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Conflict with higher-up (nurse)

#1 · July 14, 2023, 8:48 pm

Quote from John Freeman on July 14, 2023, 8:48 pm
Hello,
This happened to me about a month ago, one month after I started my new job as an attending in a new hospital.
The morning I started my shift a resident told me that the nurse was taking a urine sample from a baby buut that the baby had his butt in the sample collector. So she was not sure that the sample would be of good quality and could be contaminated.
So I called the nurse and said with a soft-spoken voice (not harsh or anything, the resident near me and the intern confirmed that I was being gentle afterwards):
Me: this is me, I'm calling just to remind you that it's important that the sample is not contaminated.
Person on the phone (curt and harsh tone): Well if you want to come help us.
The person said that the nurse was busy and she could not talk now (I thought I was talking with the said nurse) I said I was going to come down. We were busy at the time so I could not come right away. I wondered if I should let it slip but I decided to stand up for myself. As Lucio says, I will always learn something from the experience of confrontation, which I did.
When I go to the ER, I say to the nurse the same thing and add that I know it's not easy and she says that she's doing her best with a smile and I thank her. Then I ask her: "who was I speaking to on the phone?". She says: "my (nurse) boss, Sonia". I ask where she is and she directs me to her.
I go and ask to speak with her apart (she was in the middle of her reports), her report of course understood that I was coming to scorn her:
Me: When we talked on the phone I found that you were a bit curt.
Her (agressive tone): it was you who was curt.
So I thought right away as she accused me of doing what she did: "she's not going to have a honest conversation and it's not worth the escalation": we never worked together and it was a small issue. She also told me that she was afraid that I was criticizing her colleague's work and I said "absolutely not". So I decided to de-escalate and let it go:
Me: Well, it happens sometimes that there are misunderstandings (hand gestures, smile). Thank you I wish you a good day.
And moved on. So I was proud to have stood up for myself and be assertive and also for not going into a conflict further with this person. So I took note that she was probably a manipulator (also her face/facial expression is weird: difficult to explain more but some manipulators have a typical facial expression). So it's stopped there and when I saw her in the hospital, I made sure to say hello and smile to rebuild some rapport. It was all fine and I thought it was settled.
This week, I had my performance review which went really well as I told in my journal. BUT they brought up this story (she denounced me to them, very common in Switzerland: people you have a conflict with will go to your boss, you cannot straighten things up 1-to-1, they always involve higher ups). She basically said: "Ah John works with you?" like she didn't know she know well that I work in pediatrics (she's one of the head nurse of the ER).
During my performance review I told them that I knew I should have told them (because it might have come to bite my ass) when it happened. I was angry that she spoke behind my back. Basically she told them that they were really busy at the time. So my boss told me: "you have to put yourself in the other person's shoes". This is good feed-back, but she did not take into account the way she spoke to me. I just thought today that I could have said: "yes, but this is not a reason to speak to me like that".
So in the end she "won" in the sense that she has been able to disrespect me without apology and then complain about me to my bosses. It's a small thing but with my current boss I already had an issue of disrespect towards me that I called out (too strongly) where basically she apologized through an email 2 years ago later on. She's the one who hired me in this role. So now there's the risk of them putting the image on me of "the guy who has communication issues", which is was she actually said.
So basically I think the head nurse is a manipulator and she felt disrespected when I confronted her (they are not owning their behaviour) in line of sight of her reports and sought revenge for that, typical behaviour.
So it did lower my status in front of my boss' eyes and I have had been had once again by a manipulator (what frustrates me the most). Lesson learned: when I have a conflict with someone I will tell my boss afterwards right away. I knew this move but I thought that she was going to behave like an adult and keep it between her and me. But she felt she had higher status than me and wanted her revenge: "how dare he...".
That's why I think that being assertive with one's boss when they disrespect us does not work that well in my context in Switzerland in medicine. One is expected to take it from the boss. So even though it's the right behaviour (I agree with you Lucio), it's very dangerous to do it in my context. In Switzerland the higher up is always right. It's a very hierarchical culture. My current boss (normal person) apologized 2 years ago but manipulators make you pay for it.
I'm curious to know what you guys think of this situation. Where was my mistake do you think: in being assertive, in the timing of talking to her, in not telling my bosses?
Because I think I have the right to be respected. And now I'm ready to demand that respect whatever the cost. Of course not to the point of stupidity.
If something is not clear, I'm happy to clarify.
I want to learn: I'm happy to change my mind and be wrong about anything, in particular this:
That's why I think that being assertive with one's boss when they disrespect us does not work that well in my context in Switzerland in medicine.

