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Blocking Versus Beatitudes (Blessings)

Improv Principle #3: Avoid yes/no questions.

Improv Principle #4: Be helpful.

Building Relationships

The Trouble With Polar Questions

We continually remind students to replace “Yes, but…” with “Yes, and…” because the answer prohibits conversation flow and building relationships. Similarly, yes/no questions do the same.

Let us begin with a demonstration of polar questions. Notice how a scene stalls because of inaction.

In class, two students stood next to each other. The audience suggested a bus stop.

A:

Is it gonna rain?

B:

Uh-huh.

A:

How about them Dodgers?

B:

Yep.

A:

You been to a game?

B:

Yep. You?

A:

Yep.

(Yawning.) This scene is boring because it goes nowhere. The characters accept each offer, they agree on everything, but it’s small talk; it doesn’t amount to anything. Neither player is helped in any way. They are each in their own little world; there is no relationship.

Why? The questions require a yes/no answer that stops the action. If the questions were open-ended, that might lead to interaction that sparks a more interesting conversation and helps build a relationship.

Let’s try it again with the same suggestion: a bus stop.

A:

What’s that up there?

B:

I don’t know… but it’s coming right toward us!

A:

It’s a ... broom!

B:

Watch out!

Both: Augh!!!

See the difference? The second example has multiple, potential directions we could explore. The problem becomes interesting! The players spontaneously adapt to what was said and we see possibilities of them building some sort of relationship, if only to survive the danger.

There’s that word again: relationship. Let’s explore that for a minute.

How to Build a Relationship

You may have heard that in any good story, there needs to be a conflict to hold audience interest. That may be true, but in real life, our object is not viewer ratings, product placement, or expository journalism. In real life, we care about creating relationships. Can you imagine what it would be like if you came to work and no one said hello? If you went through your day making small talk about the weather but no one asked about you, your family, hobbies, or what you did on vacation?

That’s not interesting. That’s just sad. (It’s also a sure route to depression and burnout.) We care about the people we work with; we even care about characters on TV when we see they develop some sort of relationship. It’s the same in improv.

The way to build a relationship with someone in improv is like real life; you have common interests. That could mean you both like baseball or it could mean you’re both stuck in an elevator. It could be anything that gives you a reason to get to know each other and/or help each other. In healthcare, teams come together and are formed in a heartbeat.

We sort out who will be in charge, settle on the roles and tasks and in less than a minute, we’re ready to take care of the patient. It’s what Bruce Tuckman proposed in 1965 as the four stages of group development: Forming, Storming, Norming, and Performing. Indeed, this process is necessary to face challenges, find solutions, and deliver results.

Likewise, in improv, the “help” you offer could be to accept a scene where you’re being tormented! Just go with it and see what happens; a solution will likely occur in a way no one would have predicted. That’s the beauty of the exercises, if you keep an open mind and see what happens.

The point is that you accept all offers, ask open-ended questions (“What’s for dinner?” versus “Do you want to go out for dinner?”), and help the scene progress.

This is because in life, as in improv, you often do not get the luxury of selecting your co-worker or your scene partner, or the situation. However, in both cases, you do get to choose how to respond to the person with whom you are forced to interact.

See what happens when we apply the improv lesson of avoiding yes/ no questions and being helpful? In her book, Training to Imagine, Kat Koppett mentions the improv mantra, “Make your partner look good,” or be a blessing to someone else.20, 21

Blessing? You may ask: Why is being helpful and making your partner look good a blessing? Because onstage, as in life, if your words make a situation easy, you will not only manage to complete the task and solve the immediate problem, but chances are you and your teammates will also feel good about each other, especially if the situation was scary or dangerous. (Interesting how that Golden Rule applies, eh?)

Let’s replay that scene and see what happens when we apply improv Principles #3 and #4, avoiding Yes/No questions and being helpful:

A:

Nice day for the game. No rain in sight.

B:

Yes, and it’s gonna be hot at the ballpark!

A:

Phew, that’s right! Glad I packed a bottle of cold water.

