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How to deal with subordinates when you're new (doctor & nurses)?

Another question: do you have any good book to recommend about dealing with conflicts? At work especially. Thanks!

And how would you react when a nurse generally speaking tries to take on the judge role or tries to put you in the child role?

Hey John,

I'm not aware of any really good book on dealing with conflicts at work while being assertive -good idea for a book, maybe :)-.

I've read many workplace books and some books on assertiveness, but few had very well detailed examples or mock dialogues. And that's one of the main reasons I started this website: there was a lack of practical information on this kind of stuff.

Do you have some clear examples on when a nurse might take a judge role and/or tries to push you in a child role?

 

Have you read the forum guidelines for effective communication already?

Thanks for your answer.

One example happened to one of my junior doctor colleague today. A nurse called her a "cute" name, then when she did not say anything, she escalated by calling her other "cute" name, ending with "my piccolo papardelle" (my colleague is italian) but it was basically a show to her other nurses friend that she can call her whatever she wants. It's all in the tone. It's the same nurse who called me "chouchou", of course.

Another example today is one of my other junior doctor friend when she accepted a patient in the hospital before verifying we have enough beds. Instead of explaining to her how things work, the nurses basically just shamed her.

It's the same when a colleague calls me "DOCTOR" in a tone that implies that I'm not really a doctor.

Regarding your exact question, now that I put better boundaries and that I perform better, I get more respect, so I don't remember on top of my head an example. I'll let you know when my brain is refreshed and I find one.

So, this is a really common power dynamics in hospitals when older or more experienced people have no hierarchical power over you and try to exert an informal one, not for the benefit of the patient or the team, but to show off their power over you. If it is done respectfully and with tact, it's important that more experience people teach the young. In these instances, you learn, but with pain and emotional punishment.

Nurses in hospital have a very ambiguous role, they are very much needed to run the hospital but have few formal power and not much recognition. They also peak quite fast in their skills and then they get bored. I always give a lot of recognition to everybody, including the patients. But I realized how recognition-starved many of them are. That they don't feel listened to or respected. So I give them more respect, recognition and listen more to them. It's giving me better results so far. I may have approached them the wrong way in the first place.

What do you think?

I found an example. There is one nurse, who is used to say: "there is this patient with this problem, I give you 5 minutes to take care of it". As if he's my boss and is the judge of how long it takes to take care of this patient. He is a kind person and he says it jokingly but still, this plays into the dynamics where the nurses set the standards and we have to reach them. In every hospital we have to prove ourselves to every person to earn their respect, even though these people might not be as good as they think they are.

Another one from this same nurse, who once again is a kind person, he said to me that I'm "too serious", which is a judgment. So it gives you a flavor of the power dynamics.

The cute names are definitely power moves.

"Babying power moves".

Not necessarily "bad" depending on the situation. But it definitely shows that the one playing them feels confident, strong, and possibly more socially powerful.
They do become bad though when they are done publicly.

I used to have an alpha female colleague -the one in the sociopath's lesson of Power University, actually-, who would call a male colleague "sweety".
Since she always did it publicly, that definitely diminished "sweety's" authority and status.

 

Have you read the forum guidelines for effective communication already?
Quote from John Freeman on June 24, 2020, 6:54 am

I found an example. There is one nurse, who is used to say: "there is this patient with this problem, I give you 5 minutes to take care of it". As if he's my boss and is the judge of how long it takes to take care of this patient. He is a kind person and he says it jokingly but still, this plays into the dynamics where the nurses set the standards and we have to reach them. In every hospital we have to prove ourselves to every person to earn their respect, even though these people might not be as good as they think they are.

Another one from this same nurse, who once again is a kind person, he said to me that I'm "too serious", which is a judgment. So it gives you a flavor of the power dynamics.

Yeah, that first one seems quite annoying and since it's done jokingly, it make it difficult to answer.