Hello,

This happened to me about a month ago, one month after I started my new job as an attending in a new hospital.

The morning I started my shift a resident told me that the nurse was taking a urine sample from a baby buut that the baby had his butt in the sample collector. So she was not sure that the sample would be of good quality and could be contaminated.

So I called the nurse and said with a soft-spoken voice (not harsh or anything, the resident near me and the intern confirmed that I was being gentle afterwards):

Me: this is me, I'm calling just to remind you that it's important that the sample is not contaminated.
Person on the phone (curt and harsh tone): Well if you want to come help us.

The person said that the nurse was busy and she could not talk now (I thought I was talking with the said nurse) I said I was going to come down. We were busy at the time so I could not come right away. I wondered if I should let it slip but I decided to stand up for myself. As Lucio says, I will always learn something from the experience of confrontation, which I did.

When I go to the ER, I say to the nurse the same thing and add that I know it's not easy and she says that she's doing her best with a smile and I thank her. Then I ask her: "who was I speaking to on the phone?". She says: "my (nurse) boss, Sonia". I ask where she is and she directs me to her.

I go and ask to speak with her apart (she was in the middle of her reports), her report of course understood that I was coming to scorn her:

Me: When we talked on the phone I found that you were a bit curt.
Her (agressive tone): it was you who was curt.

So I thought right away as she accused me of doing what she did: "she's not going to have a honest conversation and it's not worth the escalation": we never worked together and it was a small issue. She also told me that she was afraid that I was criticizing her colleague's work and I said "absolutely not". So I decided to de-escalate and let it go:

Me: Well, it happens sometimes that there are misunderstandings (hand gestures, smile). Thank you I wish you a good day.

And moved on. So I was proud to have stood up for myself and be assertive and also for not going into a conflict further with this person. So I took note that she was probably a manipulator (also her face/facial expression is weird: difficult to explain more but some manipulators have a typical facial expression). So it's stopped there and when I saw her in the hospital, I made sure to say hello and smile to rebuild some rapport. It was all fine and I thought it was settled.

This week, I had my performance review which went really well as I told in my journal. BUT they brought up this story (she denounced me to them, very common in Switzerland: people you have a conflict with will go to your boss, you cannot straighten things up 1-to-1, they always involve higher ups). She basically said: "Ah John works with you?" like she didn't know she know well that I work in pediatrics (she's one of the head nurse of the ER).

During my performance review I told them that I knew I should have told them (because it might have come to bite my ass) when it happened. I was angry that she spoke behind my back. Basically she told them that they were really busy at the time. So my boss told me: "you have to put yourself in the other person's shoes". This is good feed-back, but she did not take into account the way she spoke to me. I just thought today that I could have said: "yes, but this is not a reason to speak to me like that".

So in the end she "won" in the sense that she has been able to disrespect me without apology and then complain about me to my bosses. It's a small thing but with my current boss I already had an issue of disrespect towards me that I called out (too strongly) where basically she apologized through an email 2 years ago later on. She's the one who hired me in this role. So now there's the risk of them putting the image on me of "the guy who has communication issues", which is was she actually said.

So basically I think the head nurse is a manipulator and she felt disrespected when I confronted her (they are not owning their behaviour) in line of sight of her reports and sought revenge for that, typical behaviour.

So it did lower my status in front of my boss' eyes and I have had been had once again by a manipulator (what frustrates me the most). Lesson learned: when I have a conflict with someone I will tell my boss afterwards right away. I knew this move but I thought that she was going to behave like an adult and keep it between her and me. But she felt she had higher status than me and wanted her revenge: "how dare he...".

