Leadership Lessons - More NHS memories ...

'The problem with communication is the illusion that it has been accomplished’ - George Bernard Shaw.

When I was about 18 I spent some terrific time going round various departments in the hospital I worked at to learn the ropes so that as an aspiring manager I might have an appreciation of what it is really like to be doing the work at the front line. Quite forward thinking in 1970 when I think about it, so let’s immediately dispel the myth that all the best ideas were invented in the last 7 days.

One of my placements was with the female (yes they were all women) telephonists at the hospital. This was a fascinating place. These folks knew everything. I was impressed. Every call - and there were hundreds - that came through was processed efficiently and the women always seemed to know just what to do. It was like watching an orchestra conductor to see them use those old fashioned plugs. Never once in the time I spent observing them and learning did I see any of the staff ‘lose it’ or get flustered. They always seemed in control and take it from me the volume of calls at peak periods was phenomenal.

At non-peak times such as early evening the women had time to tell me of some of their stories and of course I was very eager to learn. One story sticks in my mind.

It was in the early hours of the morning on a cold winter evening when there was a knock on the entrance door to the hospital which was adjacent to the switchboard. The telephonist on duty opened the door to be greeted by a confused looking elderly lady. She was invited into the switchboard office and as this was an unusual occurrence the telephonist was keen to find out what the problem was. The old lady explained that she had been to the accident and emergency department a few days previously after a fall which had resulted in a nasty laceration. She explained to the telephonist how she had been given a tetanus injection by the doctor and she had been asked to return for a booster injection in five years time. The telephonist listened intently wondering what the problem could possibly be.

The old lady became increasingly emotional and upset as she went on … I have ‘paraphrased’ but the message is authentic.

‘The doctor told me to come back in five years time for another injection. I have been doing some research and I have just found out that in five years time the anniversary of my injection will be a Saturday and your accident and emergency department is closed at the weekends. I got worried about it and couldn’t sleep which explains why I am here. I need to make sure I got the right date. Can you check for me please?’

When I tell this story many people say it has an ‘Ahhhh’ value which of course it does. The story is an accurate reconstruction of something that has stuck with me for over 30 years. The story illustrates how important checking out comprehension is. The patient had taken the instruction literally. She acted ‘correctly’ and yet all of us would say – ‘well of course anyone would know that the 5 year request did not mean an exact requirement.’ But I do not share that view. I am often accused of being pedantic about checking out whether my listener has understood what I am asking. Life has taught me this and I make no apology. So often in my career I have said something that has been heard by my listener as something else. This is not complicated – take time to check out comprehension.

Leadership Lesson - Never, ever assume – become a pain in the backside - check out comprehension of your listener