Monthly Archives: May 2013

Research Demonstrates Efficacy of Cultivating Emotional Intelligence with Nurses Through Equine Facilitated Experiential Learning

Back in 2009 we introduced, “The Emotionally Resilient Nurse”, a relationship-based, equine facilitated experiential learning program designed specifically to cultivate Emotional Intelligence(EI) competencies in nurses.  This program came right on the heels of our pro bono program, “Warriors in Transition”, designed to help combat veterans and their families wrestling with PTSD, and quite often PTSD/TBI.  For anyone participating in or monitoring our warriors program, the efficacy was remarkably apparent.  Sleep patterns improved, agitation levels diminished, and family relationships improved almost overnight.  The program, which we’ve helped to introduce in six states, was formally commended by General David Petraeus in 2010.

Having worked in the health care field for two decades, I had personally witnessed the challenges nurses face on a daily basis.  Their environment is emotionally toxic and they are constantly walking a tightrope, without a net, of expressing authentic empathy through healthy, professional boundaries.  It is not a task for the faint of heart.  Having witnessed the success of our approach with combat veterans, migrating this approach into acute care hospital settings, specifically designed for other front line professionals, seemed like a no-brainer.  Unfortunately, at the time, hospital administrators were still laying off nurses to cut costs.  In the very short term, this may have helped the bottom line, but over time, lowering staffing levels only exacerbated the costly problems of nurse burnout, high turnover rates (the Florida Nurses Association reports that it costs a hospital an average of $64,000 to backfill an open nursing position.  Extrapolated across the nation, this problem adds approximately $17 billion in hard dollar costs to the health care delivery system, adding absolutely no value whatsoever.) and perceptions of quality of care with patients and their families.

As we do with the development of all of our programs, we dove into the peer-reviewed, published research on the effects of cultivating emotional intelligence in nurses on the delivery system.  Here’s a snapshot of what we discovered:

    • Patient satisfaction is a widely recognized measure of medical care quality and a predictor of several positive consequences for organizations and patients (e.g. patient adherence to treatment regimens, fewer malpractice suits, hospital employees’ satisfaction, and financial performance).2
    • Compassionate behavior is threatened by technological concerns and economic constraints.3 “Continually, we experience situations where patients received excellent technical care but, when the emotional side of their care was not met, they believed that their care was inadequate”.4
    • By understanding the patients’ emotions, and being more empathetic, nurses are more able to understand the values, worries, and fears of patients. They are more apt to automatically connect with patients, appreciate the patients’ perspectives, understand the impact of their actions, understand and satisfy patients’ needs5 and respond appropriately.6
    • Nurses need to interpret and understand how patients feel, to ascertain their motives and concerns, and demonstrate empathy in their care. They also need to understand and manage their own emotions, not just for high quality care, but for their own self-protection and health as well.7
    • Nurses capable of a self-reflective process become aware of their own emotions.  When nurses recognize their own feelings they are more likely to manage them and communicate in appropriate ways.8
    • Non-verbal interactions play a vital role in nurse-patient perceptions.  The non-verbal interactions include patient-directed eye gaze, affirmative head nod, smiling, leaning forward, touch, and instrument touch.9
    • Emotional Intelligence in nursing leads to more positive attitudes, greater adaptability, improved relationships, and increased orientation towards positive values.10
    • Emotional Intelligence has a positive impact on nursing team cohesiveness and patient/client outcomes.11
    • Emotional Intelligence minimizes the negative stress consequences of nursing.12
    • Emotional Intelligence is important in managing stress and reducing nurse burnout.13
    • Emotional Intelligence is an important characteristic for building successful nursing leadership, enhancing nursing performance, and reducing nurse burnout.14
    • Emotional intelligence scores in clinical staff nurses correlate positively with both performance levels and retention variables. Clinical staff nurses with higher emotional intelligence scores demonstrate higher performance, have longer careers, and display greater job retention.15
    • Emotional Intelligence should be integrated into the nursing profession by a model of transformational learning for nurse education.16

It seemed as if we’d made a fairly strong case for how cultivating the soft skills in nursing could save hard dollars in health care.  Unfortunately, we were in hindsight, more that a bit ahead of our time.  With the coming of HCAHPS, and the effect these patient satisfaction surveys will have on 30% of a hospital system’s reimbursements from the Medicare, perhaps it is time to revisit the value this approach represents.  An approach that is capable of delivering an ROI that soars into the thousands of percent.

