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Should you address the team complaining behind your back?
Hello TPM community,
yesterday the head nurse told me that the nurses complain every day or every 2 days that the rounds are too long (that we do some teaching, etc.) to her.
Well, they never told me that in 9 months I've worked there. And I actually think they're exaggerating. They have little work and complain about the little they have. So basically, they just want to do the bare minimum and then complain to the head nurse behind my back.
So hypocrisy and backstabbing. It's a team of women, so talking behind people's back is the norm rather than the exception based on my experience.
That's the problem.
Now, I want to be strategic about it. I want to address that they talk to their chief for little things like that. If I tell their chief I disempower her. She's useful because they complain.
If I tell the complainers they probably have a fragile ego.
But I want to address 2 things:
- It's better to talk directly to the person to solve a problem
- I'm open to any feed-back
Shall I tell the nurses directly? Or shall I document how the rounds are going and then talk with the head nurse and my bosses.
The rounds take 2 hours for 8 patients, which is reasonable to me and my doctor boss. But too long for the head nurse.
I'm thinking about documenting the duration of visits and what happens during them for 2 weeks and then talk to my bosses and the head nurse about it.
Because it's basically false attacks and the old "doctor vs nurses" thing from fragile ego complainers lazy rebel nurses.
Also this issue, even if partly fabricated is helpful to improve the rounds (good for me and the team) and also close ranks for the nurses (they have their petty fights and don't like their boss, but now they're a team towards a common enemy: us).
I also want to add that I never complained about them to their chief and I thought we had an excellent relationship.
Normal. This is what I call rusted on bureaucrat behavior. They have a small part to play they know it's small and they always want to talk it up.
I was just two things.
Having a chat with the head nurse about how we can cut down demands on her staff during rounds maybe she's actually got some decent ideas you might get lucky.
Otherwise she is likely to play the we are never consulted card professional victims love that one.
And start gathering some facts i.e how many nurses do you need for rounds how many minutes per patient that is.
And then the other thing that is wonderful if you can get it she's pointing out that other people do more and don't find it a problem.
So if you can get stats from another Ward that has more complex cases and proves that the nurses are doing more on rounds.
Now if all the nurses band together against the doctors then it's probably going to be hard to approach another nurse and charge for that but what you can do is take the chat with this head nurse and then go to the layer above them and say that your interested in process improvements and you've been discussing with the nurses and so you'd like to look at these stats
If you have some facts ready and then she starts whinging and moaning loudly at a meeting you can say all good points of view and I like to be fact-based in my discussions and then you pull out your stats
In the meantime standard damage control keep writing emails to the nurses telling them how wonderful they are so that nobody can say that you are against the nurses
Hello Transitioned,
thank you so so much!
Quote from Transitioned on January 11, 2024, 11:25 pmNormal. This is what I call rusted on bureaucrat behavior. They have a small part to play they know it's small and they always want to talk it up.
That's exactly it. During the rounds, they give us update on the patient and we sometimes consult them for decisions. But they don't run the show hence the common frustration of the subordinates who crave power.
I was just two things.
Having a chat with the head nurse about how we can cut down demands on her staff during rounds maybe she's actually got some decent ideas you might get lucky.
She did gave great ideas. I'm going to assemble them together along with them from my boss and mine and send them to both after having practiced them for 1 month.
Otherwise she is likely to play the we are never consulted card professional victims love that one.
That's what the nurses (not head nurse) said in the first 6 months I arrived. Another one you might like: during winter time we have to "mix" diseases and viruses. That means that there is low to high chance (very variable) that the kids will cross-contaminate in the same room (2 beds). We have no choice as otherwise we have to refuse hospitalizations. So it's the least worst solutions. So what do they say: that it is our fault (the doctors). Of course. So yeah they love to play the victim card.
And start gathering some facts i.e how many nurses do you need for rounds how many minutes per patient that is.
Yes right, thanks. The head nurse says: take 1 nurse, do all her patients and then the next one. The time per patient our bosses don't agree on it. Head nurse says it's too long. Head doctor say it's fine.
