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April 27, 2010

“I am knowledge worker”, says the Janitor

On a post from a while back Andrew Gent spoke about the different types of knowledge workers: generators, brokers, consumers. And for the KM strategy to reflect these groups, rather than one-size-fits all. Peer-to Peer-tools for knowledge generators and the assumption of best practices for consumers…Andrew says:

 "The outsourcing of support is an example of the latter, where the assumption is that the knowledge pre-exists and anyone — even someone for whom English is a second language — can be taught to give the right answers. Here documenting the "right" answers is the primary focus."

Where’s there to go next when you have squeezed all the efficiencies you can out of a process…all that’s left is to be able to sell these skill-based processes as a commodity.

Thus KM being about best practices, rather than supporting knowledge generators.

Andrew highlights the problem here:

"But strategy does not equal reality. What happens in the field often does not match the suppositions of headquarters. And unfortunately — or fortunately, depending on your point of view — knowledge management has to deal both with goals and realities if it is to succeed […] management closest to the field demands support for what is and those at a global level demand support for what is desired."

And then gives an example:

"…there is a significant gap between what can be documented and what happens "on the street"…the case of Xerox technicians who were bombarded with printed information (i.e. "answers") but struggled to solve customers’ problems until they were connected through a community so they could exchange tricks of the trade learned through experience. Almost an exact replica of today’s managers pushing "best practices" to the exclusion of other KM activities."

NOTE: Another example is the knowledge economy of the World of Warcraft.

In this black and white view KM supports strategy (and for any social content to be aligned to strategy), rather than the needs of employees…then you wonder why no-one is motivated to share anything.

Andrew warns to not fall for the lure of strategic alignment:

"KM must stick to KM — actually managing knowledge — not falling for the lure of "strategic alignment". By laying the proper foundation of technical support for collaboration, goals and incentives for individuals, and KM policies and procedures that align with business processes rather than specific, short-term business targets…"

I’m not going to get into "best practices" in this post, but I really like how Andrew puts KM into two camps, the new camp being about support, sense-making (also innovation and learning). This is the place where sharing happens due to enabling intrinsic motivation, and a focus on social capital…basically a distributed way for people to source help and connect with others…making the workers life more empowering, less frustrated…and more engaging.

Bas Reus ponders this:

"It can be the manager that tries to make others only work harder instead of really making them really more responsible for what they do, or it can be the employee that feels like not having enough resources or information he or she needs, or to feel more involved."

Emergent practices

And speaking of emergent practices, lessons applied and the importance of context and conversation, have a read of Nancy Dixon’s post on the eradication of small pox.

Agents in the field applying what they learn daily to what needs to be contextually practiced rather than the top-down generic practice, is a great example of perpetually evolving practice. We need to be able to adapt to the complexities of our situation. If this was done today, the agents could report their experiences in the field using blog posts and comments, and the perpetually changing practice can be updated in the wiki…very agile.

The knowledge worker and routine jobs

A while back the Anecdote blog mentioned that we could do without the term knowledge worker, as even routine jobs require some element of dealing with context.

I agree. Yes a brain surgeon may have to improvise a whole lot more, and use their head a whole lot more, and possess lots of knowledge, way more than a janitor…but this doesn’t mean the janitor is a robot.

This thread has picked up again. A post by Joe McKendrick headed me over to a post on the Big Shift blog, called Are All Employees Knowledge Workers?

The authors are saying something similar to the Anecdote blog post on the false dichotomy that the term knowledge worker creates:

“We increasingly group the people in our firms into two classes: those who have knowledge and talent and, by implication, those who do not. This segmentation is misleading and damaging to firms in the long run.”

The authors say that routine jobs still require thinking:

"When executives focus on "knowledge workers", they lose sight of the fact that even highly routinized jobs require improvisation and the use of judgment in ambiguous situations, especially if the goal is to drive performance to new levels. Many of these improvisations require interactions with one’s fellow humans. Consider the company receptionist. When people walk in the door, or "dial 0 to reach an operator," the receptionist has to engage in a delicate and sophisticated "improvisational choreography," one in which professional competence has to come across through "interactional proficiency.""

