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Avoiding Self-Defeating Feelings
JULY 1988. VOL. 48. NO I
A OR N J O U R N A L
Avoiding Self-Defeating Feelings TIR FOR MANAGERS
Ruth E. Davidhizar, RN; Nan0 F. Farabaugh, RN
T
he responsibilities of the OR nurse manager are complex; he or she handles interpersonal conflicts among staff, patients, and physicians and motivates employees and coworkers to be Cost-effective without compromising care. All too often these multiple and changing demands and responsibilities of an O R manager result in stress and self-defeating feelings. If these feelings persist, they can negatively affect the nurse involved in personal turmoil, the success of the managerial team, and the nursing profession in the form of burnout. This article describes four self-defeating feelings common to the nurse manager: inadequacy, overstimulation, helplessness, and anger. It also suggests how to avoid these feelings.
Feelings of Inadequacy
A
n O R manager usually has strong positive feelings of self-worth, which are reinforced by education and past accomplishments. He or she may experience feelings of inadequacy and decreased self-esteem because a person whose opinion is valued gives negative feedback. Not being recognized for an accomplishment for which praise was expected also may cause a person to feel inadequate. Other causes include being overwhelmed by personal conflicts, failing to handle a managerial problem, and being forced into performing an unfamiliar task. When preparing for an accreditation visit for the first time, the new manager lacks confidence. Even experienced managers may feel inadequate when faced with responsibilities they failed to meet 92
successfully in the past. For example, a manager who feels inadequate may be heard mumbling, “I don’t do anything right. Anybody could do this job as well as I do it. In fact, if she had been trying to solve that problem last week she would have had it taken care of a long time ago. I’m not smart enough for this job.” A manager who feels inadequate soon cannot confront employees who make mistakes, give positive affirmation to others, gain support from others, or try out new ideas and innovations. Feelings of inadequacy significantly handicap the manager’s ability to function. Solution. The O R manager needs to define why he or she feels inadequate through personal introspection or talking with a peer, supervisor, or mentor who will provide positive affirmation. By talking the situation through with somebody, the manager may be able to view a situation handled poorly as a learning experience and benefit from it.
Feelings of Overstimulation
F
eelings of overstimulation result from personal and staff expectations that problems be solved immediately. They also result from failure to set priorities and budget time. A manager induces feelings of overstimulation by failing to appreciate his or her staff, family, and friends who can provide needed support. Like inadequacy, feelings of overstimulation also limit the manager’s ability to handle a situation, resulting in a manager who is unable to function as a leader.
JII1.Y I Y X X . V O L 1 X . N O I
AORN JOURNAL
Many managers believe that they have too many tasks to accomplish at one time. For example, as soon as they arrive at work, managers are confronted with a ringing telephone, people wanting yesterday’s problems solved, people wanting today’s problems solved, and a meeting with no time to prepare for it. Solution. The manager needs to change his or her personal expectation that all problems be solved immediately; the manager needs to allow time for the staff as well as himself or herself to analyze each day’s priorities. If the manager arrives at work when everybody else does, he or she may find it difficult to greet coworkers as well as respond to immediate problems. The problem can be solved if the manager arrives early and schedules problem-solving activities 10 minutes after arriving at work. Feeling overstimulated upon return from a vacation is normal. In this case, it may help if the manager goes to the office a few hours the night before to read through memos and letters. This strategy will allow the manager to focus on greeting coworkers the next morning, and this in turn, will meet staffs need for attention as well as the manager’s need for time to set priorities. If the manager is feeling overstimulated because he or she is involved in a long-range project, he or she should break the project into a series of tasks and steps and focus on the first step rather than the end result. The manager spends a lot of time relating to
other people, and therefore, he or she must learn to pay attention to their needs. Although a manager must be production- and task-oriented, it is important that the manager not appear self-oriented to those being supervised. It takes experience and tact to balance the needs of the staff.