That's why I think that being assertive with one's boss when they disrespect us does not work that well in my context in Switzerland in medicine. One is expected to take it from the boss. So even though it's the right behaviour (I agree with you Lucio), it's very dangerous to do it in my context. In Switzerland the higher up is always right. It's a very hierarchical culture. My current boss (normal person) apologized 2 years ago but manipulators make you pay for it.

I'm curious to know what you guys think of this situation. Where was my mistake do you think: in being assertive, in the timing of talking to her, in not telling my bosses?

Because I think I have the right to be respected. And now I'm ready to demand that respect whatever the cost. Of course not to the point of stupidity.

If something is not clear, I'm happy to clarify.

I want to learn: I'm happy to change my mind and be wrong about anything, in particular this:

That's why I think that being assertive with one's boss when they disrespect us does not work that well in my context in Switzerland in medicine.

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#2 · July 15, 2023, 4:43 am

Hi John I don't think this was so bad more a case of an unsupportive boss.

I love your misunderstandings speech. Simple and effective.

This lead nurse is probably known to be difficult and your boss probably just appeased her. From your bosses point of view it's easier to go with the hierarchy and use her boss power to put all the blame on you.

Instead of this.

Me: this is me, I'm calling just to remind you that it's important that the sample is not contaminated.

Maybe this:

Hi it's John here from pediatrics. I just wanted to check on that sample for the Smith baby. We had one last week where the baby was wriggling around and somehow managed to give her bottom in the sample. Sorry to be a pain, would you mind getting 1 of the guys to just check that it's OK.

-------------------------------------------------------

I find with these ladies if you can start talking about the detail of the work you can get alongside them better. Any kind of directness or upfront tasking seems to activate their hamster terminator.

Yes agree on letting your boss know. And I d suggest any time you have a run in follow up with an overly nice email. Otherwise they can just make shit up.

You don't want to give snakes room to twist and turn

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#3 · July 15, 2023, 7:50 am

Thank you very much Transitioned for your answer!

Quote from Transitioned on July 15, 2023, 4:43 am
Hi John I don't think this was so bad more a case of an unsupportive boss.

Yes, definitely.

I love your misunderstandings speech. Simple and effective.

Thanks! :)

This lead nurse is probably known to be difficult and your boss probably just appeased her. From your bosses point of view it's easier to go with the hierarchy and use her boss power to put all the blame on you.

Definitely!

Instead of this.
Me: this is me, I'm calling just to remind you that it's important that the sample is not contaminated.
Maybe this:
Hi it's John here from pediatrics. I just wanted to check on that sample for the Smith baby. We had one last week where the baby was wriggling around and somehow managed to give her bottom in the sample. Sorry to be a pain, would you mind getting 1 of the guys to just check that it's OK.

Yes, much better. For clarification: I did not know I was speaking to the head nurse but I think you got that.

-------------------------------------------------------
I find with these ladies if you can start talking about the detail of the work you can get alongside them better. Any kind of directness or upfront tasking seems to activate their hamster terminator.

Definitely, thanks! Did not think about this, yes it definitely works.

Yes agree on letting your boss know. And I d suggest any time you have a run in follow up with an overly nice email. Otherwise they can just make shit up.

Thanks for the suggestion, definitely will do this. Not exactly sure though who to send the email to: my boss or the person I had a conflict with?

You don't want to give snakes room to twist and turn

Yes, that is exactly how I called her: a snake and yes she definitely had room to maneuver. As in it started with the excuse of: "I was afraid you were criticizing my colleague's job" to "we were too busy".

Thanks a lot my friend!

#4 · July 15, 2023, 9:35 am

Email to her. Thanking for help. Lovely to meet you. Heard great things about your team. Looking forward to working with you

Makes harder to hang the bad communicator rat around your neck. Over many bosses I have found that having a female boss is a bit different. They are more concerned about all the social herding skills. And people's feelings. E.g. to a woman boss some lady saying you upset her is a valid complaint. No evidence needed and the accuser probably won't even say how you upset her.

