- Email: [email protected]
Will mediation help?
League of Our Own
Q
A
WILL MEDIATION HELP? Victoria Hekkers, RN, BS
I am a male nurse in a new transplant case management position. The work environment is hostile at best, and it seems that the current staff members resent rather than welcome us. There is a general lack of professionalism and courteous behavior. The theme seems to be “each nurse for herself.” There is little time for training and support but lots of time for criticism. I am not sure if this is a gender issue or just rudeness. It is almost as if they do not want us to succeed. I am confused and hurt by their behavior, which includes direct confrontation and indirect (negative e-mails and voice mails) on almost a daily basis. As a result, we are on the defensive much of the time. We have met with our manager regarding our concerns, but she has not offered any possible explanations or solutions. Is this what nursing has come to, and if so, why would we want to stay? I can understand your concerns, because working in that type of environment can be like a black hole, sucking the life and enjoyment out of each day. Although many health care professionals think that this type of behavior is specific to health care, I can assure you it is not. The demands of positions in health care, unfortunately, leave many individuals exhausted, ornery, and just plain drained of the ability to be kind or to assist newcomers. I also can assure you that most of the letters and comments I get regarding this type of behavior come from women, so gender does not appear to be an issue. I am not excusing this general lack of empathy for the new kid on the block, just trying to help you see that your perception of these individuals as cruel and mean spirited may be just their attempt at the self preservation of their time and energy. The other possibility that I see quite often is that these individuals may be angry with the management at the facility for past occurrences or some per-
ceived wrongdoing. They display this anger in a passive manner by mistreating newcomers until they leave, thereby sabotaging any attempts by managers to restaff the unit. The managers are then stuck with the nay sayers, and the vicious circle goes undaunted until upper management notices the turnover and the resulting financial costs of this recurring hiring and training routine. The type of gang-like behavior you are experiencing is inexcusable and allowing it to exist suggests an inherent lack of leadership. It takes a lot of courage and fortitude to stand up in an adversarial environment and address a conflict. You asked: “Is this what nursing has come to and if so, why would anyone want to stay?” Look up the chain of command and check how supportive and visible your boss’ boss is. I’d bet my boots that her boss is no prize, either, and so it goes. As long as the people above you bury their heads in sand, you are at their mercy. Waiting around for their incompetence to be “discovered” may be longer than you or any of the other newcomers are willing to wait. What to do in either case, whether the staff is too burned out to help you or if they are indeed an angry mob with a grudge, this situation must be addressed at a much higher level. I would suggest that you alone or with other dissatisfied newcomers ask once again to speak to your manager and her manager. In the meeting, suggest a group staff meeting with a mediator or a facilitator experienced in conflict management who could create a safe, structured environment in which to resolve difficult issues. An experienced facilitator/mediator will create ground rules that will keep a meeting on track and prevent it from becoming inflammatory or one sided. The process he or she designs will have
some structure, so everyone has an opportunity to be heard and respected. I know most people are afraid of this type of facilitation. They are afraid of hurting someone’s feelings or afraid of what they will say or do when certain issues come up. They are afraid of sounding passionate or possible becoming emotional during the discussions. My experience has shown, however, that if handled appropriately and respectfully, these meeting can have incredibly positive results. The greatest value that this type of gathering brings to the table is the clearing up of misperceptions. One party might suggest that they felt disrespected when they did not receive a return e-mail on a particularly sensitive subject, only to find out in the facilitation that the other party never received the e-mail. Often people are unaware of how their actions are perceived by another. It is interesting that, if handled by a professional in an expedient manner, the blame game soon disintegrates into an option-generating opportunity for resolution. There may be an ombudsman in the hospital who could act as a facilitator/mediator, or perhaps you could suggest an outside facilitator/mediator to the management staff, providing the name and possibly the cost for this unique service. What do you have to lose by suggesting this service? It will certainly show that you are part of the solution and not part of the problem. Please let me know in a few months how you are doing. Good luck. ❏ Victoria Hekkers, RN, BS, is the president of Hill Street Group and a certified case manager, mediator, and Myers/Briggs trainer. She welcomes questions, comments, or concerns at [email protected]. Reprint orders: E-mail authorsupport@ elsevier.com or telephone (toll free) 888-8347287; reprint no. YMCM 328 doi:10.1016/j.casemgr.2005.08.009 November/December 2005