Adding to the evidence, a pilot study has just been conducted and released from the University of Kentucky that warrants attention.  The study, authored by Patricia Dyk, and Robyn Cheung, et al, entitled, “The Effectiveness of Equine Guided Leadership Education to Develop Emotional Intelligence in Expert Nurses“, demonstrates statistically signifiant improvements in Emotional Intelligence competencies with nurses employing this approach.  This comes as no surprise to us, as we’ve been traveling the United States for the past four years, conducting our evidence-based approach to Equine Facilitated Experiential Learning, seeing consistent, reproducible results in very challenging populations.

The fact is, we’ve crossed a threshold into a period of adaptive challenges.  Unprecedented challenges that require unprecedented solutions.  The complexity of the challenges institutions and enterprises face today will require the integration of seemingly disparate disciplines and methodologies in order to find sustainable solutions.  One thing’s for certain, investing in our nurses would be a major step forward in improving the health care delivery system in the United States.

Copyright 2013, Terry Murray.

 1.)  Daniel Goleman, (1995).  “Emotional Intelligence”, Bantam Books, New York, NY.

2.)  Gesell, S.B. & Wolosin, R.J., (2004).  Inpatients’ Rating of Care in 5 Common Clinical Conditions. Quality Management Health Care, 13(4), 222-227.

3.)  Godkin, J. & Godkin, L., (2004).  Caring Behaviors Among Nurses:  Fostering a Conversation of Gestures. Health Care Management Review, 29(3), 258-267.

4.)  Kerfoot, K., (1996).  The Emotional Side of Leadership:  The Nurse Manager’s Challenge.  Nursing Economics, 14(1), 59-62.

5.)  Ibid., 59-62.

6.)  Vitello-Ciccui, J.M., (2003).  Innovative Leadership Through Emotional Intelligence.  Nursing Management, 24(10), 28-34.

7.)  McQueen, A.C.H., (2004).  Emotional Intelligence in Nursing Work.  Journal of Advanced Nursing, 47(1), 101-108.

8.)  Ibid., 101-108.

9.)  W. Caris-Verhallen, (1999).  Effects of Video Interaction Analysis Training on Nurse-Patient Communication in the Care of the Elderly.  Patient Education and Counseling, Volume 39, Issue 1, 91-103.

10.)  Kristin Akerjordet & Elisabeth, (2007).  Emotional Intelligence: A Review of the Literature with Specific Focus on Empirical and Epistemological Perspectives. Journal of Clinical Nursing. 16(8); 1405-1416.

11.)  Quoidbach & Hansenne, (2009).  The impact of trait emotional intelligence on nursing team performance and cohesiveness.  Journal of Professional Nursing, Volume 25, Issue 1, pp. 23 – 29.

12.)  Montes-Berges & Augusto, (2007).  Exploring the Relationship Between Perceived Emotional Intelligence, Coping, Social Support and Mental Health in Nursing Students.  Journal of Psychiatric and Mental Health Nursing. 14 (2);163-171.

13.)  Linda Gerits, Jan J. L. Derksen, & Antoine B. Verbruggen, (2004).  Emotional Intelligence and Adaptive Success of Nurses Caring for People with Mental Retardation and Severe Behavior Problems.  Mental Retardation: 42, (2); 106-121.

