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

Wow, just wow! These are great advices, thank you very much. About your last advice: this is what they call a "power move"!

I can use it during my evaluation in 5 days and I can totally turn it around. Also one critic I've heard for which I don't have a defense yet, it's that I don't respect their experience. Do you have any hint for this one?

Otherwise, to give you an idea, how bullying is prevalent in nursing, a nurse has a whole youtube channel about it:

And you can see that there is some literature about it.

As I told you, my goal is to bring new mindsets, processes and technologies in pediatrics as there are LOTS of problems to solve. From my epxerience, I think nurse bullying is one of these core problems to solve. I was not expecting this coming into this profession but it is what it is.

Thank you very much for your help!

John,

Strong of your power-dynamics studies and your self-development plans, you got a book deal ready for you after you've accumulated a few decades of experience: games the medical profession plays :).

On the feedback on not taking people's experience seriously, the first advice I would give you is to take that feedback seriously.
Which does not necessarily mean that you don't take their feedback seriously, but it might mean that they truly don't think you do. If that's the case, you might want to consider making some changes to your communication style.

Second step I'd advise you is to consider who is saying that.
It might be individuals who are overly touchy, or who need a dose of extra-care because they are very thin-skinned.
And if it's only coming from those who have become your enemies, it might be an excuse that they made up to criticize you. Or it might be something that was true, maybe a few times in the beginning, but they are not giving you credit for improving on because they'd rather use it as a way of attacking you.

In that case, it might be time for plotting out some social strategies.
For example, being extra kind towards those who are not enemies yet, so that you prevent the enemies from turning those who are neutral. If you manage to establish a good relationship with your boss and a good relationship with all the nurses that are not enemies yes, you effectively isolated and neutralized any threat.

At that point, from a stronger position, it also becomes easier to win back the enemies. Not too nice in the beginning, or it might feel like a sign of weakness. Very professional and slightly distant first and then, little by little, adding more warmth as if to say "OK, not that you stopped your fuckery, you are winning me over again and we can be friendly".

 

Have you read the forum guidelines for effective communication already?

Boom. Once again.

About the book: hahaha, I'll think about it! But you'll have to be the co-author!

I think it's a mix of several things:

  1. My communication style and personality: quite direct, respectful, polite. It can come across as over-confident. So I'm taking responsibility for this one.
  2. My appearance: since I'm half-north african half-swiss, I realized that most people who don't know me have this prejudice: I'm macho, proud and think women are inferior. I'm proud but the rest is wrong. So they project their own insecurities on me and then they end up being stuck with dealing with the person they think I am, which I am not. It's something I had to learn, is that unfortunately racism and prejudices are more prevalent that I thought. I'm also 10 years older than I look so they also treat me like I'm younger and that gets into the confusion.
  3. Their mindset: they think that because they've been doing this one thing for 10 years they must be good. The confuse practical experience and with knowledge and skills. If you do this one thing with mediocrity for 10 years, it does not make you good. They want to be recognized which they are not a lot but also don't know how to communicate this need as it would be seen as weak.
  4. The communication style: in Switzerland, people are mostly indirect. So there are lots of things that are left unsaid and have to go trhough the grape vine to get to someone. Based on research, Switzerland is one of the least assertive countries. This leads to confusion and passive-agressiveness and anger. For no reason. Cold conflicts escalate in each person's mind as they are not socially allowed to talk openly about the issue. Conflict avoidance culture.
  5. Their group dynamics: in nursing, there are conflicts within the team of course as in any other group. However, for the reason above, it cannot be in the open. So one way to channel their aggression is to redirect it towards another group: the junior doctors. Therefore, it brings them together towards a common ennemy: the mean junior doctors who make them work so hard to do things that are so unnecessary. I do believe it's unconscious.
  6. The power dynamics: they are given the role that any thing that they think we do is not ok, to report it to the supervisor, instead of telling us to tell our supervisor. This leads to triangulation. I followed a nurse after he said: "oh we should ask the supervisor" and he went just like a little kid tell his mommy and the supervisor was a little embarassed as I caught their little game. He could have told me to go and ask her, which I was going to do anyway.
  7. The sex-bias: I'm working with 90% female. I love females so it's all good. However, they do have sex-specific needs (tired of this "gender" word), especially in terms of safety. A new person in a group, especially a man is quite threatening to females, whether they are in a leadership or in a subordinate role. A lot of protection mechanisms come into play and trying to reject the newcomer is one of them. It's something I've not taken into account enough, I'm doing it now.

