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Keeping Employees Accountable for Results Quick Tips
for Busy Managers 1st Edition Brian Cole Miller Digital
Instant Download
Author(s): Brian Cole Miller
ISBN(s): 9780814473207, 0814473202
Edition: 1
File Details: PDF, 3.55 MB
Year: 2006
Language: english
Keeping Employees
Accountable
for Results
PAGE ii
✓
Keeping Employees
Accountable
for Results
Quick Tips for Busy Managers
Acknowledgments ix
Introduction: The SIMPLE Approach to Accountability 1
Chapter 1. SET EXPECTATIONS 7
Step 1. Determine what your organization wants to
accomplish. 7
Step 2. Determine what part of your organization’s
success is your team’s responsibility. 13
Step 3. Determine what part of your team’s results you
will hold each individual accountable for. 14
Step 4. Determine who should write your employees’
goals. 16
Step 5. Use SMART to define each employee’s
responsibilities with goals that are Specific. 19
Step 6. Use SMART to define each employee’s
responsibilities with goals that are Measurable. 22
Step 7. Use SMART to define each employee’s
responsibilities with goals that are Action-
oriented. 26
Step 8. Use SMART to define each employee’s
responsibilities with goals that are Realistic. 29
Step 9. Use SMART to define each employee’s
responsibilities with goals that are Time-bound. 32
Checklist: Set Expectations 35
Chapter 2. INVITE COMMITMENT 37
Step 1. Be prepared to explain to your employees why
their goals exist. 37
Index 137
PAGE viii
ACKNOWLEDGMENTS
Thank you to the busy managers and professionals who took time
to read my manuscript and give me such valuable insight and feed-
back, including Rachel Cope, Lynn Jackson, Chris Kennedy, Dean
Miller, Alex Rodriguez, Wendy Shaw, and Dawn Snyder. Also,
thank you, Adrienne Hickey, for your patience and understanding
through the rough times.
Thank you, Lisa Alexander, for demonstrating to me how to receive
feedback. I’ve never met anyone so addicted to it!
Thank you, Wendy Shaw, for showing me that measurement mani-
acs can be such fun people!
Thank you, Patty Skerritt, for showing me how this stuff works in
the real world. You are one great manager!
Thank you, Garbage. I listened to you constantly while I wrote. I
bet you never imagined your music could inspire someone while
writing a business book!
Thank you, Chris Kennedy, for teaching me several important les-
sons about accountability. And thanks for believing in me, my
friend!
Thank you, Lynn Jackson, for caring enough and having the cour-
age to give me that extremely difficult feedback about the flow of
my third (and what I thought was last) draft. I love you, Sis!
A special thank you goes to my family—Logan, Heidee, Benjamin,
Gail, Wayne, and Dean. Your support, encouragement, and confi-
dence simply overwhelm me!
And most of all, thank you, Tim.
ix
PAGE x
Keeping Employees
Accountable
for Results
PAGE xii
INTRODUCTION
This book is written for the busy manager who wants to maximize
employee and team productivity through accountability.
The principles in the book are not exclusively for the busy man-
ager, however. Anyone can use them with a boss, peers, vendors,
consultants, and business partners. You can even apply them out-
side the job. Use them to hold contractors, lawyers, designers, com-
munity leaders, mechanics, your teenagers, and just about anyone
else in your life accountable.
While this book includes a process, several pieces can be used
separately. For example, providing feedback is useful in many other
day-to-day activities. Praise your son’s success in school, recognize
your niece’s efforts in her lacrosse game, or complain to a restaurant
manager about poor service.
What You Can Expect from This Book
Heavy on application, light on theory, this book focuses on how-
tos. It includes steps, tips, and examples throughout. You’ll learn
what to do, when to do it, and how to do it. What you won’t find
is a lot of theory. I’ve included just enough to validate the how-tos
but not enough to make you an expert on the subject. Busy manag-
ers don’t have time for that. ‘‘Just give me what I need to get the
job done!’’ is what I hear most from my clients, whether large or
small, for-profit or not-for-profit.
In each chapter here’s what you’ll see (and not see):
● Lots of examples. Wherever possible I’ve shown one or more
examples of the particular step or point. Most of them are
from real companies or real-life experiences.
● Some theory, but not a lot. I’ve included just enough to help
the steps make sense, and to justify their order.
● Not every possibility is covered. If it were, this book would be
several volumes long. I’ve covered the most common circum-
◆ This book outlines an ideal process that may not always jibe
with the real world you live in. I recognize this and realize that you
may not be able to follow every step presented here. I considered
trying to anticipate every possible contingency and addressing it.
