The Neuroscience of Decision-Making in Long-Term Care Leadership

The Neuroscience of Decision-Making in Long-Term Care Leadership

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Dennis Gill: Welcome to CareSmartz360 On Air, a Home Care Podcast. I’m Dennis Gill, Senior Sales Consultant at Caresmartz.

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Dennis Gill: Today, we are thrilled to announce our guest Hoss Notarkesh, a Dynamic Executive Business Coach, and Tony Robbins Certified Life Strategist with a passion for unlocking potential.

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Dennis Gill: With 17 years of frontline leadership as a Senior Corporate Healthcare Executive, Hoss not only managed operations across 10 long-term care homes in Ontario, but he also steered a team of 9 executives, 100 plus directors, and around 3,000 dedicated frontline heroes.

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Dennis Gill: A Bachelor of Science in Microbiology and a Master of Business, set the stage for his transformative journey. As a globet-rotting entrepreneur, owning ventures on 3 continents, holding a U.S. Patent with 11 claims and creating groundbreaking programs like Zen team building, hidden potential and passion discovery,

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Dennis Gill: Hoss is uniquely equipped to explore the Neuroscience of Decision-Making in Long-Term Care Leadership.

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Dennis Gill: Strap in for a delightful dive into decision science and leadership dynamics that will spark your imagination!

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Dennis Gill: Get ready to challenge your brain and transform your leadership outlook today. Welcome to the podcast, Hoss.

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Hoss Notarkesh: Appreciate Dennis. It’s great to be here. I appreciate that introduction.

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Dennis Gill: Oh, no, we are really glad you were able to take out the time today for our meeting, and it would be really helpful and a great insight for our listeners today, and they’ll be able to learn about this very important topic. Most of the listeners are not aware about it.

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Dennis Gill: Okay, alright. So I’ll straight away. Jump on with the 1st question for you.

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Dennis Gill: So can you share some insights on how brain science can help leaders balance intuition and analytical thinking in high stress, home care environments?

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Hoss Notarkesh: You know. That’s a loaded question. But you know I I respond to the best of my ability to say the fact that you know, when we are

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Hoss Notarkesh: aware of our value hierarchy.

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Hoss Notarkesh: then we don’t simply react to scenarios. We reflect before we respond. And these 2 are very distinguished. When it comes to the decision making process for a high stress environment, especially healthcare. Because again, it’s a life and death, you know, scenario kind of thing.

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Hoss Notarkesh: So you know we have a chance to work with high decision makers and executives in many different domains, but specifically in healthcare, because that’s my background. But that’s exactly what it comes down to. So knowing the fact that so we perceive reality through a story

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Hoss Notarkesh: That’s like the neuroscience of the human psyche. But what is the story is a description of value, hierarchy, that is, structures perception.

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Hoss Notarkesh: That’s the story that becomes the lens that we experience life through it as our truth.

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Hoss Notarkesh: That’s why we don’t experience life. We experience life that we focus on

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Hoss Notarkesh: So knowing just this piece itself that we’re not really seeing the 3 dimensional reality as one reality is a different reality through each people’s lenses and stories, it would enable us to think more from our own value. Hierarchy. So what I’m saying is that when it comes to intuition versus an ethical mind.

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Hoss Notarkesh: if we are aware of our value hierarchy.

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Hoss Notarkesh: there are a lot of great assessments out there. We help our executives with their assessments as well, but we show them what their values are. Hierarchy.

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Hoss Notarkesh: Then you would know when there was a scenario that brought your attention that needed an immediate decision. You know how you are responding, is it reacting or reflecting? And then basically responding to the scenario? Accordingly, for example, that could be a patient origin, abuse. It could be staff, negligent or so on, and so forth, or it could be financial abuse, for through the corporation.

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Hoss Notarkesh: So there are many different sensitive scenarios that you know might trigger some of your

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Hoss Notarkesh: I would say personal values that could be a little bit more reactive like, for example, in neuroscience there’s a term that I in my book, I talk about it. I wrote a book called The Journey of Consciousness. The subtitle is

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Hoss Notarkesh: the path of least resistance to ego dissolution. We dive deep into basically, you know, human perception. So in the last 10 years or so, I’ve been studying the neuroscience of perception. So that’s basically the focus of the book. And how we can be aware of it to tap into that ego dissolution which is the ultimate level of awareness in the form of being an intuitive decision maker, if that makes sense. So that’s exactly

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Hoss Notarkesh: what I mean by that. So what I mean by that is that when we are talking about that, you know, knee jerk reaction.

