Role modelling isn’t just for leaders

In the third of my trilogy on ‘joy’ I will explore the things that everyone can do.  As it says in the title, role modelling isn’t just for leaders.  Firstly, everyone has the ability to be a leader no matter where your role sits within the hierarchy or structure.  Secondly we can all role model the behaviours we want to see in others including joy. Similar to our @signuptosafety twitter campaign #kind2018, there are some really simple things you can do today to bring joy to others.

Say thank you

Saying thank you is a powerful act of civility

(Kumar and Epley 2018)

We never thank people enough.  I don’t mean just the generic ‘thank you’ at the end of the shift or clinic or session.  It has to be authentic and genuine – you have got to mean it.  Research* shows that we underestimate the positive impact on others and ourselves when we say thank you.

What can you do today? Send someone a thank you message; write a text, a tweet, an email or a letter telling someone how they had helped you.  Do this in a meaningful way by being personal and detailed, explaining what they did and how it had affected you, how it had made you feel.

Be kind

What’s not to like or to lose by being kind to people?

What you can do today? Follow the people who inspire me everyday with their efforts to mainstream kindness, fairness, learning from excellence, joy in work, appreciation, and civility…:

  • Gemma Crossingham – Consultant Anaesthetist in Plymouth.  Tweet: @gemolio
  • Adrian Plunkett – Consultant Paediatric Intensivist at Birmingham Children’s Hospital.   Tweet: @adrianplunkett
  • Emma Plunkett –  Consultant anaesthetist at University Hospitals Birmingham and Birmingham Women’s Hospital. Tweet: @emmaplunkett
  • Neil Spenceley – Head of Paediatric Intensive Care in Glasgow and the Scottish Paediatric Patient Safety Lead. Tweet: @Neilspenceley
  • Chris Turner – Consultant in Emergency Medicine. Tweet: @orangedis and more via http://www.civilitysaveslives
  • Steven Shorrock – Psychologist – Human Factors and Ergonomics Blog at and Tweet: @StevenShorrock
  • Richard Taunt – Tweet: @RichardTaunt and @kscopehealth
  • and of course – the team @signuptosafety

Keep a gratitude journal

Its hard being positive all of the time, in fact I would suggest impossible.  But there is a human trait which is to doubt ourselves or to feel like nothing seems to go right.  To help, some people have found it works to keep a gratitude journal. It has helped them feel more positive about their life or their work.  Those that keep one have said it is really easy and over time the things that they feel grateful for become smaller and smaller, as in they recognise more and more the things they feel grateful for.  Some people have given blank notebooks to staff when they start a new job or a new rotation or for attendees of courses to use to keep a gratitude journal.

What can you do today? Simply jot down the things you are grateful for at the end of the day or the end of the week. Write about what you feel is great, what you are proud of, who you might want to thank, what kind act you mind want to do, as well as things you might want to do differently.

Share stories

Lisa Rosenbaum** wrote an article ‘Twitter tailwinds – little capsules of gratitude’ about the Twitter campaign #ShareAStoryInOneTweet – this as she says ‘briefly transformed twitter’ into the most wonderful collection of stories from healthcare practitioners. It describes how an emergency doctor in Oregon US – Esther Choo – shared a story and used the hashtag. This role modelling of storytelling was picked up and briefly twitter ‘lit up with stories’.

What can you do today? Share your own stories with others.  Share what brings you joy and what you are proud of or grateful for.

Don’t use incident reporting systems as threats

Sadly so many people tell me that incident reporting systems have lost their purpose.  Rather than being used to learn they are being used to threat.  This keeps the negative culture alive.  It is a significant symptom of the culture of your organisation if it is used to blame people, target individuals, prod people to prioritise your issue above others.  It is a significant symptom of the culture of your organisation if it is used to replace a simple conversation between one human being and another.

What can you do today?  Completely rethink the way incident reporting is implemented in your organisation so that it is purely about learning.  If you need to tell someone that you are not happy with their attitude or behaviour then think of a different way and if possible sit down and talk it through with them.  And Be kind to people when things go wrong….  Ask the 3 questions Sidney Dekker suggests; who is hurt, what do they need and whose obligation is it to meet those needs.

Learn from what works

Shift the emphasis from just looking at things that go wrong and move towards learning from things that go right.  Try it out. When you are in a room full of people talking about what works you can almost touch the joy.  Appreciative inquiry is a great method for shifting the tone of a conversation from relentlessly focusing on the negative.  Carrie Biddle shared a blog*** on how she used appreciative inquiry in culture survey debriefings to keep a positive focus on what people wanted to do for a better future.