Feelings of Helplessness
T
he OR manager is confronted with two types of problems: those that cannot be solved using present technology and resources, and those that others do not want to solve themselves. Usually, most of the problems brought to managers are beyond their control. For example, problems in today’s health care system cannot be solved using present technology and resources. Problems that can be solved often are brought to the attention of the OR manager because other individuals d o not make the effort to solve them. Although the manager may be responding to a problem, his or her efforts may appear to have little impact. Because results are not apparent, the manager’s efforts may be unknown and therefore staff continues to complain about the problem. In addition to realizing the helplessness of solving unsolvable problems, the nurse manager soon realizes that he or she cannot achieve personal expectations and significantly change adverse conditions in the work setting. He or she also realizes that initial mistakes accepted as beginner
of nursing, Logansport (Id) State Hospital. She received her bachelor of science degree in nursing from Goshen (Ind) College, and both her master of science degree in nursing and her doctor of nursing science degree in psychiatric nursingfrom Indiana Universiiy, Indianapolis.
Ruth E. Davidhizar
Nano F. Farabaugh
Ruth E. Davidhizar, RN, DNSc, is the director
Nan0 F. Farabaugh, RN, MS, is an associate professor at St Mary’s College, Notre Dame, Ind She received her bachelor of science degree in nursing from the College of St Teresa, Winona, Minn, and her master of science degree in psychiatric nursing from the University of Massachusetts, Amherst. 93
JULY 1988. VOL. 48. NO I
AORN JOURNAL
errors are no longer acceptable, and this may prove more frustrating. These feelings of helplessness frequently lead to apathy, decreased productivity, and decreased creativity. Solution. The OR manager must realize that significant changes cannot be made overnight. Finding solutions to problems that existed before he or she became OR manager takes time. The OR manager must learn to take one day at a time. Most of all, the OR manager cannot assume responsibility for all the problems of the hospital or health care system. When confronted with a myriad of problems, the OR manager must learn to identify which problems require an active problem-solving approach, which problems can be solved by the person requesting the help, and which problems have no solution. When confronted with the latter, though, the manager still has options. He or she can respond to the individual with a supportive and affirmative approach that makes the person feel better about himself or herself and to view the situation with less stress. By being able to listen attentively, the employer can help the employee cope with the problem.
Feelings of Anger
A
nger is a normal reaction to a frustrating situation with an employee or supervisor. Employees often complain that their supervisors have no idea how to effectively relate to them. For example, “He talks about participative management but all we get is memos that tell us what to do with no opportunity for feedback.” The manager may express anger by verbal outbursts, sarcasm, demanding behavior, or negative comments. By expressing anger, the person feels more in control by making the other person feel uncomfortable. Unfortunately, when a manager expresses anger in the workplace, it frequently leads to separation and alienation from coworkers and employees. If anger is directed at employees, they may feel they are the cause of the manager’s anger. Directing anger at one’s immediate supervisor is self-defeating. Solution. To handle anger correctly, a person 94
must accept responsibility for feeling angry and seek to identify the source of the anger. Whether the manager is fed up with the administration, the system, or the staff, the situation cannot be changed without first identifying the source.’ After defining the source of anger, the OR manager should stay calm and delay actions until there has been a cooling-off period. For example, a manager should say, “I think it would be better if we talk about this tomorrow.” After his or her feelings are under control the manager should use a direct approach-one in which he or she claims personal responsibility for the situation and thus avoids blaming another. For example, “I am concerned about . . . and I would appreciate it if we could talk about this.” The OR manager should avoid making negative comments to others for several reasons. First, the information may be wrong, especially if the manager did not receive the information firsthand. Second, negative comments may be used against the manager by being repeated incorrectly or out of context. Third, negative comments can breed distrust; the listener may feel that in another situation he or she may be the target. A manager should not convey negative reactions that can be misinterpreted (eg, a tone of voice, a shrug, or a conspicuous silence). A manager should respond to situations that elicit angry feelings at the time they occur in a direct, firm, and tactful manner rather than accumulating unresolved issues over time. By responding directly to a situation when it occurs a manager can avoid overreacting and taking out frustration on the wrong person.
Summary
T
he feelings identified in this article are selfdefeating and harmful to the OR nurse and the nursing profession. To be successful the operating room, a nurse manager needs skill in reacting to stressful situations so that he or she 0 can deliver quality, cost-effective care. Note 1. R Davidhmr, N Farabaugh, “Dealing with anger: Every manager’s dilemma,” AORN Journal 46 (August
1987) 297-299.
