Navigating Difficult Conversations in the Workplace

"Difficult conversations" are an inevitable part of any workplace, particularly in the clinical working environments of healthcare, often due to the intimate occupational environments we are working within and the subsequent relationships we form with our colleagues.

Whether you're conducting performance reviews, implementing performance management plans, or dealing with hiring and firing decisions, navigating these conversations effectively is essential for maintaining strong professional relationships, promoting healthy work environments and ensuring the smooth operation of your clinic.

In this article, I want to provide some practice tips, strategies, and resources for handling some of the more difficult conversations you may have in the workplace with confidence and sensitivity.

Difficult conversations often arise in situations where there are opposing interests, high stakes, and strong emotions (1). They can be challenging for various reasons, such as fear of damaging relationships, fear of confrontation, or a lack of confidence in one's ability to communicate effectively.

As I mentioned earlier, these conversations can be particularly challenging in the healthcare setting, due to the oftentimes intimate clinical settings we work in, especially in private practice as we may only have one or two employees.

Interestingly, even how we think about the conversations we have at work that may be 'difficult' can, in a way, create a self-fulfilling prophecy. If we head into a conversation with the established mind-set that it will be a difficult conversation, then our preconceived ideas & heightened anxieties may simply add fuel to the fire, and turn a potentially benign conversation into a 'difficult' one.

Whilst not an expert in HR by any means, I certainly learnt a lot from my time in the Workers' Compensation space, handling exceptionally adversarial and difficult conversations on a weekly basis. Couple this with having worked in a number of organisations of varying sizes, having been an employer and having to navigate multiple sides of difficult conversations, there's a few insights I feel may be beneficial to those who find the thought of having to have a conversation that is outside of your comfort zone at work.

Tips and Strategies for Handling Difficult Conversations

Scheduling is your friend

The best conversations are those in which both parties are able to respond and not simply react. If possible, scheduling a meeting ahead of time is the best way to mitigate a conversation driven by reaction and emotion. If either party enters a conversation on the 'back foot', there's a good chance it won't be anywhere near as productive as it could or should be.

Remember to be considerate of the other party too, anxieties run high when we're heading into a conversation, and humans definitely have a negative bias (ie: we catastrophise very easily, especially those of us with anxiety!). So, if possible you may give a brief run-down of what you would like to discuss.

For example, if you're wanting to talk to your boss about a pay rise. Simply asking for a meeting and leaving it at that might have them fretting that they've got a resignation on their hands.

A possible framing for the meeting request may be an email containing "I'm in the process of working on some personal and professional goals, and was hoping to schedule some time to speak with you to get some input from you about this. I'd also like to get some input about how you feel I'm performing/contributing within the clinic and review some goals of mine here." (remember, use your own words, this is just an example).

Conversely, if you're wanting to talk to an employee about some concerns you have regarding their work, but simply leave it at "We need to have a meeting." may have them on edge that they're going to be on the job market again very soon, especially if you're a business owner who very rarely holds any formal check-ins or performance reviews with your staff.

A possible framing for the meeting request may be an email containing "It's been a while since we've caught up properly and I was just wanting to check-in with you to see how you feel you're going in the clinic, and if there's any input/suggestions you have, or if there's anything you're needing support with." (remember, use your own words, this is just an example).

A reason I like to put forward suggestions like this, is that conversations like this should definitely be a two way street, and many of the common conversations we have (pay rises, contracts, performance etc) almost always require input and consideration from both sides.

So, after setting up the meeting what are some of the next steps?

Prepare for the conversation

• Set clear objectives for the discussion and ensure you understand the desired outcome. Essentially, what do you want to achieve from having this conversation?
• Schedule a time, don't just aim to have the conversation in between patients or at the end of a lunch break. Failing to schedule will almost guarantee neither party will get the most out of the interaction.
• Take time to gather your thoughts, emotions, and relevant information before engaging in the conversation (2). If you're running late from a consultation or traffic, you're already late, taking 30 seconds to take some deep breaths and settle yourself (at least a little bit) before going in can help immensely.
• It's not always just about you in the conversation, be mindful of the other person you are dealing with. So, again, don't ambush.

Create a safe and respectful environment

• Choose a private, comfortable setting for the conversation. Prying eyes or ears are never a good thing.
• Begin the conversation with a clear statement of purpose, emphasising the importance of resolving the issue (3). This is often why it is also a good idea to a) request your meeting and have already outlined some of what you would like to discuss, as it will already give you both an idea of the purpose of the meeting, b) it can assist you both in getting in the mindset of what you've (hopefully) prepared coming in.