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Hoss Notarkesh: That’s analytical thinking that often leads to definite outcomes that are not desirable. So intuitive decision making. It comes down to the fact that we need to know our value. Hierarchy, then, based on that you can react, based on response based on your value, hierarchy, right and react as an immediate reaction. So what I’m saying is that if you, if intuitively. And again, if you even reflect back in your personal life.

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Hoss Notarkesh: when you are new to a domain or or industry, or even a team, or in a different setting. So your reactions are more fight or flight mode kind of things. It’s

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Hoss Notarkesh: based on the sympathetic nervous system, which is

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Hoss Notarkesh: that reactive mode. Adrenaline is pumping basically the muscles. And then your awareness is heightened to react in the form of survival. But when you’re in an intuitive decision-making process, you’re in a parasympathetic, nervous system, which is more reflective, more understanding, and aware of the scenario. You don’t see through your own

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Hoss Notarkesh: lens alone. You’re seeing the whole scenario. That’s how I have had a chance to serve and help a lot of clients with their intuitive decision making versus just an ethical mind.

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Dennis Gill: Okay, okay, that does help. That does help. And in what ways does understanding neural processes contribute to better handling of ethical dilemmas in long-term care management. According to you.

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Hoss Notarkesh: Well, I think you know what, though ethical, we need to clarify on that ethical dilemma because I’m going to give you a scenario. I don’t know. If that helps. If not, then help me to understand the ethical dilemma a little better. You know it is known to a lot of individuals that you know the neurons that they fire together. They wire together.

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Hoss Notarkesh: Simple as that, you know, is a principle of neuroscience. The neurons that fire the wire together. So meaning that if you just understand that basic concept of neuron processing, you understand that you know ethically, you know, when you are not able to connect with a subject there is, there’s that would call it, I would say,

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Hoss Notarkesh: deep, fundamental, this, this connection with that topic, like. For example, we had a case in one of the homes where we had a Poa who was a decision maker for care and resident cps, I think, was 4 or even 5, and then but he wanted to have chicken wings, and.

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Dennis Gill: Okay.

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Hoss Notarkesh: And the Poa made a decision that you know. No, my dad can have chicken wings based on his diet, so you know, and then. Obviously, now, that’s like an ethical dilemma right there. I don’t know what kind of ethical dilemma you had in mind asking that question. But again, there are many different ones out there, but that’s like right there and then we had an ethnic committee to make a decision.

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Hoss Notarkesh: What should we do like, you know a residence is, you know, is asking for chicken wings that could be a choking risk, and the poa say no, or many other cases that you know. Residence was palliative, but cognitive enough to respond to say the fact. You know.

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Hoss Notarkesh: You know I no longer want to be on a machine. You know I’m totally fine to basically, you know, using the simple term unplug. And then some family members are basically, you know, opposed to it, you know, saying to the last breath. Let’s try, and then some resident is to some degree suffering from many problems.

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Hoss Notarkesh: I would say, underlying illnesses, that it is prompting them to make that decision. Those are all ethical dilemmas. Would neuroscience help you to make a better decision? I don’t think, really, I would say

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Hoss Notarkesh: practically will come down to that, but is reflective of it, because again, you have to again trust your gut feeling about your value, hierarchy, understanding. You know the mission and vision and values of your company and your organization, knowing the fact that you know what? Why are you there in 1st place, to be honest with you like, are you there to prolong someone’s life at all costs? Kind of things? Or is there like, you know, the quality of life is more important, like these are all very complex. So

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Hoss Notarkesh: You know, I love to answer that question, but I think we would need a little bit longer. I would say forum or a panel to dive into one specific.

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Hoss Notarkesh: You know the ethical dilemma at a time. And then let’s just say, take advantage of that neuroscience to see how that could help us? But to be honest with you, when we know how the neuron processing is happening which is ultimately helping us to make a decision, I think, to some degree, will help us to have a more precise decision-making process in that ethical dilemma.