A OR N J O U R N A L
Avoiding Self-Defeating Feelings TIR FOR MANAGERS
Ruth E. Davidhizar, RN; Nan0 F. Farabaugh, RN
T
he responsibilities of the OR nurse manager are complex; he or she handles interpersonal conflicts among staff, patients, and physicians and motivates employees and coworkers to be Cost-effective without compromising care. All too often these multiple and changing demands and responsibilities of an O R manager result in stress and self-defeating feelings. If these feelings persist, they can negatively affect the nurse involved in personal turmoil, the success of the managerial team, and the nursing profession in the form of burnout. This article describes four self-defeating feelings common to the nurse manager: inadequacy, overstimulation, helplessness, and anger. It also suggests how to avoid these feelings.
Feelings of Inadequacy
A
n O R manager usually has strong positive feelings of self-worth, which are reinforced by education and past accomplishments. He or she may experience feelings of inadequacy and decreased self-esteem because a person whose opinion is valued gives negative feedback. Not being recognized for an accomplishment for which praise was expected also may cause a person to feel inadequate. Other causes include being overwhelmed by personal conflicts, failing to handle a managerial problem, and being forced into performing an unfamiliar task. When preparing for an accreditation visit for the first time, the new manager lacks confidence. Even experienced managers may feel inadequate when faced with responsibilities they failed to meet 92
successfully in the past. For example, a manager who feels inadequate may be heard mumbling, “I don’t do anything right. Anybody could do this job as well as I do it. In fact, if she had been trying to solve that problem last week she would have had it taken care of a long time ago. I’m not smart enough for this job.” A manager who feels inadequate soon cannot confront employees who make mistakes, give positive affirmation to others, gain support from others, or try out new ideas and innovations. Feelings of inadequacy significantly handicap the manager’s ability to function. Solution. The O R manager needs to define why he or she feels inadequate through personal introspection or talking with a peer, supervisor, or mentor who will provide positive affirmation. By talking the situation through with somebody, the manager may be able to view a situation handled poorly as a learning experience and benefit from it.
Feelings of Overstimulation
F
eelings of overstimulation result from personal and staff expectations that problems be solved immediately. They also result from failure to set priorities and budget time. A manager induces feelings of overstimulation by failing to appreciate his or her staff, family, and friends who can provide needed support. Like inadequacy, feelings of overstimulation also limit the manager’s ability to handle a situation, resulting in a manager who is unable to function as a leader.
JII1.Y I Y X X . V O L 1 X . N O I
AORN JOURNAL
Many managers believe that they have too many tasks to accomplish at one time. For example, as soon as they arrive at work, managers are confronted with a ringing telephone, people wanting yesterday’s problems solved, people wanting today’s problems solved, and a meeting with no time to prepare for it. Solution. The manager needs to change his or her personal expectation that all problems be solved immediately; the manager needs to allow time for the staff as well as himself or herself to analyze each day’s priorities. If the manager arrives at work when everybody else does, he or she may find it difficult to greet coworkers as well as respond to immediate problems. The problem can be solved if the manager arrives early and schedules problem-solving activities 10 minutes after arriving at work. Feeling overstimulated upon return from a vacation is normal. In this case, it may help if the manager goes to the office a few hours the night before to read through memos and letters. This strategy will allow the manager to focus on greeting coworkers the next morning, and this in turn, will meet staffs need for attention as well as the manager’s need for time to set priorities. If the manager is feeling overstimulated because he or she is involved in a long-range project, he or she should break the project into a series of tasks and steps and focus on the first step rather than the end result. The manager spends a lot of time relating to
other people, and therefore, he or she must learn to pay attention to their needs. Although a manager must be production- and task-oriented, it is important that the manager not appear self-oriented to those being supervised. It takes experience and tact to balance the needs of the staff.
