Fundamental Attribution Error (Nursing)

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.