Lead Clinical Nurse is Dealing with a Negative Nelly, HELP!

[JKL33]

Nurse SMS said:

I actually disagree strongly with your interpretation of the bolded portion above.

Also: I believe my interpretation is correct because she doesn't work through this in an intelligent ("we're equal") way but rather in a way that utilizes mockery and (uh....fingerpointing) to make others feel that they have been silly.

Nurse SMS said:

From a humanitarian standpoint, providing reassurance and explanations is the right thing to do. I usually love the things you post, but sometimes your view of leadership and management is highly skewed toward cynicism and outright hostility based on your personal experiences. I just don't see the presence of matrix outcomes the way that you are in this situation. I see a nurse being encouraged to get past her overly emotional reaction to go take care of a patient who has been frightened to death.

I was writing as you were and I believe my interpretation is correct.

[Nurse SMS, MSN, RN]

1 minute ago, JKL33 said:

Just disagree. Reassurance is not always warranted although explanations and especially active listening almost always are.

Reassurance is inappropriately utilized as a tool over and over and over in numerous ways in this business. In fact, the off-hand "I have the time" example I already gave is one of said innumerable inappropriate reassurances, that is to say, those primarily meant to deceive.

I have never been a fan of scripting either. After two people say the exact same words it rings pretty hollow. Patients aren't stupid.

My choice of the word "reassurance" is perhaps not the right one. To me, active listening, honest explanations and collaborative planning with the patient are the things that reassure. I have never seen a head pat and "there there there" as a reasonable approach.

[JKL33]

Nurse SMS said:

That's so interesting to me. I don't see or feel that at all.

Seriously?? She's literally up there with the 'you know what you do' coy spiel to a group of professional nurses waiting for people to clap while she mocks people's emotions...??‍♀️

She has a lack of humility even I can't say I've seen a whole lot, cynical as I am...?

[Nurse SMS, MSN, RN]

Just now, JKL33 said:

Seriously?? She's literally up there with the 'you know what you do' coy spiel to a group of professional nurses waiting for people to clap while she mocks people's emotions...??‍♀️

 

She has a lack of humility even I can't say I've seen a whole lot, cynical as I am...?

You say mock, I say wry humor. I think we just interpret this differently, but it is certainly eye opening to see that could have actually put some people off instead of uniting them in humor. You have given me something to think about. 

[JKL33]

I feel that she's just driving at a result and she is mocking nurses to get there.

People's emotions are real. Maybe if anyone ever leveled with us it would be much easier for us to learn how to independently see better ways.

I loved what my previous manager said probably because she did not try to dictate what accepting her premises would result in. She demonstrated loving people. She gave some wisdom that could really help people if they chose to apply it and she gave it without demanding what others should do with it. That's big.

What we are watching here is not big. It's I'm desperate to get you to change....let's try mockery!

I am being cognizant and really trying not to exaggerate - - but it seems that we are extremely frequently being criticized for how we respond to choices that others have already made. And to make it worse, much worse, our reactions, because we are nurses, are tied up into a moral context pretty much immediately.

[JKL33]

35 minutes ago, Nurse SMS said:

I usually love the things you post, but sometimes your view of leadership and management is highly skewed toward cynicism and outright hostility based on your personal experiences.

I agree. I don't know why (a lot of work gaining self-esteem, possibly) but I have spent way too much of my career thus far in a system (Magnet, not-for-profit) that has a particularly patronizing and always-blame-shifting manner of interacting with nurses. They do this exact stuff, which, I don't mean to be dramatic but I can't really think of another term to call it besides gas-lighting. Days are filled with the literally impossible ideas they come up with (and I'm not talking "I don't think I can do this--it sounds like hard and too much trouble," I'm talking, "Your plan here is literally that I will be performing hands-on duties on two opposite sides of this department at the exact same time, and that is the performance you expect from me")--and when people try to understand how they can meet expectations, administrators full-on act as if reality isn't reality.

When one very gingerly tries to ask an appropriate question to clarify the situation, it is **instant** anger and disparagement in reply. It is, "What is wrong with you." "Why don't you have a better attitude." "Why aren't you a team-player?" [Rarely, it has been me personally who has received this treatment, but usually it is in meetings, huddles, emails or other instances where I see how they respond to any of us if given the chance].

Nurses are spoken to in ways that people wouldn't routinely speak to other professionals or to anyone for which a degree of regard is held. This happens corporately and individually--in meetings and 1:1 interactions.

Do you think Cy Wakeman would attend a hospital board meeting and speak in this way? Do you think she'd attend said meeting with important community members and say, "Now mama loves to play poker, so listen up: You know what you do! You sit here and you hope and pray that those providers and nurses can make good despite this kind of budget....come on, now - you know you do! When you get reports of difficulties you panic and start setting up your secret coffee meetings at Posh Coffee so you can figure out how best to double-down...come on, haha, you know it's true! Secret coffee...amirite?!"

[Nurse SMS, MSN, RN]

3 hours ago, JKL33 said:

I agree. I don't know why (a lot of work gaining self-esteem, possibly) but I have spent way too much of my career thus far in a system (Magnet, not-for-profit) that has a particularly patronizing and always-blame-shifting manner of interacting with nurses. They do this exact stuff, which, I don't mean to be dramatic but I can't really think of another term to call it besides gas-lighting. Days are filled with the literally impossible ideas they come up with (and I'm not talking "I don't think I can do this--it sounds like hard and too much trouble," I'm talking, "Your plan here is literally that I will be performing hands-on duties on two opposite sides of this department at the exact same time, and that is the performance you expect from me")--and when people try to understand how they can meet expectations, administrators full-on act as if reality isn't reality.

