Power, psychological safety and pulling the cord

Differences in power are everywhere, including (perhaps especially) the office, and they directly affect Psychological Safety.

They exist for many reasons, not the least of which are org charts that put people in positions of power over other people. Further, and despite the org chart, there are organisational power differences created by longevity, expertise, personality, gender, nepotism and others.

Clearly, some differences in power may be legitimate and some not. Sometimes they are earned, sometimes granted. 

There are various ways of labelling this difference in power:

  • Power differential
  • Power distance
  • Power gradient
  • Authority hierarchy
  • Authority gradient
  • Status asymmetry.

Power differential

In some arenas, while the difference in status may be steep, the difference in power may not be. Someone on the shop floor may be perfectly able to contact and chat to the CEO, raise issues and effect change. That’s a low power differential.

By contrast, a vice-CEO may struggle to get access to, or their views heard by, their own line manager, the CEO. That’s a high power differential.

We use expressions like ‘the higher ups’ to indicate things and people that are beyond our pay scale and which reflect the obvious power differences we experience.

Some groups naturally have a steeper gradient than others. (We spoke about this a little before where I managed people from a different culture.) Malcolm Gladwell wrote about this in Outliers, discussing the status hierarchy of Korean pilots and how it affected cockpit communication. He also noted how it was resolved.

Exactly how the manager or leader navigates this differential determines much about how the team functions. For our purposes, the way this power is employed is directly related to psychological safety and, subsequently, performance, managing failure, speaking up, creativity, innovation, learning, use of discretionary time, absenteeism, turnover and so on.

Power can be a tool, or it can be a weapon.

And while the buck has to stop somewhere, meaning that your manager will almost always have more power than you, culture and mechanisms that reduce the differential, and flatten the gradient are pivotal.

Here’s why.

Implications of high status differences

“Can’t intubate, can’t ventilate”

It’s an old case , but wonderfully illustrative, and widely used for that reason.

Due to ongoing and serious sinus problems, Elaine Bromiley, 37, needed surgery. Early in the anaesthetic process, problems developed, and her airway became obstructed. The team struggled to get fresh oxygen to her lungs despite 20 minutes of effort.

Her brain was deprived of the crucial oxygen it needed, and she suffered catastrophic brain damage. While unconscious, Elaine was transferred to ICU.

She never regained consciousness and, 13 days later, died.

In corresponding with her husband, the surgeon stated “I still do not see how we could have anticipated or avoided the problems we encountered”.

Not all workplace incidents end in such tragic fashion. What happened next tells us a lot about how the team, group, or company performs.

Reviewing the incident

Mr Bromiley believed a good investigation would highlight areas of opportunity to learn. He believed there was benefit in understanding what went right, and what went wrong, to improve. That’s an incredibly useful mindset. He focused on a learning review rather than root cause, which can tend more to blame.

Subsequent reviews developed a definitive picture of events.

By four minutes Elaine was obviously blue, with oxygenation at 40%, well below the critical level of 90%. This continued for a further six minutes. Despite help, efforts to intubate Elaine failed. In the vernacular, the situation was “can’t intubate, can’t ventilate”, an anaesthetic emergency.

It was not for lack of equipment, personal or collective expertise. It was a modern, well equipped theatre and the consultants and nurses were extensively trained with deep expertise.

However, the three medical consultants persisted with their strategy, even though their goals were being blocked. While that’s a problem in its own right, the real kicker concerns the other people in the room.

They didn’t say anything

The other people were the nurses.

The nursing staff were strongly hinting at different options.

Not ‘directly stating’, ‘confronting the doctors’, ‘making it clear’, or ‘taking over’, but strongly hinting.

Two nurses claimed they knew what was needed but weren’t sure how to raise their concerns.

The consultants argued over who was the lead. One said he had lost control. There was general loss of situational awareness, particularly in relation to how much time had passed, and the seriousness of the situation.

As the surgeon said: “I still do not see how we could have anticipated or avoided the problems we encountered”.

For all the expertise and experience the team had, and it’s substantial, none of them had been trained in any of the extra-to-surgery skills they needed to prevent such an outcome.

  • Leadership.
  • Decision making.
  • Communication.
  • Voice.
  • Situational awareness.

