Baccalaureate 2019 – Kenneth Sharpe

Baccalaureate 2019 – Kenneth Sharpe


– Thanks Rick. Thanks to you all. This is your last class at Swarthmore, and mine too. And I find myself doing one of my least favorite things, with some of my most favorite people. Lecturing, to a huge class
instead of puzzling with you in small discussion groups. One puzzle in putting
this together was this. Many of the most important
things that you’ve learned at Swarthmore are things that
you may not know you learned. A second puzzle is this. These things can’t be taught by giving you reading assignments and lectures, so how am I gonna teach this class today? So here’s an article. (audience laughing) That we might have discussed together had I been allowed to
assign it before class. (audience chuckling) This is from The Journal
of Nursing Management. It’s called The Making of a Nurse Manager. It’s by Cathcart, Greenspan, and Quin. Let me give you a synopsis, then we’ll just imagine that
you’ve actually read it. It’s about Matt Quin, a young professional recently promoted to nurse manager at the intensive care unit, the ICU of cardiac surgery of Brigham and Women’s Hospital in Boston. He’s headed out the exit
door after a long day of exhausting work. He doesn’t know that on the next floor, a crisis is brewing in the operating room. The surgeons can’t stop the bleeding of a 20-year-old woman because
of blood thinner medicine she’s been taking. Her kidneys won’t clear it
’cause they’re not working. They desperately need the
new hemodialysis machine that Quin’s intensive care unit has, and someone who knows how to operate it. So as Quin hits the
automatic exit door button to get home from work,
he hears the charge nurse at the desk behind him say into her phone, oh no, we don’t do that in this unit. Our management stopped us
from doing that years ago. Quin says to himself, put your head down, keep heading out the
door, you’re so close. But he turns back. It was just something inside me, he said, that did not feel right
leaving for the day. The nurse reassured him,
it’s nothing, take off, enjoy the afternoon. We can take care of it from here. It always works out, you know that. Quin pressed, what was it
that we don’t do anymore? She tells him what the OR wants and explains it’s no longer
policy to send the machine down and an ICU down from the
ICU down for this purpose. Quin is taken aback, and lets her know. She quickly pulls together
a group of other nurses in the unit to support her. They say, it’s unsafe
to practice hemodialysis with our new piece of
equipment in a new environment. Quin remembers, I quickly
went to my office. I took a deep breath. Then another deep breath. I had no ideas how to
approach this situation, since it was the first time I
was in a predicament like this since I started as manager. There was no manager
orientation or rule book on how to handle this
specific sort of situation. I instinctively knew that we
absolutely needed to respond. I knew what we had to do and I knew it needed to be done quickly, regardless of any policy that existed. He rapidly imagines alternative scenarios and hits on a plan. He quickly arranges the
educator who trained the nurses on the new equipment to join him and an ICU nurse in the operating room. He then pulls aside the
two charge nurses and says, we will send somebody. Relieve a nurse from
the current assignments. The charge nurses resist. No nurse they say can be spared. Quin takes their
assignment sheets from them and starts speaking to other nurses. He finds one with the right
skills who agrees to go. He contacts the OR, we’ll be right down. 10 minutes later he goes
back to get the nurse. She says, I’m sorry, I don’t
think I can go anymore. The other nurses had convinced her that it would be an unsafe
move to violate protocol. I couldn’t believe my
ears, remembers Quin, I was a bit panicked and began thinking, how am I gonna deal with this? It dawned on me that there was
one of the night shift nurses who was particularly
skilled with this device who was about to come in. He’d not yet been pressured to refuse. Quin contacts the nurse and he agrees. 15 minutes later, Quin,
the nurse, the educator, and the machine were all down in the OR. The next morning the cardiac surgeon calls Quin’s unit to thank the nurses for saving the patient’s life. So the next day, the first thing Quin does when he goes in is to listen to his staff. He then organizes two staff
meetings every day for a week. He encourages the nurses to talk about why they became nurses. He says, once it was brought back to doing what was best for the patient, it was really only one
answer everyone had. It was agreed then in a moment
of an emergent situation, we need to do what we can for the patient. I was glad to know he said that I was not on an island. Okay, let’s now stipulate
that you read the article. And while we’re at it, let’s stipulate that we’re in a small class. How might we discuss this article? Most of your teachers here oughta encourage learning
through the process of discovery. And the process might be as
important as what you discover. For example, if I wanted to encourage us to notice the details
of a complex situation, I might ask you to describe
the situation Quin faced. Did you notice that the incident did not come pre-framed as
an ethical problem for Quin? That the situation was messy, ambiguous, fraught with conflicting aims, send help, obey rules and avoid punishment, don’t risk operating a new