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Dennis Gill: And I think there is an ethical dilemma. It would be different, according to situation, to situation, and person to person, so it can be very difficult, and it can be obviously, as you said, a very vast topic to discuss. And obviously it will require a lot more time. I answer that, yeah.

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Hoss Notarkesh: Yeah. And I think the basic basics of it. As I said, you know the neurons that they fire together, the wire together. So again. Going back to the 1st question you asked me like, for example, I would say, just knowing that whoever is biased towards that ethical dilemma shouldn’t be part of that committee, for example.

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Hoss Notarkesh: Like, that’s just one of the examples. You could eliminate at least some of those biases towards those decision making processes. Then, at least, you will have a little bit more straightforward committee or team to have more.

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Hoss Notarkesh: goal oriented decision-making process.

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Dennis Gill: Got that point? Yeah, biasedness needs to be handled in that way. And how can insights from neuroscience help mitigate decision fatigue among leaders, managing complex operations across multiple care facilities. Again, this is a very vast topic about it.

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Hoss Notarkesh: Yeah, I love this, because, as I suggested, before we went live, we just had a 2 h session at advantage, Ontario in Toronto, for our healthcare leaders about neuroscience of decision making.

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Dennis Gill: Okay.

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Hoss Notarkesh: How does that help our healthcare leaders? You know, when it comes to decision making fatigue, it comes down to the fact that you know.

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Hoss Notarkesh: When we’re talking about, you know, perception is projection, we dive deep into that. We dive deep into the neuroscience of what it really means? Perception is projection, and we have a saying that is very famous all over our platforms. When you check out zenteemlink.com, and many other platforms that we have, and any sessions that we have done in many years of doing

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Hoss Notarkesh: team building and executive coaching. I say your perception of me is a reflection of you.

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Hoss Notarkesh: and my reaction to you is an awareness of me.

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Hoss Notarkesh: You know, when we, when we study that, and as a group. We really discuss it, you understand. You know, every scenario that is prompting us to make a decision is deeply, you know, rooted in our values. Hierarchy. That’s why it’s a reflection of me, you know a scenario that happens. For example, if a staff member is complaining about, you know, being the subject of racism.

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Hoss Notarkesh: You know it’s totally different. If you personally have experienced that or not, or if someone says, Hey, listen! You know what they say was sexual, you know.

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Hoss Notarkesh: Abuse or harassment has happened. It’s so different than when, if you have ever experienced those things or not, if you’re part of the investigation team or not. So what I’m trying to say is that, you know decision making fatigue comes from the fact that you know, what does that scenario mean to you?

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Hoss Notarkesh: So what I have always put out there is that, you know, not making a decision

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Hoss Notarkesh: is also making a decision itself. Not making a decision is a decision itself so many times. What we have noticed is that a lot of directors and and executive and healthcare leaders, because again, it’s a fast respondent

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Hoss Notarkesh: environment. And it’s a human to human connection. Because what happens? We need to be mindful of the fact that what is our main product and services in healthcare, you know, typically, people will say, Care, but what is care? So care is the most intangible product and service in the world that, delivered through a vehicle of love.

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Hoss Notarkesh: I’ll keep

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Hoss Notarkesh: that consistent because it’s such a it’s such a, you know. It’s such a wide range of, I would say culture and understanding of what is care. So what I’m saying is that it’s a human to human delivery.

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Hoss Notarkesh: Look with all the healthcare is one of the toughest jobs in the world for a reason, because again, everything is so subjective and so abstract, everything’s so, I would say, offer interpretation. So what I mean by that, you know, not making a decision, the decision meaning that you know not every, I would say concern required for you to react to it.

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Dennis Gill: You could hold on to it like in neuroscience. We say, you know, you don’t have to close every door.

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Hoss Notarkesh: Because we cannot rush to it like you know, there was a concern. We want to make a decision about it. You know. There was a there was some sort of a

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Hoss Notarkesh: complaint. We want to make a decision about it, you know. Obviously, you follow policy procedure within a company when it comes to, you know, complaint and and concern procedures within your company. But again, a lot of other I would say scenarios that require that it requires only your attention rather than decision making. It’s 2 different things.

