The Bridge Between Improv Comedy and Medical Improv!

BB closer Headshot3:6:2015I’ll never be a professional improvisor and don’t plan on returning to direct care as an RN. What I AM focused on is building a bridge between the transformative learning from theatre improvisation and skills we need to develop healthier relationships, teams, cultures, and systems.

My 3rd book, tentatively titled, The Medical Improv Primer:  15 Fundamental Activities You Can Teach STAT! is being reviewed now and scheduled for publication later this year.

From Chapter One:  Medical Improv as an “Escape Fire”!:

Enter the emerging field of Medical Improv! Where theater techniques and philosophies can be used to develop emotional intelligence, communication, teamwork, and leadership capacities and promise a host of additional benefits such as; managing conflict, reducing stress, and improving creativity, flexibility, and spontaneity.  All of which can permeate our cultures and the care we provide with improved outcomes and a hopeful new energy.

Healthcare professionals will be able to use it to teach basic improv activities to staff at all levels without spending a lot of time or resources.  Improvisors will find it helpful in understanding the problems we face so they can be more effective in applying their expertise to healthcare’s unique needs.

I’m also working on broader applications of improv and recently completed a 4-session pilot launch of the Portsmouth Improv Learning Lab (PILL)!  In the last session about 15 friends and colleagues tried out an activity called, Physical Phone.   It was easy to teach, incredibly fun, and potentially very valuable if framed in the context of a Medical Improv learning session.  I can use it to explain this bridge between improv and healthcare.

If you watch the video and try it just for fun as we might do in improv, I’m pretty sure you’ll have some. If you use it as a Medical Improv activity, facilitate discussion with these talking points: Click To Tweet

  • What would happen if the communication was more complex?
  • What if we added some interruptions to the process?
  • What if the environment included sound effects like phones ringing, overhead pages, IV alarms?
  • How might it relate to issues we face with communication in “Handoffs”?
  • How could we improv communication in this process?

If you try it, I’m pretty sure people will enjoy the experience and walk back into their Improvoscopy logo draft NO wordsclinical environments with less tension, more awareness and skills associated with effective communication, an appreciation for their own and each other’s limits, and maybe even some ideas about safer “Handoffs”.  (You can bet if they come up some they will be much more committed to trying them in a collaborative way!)

If you try it with a group of friends or staff let me know how it goes and what kinds of learnings you experience!

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Thank You Delta Airlines & Emma Baum: Your Stand about Civility is Critically Important!

Boundaries for appropriate behavior are being tested everywhere in the USA right now.  Regardless of who you voted for,  appropriate i.e. respectful behavior is an expectation that we must all be responsible for.   This means clear expectations and ‘no innocent bystanders‘.  We need to do this in healthcare to address bullying and in our society for the same reason and at every opportunity.

It is NOT OKAY to say the things that the male passenger on Delta Flight 248 on 11/22/16 said while standing up shouting and raising his fist.  It is threatening, disrespectful, and rude!

Delta Flight 248-11/22/16 Passenger's remarks & physical demeanor are bullying behaviors! Click To Tweet
  • “Donald Trump, baby! We got some Hillary bitches on here?”
  • “Donald Trump! It’s your president. Every goddamn one of you. If you don’t like it, too bad.”

His remarks and physical demeanor are bullying behaviors!

A BIG shout out to Emma Baum who video-taped and put up on social media this guy in action and for Delta Airlines for setting clear expectations for behavior on Delta flights! She is the perfect example of someone willing to step up and address poor behavior and Delta, albeit with a delay, responded in a healthy way!  You realize if they just ignored his behavior, they would be condoning it and that would NOT OKAY either!

Delta issued the following statement regarding Flight 248 from Atlanta to Allentown, Pa., on Nov. 22:

“We are sorry to our customers who experienced this disruption. We have followed up with the teams involved and all agree that this customer should not have been allowed to continue on the flight. Our responsibility for ensuring all customers feel safe and comfortable with Delta includes requiring civil behavior from everyone. The behavior we see in this video does not square with our training or culture and follow up will continue so we can better ensure our employees will know they will be fully supported to make the right decisions when these issues arise.”

–Delta CEO Ed Bastian



Posted in Assertiveness, Communication in Healthcare, Complexity in nursing, Diversity, Healthy Workplaces, Patient Safety | Tagged , , , , | Leave a comment

How Will a Trump Presidency Impact Nursing?

BB closer Headshot3:6:2015As a systems’ thinker and communication expert, I believe that in this moment of time we are seeing two complex adaptive systems that are interrelated and in chaos.  One based on the old paradigm of relationships where having power over others is prevalent.  This one is collapsing.  Hard to tell because right now it is still very powerful as evidenced by Trump’s behavior and the large numbers of people who voted for him.

The other is a new system where having power with others, a collaborative approach to relationships is emerging and is evidenced by the even larger number of people who voted for Clinton.  While I have faith in the emergent system and the huge number of people in the USA who believe in sharing power, equality, inclusion, democracy, and collaboration, I have no idea how long it will take for this system to become stable or the dying one to become impotent.  Or how many will suffer along the way.

President-elect Trump is a Theory X kind of leader! Click To Tweet

I see Mr. Trump as representative of the old dying, but still powerful kind of leadership.  If you are familiar with Theory X and Y management styles, you’d recognize the former in his behavior and language thus far. Dominant and abusive, it is the kind of power that led to and sustains  our toxic hierarchies. His behaviors along with the large number of people willing to overlook them, lack of ability to recognize them, and/or feeling justified in approving of them create dynamics like those we see in healthcare organizations where cultures of blame or bullying exist.  It isn’t good for patient safety, staff morale, patient experience, teamwork, or quality improvement initiatives.  We know this!

