How Great Leaders Deliver Bad News

One of the most difficult aspects of being a leader is having to deliver bad news to your team. Bad news can come in many forms such as firing an employee, explaining some type of large mistake that happened within the company, or letting your team know that the company isn’t doing very well. Having to confront these types of situations tends to make most people run and hide, but it’s something that is inescapable for most leaders. Being able to properly navigate these situations is a sign that you are a good leader, no matter how frightening it might be, but there are still many leaders that manage to mess it up. So how does a great leader go about delivering bad news?

Don’t Hide Anything

One of the worst things you can do when giving bad news as a leader is to leave out important details. Transparency is one of the best ways to ensure your team members trust you when something bad happens in the company, or when an employee is having performance issues. If you choose to leave out important information or you choose to completely ignore a bad situation and keep it to yourself and higher-ups, it’ll likely still find its way out to the team eventually and cause even larger problems.

Take Responsibility

Another thing to avoid when delivering bad news is blaming people or groups that aren’t at fault. When running a company or leading a team, the leader should always take the blame for what has happened, even if it wasn’t directly their fault. This shows that they are confident and courageous enough to admit that they made a mistake. The bad situation happened under your direction, so it’s imperative that you address this.

Share Your Plan

If there’s already some sort of plan created in order to rectify the situation then it’s best that you share that with the team while giving them the bad news. It shows that you and whoever else is involved are already on the case and making sure that things don’t get worse or that mistakes don’t happen again. Once you’ve shared your plan with the team, it’s also smart to invite employees or team members to refine the plan or to add anything they think might help. This allows everyone to come together to tackle the problem and can give team members more security in the issue.

This article was originally published on DrAdrianCohen.org

Tips For Leading Your Team Remotely

The world has changed quite a bit over the last month or so. Due to the pandemic known as COVID-19 people all over the world have begun quarantining and social distancing from others in order to attempt to halt the virus in its tracks. This has caused many businesses that have the means to do their jobs from home to do just that. While it’s great that so many people are still able to work, it can be a difficult adjustment to make for both employees and their leaders. Employees might prefer being in the office, and not having that in their day to day can make the home and work lives mash together. Leaders in these situations have to figure out creative ways to make sure everyone is still getting their work done while also not losing their minds, but just how are they supposed to do that? Here are a few tips to help you lead your team remotely.

Communication Is Key

While communicating with your team is always vital, it’s even more important when you’re forced to work remotely from them. Whether it’s communication about what’s going on in the company, or just checking in to make sure members of your team are doing okay, communication is key. One good way to encourage communication is by having a short meeting each day where members of the team get together and ask how they’re doing or what they’re working on that day. Leaders can also have one on one check-in calls where they ask about things they’re struggling with when it comes to working remotely or getting them caught up with the day to day business of the company.

Make Sure There Is Access To The Proper Tools

Another point to keep in mind when leading remotely is that each of your team members has what they need in order to do their job and do it properly. This usually comes down to technology, such as making sure they have internet access or a computer they can use. It isn’t all hardware either though – you’ll want to make sure they have any software they may need to access business portals or to be able to have video meetings with you and the rest of the team.

Trust Your Team

Trust is the foundation of a winning team. If you normally see your team every day, it’s easy to stay on top of them and make sure they’re doing what needs to be done. When working remotely, it’s pretty much impossible to find out if they’re even doing actually getting their things done. There are tracking systems of course, but when it comes down to it you’ll need to be able to trust each team member and be flexible if situations arise that require flexibility.

This article was originally published on DrAdrianCohen.org

Questions For Managers To Ask Potential Employees

Preparation is of the utmost importance when preparing for a job interview. This doesn’t just go for the potential employee though – this also stands for the person who is conducting the interview. In order to get a true sense of if the person you’re interviewing is the right fit for your organization, there are certain questions you’ll want to think about asking them. Here are a few great questions that any manager should consider asking potential employees during an interview.

