NLN Nursing EDge Unscripted

Surface – Exploring the “Third Space”: An Invitation to Redefine the Boundaries of Innovation - Part 1

February 16, 2023 Matthew Byrne Season 3 Episode 5
NLN Nursing EDge Unscripted
Surface – Exploring the “Third Space”: An Invitation to Redefine the Boundaries of Innovation - Part 1
Show Notes Transcript

This episode of the NLN Nursing EDge Unscripted Surface track is part 1 of 2 featuring guest Matthew Byrne.

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[Music] Welcome to this episode of the NLN podcast Nursing EDge Unscripted the Surface track and thank you for joining us. This episode is entitled, Exploring the Third Space: An Invitation to Redefine the Boundaries of Innovation, where we are going to explore the third space an interesting concept that promotes a special synergy that occurs when diverse minds and voices come together to solve complex problems. While this concept is used in many industries including that of the tech world, today we will make some connections on how the third space concept can apply to innovating the complexities and thorny issues of health care, nursing education, and clinical practice. To help us today we have a very special guest. Dr. Matthew Byrne has worked as a nurse informaticist and nurse educator in a variety of settings from clinical informatics to academia and the health care industry. He is currently the director of nursing technology resources for the Mayo Clinic and teaches about informatics and educational technology courses. He is passionate about ensuring that technology is ideally suited to serving the knowledge needs of nurses. Welcome Matt, thank you for joining us and I'd like to start by having you tell us a little bit about your role at the Mayo Clinic because I think your role will help set a foundation from which we can sort of expand and talk about this kind of cool concept that we want to explore together. Yeah, great. Well I'm very honored to be here. I've just had a wonderful experience with NLN and a great time getting to know and talking with both of you so it's a huge honor to be here. So I'm the director of nursing technology resources at the Mayo Clinic, which is a job I recently took on and it really a long title for basically serving the information needs of nurses as they go about their day-to-day work. I helped to make sure that they have the resources they need to provide care, to make sure their schedules are right, to keep up to date on different news and information needs they have. I serve across the enterprise so from the London office to Sparta, Wisconsin, really trying to meet the information need of all the nurses at Mayo Clinic. I really love it because it brings together my passions which are education and technology and clinical practice. It's just been a really fun opportunity for me to explore that and to really serve an institution that that I kind of grew up with. I started my career there so I'm returning back to to the to the place that I was a baby nurse as I say, back in the day. That's awesome Matt. Well I think your role, that's interesting and I think a previous conversation we talked about sometimes how hard it is to marry so many different specialty areas and to find that all these specialty areas and all this expertise in one person and you have that. I think that how you serve your role is very important because they're so much of the information and the technology that nurses touch. It all comes down to the interface of patient care and I think that's a really important role to have somebody as diversely and experienced as you are in so many different areas and they're putting them together. Well it's very nice of you to say. I think that's more a consequence of intellectual restless then intentional building of expertise, but it's a very kind of you to say. I think it's a great segue into the topic today because one of the things that has really driven my passion and interest in this topic which is around third space, third space professionals and and third space work, has been the fact that I've had to navigate worlds that aren't always compatible and sometimes actually maybe a little bit hostile towards each other. It's been a very interesting journey for me and this is something I've been thinking about for almost 20 years so I have lots of lots of ideas and thoughts and experiences to expand upon. I think one of those has been the fact that as a registered nurse who likes technology I've had to often operate in a space that is very unfamiliar and can be uncomfortable, where I'm sitting down to talk to people on the I.T. side, the development side, that I don't know, I mean I know a lot more about it now, but we don't speak the same language or we didn't. I've had to enter that third space, a space in between their world and mine and kind of navigate the culture and then the norms, the, language, the etiquette and really figure that out in order to achieve what I need to achieve for my job or or for research or whatever else. It's actually a great segue into this topic today. Actually I would bounce a question back at you guys because I do think to get into this mindset I would ask the two of you, do you find yourself navigating different worlds because I know both of you do a lot of different things so I guess I would throw that at you first and then we'll rabbit hole from there. That's fantastic Matt. It's funny because I was just talking to Rachel