Strictly Clinical
  • How to Listen Like You Mean it

    Author(s): By Thomas Davis, CRNA, MAE, Lt. Col. (ret)

    At the core of feeling valued and respected is the perception of being heard by leadership, that “my opinion matters.” Ergo, effective leaders listen.

    Leaders who listen are positioned to build productive teams. According to the Harvard Business Review analysis of employee engagement and productivity, employees are 31 percent more productive with 37 percent higher sales on average when they are happy or satisfied. Building a happy, satisfied team of employees is multi-faceted and based on the worker’s perception of being valued and respected. At the core of feeling valued and respected is the perception of being heard by leadership, that “my opinion matters.” Ergo, effective leaders listen.

    Writing in magazine, author Samuel Edwards offers 6 tips for enhancing employee satisfaction. At the top of the list is listening. Edwards emphasizes the importance of listening when he says, “By listening to your employees, you show that you respect their opinions and truly value them as part of the organization.” The same can be said of the importance of listening to your clients as evidenced by the 2013 report issued by CMS that indicated 6 in 10 patients stated that they were not listened to or respected. Satisfaction is enhanced by Value and Respect. Sound familiar?

    In a recent Prosynex online webinar for CRNA leaders, we discussed listening as a powerful tool for leaders who are intent upon building a productive team and preferred workplace. We had a stimulating dialogue regarding the levels of listening, after which, we reviewed techniques for improving listening skills. Below is a summary of our discussion of the three articles covered in the webinar.

    The 5 Levels of Listening

    Team members seek the attention of the leader and want to share personal or professional thoughts with the expectation that they will be heard; if the leader’s mind is elsewhere, both people walk away empty.  In our first article from the Black Swan group, Derek Gaunt notes that there are 5 levels of listening:

    Level 1: Listening for the gist — The listener’s mind is elsewhere while the person is talking. The listener may nod and say, “ya, ya” as the person talks but very little is absorbed. If the listener is texting or checking email while talking, the speaker is tuned out.

    Level 2: Listening to rebut  — The listener is actively preparing a reply as the person is talking. The listener is more intent on defending his/her point of view than learning about the issues motivating the talker. The listener learns nothing new and the talker walks away feeling invalidated.

    Level 3: Listening to logic — The listener is aware of both the words that are being spoken as well as the logic driving them. Without the need to be defensive or rebut the talker, the listener is able to learn new information and gain insight into the speaker’s point of view.

    Level 4: Listening to emotion —  The listener is aware that many issues emerging to the surface are triggered by emotion. Moving beyond the logic of the points being made allows the listener to observe body language and voice inflection that may reveal any underlying emotions, such as fear or anxiety, at the core of the concern.

    Level 5: Listening for the greater world view — The listener walks away with an awareness of the foundational values that the speaker. During the conversation, the speaker may leave clues about whether he/she is liberal, conservative, religious, financially responsible and many other basic personality traits.

    Our consensus during this part of the Prosynex discussion was that “most leaders tend to listen at levels 1 and 2.”  But, by semi-consciously tuning out, or consciously rebutting a speaker, the leader shows disrespect and misses a valuable opportunity to connect with team members. Avoid assuming a defensive posture and move to the preferable next step of listening by attentively tuning in to the logic behind the other person’s words.  Effective listening is respectful and empowering for both parties.

    6 Ways to Become an Effective Leader

    We pursued this pithy discussion by reviewing 6 tips for becoming a more effective leader as suggested by author, Glen Llopis, in Forbes magazine.

    • Show that you care. Have a physical presence with your team and take an active interest in their concerns. When people talk to you, give them your full attention and never allow yourself to be distracted with mobile devices while listening.
    • Engage yourself. While you are interacting with your team, ask members for their opinions. Many people wait until they are asked before sharing.
    • Be empathetic. Problems affect people on a personal level and an emotional one. Commonly, issues are either triggered by emotions or the issue triggers an emotion. Either way, learning to sense the subtle non-verbal signs that accompany a person’s words will increase understanding and reinforce the perception of being heard.
    • Don’t judge others. One of the quickest ways to cut off dialogue is to tell the other person that he/she is wrong and why. If you don’t have all the facts, pre-judging ensures that you won’t get them. Listen attentively even if you think the other person is wrong.
    • Be expansively mindful. Put the other person’s words into the context of their environment, personal background and emotional state. Imagine how you would look at a problem from the other person’s point of view.
    • Don’t interrupt others. Just like being judgmental, interrupting will shut the other person down. You know what you know, and nothing new is learned by interrupting and stating your point of view. Resist the urge to be the expert leader and be the expert listener and learner instead.

    The giants in leadership agree: Employee happiness and sense of self-worth affects their commitment to the job and ultimately, productivity. It is no accident that effective listening will enhance scores in 6 of the 12 identified on the Gallup Q12 employee engagement survey. Effective listening is at the core of effective leadership. Show each member of your team that he/she is valued; be a listening leader.


    Tom S. Davis, DNAP, CRNA, MAE, is the former Chief of the Division of Nurse Anesthesia at The Johns Hopkins in Baltimore, and former Chief CRNA at (Baylor) Scott and White, Main OR in Temple, TX. Col. Davis, USAF (Ret.), is well-known throughout the Nurse Anesthesia community for his leadership in clinical anesthesia, including developing the first distance education model while on the graduate faculty at Kansas University Medical Center. Recognized for his expertise in team-building across department lines, Tom is a sought-after speaker, educator, author, and leadership trainer. Follow @procrnatom on Twitter.