How to use failure to drive innovation

Everybody recognizes that failure plays is an important role in innovation but there is a lack of structured advice about how to encourage and use failure in a practical way. Below are some thoughts about how failure can be used in a practical way:

1) Remove the stigma from the word failure Failure is a word that has a lot of negative connotations and is a word that many people are uncomfortable using. In a recent interview I asked applicants “what was their greatest failure” and many replied that they did not like the word and did not associate anything they did with failure. If conversely I had asked “when have you ever tried anything new”, none of them would reply “I have never tried anything new in my life”. And yet this is precisely what they are saying by saying they never failed. Nothing is ever achieved successfully on it’s first attempt so any attempt to try or learn anything new will involve some failures along the way. We need to reclaim the word and recognize it’s importance as a developmental step.

2) Encourage the sharing of failure If you are trying to encourage innovation, there will inevitably be failures along the way. By encouraging people to talk about it and to share their stories of failure, the group or organization as a whole can learn much faster. If the same mistakes are being repeated over and over again in isolation, it makes the learning process much harder and much slower. The sharing of failure needs to be seen as an important contribution to the success of the group and the success of the organisation.

3) Fail often and fail small Where failures become catastrophic, they are often very large failures and can result in the destruction of an organization (e.g. Barings Bank, NHS University, etc). Even when the organization survives, a catastrophic failure can seriously damage an organization’s reputation (e.g. BP, Nasa, etc). The trick is to iterate quickly so that any failures happen quickly and at a small level. By encouraging experimentation and innovation at a small scale, the lessons can be learned before significant resources are invested.

4) Make failure survivable for the person and the organisation Linked to the previous point, the board and management team of an organization need to make sure that failures do not destroy the organization and so this needs to be managed in a way that encourages failure but at a small enough scale so that learning can happen. Equally individuals who fail must be protected and possibly praised for their innovation. If a culture emerges that failure is met with punishment, then people will quickly learn to avoid doing anything new or innovative and this can be far more damaging to the organization as a whole.

If we can learn to reduce the stigma around failure, openly share our failure stories and learn how to fail fast and often, then we will be well on the road to creating truly innovative organizations and teams.

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What to do when your manager is an idiot

“So what do you do when your manager is an idiot?”

If I had a pint for every nurse I met who felt their boss was an incompetent idiot, I would spend nearly all my waking hours staggering around in a drunken haze. I would go even further and say that most of the nurse entrepreneurs I meet would not be looking to leave their current organisation if they had a creative, supportive and empowering manager.

So what do you do when your manager is an idiot?

Well a couple of suggestions and approaches might help make your job and your life more bearable. If you find yourself thinking about your manager a lot when you are away from work and talking about them a lot with friends and family, then this is a sign that they are having a very unhealthy impact on your life and you need to do something about this. Either that or you have a crush on them and that is an entirely different blog ☺

Firstly a word of caution. Acting like you know they are an idiot (no matter how tempting) will only make things worse. If you antagonise, embarrass or annoy your manager they can easily transform from being an idiot to a bully and the bane of your life.

So where do you start?

The easiest route is if you can turn them from being an idiot into an ally. Do you understand why they act the way they do? What are their priorities? What are their problems? What would make THEIR life easier? If you don’t know the answers to these questions, then find out. Nurses are highly skilled in verbal and non-verbal communication and in making complex assessments – use these skills on your boss. Find out what drives them, what their priorities are, what their hopes and aspirations are and what they really care about. Very few people ever spend much time analysing situations from the world-view of others and it can be a very rewarding and transforming experience.

So let’s assume that you’ve worked this out. How do you use this information to improve your life (which is the purpose of the exercise)? What you need to do is to reframe what you want in terms of what they want. Do they want shorter waiting times, reduced sickness and absence, cost savings, more recognition from their manager or peers, better clinical outcomes, service redesign, etc? Once you know what THEY want, then you can present your ideas and your changes in terms that meet THEIR needs. So (for example) if you want an additional nursing post, you have to come up with a way of selling that as a way of meeting what they want and solving their problems (e.g. will this new post improve documentation, reduce complaints, help implement a new care pathway, reduce spend on agency staff, etc). It is like a move in the martial art of judo, where you use their energy and their momentum to move them where you want them to go.

