“Life is like music,” Sam observed.
I coach Sam, a healthcare clinic manager on staffing issues. His comment perked my interest. “Say more, Sam.”
“Here’s what I mean,” Sam explained. “All notes need to be heard. For example, I often compose piano music in the key of C major. If my melody includes an F major chord and I want to finish my song, I usually take my music directly to a C major chord. This transition is the quickest way to finish my tune because I hear two compatible major chords that suggest completion.”
“Other times,” Sam continued, “I move my melody from F major through E minor and D minor to C major. This progression is less direct than my usual choice. The additional minor chords also build tension in the melody. Unlike major chords that bring completion to music, minor chords keep a listener in suspension because minor chords sound incomplete.”
“Hmm, I feel a problem in the works,” I mused.
“Yeah,” Sam replied. “We want to improve customer service. When a patient calls for a prescription refill, for example, nursing assistants triage the call. Nursing assistants are authorized to renew medicine. However, if other, non-emergency health issues are identified, nursing assistants must refer patients to a registered nurse or doctor. A nurse or doc will then return the patient’s call later that day or early the next.”
“Okay, Sam, your policy seems reasonable. What’s the issue?”
“Here’s the problem,” Sam explained. “Management wants nursing assistants to follow the protocol I just described. However, assistants have different ideas of how to improve customer service. Let’s go back to my example. A patient calls to renew a prescription. A nursing assistant discovers a possible need for other, non-emergency care. Nursing assistants have recommended that a nurse or doctor immediately follow-up with the patient.”
“The nursing assistants’ request for more timely return calls,” Sam continued, “like the minor chords on my piano, created tension in our company. Immediate return calls might require additional work or create schedule problems for doctors or nurses. But, I feel that an effective solution to this issue - one that acknowledges the views of the assistants could improve customer service. And, maybe there’s a compromise such as return calls within an hour.”
I leaned toward Sam. “You’re caught in the middle. Is that correct?”
“Yeah,” Sam replied as he slumped in his chair. “Assistants have first contact with customers and they are key to effective patient management. We need nursing assistant ideas and I want their cooperation.”
“So,” I asked, “what’s blocking a stronger voice for nursing assistants in your organization?”
Sam leaned toward me. “Look at it this way. My boss and I represent clinic leadership. Organizationally, we report to headquarters. The company wants quick, low cost solutions. To use my piano analogy, we are major chords in our business. Headquarters wants us to go directly, so to speak, from F major to C major with our current patient protocol. However, when we apply a quick conclusion to a phone call and make a referral, like the major chord progression in my analogy, we are efficient in short-term patient management but ineffective in long-term customer care.”
“Think of nursing assistants, as minor chords,” Sam continued. “Assistants’ voices enrich our music. But, in a centralized leadership structure, such as ours, strong voices of the majority (the major chords) are dominant. I want to incorporate the voices of the minority (the minor chords). Unless we listen to assistants’ recommendations, we’ll miss long-term, critical patient needs and fail to achieve the vision of excellence on which our organization was founded.”
“Sam, I’m pleased to hear you deliver an eloquent argument to incorporate minor chord voices in your clinic operations. You need the tension of the minor chords. Minor chords balance the dominance and bias toward resolution of the major chords. Minor chords help you reach alternative solutions that accommodate different viewpoints. Maybe the compromise you describe is possible because minor chords are in your music? Your customers want all voices (major and minor) to be heard.”
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Richard Wilberg, MS, PLCC, ACC
Life Coach for Personal Fulfillment and Career Success
About the Author
I write personal essays, creative non-fiction, flash fiction, and self-development articles from my home in Madison, Wisconsin.