Use active & reflective listening + empathetic communication

Soft skills are often the harder skills to develop. They come naturally to some, and eternally elude others.

• Give the other person your full attention and listen to their concerns without interrupting or making assumptions.
• Reflective listening is a fantastic way to facilitate meaningful and productive conversations, especially those that may be more emotionally-charged.
• Show empathy by acknowledging their feelings and validating their perspective (4). This can be hard to do in some more adversarial conversations, but try to remember that you're both likely after a mutually beneficial outcome, whatever that may be.
• Maintain a calm and professional demeanor during the conversation. Being aware of your triggers can help!
• Keep the discussion focused on the issue at hand, avoiding personal attacks or unrelated topics. Sometimes having a checklist written to refer to can help either of you refocus should things start to wander.
• Be prepared for emotional reactions and be ready to respond empathetically and calmly (5).
• If the other person becomes overly upset or distressed, it's perfectly acceptable to take a short break to allow either party to regain composure before resuming the conversation.

Be aware of your triggers

Whilst not commonly mentioned, I find this is a huge one for me.

The more aware we can be of our own body language and behaviours when we're engaging in uncomfortable conversations, it can give you a profound level of control over whether the conversation remains productive or dissolves into a dumpster fire.

When I am talking about triggers, these are things that can occur in conversations that irritate, frustrate or provoke you. Moving beyond the triggers, there's an awareness of knowing how you physiologically respond when triggered.

Using myself as an example, when I am interrupted and spoken over this can infuriate me, and whilst I don't necessarily get combative, I certainly begin t move from being a naturally agreeable person to an exceptionally stubborn stonewall. The earliest signs for me edging away from agreeableness are I find my ears get warm and I also can't recall more than one or two sentences of what the person is saying.

How I try to nip this in the bud is to kick into reflective listening.

"It sounds like you're saying __________."

"What I'm hearing is ____________."

Don't be a jerk

Whilst certainly not the most profound advice, it's possibly the most important.

There are a few things that aren't acceptable (in my opinion) regarding workplace conflicts and conversations.

• Don't ambush someone. Storming into a clinic room and launching into a tirade about *whatever the topic is* is disrespectful and can border on bullying.
• Don't interrupt. If you're wanting to have a conversation that requires a resolve (ie: almost all of the conversations we're talking about here, even termination discussions), allow the other person to speak.
• Loose lips sink ships. The conversations you have between your employee/employer should remain confidential, and not shared with the rest of the clinic/office. Failing to maintain confidentiality can have profound impacts on workplace culture, toxicity and the mental & emotional well-being of those in the workplace.

Whilst, engaging in difficult conversations in the workplace is always an area we would ideally avoid if we can, they will be essential at various stages of our careers, and are always areas we can work to improve on.

The better we are able to handle these conversations, the better we are able to maintain strong professional relationships, promote a healthy work environment and ensure smooth operations within your clinic environment.

Hopefully this article has given some insights into how you may better approach and navigate some of the more challenging aspects of working life (to save some needless anxiety and help you maintain healthy working relationships!).

As always, I'm keen to hear your thoughts. Please share your thoughts & feedback with me.

Resources for Further Reading

1. "Crucial Conversations: Tools for Talking When Stakes Are High" by Patterson, Grenny, McMillan, and Switzler - A bestselling book offering practical advice for navigating difficult conversations (7).
2. "Difficult Conversations: How to Discuss What Matters Most" by Stone, Patton, and Heen - A comprehensive guide to understanding and engaging in challenging conversations (8).
3. Harvard Business Review - A variety of articles and resources on difficult conversations and conflict resolution in the workplace (9).

References

1. Stone, D., Patton, B., & Heen, S. (2010). Difficult Conversations: How to Discuss What Matters Most. Penguin Books.
2. Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2011). Crucial Conversations: Tools for Talking When Stakes Are High. McGraw-Hill Education.
3. Goulston, M. (2015). Just Listen: Discover the Secret to Getting Through to Absolutely Anyone. Amacom.
4. Riggio, R. E. (2017). Listening and empathy in multicultural communication.
5. Porath, C. (2016). Mastering Civility: A Manifesto for the Workplace. Grand Central Publishing.
6. Kabat-Zinn, J. (2013). Full Catastrophe Living (Revised Edition): Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Bantam.
7. Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2011). Crucial Conversations: Tools for Talking When Stakes Are High. McGraw-Hill Education.
8. Stone, D., Patton, B., & Heen, S. (2010). Difficult Conversations: How to Discuss What Matters Most. Penguin Books.
9. Knight, R. (2015). How to Handle Difficult Conversations at Work. Retrieved from https://hbr.org/2015/01/how-to-handle-difficult-conversations-at-work