Practice advice Continued »
to the fire by declaring they didn’t find them a bit rude. The nurse’s opinion will remain unchanged unless, at some point, the patient demonstrates that they share another value in common.
What can we learn? In life we are driven toward the things we value, situations which uphold our values and to people who share our values. Values are our attractions and (perhaps more significantly) our repulsions in life. In our personal life, this is a very useful tool as it ensures that we do not waste time with people who continually hurt, confuse or make us angry. There are two important distinctions with regard to our profes- sional life: We cannot choose who comes into our
surgery in the first instance or how long we might be required to spend with them to complete treatment. We cannot express an opinion when our
values differ as this may be perceived as passing judgement. We will therefore undoubtedly treat
patients who hold dear to values which digress markedly from our own. This can make us feel uncomfortable and stressed. I would be surprised if we haven’t all identified this effect at some point. Can we combat this? There is certainly merit in identifying
our personal values and the order in which we prioritise these. This is frequently referred to as our ‘hierarchy of values’. If we progress down our hierarchy (list in order of importance starting with the most important) systematically, we will usually find that we share a value on some level even with the most challenging of patients. We may have to consciously look for it and once found determine to keep it in focus. In the clinical example above for
instance, the nurse may also value organi- sation and efficiency. She can therefore choose to focus on this and not her higher value of gratitude. This perspective allows an appreciation of the fact the patient left as quickly as possible to avoid wasting more of their time. It may not be the higher value of gratitude – a rich reward – however, it acts a consolation prize of sorts. It is always less emotionally taxing to focus on what we share in common than on where we differ. “Find people who share your values and
you’ll conquer the world together.” – John Ratzenberger The provision of good dentistry relies
almost entirely on good team work. It is impossible to work as a dental professional and remain unaffected by the interac- tions you have with your team members. Superficial differences in approach and
Diligence Equality Gratitude Loyalty
“If this is not addressed, we frequently report feeling helpless”
process occur regularly and these are easily aligned. Difference on the level of our values is much more emotive and these differences feel much more personal. When we work with people who share
our values we feel personally valued, supported, fulfilled and safe. We feel energised, have a shared direction and are inclined to celebrate our collective success. To work in a system or team forcing us to behave contrary to our values creates internal conflict and a sense of sadness leading to a profound lack of motivation and dampening of spirit. If this is not addressed, we frequently
report feeling stuck and helpless. We lose our confidence and sense of worth (value). We begin over analysing, feeling uncomfortable and perceive ourselves as a dispensable commodity leaving us feeling a little paranoid on a daily basis. I hear the words “they just want rid of me” or “I just don’t fit” frequently when coaching. This escalating negativity is then picked
up by the team and tests its patience. Incredibly, we frequently tolerate this situation until we are either managed out or burnt out. It is important to point out this doesn’t make a particular setting or practice a ‘bad place’ it is just not a good place for you.
Clinical scenario A principal has three associates. One of them (Associate A) has been there for 10 years, the others are more recent addi- tions of less than four years (Associates B and C). The principal is very forward thinking, he is building a visionary practice
and has a very specific business model he has decided to follow. This will entail cutting associate percentages to release working capital and make the required improvements. He has a high personal value around
loyalty and, therefore, regards the first associate as an extremely valuable asset and reduces his share by 5 per cent and the other two he reduces by 10 per cent. Associate B who has a high value around equality is horrified that his diligence and unwavering commitment to the practice has been valued at less than Associate A. He now pays attention to all the other ways a distinction has been made. He notes that Associate A is not expected to do a late evening, that Associate A always has the same nurse and never has to rotate, etc. He turns to Associate C for support,
as he naturally assumes they will view things in a similar fashion. Associate C sympathises with him, since he also values equality. However, Associate C has an even higher personal value around respecting authority and elders and is not inclined to challenge this. To do so would make him feel extremely uncomfortable he would rather “take the hit”. Associate B suddenly feels very isolated,
undervalued and resentful. He takes time now on a regular basis to survey the set up and, suddenly, can notice little else about the practice except examples of inequality. Things that did not bother him previously now do. For instance, the fact new patients are charged for every item while long-term
Continued » Ireland’s Dental magazine 25
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