Can you tell me about a time you overcame a challenge?

Most potential employees dread this question, but it’s a great way to get a better understanding of their experience and how they react in tough situations. Starting a new job is never easy and practically every new employee runs into issues so this is a good opportunity to gauge how they will react and hopefully overcome those issues.

Why are you leaving your current employer?

Another question that is undesirable by many interviewees, but still important to ask. If hired, interviewees will be leaving their current employer to come work for you. There can be a number of reasons as to why they’re choosing to do this – it could be money-based, unhappiness with their current employer, unhappiness with what they’re currently doing, or the desire to try something new, to name a few different reasons. Asking this question gives you a better idea of what their professional history is like, and can raise possible red flags that might tell you this person isn’t the best fit for the role.

What’s A Skill You’d Like To Improve And How Do You Plan On Doing So?

A great way to gauge a potential employee is to ask them if there is a skill they’d like to improve on, as well as their means of doing so. This is similar to the typical question of “what’s your biggest weakness” but turns the question on its head a little bit. The employees you hire should be aware of their weaknesses and be actively working on improving them and the second part of the question allows them to explain to you how they’re going to go about it.

This article was originally published on DrAdrianCohen.org

Differences Between A Leader And A Manager

While almost anyone can become a manager in a business, this doesn’t necessarily mean that they’re also a leader. Many distinct differences exist between the two phrases, and in order to be good at either role, you must understand those differences. Here are a few of the major differences commonly found between managers and leaders. 

Vision vs Goal

Leaders are all about vision. They look at their team while engaging and inspiring them to turn a vision into reality. Leaders understand that when providing a vision to a group of people, that group can come together to achieve great things. Managers, on the other hand, focus more on individuals. Managers are all about setting goals with each member of their team, doing their best to control situations that allow individuals to reach or exceed their objectives.

Long Term vs Short Term

This relates to the difference between a vision and a goal. Managers think more in the short term. They focus on what they can do to accomplish different tasks within their organization. A leader, on the other hand, is in it for the long haul. They understand that what they’re working towards isn’t something that will be accomplished in a month, or 6 months, or even a year. They have to stay motivated, likely without any compensation, for long periods of time.

Relationships vs Structure

People and the relationships they form with them is a core aspect of being a leader. In order for a leader’s vision to be reached, they understand that they have to focus on the people involved in making that vision a reality. By doing this they end up building a sense of loyalty and trust with their team. On the other hand, managers focus more on the structures they need in order to set and achieve goals, making sure systems exist to attain desired outcomes.

Coaching vs Directing

Leaders have the utmost faith in their team. They understand that the people they work with are confident and are able to find the answers they seek if they don’t already have them. Leaders do everything they can to avoid telling their team what to do. On the flip side, managers tend to assign their team with tasks, giving each individual guidance on how to get the best results.

This article was originally published on DrAdrianCohen.org

Tips For Ultrasound Guided IV Placement

When working in a hospital you’ll occasionally encounter an unstable dialysis patient whose providers are struggling to give venous access to. At this point, many healthcare providers will use an ultrasound to find the vein they’re looking for, hopefully making things a little easier and allowing proper care to be provided. Struggling with venous access can also frustrate the patient, which ends up causing many healthcare providers to resent this task altogether. Luckily, an ultrasound-guided IV can decrease complications and improve the chances of success. Here are a few tips to help improve the odds of success and avoid any potential risks.

If You Can’t See Any Good Veins, Look Distally

In most situations, healthcare providers will scan proximal to the antecubital fossa when trying out ultrasound-guided access. It’s suggested that you should think about looking distally while utilizing a shorter and smaller gauge needle. Doing this helps you avoid injuring more proximal veins and allows for vessel preservation. Radial veins are a good candidate for IV placement in most patients but are often discounted due to their size and proximity to the radial artery. On the contrary, the radius stabilizes these vessels and can make them less likely to roll or dislodge the catheter. It’s also possible to use the “intern vein” if needed.

