Fundamental Attribution Error (Nursing)

by Amber Vanderburg

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    00:01 I want you to imagine that you are driving down a peaceful road.

    00:07 You have the windows down on a sunny day, favorite music playing through the speakers, you take a deep breath, and bam a car comes out of nowhere and cut you off.

    00:19 Now, you look at this buffoon and assume that the driver is a self-centered, egotistical, good for nothing, downright jerk who should have their license revoked because they have no consideration for the road and they are a complete hazard to society.

    00:38 What a nuisance! However, when we cut someone off, we tend to find loads of justification for our actions.

    00:50 We didn't intend on cutting someone off. We didn't see the other car.

    00:56 We simply needed to get in to the other lane and the turnoff was quicker than expected and our GPS didn't give a proper heads off and we judge ourselves by our intentions while we judge others by their outcomes and behaviors.

    01:13 We see this happen on the road and we see this happen with our team members in patient care.

    01:19 Think of all of the times you saw someone miscalculate, misspeak, make a less-than-perfect decision, misdocument, not document, forget, and mess up and now think of the times that you have done the same.

    01:37 One of the greatest blenders in providing effective performance feedback is the fundamental attribution error.

    01:47 This is really a fancy way of saying that too often we judge other people by their behavior while judging ourselves by our best intentions.

    01:58 And this brings me to an important element of effective performance feedback.

    02:03 You need to acknowledge intention alongside behavior when giving your feedback.

    02:10 When addressing undesired performance, identify outcomes, or behavior and disregarding intention is pretty easy.

    02:21 However, this mindset can create tension and a disconnect between both parties and can be an obstacle in influencing performance improvement.

    02:32 For example, I was working with a seasoned, established team member that was described by his team as constantly blunt, sometimes abrasive, headstrong, argumentative, and at times called malicious.

    02:48 I spoke with the team member and asked him about his behavior.

    02:53 He did not perceive his actions the way they were interpreted.

    02:58 He was intending to be confident, passionate, and convincing.

    03:04 What others saw as abrasive, he saw as passionate.

    03:09 And there was a gap between his intentions and his outcomes.

    03:14 Rather than reprimanding the behavior, I partnered with him to better match the intentions and the outcomes.

    03:22 This was a more productive dynamic for improved performance and effective change.

    03:29 When considering the intentions, first look at the surroundings of the performance to get a better context of the environment.

    03:39 Did the patient have a family member that was challenging and distracted or undermined the team member? Did the nurse return from a code and was so flustered? Was the team short-staffed and overwhelmed? These are not excuses but it is context to give a holistic view of the undesired behavior.

    04:02 First, take a moment and observe the context of the performance, frustration, behavior, or attitude.

    04:11 Next, genuinely and sincerely ask "What was your intention?" to establish an understanding of intentions.

    04:21 People generally do not intend on being low performers, bad drivers, or challenging team members.

    04:29 Find out the other person's intentions so that you can best coach the team member to better match the behavior with the intention.

    04:41 Lastly, inquire. What can I do to help? Sometimes the answer is nothing more than showing support.

    04:50 Sometimes, there are practical action steps you can take to help champion your team members' success.

    04:57 Sometimes, the team member needs some guidance or mentorship.

    05:03 No matter how clearly you communicate expectations, there is always an opportunity for expectations to be unmet.

    05:13 The goal in these situations is to help the person improve so that your entire unit can provide better patient care.

    05:23 So, here's what I want you to do when addressing undesired performance.

    05:29 Begin by observing the context, asking for intentions, and offering help to improve.

    About the Lecture

    The lecture Fundamental Attribution Error (Nursing) by Amber Vanderburg is from the course Communication in Healthcare (Nursing).

    Included Quiz Questions

    1. Judging oneself based on intention while judging others based on behavior.
    2. Making an error and attributing it to a coworker.
    3. A character flaw that is personality-based and not modifiable.
    4. Accusing others of flaws while refusing to work on one’s flaws.
    1. Acknowledging intention alongside behavior.
    2. Allowing the employee to choose who the feedback comes from.
    3. Providing feedback in verbal and written form.
    4. Only providing feedback at designated intervals.
    1. Ask the new nurse for more context and what their intentions were.
    2. Ask the new nurse to write an apology letter to the nurse.
    3. Discuss effective communication strategies with the new nurse.
    4. Suggest that the new nurse take the rest of the day off and reflect on their actions.

    Author of lecture Fundamental Attribution Error (Nursing)

     Amber Vanderburg

    Amber Vanderburg

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