Research in the healthcare industry has found that kindness to colleagues can improve both patient outcomes and employee wellbeing. And the same principles can be applied in the legal workplace.
In the healthcare industry, there is a proven relationship between staff wellbeing and the impact on patient wellbeing. While kindness is sometimes seen as a nice-to-have rather than a fundamental, a growing body of research is indicating that kindness is essential to a well-functioning workforce.
In the healthcare space, lives are at stake. If a doctor feels unappreciated, even bullied, within their workplace, it is possible that they will not expend the optimal level of attention and compassion on their patients. The legal industry has many similarities to the healthcare industry, insofar as it is a ‘helping profession’, and an industry that features time pressure, high emotion, the dependency of the client on the attention and diligence of the professional, and the need for that professional to make quick decisions without distraction.
In 2020, the Hush Foundation, founded 20 years earlier, undertook a survey of the healthcare industry. It was early in the pandemic, at a time that the industry was under particular pressure. Of the 129 voluntary respondents, ranging from healthcare professionals and hospital administrators to patients, 96 per cent agreed that a culture of kindness would make a difference to their feelings about their work, and 94 per cent said that kindness had an impact on staff morale. Only half of the respondents agreed that their organisation actively encourages kindness.
Dr Catherine Crock AM is the Hush Foundation’s founder and chair. She says, “I think in healthcare the need for kindness is obvious because of the imperative that we have good teamwork to be able to make it safe for the patients, their families and ourselves. When there is a lack of kindness, neither the patients nor the staff feel safe to mention concerns if they’re worried. Where there is kindness, there is a readiness to share the load, and to raise concerns so that there is teamwork to come up with the right answer.”
The impact of a lack of kindness on individual psychological wellbeing is profound, Crock says.
“You actually lose your bandwidth, you can’t look at a whole situation and all its complexities – rudeness or unkindness causes a brain freeze in the recipient, so that you spend your energy trying to cope with the unkindness rather than exhibiting good situational awareness, and the consequences of that are seen in industries outside of healthcare, that’s across the board.”
In a 2021 article in the American Journal of Lifestyle Medicine, Dr David A. Fryburg reports on what his epidemiological and clinical observations reveal: that kindness and connection can measurably improve health and longevity, countering the negative biological markers of stress.
Stress is a major contributor to cardiovascular disease and suicidal ideation, and exacerbates anxiety and depression. As Fryburg reveals, workplace stress alone is estimated to cost upward of US$300 billion in the US and €600 billion in the European Union.
Kindness is central to positive relationships, trust and resilience. In the workplace, it can establish a sense of loyalty, belonging and purpose, as well as a sense of being appreciated and valued. Positive social connection is associated with a 50 per cent reduced risk of early mortality, an observation that has been explained through its effect on buffering stress. In the healthcare environment, where kindness is exhibited by the provider, patients feel a sense of connection and trust, which not only improves their satisfaction directly following an interaction, but has also been shown to improve the patient’s adherence to a healthy diet, exercise, correct medication use, and commitment to regular check-ins with their physician.
In the legal workplace, there has traditionally been a perception that competition, efficiency and productivity should take precedence over less measurable, quantifiable qualities such as kindness. However, a study in the journal Emotion indicates that kindness has a ripple effect throughout the workplace. A four-week trial where employees were targeted with acts of kindness resulted in a measurable lowering of depressive symptoms, and an increase in job satisfaction and life satisfaction.
“Understanding clients and exercising empathy and compassion comprise the heart of lawyering,”, writes legal academic Kristin B. Gerdy in “The Heart of Lawyering: Clients, Empathy, and Compassion“.
Gerdy says, “while analysing the law and using one’s intellectual skills are the key to preparation, to learning the law, to conducting legal research, and to analysing problems, once the lawyer steps into the room with the client, her understanding, empathy and compassion become equally important.”
‘While analysing the law and using intellectual skills are the key to … analysing problems, once the lawyer steps into the room with the client, her understanding, empathy and compassion become equally important.’
