HRO: (13) Combating Complacency with Brotherly Love

In their article critiquing the state of modern medicine relative to High Reliability principles, Chassin and Loeb discuss three deficits that I choose to lump together:  failure to be sensitive to operations, poor inter- and intra-team communication with associated “culture of low expectations”, and intimidating behavior.  When we consider these deficits, we can easily imagine—or possibly remember—a work environment where people are harried, task-saturated, understaffed and un-heard; the underlying motivator is to just survive the day, the predominant attitude is to keep one’s head down and press forward with a mulish determination, complete with blinders.  Workers trudge into work at the beginning of each shift and shuffle home again at the end; in the interim, they expect to be bullied by the pecking order above them, and ignored by team members and leadership alike.  They are in no emotional or psychological position to be “sensitive to operations” because previous attempts at expressing concern have either gone unaddressed, frankly discouraged or even punished outright; and because communication is stymied by workload, by uncoordinated, ungainly systems and by unreasonable, untenable bureaucratic demands.  

This is a grey, gloomy work environment, suitable not even for mining coal let alone for the provision of life-giving and life-saving care.  Of course, not every hospital or clinic is really like this—at least not every day or for every person.  But if it feels that way—if the perception of the Average Joe or Average Jane is that of disrespect, of being ignored and unappreciated, and of unrewarded or unwelcome efforts toward preserving patient safety—the resultant disengagement produces that lack of sensitivity, poor communication and low expectations.  

A paper published by the Institute for Healthcare Improvement describes the importance of “joy in work” and gives a framework for how leaders can create and sustain joy in work.  Joy in work relates to patient safety in that it counters poor sensitivity to operations: people who are joyful are full engaged; fully engaged people are alert to risks to those around them.  The IHI paper specifically discusses “psychological safety” as essential to joy in work.  Psychological safety refers to the ability to participate fully in discussions, problem solving, and team activities without fear of being demeaned or bullied.  It also is founded upon clear expectations for behavior and just treatment of those who make mistakes.  Disrespect, bullying or “scape-goating” are the opposite of psychological safety.  People who are psychologically safe are fully engaged, leveraging their energy and creativity toward their work related goals.  Joy in work also relies upon feeling heard, understanding where one fits in the team and having a clear understanding of how individual efforts connect to organizational goals.  The IHI paper provides an entire framework for understanding and creating joy in work; I believe these components discussed above are key for combating the insensitivity, obliviousness, poor communication, bullying and disrespect that get in the way of safe, reliable patient care.  

For Christians, we know that our true joy comes from Christ Jesus—in Him, we are redeemed children of God; we are forgiven, born again by our baptisms and preserved in relationship with God by His Word and Spirit.  At the end of the day, this is where joy begins and ends; horrible work conditions, cruel coworkers and unrecognized effort will never take away that joy.  Because we are connected to such an enduring and immense source of joy, the world cannot snuff it out no matter how much it might feel that way.  Our joy is not based on feelings but upon the reality of God’s work in Christ Jesus.  This joy fuels our purpose in life, as we serve others to God’s glory; this joy keeps us engaged because we have a resilience in Christ that others do not have.

How can we bring this joy into our workplaces?  What might that look like? 1 John 4 gives us a place to start, as it relates the love of God for us and in us to how we behave toward other people.  Our joy comes from the love of God shown in Christ Jesus; 1 John 4: 9 says “This is how God showed his love among us:  He sent His one and only Son into the world that we might live through Him.”  1 John 4 ends with verse 21, “And He has given us this command:  Whoever loves God must also love his brother.”  Let us say it this way “….Whoever loves God must also love his/her coworker…his/her patient…his/her supervisor….”  This is a hard thing but something we cannot ignore or discount:  God expects us to love other people.  Obliviousness to the risks faced by other people, refusal to communicate with team mates, disrespect and bullying—these do not fit into this demand for love.  “…anyone who does not love his brother, whom he has seen, cannot love God, whom he has not seen.”  (1 John 4: 19)

But we do not approach this demand to love with fear of failure—even though we know that we cannot and do not love perfectly, and we know that every day our ability to love others will be challenged.  We know that perfect love comes from God because God is love; the perfect love of God was shown to us in Christ’s redeeming work; and perfect love casts out fear and leaves only “…the joy of [God’s] salvation” (Psalm 51: 12).

1)      What in your workplace sucks away your joy and keeps you from being fully engaged, alert to risks, willing to communicate, and respectful to others?  Is there anything within your control to make those circumstances better?

2)      In 1 John 4: 15, 16, we read “If anyone acknowledges that Jesus is the Son of God, God lives in him and he in God.  And so we know and rely on the love God has for us.”  How does God’s love fuel your “joy in work” and counter negativity in your workplace?  

3)      1 John 4: 20 says that if someone claims to love God but hates other people, they lie.  Love of God is displayed by love for others.  How does this create a culture of respect and compassion which can counter workplace intimidation, disrespect or bullying?

4)      A joyful workplace is one where people are respected and listened to, and where a just culture—not one of scape-goating, shame or blame—is cultivated.  How does the love of God revealed in Christ—God’s desire to save the world out of His love for all people—inspire workplace joy?  How does the forgiveness you have in Christ allow you both to forgive yourself for errors, but to also forgive the errors of others?

5)      Contemplate how your attitude and behaviors at work have not displayed the love of God for others.  Confess this lack of love to God, and come to Him without fear to receive forgiveness in Christ. Take time to renew the joy of God’s salvation which you have and consider how you can bring that joy and love into your workplace.