about that because at the NLN...I came from, you start at the bedside you know practicing nurse you might start doing some education because I never went up an administrative track. I always from the very get go went education so you start precepting. Then I went into a new grad residency program, more teaching and then went into academics. And then just hardcore teaching - an immersion in the academic setting and that took all the full 12 years I was in academics to orient myself. That was a 12-year orientation and then just when you get kind of comfy I moved to the NLN full time. The work at the NLN is this wonderful ability to take my nursing knowledge, my nursing language, my teaching language, and my love of creativity and Innovation and marry that into my role but the interesting thing is that with the NLN we partner with Laerdal Medical and Laerdal is really very different, very different space, very different organization. It's much more corporate. It's much more business- oriented. Their mission is to save lives, which aligns. That's kind of probably our shared space, right, I guess when you have a third space you might have some a little bit of a black hole of like where do we line up? But there are some shared overlapping areas so I'm often working with a team of people that aren't nurses but they are gamers or they are computer programmers and so we have to we find ourselves often in this partnership and in it when we're innovating and creating something together, which is exciting but it can be challenging because absolutely you need all the stakeholders at the table all the time because of the different languages and that even might be literal languages because it's also an international company so it's pretty fascinating. Does that answer your question with regard to a a third space? Absolutely and I know Rachel you've moved into an administrative role, I think. You're probably experiencing the culture shock of that too and the different hats you have to wear from being a nurse to a nurse educator to an academic administrator. There's probably a wide gulf. Yeah, you know and I think a lot of folks can relate to this regardless whether they're in a role transition or organizational restructure. As things change, you recognize that different departments or different buckets or teams have different priorities or a different lens through which they see and carry out the mission and vision of the larger organization that they're in. When you come together in that shared space recognizing we are all working towards the shared mission or vision, but we come with a different lens, we come with a different set of priorities. We come with a different set of resources and tasks even though some resources are shared amongst and across teams. Sometimes it's not and at that intersection of teams or departments or specialties or disciplines, wherever you are, I think we all face that, right? We may have a shared mission or vision, but there's different lenses to which we see it and approach it. Different priorities and different and shared ways that we can occupy that space together. I couldn't have like prepped this better because I think you both get on two really, really important things. The first thing I think Michelle you talked about shared vision and I think you did as well Rachel. This idea that at the center of the sort of Venn diagram of knowledge and experience and role is this notion of we all want to achieve

something similar:

saves lives, educate students, give nurses the resources they need, whatever. That's often the thing people are rallying around in this third space, which is really a theoretical space or an intellectual space where people gather either physically or virtually to really talk about thorny problems or complex issues. I think the difference is you guys are talking about, hey we're gathering around a problem, you know an academic administrative problem. We have enrollment issues or whatever, but you're expected to stay in your lane because people trust that you're going to do your job. People trust you're going to advocate from the perspective that you have have to safeguard. The difference in third space is you let that all go and so there becomes sort of this diffuse set of boundaries. Boundaries become blurry and you operate instead in an open space what I call a co-creative confluence where you come together to often create something new that maybe didn't exist before. I know synergy is like this dirty word, but that's truly the goal is that you as an individual staying in your swim lane probably would not have come up with this magical thing in this third space, but it's that letting go of self, letting go of expectation, letting go of your specific role that differentiates a third space from like a teamwork space because in a teamwork environment you got to do your nurse stuff, the physician and the respiratory therapist they need you to do your nurse stuff, they're trusting that you're going to do your nurse stuff. In the third space, you just let that go. You're just people with a vast array of experiences and knowledge and whatever else sitting in a room tackling a thorny problem and dreaming up new solutions to it, innovative ways to approach it. So Matt as you're explaining this I'm getting this vision in my mind. You can tell me if I am totally off or not I'm getting this vision of us moving from like in a highway with guard rails and our lanes to