If You Only See Tiny Veins, Look For A Y-Shaped Junction Between Veins

Don’t fret if you’re only finding small veins. Even these can be cannulated successfully by looking for a Y-shaped junction where two veins merge. Approaching this venous junction allows the needle to puncture perpendicularly against the vessel wall while remaining parallel to the overall vessel course. In order to do this, you must first mark the location of the junction on the skin as well as the direction of each branch distally and proximally. After, puncture the skin between the distal branches 1 – 2 cm distal to the junction. You’ll want to advance the needle and maintain it between the two distal branches until they converge, continuing towards the junction until the needly is visible in the larger and more proximal vein.

If The Vein Rolls Away As Soon As You Get Close, Try Approaching From the Side

Veins can collapse easily or fade behind artifact as the needle approaches, especially in patients with sclerosed vasculature or that are dehydrated. When this happens, a great alternative is to approach the vein from the side as opposed to from above. In order to do this, you’ll want to intentionally pierce the skin lateral or medial to the vessel, followed by advancing the needle approximately 1cm until it lies alongside the vein. You’ll want to then aim for the vessel from beside it. This technique makes it so needle artifacts don’t obstruct visualization of the vessel.

This article was originally published on DrAdrianCohen.com.au

A Brief Guide to Procedural Sedation

Being a pro at procedural sedation is a great skill to have. It helps make your job safer and more efficient while also making your patients more comfortable with the process. There’s a lot to know about sedation though, so here’s a brief guide to help you make sure you’re doing everything properly for both yourself and your patients.

The first thing to know is that sedation has multiple definitions. These are defined by the responsiveness and ventilation pattern of the patient and are known as dissociative, moderate and deep sedation. Dissociative sedation is defined by a trance separation with retained airway reflexes and ventilation. Moderate sedation involves depressed consciousness with responses to commands or touch, with no ventilation changes. In deep sedation, patients are aroused by pain and ventilation may be irregular but is intended to be adequate.

What Do You Need?

In order to properly go through with the sedation, you’ll want to make sure you have respiratory therapy, nursing and a second provider if possible. A sedation certified nurse can help push medications at the direction of the physician, making things easier for them, while having another provider present – one for the sedation and one for the procedure – also makes things easier. If alone, make sure you’ll be able to stop the procedure and resuscitate if the need arises.

When preparing for the sedation, do your best to keep everything organized. You’ll want to have the blood pressure cuff on the opposite arm of the IV as well as opening up your fluids. Be sure that the IV flows well before starting as well. Another good tip is to draw up more medications than you expect to use, just in case. 

Medication

When choosing your medications of choice, be sure to consider your goal depth and duration as well as the characteristics of the patient. While every provider has their own preferences when it comes to medication, it’s always good to be comfortable with multiple options in order to play it safe. The dose you’ll need for a specific level of sedation will be different for every patient, and it should be based on the desired depth of sedation. There are many medications you can use, all with their own suggested doses and concerns to be aware of.

This article was originally published on DrAdrianCohen.net.au

Tips For Managers To Form Meaningful Relationships With Their Employees

More than anything, human beings strive to form meaningful relationships with those around them. Having those meaningful relationships creates an idea of belonging to something. This can be extremely important in the workplace, especially since research shows that people in the workforce spend more overall time with their coworkers than they do with their own families. Just like with a sports team, having a meaningful relationship with your employees encourages them to want to work harder, or to help their peers out more often. It’s also important that not only do employees form meaningful relationships with one another but that managers are able to do it with their employees as well. By forming meaningful relationships with their team they can develop a better understanding of what makes each employee tick, the goals they’re striving for in their career and in life, and how to approach each situation in a way that works best for that employee. Here are a few ways managers can begin to form meaningful relationships with their team.

