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8.3 What do the second messenger conversations look like in practice?

The key to having a positive ‘calling it out’ conversation is to have a structured and practiced approach that is calm, kind and compassionate, while remaining non-accusatory and non-judgemental.

Remember the principles of this second messenger system:

2 purposes

  • Care about the person you are talking to
  • Land the information

3 parts

  • Check in: ‘How are you?’ Show that you really want to check that they are OK and listen.
  • Enquire: Use and open-ended question to get their side of the story.
  • Deliver the messenger: ‘They were upset and I know that you would want to know’. Trust that they will do the right thing

Following on from a conversation discussing the principles of ‘calling it out with compassion’ recorded specifically for this module, Chris Turner went on to facilitate some role play scenarios where we put the techniques into action.

We recommend watching the next video in its entirety as the summaries below are just the tip of the iceberg. The video contains 3 scenarios, each of which is followed by feedback.

Please note that these scenarios were deliberately unrehearsed as we wanted to keep things as realistic as is possible on role plays in a virtual workshop.

These scenarios illustrate how many everyday interactions can lead to individuals feeling distressed or undermined and how the situation could have been perceived very differently by the people on different sides of the conversations. More importantly it shows that most negative behaviours are unintentional but should not be ignored.

Scenario 1

The back story:

'Sandra/Ganga is a brand new consultant in a new unit and has confided in Sarah after Sarah saw her looking very upset. Sandra/Ganga was doing a morning antenatal clinic which was running late for the 3rd week running, Mark knocked on the door as he needed the room for his afternoon clinic, when Sandra/Ganga told Mark that she had another 2 ladies to see he rolled his eyes and left then talked loudly in the corridor about how frustrated he was. Sandra/Ganga was very upset after the clinic and confided in Sarah (another consultant colleague) who then speaks to Mark as a peer messenger.'

Watch the video to see how the conversation pans out. Sarah uses the previously discussed three pillar model ‘Check in, establish their perspective, land the message’ to structure the conversation. The conversation is followed by invaluable feedback and reflection.

Please note that the name Sandra and Ganga have been used interchangeably through the scenario.

Scenario 2

The back story:

'Mark is the consultant on labour ward for the day, when he arrives for his shift the night registrar tells him that she has had a difficult interaction with the senior midwife Ganga overnight. She felt her decisions were being undermined through the shift. Mark speaks to Ganga.'

Very insightful feedback. Highlight’s the importance that hierarchy should not play a part in these conversations and potential issues that may arise when conversations aren’t truly peer-to-peer. It also re-affirms the importance of practicing and considering the language you will use and unhooking yourself from your own emotions/judgements before you walk into room regardless of how much experience and training you have.

Scenario 3

The back story:

'Mark (Obstetric Consultant) was called down to the Emergency Department to review a woman who was having a secondary postpartum haemorrhage. He had an interaction with the Emergency Medicine registrar who later told Chris (Emergency Medicine Consultant) that he had felt undermined.'

Done by the expert! Discussions surrounding how these conversations can result in good, unexpected outcomes such as service improvement. Demonstrates how ‘practice makes perfect’ but even those that do this all the time have to prepare themselves each time. During the feedback Chris touches upon the importance of having situational awareness and that if having started the conversation with 'checking in' it is clear that the timing is not right then it is ok to stop. Just 'check in' make sure the other person is ok and address the behavioural issue later (but not too late).