14.)  Vitello-Ciccui, Joan M., (2002).  Exploring Emotional Intelligence:  Implications for Nursing Leaders.  Journal of Nursing Administration.  32(4):  203-210.

15.)  Codier, Estelle PhD, RN; Kamikawa, Cindy MSN, RN, NE-BC; Kooker, Barbara M. DrPH, APRN, NEA-BC; Shoultz, Jan DrPH, MPH, (2009).  Emotional Intelligence, Performance, and Retention in Clinical Staff Nurses.  Nursing Administration Quarterly:  October/December, Volume 33, Issue 4, 310-316.

16.)  Dawn Freshwater & Theodore Stickley, (2004).  The Heart of the Art:  Emotional Intelligence in Nurse Education.  Nursing Inquiry. 11(2); 91-98.

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Lead As If We’re All Connected….Because We Are

As the tools of social media migrate into the business community, we are all reading a lot about the power of connectivity in the workplace.  In a study published by the McKinsey Quarterly last November, their analysts identified the application of social platforms could unlock $900 billion to $1.3 trillion in untapped value in just four industrial sectors representing 20% of total global output.  Without a doubt, unprecedented opportunities are emerging that will transform the face of business in the years to come.  However, before a firm can unlock this potential through the application of technology, they must first address a cultural artifact that represents a very real impediment; employee disengagement.  Gallup has consistently reported that upwards of 73% of employees are disengaged or, at best, only partially engaged with their employer.  The question that immediately comes to mind is how much value can emerge through the virtual connectivity of a disengaged workforce?

In order to reverse the endemic, employee engagement crisis, leaders may wish to consider a single, scientifically substantiated concept;  we’re already, all of us, connected.  Not just to one another, but to everything throughout the universe.  Before you dismiss this concept as some sort of woo woo, new age precept, please allow me to share some eye-opening research, specifically, research demonstrating the non-locality of consciousness from the field of quantum physics.

In 2003, physicists J. Wackermann, C. Seiter and K. Holger published a research study entitled, “Correlation Between Brain Electrical Activities Of Two Spatially Separated Human Subjects”, in the scientific journal, Neuroscience Letters.  In this experiment two people began meditating together with the intention of being connected.  While sustaining their meditative states, they were separated  and placed in isolation chambers incapable of receiving any signal, electronic or otherwise.  Once isolated, the scientists attached electroencephalography devices (an EEG measures and maps electrical activity in the brain) onto the two subjects.  After a few moments, the scientists flashed a series of colored lights at one of the subjects.  The EEG recorded the subject’s brain’s response.  The second subject was not exposed to the lights, yet both subject’s brains responded instantaneously in nearly identical ways.  No signal existed between the subjects, yet their brain’s shared the experience.  They were still connected.  This experiment has been reproduced by other scientists around the world.

Another example of the non-locality of consciousness was recently revealed when the Chinese government conducted an experiment with spinning electrons.  The scientists isolated two electrons that shared the same orbital spin.  They then separated the electrons by a distance of approximately 400 miles.  When they changed the spin of one electron, the other reacted immediately and in the same direction.  This occurred instantaneously, faster than the speed of light.  The purpose of this experiment is the development of communications systems that cannot be decoded because there is no signal carrying the information.  No signal, no intercept.

Perhaps you saw the headlines a few weeks ago about a study from Australia that was published in the journal, BioMed Central.  “Our results show that plants are able to positively influence growth of seeds by some, as yet, unknown mechanism,” said study author Monica Gagliano of the University of Western Australia. “Bad neighbors, such as fennel, prevent chili seed germination in the same way. We believe that the answer may involve acoustic signals generated using nanomechanical oscillations from inside the cell which allow rapid communication between nearby plants.”  Plants may actually be communicating with one another better than people do in many organizations.