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Hoss Notarkesh: You don’t have to make a decision to give attention. You can really study the scenario, help them make sure they have heard they’ve been heard, and then you have given all that attention. But you don’t have to make a decision right away in different cases, like sometimes when you’re a charge nurse, when you’re and again, you’re Rpn. Or some other decision makers that are on the floor.

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Hoss Notarkesh: That’s a different story. You know. There’s a critical thinking approach to that process that I’m not going to even get into. But we’re talking about that more of a management side of the case. So when it comes to leadership, I would say, hold on to your decisions. You don’t have to make a decision right away. You don’t have to be a decision making machine and be a fast decision maker. You can give your attention to the scenario, but hold on to it. Sometimes

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Hoss Notarkesh: In my experience, again having the chance to serve many different, I would say long term care homes and different facilities and different teams. I learned that you know what to address. You received the concern, and you definitely gave your attention to it. But you don’t have to really make a decision, let it be for a day or 2, even sometimes give a week or 2, sometimes, in my case, at least, they went away.

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Hoss Notarkesh: It was all resolved, because it was a misunderstanding. You know there was. There were new evidence that, you know came to life that you know we didn’t even have to worry about it like

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Hoss Notarkesh: a lot of times. A lot of times. Again, that fatigue comes from the fact that you feel the urge. I gotta. I gotta really respond to this. I gotta make a

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Hoss Notarkesh: You know we got it. We gotta do something about it, you know. No, you don’t have to close every door, you know, that’s what I do but that’s what. And again, many times like, you know, if, like Cis, that report reportable scenarios in long-term care that you have to file a Cis absolutely file it. But again you have protocols to follow. Take your time, see? See? You know what else?

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Hoss Notarkesh: Again, evidence, or or I would say, information is there for you to gather before you can heavily rely on your assumptions, because when you’re reacting to the scenario for making a decision. And then you don’t have all the information you have to heavily rely on your assumptions, and we have 4 rules that we always put out there that you know. Be empical with your word

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Hoss Notarkesh: in your leadership style. So say what you mean, and then just be very brave to express yourself authentically. Second, one is, don’t take anything personally, because your interpretation of the world is your story, not mine. So how you react to what I say has nothing to do with me. It’s something to do with you.

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Hoss Notarkesh: And the 3rd one is that don’t make any assumptions. Because again, the assumption is a fear-based model, meaning you don’t want to ask questions, and the last one, which is really good for long-term care. Homes, especially farmland staff, always do their best and believe the facts. Your best time to time. Moment to moment is different.

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Hoss Notarkesh: because again, that’s the exhaustion in long-term chairs. There’s never ending work. I remember when I started 20 years ago, long-term care used to have like one staff per like 15 residents right now. I think we have one staff per 5 or 6 residents, so it still has work to be done.

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Hoss Notarkesh: I bet you even you have one on one, for every resident there will be work to be done. So just be mindful of that. Do your best, and a lot of homes are suffering from staff shortage, so do your best. That’s more than enough. We’d love to have you know, at the facility. Just do your best. Of course, you know, following the procedures is good. But again, do your best, whatever that means to you in that very moment, and there will be no misunderstanding, or there will be no, I would say, disappointment. There.

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Dennis Gill: Do your best. I think that’s a thing for everybody, not for the home care leaders. But anybody who is going through our podcast do your best in whatever you are doing.

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Hoss Notarkesh: Yeah, and believe in the fact. Your best is different from time to time, because we set a guilt trip for ourselves because we always evaluate and judge ourselves based on the best case scenario ourselves. But that’s what I’m trying to create awareness that avoids that guilt trip your best moment to moment is different, you know.

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Hoss Notarkesh: Just believe in that very moment you’re doing your best, and that best is good enough. And again, if anybody else has any objection to it. That’s you know their judgment about that scenario, and you cannot do anything about it. That’s like avoiding creating the guilt, because that’s what eats our soul.

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Dennis Gill: Okay, okay? And has, can you discuss a little bit about how emotional regulation and cognitive biases influence leadership decisions as most of the things you did discuss, and what strategies help overcome. These challenges.