Rather, I chose to trust that you wouldn’t have the title ‘‘manager’’
if you didn’t already know how to adapt or go with something that
was less than a perfect fit.
Use the steps as a model or a pattern to follow when they make
sense for you. Adjust your approach when they don’t pertain. I have
confidence that you, Busy Manager, can take what is relevant and
use that to become an even better manager.
PAGE 6
CHAPTER 1
✓Set Expectations
The Basics
1. Review all of your organization’s mission statements, vision
statements, values, strategies, goals, and objectives.
Supposing that the mother has been safely delivered, the child
separated, and the after-birth cast off, what advice have we to give in
regard to her recovery?
I have before remarked that the birth of the secundines is the most
dangerous part of labor, although not the most painful. I have now to
remark, that the real danger in midwifery does not commence until
after the whole birth is completed. Childbed fever, inflammation and
abscess of the breasts, these are the sad mishaps which we have to
fear in these circumstances, and for which I feel an anxious solicitude
in your behalf.
You may think me strange when I inform you, that I have had
more trouble in the practice of midwifery from the one circumstance
of the woman having too much mental excitement within a few days
after delivery, than from all other things combined. I am sure I am
not mistaken when I assert that I have known more accidents and
mishaps to occur from this one cause of seeing company too soon
after the birth, than from all other causes put together. So important
do I consider it for you to keep, as it were, quiet in this respect, I
should think my labor in writing these letters a hundred-fold
rewarded, if I could be successful in warning you of the danger of
over-excitement at the time when you are getting up from
confinement. As the most important advice, then, which I can give in
regard to all the subjects connected with midwifery, Do not allow
yourself to see company for many days after the birth.
“Most of the diseases which affect a woman in childbed,” says the
great Velpeau, “may be attributed to the thousands of visits of
friends, neighbors, or acquaintances, or the ceremony with which she
is too often oppressed; she wishes to keep up the conversation; her
mind becomes excited, the fruit of which is headache and agitation;
the slightest indiscreet word worries her; the slightest emotions of
joy agitate her in the extreme; the least opposition instantly makes
her uneasy, and I can affirm, that among the numerous cases of
peritonitis met with at the Hospital de Perfectionnement, there are
very few whose origin is unconnected with some moral commotion.”
Is it not possible to change the fashion in regard to this matter?
This remains wholly with yourselves; for we of the masculine gender
have nothing to do with it. Are you not all sisters? Why, then, be
offended with each other if you do not go to see the sick woman for a
whole month after her child is born. Could you not write her now and
then a friendly note, or send her some little delicacy to eat, which
would be evidence enough that you had not forgotten her? I am
aware there are among your sex a certain set of gossiping idlers, who
do not know how to kill time in any better way than to be gadding
abroad when they are least needed. If one is really sick and needs aid,
they are the last persons in the world to leave their homes; they are
good for nothing among the sick. To such women I care to say but
little, for I consider the task of reforming them a very hopeless one,
as all experience proves. Especially where a new method of
treatment, as, for example, the water-cure, is practiced, do these
twattlers gad about, making mischief wherever they go.
Bathing.—It is no new thing for a woman to be bathed, and that in
cold water, soon after delivery. It was practiced among the Romans,
and, as we have seen in another part of these letters, is still the
custom among several of the savage nations.
I need not remind you, however, that this practice has, for a long
time at least, found no place among the more enlightened portions of
our race; that instead of cold water being regarded as a most
estimable remedy in childbirth, it has been considered as a very
dangerous agent, which, in truth, it is when improperly
administered. Many of you can but too easily call to mind the old
notions which were instilled into your minds on this subject; notions
which you now know to be not only erroneous, but sadly mischievous
when carried out in practice.
More than ten years ago, and while I was yet a student in
medicine, and had never heard of the water-cure as practiced by the
great Priessnitz, I was in the habit of revolving these matters in my
mind. It occurred to me often, that if the Roman women, and the
Indian women of different nations, could reap so great a benefit as
appeared to be derived from ablutions performed soon after
childbirth, that our own females too, weakly although they are many
of them, could gain similar advantages from pursuing a like course.
It was thus that I was led, as far back as 1843, to strike out a course
of treatment for myself in these cases, having no medical authority or
precedent to go by. The result of this treatment is now, fortunately,
getting to be pretty well understood, and the merits of the new
method appreciated in almost all parts of our country. In Europe
they are altogether behind us in the improvement to which I allude.