And then the other thing that is wonderful if you can get it she's pointing out that other people do more and don't find it a problem.
So if you can get stats from another Ward that has more complex cases and proves that the nurses are doing more on rounds.
Yeah, it's a great idea. Thanks I'll do that. They're underworked but because they got used to it they feel overworked. They're used to coffee and chit-chat so when real work is coming they're overwhelmed.
Now if all the nurses band together against the doctors then it's probably going to be hard to approach another nurse and charge for that but what you can do is take the chat with this head nurse and then go to the layer above them and say that your interested in process improvements and you've been discussing with the nurses and so you'd like to look at these stats
Wow. That's powerful option. I would do it but this is escalating and I'm already suspicious to my boss when she knew I was in the head nurse's office. She came to join us and was full in our ego watching us: "what were you guys talking about?". I chose an innocent topic that was politically correct that we were just talking about and spun it in a positive light and said: "we were talking about that...". The head nurse got it and went along: "yeah we were just talking about that..". It was the truth but we did not say the more controversial topics we evoked. So I would say I'm already out of my comfort zone in politics here. And they're more experimented than me. If they feel one second that I'm going above their head, along with the conflicts (even if innocent), I'm good for a private interview and slap on the wrist.
Switzerland is formal and hierarchical culture so very similar to germany or japan. So they will tell my boss if I go talk to them. I think it's a great option IF I'm one level above or if the culture is more informal or flatter culture. Took note though.
If you have some facts ready and then she starts whinging and moaning loudly at a meeting you can say all good points of view and I like to be fact-based in my discussions and then you pull out your stats
Thanks, I think it's a great idea! I'll record the time per patient for a full month then show it to them. If I compare numbers with other services like medicine or surgery I'll get the age old argument: "Yes, but pediatrics it's different. It takes time to approach the child blah blah blah. This is true but they're exaggerating it and making an excuse out of it. Yes it takes more time to approach the patient but the care is simpler most of the times. Don't have to clean an old handicapped person's ass. Not have to give 5-10 medications to a single person.
In the meantime standard damage control keep writing emails to the nurses telling them how wonderful they are so that nobody can say that you are against the nurses
Took note, great idea, thanks! I don't write emails to them so I'll pepper it to my bosses and their boss when they're around publicly.
So if I got it right:
- Ask informally other services how many nurses per patient
- Gather statistics on our own practices
- Stay friendly openly with the nurses and advertise how much I love them (machiavellian)
If that's it I love it. I love the elegance of it: gather data, stay friendly and basically win.
Actually, it's interesting because I started to work on improving my reputation. What did I say to my boss at lunch publicly with other bosses from other departments:
Me: We are very lucky with our nurse team
I think it so easy to say. There are a few rotten apples injecting negativity. Otherwise it's a good group. Just a couple manipulators. It's not totally rotten like other nurses' groups I worked with where manipulators are the majority.
My boss: you're in a good mood today! (smile)
That showed that I successfully projected another image. Now I have to keep working at it for 3.5 months and people's perception of me will change. No more enemies, only friends. No more blaming, only objective problem solving. Supporting the team, ass kissing, biscuit boy: the whole shtick. I'm here for the team and the patients, which is true. I'll use it as brainwashing ad nauseum so when they think of me they hear my voice in their head and say in a monotonous tone: "John is here for the team and the patients". I will use humour to defend against the social climbing.
Off-topic
It's crazy how far people are willing to go to do minimum effort while gaining status: complain, shift blame, play the victim, make excuses, pity play, go above my head, etc.
What I'm learning is how hard it is to behave like an eagle. Because you get attacked left and right by the other zoo animals and still have to keep the standards. So it's way more mental, physical and emotional energy than they expand. The mistake they do is that they believe that this energy is wasted.
This energy is not wasted it is invested. It is invested in growth.
Had to quote it. I now understand why Jocko Willink says: outwork the haters. Since they're not working they're not improving and that's how one leaves them in the dust.
/Off-topic
Yep you've got it perfectly and I expect will execute it better than I would.
No way man! Your humility is as big as your heart. You inspire me, thank you.