Be Authentic, Informal, and Frequent with Communication

When trying to form a relationship with your employees, it’s important that you don’t always come off as only their boss. You’re human, just like them, and it can be easy for employees to forget that. In order to ensure your employees don’t see you as a robot, make an attempt to truly get to know them. Engage in casual conversation with them by asking them how their weekend was or seeing if you have similar interests. Make sure this is something you do often as well, as only doing it once in a blue moon may throw employees off guard. Trust levels between managers and employees will grow more when employees see the human side of you, making it easier to form a relationship with them.

Reach Out To New Hire/Team Members

When a new employee joins the office, or your team gets a new team member out of an existing employee, it’s imperative you begin the relationship-building phase right away. You don’t need to necessarily wait until they’ve actually joined the team other. Once things are finalized and you know they’ll be joining, reach out in an informal manner. Some managers or team members will send welcome emails to new hires before they join, or they may choose to invite a new incoming team member to a team lunch. This is a great way to introduce them to their managers and other new team members in an informal setting.

Celebrate Employee Milestones

Managers can also form relationships by celebrating the milestones of their employees, both in and out of work. If someone is having a baby or got an award, be sure to get the team together to celebrate it. This can help employees be their whole selves in the workplace and give them the sense that they can share their personal lives with people who care, fostering an overall greater feeling of inclusion. The people you work with often come from all walks of life and it’s important to recognize that.

This article was originally published on DrAdrianCohen.org

Tips For Giving Negative Feedback To Employees

One of the most difficult aspects of being a manager is having to provide them with negative feedback. No employee is perfect and there is always room for improvement but sometimes you’ll have an employee who is struggling more than others. As a manager, it’s your job to guide them and help where you can so they can become the thriving employee they’re meant to be, but that usually involves telling them where they might be failing in the job. While this can be a difficult task, there are plenty of ways you can approach it in order to ensure employees understand where you’re coming from and that you’re trying to help them. Here are a few tips to help you give your employees negative feedback. 

Create A Comfortable Environment

The first thing you want to do when looking to provide an employee with negative feedback is to make sure they’re in a comfortable environment. It’s important to find a quiet place away from prying eyes in order for both of you to speak freely about the feedback, otherwise, they’re more likely to shut down and not talk to you about the what you’re telling them. Employees are more receptive when they feel comfortable and safe, whereas being scolded for something in front of their peers may make them defensive. You’ll also want to make sure you don’t come off as threatening unless it’ a more dire situation. The language you use when addressing an employee can change the way they react, so avoid using phrases such as “you need to…” or “you didn’t do…”. 

Try To See Their Perspective

As previously mentioned, employees will occasionally shut down or become defensive when they’re given negative feedback. One way to avoid this is to do your best to see their side of things. As a manager, you should ask them how they thought they handled a situation or why they approached a task the way they did. Giving your employees the opportunity to explain themselves and share their views is important in understanding where a misunderstanding or challenge may have occurred. While you may be giving an employee constructive criticism, you also want to be sure that the conversation isn’t one-sided. This also helps managers build relationships with their employees, getting a better understanding of things in their life that may be affecting their job performance.

Make Giving Feedback Normal

While giving negative feedback is of great importance in any workplace, it’s important to provide positive feedback as well. By providing both forms of feedback, it helps create a culture of feedback where both management and employees feel they can be open and honest with one another about issues in the workplace, whether they be about structure, culture, or just the work the employee or manager is doing. Make sure feedback is continuous within the workplace, and not something that happens once in a blue moon. This encourages employees to be open about the way they’re feeling and helps both management and employees understand what is expected of them.

This article was originally published on DrAdrianCohen.org

A Brief Guide To Evaluating Syncope

Syncope, or fainting as it’s more commonly referred to, is a temporary loss of consciousness that typically involves an insufficient flow of blood to the brain. Having blood pressure that is too low is the most common reason it happens, but there can be various reasons as to why it occurs, with some having the possibility of having an underlying medical condition. In the field of emergency medicine, it’s important that a healthcare provider is able to recognize whether or not someone is suffering from syncope, and how to go about treating it. Read on for a brief guide to evaluating syncope.