That's the power of humorous frames: take it seriously, and you might look like overreacting. Let them go, and they can sap your power and authority.

Answering back humorously can be a good option.
Imagine:

Nurse: I give you 5 minutes to take care of it
You: And I give you 5 seconds to get the hell outta here (smiling, potentially patting in on the back).
(then back to serious)
Jokes aside, thanks for bringing the patient in

The first joke serves to send the message that you don't appreciate being put one-down (notice that to be effective you have to one-up him with whatever he says, that's why you move from minutes to seconds).
Going back to serious later serves to mend the relationship.

You made your point with the joke, and then you transition back to professional, but this time with your where you belong: at the top of the pecking order.

If he doesn't get it and keeps playing the same one-up games, then you can consider telling him you'd like to speak privately for 2 minutes and have a more serious talk, in which you could say something:

Man, I appreciate the friendliness, I really do. I think it's great for us, and I think it's good for the patients, too.
There are these power jokes though that I'm not too fond of.
For example, when you told me XYZ...

P.S.:

I also made a video on the tonality with which you could address the "chouchou" babying power moves. I'll see if I can upload it on YB soon.

Have you read the forum guidelines for effective communication already?

Hello Lucio,

thanks a lot for taking the time to answer my questions. This is very useful for me now and for the future. My goal is to bring servant leadership and a positive and collaborative culture to medicine and healthcare. So I want you to know that you're not helping me as an individual but also it helps me for creating this vision. This is not about my career, it's about changing a culture that I think is outdated and has too many negative elements to it still.

It all makes sense. I was reading this article from yours about covert aggression as well. So I think for me, it's about building an automatic default answer to these power moves. So if I put it all together, from my understanding so far:

  1. Prepare for power moves from (unknown) individuals who look dominant in their body language
  2. If not prepared, identify them after a first (hurtful) episode and mentally prepare in the future for aggression from their part
  3. Do not let any (public) aggression go uncheck, this is easier if mentally prepared to defend
  4. (My) Default response: answer with humor to highlight the covert aggression/domination and move back to serious to a more collaborative and professional frame

I definitely agree. I got stuck on the course in module 2 due to work overload and I cannot wait to go back to it since I know that many answers and golden nuggets are still in it for me. Thanks for everything you're doing.

Hello Lucio,

I have 1 question and 1 information to share:

I realized that the mistake I made is that I made enemies among nurses. One who is following blindly protocols and has been working 10 years or more in the field, so she thinks she's good (but she's not) and bosses doctors around. Another who's lazy and does not like her job. And a third who is stupid and thinks she's cool and thinks she has status because she's a mother and also bosses people around like nurse 1. So it was an ego thing from the beginning as I thought it was and from there, they put the group against me and reported me to my supervisor (nurse 1). I did the part in the course where you talk about enemy at work: it's very good and this is what made me realize the current dynamics.

What I learned is that I was right not to submit, thanks to your course. My mistake was to make enemies, next time I will be more diplomatic and more indirect. I also did this mistake with another male nurse who tried to boss me around but I did right when I sat close to him at a meeting. I did intuitively to show him I considered him a friend, which was the case. I read that's what you recommend and I agree it works very well. He completely stopped his behavior and we have a better relationship. The other nurses, I made the mistake to not try to get close to them.

Another mistake I made: some nurses I did not introduce myself to and they were the ones with whom I had some issues. The critics they told my supervisor is that supposedly I don't respect their experience, which is wrong. I respect their experience, I dont respect their attitude and lack of competence.

So this would be my recommendation for other forum members: if you're new to a workplace, introduce yourself to EVERYBODY, each relationship is individual. The people you don't introduce yourself to, like in my case maybe 2 or 3 people in a group of 40 people, are the ones who will cause trouble for ego reasons. 2 or 3 out of 40 was enough to get in trouble.