So to answer the question about Trump's presidency impacting nurses is... Click To Tweet

Some nurses will continue to be afraid to speak up, some will be punished for speaking up, horizontal and vertical violence will continue in places and all of these behaviors will be reinforced by Trump’s leadership.  No doubt there will be additional suffering for patients, families, and all of us trying to provide safe, compassionate care.

What can we do?

Be assertive! Assertiveness, i.e. respecting self and others is especially challenging in the face of aggression.  And it is key to forming this new collaborative system.   I call upon all nurses who understand and practice assertiveness, those who are learning to be more assertive, and those who teach them to develop this skill to be vigilant.

  • Speak up for any clinical concern you see or think you see.
  • Speak up for your patients, your colleagues, and yourself to ensure compassion and respect.
  • Find kindred spirits.  Not to exclude others, but rather support you.
  • Speak up against horizontal and vertical abuse every possible time.
  • Validate others’ points of view even when you disagree.
  • Use inclusive language and curiosity to help others feel safe.
  • Keep yourself healthy in body, mind, and spirit.  (It could be a long ride!)
  • Help patients and families feel safe to express concerns.
  • Share your stories with “Confident Voices”.  (This can be your platform to share challenges and successes. email me if you have an idea or questions:

These ideals will help you become part of the new system while contributing to safer, kinder care and a healthy career.

Also, I find comfort in Margaret Wheatley’s message to decide who you/we want to be in this world and create “Islands of sanity”.  Not because it can stop the old system from collapsing, but just because it is the right thing to do.  If you’re looking for more about this I recommend her book, “Lost and Found in Our Brave New World”  and this 25 min vimeo for



Posted in Communication in Healthcare, Complexity in nursing, Diversity, Healthy Workplaces, Holistic Health, Nurse Entreprenuers, Nurse Leadership, Patient Advocacy | Tagged , , , , | Leave a comment

Rape Culture and How to End It

by Jane Moore

Photo via Pixabay by Ryan McGuire

Photo via Pixabay by Ryan McGuire

Rape is an epidemic, not to mention one of the top causes of drug addiction. The scars are invisible, and the resulting trauma can never fully heal. Even if you’ve never physically done the act, it’s possible that you’ve been a propagator of the rape culture in some form. From nonchalant comments in conversations with our friends to the media we absorb, we tolerate the degradation of women and write off the uncontrollable overly aggressive sexuality of men and accept it as the norm. Whether you are guilty of this mentality or not, it is never too late to change your mindset or become an advocate for change. There are ways to combat the issue.


It is crucial to understand what it is you’re fighting for. Here are some of the terms that float around when this subject surfaces:

Rape Culture: A term that was coined by Feminists in the United States in the 1970’s that was meant to imply the ways in which society blamed victims of sexual assault and normalized male sexual violence. Here are some other ways to phrase it.

Consent: permission for something to happen or agreement to do something. Consent doesn’t have to only pertain to sex. You have a right to say no in any situation, be it a pinch on the cheek from your grandmother or the pranks and horseplay you’ve been subjected to over the years. It doesn’t always have to be verbal either. There are plenty of signs or gestures to suggest consent, like a hand signal or a squeeze of the hand. And while we’re at it, just because the conversation is framed around needing female consent, men have a right to say no, too.

Sexual Coercion: When a partner doesn’t ask in a way that welcomes no as an answer, or hears no and pressures or makes you feel guilty about it

Long Term Relationships

The fact is, most sexual assaults are committed by a friend or acquaintance, not by a stranger. And just because you’re currently in a relationship or have been with someone for a long time doesn’t mean you can throw consent out the window. After the initial sparks fade away, you begin to realize that one person’s sex drive is higher than the other. It is difficult to distinguish between compromise and lack of consent. Here are some ways to differentiate between the two:

What Consent Looks Like:

  • Communicating throughout the entire process. Ask permission to do something rather than assume it is okay, even if you’re in the heat of the moment.
  • Respecting that when they don’t say “no,” it doesn’t mean “yes.”
  • It’s not always the guy’s job to initiate, and the girls are not always the only ones that might want to take things slow.

What Consent Does Not Look Like:

  • Assuming that suggestive clothing, flirting, or accepting a ride is a sign that anything goes.
  • Saying yes, or not saying no, while under the influence of drugs or alcohol.
  • Saying yes or giving in because you feel too pressured or afraid to say no.

Red Flags In a Relationship:red flag

  • They pressure or guilt you into doing things that you don’t want to do.
  • They manipulate you to feel like you “owe” them.
  • They react with sadness, anger, or resentment if you say “no” to something.
  • They ignore your wishes and don’t pay attention to nonverbal cues that show you’re not consenting.

3 Ways to Dismantle Rape Culture

  1. Name the real problems: violent masculinity and victim blaming go hand in hand. Instead of asking about the victim’s sobriety or what she was wearing, ask why he thought his actions were acceptable.
  2. Re-examine and redefine masculinity: once you get to the root of the problem (violent masculinity), begin the journey to understand that rape is not a natural masculine urge. Re-frame the conversation around what it means to be a man without resorting to violence. Join organizations fighting to spread the real meaning of masculinity.
  3. Seek enthusiastic consent: rather than looking for a verbal “no” or nonverbal cues, seek an active “yes.” It takes a lot of the excuses away if every party involved assumes responsibility that your partner is into everything you’re doing sexually.
Rape culture is about blaming victims and normalizing sexual violence. Click To Tweet

Sexual violence is a tough conversation, especially when you’ve been with the same partner for a long time. It gets harder because you have grown to care about that person and you don’t want to disappoint them. But it is necessary not only to express your concerns and wishes, but to educate the masses and hope for an eventual culture change.

–Jane Moore believes in the healing power of travel. She loves exploring unfamiliar places and writing about her experiences at FitwellTraveler.

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