B:

Good for you. Wish I had thought of that.

A:

Well, that’s funny, I just happen to have two bottles of cold water. Here ya go.

B:

You kidding me? You’re giving this away to a complete stranger?

A:

Well, ya know what they say ... a stranger’s just a friend you haven’t met yet!

Of course, we could have played the scene to comic effect, and had Person A pour water all over Person B. Then, Person B might have loved it, or he might have screamed, shouted, and threw a fit. Who knows?

There are as many variations as there are ideas. How might these principles look in healthcare? Let’s zoom in on a hospital scene.

Audience suggestion: The nurses’ desk in a hospital

Manager:

Good morning. Have you been reading your company emails? As of today, your report from the nightshift will be given at the patient bedside. Also, there will be no overtime given for charting after 1530. Thanks for your attention.

Nurse A:

Wait! I have to get a report from three different nurses. How do we do that?

Manager:

You’re clever. Figure it out.

Nurse B:

Excuse me! If we only know about the patients we have in our assignment, what happens when we answer a call light for someone else? We won’t have a clue about that patient’s acuity or orders.

Manager:

The break nurse will take the report when the main nurse is away. They will take care of those patients.

Nurse B:

But what if that nurse has her hands full in another room? We always work as a team!

Manager:

The administration has decided that, according to patient satisfaction surveys, they want to be included in nurse hand-off reports. This is the most efficient way to involve patients in their own care.

Nurse B:

But what about the ones who have psychosocial issues? I’m not about to tell another nurse that, “last night this patient was confused and hit me,” in front of them!

Manager:

Of course not. Use common sense.

Nurse B:

Well, then, if I understand this new system, we’re supposed to give part of the report at the bedside to include the patient and then give the rest of the report individually to the oncoming nurse somewhere else?

Manager:

I suppose so.

Nurse A:

But what about those patients who just got to sleep again? Not everybody wants people traipsing in at 0700. It’s bad enough they get woken up at 0500 for weights and blood draws.

Manager:

(looks at clock): I have a meeting. If you have questions, email me.

This is an example of a typical nurse manager speaking to their team. The conversation is fictional. However, it is an amalgamation of several you may have heard. I know I have! These types of conversations are concerning because of the obvious authoritarian and autocratic leadership displayed. The principle of being helpful is played out in transactional terms by the manager.

In improv, this person is blocking the action by negating every possible statement of concern. She is also blocking any personal relationship with her team. (She is also taking advantage of her role with status play, which will be explained in depth in Chapter Six).

If we were to rewind this scene and play it in an improv workshop, utilizing improv Principle #3, it might go something like this:

Manager:

Good morning! It’s so good to see you all. As you know, from the emails the administration has been sending out, today is the first day we rollout our new program of patient involvement in care. We had a staff meeting about this last week where lots of your concerns were brought forward. I appreciate your thoughtful questions and possible solutions.

Linda:

Yes, and it was good to know that you don’t expect every detail to be shared at the bedside.

Manager:

That’s true. We have to use our common sense here. As many of you said, some patients don’t want the staff to traipse in and bother them. Our research bears this out. According to our exit surveys, patients really just want to be kept in the loop. They want to be introduced to the oncoming nurse, when their next pain med is due, when to expect to have a specific lab test or appointment and when will the doctor arrive. (She clears her throat.)

They also want you to shut the door on the way out. (Laughter.)

Lucy:

Sorry, I couldn’t make to the meeting. Will the rest of the team get any kind of report?

Manager:

Great question, Lucy. You notice we have placed a white board over there, with the three first letters of the patient’s name, any appointment times, diet and ambulatory status, possible discharge date, and room for comments. That’s for all to see, so that when a call light goes off, you can look and see who’s who and what’s what. Thanks to Marcie for that idea. Let’s hear it for Marcie! (Gentle applause.)

Lucy:

What about the charting problem? No overtime for charting? That’s not fair!

