July 2012: Trade-offs and Sacrifices

The large intravenous catheters that routinely deliver medication, nutrition, and fluids to patients in intensive care units have saved millions of lives.

At the same time, bloodstream infections originating from these medical wonders result in thousands of deaths per year.  In fact, so-called central-line infections account for at least 30 percent of the 99,000 annual hospital-infection-related deaths, according to the best estimates available.

Most of the infections can be prevented.  A single measure – better hand hygiene by nurses, doctors and other caregivers – would greatly reduce these deaths.  (It’s a chilling reality that caregivers wash their hands in only 50 percent of the advised circumstances).

Hospital administrators regularly conduct seminars on patient safety that emphasize more vigilant hand-washing.  Many have installed sinks and soap dispensers in every hallway of every floor to encourage more frequent scrubbing.  But their pleading and safety investments have not eliminated the problem. Care-providers sometimes forget to scrub with soap, and patients continue to die from central line infections.

If patients keep dying, why haven’t hospital administrators discontinued the use of IVs in intensive care units?

Because, while not optimal, using IVs offers a sensible trade-off.  The devices save many more lives than are jeopardized.

This situation mimics leadership.  In the complicated world of customer complaints, relationship challenges and business deals, the artificial categories of wrong and right melt quickly away.  Leaders rarely have the luxury of a “no brainer” decision.

Navigating the murky waters of leadership favors not the cocksure, but those who make use of trade-offs and sacrifices.

Trade-offs

Trading off means giving something up in order to get something back in return.

In my organization, we offer clients a trade-off that is sometimes accepted and sometimes refused:  value in exchange for risk.  We demonstrate innovative strategies and skills to partners or leadership teams by employing the actual relationship challenges of participants as fodder. Real-life scenarios are exposed in front of the entire team.

This is risky because it’s personal and sometimes nerve-wracking for some leaders to reveal their experiences to colleagues.

At the same time, in-the-moment addressing of live issues consistently delivers the greatest relevance.  When participants not only hear good ideas, but see the ideas applied to actual dilemmas, the learning value expands.

Is there a risk associated with open disclosure in a group?  Yes.  Is open sharing always a good idea?  Of course not.  But reaping the highest benefits often requires a robust risk.  A “safer” process increases comfort but decreases value.  Sometimes, it makes sense to take the less risky route and accept more modest gains.  It’s a trade-off.

Sacrifices

Trade-offs involve letting go of something.  Sacrifices raise the ante by requiring the giving up of comfort.

I recently had the privilege of visiting the D-day beaches at Normandy, France with my son, Nick.  One of the caretakers at the American Cemetery near Omaha Beach related this story:  Last year, an 89-year-old man, walking with a cane, visited the cemetery to say goodbye to a childhood friend killed in battle in 1944.  He made the arduous trip from Oregon to France to keep a promise made 67 years earlier to his friend’s mother.  He promised the mom he would personally say goodbye to her son on her behalf.  The hardship of that trip required sacrifice.

Many years ago, my long-time friend and former teacher, Dr. Jim Zullo, told me about a visit with his elderly father, who was then suffering from constipation. “I undressed both of us, walked my dad into the shower, and relieved his constipation with my fingers,” he said.  What a moving example of sacrifice.

Most sacrifices are not that dramatic.

Sticking with a strict diet involves sacrifice, as does giving up a golf outing to attend a wake.  Major life commitments – college and professional degrees, marriage, parenting, large purchases and all entrepreneurial ventures – cannot be honored without daily sacrifices. The defining element of a sacrifice is saying no to something prized, desirable or comfortable for the sake of a greater good.

Leaders who are in tune with trade-offs and sacrifices accept that life is not fair, organizations are never perfect and all leaders are flawed.

A path to reflection

This reality-based approach encourages those in charge to accept risks and limits as necessary life/work companions.  This is a far cry from the shallow chants of “You can have anything you want!” and “Failure is not an option!”

A willingness to sacrifice leads to a path of deeper reflection, where the sages of the great spiritual traditions speak a quiet, unified message: life is full of uncertainty, and what is tightly held onto will soon pass away.

Once parents, presidents, principals and partners really get that, they can make trade-offs and sacrifices with the wisdom and joy that accompanies voluntary discomfort.