We are all knowledge workers…we think and improvise, use heuristics, rules of thumb, and workarounds to get things done…humans are great at self-organising themselves around exceptions to processes, and improvising where processes don’t exist.

The example of the Janitor

Even a janitor’s routine work needs some improvising, see the article Turning a Janitor into a Knowledge Worker.

This article is about micro-managing vs autonomy and leadership…giving the worker some decision-making responsibility as they know their context and local conditions best in order to make an effective and timely decision. Not only does it make for a more agile and responsive organisation, but the worker is more engaged as they have impact on how things are done…they are not just a robot.

In this fictional example the routine work of the janitor is not adapting to mess that is being generated of late due to some new work that is being carried out in different frequencies and parts of the building. The CEO tells the supervisor to cut cost costs and improve quality…the building is too dirty.

The supervisor does a clever thing and gives the janitor some decision-making responsibility…to basically give priority to dirty areas on any given day. As a result the CEO is happy because there are less complaints, and it’s due to the janitor following his own practice.

The supervisor also included the janitor in meetings with sales reps. Where the janitor communicated some issues like wax build up in corners and long waits for the floor to dry between cleaning and waxing, which the sales rep could remedy with different products.

In this story we see that top-down rules and micro-managing are just not adaptive enough, and that localised decision-making and improvisation not only improve agility, but also engagement.

The Janitor and social interactions

Barry Schwartz in his TED presentation refers to Hospital Janitors. It really is a brilliant talk.

Below are some of my transcripts, some bits are verbatim:

Janitors job duties involves no social interaction

Yet when a psychologists interviewed Janitors, they were surprised to hear these contrasting anecdotes:

  • Mike stopped mopping the floor as Mr Jones was out of his bed getting exercise, building strength walking up and down the hall
  • Charlene ignored supervisor orders and didn’t vacuum the visitor lounge due to family members taking a nap
  • Luke washed the floor in a comatose young mans room twice because the mans father who had been keeping a vigil for 6 months didn’t see Luke do it the first time, and his father was angry

The discretion and autonomy of local decision-making of the janitors role improves the quality of patient care.

These janitors think these human interactions (kindness, care, empathy) are an essential part of the job, yet their job description does not reflect practice (reality).

These janitors have the moral will to do right by others, and moral skill to figure out what doing right means.

A wise person knows when and how to make the exception to every rule…janitors knew when to ignore their job duties in the service of others.

Janitors say is takes lots of experience to learn the human interaction part of their job. Experience and time spent with people is important, learning to improvise, try new things, occasionally fail and learn.

"Real word problems are often ambiguous and ill defined, and the context is always changing. A wise person is like a jazz musician, using the notes on a page, but dancing around them, inventing combinations that are appropriate for the situation and the people at hand."

I’m going to revisit this presentation on a future post about excessive rules, best practices and incentives which decrease the quality of moral skill.

More

Michelle Martin reviews Matthew Crawford’s book, which poses whether white collar works get to be creative and think as much as they think they do:

"Ultimately, Crawford maintains,  we are blinded by the idea that freedom to make small decisions–deciding which letter to send to a disgruntled customer or which medication to prescribe after following the decision-tree–is somehow real "thinking," when in fact these merely give us the illusion of problem-solving and independent decision-making. In reality, many knowledge workers are as bound by  quotas, rules, policies and procedures as any factory worker. True creativity, innovation and problem-solving has been leeched out of many of these jobs. At best, creativity for most knowledge workers occurs on the edges."

Mark Gould also posts about Matthew Crawford’s work, which gets into the difference between manuals and practice. The context of situations call for hunches, heuristics rather than rules.

This post was meant to be about knowledge workers, but as you can see it gets into territories such as leadership, autonomy, decision-making, engagement, best practice, context…

Mark Gould’s perspective that I’m sure we all agree with:

"Perhaps knowledge work is actually too easy for people to engage with it properly. By documenting processes in excruciating detail, organisations have simultaneously suppressed creativity and innovation, and created the conditions for inadvertent (but inevitable) error and failure."

Let’s finish off with this quote by Marshall Goldsmith that perhaps encapsulates this whole thing:

"Knowledge workers can be defined as people who know more about what they are doing than their managers do."


