Management/personality isues.....input needed.

Charles S. Smith, RN, MS · Feb 28, 2001

Originally posted by CEN35:
I work in an ER with almost 100 staff members. Our census has increased each yeah by 1,000-2,000 patients, until last year. In 2000 our ER census increased by almost 10,000 patients.
Anyways, there seems to be a wide variety of employees that work there, as far as personalities. For example, I'll list the following people by letter:
A- Works hard, gives 101% all the time, and complains about some of the others once in a while.

B- Good nurse knowledgable... works well when busy....but other times needs a push to get going.

C- Comes in late, takes an assignment and no matter how busy or slow, always is just doin what they want. Always has time to eat, when others dont, and falls behind on patient care.

D- Good nurse works their behind off. However, the person s very moody and tempermental, can cause problems with others.

E- Good worker......excellent nurse, never complains, does the job well and apparently likes it.

Anyways, the bottom line is.........others see each other in the same ways I see these people, I know because I get the complaints. Why does this person always get away with coming in late, this person only takes care of their people and doesn't help others, this person is nasty to me, etc etc.

I have worked in our ER for 4 1/2 years, and due to growth some new positions were added. So people moved up the ladder (so to speak), leaving nurse manager positions open. I took one of these and was told, I will be real good at it.
Being new to a position like this, I would like some different suggestions from those that might have input. How do I handle some of the friction or situations appropriately, without making them worse. The one thing that adds to the mess, is nobody says anything to anybody else......they just pile their thoughts up on me.

I have some thoughts of my own, but would like to see what other ideas are out there. Things that might smooth over the situation as a whole, and maybe make things a little more fluid in the department.

Thanks for any input I might recieve.

CEN35

A great place to start is with your basic knowledge of what workgroups are and what teams are. One of the best books I have found is called "The Wisdom of Teams" by Katzenbach and Smith. Excellent resource.

You are in a situation that other new manager/leaders face. Little attention to developing the leadership potential and management skills. Email me directly for more information. My email address and profile can be found under the profile section above.

I look forward to your email.

chas

CEN35 · Mar 31, 2001

well thanks for any input chas, apparently this is a dead thread subject.

Rick (CEN35)

Janet Barclay · Jul 25, 2001

Hey Rick,

I just reread your post and have a few thoughts to share.

I've been a manager (low level) for about three years now and I recognize the nurses you are describing with a few caveats.

1. Most people over the course of time can be all of the people you decribe.

2. Everyone would prefer that you deal with their interpersonal problems rather than tackle them themselves. (almost everyone)

when staff come to me with a problem about another nurse, the first question that I ask is: "have you talked to this person?". The answer is generally no. People need coaching in how to approach their colleagues without giving offense or starting a war. I try to coach them appropriately eg: keep it real and about events. Stay away from "every time..."

Nurses B and C may need a push from their peers more than a push from you. You're not dodging the problem by doing that, you're dealing with it!

Ask nurse D what her issues are . I've had several HR type problems with moody people ending up with me referring to the employee assistance program.

MOST nurses want to be nurse E. They just need support and mentoring to help them get there.

Don't forget that not every nurse is an A plus nurse and that there is a place in critical care areas for the B plus nurses of this world. Let them work in the areas that they excell in. Our ER is set up in areas as I think most are. Some people are never going to function really well in the trauma rooms, don't make them. Let them shine on the minor side (minora, my friend calls it:) )

Anyway, this seems to be running on and on, so I'll get off my apple box :rolleyes:

Janet

IR5676 · Jul 28, 2001

Having recently entered the management area, being now the interim DON of a small, rural extended care facility, I've found that letting everyone be themselves while giving and setting limits works. We were all under a great deal of stress, rumors were flying, but I knew where I had to take action. First, morale needed to improve for both the residents and staff. I went on the floor and worked alongside my CNAs to ensure the job got done. This improved morale considerably, iIwasn't just a desk-jockey. Then I tried to influence others' moods by always having an up, nutty attitude when at work. But I'm always something of a nut, so that wasn't hard. And thirdly, I gave each individual the respect due them. That in itself made up for long hours and weeks, and enabled me to take over the job. You'll always have different personalities, people that seem to gripe all the time, and those that never say no to any request. I always try to remember these things during scheduling , because now everyone is trying to help 110% to get through our current crisis. Hope this helps in some way.