So what if that doesn’t work?

There are a few things that you can do which will definitely make the situation worse. The worst culprit of all is complaining about your manager to anyone who will listen. Not only does this make you look very unprofessional but your manager will have friends and allies all around you, particularly people who see their future career success as something your manager can help them with. Very quickly your manager will find out what you are saying and then the relationship is likely to deteriorate very badly very quickly.

What if your manager just enjoys dominating others?

There are people out there who just enjoying dominating others, whether this is about their own insecurities, their personal ambition or this is the approach they learned from their early role models. If you have a dominating manager there are no easy solutions. One solution is to give in on some things and consider them as insignificant as it will become personally draining to fight them on every front. If they insist on small issues are done in a
certain way then sometimes it is easier to just go along with it and do what they want. If they want all the pillowcases facing away from the door (these Ward Sisters really do exist!) sometimes it is just easier to turn the pillowcases. However, whilst it is good to give in on small things, there are certain issues where we cannot allow ourselves to be pushed around. If your manager is encouraging you to be unpleasant to others, to treat other people badly, to ignore the needs of others and even to lie for them, then you should not feel compelled to follow. If you feel inwardly awkward about
something then avoid doing it. If you simply follow all the whims and dictats of your manager, they will exploit this and the situation will only get worse, but choose the issues to argue over and if you can trade “your way” on a few important issues for “their way” on minor issues, then this may be enough for you.

What if your manager is constantly criticising?

Some people seem to have real knack for spotting every mistake and error around them, no matter how small. Some of them even seem to get a perverse pleasure in pointing out other people’s errors and mistakes and this is annoying enough in a colleague but awful if they are your manager. They even seem to get a certain sense of satisfaction from pointing it out. There are ways of coping with this though. The most important approach is not to take this as a personal criticism. If you have made a mistake at work, it doesn’t mean you are a bad nurse or a bad person, simply that you did something wrong. This could be a great learning opportunity to improve your skills and performance but only as long as you don’t react to this as a criticism of you as a person. Remember that one of the roles of your manager is to manage your performance and pointing out mistakes is a legitimate part of that activity. Some nurses react to any performance management as if it is bullying without recognising that it is a legitimate and important management function.

If your manager is pointing out all your mistakes all of the time, remember all the things you do well even if this is not mentioned or recognised by your manager. The worst thing you can do is criticise them back as you will be locked in a cycle of criticism in which you will inevitably suffer. If your manager does infrequent performance reviews (or does them in a very mechanistic way), use the opportunity to present some of the excellent work that you have done and your achievements. Even the act of thinking about your success and achievements and writing the down will make you feel more positive, irrespective of your manager’s reaction or level of interest. Whatever their motivation for constant criticism, if you can put this in the context of all the good things you are doing, depersonalise it (even if only in your own head) and learn from it, then this will reduce the impact of this criticism on your self-belief and your happiness.

So when do you openly challenge them?

Many people think that openly challenging and confronting your manager is the way forward. Sometimes, particularly when the welfare of patients or other staff are concerned, openly challenging your manager’s behaviour and decisions is the way to go. However, even if you win, this is not a slight that they will easily forgive and neither will their allies. It is rare to find a nurse who has openly challenged their manager, has won and has still stayed very long afterwards in that area. Some complain of ongoing bullying from the manager, some complain of bullying from their manager’s manager, some complain of being ostracised by many of their colleagues and some feel that they have won a battle only to lose a war. If you are going to openly challenge then you need to make sure you get plenty of good professional support (e.g. trade unions, professional bodies, legal advice, etc) and plenty of personal support (e.g. friends and family). It is also worth assuming that after you have won, you need to move to another area or organisation afterwards and you should plan your exit strategy as early as you can. It is much easier to go through this difficult process knowing that you are leaving to a better environment and you will also find job-hunting difficult in the middle of a complaint, grievance or even legal process.