machine in a new environment? I might ask us to wonder
about the kinds of capacities that Quin needed to figure things out. He was caring, obviously, he had the right values,
but was this enough? Did you notice that
Quin also needed to know how to care? Not simply to care, but how to care. He needed the skills of good listening, to have the empathy to figure out what the staff were thinking. Quin needed imagination skills to quickly see the alternatives and when each one failed,
he had to imagine more. I would want us to grapple with the choice-making
that Quin undertook. Quin was not simply being asked to think about the right thing to do. He actually had to do the right thing. He actually had to act. This was not a textbook
case in an ethics class. What character traits
did Quin need to act? For example, how important
was courage and why? Maybe we would discuss
how you, in the class, learned the resilience or grit needed to try again at
a time when you failed. Matthew Quin was an advanced novice. He was learning the practical wisdom to become an expert nurse manager. This is not the capital W
wisdom we might associate with a sage, with Plato, philosopher,
kings, or with prophets, or even with Yoda. It is what Aristotle called phronesis, practical wisdom, small P, small W. It’s knowing the right purpose. Aristotle would say the
telos of a practice. And very concretely it’s knowing how to do the right thing in the right way at the right time. Quin was learning practical wisdom, not through books, but through practice, through the experience of trial and error. I also might want us to notice that I framed the discussion so far around Quin as an individual struggling to do the right thing. But what does Quin do the next day? He doesn’t punish his
staff or lay down the law. This will never happen again. Instead, he designs a process to transform the culture in his ICU unit. First he creates a safe
space for the nurses to reflect together, instead
of a gotcha environment. He then gets them to think about what kinds of nurses they wanna be. What kind of unit they wanna practice in. He has his staff practice good listening and group noticing. He has them practice imagining,
reflection, deliberation. And notice that these are
exactly the same things we would be practicing
if our class discussion were well-designed. You’ve probably noticed that
I’ve been using the word designed a lot. It’s an increasingly common term. You hear it used to describe
the work of architects, builders, illustrators,
clothing designers, web masters, IT geeks. My focus is on a different
kind of designer, one who designs systems
that develop the character and judgment of the people
so they can practice better. My favorite political philosophers are all aiming to connect
their systems designs to human character. I teach Hobbes in my theory classes because he designs political institutions to contain the worst in people. Hobbes looked into the soul of man and saw only disorder, unregulated emotion, an insecure ego that sought gain, glory, and power. That meant that life always risked being in his words, nasty, brutish, and short. Beneath the thin veneer of civilization was a seething disorder, said Hobbes. Chaos always lurking, waiting to break out into a war of all against all. Order, Hobbes argued,
depended on a strong man, a leviathan, that could use
fear to get us to obey his laws. Aristotle, the antithesis of Hobbes, is always another staple in my classes. Writing over 1,900 years earlier, he understood Hobbes’ vision, the potential for human beings to be what Aristotle called barbarians. But human nature held
another potential as well. People could become social beings. Beings who sought happiness, flourishing through family, friendship, and community. Aristotle saw the possibility
that people could learn the habits that enabled this flourishing. Courage, patience, a sense of fairness, self-restraint, love. Reason gave men, and alas
Aristotle did mean men, the human capacity to design systems to nurture these virtues. How, he asked, could
communities be designed to encourage the right character traits? How could people learn
the practical wisdom to choose well, to do good design? (coughs) It turns out that Quin
himself was in a program designed to develop character
and practical wisdom. He and a half dozen other nurse managers were part of a pilot course at Brigham and Women’s Hospital in Boston, eight one-week seminars
spread out over two years. A seasoned nurse manager and a facilitator designed a program to encourage
the learning of reflection and practical wisdom. Quin and his colleagues wrote stories about their ongoing experiences and discussed them with each other. The course was designed to
provide a safe space for them to talk about their struggles and mistakes and to reflect on what had gone wrong, to imagine alternatives. So Quin was becoming a kind
of Aristotelian statesman. In the ICU he was designing a slow but transformational
process of cultural change. His staff had lost their way in knowing what the right thing
to do was and how to do it. He helped them get back
in touch with that. The new design was so successful that the staff went on to
win several prestigious Beacon Awards of the American Association of Critical Care in Nurses
for Excellent in Practice. Many of you will be called on to design relationships and institutions
after you graduate. Friendships, communities, workplaces, organizations, you didn’t
