34th Annual Scientific Meeting proceedings

What is a challenging day? And what makes a challenging day a rewarding one? A day where, when you have got through it, you can look each other in the eyes and say, ‘Wow, that was tough, but we did it! Good job!’?

Teamwork, including effective leadership, gets us through those challenging days. Being part of a high-functioning team can be incredibly life-affirming. Teams that perform amazing work, that are so much more than the sum of their individual parts, are characterised by great communication and strong relationships. They do not, however, develop spontaneously and require work.

Assuming your team is formed, what can you, as a leader do to help everyone through a challenging day, and be ready to come back tomorrow and do it again?

Practise
Whilst every piece of work should be seen practise for the next, for specific occurrences, practice without risk is appropriate. Our emergency services, such as fire and rescue, practise continually, and for certain situations e.g. CPCR, we may also routinely practice. But how much do we practise for more ‘day-to-day’ work? What opportunities do you miss to iron out glitches, improve communication and develop relationships? What would this sort of practise look like?

Planning
Before the task work of the day starts, it’s a great idea to get together as a team to outline what is anticipated and to sort priorities, thinking about who will need to be where and when. Consider who needs to be in that meeting, where it best happens, and how best to facilitate it. Make it a habit and an expectation.

Space
Give everyone space to work. That includes both physical space and mental space. Avoid micro-management and trust your colleagues to do their jobs. They have been selected and trained to have the right knowledge, skills and behaviours so let them solve the minute-by-minute challenges collectively.

Awareness
Maintaining situational awareness can be a challenge when lots is happening around you, especially when you have clinical/technical responsibilities of your own. It is all too easy to become hyper-focussed on the task in front of you and lose sight of the big picture. This includes what is happening and how colleagues are feeling and behaving. It is important, therefore, to establish a culture of psychological safety, so everyone feels empowered to speak up, and to delegate and share leadership throughout the group. If necessary, even if you are the most senior member of the team, delegation of leadership responsibilities might be entirely appropriate, if your attention is required for highly skilled work, such as delicate surgical procedures.

Pace
Pacing is important. No-one can sprint a marathon, and it is the responsibility of leadership to consider when to fully commit and concentrate, and when to slow the pace down to allow for rest and refreshment, re-gathering of thoughts and re-assessment of needs. Our cognitive functions and control can significantly when we are tired, thirsty and hungry, which will affect teamwork and risk negative outcomes. Think HALT (Hungry and/or Thirsty, Anxious and/or Angry, Late and/or Lonely, Tired) and be ready to schedule breaks.

Communication
Clear and constant communication is key. Teams working through challenging days are complex things and the more understanding there is of what is happening in the here-and-now, for everyone, the easier it is for the team to collectively find solutions and negotiate ways through. Think about how best to facilitate communication, what people-based solutions are there and what technological options might help.

Flexibility
Planning is essential but plans are useless. To quote the boxer, Mike Tyson, ‘Everyone has a plan until they are punched in the mouth!’. We need to be flexible, prepared to respond and adapt to those inevitable upsets to our carefully crafted plan, be it the unlikely complication, the critical emergency, or something more (superficially) mundane like loss of the internet connection. Be prepared to stop and have a team ‘huddle’ to re-assess the situation as it is, not as it was planned to be and re-plan.

Learning

Use today’s experience to improve tomorrow’s. Build time for a little reflection at the end of a challenging day. What went well? Why? What can we do more of? What did not go so well? Why? What can we try differently next time?

Closing
Having survived or, even better, thrived in that challenging day, do take the time to acknowledge and be grateful for your colleagues, yourself, and the care you have given. You deserve it!