Feelings of Helplessness
T
he OR manager is confronted with two types of problems: those that cannot be solved using present technology and resources, and those that others do not want to solve themselves. Usually, most of the problems brought to managers are beyond their control. For example, problems in today’s health care system cannot be solved using present technology and resources. Problems that can be solved often are brought to the attention of the OR manager because other individuals d o not make the effort to solve them. Although the manager may be responding to a problem, his or her efforts may appear to have little impact. Because results are not apparent, the manager’s efforts may be unknown and therefore staff continues to complain about the problem. In addition to realizing the helplessness of solving unsolvable problems, the nurse manager soon realizes that he or she cannot achieve personal expectations and significantly change adverse conditions in the work setting. He or she also realizes that initial mistakes accepted as beginner
of nursing, Logansport (Id) State Hospital. She received her bachelor of science degree in nursing from Goshen (Ind) College, and both her master of science degree in nursing and her doctor of nursing science degree in psychiatric nursingfrom Indiana Universiiy, Indianapolis.
Ruth E. Davidhizar
Nano F. Farabaugh
Ruth E. Davidhizar, RN, DNSc, is the director
Nan0 F. Farabaugh, RN, MS, is an associate professor at St Mary’s College, Notre Dame, Ind She received her bachelor of science degree in nursing from the College of St Teresa, Winona, Minn, and her master of science degree in psychiatric nursing from the University of Massachusetts, Amherst. 93
JULY 1988. VOL. 48. NO I
AORN JOURNAL
errors are no longer acceptable, and this may prove more frustrating. These feelings of helplessness frequently lead to apathy, decreased productivity, and decreased creativity. Solution. The OR manager must realize that significant changes cannot be made overnight. Finding solutions to problems that existed before he or she became OR manager takes time. The OR manager must learn to take one day at a time. Most of all, the OR manager cannot assume responsibility for all the problems of the hospital or health care system. When confronted with a myriad of problems, the OR manager must learn to identify which problems require an active problem-solving approach, which problems can be solved by the person requesting the help, and which problems have no solution. When confronted with the latter, though, the manager still has options. He or she can respond to the individual with a supportive and affirmative approach that makes the person feel better about himself or herself and to view the situation with less stress. By being able to listen attentively, the employer can help the employee cope with the problem.
Feelings of Anger
A
nger is a normal reaction to a frustrating situation with an employee or supervisor. Employees often complain that their supervisors have no idea how to effectively relate to them. For example, “He talks about participative management but all we get is memos that tell us what to do with no opportunity for feedback.” The manager may express anger by verbal outbursts, sarcasm, demanding behavior, or negative comments. By expressing anger, the person feels more in control by making the other person feel uncomfortable. Unfortunately, when a manager expresses anger in the workplace, it frequently leads to separation and alienation from coworkers and employees. If anger is directed at employees, they may feel they are the cause of the manager’s anger. Directing anger at one’s immediate supervisor is self-defeating. Solution. To handle anger correctly, a person 94
must accept responsibility for feeling angry and seek to identify the source of the anger. Whether the manager is fed up with the administration, the system, or the staff, the situation cannot be changed without first identifying the source.’ After defining the source of anger, the OR manager should stay calm and delay actions until there has been a cooling-off period. For example, a manager should say, “I think it would be better if we talk about this tomorrow.” After his or her feelings are under control the manager should use a direct approach-one in which he or she claims personal responsibility for the situation and thus avoids blaming another. For example, “I am concerned about . . . and I would appreciate it if we could talk about this.” The OR manager should avoid making negative comments to others for several reasons. First, the information may be wrong, especially if the manager did not receive the information firsthand. Second, negative comments may be used against the manager by being repeated incorrectly or out of context. Third, negative comments can breed distrust; the listener may feel that in another situation he or she may be the target. A manager should not convey negative reactions that can be misinterpreted (eg, a tone of voice, a shrug, or a conspicuous silence). A manager should respond to situations that elicit angry feelings at the time they occur in a direct, firm, and tactful manner rather than accumulating unresolved issues over time. By responding directly to a situation when it occurs a manager can avoid overreacting and taking out frustration on the wrong person.
Summary
T
he feelings identified in this article are selfdefeating and harmful to the OR nurse and the nursing profession. To be successful the operating room, a nurse manager needs skill in reacting to stressful situations so that he or she 0 can deliver quality, cost-effective care. Note 1. R Davidhmr, N Farabaugh, “Dealing with anger: Every manager’s dilemma,” AORN Journal 46 (August
1987) 297-299.