The surgery needed a conductor to manage the orchestra’s moving parts with the ability to step back, take information from different sources, weigh it in light of what was happening and adjust on the fly.

Why didn’t they?

Q: Why challenge the surgeons?
A: Elaine Bromiley was dying.

Q: How do we challenge the surgeons?
A: Very carefully. And with genuine regard for consequent personal or career repercussions.

As we said before, some cultures have a steeper natural power differential than others. This can affect how issues are raised, such as hinting rather than direct statements or action, as Gladwell noted in his aviation example. Aviation has managed to overcome national cultural style with workplace cultural styles.

Medicine, too, has a strong hierarchy, and can override national cultural norms so that people agree on when to raise concerns. In this circumstance though, it was the how that was the issue. The nurses knew when and why, but struggled with how.

That’s the power differential at play. In this case, it hinges on implied threat and fear, rather than the cultural deference noted by Gladwell. And it destroyed any shred of Psychological Safety.

The impact of power

Consider for a moment how much power your manager, or someone senior to you, actually has.

In the first instance, they control resources, including you, along with access to opportunities, your reputation among influential people, your suitability for promotion and career development and your remuneration.

The effects of this power can then extend beyond nine to five into power over aspects of your non-work life.

Perhaps there’s a culture where overtime without pay is expected, emails or phone calls at all hours demand an answer, breaks aren’t really tolerated, and your boss’ power extends into your family time, relationship, parenting, hobbies, sleep, health and so on.

All of which is to say that if the culture doesn’t support speaking up, and Psychological Safety is poor, the costs can be significant.

Flattening the curve

The primary responsibility sits with leaders.

Leaders carry the weight of creating a Psychologically Safe environment, particularly where speaking up is needed. There are micro and macro requirements.

Micro requirements might mean some personal coaching around handling feedback, dealing with failure, communication, listening and so forth. It’s surprising how some understanding and insight here can have major impacts for people’s willingness to speak up. More on them another time.

This is not to say that action by teams won’t work and shouldn’t happen, but that they should be allowed a psychologically safe environment without having to fight for it themselves.

Systemic changes

Leaders also have more influence around macro changes such as policy change and cultural change, both of which may be needed. You can think about initiatives like suggestion boxes and whistleblower systems, but we’re focusing here on active and transparent efforts that directly target power differentials.

Aviation has developed a strict process to overcome cultural issues. The two challenge rule allows a co-pilot to make two challenges. If the pilot fails to respond, the rule gives the co-pilot the authority to assume command.

You can broaden this to crew members, surgical team members and so on. Healthcare, and in particular anaesthesiology, has adopted a similar rule.

There’s some thinking required around the issue, because you may not want an apprentice/intern/trainee taking over something they can’t handle. Maybe they have the option to call a senior for input rather than assume immediate command.

You may have heard of the Andon cord (sometimes Andon Board). This was Toyota’s literal cord in a manufacturing plant, that employees, all employees, were obligated to pull if they found an issue in production. All production was immediately halted until the issue was addressed.

Leaving things unaddressed led to workarounds, danger, defects, recalls, lost time and increased costs. Pulling the cord became the fastest and cheapest way to get things resolved. And it was an expectation, not a right, to pull the cord. You can see similarities with the two challenge rule.

It’s now a button, not a cord, but it’s the process that’s important.

There’s also the story of Paul O’Neill, who took over as CEO at Alcoa aluminium in 1987.

O’Neill chose to focus on worker safety as the route to process and organisational improvement. He immediately flipped the script, so that speaking up became the rule, not the exception. Not speaking up led to sanctions, including immediate dismissal, regardless of seniority or tenure.

Granted, he had to persist, and show he would put bite to the bark, but it immediately flattened the curve, removed fear of speaking up, and provided Psychological Safety at the flip of a switch. And he did back it up, firing a senior executive for failing to report an incident, and showing all employees that he was serious about the culture change.

It may be a listening session where the CE is available to all comers to listen to suggestions. Not a gripe session, or for personal grievances, but to identify improvements and opportunities that may get help up with line managers.

These are all ways of flattening the curve, reducing the asymmetry, lessening the gradient, and giving people the opportunity to speak up.

You may have other examples?

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