Let’s start with the skill of listening. A trusting work relationship begins like any other—through conversation. Questions drive conversations; statements stop them. Ask more questions. Make fewer statements.

In baseball, no matter how well you play defense, you cannot score runs while you are in the field. Listening works the same way. You can only learn by listening, no matter how good of a speaker you are. See Chapter 7 for strategies on becoming a good listener.

Cultivating Respect

The next component of trust is respect. Everyone deserves to be treated with respect and equality. To treat others equally, you must forget your ego. Humility generates trust; arrogance destroys it.

So how do you demonstrate respect? First, remember that small efforts make a big difference: use names, ask about family or experiences, offer to help, pay sincere compliments. When you demonstrate this kind of interest and acceptance, people perceive you as accepting, reasonable, and intelligent. They will know that you respect them. Figure 4-1 shows a health professional expressing genuine interest in her patients. This interaction displays the trust that you should work to achieve with every patient.

How to Instill Trust in Others

Ronald Reagan said, “Trust, but verify.” He knew that earning trust takes a long time. Trust requires honesty and competence. You will have to demonstrate both of these qualities repeatedly before your co-workers will be able to trust you. You must be honest and you must contribute to the fullest of your capacity, day after day. People want to achieve mutual trust, but we still have to earn it in the long run. Trust will develop only after you have demonstrated that you deserve it.

If you want to start building trust right away, follow the tips in Box 4-1.

Organizational Trust

Sometimes health care professionals who receive promotions have a difficult time giving up their duties, because they trust their capabilities and are hesitant to trust someone else’s standards. Even though extending trust to someone is a risk, it is essential for any health care practice to work. Co-workers must be able to trust each other to do their jobs because each role is interrelated.

In an atmosphere of trust, people share information and tolerate mistakes because they acknowledge that mistakes are necessary steps on the path to excellence. People are loyal and support one another. The environment fosters creativity, innovation, and workflow improvements. Co-workers regularly demonstrate a high degree of productivity and good morale. Figure 4-2 shows important aspects of trust.

In contrast, a distrustful environment is divisive. Morale suffers, turnover increases, and patients leave after acknowledging this dynamic. Table 4-1 compares characteristics of trusting organizations and organizations where trust is lacking.

When Trust Is Broken

Trust is fragile. It takes a long time to build it, but it can be broken in a heartbeat. Even when trust is sustained, it takes a lot of work to keep it going day after day.

If you break someone’s trust, there are only two things you can do to repair the damage. First, you must apologize. Then, you will have to start all over to slowly rebuild trust one act at a time. You will be able to redeem yourself eventually.

What if a co-worker betrays your trust? It is tempting to lash out emotionally, but it is best to restrain this urge.

Saying nothing is sometimes the wisest course. After all, everyone slips up now and then, and we usually feel bad enough without being reminded of our errors. However, if the error is significant and you feel it is more constructive to say something, it might be appropriate to calmly address your co-worker. Make your feedback easier to deliver by first calling attention to your co-worker’s strengths: “You’re usually such a great team player, Anna. That kind of behavior was the last thing I would have expected from you.”

Whether you address the situation or not, give yourself a little time to heal before attempting to mend the relationship.

It’s best to forgive a co-worker even if they don’t ask for your forgiveness. When you forgive someone, you feel better. We all make mistakes. Forgive, move on, and leave the door open to repair the relationship. After all, you have to work with this person, and it’s difficult to work effectively without trust. Forgiveness means letting go of resentment and bitterness, not forgetting. Although you may remember the incident, you are no longer emotionally affected by it.

Like a broken bone that has healed, trust that is rebuilt can be stronger than it was before it was broken. Once everyone involved forgives, the relationship can become stronger than it was before the incident. Your perception changes when you strive for forgiveness because you gain understanding of how the incident happened in the first place, and learn how to avoid similar instances in the future.

Case Study 4-1   Trust Me

Richard Fecht wasn’t even born when his father was killed in Vietnam. He had two older brothers, but they weren’t close. Richard struggled through high school and worked a series of odd jobs since graduating.

After several years stuck in a rut, Richard decided he needed to start over. He packed up the Jeep and drove to Flagstaff because he heard they needed EMTs. The training was even subsidized by the county. Richard signed on and worked at a nursing home to make ends meet.

Richard’s EMT-Basic class was a diverse group. At 40, Richard wasn’t among the youngest in his class. Most of the people were young, just beginning careers that many of them had been committed to pursuing for a long time. Once the training began, Richard started to think that being an EMT could be the solution to his lack of direction.

Richard was hired once he completed his training. The company put Richard with a different crew every few days, so he could get to know the other employees. He asked everyone he met the same questions. How long would it take to feel comfortable with the job? What did they like about the company? What was their background? He heard about memorable runs and imagined what he might have done if he was faced with the same situations.

One day, the company installed new defibrillators on each unit. Everybody received training, but some of the EMTs complained about always having to get used to new equipment. Rather than complaining, Richard picked up a copy of the training manual and familiarized himself with all of the defibrillator’s functions.

A few days later, Richard’s efforts paid off. His unit got a call from a hysterical mother. Her infant son wasn’t breathing and was turning blue. His crew started performing heart compressions as they carried the infant to the ambulance. The team wasn’t able to find a heartbeat, so Richard prepared the defibrillator. “Here,” said Richard. “We need to turn the infant key.”

“Are we ready?” one of Richard’s teammates, Rachel, asked as she grabbed the paddles.

Richard nodded. “Clear!” yelled Rachel. She shocked the infant twice and was able to detect a feeble heartbeat. The heartbeat continued all the way to the Medical Center, but it was erratic. Richard located a cable to attach his iPhone to the strip stored in the HeartStart’s memory. As soon as they got the infant into the ER, he worked with one of the emergency department technicians to download the strip from his iPhone to their main system.

Back in the unit, Richard explained the infant key to the rest of his team and explained how he downloaded the sinus rhythm strip.

“Lucky to have you aboard,” said Art, the crew chief.

Mr. Carmichael, the vice president of operations, asked Richard to develop a more in-depth training course for the defibrillator.

Questions for thought and Reflection

1. What was missing from Richard’s life before he arrived in Flagstaff?

2. What listening skills did Richard demonstrate?

3. Even though he was new to the profession and the company, how did Richard manage to demonstrate his clinical skill competency?

4. List the trust-building efforts that Richard made throughout this story.

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