take courses at Swarthmore on these things, but I’m suspecting that the hidden curriculum here has encouraged you to learn more than you think you’ve learned. When I was a student at
a liberal arts college, I thought my classes were
designed to teach me the material and prepare me to be examined and ranked, but as I grew into being a teacher, I noticed that many colleagues
were designing classes to encourage other kinds of learning. For example, learning how
to talk to each other. Or when and how to listen. Learning how to imagine and be curious, how to have the courage
to talk up in class and to defend an unpopular idea. You learn these things
not just from the courses we design, you also learn
them from how we teachers interact with you. What questions we ask in class teach you how to ask questions. How we pursue the dialogue
with you models reflectiveness. You watch who we call on or who we don’t and you learn about fairness. We teach you when and how to interrupt by when and how we interrupt you. We teach you how to listen by how carefully we listen. If you hear us repeating what you’ve said to clarify a point, you
learn that it’s okay to be uncertain if you
don’t understand something. If you see us admitting that
we don’t know something, we encourage intellectual honesty. If you see that we admit our mistakes and reflect on them, we encourage you to learn through trial and error too. We teachers are always modeling character and practical wisdom,
for better or for worse. And you are always watching us. You also learn these things from classes that take you into the community. For example, the politics
of punishment course, which meets every week
inside the prison in Chester with half Swarthmore
students and half inmates. Keith Reeves and his colleagues have carefully designed this experience. Students and prison insiders
are reading the same things, but then they’re encouraged to get inside each
other’s hearts and minds. The friction caused by
rubbing different lives and perspectives against each other is designed to foster judgment,
reflection, and empathy. When the students in Syed Ashan’s class in the Israel Palestinian Conflict went to the Middle East, they sat down with people on multiple
sides of the conflict. They practiced noticing where the radically different frameworks and understandings came from. They practiced deliberating about policies and imagining alternatives. Then of course there are the
sports programs at Swarthmore. You learn the athletic skills and prowess to compete and win, but
what most Swarthmore coaches are also encouraging you to
learn how to work together to bring out the best in each other. Your development is the team’s development and the team’s excellence
depends on the character traits and judgements that are
exactly what Aristotle was trying to design for. Courage, resilience, good listening. Note the design of the pedagogy here. Coaching and practice. Then reflection and deliberation. Then more coaching and more practice. Think for example of the post-game review. It’s an exercise in learning
through trial and error. What worked, what didn’t, how can you do better? How can you continue to work together or improve your work together so that the team does better? We’ve been noticing how design encourages a certain kind
of learning at Swarthmore. But let’s also notice how
you’ve been encouraged to practiced design. You think about the
design work you’ve done in creating and in running War News Radio, Dare to Soar, Learning for Life. Think about the study
groups and review sessions you’re constantly designing. You sit down, sometimes late at night, and learn how to listen to each other, to give counsel, to
empathically think backwards and figure out why a
fellow student is confused. Think about the work some of you have done as resident assistants in your dorms, RAs. You have to design a
system which enables you to mentor and model and
coach a group of freshmen. You have to figure out
how to encourage them to learn how to listen to each other, solve problems together, and navigate the first year. Or think about the design work done by the writing associates. You’re learning how to mentor students to write better papers. You have to design dozens
of conferences each term. You have to figure out
how to think backward with your mentees to identify
a block or a confusion. You have to learn how to notice when the obstacle your mentee faces is not simply a lack of skill,
but a lack of confidence. You WAs, that’s the
Swarthmore’s short-term for writing associations, WAs,
unfortunate but there it is. You WAs have to figure out
how to critique your mentees without leaving them feeling
helpless and ignorant. You get coached and
mentored in how to do this in an incredible training program that Jill Gladstein and
her colleagues designed. You also get backup. But then, your coaches step
back and let you coach. So the design of the
program encourages you to become good system
designers yourselves. Let me conclude by reflecting for a moment on your upcoming transition to what you call the real
world after Swarthmore. Most of you are still
novices in system design like Matt Quin was, and
you’re facing a tough world, a world that will put physical distance between you and your friends. A world of finding jobs
and paying off debts. A world of institutions
that are designed to control your behavior with their
rigid, standardized procedures and incentives. Is there space for you to bring
out the good in each other? It will be difficult, but yes. Just like Matt Quin created