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Hoss Notarkesh: I think you know what knowing those biases is is definitely a lens to look within.

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Hoss Notarkesh: Because, again, if my perception of reality is a reflection of me, then definitely, my reaction to that reality is an awareness of me, just knowing what the biases are. And then, you know, we dive deep into this particular topic in our sessions, because, you know, we have videos. And then we educate individuals about those you know, many different types of biases, but unconscious bias is the biggest one.

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Hoss Notarkesh: And we said, we cannot cure the unconscious bias because it has developed within our human psyche through our lives to protect us, but we can be aware of it.

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Hoss Notarkesh: That’s the key, you know. I’m saying, that’s the key that you know. You need to be aware of those unconscious biases in stereotyping. But coming back to that emotional regulation, what I mean by that is that you know, when you are aware of those unconscious biases, then you will automatically have a better handle of your emotional stability.

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Hoss Notarkesh: So because you’re not just reacting to scenarios, like, you know, unconsciously. So you are basically mindful of that event beyond what meets the eyes. That is very important, I would say, in not only healthcare, but in any other workplace scenarios, because at the end of the day you know, your decision making is a true reflection of how you’re interpreting that what you call it that scenario.

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Hoss Notarkesh: So again, coming back to your perception and perception, question and emotional emotional stability, and any what you call it tips that could help us to really navigate through this labyrinth of complex scenarios within healthcare. I would say, you know, we need to slow down in our decision-making process. In one of the videos. We talk about unconscious bias.

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Hoss Notarkesh: We said we cannot cure it, but we can be aware of it. So number one to be aware of it. Slow down your decision-making process. Because again, that reactive mode that I talk about at the beginning rather than reflective to be aware of that response you’re offering. And you’re basically just slowing down that decision-making process. Because again, at the end of the day, many times

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Hoss Notarkesh: new information would help to see through some of those assumptions before you can again be reactive. And again, when you’re reactive, you cannot help to become emotional, because at the end of the day you’re emotionally invested in that outcome. Does that make sense? Because I’m seeing?

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Hoss Notarkesh: Yeah.

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Hoss Notarkesh: We are seeing. When we have a resident who had just experienced or suffer from like

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Hoss Notarkesh: any type of abuse. As a healthcare leader you cannot help to, but that. Take that personally because you could. You would tell yourself that you know I could prevent that within my

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Hoss Notarkesh: decision making optimization or operational optimization, or whatever you name it. So those are the guilt traps. You need to be avoiding it, because again you burn yourself out. So

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Hoss Notarkesh: I don’t know if those tips would help, but definitely slow down your decision making process. Make sure of your value. Hierarchies make sure you know your biases, and you know I would definitely say those few things

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Hoss Notarkesh: on its own will help to eliminate some of those I would say scenarios, that you would take things personally.

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Dennis Gill: No, no, definitely, these things definitely would help. And lastly, what practical advice would you give to home care executives striving to harness neuroscience, principles for nurturing innovation and fostering resilient teams.

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Hoss Notarkesh: You know something that I’ve always put out there. That, I think, is a is a quick

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Hoss Notarkesh: biohack to adopt is to stop gossiping.

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Hoss Notarkesh: Because because we talk about this gossip in any any place that we’re invited, and then what truly that means is that if you believe, which is again, this is the, you know, very principle of neuro-linguistic and human psyche when it comes to understanding reality on life, that when you believe that your perception of me is a reflection of you. Then, when you gossip about me, who do you really gossip about?

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Dennis Gill: Gossiping about myself. I think whatever comes into my mind.

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Hoss Notarkesh: Exactly. Exactly. So. You’re really judging yourself.

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Dennis Gill: Yeah.

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Hoss Notarkesh: So. So what happens is, though, when you really gossip, what you do is basically, you know you judge yourself, and then when you judge yourself. No matter what the scenario is, you’re going to find yourself guilty.

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Hoss Notarkesh: It’s always the case. It’s always the case. And then, when you find yourself guilty. You’re going to find a way and means to, you know.