I need not here go into any lengthy details concerning the methods
of bathing that are proper to be adopted in the parturient state. The
numerous cases which I have given will serve as a sufficient guide, I
trust, to all of you who are concerned. I may remark, however, in
general terms, that there is no need of doing any violence in the way
of a bath; and those who have not access to the personal advice and
superintendence of a physician who understands the practice, may
always act safely by washing the patient in her bed. Thus, if a blanket
or some other extra article is placed beneath her, she may easily be
washed over the whole surface, piecemeal, a practice which, though
it is neither so thorough nor useful in most cases, as it would be to go
at once into the tub, is yet a good one, and productive of great
comfort.
The Binder, Compresses, etc.—As to the use of the wet bandage,
the compresses, etc., a few words will here be in place. If a dry
bandage is ever needed as a support, the wet one is much to be
preferred to it. As a general thing, however, we put no bandage upon
the woman soon after the birth, as will be seen by reference to the
cases given in this work; we wish to change and rewet the application
frequently, and for this reason the simple compresses are the most
convenient. But when the patient is to sit up or walk about, the wet
girdle, if properly arranged with tapes to secure it, and made pretty
tight at the lower part of the abdomen, affords a good deal of
support. The wet bandage does not slip upward and get out of place
near so readily as the dry one.
It will naturally occur to you, whether the going without the old-
fashioned belly-bandage will not be likely to prove injurious to the
woman’s form. The sum and substance of this whole matter is just
this: whatever tends to weaken the constitution in general, and the
abdominal muscles in particular, must have a tendency to produce
laxity of the fibers, thus rendering the part more pendulous. On the
other hand, whatever tends to strengthen the system and to give tone
to its fibers, must have a contrary effect. Now, the dry belly-band,
even when it is so arranged as to keep its place—which it generally is
not—is too apt to become heating, and, of course, a source of debility
under such circumstances. For this reason it is plain that a cold wet
girdle is altogether better than a dry one. Nor should this even be left
on too long a time without changing and rewetting it. This should be
done, as a general thing, every three or four hours at farthest, and in
warm weather oftener.
The Repose.—Some have feared to allow the woman to go to sleep
for some hours after delivery, fearing that she might be taken in
hemorrhage as a consequence. It is possible that a patient under
such circumstances may wake suddenly with a flooding upon her,
particularly if she be too warmly covered up in bed. But by all of the
best authorities it is regarded that the sooner the woman sleeps after
she has passed through the agony of labor the better. Sleep is,
indeed, no less “nature’s sweet restorer” under such circumstances
than at other times; and it would be most cruel to deny a patient this
privilege, when it would be so grateful and refreshing to her.
Sitting up soon after the Birth.—I have proved satisfactorily to
myself, that there is great error abroad in this country generally in
regard to the parturient woman rising soon after the labor is past. It
appears to be the belief of physicians generally in this country, that it
is highly dangerous for a woman to sit up before some days after
accouchement. The common saying concerning the ninth day you
have all of you heard.
Velpeau, of Paris, who is higher authority by far than any old-
school man in this country, says: “After this first sleep—that is to say,
after the lapse of two or three hours—the patient should sit up in
bed, and take a little broth; this position seems to rest her, and
allows the lochia which had accumulated in the vagina to flow
readily off.” That is the point: it serves to REST her; that is, when a
woman is tired of lying down, both common sense and instinct
declare that she should change her position; in other words, sit up.
This very same thing I have taught strenuously for these seven or
eight years, as many of you know; and just now, while I am writing, I
find that Velpeau long ago recommended the same thing.
Walking About.—Precisely the same principle holds good in regard
to walking and all other modes of exercise as in sitting up. A little
and often should be the rule. The cases which I shall give you will
form a sufficient guide on this point.
I have known a great many more persons to be injured by
inactivity, remaining too much in bed and in overheated rooms, than
by walking about too much and too soon.
The Food and Drink.—I have but a word here to say on this
subject. The patient should begin directly after birth with the same
kinds of food and drink which she intends to use during the period of
nursing. If she is to eat fruit, which I consider good for her, she
should take it from the first. Prudence should, of course, be exercised
in regard to quantity as well as quality of food under these
circumstances.
One of the greatest and most common errors in regard to the diet
soon after labor, is that of partaking of articles which are of too fine
and concentrated a nature. The bowels tend naturally to sluggishness
for some days after confinement; hence the diet should be of an
opening nature, such as brown bread, cracked-wheat mush, good
fruit in its season, and good vegetables. It is a poor practice to keep
the patient for nine days on tea, superfine bread, toast and butter,
and the like articles. It is no wonder that women dieted in this way
become constipated, nervous, low-spirited, and feverish.