Finally, it is very unlikely that you will be able to change your manager’s behaviour or their personality. If you can turn them into an ally then that will make your life easier and will help you push through the changes you want. If you can’t then you will either have to live with it (which can be a pretty miserable existence) or leave. If other people’s welfare is at stake then you may choose to openly confront and challenge your manager but you need to plan your support and our exit strategy in advance.

Whatever happens, remember that a good job is a job doing what you love, surrounded by colleagues you like and respect with a manager you respect and who supports you – having only one or two of those in place means that it isn’t a good job and there are better jobs out there for you. As Confucious one said “Choose a job you love and you will never have to work a day in your life”.

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My favourite blogger

This is going to be an odd blog post for a two reasons:

a) I am going to write about my favourite blogger, I am not going to tell you her name or where you can find her blog
b) I know more about this woman than I know about most of my friends but I have never met her and don’t even know her real name

So where to start with all this?

Well I suppose it started via twitter and I came across a number of posters who also wrote really good blogs and tended to link and comment on each other. What connected them was that they all had mental health issues and for some (but not all of them) writing about their mental health was the main focus of their blog. Reading what these bloggers were writing was an experience that I had never had in any other context. I worked in mental health during my training as all nurses do and had worked in hospital and community settings and though I knew a reasonable bit about mental health. It was all seen through the lens of a professional though and so I knew about medications, diagnoses, referrals, etc but not really much about what it is actually like to live with this. Some of my friends received treatment and a few ended up as inpatients during their training but we never really talked honestly about what those experiences were like. So initially I was really taken aback by these incredibly vivid honest accounts from these bloggers.

At first I felt like this was somewhere I shouldn’t be and reading blogs I shouldn’t be reading. After all I have never had treatment for mental health problems and had a pretty big online label identifying myself as a health professional. I was also actively connecting with them through twitter and blog comments rather than just passively reading their blogs. But people were OK with this and I never tried to pretend to be something I wasn’t or (god forbid) ever try and give clinical advice or information. Mind you that is probably because my mental health clinical skills are almost non-existent these days but also they knew far more about the ins and outs of the healthcare system, medications, diagnoses, etc than I did. And also, to be honest, these weren’t blogs about being ill, they were blogs about being human and being alive. Although health issues were what drew them together in an online community, they were all just providing very raw honest accounts of their lives. Some days were all about symptoms and the failings of healthcare and socialcare professionals and other days were about wine and love and poetry and family and jobs and dreams and fears.

It was the writing more than the content that really drew me and the quality of the writing took my breath away. I am a bit of a crap writer and although I try not to let that stop me flexing my writing muscles, I am under no illusions that my writing is not my best way of communicating. On a good day with a good crowd, I can do presentations and talks that make people laugh, cry and touch people’s innermost dreams and emotions. My writing has never come close to that, but these writers did. They shared a view on their inner and outer world that they openly said they did not share with family, friends, professionals or therapists. I would follow accounts of therapy sessions where they would talk about what they did and didn’t share and discuss whether or not to let professionals know about some of the dark scary things. And yet they were sharing this with complete strangers. Although for me some of them didn’t feel like strangers because they had shared huge parts of themselves that even good friends don’t really share, albeit through a veil of pseudonyms and anonymity. One person made a suicide attempt and we all knew because of her last blog post, her abrupt ending of a twitter stream and then her post when she was finally discharged from A&E having convinced them not to section her again. What became obvious was that for many of them, this anonymised electronic network was actually their primary source of support and there was real depth to the care, emotion and support that they shared with each other. If you have never been part of an electronic community it can be hard to imagine how much support and how much affection you can have for someone you have never actually met.