like we're on a dirt road now and you know we're kind of or maybe a really wide dirt maybe field and we're kind of the dirt kind of flies up and we don't have the boundaries or the guardrails that we would have on... I would say you're full Back to the Future - like where we're going you don't even need roads. You're not even on roads anymore. Okay. You just get in the DeLorean and you're up in the air flying around. So it's even the idea that we're not even on roads anymore. You're doing something maybe way outside of your experience and understanding and there's an okayness with that. Hey, the nurse is going to talk about technology stuff. They may not have all the right words but they have enough knowledge and experience and we have mutual respect and safety in that space to just dream stuff up and build on each other's ideas and co-create in a way that we probably couldn't and shouldn't in a true team environment where I need you to do your job to protect the patient or to make sure that this course is delivered the way that it needs to be delivered. So it's like you're totally, you don't even need roads in a third space. You just move completely outside of kind of that normal navigation. So listening to you describe, Matt, the third space, I had a very different vision than Rachel, which is pretty common for Rachel and I to have these these very different perspectives. I'm not even sure if my vision is going to make the final editing cut because it's a little out there. My question is how do you get into the third space because I always think we have all these identities and we wear them like shirts sometimes even like armor. I've got my nursing shirt and I've got my teaching shirt and I've got my colleague shirt and I've got my creativity shirt. I've got all these shirts, my scholarship shirt. How do I now enter into this third space and take off all these shirts? I'm imagining we're entering into this space like naked to do this work, I mean maybe not literally, but figuratively. I'm wondering how does one get themselves to derobe and to de-identify where you're not going in with all of this pre-programmed knowledge and experience? How do you really clear yourself for this space? Do you have to use sage, do you have to meditate, what do you have to do? I mean probably all of those are probably just fine. So to some extent I think it's actually the opposite. I don't think you want to enter disrobed. I think you want to walk in with all the knowledge and experience you have. But I think there's different habits of mind that you have to bring to this kind of space, which is part of why I wanted the two of you to talk about your selves as third space professionals, which in the last year that was a whole thread of research in this area that I found that was totally different from what I looked at before. I've been reading very exclusively about third space participatory design, which is where we bring two people together in a room and we do a thing. I found a whole thread of research about third space professionals which I think the two of you are great examples of that where you kind of straddle and negotiate and navigate and are you're both very successful can successfully do things that exist in this third space between your academic and professional and whatever hats. I think when you walk into a third space situation, I think a lot of times it's accidental and serendipitous and what I'm really interested in is how we do that intentionally because I think we need it now more than ever to be very honest with you. I think you want to walk in letting go of a little bit of self. I think it can be very easy to feel like, oh these are austere colleagues or you know people that I wouldn't maybe normally talk to or do we have a lot in common because they do unit testing or they do instructional design work and I would usually only interface them with them in a very specific context. I think that letting go of self and self-awareness to some extent, which is kind of a lost art. Not everybody's good at that. I think leaving behind your boundaries in terms of what we're typically used to which is I got to stay in my swim lane for safety reasons like I got to do my nursing stuff because everybody's expecting me to do my nursing stuff. They're trusting that I'm going to take care of that side of the patient care situation so you actually have to let go of that boundary a little bit and be open to different ideas and different perspectives and maybe even stretching yourself intellectually to talk about something that you maybe normally would kind of stay out of because it's not within your scope or role. And then I think the last piece is letting go of some prior assumptions. We all have assumptions about the people we work with. There's lots of jokes about lawyers and accountants and whatever else. We have the same jokes about physicians and I'm sure they tell the same jokes about nurses but letting go of those those assumptions about the people that you're going to sit around the table with is super critical to entering that that third space and those three things that I'm talking about actually come from a fascinating article I found a month ago that was written by two doctoral nursing students who got into this beautiful collaboration with each other and tried to figure out how they can move regularly into this what they called transformative collaboration space. I think what's fun about this