Since I wrote this message, I think things have changed from the nurses as I feel that the message (through unknown channels as usuals) has gotten to them that I was being attacked a lot. It seems as they took a step back. The nurse who was very mean with me now makes an effort to show (to the group as well), that she follows my orders. I'm still tip-toeing with her as she has a huge ego.

So all in all::

  • Yes it's mainly my communication style: be more indirect.
  • yes the social strategy to get on board the most friendly people is the one I follow. I do it naturally: I sent an email to a nurse to thank her because I liked her job, as a colleague, simply. They want me to be their friend, but I don't. They said it specifically as a group yesterday in front of all of us (their expectations): "Oh this previous resident was so nice and cool, I would love to drink beer with them". "Oh this previous group of residents was so nice last year, it was the best". So they basically are setting their expectations for us, as "judges" = fuck you all of you, I'm your colleague and not your friend.
  • Warm up progressively to my previous enemies: great suggestion!

However, this is not a work environment I would like to work in long term. I'm learning tons of lessons, though.

One more question, back to the example:

The group of nurses were all together and there was no patient, people were joking and this is when they set their expectations in an indirect way about the residents and said things like:

  • "Oh this previous resident was so nice and cool, I would love to drink beer with them" (implying: and you're not)
  • "Oh this previous group of residents was so nice last year, it was the best" (implying: and you're not)
  • "For me, I try once or twice to make a contact with a resident and then I stop" (implying: they have to prove themselves)
  • "This resident was scary to children, etc. When one person has one opinion on a resident, it might be subjective. But when the whole group (of nurses) has this opinion on the resident, then it means it's true/objective" (implying: you might not get along with me or one of us and it's ok the group but it's the group of nurses who decides who's a good resident and who's not)
  • "There was this resident in the past, he had an incredible mind and thinking ways" (implying: and you don't)

How would you address these frames?

Oh yeah, those are all power moves.

When they talk about previous residents I would avoid any one-upping back and go superior, probably say something like:

Oh that's awesome. Yeah, there are some great people in this world. I suppose we can all learn from those people

You confirm that those previous people might have been awesome indeed, which shows you are unthreatened and open-minded, and that you love great people.
Indirectly, you say that you always work on yourself to be awesome. But are they doing the same?

Or:

Cool, is he still in town? Maybe I can meet him for a coffee.

Nice trick here: you just take them for their literal word.
It says: your covert aggression is not making any headway here, I take you for your literal word, so drop the covert aggression and speak directly if you wanna say anything.

Covert aggression only makes sense when the message is received.
But if you constantly fail to entertain it, people eventually will realize it's not working.

 

Have you read the forum guidelines for effective communication already?

Thank you for these techniques.

I would like to develop my intuition on dealing with covert aggression by abstracting your concepts above.

If someone pulls a covert power move by saying

"I'm sorry that I'm late"

To show that I am unthreatened and open-minded, could I say

"I used to be late to meetings from time to time as well."

to suggest that I work on being timely, but is he/she working on being timely?

For the second method, I could be more direct and say

"No worries, in the future, you can let me know in advance if it's an inconvenient timing.
We can re-schedule for another time when this is of priority."

to suggest that you would like to meet only when a discussion is of priority and convenience to both parties.

What are your thoughts?

Hi Matthew,

Let me start this by highlighting one important aspect.
It's something that I probably haven't stresses nearly enough but that is fundamental to personal empowerment, achievement, and quality of life alike:

  • One of the biggest benefits, as well as one of the major goals of learning power dynamics, is to move beyond value-subtracting behavior and to either demand or influence others to adopt more value-adding behavior

Part of value-subtracting behavior includes:

  • Covert aggression
  • passive-aggressiveness
  • nasty games, and/or too many games
  • nasty power moves and/or too many power moves

Being able to change the social dynamics from value-subtracting and toxic to value-adding and positive takes power and influence, so you will not always be able to.
And sometimes, some bad apples might be too spoiled to fix.
However, going from value-subtracting to value-adding should still be your goal.