May 18, 2009

Sensemaking, PKM and networks

In a past post I elaborated on social networks like Twitter as being a Help engine; an alternative to a search engine in some cases in finding answers and making decisions.

I also paralleled this concept to the aims of KM, productivity, performance, sense-making, decision-making, etc:

“I think it’s getting us closer to the KM productivity (sense-making) aim that knowledge sharing and knowledge transfer has always aspired to, which is:

  • finding the right information at the right time
  • re-frame that information to be usable in your context and situation
  • by connecting you to a social network of people you trust who will be willing to help out in a reciprocal relationship
    (which also helps out in the re-contextualising process as you share a common wavelength or level understanding with people in your network)
  • learning organisation, information re-use, and corporate memory”

And one thing I missed out is “adapting”.

This is how it goes:

I’m after some information and people to help me out on an issue or some research

I perhaps search my network (strong and weak ties), or I may search the entire network (potential ties)

If no go, I then post a question to my network

A response may point me to someone or a piece of work, or the response may be from the person I need to talk to

If I have a strong tie, this is good, as we already know about each other and share some context

Through conversation in real-time or via the online network/blog we are able to probe, clarify, re-frame the information that is usable for my context. The conversation and perhaps related blog entries may reveal lots more peripheral information than what’s included in a report. The blog entries will have the work in progress, thinking out loud, workings out of the report, that may include, approaches, styles, and bits and pieces that trigger thoughts for my situation.

From this interaction we have information/knowledge transfer.

When I act upon this information we have knowledge creation.

The results of this interaction remains for the process to repeat itself.

In this way the same content is able to be mutated or re-contextualised, on a perpetual basis.

We are not precisely re-using a piece of information, instead we are re-blending existing knowledge by connecting and conversing. It’s not about re-inventing the wheel, it’s about making a new wheel using some of the concepts of the other wheel.

Rather than “best practices”:

  • codifying
  • storing solutions
  • wiped of context in order to be applicable to many situations
  • getting people motivated to do this after the fact
  • hoping it’s worthwhile in people one day seeking this information
  • hoping it doesn’t expire
  • less adaptable and less chance of innovation as the best way is already prescribed
  • not really a method to elicit and create new knowledge

We instead turn to our “network”:

  • timely information
  • probe/clarify
  • re-contextualise
  • trust the messenger as you have a history
  • willingness to help as you have a reciprocated relationship
  • peripheral information (not apparent or shared in a report)
  • tapping into tacit knowledge to understand what’s behind the approach or how it comes together
  • adapt to our situation
  • creating new knowledge
  • interactions that blend into new knowledge may lead to innovation
  • build a relationship/contact for ambient awareness and future help
  • each interaction makes your network richer and feeds the core network

What does all this mean?

It means I’m not lost, it means I have a framework in which to makes sense of my situation.

It means thoughts and concepts have a chance to emerge, it’s means being adaptable.

This type of knowledge flow and creation is more close to the aims of KM rather than a storage approach.

My approach to social productivity on the web needs to also happen in the same way in the workplace.

Enterprise federated search is a good step to search across silos, and personalised/customised pages is a good way to create your own dashboard, but it’s not enough…

When I research material for a blog post, most of the time I know where to look as I recall information passing my radar. I have ambient awareness of what’s happening…that piece of information when I saw it meant nothing, but now it has value as I have a need for it.

I can search my Google Reader, browse my delicious/slideshare bookmarks, check out my previous blog/tumblr posts and perhaps ask my Twitter network for help.

This is my personal information/knowledge management (PKM) environment and this personal and social productivity orientation helps me work more efficiently and effectively.

This online participation model is not enterprise 2.0, it’s social computing, but it may one day be the catalyst for enterprise 2.0.

We can never have complete KM, instead we have PKM nodes that are connected in a network.

I came across Nick Milton’s blog the other day, and one of his posts that speaks a lot of truth, says something I don’t agree with:

“So for me, PKM is a sign of failure of corporate KM. If you get corporate KM correct, you don’t need personal knowledge management, as all knowledge management will be collective, giving the individual access to far far more than their personal store.”

To say you no longer need PKM is to say you never need to create new knowledge or learn…it’s like saying you have traveled every path, and moved every move possible to encounter anything new.

