Something that is often not spoken about in professional settings whether it be a healthcare or a sports performance environment is dealing with less than satisfactory outcomes. Now it is not for one moment that anyone is naive to think that they will not have negative experiences. Injuries, poor performances, form slumps, errors in judgment are common. But what happens when this occurs is often an environment of uncomfortable silences. 

And if you are like us and you care about what you do as a professional, and you care about the success of the people that you deal with in your professional setting then it can be very difficult when things do not pan out how you would have expected. This last week saw the start of the AFLW season and the biggest headlines out of the weekend were the ACL injuries sustained to a number of top flight players. To top it off for a few of them they are what we call ‘frequent flyers’. And the first thought that went through my mind was the difficulty of that situation for the players, the staff that work with them and the long road ahead. Now this is not a sob story or a cry for sympathy for any of the parties involved, I am certain that as professionals they will work as a team to get back to playing at the highest level. Plus they are fortunate, they are paid to do the sport that they love and are choosing to participate at their own risk. But I could not help but think about the awkward conversations that you have as a team when you realise that there is not going to be an easy or quick solution to these injuries. 

All of this got me thinking about whether we have enough discussions and training around situations that are probable in these settings.The uncomfortable conversations from the outset that start with the notion that there will be difficulty, their will be setbacks and expectations may not be met for much of the time in these environments. Are we constantly aware and understanding of the fact that it is not only realistic to expect highs and lows, but use language and teaching to improve the environment when they situations do occur?

A great part of my role at the moment is working and helping mentor less experienced practitioners and a key area that they often find is left out of their training is the use of language and their approach to difficult situations. Now by no means am I an expert and I still struggle with this concept on many occasions but the factor that appears to assist the situation is the establishment of understanding around expectations, particularly before things go awry.  These discussions provide the platform for maintaining open communication throughout the process.  This does not stop the conversations from being uncomfortable, but the area that it does appear to assist with is increasing trust and the understanding that you are working towards each others best interest. 

This past week as a group we spoke about evidence based practice. A concept that was developed by physician David Sackett to assist with understanding and implementing medical practice. The concept is made up of three equal and intersecting influences. The most commonly held position is that EBP is the use of literature to practice, but this is extremely naive. Although literature should inform healthcare inputs to best practice, the two other major areas that should be used to inform the approach are clinical experience and patient values and expectations. We spoke about how patients values and expectations often becomes the key determiner for whether you develop effective professional relationships and achieve satisfactory outcomes. Now this idea may seem overblown but it is simple to see in a basic example. If two patients see the same surgeon for the exact same knee injury with very similar circumstances.  And one patient wants to be pain free but does not care about returning to high level activity, whilst the other is willing to deal with managing pain, but is adamant about returning to high impact sports, achieving the exact same objectively measured outcomes following the surgery may leave one patient ecstatic and the other distraught. It is a matter of expectations. The job of the surgeon on this occasion is to have spoken with the patient at length about what they were hoping and expecting to achieve from surgery. 

We spoke about investing in people in an article before Christmas and the thought that I had watching the ACL injuries last weekend was that good outcomes are more likely in a supportive environment such as an AFL club. There is likely to be a better relationship between the staff and players than in community settings and this can only be a good thing, particularly if they have developed trust in their processes and each other.