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Dealing with a manipulative low-performer subordinate trying to make it personal
Hello TPM community,
at work, we have a manipulative resident let's call her Sandra who's been there for about 9 months. The issues are:
- Always (and I mean always) coming up with excuse for work she did not do.
- Playing the "It's not me who..." game: blame-shifting
- Poor understanding of medical reasoning and patients' social context
- Low empathy
- Trustworthiness: habitual lying
- Responsibility: does not acknowledge her mistakes
- Professionalism/consciousness: poor work quality, not taking into account patients' interests
- Teamwork: poor, goes back to blame-shifting, avoids work, exhales when assigned tasks, in ED tries to see as little patients as possible to push her work on other residents
- Needs micromanagement: since she's bad and does not know it, needs her work to be checked and constant supervision. Does not write important information in patients' files and on our handoff paper sheet.
- Over-confidence: ultra-beginner but thinks she's better than that
- Does not improve: very poor learning ability, low intelligence (comparatively for her environment) but thinks she's smart, same level as someone who started a 1 month ago, learns things 9 months in the job that is learnable in a week (very basic stuff).
- Empty arguing: argues meaninglessly over things just to be right, even if the reasoning does not make sense (makes us wasting time and it's draining and frustrating: if I fall for it we're there for 10 min over nothing). Up to the point (sigh) to contradict herself. Example: she proposes a good diagnosis. I say it's good. She thinks a bit and then changes her mind (because I agreed, immature behaviour). Since she did it now a few times I know the game. So I say publicly with a smile: "you really have the art of contradicting yourself". She continues to try to trap me in her little game, I go: "whatever you want". Tries again. Me: "whatever you want".
- Lazy: prefers to be told what to do than to think, learn and understand
- Slow: just a slow worker
- Nurses very unhappy with her.
- Disagreeable personality
In summary: low performing, low quality manipulative resident.
2 months ago I pushed for a meeting to talk about the residents. When talked about her, I asked for her to be on performance watch with objectives to reach in the short term. Since she had a recent performance review, my opinion was pushed aside as if I was being too negative/it was personal.
2 weeks ago, since when working with her I had to work way more (basically doing part of her job) I talked with one of my bosses (nice sometimes too nice person). She understood the problem, told me there are always 1 bad resident in each team every 6 months. Told me that "if she does not want to learn, don't waste your time on her". Advised me to be more directive and "military" with her. Since with her personality she responds better to carrots and sticks rather than adult communication, it worked.
1 week ago, she compromised patient safety. In short there was a 2 month old baby with a bad bronchiolitis and was spending the night at the hospital under our watch. I told one of the residents to tell her that this baby had to be watched every hour. She only went at 5-6 am in the morning to check on him. And at 7am asked the nurse: "how do you find him?" which is absurd since it's obvious this baby is struggling (had to be transferred in the morning to intensive care). The baby was ok but it could have been life-threatening. In the morning our boss who's a neonatologist is pissed off to learn that. He scolded her and asked us for a feed-back on her via e-mail. I give my feed-back as objectively as possible.
3 days ago, management gets together with her and sets objectives for the next 2 months. They send us these objectives via email (frankly, they were too easy on her: 3 objectives and not really measurable, ok but not great management).
Yesterday, I talked on the phone with one of our bosses and she tells me she met with Sandra. Sandra told her basically that I'm being mean with her, that she's overworked. She tells me that I allegedly told her: "Get by on your own!" which is a blatant lie. 1. I never said that. 2. I don't talk like that to people. 3. I don't see why I would have said that. I told my boss among other things. She tells me that maybe we need a mediation. I tell her it's not personal that she has the same issues with other people also with other attendings. She says: "I don't know if it's personal or not". So basically, now she thinks it's a personal issue. I refuse the mediation and say truthfully: "I think the most important thing is for you the upper management to have set those objectives. Before your call I thought that now she needs time. I'll do my best to teach her". It's the truth. On the machiavellian side, I don't want to have a mediation with her as it signals that I'm part of the problem, which is not. So it's basically a smear campaign and she's trying to drag me in her downfall.
Issue
Not this woman is trying to push on management that it's me who has a problem with her. I talked about it with nurses and they told me: "Don't worry, we all know it's her the problem. If upper management asks us we'll tell them the truth".