The issue is that what’s happen in the network (PKM nodes) is not feeding back into the procedures. The PKM is the spring, KM the bottle…without spring you have nothing.

“It’s easier to reorganise your personal information habits, than it is to change the culture of a company. It’s easier to be personal, than it is to work in community. But for me, working KM as a personal issue just does not deliver the value. It may give the individual more efficient access to information and documents, but it does not give access to better knowledge.”

This above paragraph is true if you treat PKM as nodes on their own, but if you connect these nodes into an open network, then you don’t just have access to people and then knowledge, in your interactions you are creating new knowledge. This is doing KM bottom-up, empowering people to do KM without even realising it.

I’d also add that you don’t change the culture of the company, you create conditions to make a difference in an individuals experience. You give them an environment where they can more easily sensemake, and eventually this node connected environment will bring about a culture change without realising it…we hope…but it has to be a naturalistic approach.

“Now I know that many people develop PKM habits out of frustration. The information they need is not readily available through the company, or through the community, so they build their own stores. But as soon as the content of those personal knowledge stores starts to drift away from community knowledge, then all you are doing is introducing information and knowledge silos at the level of the individual.”

Again this is a true observation, but the problem is not PKM, the problem is not being connected.

At work we use a blog for our support team to post about tips, tricks, error solutions we encounter. I post in this blog for memory management (yes on many occasions, I have encountered the same problem 3 months later and forgot what to do, and consulted the blog…booyah.), and for others to also benefit. This is a reciprocated relationship, so we all gain from each other. If we don’t know answers we ask in the forums.
My next goal is to refine the process, by perhaps having a few people mine the blog and forum for a solutions wiki. The blog and forum are as it happens, and the wiki can contain the cream the floats to the top. The wiki will bring things together on topic pages.

Anyway, what we are doing here is leveraging on each others PKM, and we have created conditions for people to do some of the PKM in an open and shared place. Not only that but as a result we have interactions eg. comments, etc… that make it even more valuable.

We needn’t go on, but this ecoysystem has not only sensemaking benefits for the individual, but has self regulation and recognition (incentive) built in.

In all it’s not that I don’t agree with all of Nick Milton’s post, it’s more that the solution is a bottom-up connected network, rather than PKM not existing at all.

Nick adds a good comment:

“There’s a great methodology that Shell Drilling use, called Drilling the Limit, where Drilling teams seek out all existing knowledge of drilling a well in a particular basin, and challenge themselves to step out beyond the performance benchmark. This is a very powerful process, all the more powerful by being worked collectively as a team, and being based on a full knowledge of what’s been done in the past. That way the tensions are resolved.”

All that “existing knowledge” came from recognised PKM, ie. actioning PKM. This is why social computing is not just about bottom-up, there is also a facilitating factor of taking the good stuff and feeding it back into processes and procedures.

So yes, it’s essential to look at past methods, but it’s also essential to ask people for timely information, where you can re-frame the context.

And what if you are drilling a new basin, then a PKM network enables you to adapt to uncertainty and new situations. You ask people before taking on the exercise. You then use forums and blogs during the exercise to capture and mull over as it happens, and then perhaps if this will be a repeatable endeavor a good practice is drawn up.

Steve Barth also has his thoughts in his post, Does Corporate Failure = PKM?. I personally like one of his past posts on PKM.

“Personal KM explores how expertise and effectiveness scale up to organizational value with a focus on the capabilities and contributions of each and every knowledge worker. PKM starts with individual priorities and processes that lead to self-organization in the workplace with values, skills and tools to build stronger teams and networks from the ground up.”

“Successful companies know they have to evolve. Executives consider knowledge worker productivity to be a priority for bottom-line results. Knowledge workers need to make informed decisions, but then they need to translate decisions into successful actions.”