When one very gingerly tries to ask an appropriate question to clarify the situation, it is **instant** anger and disparagement in reply. It is, "What is wrong with you." "Why don't you have a better attitude." "Why aren't you a team-player?" [Rarely, it has been me personally who has received this treatment, but usually it is in meetings, huddles, emails or other instances where I see how they respond to any of us if given the chance].

Nurses are spoken to in ways that people wouldn't routinely speak to other professionals or to anyone for which a degree of regard is held. This happens corporately and individually--in meetings and 1:1 interactions.

Do you think Cy Wakeman would attend a hospital board meeting and speak in this way? Do you think she'd attend said meeting with important community members and say, "Now mama loves to play poker, so listen up: You know what you do! You sit here and you hope and pray that those providers and nurses can make good despite this kind of budget....come on, now - you know you do! When you get reports of difficulties you panic and start setting up your secret coffee meetings at Posh Coffee so you can figure out how best to double-down...come on, haha, you know it's true! Secret coffee...amirite?!"

I don't disagree that much needs to be revamped in our nursing world. I have crossed over and straddle the dark side these days and I try hard to be a voice of reason in the projects I get placed on. So much of what gets decided has no bearing in what the actual bodies on the floor are doing. When I worked the floor, I once put on paper the number of hours it would take to do my usual stuff, on a good day, plus the hourly rounding, plus the charting and checklists and multiplied it by the average number of patients I was assigned. It came out to two hours more than I actually had on my shift. The addition of so many "this should only take 5 minutes" really does begin to add up.

I don't know the answers, but I do know there are people like me out there fighting for sensibility and responsibility among the suits. I also know that there are plenty of negative nelly's out there who want to complain, blame the patient, blame one another and in general feed on the drama of stirring themselves and everyone else up.

I think the answer is pretty obvious and I think as long as the healthcare institutions are corporate driven and in bed with insurance companies we are going to see more of the same. I can't solve it. But I am here in my own little world trying to be one finger in the dam, so to speak. I appreciate your insights, as always. For me, Cy Wakeman actually has provided a pathway to self discovery and made me see that being happy at work is a choice I can make. I don't have to get sucked down into the drama that is so, SO common. It's definitely NOT all upper management making this profession miserable at times. But....I can appreciate that her approach probably won't work for everyone. It did revolutionalize my thought process, helped me draw boundaries around the drama inside myself and made me better at my job.

[Hirene Onne, ASN]

Before I would formally call her on the carpet, I would have an informal one-to-one conversation with her.  "You're a good nurse, I like you, but I don't think you realize how your negative comments about staffing is demoralizing everyone and causing disruption.  If that doesn't help, escalate it formally.

[NICURN56]

I have a lot of years experience in several different hospitals and positions. I have worked as a clinical RN, nurse educator and lead roles like ANM, CN, Team leader etc. in NICU and Labor and Delivery. I also have 8 years experience as a Department Manager. There are always negative people in the workplace. They are a drag on everyone's energy. Most people do not like their negativity and look to their leaders to either minimize it or eliminate it. In a leadership vacuum some negative people who have other dysfunctional behaviors like bullying and controlling others with fill the leadership void and create a whole team engaging in dysfunctional workplace behavior. That is why good leadership on your part is, as others have stressed, so important. I agree with the person who said your staff is watching how you handle her behavior. Work with your manger and HR, make a plan and be consistent. (Sounds like you have already done so). If you are clear and consistent that her negativity is the issue being addressed then it really is up to her to change it. If she really is a valued employee then tell her you want to help her overcome this. If she is truthfully someone who needs to move on then let her go. It is not worth investing a lot of time and emotional energy in employees like that because they rarely make the effort to change. Cy Wakeman, Brene Brown, any of them are a matter of personal choice how their philosophies and systems work for people. I see some value in Cy Wakeman's suggestions but don't really like her style. Read a variety and choose your own to develop your leadership style. Best of luck to you!

[Nurse Beth, MSN]

Words Matter said:

Thank you everyone for your suggestions, experience, and conversation. Here is the latest update:

I met with our interim HR manager for 2.5 hours. I was expecting no more than an hour meeting as the original intention was to review the current bargaining contract, review my documentation of anecdotal notes and get direction on future account documentation. The reason the meeting was so lengthy was a majority of the time was spent on the HR manager getting my perspective of the unit needs, complaints from other staff (r/t both staffing and said nurse), and solutions I or management have offered/initiated. It turned out the nurse had met with HR just two days prior to my scheduled meeting. 

I received good direction from HR specifically in regards to not labeling behavior, just being factual. She educated me on the disciplinary process, my involvement as a supervisor, and the responsibilities of management. I then met with my manager and learned of other reported actions by this nurse related to her now documenting timelines of my comings and goings during the shifts I work with her.

  I have been asked to trust there is a solution in the works. 

My goodness. 

So this nurse has been keeping documentation on you and meeting with HR behind your back? Unbelievable.

It's clear HR has a plan to deal with this employee.

HR is mitigating risk by coaching you. They want to ensure that you make no missteps because the situation has escalated to well, frankly, war.

Best wishes my friend, keep on doing a great job 

[Words Matter, BSN, RN]

17 hours ago, Nurse Beth said:

It's clear HR has a plan to deal with this employee.

HR is mitigating risk by coaching you. They want to ensure that you make no missteps because the situation has escalated to well, frankly, war.

Thank you so much Nurse Beth! I am beyond grateful not to be alone in navigating this situation, both within and outside of my organization.