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Promote a Positive Healthcare Workplace using the Stories of Your Staff

By Dr. Lorraine Dickey MD MBA

In the healthcare industry, we often hear staff members talk about their “toxic work environments.” It’s well known that a civil, cohesive and caring work environment is good for patients, staff, and the healthcare organization's bottom line. Working in a positive environment helps engage staff and may lead to improved HCAHPS scores from patients.

The key is making a personal connection -- an authentic connection between each staff member, their patients and their co-workers. Sharing stories is a proven method to uncover these authentic connections.

Recognizing the Problem

A toxic work environment is never good for anyone. In the healthcare industry, it can prove harmful. Healthcare professionals willingly deal with long hours and stressful jobs, and now they also deal with the extra challenges of the Covid-19 pandemic. Regardless, patients still need their technical expertise AND compassion from their health care provider. In this changing environment, it can be difficult for healthcare leaders, managers, and staff to recognize when the accumulation of smaller issues tip the scale of the workplace from “civil” to “toxic” making it even more challenging to provide consistent compassionate care. It may take worsening HCAHPS scores to bring such problems to light. How can we help healthcare workplaces remain civil and supportive while continuing to meet these new challenges?

The Value of Sharing Authentic Stories

Everyone has a story to tell, but too often in demanding healthcare environments we are reluctant to reveal our authentic selves and share stories about how we are impacted by the work we do. There is little time or training devoted to learning how to listen with empathy, act kindly, suspend judgment, or how to reflect on the words in our colleagues' stories of challenges or joy.

In as little as three minutes, the experience of writing a story can help define what is important and help reframe the challenges we face. Stories help build authentic connections not based on profession, position or status. Sharing a story about caring for patients in a safe space can help to integrate the challenging and uplifting experiences of providing “good care.” Sharing a story with those who understand you can help validate your perspective and help you validate the perspectives of others. Sharing stories of everyday challenges in an on-going fashion decompresses staff. Smaller “civil” issues can be addressed before they become bigger “toxic” ones.

How TNI Can Help

The Narrative Initiative, LLC, (TNI) uses research-based facilitated narrative techniques to bring together healthcare staff to share their stories in a safe place. TNI workshops address the challenges of providing person-centered care (including why it is hard to be kind to ourselves, our colleagues, and our patients), listening empathically, remaining professional, and communicating effectively. TNI also directly addresses staff challenges to the Covid-19 pandemic.

Certified TNI Narrative Facilitators focus on modeling how to identify and reflect the writer’s word selection, tone, and metaphor. This focused, empathic listening skill efficiently uncovers what the author really means. Participants say they can immediately use these new techniques with patients and co-workers. This helps them quickly identify what was really being said rather than wasting time by making assumptions about what they thought was being said. Gaps in communication and expectations can be bridged immediately.

Learn more about how TNI can help promote a positive healthcare workspace by helping staff learn to share their stories in a safe way. Truly listening and reflecting on each other’s words can decompress smaller issues before they become bigger, more “toxic” problems. Together we can help your staff provide the “good care” they want to provide. Together we can improve HCAHPS scores showing patients are receiving the “good care” you want them to receive.



Defenbaugh N, Dickey LA. Flattening the curve of emotional distress during COVID-19. Int J Acad Med 2020;6:110-5

Dickey LA. Examining courage through personal story. Physician Leadership Journal 2019;Nov/Dec:53-7

Dickey LA, et al. Promotion of staff resiliency and interdisciplinary team cohesion through two small-group narrative exchange models designed to facilitate patient- and family-centered care. J Comm HC 2011;Vol 4:No 2: 126-138

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