Management's interests
- They're afraid that she's going to do a burnout: we would be understaffed and the team would be worse off. Also, it's difficult to recruit since the hospital is "remote" (for Switzerland, that means 30-40 min drive from larger cities) so people prefer their comfort.
- She successfully gaslighted them when she arrived: they think she has good clinical intuition (newsflash: she does not) so it's a challenge for them to change their opinion on them. She made good first impressions. That means that they would have to admit they were wrong. And we all know how much humans love to admit they've been wrong (irony of course).
- They also want to be "nice" to themselves so challenging for them to discipline her.
Strategy
So my current strategy is:
- Going emotionally neutral, being superficially nice with her: so no one can hold against me that I don't like her (actually I have no problem with her on the personal side, went to the restaurant with her and a colleague, just a very poor worker). Also puts her to sleep regarding the issue so she does not perceive me as an enemy and will try to avenge herself.
- Documenting every mistake she does in a file, with dates and name of the patient: she did again a mistake today (it's several times a day), I'm going to send the boss who was involved in the case along with the other attending while being very nice with her in the email.
- Don't talk about her anymore: she's already trying to frame me as the "mean person". Otherwise she'll recruit people as the victim. So rob her of her "I'm the victim" game.
- Focus on my job: the risk is that I spend too much time/energy on this and end up being flagged if I don't do my work well/in time.
If you guys have any comment on this situation, I'm curious to know it.
Our boss talked with us (the attendings) today:
- We have to do less feed-backs as it demotivates the residents (she was intending at me in particular)
- She wanted to do a mediation with me and this resident
- She said she's never going to be a good resident, we have to make do with her for the winter, they don't want her to do a burnout
- Since she's basically got the whole team against her, we have to ease on the negative feed-backs, that probably dread going to work
I agreed with it all expect the mediation. I admitted I was probably too demanding with the residents. She said: "it's because you're very demanding with yourself". I said "yes, but the truth is that I'm demanding for the patients".
I said that frankly I found it unfair as she was trying to make it personal with me and I did not see why I should be concerned with her dysfunctionments. She said "ok, we're not going to do it".
So basically, I got a small slap on the wrist.
It's a bit disappointing as the upper management is not really supporting us in bringing excellence to the service. They prefer the residents to be average to sub-par.
So basically, now I have to give ego candies.
My challenge as a leader is with people with fragile egos/fixed mindset. They prioritize image/feeling good about themselves and I prioritize learning.
So I have to switch to machiavellian/political and let errors slip.
It's disappointing as my intention is the best for the patients.
I admit that I'm too demanding with the residents so I'm going to tone it down. However, they also cannot take negative feed-back even if I give plenty of support/encouragement.
So in the end it does feel as they prioritize the residents over us the attendings. I got the feed-back I'm being self-critical and I'm going to do the changes. But still it leaves a bitter aftertaste.
I spoke with a nurse and a medical assistant about this topic: they think and I agree now that it's a matter of generation.
I accept it and feel better about it. I'll adapt.
As you can see it's a topic dear to my heart: first the health of children, second the supervision, coaching and teaching of residents. I want them to be the best they can be but they have to want it for them first.
Our boss now wants a break from feed-back to all residents. That means basically not doing my job of teaching. So this is demotivating to me and I'll invest less in the service. I'll do well my job but no more extras. This shows how a bad element can pull a whole team down. Basically we adapt to her bad level. To me this is really bad leadership, just for a fear of her doing a burnout and not enjoying her job. What about the good elements? Sacrificed on the altar of affiliative leadership.
I thought that upper management was supporting us but that's not the case.
Also, my colleague is taking advantage of the residents rebelling and said to our boss that 1 of them wanted to talk with me. He's also a low performer that I tried to coach and took it personally: he wants to be recognized as a a doctor (instead of improving). So another tough lesson on human nature.
Now I don't see myself in long term in this hospital for sure since excellence is not one of their value.
Also, my boss said: "we don't have any problem (upper management) in our relationship with her. She differentiates well." I told her: "yes of course, you're upper management, she behaves well with you". So naive. People see what they want to see. And if they want to see only the positive we've got a problem.
My goal is to have a good performance review in 4 months. I’ll adapt and go full Machiavellian. I’ll be selfish on that one. I thought I found a healthy work environment but I was wrong.
As you can see I’m quite stirred up by this. As to me it feels like they don’t trust me after all the value I’ve given. So that means that the value I have to offer is not valued enough. So I better keep my time and energy for myself instead of giving it to my employer.