Step 1: Ensure it’s Syncope

If a patient is stable after waking up from a loss of consciousness, you’ll want to make sure it’s actually syncope versus what could possibly be a seizure, mechanical fall, or something else entirely. This is important because syncope shares many commonly cited symptoms with other health issues, such as myoclonic jerks which bystanders may view as a seizure, or bladder incontinence which can occur during seizures, severe head trauma or syncope. Tongue biting is also common in syncope, seizures and mechanical falls. A good way to determine if it was a seizure is if they have lateral tongue biting or postical confusion, whereas for a mechanical fall you’ll want to as about prodrome because a preceding prodrome is more likely with syncope. 

Step 2: True Vs Symptom Syncope

Now it’s time to figure out if it’s true syncope or symptom syncope. Patients with true syncope typically lack any symptoms and after the syncope occurs. If there are other symptoms to go along with the syncope, it’s instead syncope secondary to another health problem and should be evaluated for the disease that’s associated with the symptoms they’re displaying. For example, if they have abdominal pain and syncope, they may be suffering from a rupturing abdominal aortic aneurysm with syncope as a high-risk symptom. Syncope can occur from practically any dangerous disease, making being able to distinguish between true and symptom syncope a vital skill.

Step 3: Risk Of Dysrhythmia

If a patient has true syncope, the final thing you’ll want to do is determine their risk for dysrhythmia. This usually involves performing an ECG. There are 6 factors that tend to increase the risk of adverse outcomes – family history, age, heart disease, exertion, hypotension, and abnormal ECG. If any of these factors are relevant to a patient, they should be admitted for telemetry monitoring and most likely an echocardiogram.

This article was originally published on DrAdrianCohen.net.au

Using A Sphenopalatine Ganglion Block For The Treatment Of Headaches

When it comes to migraines and other primary headache disorders, the autonomic nervous system is typically involved, with the trigeminal nerve being the main nerve involved in them. The sphenopalatine ganglion is a collection of nerve cells that are closely associated with the trigeminal nerve and has connections to the brainstem and meninges through this nerve. When inflammation and the opening of blood vessels around the meninges occur, they send pain impulses through the trigeminal nerve, and in the case of migraine and cluster headaches, these pain signals pass through the SPG. A common hypothesis is that by blocking the SPG, pain relief can be produced from primary headaches by modulating the autonomic fibres involved in headache disorders. These blocks have had many positive results, but there is only so much evidence for its use in the emergency department. 

When performing an SPG block, there are several methods you can perform. The most common approaches include transnasal, transoral, and lateral infratemporal, with the transnasal approach being the easiest and most practical way of performing the block in the emergency department. This approach has a few advantages over the others; it’s a fast and safe way of performing the block, it’s easy for patients to tolerate with little risk of complications, and it’s non-invasive compared to other methods due to avoiding the use of needles. 

Technique

Performing an SPG block in the emergency department typically uses supplies that can be found in any ED. You’ll want to begin by soaking a 10-centimetre cotton-tipped applicator in local anesthetic, typically either 1% to 4% lidocaine or 0.5% bupivacaine. Next, you’ll want to make sure the patient’s head is in a sniffing position and insert the soaked applicator into the naris, on the unilateral side of the patient’s headache. Make sure to apply firm and steady pressure along the superior border of the middle turbinate. Do this until you meet resistance at the posterior wall of the nasopharynx, which is when the anesthetic should contact the SPG and anesthetize the ganglion. You’ll then leave the applicator there for about 5-10 minutes, which should result in the patient experiencing a vast improvement or resolution of their headache.SPG blocks are a satisfactory option for patients suffering from primary headaches but more studies need to be performed before they’re considered standard first-line therapy for migraines and the like.

This article was originally published on DrAdrianCohen.com.au

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