Manager:

Thanks for bringing that up, Lucy. I am sending out an email about that today. Everybody knows it’s not possible to chart everything every day and be out on time. Don’t we all wish it were! (Nods of agreement.) So, now we ask that you tell your clinical coordinator if you had an incident after 1400 that might cause you to be a bit late with charting. Those who are new get an extra 15 minutes for the first 90 days in order to learn the software. Let’s all remember that charting by exception is the rule. Also, that a follow-up to medication administration within 30 minutes is expected. (She looks at the clock.)

Okay, I have a meeting, but I’ll check back by 1000. I’ll be around with a clipboard so I can hear your feedback on how it’s going. Other questions, feel free to email me or leave a message on my phone. Either my assistant, Carol, or I will get back to you within 24 hours. And if you’re off the next day, leave me your cell number and I‘ll text you.

In the words of Peters and Waterman from their 1982 book In Search of Excellence, this is an example of transformational leadership or managing by walking around.22 In the world of improv, this is the epitome of being helpful. The manager is open to ideas and willing to adapt to situations. That willingness to be helpful creates positive relationships and is a key takeaway in improv.

Now, it’s your turn to practice the three principles we’ve learned so far: accept, avoid yes/no questions, and be helpful.

Low-Risk Group Exercises

Exercise 3a—Sound Ball

Facilitator: Everyone, let’s stand in a circle.

Let’s count off by twos, starting HERE. (…1 - 2- 1- 2- etc.)

Everybody has a number, right?

Ok, I want all the ONES to take a step forward. (They do.)

When I tell you, I want all you ONES to find a completely different place in the circle.

Ready? GO! (They move.)

Now, reintroduce yourself to the person on either side. (They do.)

We are going to toss around an imaginary ball.

The rules of this game are simple.

FIRST, you start by making eye contact with someone else.

Next, you send an imaginary ball to that person.

You create a SOUND that sends the ball over. (Example: Whooosh.)

If you are the person receiving the ball, you must RECEIVE the ball with the SAME sound that was sent to you.

Let’s try that. (Pick a person)

_____, you make eye contact with ME and send me a ball with a sound.

(Leader receives it.)

After I receive it, I will make eye contact with a different person and send the ball with a NEW sound.

That person receives the ball with the same sound and sends it off with a different sound. Concentrate and keep your eye on the ball!

Got it? If you mess up, we will briefly CELEBRATE and keep moving on.

Let’s practice it slowly at first and then we’ll speed up.

Remember: The goal is to practice saying WHATEVER sound comes to mind FIRST.

Do NOT judge it, just let it drop out of your mouth. It takes concentration.

ALSO, if/when you mess up, we’ll all CELEBRATE, for a moment, and then continue the game.

The game is over when the facilitator raises their hand and says, “Here.”

Whoever has the ball at that time will pass the ball to the facilitator.

Debrief:

1. What surprised you about this game?

2. What was going through your mind as you threw the ball?

3. Were you judging yourself?

4. What happened when you slowed down?

5. What happened when you sped up?

Exercise 3b—The Birthday Gift

Ask for a volunteer. Demonstrate one time, for the group.

This game is played in pairs. Decide who will start. That person is the Gift-giver and the other receives the Birthday gift.

1. The Gift-giver turns away from their partner and thinks of a gift to give their partner.

2. The Gift-giver turns around, mimes carrying their gift (large, small, etc.) and presents it to the Receiver.

3. The Gift-giver must present the gift with a few words, but they may NOT tell the Recipient anything about the gift (e.g., Happy Birthday, BFF!)

4. The Recipient must “see” the gift as the first thing that comes to mind, receive it, unwrap it and graciously comment on why they like and appreciate this gift. (Do not listen to the Inner Editor!)

5. The Gift-giver accepts the offer and builds on the story.

6. Continue back and forth for a few sentences, then SWITCH.

7. Allow pairs to have enough time to be the Gift-giver at least twice.

8. At the end of the exercise, remind players to thank their partner.

Debrief:

Depending upon the size of the group, ask several pairs to share what was “given” and what the Gift-giver thought they were giving before the Recipient “saw” something completely different.

Allow players to share their aha-moments.

 

Notes

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