Moving from plant science to molecular biology, another study, “Quantum Correlations in Biomolecules”, authored by Vlatko Vedral of the University of Oxford in the U.K., explored quantum signally between biomolecules.  This correlates to things I’ve witnessed firsthand.  Back in 2004, I was the lead strategist in the commercial launch of the first human stem cell (multi-lineage progenitor cells, discovered by Dr. Dan Collins of BioE, Inc.) derived from human umbilical cord blood (this is not an embryonic stem cell, but a naturally occurring cell harvested from post-birth, medical waste).  Dr. Collins was able to differentiate these rare cells into many forms of human tissue and cells.  I had the privilege of standing in the laboratory with Dr. Collins, and looking through a microscope, witnessed a single, myocardial cell twitching in heart rhythm.  I witnessed oligodendrocytes (a type of brain cell), set apart on a slide, extending dendrites towards one another to create new, neural networks.  These single cells, native to the human body, exhibited a form of consciousness in and of themselves.  They knew what to do, even outside of their host organism.

In 2009, working on another strategic project, I had the remarkable opportunity of visiting the Horn Telescope at the old Bell Labs in New Jersey.  The telescope that provided the first proof of the Big Bang, back in the 1930s.  Everything in our observable, and unobservable universe, emerged from this event.  As Carl Sagan said back in the 1970s, we’re all made up of this star-stuff that emerged in a sudden burst of creation, billions and billions of years ago.  Every atom in our bodies, every element, is from that single source.

When leaders begin to shed their conditioned blinders and entertain a slight shift in perspective to include these insights, a remarkably different world begins to emerge.  One of authentic presence, insight and engagement that sheds the us versus them orientation.  If we choose to embrace these scientific findings, and view our world through this new lens of real connectivity, opportunities for growth, innovation and productivity breakthroughs appear all around us.  With a little bit of practice, we might even begin communicating as clearly as plants!

© 2013, Terry Murray.

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Filed under Health Care, Leadership Development, Organizational Culture, Talent Management

What Neurosurgeons and Horses Can Teach Us About Leadership

_PPH5798Sounds strange, doesn’t it?  I’ve grown accustomed to the quizzical looks over the years when I tell people we work with horses to help leaders develop the critical competencies necessary for today’s volatile workplace.  It isn’t a gimmick, an arcane game or ropes course.  It is a scientifically substantiated approach to experiential learning.  One that greatly accelerates development thanks to the fact that our carefully structured exercises ferry participants through all four modalities of Kolb’s Adult Learning Style Inventory.  Our approach also draws heavily from the neuroscience research of such luminaries as Dan Goleman, Rich Davidson, Jaak Panksepp and Ravi Rao.  Going beyond psychology, the brain research that is continuously emerging enables us, as leadership development experts, to address the causal, neurological pathways that result in demonstrated behaviors. Traditional leadership development methodologies, focused on behaviorism (i.e., mainstream psychology’s embrace of cognitive behavioral therapy), have had thirty years on the main stage, and left us with a dearth of effective, mindful leaders.  If anything, traditional approaches to development have added to the inertia in leadership we see all around us.

If you don’t believe me, ask Dr. Allen Hamilton, neurosurgeon at the University of Arizona Medical Center.  Dr. Hamilton is employing a form of relationship-based, Equine Facilitated Experiential Learning.  An approach very much in alignment with our own.  If you happened to have missed it, here’s a story about Dr. Hamilton employing horses to cultivate emotional intelligence competencies, heightened sensitivity to non-verbal communication, and empathy with medical school students:  http://www.today.com/health/open-say-neigh-horses-help-teach-med-students-6C9790792.

Need a second opinion?  If you have a few minutes, I’d like to invite you to listen to Dr. Ravi Rao, a Harvard trained neurosurgeon (who also holds a Ph.D. from Johns Hopkins), who joined me on a radio interview, sharing his thoughts on our approach.  

So, why is this approach so effective?  The research demonstrates our brains have plasticity.  We can, through conscious effort, literally change the way we interpret and react to the work around us on a basic, neurological level.  

