1. Healthy Conversations about Tough Issues
There are all kinds of examples of conversations that need to occur they can have serious implications….
Clinical medical example: A patient relates a story to you that indicates that they are not fully aware of the implications of the surgery they will have tomorrow. There is a chance that the patient may not make it! You know Dr. X/Nurse X is their caregiver and your past experience tells you just to leave this one alone. You’re probably mistaken anyway and this is just far more trouble then you need today.
Family example: “On weekends your spouse drinks to the point that you have to cancel evening social engagements. You also have to rearrange transportation plans for your children because dad is too drunk to drive the gang to the basketball game. You’ve cried, lectured and threatened in the past but his promises go unkept.”
Pop culture example: The Columbia shuttle explosion. Would you believe that people had complained about the design flaw for sometime. For a variety of reasons nothing had been done. No one felt empowered enough to speak up. All astronauts on board perished.
These examples are great instances where failing to have a conversation has a great impact but don’t the things we see every day have the same impact. If a patient spends several additional days here because they get an infection acquired because we refused to confront a coworker about washing their hands. Is this a critical impact to the patient? Think of some other simple yet critical impacts we encounter every day.
Behind every national disaster, organizational failure, and family breakdown you find the same root cause. People are staring into the face of a crucial confrontation, and they’re not sure what to say. This part they do know: First, they need to talk face to face about an extremely important issue. Second, if they fail to resolve the issue, simple problems will grow into chronic problems.”
Presenter:
Scott Foster

2. Share Success Stories
Slide 3 Share Success Stories
Jen….“These examples represent one end of the continuum. But the reality is that we know that healthy conversations take place everyday, in every family, in every organization. The problem is that since the conversations are about sensitive things they are usually conducted behind closed doors. That means that we don’t get to hear or see all of the stuff that may be most helpful for us.
We’d like to ask you to share some stories with us. But before we ask you to do that, let’s take some time to go around the room and hear about who’s in the room today. Please share with us your name, what you do (role at SSM), and what you hope to get out of this session.
(Chart – use throughout session to check in and see if their expectations are being addressed)
Here’s our expectation for the class: Jump in with both feet! This is a highly participative session where together we can create a safe environment to practice conversations in and learn together!
So we’re going to ask you to join with 1 or 2 other people at your table and share some stories of how you were either part of a difficult conversation or heard about a difficult conversation. Remember….We’re only interested in the really healthy ones…We’re going to be each others role model.
Mary….Hey, Jen, I think I may have an example… (gives the example of the conversation between Mary and Steve.)
Now it’s your turn Take about15 minutes to talk about your examples in your group and then be prepared to share with the class. (groups of 3)

3. AND “What caused these conversations to go well?”
“Where did you learn how to do this?”
Slide 4
Healthy Conversations Sharing
Scott…..Facilitate discussion around commonalities to the questions:
”What caused this conversation to go well?”
&
“Where did you learn how to do this?”
(Jen and Mary will flipchart responses while Scott facilitates the group.)

4. Dealing with Difficult Situations
The event – what actually happened
What we believe happened- the story we tell ourselves
How we feel about what happened- this determines how we will act
The action- how we act on how we feel- the conversation
Think about this difficult situation/conversation and walk through each of these steps. Feel free to take some notes if you wish.
Remember a few details about the situation. What facts do you remember for sure?
What did you think the story really was? Base on past history, what was likely to be the case?
How did you feel when it happened? How about later?
What did you do? How did you treat someone else because of the situation?
Did you ever find out what really happened? Is there a chance that you acted on a false assessment of the situation?