Empathy and kindness play an important role in establishing effective communication between lawyers and clients. Clients who feel that their lawyer understands them are more willing to provide information, including information that might be potentially embarrassing yet important to their case. Through reducing a client’s anxiety, there is an increased accuracy and relevancy in what the client tells the lawyer. Empathy, Gerber writes, can also improve a lawyer’s legal analysis.
Not some soft and fluffy thing
In healthcare, the cause of errors in medicine was not a focal point of research and reports until the 1990s, Crock says. With the release of the article “Error In Medicine” in 1994 by paediatric surgeon Lucian Leape, the workplace culture in healthcare was recognised as the common source of deadly errors.
Crock explains: “Until Leape’s reports, the cultural source of errors had not been documented, so he looked at other industries, like the airline industry, to recognise that rudeness in the cockpit between pilots could bring down a 747. So, that’s a very obvious consequence, whereas in healthcare we hadn’t acknowledged that 100,000 people in the US were being harmed in healthcare as the result of errors. When you unpack that, it comes down to communication, civility, and a lack of kindness leading to teams not functioning at their best. Kindness is not some soft and fluffy thing, it’s an important way to bind a team together and have them functioning at their best.”
As Crock illustrates, when you’re in a high-pressure environment like an operating theatre or the emergency department of a hospital, being distracted by rudeness or cruelty can affect people’s ability to focus and do their job safely. Additionally, if staff don’t feel safe and supported in raising problems – either with the circumstances of individual patients or a systemic problem – the consequences are potentially fatal and traumatic for staff and the families of patients.
‘Kindness is not some soft and fluffy thing, it’s an important way to bind a team together and have them functioning at their best.’
The Hush Foundation runs interactive plays and workshop discussions to enable workplaces to have discussions around culture, Crock says.
“We’ve worked with actors and playwrights to put on plays in the healthcare system to illustrate the nature of bullying, staff not listening to patients and underlying unsafe culture. To date, 15,000 people have been involved in the facilitated discussions, and people reveal that they have felt bullied, harassed or burnt out in their workplace. If we acknowledge this crisis in culture, we have to look at how we build a kind culture where providers are kind to each other and to the patients and families. We need the patients to be kind to the staff, too, which we really observed throughout the pandemic, especially.”
Changing the conversation
Crock says that changing an existing workplace culture begins with changing the conversations that are taking place between staff at all levels, and between professionals and clients.
She says, “The legal profession and the people who deal with it need to be having a discussion about how we make this a kind culture.”
She gives the example of a hospital where a senior staff member made it unbearable for junior staff to communicate with him, to the point that patients were put in jeopardy rather than staff seeking his expertise in emergency situations. This is a scenario that can be superimposed on the legal workplace, where junior lawyers may feel intimidated or tyrannised by senior staff who are already feeling overwhelmed by their own workload.
“I’ve spoken to the junior staff at one hospital where they don’t feel safe calling the cardiologist because they get yelled at, so they’ve allowed things to go wrong. That shame-and-blame culture discourages junior medical and nursing staff from admitting to mistakes. Later, the hospital decided to record overnight phone calls for the purposes of training. So, the consultants would then check their language when juniors rang up. That was the hospital’s practical measure to improve the culture.”
Crock notes that recording and auditing conversations may not be applicable in the legal workplace, and that measures for tracking interactions need to be customised as appropriate to specific workplace types. However, she notes, what is common to all workplaces is the agency individual staff members have to be kind.
“An individual can start with small steps. If you’re in an interaction, or you’re about to be, or you’re irritated, it can be beneficial to think through, ‘what’s going on for this other person? Are they hungry, angry, late, tired, scared?’ If you can empathise with that other person, that can prevent the situation from getting worse.”
She comes back to the point she made earlier. Kindness is not fluffy: it impacts productivity, staff retention and case outcomes.
“We’ll never get it right for patients and families if we don’t treat our colleagues with kindness. You need the mental capacity and resilience to feel supported to do your job. In the law, you’ll [also] get amazing productivity and results by looking after each other.
“An individual who begins to enact kindness in their workplace can change things almost immediately. You don’t have to wait for a better CEO or manager, or for somebody else to do a better job. You can change a team by changing your own behaviour. “