And of these writers, my absolute favourite is L. Well actually I know L is a pseudonym because she has since told me her name is actually J although that could be another psuedonym. L is an outstanding writer and we would generally communicate through blog comments and twitter. A few months ago, her family discovered her blog and so she has now moved it to a password-protected hidden place and I promised never to reveal where this is or provide any clues where her family could find it again (which is what makes writing about this tricky and why I seem to referring to her in a George-Smiley-kind-of-way). For people who have never really used twitter or blogs, it may seem strange to think that you can follow someone’s live, moods, ups and downs in real-time if they are very open and transparent. I know when L is having a great day, when she is curled up under the duvet on her laptop, when she is scared, when she has had crap treatment from professionals, when she is wondering whether to eat again, when she is drinking wine, the ins and outs of her love life and when she is thinking of ending it all. There are lots of days she makes me laugh out loud, there are days she makes me worry about her and there are days she makes me desperately painfully sad. But if she was sat next to me where I am writing, I wouldn’t know how she was. L has probably helped me understand aspects of mental health I never could have understood, not as a label or diagnosis or treatment pathway, but as one aspect of a bright multi-faceted life that sometimes takes centre stage and at other times is part of who she is with no more impact than hair colour or taste in music.

I will probably never meet L or share a glass of wine with her but she has touched my life in a way that probably seems bizarre to those who treat social media as a scary impersonal technology. She has also shown me the joy of beautiful honest writing and how electronic communication can sometimes be far more human, deep and powerful than what most of us experience in face-to-face “real life” conversation.

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Is volunteering the new exploitation?

Another great conversation that emerged at the Shine 2010 unconference was about the nature of volunteering. I think we just assume that volunteering is a force for good and is about people being generous with their time and skills for the benefit of others. I mean what could possibly be wrong with that?

Doug Richards from the School for Start-ups suggested a very different way of looking at volunteering. He argued that asking people to provide labour for free is simply exploitation. That if a social business is genuinely trading then it should pay people for their labour and incorporate their costs in the price of the goods or service. His final parting shot on the subject is that "working for free is a hobby not a job".

I think there is something to this point of view. If the driver for a charity or particularly a social enterprise for using volunteers is that they can't afford to pay people then it means they are admitting that they cannot compete with other organisations. If a competitor's product or service is so much better than yours and the only way you can compete is by using free labour, then you do not have a sustainable position in the market. If we criticise firms that use sweat-shop labour as being unethical, shouldn't we apply the same standards of criticism to those who pay their workers nothing.

This isn't criticising the motivation or altruism of people who want to give their time for free but the lack of aspiration of the organisations that accept it. If you are a charity and using free labour is the only way of plugging a deficit in your funding, then I have some sympathies but I think this should be challenged in anyone who aspires to be a social enterprise.

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Profit isn't evil - get over it

The interesting thing about social enterprise is that everyone asumes that we are talking about the same thing until a question arises that sharply divides them into various camps. There was such a question at the Shine unconference this morning and that question was "Is profit evil"?

Because within the social enterprise community are charities, voluntary groups and social businesses; some totally dependent on grants, some that genuinely trade and some that make considerable profits. For my money grants are simply donations from rich people or rich organisations and whilst they sometimes generate social good they are not sustainable. Grant income is simply a 21st-century version of medieval patronage and is entirely dependent on the whims of the rich. Whilst free money is always nice, it clearly isn't sustainable; which brings us to the idea of profit.

At a purist level, profit is simply the surplus of income over expenditure but for some charitable organisations, the word and the idea carry connotations of the most evil blood-drenched capitalist machines. For those of us at the social business end of the spectrum, profit gives you sustainability, independence and the potential to grow (and therefore massively increase your social and environmental impact). Whilst there may be an emotional (and arguably irrational) reaction to the word "profit", it is really just surplus and if you aren't making a surplus then you are just going out of business slowly.