third space work is that there's a lot of different language around it. What they were describing is exactly what I'm interested in terms of understanding and creating third space experiences, but they use totally different language but are giving skills that you need to answer your question, Michelle, that the skills that you need to get into that third space mode. The other thing is just really making sure that you have some of the basics that go into any collaborative working environment. The sort of not having people checking their phones, the mutual respect, the sort of recognition that people are going to say things that you know may sound dumb. We talk a lot about being vulnerable and creating safe spaces. Well that's not easy. It can be very difficult to do that. Those are really cool bumper stickers, but actually creating environments for that is very, very difficult especially in virtual environments. I think face-to-face we're a little more attuned to body language and people's reactions, but you do that in a virtual space people turn off their cameras, people mute, you don't see people's full body language, and as nurses were very attuned to that but not everybody is and they need those cues. I think some of it is yes, doing those three things, the sort of self-awareness, self-checking, drawing down those boundaries, opening them up and letting go with some of those prior assumptions. But just doing some of the good basic team stuff so that you can move into this almost because my experiences here have been almost magical and that's part of why I've been so interested in this for 20 years is that things happen and your brain tingles in a way that it doesn't in other types of meetings. There is a very mystical kind of aspect to this scientist and tech guy, but there is an almost mystical feeling when you're in those spaces and the times I've been there all of these things that I read about and I see describe have started to happen. That's what makes it kind of fascinating and cool but also really necessary in these times. I really appreciate you speaking on this idea of psychological safety in these spaces. Michelle and I - you're speaking to our one of our big passions. Michelle and I spent a lot of time offline talking about psychological safety: how do we build it, cultivate it, protect it, how do we address it when it's at risk. I could imagine that that is a huge and I agree with you it has to be intentional, deliberate authentic, genuine and when I hear you talking about these attributes and what we need to think about and bringing ourselves into the third space, I also think perhaps and you can help shape my thinking on this... how it lands on you. I also think listening to understand might be a huge thing being able to hold the idea of being both student and expert at the same time, right. That's not mutually exclusive. I'm here to offer expertise but also be a student to learn at the same time from those who are offering their expertise and then what Michelle and I talk about a lot is a nod and comes from the Center for Medical Simulation up in Boston is this basic assumption, that we believe those that we work with are intelligent capable wanting to do their best and wanting to improve. We often talk about that - of holding it of each other but also holding it of ourselves. I think oftentimes when we step into this third space where we're vulnerable and uncomfortable and stretching beyond the edge of our expertise it's really important that we hold that of ourselves that I'm intelligent, capable, wanting to do my best, wanting to improve. I think that might help let go of because I think there's a perhaps an ego part of this where we have to let go because when we're with our colleagues and sometimes there's a feeling of wanting to prove that you should be there at the table, that you have something to contribute and letting that go I think are going to be necessary ingredients to create this as you say mystical space where transformational thinking and outcomes can happen. Yeah. Absolutely. I think it also requires people to be able to hold paradox. We've talked about this before too Rachel. Our culture, our westernized culture doesn't do that very well that both/ and that you can be both teacher and learner at the same time, that you don't have to pick one and you have to be the teacher so you're the teacher right we can we can hold seemingly opposite things in the same space and create space to allow for that and that's part of probably that boundary, letting some of those boundaries go around what it means to be a teacher, what it means to be a learner, and what your role is in either one of those that there can be this almost third space within a person. You can be both that overlapping of roles. I think that's pretty interesting too and I think you guys are both again kind of hitting on something that I've discovered only recently and again, I've been thinking about this for 20 years when I had a very mystical third space experience very early in my career and at various milestones have read something or found it again, but I think the newest revelation I've had and I think you're both validating and articulating that and reinforcing it is that my theory is that third spaces probably cannot be really successful or created without third space professionals because I think third space professionals have had to be stealthful, self-aware, have had to be in tune to the