Here’s some Twitter conversation on PKM networks or click here:


johnt: disagree http://snipr.com/huqpe I think PKM in a socnet builds culture as it's networked + gains momentum, scales http://snipr.com/huqym
about 4 days ago

yurial: @johnt wrt PKM: agreed. PKM = what you know; networking = who you know. That's a winning combo.
about 4 days ago

johnt: @yurial @markgould13 PKM is greater than sum of it's parts b/c of network aspect-macro emergence of K-flow from micro PKM habits @stevebarth
about 4 days ago

stevebarth: @johnt @alevin, Personal #KM =Failure? Would you say that Citizenship means a failure of Government? http://bit.ly/4gKrW
about 3 days ago

johnt: @stevebarth workers do pkm using web2, if make avai enterprise wide we connect all workers in a network @alevin
about 2 days ago

stevebarth: @johnt Please define “do P#KM ” as u see it. (140ch or less!). For me much more than searching/saving, no? Your learning/collaborating style.
about 2 days ago

johnt: @stevebarth 4 me key is 2 create conditions 2 help PKM,+4 it 2 connect in2 KM big picture-like spirituality(bottom-up) vs religion(top-down)
about 2 days ago

stevebarth: @johnt excellent! sign me up
about 2 days ago

johnt: @stevebarth agree with u, most of km is macro result of pkm..always need pkm 2 adapt,a km is never complete
about a day ago

An example of a help network

I’m finishing off by coming back to the start of this post about a help network and making sense of things by accessing people in your network.

This simple Facebook status update is just a natural use of the system, the person asking the question (Chris Saad), does not consciously think he is doing KM, it’s just embedded into being a participant…something I pondered at the end of this post.

This example would be even more poignant if the Chris was clarifying and contextualising by having a comments conversation, and something else it doesn’t reveal is that personally this conversation is of interest to me as I will soon need to draw on this information (I’m getting the benefit for free).

Anyway, this simple open conversation with people you trust in your network is on par with the aims of KM suggested in the beginning of this post.

Facebook as a Help Engine
SOURCE - Click image for larger size

[ADDED 31/05/09: Sense-making with PKM, see my comment…

“Defintely agree. PKM is like sensemaking and everyone does it. But now we can do it in the open, and not only that but we can do it in a connected and networked way.

aggregated PKM is not the same as social PKM.

This section of Boyd’s law fits perfectly here:

http://johntropea.tumblr.com/post/41954985/connected-people-will-naturally-gravitate-toward

‘On a work basis, businesses today want it (or think they want it) both ways. They want their employees to be personally productive, making the classic logical error that if everyone is highly productive personally then the company will be. Nope’”]

May 5, 2009

Birthing and midwives : stories, facilitation and decision-making

It’s funny, I just finished reading a book that has nothing to do with my usual interests, but yet it relates so much. This put a smile on my face as what I’m learning is not confined to a bubble, I’m learning the essence of things that transfer, relate and apply to anything in life. Which suits me fine as parenting is just around the corner ;)

Men at Birth, Edited by David Vernon

“I read the standard birth texts…they told me about the physiology of birth. They told me how things should work and a bit of why things worked they way they did. They told me about ‘normal’ labours, ‘normal’ pelvis sizes, normal ‘contractions’ and ‘normal’ women. Unfortunately the texts use the term ‘normal’, when they mean the mathematical term ‘mean’, ‘median’ or even ‘mode’. But I found all the talk about ‘average’ births to be unhelpful because I knew from friends and family that every birth is an individual experience.”

“Interestingly, I found it was the birth stories that really gave me a handle on birth. They told me the practical things from an individual’s point of view and they told me how it felt for a woman to give birth. They told me about real experiences. There were no ‘normals’ here. Amd the stories told me how things did work, and sometimes differed from the textbook statement on how things should work.”

“These stories were not attempting to meet the rigours required of a textbook. The stories left it up to the reader to decide what the ‘take home message’ was from each story. For me, the stories made our upcoming birth all the more real, all the more exciting and something that we really looked forward to.”

What I got out of it is that midwifes are facilitators in uncertain situations.

No two births are alike, and nearly all births don’t fall on the planned date.

Every “mother to be” is different and the midwives both have to deal with people and their situation. They don’t know what to expect as they have not seen the “mother to be” going through a birth, either has the “mother to be” if it’s their first (even if it was the second or third baby, not every birth is the same anyway, so not even the “mother to be” knows how she will react to new circumstances, especially in different environments).