A much more interesting debate is whether the MAXIMISATION of profit is inherently evil. There is a world-wide track record of organisations who maximise profit by laying off vast quantities of workers, reducing pay and benefits, sourcing from lowest-cost providers, dumping industrial by-products and taking resources from countries that can ill-afford to lose them. If the overriding factor in a company's decision-making is the maximising of profit, it is almost certainly reducing its social and environment impact, if not actively causing social and environmental harm. Corporate Social Responsibility initiatives may be a public-facing sticking plaster over this activity but the scale of it is dwarfed by whatever the core business processes are.

So the really interesting ethical division for businesses is not between those that break-even and those that make profit; but between those that make profit AND social and environmental benefits and those that maximise profit (at the expense of any social and environmental considerations). Depending on which side of that divide you are is a better indicator of whether you are really a social enterprise or a profit-maxising private sector business.

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Testing my new iPhone app

In a vain attempt to blog slightly more regularly, I have installed BlogPress on my iPhone. This is my first attempt from it and so far it seems to be working quite well. Of course, when I get my iPad, I suspect that it will be even better :)

- Posted using BlogPress from my iPhone

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Nursing, politics and social enterprise

One of the areas I find really interesting is the way that both Labour and Conservative have come out in favour of social enterprises. Not sure where the Liberal Democrats and the other parties are on this subject but whenever parties seem to agree on an issue, they then immediately try and establish battle lines between each other. At the moment, within the overall consensus on social enterprise is a division about a very specific type of social enterprise, namely the “worker co-operative”. This is where staff get together and collectively own an organisation and democratically determine how that organisation will be run and who sits on the board. The Conservatives are advocating more of these in the NHS whilst Labour are arguing against it, even though they have been promoting examples of this as the way forward for community provider services.

So what does all this mean and what’s it got to do with nursing?

To understand that, I think you need to understand two things: where worker co-operatives came from and what nurses hate about the NHS.

So where did worker co-operatives come from? Well although they are now an international movement, they were born in Rochdale, Lancashire about 300 years ago as a way of workers making sure that they had good working conditions, were paid a decent wage and as a direct response to the traditional company owners simply exploiting them to make as much profit as possible. From these roots were born the trade union movement and latterly the Labour Party and there are still Labour Party MPs who are technically members of the Co-operative Party (which joined with labour a few decades ago). So worker co-operatives are a response to workers feeling underpaid, undervalued, disempowered and exploited. The way they work is that every person who works for them has a single vote and these votes are used to democratically elected the governing board and make key decisions about how the organisation is run.

OK, but what do nurses hate about the NHS? The NHS is like family members who quarrel and fight but will defend each other from any attacks from outside. We often spend so long defending the NHS that there is very little attention given to what’s wrong with it and particularly what many nurses experiences are like in the NHS. Staff survey after staff survey shows that nurses are very often treated very poorly by their organisations whether by overt bullying, poor working conditions, lack of support, no training and education opportunities, etc. Having spent much of the last 9 years working with nurses from across the whole NHS, it is common complaint that nurses don’t feel valued or listened to by heir managers and that they feel that their organisations board puts money ahead of clinical care.

I have seen many nurses interested in the idea of worker co-operatives as a direct response to this lack of control, lack of empowerment and poor management practice. At its simplest, it is a way of saying “we think we could run this organisation better than the people who currently do”.

The focus on using social enterprises as a vehicle has drawn up battle lines between the unions and between some of the political parties; and has focussed on the mechanics such as pensions, TUPE (transfer of undertakings legislation), legal structures and whether these new entities represent “the privatisation of the NHS”. What all of these fail to realise is that this is not a response to large-scale economic shifts or changes in political policies but a very local response to how valued and empowered nurses feel. What is striking about talking to nurses who have left the NHS to establish nurse-led social enterprises is not only how much happier and empowered they are but how they are able to improve clinical services the way they also wanted to. Until the NHS gets better at treating its nurses properly then this is a movement which is likely continue whatever party takes control after the election.

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