a space to design for wisdom, so will many of you. Three quick examples. Sustaining your close
Swarthmore friendships will soon be a challenge. All the unseen design elements that encourage such
friendships at Swarthmore will disappear, shared activities, shared food, shared dorm
life, shared studies, shared hanging out. Facebook and email alone
will not substitute. I learned of my first example from a group of eight Swarthmore women graduates from the class of 2003. They came back to Swarthmore in 2013 to spend a weekend with the
Practical Wisdom seminar that Barry Schwartz and I were teaching. Before they graduated, they
had already started worrying about what would happen to
their close friendship group after they dispersed around the country. They discussed with our seminar the plan they designed. Once a year they planned
a long weekend retreat. They would hangout over
cooking and long walks. They also designed a structure to assure good telling and good listening. For example, they scheduled
uninterrupted time for each to tell the others
what was on their minds, and in their hearts, and
then to get feedback, reactions, and support. Another example, they setup
a mutual check-in system throughout the entire year,
by voice, if possible. They also discussed with
us the tough decisions they had to make as they got older, like should significant
others and children be invited to these sessions, or just the intimate group of friends? Here’s another example from my research on the drug war and the
criminal justice system. Back in the 1980s and 1990s, a harsh system of
mandatory minimum sentences for drug possession was codified into law. Prison building boomed, cells were filled with mostly poor, mostly
non-white minorities. Critics came to call
this mass incarceration. Recently there have
been successful efforts to begin changing these laws. But much earlier, there were
wise and courageous reformers that started designing parallel
alternative court systems. Drug courts, veterans courts, mental health courts, juvenile courts. In the drug courts, for example, someone stealing or dealing
to support their addiction or their families could be sentenced, to support their addiction
or their families, could be sentenced to
treatment, rehabilitation, community service, job
training, and mentoring. Judges teamed up with parole officers, social workers, and even
police and prosecutors to build these systems
instead of just punishing. Instead of bringing out
the worst in people, they designed a system to
encourage these lawbreakers to reflect and to deliberate. To choose paths that
would heal their illness, restore their dignity,
enable them to work, and rejoin a better community. One more example. If you arrived at eight a.m.
at the palliative care service at Dartmouth Hitchcock Medical
Center in New Hampshire, you would see more than 20 professionals meeting to figure out how to care for the chronically ill
patients they will see that day. Around a seminar table
you would see doctors, nurses, social workers, chaplains, a massage therapist,
residents, medical students. You’d hear an opening poem. Then you’d hear bereavements for patients who recently died. Then a discussion of each patient. Not just, are the pain
medications working, but also the patient’s stories,
their fears, their hopes. It’s her nine-year-old grandson that’s giving her something to live for. Or, what can we do for
this patient’s spouse who doesn’t have enough money
to get a taxi to the hospital? If you arrived mid-week, you would see the palliative care team engaged in what they
call Wisdom Wednesdays. Two staff present an ongoing case. The whole team joins in to question, reflect, deliberate. What did you expect before
you walked into the room? What did you actually find? What did you fail to notice? What are the patient and
the families going through? How did you feel when
so-and-so said such-and-such? How did you deal with your frustration? Your anger? You would see a team that had designed a safe environment to support each other and learn the good
judgment needed to care. I could go on and as my
students will tell you, my classes do tend to go on. But let me conclude. You and I have learned
much here at Swarthmore. Things that were not part
of my job description and will not appear on
any of your transcripts. You and I have begun to learn the character traits and the moral skills to act well, and to design systems to bring out the good in each other. For the last 45 years, my
flourishing as a teacher has depended on your
flourishing as students. That is what has given meaning to my work and to the work of my colleagues. When you leave Swarthmore,
you will go forth and design systems to bring
out the good in people, not because someone has
charged you to do this. You will do it in part
because of your faith, in part because of your
commitment and your idealism, but most of all, because you
want to flourish with others. Thanks for the great education here and may the wisdom be with you. (audience applauding)

One comment

  1. LMA - The Best Improv & Sketch Comedy Classes in Sydney & Melbourne are at Laugh-Masters Academy says:

    Great talk Ken. Quinn is, among other things, a skilled improviser working collaboratively to get the best out of his ensemble.
    Learning to listen, react, adapt, and communicate the way he did is precisely what we teach at http://lma.training

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