John's situation is that he does not (yet) have direct authority as he can't fire people. Plus he's new, and at the receiving end of several power games to test his mettle. Plus he's in a seemingly semi-toxic environment where backstabbing, gossiping and power moves are the norm.
He might not yet have enough power to single-handedly change the whole culture, so he needs to make himself a reputation of a respect-worthy individua, first.
And answering blow by blow to some of those power moves is a good way for him to develop that reputation.

But your situation might be different.
If I remember correctly you are an entrepreneur with an equity stake, right?

If that's case, you probably have enough power to both demand healthier standards, and to influence others with your own examples, as the man at the top.

And since the topic here is "dealing with subordinates", I'll take it that we are discussing members of your team.

Well, in that case, I wouldn't entertain those covert power moves.
If you do, you indirectly communicate that covert aggression and covert power moves are how social dynamics and status are negotiated, and you don't want that.
You're above them, so you can demand proper behavior and show the way with direct and honest communication.

For example:

  1. First time late: "I'm sorry that I'm late". You: "it's OK". Or You: "for this time, it's OK (with a smile as if to say "you mischievous boy, for this time it's OK, next time... Get your act together")
  2. Second time late: "I'm sorry guys that I'm late" You: "it's OK, but please let's try to be on time form now on, OK?"
  3. Third time late: "I'm sorry guys that I'm late" You: ignore. At the end of the meeting: "Max, can you please stay two more minutes, I need to have a quick word with you"

Everyone will know at that point that you are going to officially reprimand him for being late. You also send the message that being late is not accepted within the team, and that small-timer covert power moves are not well received in your team.

 

Have you read the forum guidelines for effective communication already?

Hi Lucio,

Thank you very much for giving well-structured advice with the relevant context.

I should have given more context to my encounters. I didn't think too deeply that handling lateness well would vary quite greatly across situations with different power dynamics. But now I realise it does.

A core motivation of forming my own company is nurturing a collaborative, innovative environment.
It is indeed my responsibility to set healthy examples, standards and culture for the benefit of everyone in the company.
After all, our company's purpose is to ensure consumers consent to fair practices of how companies use their data.

Partially I'm finding it hard to enforce standards when managing remotely during this period.
It's no excuse, and I'm following the advice of starting meetings on time & not interrupting the flow of meetings just for people who join late.

For one highly-skilled but rebellious technical employee, he produces excellent output but does not want to follow the rules or is interested in working much with others. So I made him feel "self-employed" and scoped tasks that require less collaboration with others. I told him that it is important to show up at meeting to share his inputs and knowledge. It worked well for a while. However, he has been crossing boundaries with teammates through his dismissive attitude. I'm inclined to follow your advice that bad apples can be hard to fix and mostly need to be removed before the whole bunch is ruined.

Maybe I'm sidetracking from our main topic a little. I'm considering implementing an anonymous, peer-review system so that collaborative individuals are rewarded with higher compensation and bonuses. And so that I'm aware of manipulative, non-collaborative individuals.

Handling Lateness From More Powerful People
Now I'm thinking about how to handle lateness from more powerful people.
I have a harder time dealing with lateness from investors and potential clients because I need their financial resources.

For an example, a client has agreed to sign a contract and move forward with the sale. You are of course happy with this deal, but the client's team is 15 minutes late. When the client's team comes in, should you address the lateness? I am thinking to sign the deal and address the lateness afterwards.

If we go back to the topic of this thread, let's say that it is your first day as a resident at a hospital.
You are waiting for your boss in the meeting room.
Your boss is 15 minutes late.
Would you email your boss that you would not like to wait any longer and propose another time to meet?

Or upon meeting the boss, could you say

"Thank you for this resident opportunity. If you are running late, would it be possible to let me know in advance? I would like to meet at a convenient time for both you and I."

A more extreme example would be that a fresh graduate is meeting the CEO of the company on the first day of work. But the CEO is 15 minutes late.

Really appreciate the advice. Working to develop an intuition on how to demand healthy standards. Especially for time.