The “mother to be” can tell them their plan, but they don’t even know themselves what’s coming.
The midwife also has to deal with the surrounding environment, and the actual birth itself. When all this comes together, it’s a very unique situation, so the job of the midwife is to go with the flow and facilitate.

No best practice method or text book is going to teach a midwife these subtleties, but the multitude of stories and of course actual experience are, as they deliver the uniqueness of experiences.

Reading a hundred stories, and attending a hundred births is going to do wonders to their ability.

Not only because these stories are the antithesis to “normal” or “average” or “best”, in that they cover so many different contexts and situations, but also because stories leave more of a memorable imprint in our minds (something to do with visual, narrative and emotion).

This post is about facilitation, pattern-recognition, decision-making, sense-making, context, uncertainty, narrative, adaptive behaviours in relation to birthing and midwives.

They learn to respond and adapt to uncertainty and rapidly changing situation (real rapid, by the minute).

These stories and experiences imprint a pattern in their mind and attach an emotion which has great impact for recall, and to also be able to take fragments from different stories and blend them to the situation at hand.

Stories have know-how woven in pattern form which is in tune with how our brain best functions.

They are more aware of the thousands of different things that may happen at a birth - what fails, what surprises, what’s available at hand (eg having to think on the spot to facilitate a birth in a toilet) - a text book ain’t gonna cover this.

David Snowden refers to this, and I have posted about this concept:

“…we live in a world subject to constant change, and it’s better to blend fragments at the time of need than attempt to anticipate all needs. We are moving from attempting to anticipate the future to creating an attitude and capability of anticipatory awareness.”

David Snowden from the same article:

“…we have demonstrated that narrative assessment of a battlefield picks up more weak signals (those things that after the event you wished you had paid attention to) than analytical structured thinking.”

This applies to Gary Klein’s work on decision-making via Erich Nehrlich:

“The situation is evolving constantly, and an expert will know which elements are important to follow, and which are not. The expert has been in a situation enough times before that they can mentally simulate what should be happening, and recognize when things are deviating from their expectancies, which is a sign of danger. Another good example: a fire commander goes into a building for what he thinks is a regular kitchen fire. As he’s scouting around, he realizes that it’s not behaving like a normal fire. It’s too quiet, and too hot. He doesn’t like it, and pulls his team out of the house. A few moments later, the floor of the house collapses - the fire was actually in the basement. He had no idea that there was even a basement, but his experience let him know that something was wrong, and that he needed to figure out why the situation diverged from his expectations before he continued.”

“…how experts “see the invisible” (because they know what signs to look for), generate a course of action, mentally simulate the results of that action, and then carry it out”

Mark Gould has more on decision making and how it relates to KM:

“…what impact does KM have on people? Exactly how will they be better at decision-making as a result of our work?

My instinctive answer is that I want them to become experts (and therefore able to act swiftly and correctly in an emergency) in whatever field they work in. That means that we should always return our focus to the people in our organisations, and respond to their needs (taking into account the organisation’s direction and focus), rather than thinking solely about building organisational edifices. The more time that is spent on repositories, processes, structures, or documentation, the less is available for working with people. In becoming experts in our own field, we also need to be more instinctive.”

Brad Hinton on Dave Snowden’s pattern recognition:

“Snowden explained how human decision-making is based on pattern recognition. Our brain sees multiple fragmented patterns assembled to fit our needs in particular contexts. In decison-making, our brain makes a first-fit pattern from which we act.”

Steve Barth on decision-making and intuition:

“Even at the level of the expert or the executive, the human brain is capable of reaching conclusions and finding solutions to difficult problems by using and trusting “gut” feelings. When these decisions are based on deep background knowledge and experience, intuition can be just as effective a tool as analysis—and considerably faster.”

Erich Nehrlich on stories and memories:

“Stories are how we structure our memories. If you ask me about what I was doing on June 25, 1994, I’d say, “Um, what?” But, when you prompt me that that was the day that my friends Brian and Jen got married, I’d be able to tell you all sorts of details about that day. Our memories are not filed like a computer’s, with dates and times. Our memories are filed like del.icio.us, with tags on various memories that are associatively linked in a spaghetti-like fashion.”