What can you do today? Ask positive questions.  Ask – even when things have gone wrong, – what worked.  Ask – even when you are investigating a complaint or incident or claim, – what worked.

When you are opening a meeting or receiving a report from others or carrying out a debrief or huddle, ask what worked first.  Asking what works first sets the tone for the rest of the conversation.


*Amit Kumar and Nicholas Epley (2018) Undervaluing Gratitude: Expressers Misunderstand the Consequences of Showing Appreciation, Psychological Science

**Lisa Rosenbaum (2018) Twitter Tailwinds – Little Capsules of Gratitude N Engl J Med 379: 209-211 DOI: 10.1056/NEJMp1806737

*** Blog: Carrie Biddle (2018) Improving team culture to deliver safe sustainable services for patients – The South West Academic Health Science Network –

Joyful leadership

Every profession including healthcare has its great leaders; charismatic, high profile, some even adored. But they are not the only great leaders.  Some great leaders are humble, kind, respectful and quietly making the world a better place.

Most people, most of the time are neither saving the world nor exploiting it. [Badaracco]

The NHS is filled with leaders at all levels of the service making decisions every single moment of the day – the sum of which are a hundred times stronger than the acts of those that receive the public recognition.  These people are trying to solve important and sometimes what feels like impossible problems.  The every day problems that are messy and complicated; not having the time to do a good job, not having time to talk to patients, not having the time to reflect and think about what is working and what is not, and not enough time to sort out the staffing and resource issues everyone faces.

The every day problems are not solved by quick, decisive directives from the top, they take time in themselves.  They are addressed by leaders who build a shared purpose, engage with others and listen to their staff and patients.  Because the every day problems may not go away quickly then there is an imperative to make the day to day as joyful as it can be.  It calls for perhaps a kind of ‘joyful leadership’.

What does joyful leadership mean? 

These leaders pays attention to creating ‘joy at work’.  They also pay attention to the way they behave and how they want others to behave.  This includes being humble, kind, positive and respectful.  Many may assume that positive leadership is ‘nice’ and weak, rather than necessary and courageous.  That it might get in the way of getting the job done.

People had this lazy opinion that he’s too nice and they see kindness as weakness, but it’s the most unbelievable strength if you use it in the right way

This quote is about Gareth Southgate in a recent article in the Guardian found here. (I know I am picking up on the much talked about world cup here but its too good a quote to not share it).

Creating ‘joy at work’ is not just about having fun as the term suggests, although it doesn’t preclude having fun it is far more than that.  For me it is about really caring about your staff, taking the time to find out about them and helping them build on and make the best use of their strengths.  It is about helping people work well together and working things through together, respecting everyone’s views as equal.  Successful leaders do not just think they should be caring and kind they intuitively are.  It is crucially about how to help people find the precious resource of time.  To make dedicated time for people to work on things they enjoy together.  It is also about saying thank you and creating a culture of positivity in the workplace.

I have never felt the need to be an aggressive leader, never felt the need to be punitive or to bully people into doing their jobs.  I have concentrated on being me, its much easier being you than trying to be something or someone you are not.  And being me is to be kind, being me is recognising that I don’t know everything and that I need people around me who can talk to me, share their ideas and their concerns and who will know that I will listen to them.

Bringing ‘joy at work’ also fits with ‘Safety II’ which as you know is all about learning from when things go well.  Identifying what works also means that you can see how brilliant the people around you are – which then leads to a lot of saying thank you and celebrating what they are achieving every day.

Safety does not happen if you are negative, shout at people, blame people, keep telling people they must stop making mistakes.

I have come to believe that safety or as we prefer to call it ‘working safely’ is so much more that projects, QI, or safety improvement programmes or even necessarily new ideas, and innovations.  For all (patients and staff) when things go wrong – as Sidney Dekker says – it should be about finding out who was hurt, what they need and whose obligation it is to meet that need.  And as Eric Hollnagel says safety is about finding out what works as much as what doesn’t, replicating and optimising what is already working and removing blame from error.

For us in the Sign up to Safety team, working safely is about:

  • good leaders who listen, who care and who set the tone for their organisation
  • everyone wanting to learn, wanting to be curious about how things work
  • people who can expertly investigate when things go wrong using human factors, behavioural and safety science
  • all of us developing the kind of relationships that we all want to have where we are able to speak up, be heard and be listened to

Working safely is ultimately about the way we behave.  It helps if you are kind, respectful and supportive of people.  For me kindness, listening, empathy and creating joy at work will take you further than anything else.


Joseph L Badaracco JR, (2002) Leading Quietly Harvard Business School Press