communities in which they're entering and have that cultural humility to say this is a corporate-y Laerdal group. They're going to be speaking about things in ways and using language that I wouldn't use on a care unit or that I wouldn't use in an NLN meeting and I need to be responsive to that and aware of that and respectful of that while still bringing what I bring to the table. My new kind of theory of this is that a third space really requires at least a couple of third space professionals who are used to to living in that odd, murky, diffuse space that's kind of in between. That's fantastic and it's making me really... it's sparking something in me about how do you, how does that get identified in a person? You've got these attributes that you're comfortable with, an uncomfortable situation that you're able to hold paradoxes that you're able to navigate this and kind of be self-aware. How is that identified? How is that celebrated? How did we bring awareness to that that's a needed role? Like how do we help them build those things? Just like we talked about, how do we help create and develop leaders? How do we help develop those with a third space would you say mindset Matt? Would that be the right term? I think a mindset or or mindset's probably the best word. How do we build that and recognize it and celebrate it? I don't think it's well celebrated. I think it's becoming more commonplace somewhat by accident as people live in much more of a gig world where they teach and do clinical practice or teach and do whatever they do so I think there's been sort of a forced hybrid professional situation not just in nursing but I think nursing is very typical we have people who teach part-time and do clinical practice part-time and they just by happenstance have to live between those worlds. Sometimes they do that well, sometimes they don't. I've worked, I'm sure you guys have too, I've worked with colleagues over the years who bring some of the yucky clinical practice stuff to academia or vice versa, which isn't really in my mind the right way to approach that. Is it celebrated? I think more now as their sort of recognition that we really have to have academia and clinical practice talking to each other more and more. I think Covid really forced that issue in a way that we haven't seen before. We've always talked about that as sort of that back and forth between academia and practice from like a research perspective, but I think the DNP movement has helped that a lot. I think Covid has helped that a lot to really open that dialogue up so there's maybe a little more celebration of that, but we haven't named this. This isn't a word. We don't talk about third space professionals. We don't talk about hybrid professionals or third spaces. I think when you don't name something it's very difficult to celebrate it, recognize it, and build it up in people. Even though I think it's out there and I and part of what I've been digging into is that this language and this type of mindset exists and has been discussed in many different disciplines so it's a very heavy in the social sciences. I reached out to a scholar in Norway who does military psychology who's talked about this phenomenon. I talked with our mutual friend Sal Tagliareni about this. He used the word normative incrementalism, which is actually actually like a political mindset that is sort of adjacent to this. I think the multi-disciplinarity of it is challenging but also it's just something new and we haven't really named it yet but as we've moved into sort of a gig economy and a situation where everybody has to do something with tech. Probably 20 years ago it was like, oh, tech and education. Well now like tech is education. That was even before Covid I'd say that we were very tech dependent. Now we've shown and have been a hundred percent tech dependent because of Covid so we've all become in some ways hybrid professionals who've had to navigate the technology world, the clinical practice world, and the academic world. I think naming it is a big part of it. Celebrating it - I think we're getting there. It's not just about being an adjunct. It's about how you contribute and how you show up that differentiates you as an adjunct faculty versus a hybrid professional and then I think from there that's where we can better be able to build people up if desired. I don't think everybody can be a hybrid professional. I think sometimes it can be very disconcerting and challenging and exhausting to try and navigate multiple cultures and the cultural piece of this is actually where third space and hybrid space comes from. The original theorist talked about those who might have immigrated from elsewhere and have had to straddle their home culture and the culture of the place that they've moved to so ironically enough it's that cultural piece that I think can can make hybrid space work or third space work very, very challenging and exhausting because you're constantly rethinking your identity and figuring out what the norms are. We want to be conscious of our time boundaries. This conversation could go on and it will. We will pick up with our conversation with Matt discussing innovating in this third space on the next episode. Thank you for joining us on this episode of NLN Nursing EDge Unscripted Surface. We hope you join us next time. Until then, remember, whether your water is calm or choppy, stay connected, get vulnerable and dare to go beneath the surface.