ACNORN · Aug 5, 2001

CEN35, I can relate to your problem with the disfunctional employee behaviors. I love the way you categorized them - that is probably a good start toward developing strategies to deal with the various personalities. I have been in nursing for a long time in every position from nurse aide to chief nurse executive. I remember that I've always had employees with these various behaviors, but in the past it was easier to to keep the good ones and get rid of the poor performers. Unfortunately, with today's shortages, I have to try to rehab every employee. I spend a great deal of time every week coaching the employees who are at war with each other. In addition to doing a lot of listening, I have to correct erroneous attitudes and thoughts. I've also found that when I mimic the body language that the employee is exhibiting during the coaching session - they usually laugh and lighten up. The first thing that I make clear to them is that it is not OK to just avoid the other person. Its amazing to me that nurses don't understand that it is just as important to be able to work well with each other as it is to be clinically competent. I also take away the excuse of "well, thats just the way I am". Sometimes it helps to tell them about my own shortcomings or conflicts that I've had to resolve. It lets them know that I don't see myself as perfect and them as terribly flawed.

My goal during each of these sessions is to get each employee to accept at least partial responsibility for the conflict. I also make sure that they know that they can work on their co-worker relations or keep coming to my office for these little chats. So far I haven't had any repeat visits. It has taken the better part of a year, but these coaching sessions have also let the employees know what behaviors will not be tolerated in our hospital. Its time consuming, but it helps. You may want to try customer service training that emphasizes co-workers as customers. EAP is also a good idea in some cases, if your facility has one. Hope this helps.

PhantomRN · Aug 8, 2001

I love all these sugestions except one. I went to my manager one day and said :

"Look, such and such just told me that X is saying things behind my back.

(Not said to manager but Just so you all know the only thing she said was that I was different. Which in itself could be interpreted may ways. And I am a firm believer in nipping things in the butt. Who knows what she would say about someone else.)

I am not going to get into what she said that is not important and I am not interested. I would just appreciate it if you would discuss with her appropriate and professional behavior. I would hate to see her say the wrong thing about one of the other staff members and they go after her."

The managers response : "Have you told her how you feel?"

I said "No."

She said " I think you should go talk to her and tell her what you heard she said and tell her it is not appropriate."

I said, " I dont think I should be the one explaining to her professionalism. Do you? ( I thought :I am not the manger.) She is a new grad and she may not know that she should not say anything at ALL about anybody. "

She said "Well why dont you talk to her and explain to her what you just said to me."

And me being the fool believed my manager and went and gently explained to this new grad that she should not say anything at ALL about anyone being new and all and how that could impact her. Meaning there were several staff on that floor just waiting for a chance to rip up any new RN and boy was she giving them cannon fodder. Needless to say It took 3 months and many meetings with the manager with this girl for HER to recover from this blow. BELIEVE that or not.

So I ask you would not it have been easier if the manager had grabbed this RN and just did an Impromtu chat on how to survive on a floor? The Rn would have never knew I knew what she said and she would not have been embarrassed and felt like she had to defend herself. UGLY huh.

**canoehead, BSN, RN** · Aug 9, 2001

Seems like the manager suggested just the right thing. If you felt you needed coaching on communication skills you could have made a few dry runs with the manager as the "victim" or you could have asked for a third party to be there to mediate.

Unfortunately managers can't fix every episode of gossip, but most encourage developing communication skills in their staff. Ask her if there are any educational offerings you could go to, or committees that you could work on and practise giving constructive feedback.

To get the skill you need you will need to work on it.

mikemw · Aug 17, 2001

Welcome to the world of managment. I think conflicts between coworkers is always a headache for a manager regardless of their experience. It takes good communications and listening skills. Often the verbalized problem is not the real issue.

I do agree that often times the first action that should be attempted is for the people involved to attempt to talk out the problem. As PhantomRN pointed out this does not always work and may even cause further ill feelings. If the problem is behaivor that is unprofessional (gossiping about staff or patients) or unacceptable (continued tardiness substandard performance ) Then I believe it is an issue that needs a manger to addresss. If s manager does not address unacceable behavior it could be viewed as condoning it. If it is personal conflict then encourage the parties to work it out, but be available as moderator or facilitaor. If "personal conflicts" occrurr frequently with the same individual or are prevalent in the unit then there is also a problem lurking in the dark that needs management attention.

One technique I used when I was a manger was letting my employees know my door was always open to discuss a problem but if they had identified a problem I expected facts, not hearsay and I asked what it was that they would like to see me do about it. If there are no facts, Rumor Control may have to be done. If there are no recommended solution, it is a complex issue or a nonissue (ie they just want to vent). Venting is OK by the way. I do it often but I tell my boss I'm venting and just didn't want to let my frustration out on my patients or coworkers. We often laugh about this afterwards.

Mangement books help, but often you must to learn to deal with personnel issues by doing and see what works for you.

One thing that may help take a load off for new graduate or someone with little experience, is to appoint an experienced person as mentor.

Keep us posted on how it goes.

Mike M