Neuroscience also provides insights into why human beings resist change.  The brain consumes 25% of the blood glucose in our bodies at any given time.  The majority of it is used to support our visual cortex and our near-term memory, the two parts of your brain you are using to read this blog.  After that, the brain is very conservative in its use of energy.  It takes far less energy to follow a well established neural pathway than it does to create new ones.  Think of our established neural pathways as dry river beds cut deep into the side of a mountain.  Every time it rains, the water follows the path of least resistance, cutting an even deeper rivulet down the mountain.  Trying to get the water to flow in another direction takes significant effort.

Neuroscience guides our approach to sparking neurogenesis, particularly in the pre-frontal cortex, the brain’s executive center where the competencies of emotional intelligence emerge (self-awareness, social awareness, self regulation, and relationship management skills).  By introducing novelty, (having a professional enter into a round pen to co-create a shared goal with a horse without the use of language, touch, or dominating behaviors is pretty novel) we disrupt the established pathways associated with problem solving.  As the participant connects, engages and motivates the horse, fall-back behaviors emerge.  Interpersonal behaviors.  When we don’t know what to do we do what we know, and the leadership behaviors people demonstrate with their direct reports are revealed to the participant on their own accord.  These are powerful, breakthrough moments of self-awareness bursting to the surface of consciousness.  No one is telling the participant a thing…other than the horse.  The participant is seeing their own behaviors reflected back to them through the behaviors of the horse.  And horses don’t lie, shade or judge emotions.  Emotions are information to horses (this is also a neuroscience finding based upon the work of Dr. Jaak Panksepp), as they should be to us as well.

Research from the field also provides new assessment tools that enable us to hone in on specific areas of development.  Here’s a short, video white board describing this application:

As we move deeper into the 21st Century, adaptive challenges will continue to confront us.  Challenges in which we don’t know all the answers.  Challenges that will require collaborative efforts from a multi-cultural, multi-generational workforce to resolve.  And resolve at speed, in real time.  Working with horses from a neurologically substantiated perspective imparts learning agility in leaders.  Horses require us to park our ego at the barn door as well.  They aren’t impressed with titles, paychecks or artificial authority.  They are impressed with presence.  This approach enables leaders to learn how to dance in the moment, acting with mindful discernment even when confronted with highly novel challenges.  And to do so while maintaining congruency, transparency and authenticity.  Horses, and humans, demand no less.

© 2013, Terry Murray.

 

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May 7, 2013 · 8:43 am

The Sun Coast Renaissance ~ How Leadership, Entrepreneurship and Innovation are Reshaping SW Florida

RiverwalkFlyerSmFor those of you that may have missed it, there was a remarkable event conducted this past weekend in Bradenton, Florida (a city experiencing its own economic renaissance).  Riverwalk 2013 was a four day event, the middle two days of which were highlighted by the gathering of some of Florida’s best and brightest entrepreneurs and innovators.  On Friday, the Spark Growth Economic Development Conference brought together leaders from several of Florida’s higher educational institutions’ technology transfer organizations, young entrepreneurs that are reshaping our region’s start-up incubators and business accelerators, representatives from every echelon of the private equity and funding continuum, and successful CEOs that are moving their enterprises into our region.  The keynote speaker for the day was Jim Stikeleather, the Chief Innovation Officer of Dell, who brought his thought leadership to the forum through his insightful presentation entitled, “Disruptive Technologies and Disruptive Business Models: In a perfect economy where is growth and return?”

For those of us that have plied our professions in such high tech hotspots as Cambridge, Mass., the San Francisco Bay Area, Boulder, Colorado, Research Triangle Park, or other areas, Florida’s thin, sandy soil once felt a bit loose for our entrepreneurial aspirations.  This is no longer the case.  A new economic ecology is rapidly emerging, enriching the startup and innovative soil that lies between the beaches and the amusement parks.  The elements that came together to spark the fore-mentioned innovation hubs are rapidly emerging in the Sunshine State.  What was most impressive about the Economic Development Conference was the authentic intention displayed by all those that spoke and attended the meetings.  We were all there at our own expense, seeking to share our knowledge openly.