LETTER XXIX.
MANAGEMENT OF THE CHILD.
According to Dr. Churchill, then, it would appear, that the fifth and
sixth days are the ordinary periods of the detachment. The cord has
been known to remain undetached as long as fifteen days; but such
cases must be very rare.
Complete cicatrization is commonly effected by the end of the
second week. The healing powers vary somewhat in different cases.
In one case, where both the father and the mother were of scrofulous
tendency, it was a number of weeks before the healing process was
fully completed. The child, however, in the end did well.
OF STILL-BIRTH.
The child may be born still, from its not having passed to its full
period, or from various causes it may not have vital stamina enough
to enable it to live. In some cases the child is born without any
manifestations of life whatever appearing. The face is swollen and
livid, the body flaccid, and the navel-string does not pulsate.
In such cases we should not at once wholly despair of life, although
there is not usually much to hope for; yet, inasmuch as cases of this
kind are now and then recovered, they ought not to be immediately
abandoned without making suitable efforts for the resuscitation of
the vital powers.
A frequent cause of the absence of respiration in the new-born
infant is, separating the umbilical cord too soon after birth. Such is
the opinion of Denman, Burns, Baudeloque, Dewees, Elberle, etc.,
etc., and there can be no doubt that many a child has been destroyed
by this inconsiderate practice. By all well-qualified and skillful
practitioners it is laid down as a rule, “that the cord is not to be tied
until the pulsations in its arteries have ceased;” and this any person
of ordinary understanding, and without medical knowledge, can
easily ascertain, by simply taking the cord between the thumb and
forefinger.
In consequence of the neglect of this rule, Doctor Dewees tells us
that he had reason to believe he had seen several instances of death,
and this of a painful and protracted kind. “And that this is probably
one of the causes of the many deaths, in the hands of ignorant
midwives and practitioners,” this author observes, “we have too
much reason to suppose.” The practice with many is, to apply a
ligature to the cord the instant the child is born, without any regard
whatever to its pulsation, or the state of the child’s respiration.
Treatment.—In the cases of asphyxia, to which I have referred,
various methods of treatment have been adopted, some of which are,
no doubt, valuable, while others are meddlesome, and worse than
useless.
If the child is livid and dark-colored, it has been recommended to
abstract blood. This is best done at the umbilical cord; that is, by
separating it. If the blood will not flow, it is recommended to strip
some blood from it. It is, however, admitted that, in general, very
little, if any, can be obtained in this way.
It has also been recommended to apply a cupping-glass to the
umbilicus, so that by exhausting the air from the part the blood may
be brought into motion, and thus made to flow, and this even after
the heart has ceased to act. I know of no author, however, who has
succeeded in this method.
The object of abstracting blood in any of these various ways is to
set the vital fluid in motion, and to relieve the congested parts. But it
appears to me that there is a far better method than this, and that is
simply by friction with the wet hand. The child has in no case too
much blood; it is only in the wrong place. The wet hand does not at
all injure the skin; the cold water—for cold only should be used here
—acts as a stimulus to the vital power, and the motion of the hand
and the pressure will set a hundred-fold more blood in circulation
than the mere separating of the umbilical cord could do. Hence it is
that I would depend much upon friction, and very little, if any, upon
the abstraction of blood. This latter practice is destined to become as
obsolete in time, as that of bleeding in a severe injury or shock of the
system—a method which has deservedly gone out of date among all
scientific practitioners of the medical art.
In conjunction with the measure which I have just recommended,
there is another of importance, which should be faithfully made; and
that is, an effort to excite the respiratory function by artificial
inflation of the lungs, and compression of the chest with the hands,
so as to imitate in a measure the natural acts of inspiration and
expiration. In doing this the operator must apply his mouth to that of
the infant—the latter having been first freed of the mucus that
attaches to it—at the same time closing its nostrils, and endeavor by
a moderate but uniform force of expelling the air from the mouth, to
fill the lungs of the child. As the air is thrown into the lungs, the
chest of the child must be allowed to expand as much as it will; and
then, as this act is discontinued, the chest should be compressed a
little, carefully, so as to imitate the natural motion of these parts.