Also this is the proof that becoming a manager without being given any training and learning on the job is stupid. So I’ll find good training to better be able to deal with these situations.
Edit: I feel discouraged but it’s not the first time I’ve been fucked over nor the last. Many fights still to come and this one is preparing me for the next one.
I think this situation is a perfect example of the law of the lid. I knew this was not a high performance environment. Yes people are nice but the head of the department is not concerned with high performance rather than keeping the peace. I could push it quite a bit towards high performance but I reached the limit. If my boss’ leadership does not allow it then there’s no way I can do it on my own. There are 3 people among 6 in the leadership team concerned with high performance. That does not make a majority.
The head of deparment’s leadership is not strong enough to bring the team there and that’s why our hospital has a bad reputation. As Jocko Willink said: all organizational problems are leadership problems.
Her way of solving problems is often to ignore them. A pediatrician in town is harassing our residents with unfounded complains. Yes they met her talked to her and it did not change. So what’s the proposed solution? To ignore her messages. Yep great leadership (ironic).
I now understand the nurses’ complaints. They’ve been there for years and it’s not improving on the top level.
The worst is that the head told us yesterday that she noticed an improvement since 4 years ago. Well no shit! Us attendings put a lot of work in. Instead of thanking us she takes away our power to give feedbacks to residents.
Regarding the resident she successfully framed herself as the victim. Our boss told us the “team is against her”. Yes the team is against her but for good reasons. In a normal work environment she would have been fired. The real victims are the teams and the patients.
Interesting one.
Where you are at now, I d suggest cut contact with the 2 crappy staff and when you do interact with them be strictly formal and fake nice.
Ignore other people saying they will support you. They won't. Double down on helping the other residents (maybe schedule drop in sessions) so 'they came to you' and I can't turn them away, can I?
In future if you have a useless staff member give them extra support (aka I'm going to very obviously and publicly prop you up so everything can see how useless you are). Make sure you have a friendly staff member in all these extra chat meetings. As you said document, document. When upper mgmt is stitching me up and I'm very over it I often say - 'its good to have fact based discussions' and slap a big folder of emails on the desk or forward a gazillion emails. I don't open that folder its just like a burglar alarm, just having it is enough to deter the 'shit-talkers'.
Hello Transitioned,
thanks for your answer.
Quote from Transitioned on December 17, 2023, 3:40 amInteresting one.
Where you are at now, I d suggest cut contact with the 2 crappy staff and when you do interact with them be strictly formal and fake nice.
Makes sense.
Ignore other people saying they will support you. They won't. Double down on helping the other residents (maybe schedule drop in sessions) so 'they came to you' and I can't turn them away, can I?
That's exactly what I did. I proposed coaching sessions the same as 6 months ago. I did 2 out of 3 already. My current issue is that I've been too demanding. That is I want them to be the best they can be and to think by themselves. And due to the medical system which can infantilize residents, it's a big challenge for them. I also want the best for our patients. I try also to shock them out of their habitual thinking. The thing is that people prefer to be right. So I have to apply extra lotion on the zebras. Working on it now. People want to self-preserve yes. But they don't only want to self-preserve materially, they want to self-preserve their egos.
So I attract covert aggression (which I can handle being one rank above) and probably smear campaigns through my demands. As you said in the other thread people want to take what they can, see what they can get away with and look good in the process. So challenging to work with fragile egos/fixed mindset people. As then the person giving feed-back is basically a threat to their ego.
So the challenge is to be liked at this stage. It's dumb but that's the way it is. I have plenty of allies, but I'm challenging too much my subordinates and they cannot take it.
In future if you have a useless staff member give them extra support (aka I'm going to very obviously and publicly prop you up so everything can see how useless you are). Make sure you have a friendly staff member in all these extra chat meetings. As you said document, document. When upper mgmt is stitching me up and I'm very over it I often say - 'its good to have fact based discussions' and slap a big folder of emails on the desk or forward a gazillion emails. I don't open that folder its just like a burglar alarm, just having it is enough to deter the 'shit-talkers'.
So good, thanks. I started to do it then stopped. I'll do it again. First identify potential enemies/troublemakers then document.
All this goes into my notes of course. I think this kind of situations could deserve a comment in PU as they are quite common.
Thanks!
Cheers.
