduct. We actually do have, I have somebody on my team who does abrasive leadership coaching. And that would be what I would recommend for a leader, especially at t he C-suite who is a problem, but maybe either doesn't realize they're a problem, or they're not aware, but the organization wants to keep them so th at t hey need intensive training, but it's not easy to, it h appens a lot.

Deb: 15:32

Yeah. So someone'll have a blind spot and they just can't see it. Yeah. Now, Renee, if our learners wanna get a hold of you, are there any, any ways that they could get a hold of you, any questions that they, you know, you might be able to answer for them. What are some things that you can recommend that, you know, nursing students can maybe learn from?

Renee: 15:53

Sure, sure. Thank you for asking. Well, best place to go is my website. It's healthy workforce institute.com and there are a couple of things. Most everything on my website is free. So if you scroll all the way down to the bottom, you'll see all my social media platforms, you can join us there. So I've been writing an article, every it used to be every week. Now it's once a month, we have a blog I've won numerous awards for my blogs. We actually have a YouTube video series that I think in particular would be helpful to student nurses and new nurses. It's called coffee and conversations about nurse bullying. It's basically me sitting there with a couple of coffee talking about bad behavior and how you handle it. And that can be found on my YouTube channel. And then actually, if you're new, if you're a student, you're, you're a new nurse and you really need some help. And you want some of those scripts. The first book I ever wrote was called, Do No Harm, and applies to nurses, to strategies to protect and bully proof yourself at work, I love the student nurse and the new nurse experience. I'm all about making sure that that experience really sets them up and equips them to be competent, professional, respectful, kind, you know, professionals. And so when I wrote that book, I kept a picture of like student nurses and new nurses in front of me, cuz that's who I wrote the book for is it's it's for them. So they can find that on my website or you can, um, check out Amazon it's on there too. And then barn and noble, not all of them, but some of the Barnes and noble stores hav i t.

Deb: 17:30

Great. Great. Do you have any questions for me?

Renee: 17:33

I actually would like to find out where do you see the direction of simulation? Because I remember there was really no traditional simulation when I was a new nurse. It really evolved, you know, over time. But where do you see the direction of sim?

Deb: 17:48

Uh, I see, you know, there's gonna be some stuff with the virtual reality, the augmented reality. Yep. Um, the holograms beaming people in, I see some of that coming along simulation is here to stay. People have, I feel have learned to accept it because the pandemic created a natural disruption. There's it's not like you could say, you know, it was because of the Republicans or the Democrats. I mean, it was a natural disruption, right. Where we had to change the way that we're delivering healthcare and teaching healthcare. So simulation will continue, you know, we'll be doing some simulation. We are doing some simulation virtually in addition, you on the ground, more people are using simulation and insights you, or which means in the environment. So that's where I see.

Renee: 18:39

Yes, I agree. And I've seen some indication, uh, that they're trying these holograms and I, I was at a speaking convention and they had somebody doing this there and it was before COVID hit. But I thought that was so cool. I am sure there's amazing applications for that. What I will say is I love simulation. I think it gives you that safe place to practice what I really appreciate about it. And this is what we all need to be doing in any way that we're educating and training people is it's the conversations that you have with people after it's the debriefing, what went well, what didn't go well, what would you do differently the next time? And so that's the key and simulation does that probably better than any other way to deliver content.

Deb: 19:25

Thank you so much for this interview. This has been wonderful and I'm gonna end it with kindness matters.

Renee: 19:33

Absolutely. Thank you so much for having me. It was really, uh, an honor and opportunity to speak with you, but then all of your listeners and hopefully give them some tips and tools and strategies to help them to go back and, and really make healthcare a better place.

Deb: 19:50

Thank you. You, thank you. I'm hoping to kinda cross pollinate some, some of the work with what you're doing with simulationist with even teachers. I have some actual teachers that are listening to the podcasts.

Renee: 20:03

Yeah, absolutely. Because it's not just a healthcare issue, it's a human issue. And it's an all industries. A lot of people say that, you know, my strategies, they they've used my strategies on their families and their friends and in other industries I'm like, absolutely it works. And so, yeah, just appreciate the opportunity to, to share this.

Deb: 20:22

All right. Thank you so much. And until next time, happy simulating.

Outro: 20:32

Thanks for joining us here at The Sim Cafe, we hope you enjoyed. Connect with us at www.innovativesimsolutions.com and be sure to hit that like and subscribe button. So you never miss an episode of The Sim Cafe.