5. Dealing with Difficult Situations
Choices
Stay and do nothing
Vote with your feet
______________________________
Change your attitude about them
Change your behavior
Dealing with People you Can’t Stand by Dr. Rick Brinkman and Dr. Rick Kirschner
Jen This book goes into detail about various difficult people we may encounter and provides detailed information about how to deal effectively with those people
When you deal with a difficult person, there are four choices (slide and handout).
Let’s talk about where we are as a team. According to the feedback that you’ve provided most often as a team we currently function in the first decision. We ususally just say nothing and harbor some ongoing feelings about it. As a team you have identified that this does not work.
The final two choices give you the control of the situation and this is where this team wants to go
If you select the final choice, to change your behavior, then it will be helpful to understand the other person’s behavior and where it may be coming from. The lens of understanding provides a way to view the person’s behavior and understand their intent so that we can begin to respond positively.
We’re going to talk mostly today about how to do 3 &4
Take a moment now to think about a difficult person you’ve dealt with in the past or one you are dealing with now.

6. The Lens of Understanding
What is the motive behind the difficult behavior?
Level of assertiveness
Focus of attention
Intent
Assume good intent
The Lens of Understanding
What is that person’s level of assertiveness? Are their behaviors passive or aggressive when they are around you? Think about that person and your last interaction . . .
How did they look? – was their energy directed outward or inward?
How did they sound? – were they shouting? Mumbling? Or silent?
What did they say? – demands? Awkward suggestions?
Now think about what that person’s attention was focused on during the last interaction. Where they focused primarily on the task or the “what” of the situation? This would indicate a task focus. Or, were they focused on the relationship or who was involved in the situation, demonstrating a people focus?
A person’s level of assertiveness and focus of attention help us to begin to understand their intent – the intent that is driving their behavior with you.
Think about that person and their behavior – can you decide what their intent may have been?
Were they driven by an intent to Get it Done? Get it right? Get Along? Or Get appreciated? Were you seeing some extreme behavior reflective of this?

7. When Do We Speak Up Safety Issue? Could it become one?
Moral or Ethical Issue? Could it become one?
Does not addressing cause rework or a work-around?
Would your team function better?
Do you find yourself wishing it would all “just go away” so you wouldn’t have to address it?
If you answered yes to one of the first 2 questions, you have an obligation to address the issue.
If you answered yes to any of the other questions, it is in your best interest and that of your group to address the issue.

8. Developing a Script Clearing Conflict Communication Method
When you ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
(facts only - what the other person said or did—NO judgments)
I feel ________________________________ (mad, sad, glad, scared),
And this is how it affects our working relationship: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
In the future, I ask that ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

9. Next Steps
Select a difficult conversation you need to have with someone.
Script the conversation and practice with someone in the room over the next couple days.
I am available for practice

10. TAKE AWAYS Separate the conversation from the outcome.
You cannot control someone else’s behavior.
Your best resources are in the room
Leave with 3 thoughts….Separate the conversation from the outcome because you can do and say everything perfectly but if your goal is that the other person have some behavior change you must understand that you cannot control that.

11. RESOURCES
Crucial Confrontations: Tools for resolving broken promises, violated expectations and bad behavior: Kerry Patterson, Joseph Grenny, Ron McMillan ,Al Switzler. New York: McGraw-Hill, 2005
Crucial Conversations: Tools for talking when stakes are high: Kerry Patterson, Joseph Grenny, Ron McMillan, Al Switzler. New York: McGraw-Hill, 2002
Dealing with people you can’t stand: How to bring out the best in people at their worst: Dr. Rick Brinkman and Dr. Rick Kirschner. McGraw- Hill 1994.
Generations at Work: Managing the clash of Veterans, Boomers, Xers and Nexters in the workplace: Ron Zemke, Claire Raines, Bob Filipczak. New York: Simon and Schuster, 1999.
Resources
Share resources and highlights from bibliography.
Crucial Confrontations –
Crucial Conversations -
Dealing with People you can’t stand
Review copies of dealing with difficult people handout
Generations at Work

12. RESOURCES cont’d
Getting to Yes: Negotiating agreement without giving in: Roger Fisher, William Ury, Bruce Patton. New York. Penguin Books,1991.
Perfect Phrases for dealing with difficult people: Susan Benjamin. New York: McGraw-Hill,2008.
Vital Smarts, From the authors of Crucial Confrontations and Crucial Conversations. Go to to enroll.
What you accept is what you teach: Michael Henry Cohen. Minneapolis, MN: Creative Health Care Management, Inc.,2007.