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#5 · July 15, 2023, 9:51 am

Thanks a lot! I will definitely do that.

Yeah definitely about women’s perspective on work: it’s about harmony and avoiding conflict.

Since my field is 80% women they set the tone.

The upside is that if you make them feel safe (professionaly speaking) and is a solid stand up guy they give you free passes for mistakes and/or forgetfulness.

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#6 · July 15, 2023, 12:52 pm

Great response by Transitioned already.

A couple of notes from my side:

For sure being more careful with "feedbacking the boss" or enforcing boundaries with the boss: I don't remember where/when I said to push back against a disempowering boss, but if I said "always do that", then I was definitely in the wrong :).
I think that is also foundational to PU: you adapt to the person you're dealing with, both in personality and rank
I actually think you did good to go there and speak in person: one can always tweak a thing here and there, but generally better to take the self-respecting action than not to
Some bosses have to follow through with the "wrist slap", but they still prefer those who make things happen: in any environment where most people prefer to get by and do the minimum, bosses generally prefer high-power doers who make things happen, even if those does may strain those relationships.
When there is a complain, they will have to follow through with the expected protocol, but deep down they prefer the person who makes things happen
You can do both: go talk to her, then go talk to your boss
You could have been more assertive there: when she pushed back, you also maintain your frame. Or you can even agree, but higher power.
Ie:

You: Yeah, look, maybe, not sure about that, but my goal here is not to assign blame, but to work better together.
I hope we can do that.
Thank you for your time, and I wish you a great day!

A possible good high-level rule:

At work and with people you better have on your side, always seek the high-power but win-win and conciliatory frame of "together".

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#7 · July 16, 2023, 10:58 pm

100% agree with you John in these kinds of environments status and relationships always trump facts.

Had an example on Friday the head procurement lady accused me of pulling her guy suddenly into a meeting basically staging an ambush.

Actually I had invited them to the meeting 3 days earlier she just hadn't read her emails.

Now to smooth things over I have to work out a way of apologising for her mistake.

Just another day in the office.

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#8 · July 18, 2023, 12:11 am

Looks like John is done with the thread so I will ask here.

@lucio

You said "Some bosses have to follow through with the "wrist slap", but they still prefer those who make things happen"

I am curious do you know of any research on this?

Reason I am asking it is because every single female boss I have had when you ask them what made one of their stars good they always mention building relationships and the stakeholder engagement.

Now of course some of them would be saying with an agenda but I don't think that would be every single one of them.

And that kind of gels with what John was saying about the passes given.

I m wondering if it's relationships first, like a ticket you need to get admitted to the game and then you can get away with more cheeky moves or mistakes.

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#9 · July 18, 2023, 7:39 am

Quote from John Freeman on July 18, 2023, 7:39 am
Thank you Lucio!
Quote from Lucio Buffalmano on July 15, 2023, 12:52 pm
Great response by Transitioned already.
A couple of notes from my side:
For sure being more careful with "feedbacking the boss" or enforcing boundaries with the boss: I don't remember where/when I said to push back against a disempowering boss, but if I said "always do that", then I was definitely in the wrong :).
I think that is also foundational to PU: you adapt to the person you're dealing with, both in personality and rank
I read that caveat in the current version of PU. It was a couple years ago when I first did PU, maybe I misunderstood. It was when your boss disempowered you and you said to him to not speak to you like this again. I thought: "if I speak like that I would get fired". Or maybe it was a theoretical example and I thought it was a real life example. Anyway thanks! It's clear to me now.
I actually think you did good to go there and speak in person: one can always tweak a thing here and there, but generally better to take the self-respecting action than not to
Thanks. Yes, I think it's worth it.
Some bosses have to follow through with the "wrist slap", but they still prefer those who make things happen: in any environment where most people prefer to get by and do the minimum, bosses generally prefer high-power doers who make things happen, even if those does may strain those relationships.
When there is a complain, they will have to follow through with the expected protocol, but deep down they prefer the person who makes things happen
That's a bit how I felt: that they were half-wrist-slapping me and half-advising me how to avoid being in this situation in the future again.
You can do both: go talk to her, then go talk to your boss
Yes, definitely.
You could have been more assertive there: when she pushed back, you also maintain your frame. Or you can even agree, but higher power.
Ie:
You: Yeah, look, maybe, not sure about that, but my goal here is not to assign blame, but to work better together.
I hope we can do that.
Thank you for your time, and I wish you a great day!
In this case I think that maintaining my frame could have probably escalated things which is why I did not: "you were curt" "no you were curt" etc. I might be wrong though. The second part is golden, thank you very much! In my notes.
A possible good high-level rule:
At work and with people you better have on your side, always seek the high-power but win-win and conciliatory frame of "together".
Thanks for that! Great reminder.
Quote from Transitioned on July 16, 2023, 10:58 pm
100% agree with you John in these kinds of environments status and relationships always trump facts.
Had an example on Friday the head procurement lady accused me of pulling her guy suddenly into a meeting basically staging an ambush.
Actually I had invited them to the meeting 3 days earlier she just hadn't read her emails.
Now to smooth things over I have to work out a way of apologising for her mistake.
Just another day in the office.
Head shake. Well, to look at the positive: these are opportunities for us to learn how to be more-eagle like.
Quote from Transitioned on July 18, 2023, 12:11 am
Looks like John is done with the thread so I will ask here.
I'm here. Just got back from a get-away week-end. Thank you very much Transitioned and Lucio!

