RASHAD: I mean, that definitely sounds like what I’m dealing with. This whole situation is just so frustrating. I just want to be able to do my job!

DEVON: This is the administration’s fault. Not yours. You don’t need to feel guilty about it.

RASHAD: Yeah, I know it’s not really my fault, but like, if it’s the administration, what am I going to be able to do about it?

COACH: A statement like “you don’t need to feel guilty” can sound supportive, but it also invalidates what someone is feeling. Consider using an affirmation that accepts what someone is feeling as valid.

DEVON: I’m sure you’ll get over it soon.

RASHAD: I mean, I’ve only felt worse over the past few days. I just keep thinking about, like, what if the patient gets sick, and maybe even dies, all because I couldn’t take the time to explain vaccination? Plus, how do I keep something like this from happening again? The only thing I’m unsure of is if it’s worth the risk of escalating it.

COACH: You suggested that Rashad will “get over it soon.” In response, Rashad felt dismissed, as though the problem wasn’t worth addressing. Asking an open-ended question like “What would help you feel better?” could encourage Rashad to explore possible solutions.

DEVON: Maybe make sure your time management is on point before going to Marsha?

RASHAD: I mean, I’ve been trying really hard to keep on track and not get behind on my cases.

DEVON: Right, I just don’t want her to assume it’s because of your time management.

RASHAD: I feel like this is a bigger issue, bigger than me and my ability to manage my time.

COACH: You suggested Rashad “make sure his time management is on point,” this implied judgment that Rashad was to blame for the problem. Consider accepting Rashad’s understanding of the constraint and suggesting positive steps.

RASHAD: But, what if Marsha thinks it’s just me not being able to handle it? Maybe I shouldn’t say anything.

DEVON: Marsha’s just gonna blow you off. We should go to her manager.

RASHAD: I mean, I’m a little intimidated by Marsha, sure, but I think she’d at least listen. Plus, I think she’d be even more upset to hear we went over her head.

DR. HILLIARD: Even if there are barriers to change, just speaking up can help resolve feelings of moral distress. Expressing concerns doesn’t have to be confrontational or risky if you approach it with patience. Draw on the resilience of your organization, work within the system rather than against it. That usually means taking appropriate first steps like going to your manager or supervisor.

RASHAD: I still think I’m gonna go to Marsha. Maybe it’s stupid, but I can’t just not do anything.

RASHAD: It’s been a few days since I talked to Devon. I’m planning on speaking with Marsha tomorrow.

RASHAD: Honestly, I didn’t feel much better after talking to Devon. Sometimes her questions felt dismissive, or even like she was blaming me. I kind of felt like she invalidated my emotions. I feel like she framed some things negatively, and then I felt even worse than before. I’m still going to chat with Marsha, but after talking with Devon, I don’t feel very confident about it.

Ineffective Dashboard Example

Overall Result: Needs Improvement. After your conversation with Rashad, he was still feeling stressed, powerless, and uncertain. He felt like he should probably do something about it, and that probably means talking to Marsha. You could have done more to prepare him to have a productive conversation with her.

Feedback on Techniques

• Open-Ended Questions
• You missed some chances to ask questions that could help Rashad address moral distress, avoid burnout, and connect more with patients.
• For example, you could have said: “What about this is making you feel upset?”
• There were a few moments when you may have reinforced Rashad’s feelings of self-doubt or powerlessness by discouraging him from reflecting or acting.
• For example, you said: “Can’t you just forget about it and move on?” Instead, an open-ended question like “What about this is making you feel upset?” would have helped Rashad reflect on his experience and find solutions.
• Affirmations
• You missed some chances to validate Rashad’s experience. For example, you could have said: “It doesn’t feel right that you can’t take time to help patients understand. That makes sense.”
• There were a few moments when you may have hurt Rashad’s resilience by dismissing his uneasiness. For example, you said: “It sounds like you’re just stressed.”
• Instead, an affirmation like “It doesn’t feel right that you can’t take time to help patients understand” could have helped address Rashad’s feelings of self-doubt and reminded him he has the support of his team.
• Reframing
• You missed some chances to reframe Rashad’s frustration. For example, you could have said: “This is an issue for everyone, and you can bring it up as such.”
• There were a few moments when you emphasized negative sentiments. For example, you said: “Maybe make sure your time management is on point before going to Marsha?”
• Instead, a reframe like “Increased case load isn’t our fault, and we need to make people aware of the negative impact on patient care” would have done more to refocus Rashad on actions he can take to improve things.

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