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Atrainability Blog

Here we share some thoughts, insights and ideas related to Human Factors Training

Hierarchy and behaviour issues

Inappropriate and unprofessional behaviour is cited as a problem area across many professions, and health and social care is no exception.

There are two significant aspects to consider – why do people behave inappropriately and what effect does it have?

Taking the first of those it could be just plain awkwardness in that they can get away with it, or perhaps they think it's harmless and just a stress-relief and fine if they apologise.

Could it be a lack of insight?

Shortage of emotional intelligence could be present perhaps because no one has ever told them?

Alternatively, it could be a result of illness or stress.

We know of one older person whose behaviour changed for the worse and ultimately it transpired they were suffering from an aggressive form of cancer.

The evidence is of course crucial. The excellent work of Christine Porath demonstrates the devastating damage done to performance and motivation.

Cognitive function diminishes by over 60%, and almost 40% of people on the receiving end of bullying intentionally reduce their performance.

There is however another aspect – could I be part of the problem?

Is my behaviour winding you up? That is, for some of us, a tough question.

The Atrainability training works through the root causes and helps delegates to consider their contribution either directly considering more effective behaviour or by not helping 'difficult' colleagues adapt their behaviour.

For managers, perhaps the realisation that they need to deal with the inappropriate and unprofessional behaviour is the critical message.

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The familiar tale of high staff turnover



I've been chatting to various clients and a regular subject that we return to is high staff turnover. 

Many organisations do not perform exit surveys and so understanding why people leave is a problem to start with. Perhaps they don't really want to know. It's easier to blame the NHS and pressure of work, targets etc.



For example, Atrainability worked closely with a world famous specialist hospital a little while ago which was suffering high turnover of junior nurses in a particular department.


The view from the top was: 

"The nurses come here to get our good name on their CV's and then move on."


However, anecdotally people were leaving because it was not a great place to work.

Team-working was verbally espoused but reality was somewhat different. Work as imagined was quite different to work as done depending on your level in the hierarchy. 

One nurse told us she had worked her entire shift without any offers of help, breaks or support while the band 6 and 7 nurses had a nice relaxing time. You can imagine the atmosphere when we presented our findings. 


This is by no means unique as many of you will know. 

This very week I've listened to my best friend's wife explaining that she is burned out and leaving the profession the she loves. The reasons? She is a specialist sister in intensive care who is often told to work in other departments. She has been sent to A & E, theatres, wards and even the other sites in her trust which is 20 miles away. 

She has simply had enough. 

What a tragedy which is personal, institutional and cultural for her and us all. 


In London there are 8000 nursing vacancies and huge doctor numbers too, so making your job one that people want to come to must be worth working on? 

Staff retention rather than repeated training costs is a very worthwhile investment, and turning from a Blame Culture to a Just Culture is a crucial start. 

A worthwhile part of team-working is delving in to emotional intelligence and a fundamental concept within that is of course self-awareness. 


Get in touch and discuss with us how we could help your teams, including the senior level of course. 


Trevor Dale, Human Factors Specialist

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