Now my question:

At work, I was calming a baby and a nurse told the other nurses in the room (group of 5-6 people): "We should hire John as a nanny!". Of course this is an attack as I'm a resident in pediatrics and she's talking to the group, not to me as a joke. It was one of these "jokes" but really an attack. At this moment, I think it hit on one of my insecurity in my masculinity, I was also tired and did not know what to answer, but it hurt me. From this experience I know that it's always worth it to respond in the moment with humor, even though it's not perfect.

What would you have said to this nurse? 

I'm still learning about frames in the course and I found this video on Charisma on Command, but I would like your opinion on this specific case.

Thanks!

Hey John,

Some GREAT lessons learned there, well done!

I was nodding my head all through your post.
Yes, and that's one of the reasons I put collaborative frames as one of the foundational strategies of power, and repeat it through the whole course from seduction, to relationships, to work.
Even when you are asserting your boundaries, if you can end with a collaborative frame, it's often all the better (unless someone was just being extremely rude, of course). It helps to make friends and allies, and avoid enemies.

Introducing yourself first is a great way of starting off with a collaborative and with a mix of power and warmth: it's only confident people who take the first step of introducing themselves.

Answering the Joke

Good comebacks are great.

The problem, of course, is that you are not always able to think about one on your feet.

The second issue is that they might make you come across as a bit more like a "funny guy". It makes you come across as witty, but sometimes they can decrease your authority because you are entering their frame of joking.
So unless you can dominate them within their frame, simply replying with an attack-joke to an attack-joke can be a follower-move that makes you lose authority.
Not good when you're higher status.

Values-Based Frame Control

In this case, you might have replied by owning your actions and behavior.

This is why I believe it's great for people when they can align values, actions, and belief: you never have to feel defensive because you truly believe you have nothing to be attacked on.

So in this case, your thought pattern would have been:

  1. I'm  being a good human plus doing my job well by soothing this kid
  2. This idiot makes fun of me instead of helping us be the best clinic we can be ("idiot" fuels your indignation, it helps you enforce your boundaries, but it's anger that you keep under a civilized wrap)
  3. How can I point out the disconnect between my good values and his BS values?

With that thought pattern, you naturally embrace your behavior.
And to show that your values are the best way to go, you might say:

You: (keep caling the baby for 2 seconds, then look towards the nurse) Nurse, you say that almost as if you were trying to offend me. The way I see it, we are here to help children. From nannies, to doctors... To nurses (point your open palm towards him). We are all in it. And I take that job seriously.

Alternatively, when you have no idea what to say but you want to stick to your values, you can:

  • Ignore, and show nonverbal disapproval

In this case you wouldn't have even looked at the nurse, but you would have kept doing what you were doing, while shaking your head at his comment for a second.

Also possible:

  • Smile, and keep doing what you were doing

If the joke was somewhat funny, you can smile a bit while generally ignoring and doing what you were doing.

In this case, you would have thought to yourself "LOL, of course, the typical male-chauvinist joke, expected, but it was kinda of funny".

That way, you show that you don't take it too seriously, but also that you are committed to your own course of actions and you aren't going to be swayed by their "jokes", which shows superiority and a strong inner frame.

 

 

Have you read the forum guidelines for effective communication already?

And I wanted to make one more quick note:

Damage Control With Your Boss

You can turn the nurses' complaints to your boss into an advatange.

When you talk to your boss next time, you could take this angle:

You: Boss, I take my job very seriously and I also take the nurses' feedback very seriously. The issue was that I am really driven to the best job I can. And as I demand a lot from myself, sometimes I also demeand a lot from the people around.
I suppose I might have been too demanding from some of these people, and I understand that I might need a different approach to do the best job we can with more collaboration.

Basically, you spin a possible threat into a positive: that you demand a lot because you want to do great work.
You also indirectly hint that the nurses are a bit lazy from your point of view, which makes you come across as a doer and a hard worker.
In the end, if you frame it well, this can become a big plus for you and an opportunity to shine.

 

Have you read the forum guidelines for effective communication already?