Attitude of Gratitude – Showing Some Love in the ED

There are many things I do which are stereotypically “British”: drinking tea, apologising instinctively (especially when it isn’t my fault), engaging in our national sport (queueing), becoming intensely irritated when other people fail to comply with the [unwritten] rules of our national sport (aka queue jumping) and, apparently, struggling to express positive perceptions about people.

I know this isn’t just me; there is an intrinsic awkwardness to saying positive things to people (look, for example, how much has been written about giving negative feedback – there’s an imbalance with positive feedback because we often don’t even know where to start). BUT: when we do say thank you or express our gratitude – and mean it – it can have a tremendously positive effect.

Worked with awesome boss today. End of shift, good eye contact, thank you for all your hard work. They actually mean it. Hugely motivating.

— Kirsten Walthall (@K_Walthall) May 6, 2013

@K_Walthall @NickHarveySmith Nurse said thank you with eye contact at end of shift this morning. Still thinking about it :-). EM = teamwork

— Natalie May (@_NMay) May 7, 2013

@K_Walthall @_nmay @nickharveysmith Honestly? What kind of awful work environment do you have?

— Katrin Hruska (@Akutdok) May 7, 2013

The reason I include Katrin’s response is because she was genuinely shocked that such an event was worth talking about – that it was so rare as to be notable. This conversation occurred a little while back, but I think about it regularly. Do you thank your colleagues as a matter of routine? If not, why not?

Why is thanking people important?

I don’t know if you’ve read the papers lately, but it seems that in the UK Emergency Medicine is having a slightly difficult time (to put it in rather British terms). That said, I still absolutely love my job and couldn’t envisage myself working in any other specialty.

But I have to admit, being told by a newsreader almost every day while I get ready for work that it’s going to be horribly stressful and utterly rubbish when I get there doesn’t really put me in a positive frame of mind. What keeps me going when I do arrive is continually witnessing how incredibly hardworking and committed my colleagues – in medicine, nursing, and all our non-clinical supporting staff – are; I feel incredibly privileged to be a part of the ED team and it is one of my absolute favourite things about our specialty. But maybe I don’t tell them enough.

Energy and enthusiasm aren’t limitless and we all feel the pressure at times. Not too long ago, while I was having a particularly difficult time, someone said something non-specific but overwhelmingly positive about me. The effect on my morale was incredible. The bottom line is that we can make people feel like this every day. To quote this paper,

“job satisfaction and organizational commitment are closely linked, and are both very important for general organisational success.”

We work hard and sometimes the work is hard, both physically and emotionally. We see terrible things and do our best to relieve pain and suffering. It doesn’t always work and that can leave us feeling demoralised. So we really need this stuff; the perception that we are valued by our peers and seniors is incredibly important to our professional identity and it is reasonably well-evidenced that happy workers are productive and more healthy.

How can we make it meaningful?

My final year of medical school involved an 8-week paediatric (of course!) elective in Uganda. I worked in a small rural hospital where the nurses tirelessly translated our medical questions into the local dialect and the [often nonsensical] answers back into English. At the end of every shift we would have a short but meaningful exchange with the nursing staff in Lukonjo:

Doctor/Medical student: “Wasinja erikola” (Thank you for your work)

Nurse: “Wasinja erisema” (Thank you for appreciating me)

My written Lukonjo isn’t the best, so I may have spelled these phrases wrong, but they were delivered without fail at the end of every shift, with eye contact and a smile. I remember it very clearly along with the thought that it was so odd that we didn’t routinely thank people in the UK.

The phrase “thank you for your work” is a little clunky in English so I tend to thank my colleagues for their help as I finish a shift and when my sincere thanks is reciprocated it brings a sense of achievement and value that lasts longer than most clinical achievements. Make eye contact, be specific if you want to have real impact (“thanks for your help with that patient – you did a great job today”) and make it a habit. Once you get started it gets easier, I promise. Let’s show those Europeans that expressions of gratitude and appreciation in the workplace are the rule, not the exception.

And don’t forget, patients get better care from happy staff. And chocolate helps too.

Smiling staff reassure patients, says @Damian_Roland. I commit to continuing to keep my colleagues in chocolate & cheesy music #NHSChangeDay

— Natalie May (@_NMay) November 6, 2013

Always on a Friday as I walk out the office I think about #nhs staff who will be working their guts out over next few days. Thanks to all.

— Shaun Lintern (@ShaunLintern) November 15, 2013

Agree with me? Why not pledge?

If you agree with the above, why not make a pledge for NHS Change Day? You can make your own pledge here or join Carmen Soto‘s here – or any of the other pledges about saying thanks…