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Hoss Notarkesh: offer or establish a punishment. You think you’re doing it to someone else. It could be blocking them on social media, ignoring them, not saying Hi to them, or you know physical violence, whatever you name it, it’s a type of it. So when you judge someone, you find them guilty, and then you find a way to punish them. And then any type of punishment is basically a form of rejection.

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Hoss Notarkesh: So you’re rejecting them. That’s why you’re doing the punishment all right. So if, again, your perception of me is a reflection of you, when you are rejecting someone who are you really rejecting?

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Dennis Gill: Rejecting myself, my thoughts.

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Hoss Notarkesh: Exactly

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Hoss Notarkesh: exactly so. This, this, this, you know, battleground of duality within the human psyche is, it is the termite to your innovation.

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Hoss Notarkesh: And that’s why you realize a lot of places that are slow to process a lot of countries, a lot of companies. That’s what it is, they’re stuck in there. They’re thinking they’re basically brain cycles per second output is so slow because they’re so bogged down. It’s like.

00:25:53.340 –> 00:26:15.699
Hoss Notarkesh: It’s like a computer virus slows you down like, what is a virus virus is the same computer virus is the same code that it was is a code that is written in the same language that was written, your computer, that your software, all right. So what happens is that it’s so identical that you cannot differentiate differently.

00:26:15.700 –> 00:26:16.170
Dennis Gill: Is it?

00:26:16.170 –> 00:26:24.599
Hoss Notarkesh: Difference. So what is it like? For example, this virus is designed to check your C drive 20 times a minute.

00:26:24.890 –> 00:26:29.260
Hoss Notarkesh: So, of course, and it has no reason. It’s like gossip.

00:26:29.480 –> 00:26:33.110
Hoss Notarkesh: So what it does when you check your again your C. Drive

00:26:33.300 –> 00:26:44.789
Hoss Notarkesh: too many times in a minute it slows down your CPU, the computer, the computation per unit. So it slows you down. So that’s exactly what happened gossiping.

00:26:44.790 –> 00:27:06.320
Hoss Notarkesh: So when you’re mad at someone. That’s why we don’t make any assumption to be in pickle with your word, and then, you know, don’t take anything personally. Walk up to them and say, clarify things, so don’t. Gossip about people is number one, an ultimate solution and a biohack that I would say will really help with a lot of things. And again, when you start there, when you understand you don’t not.

00:27:06.590 –> 00:27:31.919
Hoss Notarkesh: You are not gossiping to be kind. See? That’s the thing that you know is a difference between when scientifically, you’re looking from the things and and from like neuroscience from morale, morale, said, Don’t gossip to be kind, and all those things which is good, but I even take it a step further. I would just say, you’re really rejecting yourself by gossiping, so you don’t have to look any further. Just look within. If there’s something that bugs you, it’s within you.

00:27:32.010 –> 00:27:58.599
Hoss Notarkesh: So look, look within, then, you know, address it within, and then, once you do that you become so, I would say, realistic about the scenario, and then you will find the courage to go to talk to that person. So again, we do this in a lot of healthcare settings. We talk about science, of gossip, and then how you can avoid it, and then how it has hindered you from being creative and being innovative and

00:27:58.600 –> 00:28:04.600
Hoss Notarkesh: progressing. Basically. So yeah, that’s my 2 cents. Don’t gossip, because technically, you’re gossiping with yourself.

00:28:04.600 –> 00:28:28.179
Dennis Gill: No, no, definitely. If you are trying to think 1st time in that way, it is kind of a virus. Obviously, that’s affecting my mind only rather than the other person that I’ve been gossiping about definitely does help does help. Okay? So thank you. Thank you, Hoss, for sharing your expertise today. It was lovely talking to you, and it was a very informative session for our

00:28:28.180 –> 00:28:38.129
Dennis Gill: listeners too. Hopefully they will enjoy it. And to our lovely audience, thank you for tuning in. Until next time, I’m Dennis Gill, signing off.

00:28:38.240 –> 00:28:39.349
Dennis Gill: Thank you, Hoss.

00:28:39.350 –> 00:28:41.529
Hoss Notarkesh: Thanks, Dennis, take care, my man, have a good one. Bye, bye.

00:28:41.530 –> 00:28:42.429
Dennis Gill: You, too. Bye-bye.