On Saturday, I attended my second (and their seventh) BarCamp Sarasota Un-convention, along with more than 340 other difference-makers from the area.  This is a self-organizing conference, bringing together entrepreneurs, technologists, and local business thought leaders to once again, share their knowledge openly.  This spirit of open collaboration is at the heart of what is undoubtedly a unique and profound example of authentic community.  Welcome to Leadership 2.0; leadership that emerges from all corners of our community and our organizations.  Michael O’Donnell, founder of iCopyright, Inc. and Leaves.com, who spoke the day prior, commented, “Corporations lead from the top down.  Entrepreneurs lead from the bottom up.”

BarCamp Sarasota is a refreshing forum in which anyone can sign up to speak (there were more than three dozen presentations offered) and the attending community is the only managing filter.  They vote with their feet.  There’s no controlling committee acting as a gatekeeper, screening submissions from their call for speakers submissions.  This openness breaks the control of the status quo, unleashing the kind of exchange we see in social media environments.  Creative, innovative, open.

What’s so striking for me is to contrast this past weekend’s events with a major HR conference, populated by senior executives from Fortune 500 companies, I recently spoke at in February.  It is a contrast of motion versus inertia.  Hungry, grass-roots entrepreneurs gathering to put forth answers to the challenges businesses and society faces today; listening, sharing, learning and acting.  This is the seedbed of innovation and new value creation, where agility and open networks trump market share and capital reserves.  It is from this soil that the next generation of purposeful, mindful leaders will emerge.

I wish to thank the community sponsors and countless volunteers that worked so diligently to make this past weekend a reality.  Special thanks to the Spark Growth/BarCamp Sarasota leadership team;  Sara Hand, Stan Schultes, Tracy Ingram, and Evie Totty.

If you missed this event, I highly recommend following the BarCamp Sarasota initiative for their next event!

© 2013, Terry Murray.

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May 6, 2013 · 1:37 pm

Establishing a Talent Management Baseline for Breakthrough Productivity

As the economy continues to gain ground, organizations are faced with the risk of unprecedented turnover.  Years of downsizing have left many workers disengaged, mistrustful of leadership, and generally burned out.  A recent survey illustrated the fact that 55% of employees feel they cannot handle their current workload and the resulting stress much longer.  From an organizational development viewpoint, this unsettling situation threatens the foundational competitiveness of many firms, fore it is the best and the brightest that are the most mobile.  The collaborative challenges of leading a multi-cultural and multi-generational workforce, in an ever-accelerating environment, only exacerbates the threat.

Let’s face it, traditional approaches to leadership development have fallen far short of their promise.  With enterprises investing $50 billion a year in leadership development, you’d think we’d see better results, yet only 1% of 5,560 executives assessed (McKinsey Quarterly, July, 2011) scored excellent in key competencies.  Nearly nine out of ten score below average.  The fact of the matter is, behaviorally-based approaches to leadership development only treat the symptoms of poor leadership, blindly missing the causal elements that differentiate mediocre management from inspirational leadership.  Even worse, these traditional approaches to talent management are failing to identify upwards of 65% of high potentials.  All of these factors are combining to create the perfect storm for many companies.  With the speed of business and demands for innovation what they are today, committing a misstep in talent management can be fatal…and there no longer exists even a modicum of time to respond.  If you get blindsided by this today, you may not be around tomorrow.

Here’s a short, video white board describing how leveraging the state-of-the-science findings from the field of affective neuroscience, along with incorporating targeted, demonstrated high performer competencies (in today’s volatile world), can anticipate this coming wave of disruption by creating a quantitative, talent management baseline that aligns with the demands of the day.

© 2013, Terry Murray.

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May 1, 2013 · 4:07 pm