David Weinberger on the knowledge creative:

“Implicit knowledge isn’t explicit knowledge that we’re not currently thinking about. Implicit knowledge isn’t there the way ore is buried. It’s “there” only in the sense that we can generate it when required. Most simply: That we can come up with an answer doesn’t mean that the answer was lying dormant in us all along. Answering questions is a creative act.”

David Snowden also refers to this:

“Critically fragmented material can combine and recombine in novel and different ways, a form of conceptual blending”

Text books will have a plan and the writing will be focused on achieving that goal. But stories don’t have an outcome to achieve, rather they are in the moment, they are raw, you hear lots of peripheral information and many other things that would not be included in a text book as those things may seem unnecessary or excluded as they are tangents or just the fact that they don’t belong in the narrow focus of the outcome. But it is infact these nuances that all come together to paint the holistic picture…just ask a detective :P

In contrast

What did I learn from the stories about hospitals and obstetricians?

They abide by procedures and processes that do not cater for the individual person. The “mother to be” is just a number, she is the average person, she is homogeneous. The system runs like a factory, it runs on control and risk management.

They are certainly not a facilitator, they are dominantly in control. They treat the mother as if she were the “fictional average person”, use medical interventions where not necessary, and need her out of the baby factory as quick as possible eg. inducing, episiotomy, epidural, vacuum, forceps, caesarian…

There is also something called the “cascade of interventions”, which refers to an intervention to fix a problem the previous intervention caused, and so on.

Whereas the midwife has continuity of care - she has a relationship with the “mother to be” from start to even after the baby is born. The midwife facilitates the situation, she interferes as least as possible, it’s seen best to let a natural approach arise as much as possible. This approach is more in tune with human behaviour and the natural dealings of the world, they are there to re-tune the situation where needed so it realigns itself and does it’s thing naturally, rather than take the force of control, overriding nature.

I guess they surf the biodiversity of the situation rather than try control the biodiversity itself, which is an oxymoron.

When you think of it, this approach is empowering for the “mother to be” as the midwife is facilitating her to reach her human potential, rather than taking over.

Of course all this translates into the workplace with leadership and a more self organising role based organisation.

Listening, respect, trust and sharing

This leadership role and knowledge worker empowerment are great conditions for knowledge sharing and transfer…especially listening skills.

Years ago, part of my wife’s Counseling diploma included some work experience, so I decided to tag along with her and did telephone counseling for 6 months (every Saturday). Our role was to tie people over and support them till they could get their usual help. The first thing we learnt is that we don’t give advice, instead we listen and support, just being there spoke volumes.

Of course lots of people wanted advice and solutions to their issues, but we were there to support them, trying to create an environment so they could see their issue and solve it with some guidance (like probing, triggers, re-framing questions, seeing same issue from someone else’s perspective)…much more empowering, much more personal ownership.

And of course lots of people just like talking, it’s like I wasn’t even there, then at the end of the call they would thank me. I think “listening” is the greatest thing we can do (for me it’s sometimes hard to sit back and not offer advice), but offering little building blocks so people create their own answer (or co-create) is much more effective. They now have a skill and may use it to adapt to new situations, or riff off that skill.

The more you listen, the more you are respected as people like to feel heard. Further to this their transactions with you lead to them being empowered, so there is something about you that is improving their life. And I think this type of transaction or relationship leads to trust. When we trust and respect people we want to do things for them. Ultimately this leads to sharing, and a high chance of transfer in what is being shared since we have come to know each others way.

And then there were the suicide callers. Having a framework is helpful with these calls, it keeps you grounded, but you still freeze, and the only way you can best deal with them is hearing stories and experiencing them. There is no time to search for a best practice when the person on the other end of the line is fading away. You have to immediately react, and somehow fragments of memories all come together into a decision.

Why am I writing about this?

My wife is expecting our first child in a couple of months and we plan to have a home water birth. We believe hospitals are only for sick and injured people, and this my wife is not.
But, if during the birth my wife displays signs of risk to her health and the baby, that the midwife cannot deal with, then we will transfer to a hospital.

For some interesting points of view on “birthing” in Australia, here’s a link to an episode of an audience based TV program called Insight. You can watch the episode online, get a transcript, see the comments, and also view the Cover It Live post program chat. Or download it. They are also on Twitter.

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