Quote from Lucio Buffalmano on July 17, 2020, 10:22 am
  • One of the biggest benefits, as well as one of the major goals of learning power dynamics, is to move beyond value-subtracting behavior and to either demand or influence others to adopt more value-adding behavior

Part of value-subtracting behavior includes:

  • Covert aggression
  • passive-aggressiveness
  • nasty games, and/or too many games
  • nasty power moves and/or too many power moves

Being able to change the social dynamics from value-subtracting and toxic to value-adding and positive takes power and influence, so you will not always be able to.
And sometimes, some bad apples might be too spoiled to fix.
However, going from value-subtracting to value-adding should still be your goal.

This is very important information. I think it deserves a whole post to itself. Thanks for conceptualizing this in this manner.

John's situation is that he does not (yet) have direct authority as he can't fire people. Plus he's new, and at the receiving end of several power games to test his mettle. Plus he's in a seemingly semi-toxic environment where backstabbing, gossiping and power moves are the norm.
He might not yet have enough power to single-handedly change the whole culture, so he needs to make himself a reputation of a respect-worthy individua, first.
And answering blow by blow to some of those power moves is a good way for him to develop that reputation.

100% correct.

Quote from Matthew Whitewood on July 17, 2020, 5:44 pm

A core motivation of forming my own company is nurturing a collaborative, innovative environment.
It is indeed my responsibility to set healthy examples, standards and culture for the benefit of everyone in the company.
After all, our company's purpose is to ensure consumers consent to fair practices of how companies use their data.

Rock on, mate, rock on!

A quick note on this, to give you a different perspective:

Quote from Matthew Whitewood on July 17, 2020, 5:44 pm

For one highly-skilled but rebellious technical employee, he produces excellent output but does not want to follow the rules or is interested in working much with others.
So I made him feel "self-employed" and scoped tasks that require less collaboration with others. I told him that it is important to show up at meeting to share his inputs and knowledge. It worked well for a while. However, he has been crossing boundaries with teammates through his dismissive attitude. I'm inclined to follow your advice that bad apples can be hard to fix and mostly need to be removed before the whole bunch is ruined.

Consider this:

Life is, in a way, a social exchange.

It's a fair expectation for people who give more to also ask for more back.

That's why it's not too uncommon for highly skilled people to also be rebellious.
Sometimes they rebel against the rules as if to subconsciously say "hey, I'm giving more, and you guys are being unfair by not acknowledging it".

It's often a mistake for managers to expect them to behave and get just like anyone else and still keep delivering better work than everyone else.

Now the question becomes: how are you going to give him back to make the system fair again?
Making him feel self-employed was a great idea.

Before letting him go, I'd try again to sit down with him and say something like:

You: Hey man, you're a star player. You deliver great work, and I wanted to let you that I value that immensely. I can imagine it's annoying to be on time for meetings and, sometimes, having to deal with less talented colleagues. So, I get you.
From my point of view, the reason why being on time is important is that...

And instead of telling him "be on time or else", you frame it as "I need you to help me make this team work".

And instead of telling him that "it's important to share knowledge", you can tell him "you're the most skilled and talented guy around. We can't reach the best decisions without you. This team needs your inputs."

A "pull" approach, rather than a "push" one.
Many managers shy away from that approach because they feel less powerful.
Of course ordering people around makes you feel more powerful. But it's ultimately (far) less effective.
The question for people in positions of power is: are you in it for your own validation, or for achieving end-goals? Because power is ultimately measured by achieving goals.

Give Back Emotionally For Fairer Exchanges

With that approach, you give back emotionally, by making him feel special.
A surprising number of times, that's all that rebellious star players need to behave well.
Many star players just wanted to feel treated and appreciated like stars.

Now it might be the case that this guy is just an asshole, of course, and there is no way of turning him around.
Then, firing him might be the best choice.
But it's worth to first try to make him feel "special". Which, from an exchange point of view, is a fair way of paying him back for excellent output.


P.S.: Lateness from more powerful people

Yeah, we'd go on a very different topic with that one.
Feel free to to open a new thread for that.

 

Have you read the forum guidelines for effective communication already?
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