Thank you Lucio!

Quote from Lucio Buffalmano on July 15, 2023, 12:52 pm
Great response by Transitioned already.
A couple of notes from my side:
For sure being more careful with "feedbacking the boss" or enforcing boundaries with the boss: I don't remember where/when I said to push back against a disempowering boss, but if I said "always do that", then I was definitely in the wrong :).
I think that is also foundational to PU: you adapt to the person you're dealing with, both in personality and rank

I read that caveat in the current version of PU. It was a couple years ago when I first did PU, maybe I misunderstood. It was when your boss disempowered you and you said to him to not speak to you like this again. I thought: "if I speak like that I would get fired". Or maybe it was a theoretical example and I thought it was a real life example. Anyway thanks! It's clear to me now.

I actually think you did good to go there and speak in person: one can always tweak a thing here and there, but generally better to take the self-respecting action than not to

Thanks. Yes, I think it's worth it.

Some bosses have to follow through with the "wrist slap", but they still prefer those who make things happen: in any environment where most people prefer to get by and do the minimum, bosses generally prefer high-power doers who make things happen, even if those does may strain those relationships.
When there is a complain, they will have to follow through with the expected protocol, but deep down they prefer the person who makes things happen

That's a bit how I felt: that they were half-wrist-slapping me and half-advising me how to avoid being in this situation in the future again.

You can do both: go talk to her, then go talk to your boss

Yes, definitely.

You could have been more assertive there: when she pushed back, you also maintain your frame. Or you can even agree, but higher power.
Ie:
You: Yeah, look, maybe, not sure about that, but my goal here is not to assign blame, but to work better together.
I hope we can do that.
Thank you for your time, and I wish you a great day!

In this case I think that maintaining my frame could have probably escalated things which is why I did not: "you were curt" "no you were curt" etc. I might be wrong though. The second part is golden, thank you very much! In my notes.

A possible good high-level rule:
At work and with people you better have on your side, always seek the high-power but win-win and conciliatory frame of "together".

Thanks for that! Great reminder.

Quote from Transitioned on July 16, 2023, 10:58 pm
100% agree with you John in these kinds of environments status and relationships always trump facts.
Had an example on Friday the head procurement lady accused me of pulling her guy suddenly into a meeting basically staging an ambush.
Actually I had invited them to the meeting 3 days earlier she just hadn't read her emails.
Now to smooth things over I have to work out a way of apologising for her mistake.
Just another day in the office.

Head shake. Well, to look at the positive: these are opportunities for us to learn how to be more-eagle like.

Quote from Transitioned on July 18, 2023, 12:11 am
Looks like John is done with the thread so I will ask here.

I'm here. Just got back from a get-away week-end. Thank you very much Transitioned and Lucio!

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