Authors disagree as to the amount of force allowable in forcing air
into the lungs of a new-born child. Some have recommended a
“forcible insufflation,” while others contend that such a practice is
fraught with danger to the child. It appears from a series of
experiments that have been made in France on animals, and from
observations relative to the human subject, that no very great force of
insufflation is necessary to rupture the delicate air-cells, and cause a
fatal emphysema of the pulmonary structure. In sheep, and in the
dead human subject, the air-cells were ruptured by a force of
insufflation not greater than that which may be made by a person of
ordinary respiratory vigor, without any very violent effort.
To obviate the unfortunate accident of rupturing the air-cells of
the lungs, the air should be thrown into the respiratory passage
through a silk handkerchief folded double, or a fine napkin laid over
the mouth of the infant.
In all cases of retarded, impeded, or suspended respiration
immediately after birth, care should be promptly paid to the removal
of the viscid mucus, which is usually to be found lodged in the mouth
and throat of new-born infants. In some instances the quantity of
mucus is so great, and its quality so tough, that it is believed the child
could not possibly breathe if the obstruction was not removed from
the parts. In all cases, therefore, if there appears to be any difficulty
whatever in regard to respiration, it is best to remove this mucus by
means of the finger, surrounded by a handkerchief or piece of soft
linen. If there is reason to believe that the mucus is also lodged in the
throat and beyond the reach of the finger, it has been recommended
that the child should be turned with its face downward, and the body
raised higher than the head. In this position, the child’s back,
between the shoulders, is to be patted with the hand, and its body
gently shaken, so as to disengage any matters that may be lodged in
the trachea, and permitting it to flow out of the mouth by making
this the depending part. At the same time, if the back is rubbed with
the hand wet in cold water, the stimulating effect will aid in the
expulsion of the offending cause from the throat.
Infants are sometimes born in a state of asphyxia, when, instead of
lividity and swelling of the countenance, there is the opposite
extreme, the face and surface of the body, generally, being pale,
exhibiting a want of vitality. In such cases, it is of the utmost
importance that the cord be not divided too hastily; on no account,
indeed, should this be done until the pulsation has ceased. The viscid
mucus should at once be removed from the mouth and fauces by the
methods before mentioned; and it has been recommended to apply
brandy, spirits of camphor, hartshorn, etc., to the mouth and
nostrils, with the view of exciting the respiratory function. It is
doubtful, however, if such articles do any permanent good whatever,
and they are certainly liable to harm. At any rate, it is better, I am
confident, to sprinkle cold water upon the surface, and to make
friction with the cold wet hand. This will set the blood in motion, and
aid the vital powers incomparably more than the stimulants
mentioned.
It is also advisable in these cases, if respiration is particularly
tardy, to inflate the lungs carefully, according to the method before
recommended. But the applying hot brandy, flannels wrung out of
hot spirits, etc., which have often been used on such occasions, are
worse than useless, and ought never to be resorted to.
Infants, in this condition, should not be given up too hastily.
Numbers of cases have happened in which a half hour or more has
elapsed before respiration has been established. Even a much longer
period than thirty minutes has transpired in some cases before the
breathing has been established.
The time will come, probably, when electricity will become so well
understood as to enable us to make it a valuable agent in cases of
still-birth and suspended animation. In the present state of
knowledge, however, it is better, I think, to depend on the stimulus
of cold water, frictions, and the other means to which I have already
referred. But great care is necessary in the management of all such
cases; and I have no doubt that many more infants have been killed
by too meddlesome and injudicious management, than have been
saved by the use of artificial means. The tendency in cases of this
kind always has been to do too much. It is one of the greatest
acquirements in art to learn when not to do.
WASHING AND DRESSING THE CHILD.
I have a few words to say here on these topics; but I must refer you
to my Treatise on Children for a much more full and explicit
explanation of them than the limits of this work would admit of. You
can all of you who have need obtain that work, I trust; and surely,
after you have borne a child, you will feel the greatest interest in
learning all that it is possible for you to know respecting the best
modes of rearing it.
In general terms, then, I remark, that a child should, soon after its
birth, be carefully cleansed by means of pure water and the addition
of a little mild soap. The water should not be either too warm or too
cold; a moderate temperature, as from 70° to 80° Fah., will be found
best. The child should be carefully washed, I said; and in all that is
done in handling it, you should remember that it is a frail, delicate
thing. Nor need I hint to a mother that inasmuch as some one had to
perform all of these small yet multiform offices for us, so should we
be willing to perform them for others.
The dress should be loose, and merely sufficient for the purposes
of warmth. The child should not be in any way bound with its
clothing; nor should a binder or bandage be used.
LETTER XXX.
HYGIENE OF NURSING.
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