TCM 35
Q
A
WILL MEDIATION HELP? Victoria Hekkers, RN, BS
I am a male nurse in a new transplant case management position. The work environment is hostile at best, and it seems that the current staff members resent rather than welcome us. There is a general lack of professionalism and courteous behavior. The theme seems to be “each nurse for herself.” There is little time for training and support but lots of time for criticism. I am not sure if this is a gender issue or just rudeness. It is almost as if they do not want us to succeed. I am confused and hurt by their behavior, which includes direct confrontation and indirect (negative e-mails and voice mails) on almost a daily basis. As a result, we are on the defensive much of the time. We have met with our manager regarding our concerns, but she has not offered any possible explanations or solutions. Is this what nursing has come to, and if so, why would we want to stay? I can understand your concerns, because working in that type of environment can be like a black hole, sucking the life and enjoyment out of each day. Although many health care professionals think that this type of behavior is specific to health care, I can assure you it is not. The demands of positions in health care, unfortunately, leave many individuals exhausted, ornery, and just plain drained of the ability to be kind or to assist newcomers. I also can assure you that most of the letters and comments I get regarding this type of behavior come from women, so gender does not appear to be an issue. I am not excusing this general lack of empathy for the new kid on the block, just trying to help you see that your perception of these individuals as cruel and mean spirited may be just their attempt at the self preservation of their time and energy. The other possibility that I see quite often is that these individuals may be angry with the management at the facility for past occurrences or some per-
ceived wrongdoing. They display this anger in a passive manner by mistreating newcomers until they leave, thereby sabotaging any attempts by managers to restaff the unit. The managers are then stuck with the nay sayers, and the vicious circle goes undaunted until upper management notices the turnover and the resulting financial costs of this recurring hiring and training routine. The type of gang-like behavior you are experiencing is inexcusable and allowing it to exist suggests an inherent lack of leadership. It takes a lot of courage and fortitude to stand up in an adversarial environment and address a conflict. You asked: “Is this what nursing has come to and if so, why would anyone want to stay?” Look up the chain of command and check how supportive and visible your boss’ boss is. I’d bet my boots that her boss is no prize, either, and so it goes. As long as the people above you bury their heads in sand, you are at their mercy. Waiting around for their incompetence to be “discovered” may be longer than you or any of the other newcomers are willing to wait. What to do in either case, whether the staff is too burned out to help you or if they are indeed an angry mob with a grudge, this situation must be addressed at a much higher level. I would suggest that you alone or with other dissatisfied newcomers ask once again to speak to your manager and her manager. In the meeting, suggest a group staff meeting with a mediator or a facilitator experienced in conflict management who could create a safe, structured environment in which to resolve difficult issues. An experienced facilitator/mediator will create ground rules that will keep a meeting on track and prevent it from becoming inflammatory or one sided. The process he or she designs will have
some structure, so everyone has an opportunity to be heard and respected. I know most people are afraid of this type of facilitation. They are afraid of hurting someone’s feelings or afraid of what they will say or do when certain issues come up. They are afraid of sounding passionate or possible becoming emotional during the discussions. My experience has shown, however, that if handled appropriately and respectfully, these meeting can have incredibly positive results. The greatest value that this type of gathering brings to the table is the clearing up of misperceptions. One party might suggest that they felt disrespected when they did not receive a return e-mail on a particularly sensitive subject, only to find out in the facilitation that the other party never received the e-mail. Often people are unaware of how their actions are perceived by another. It is interesting that, if handled by a professional in an expedient manner, the blame game soon disintegrates into an option-generating opportunity for resolution. There may be an ombudsman in the hospital who could act as a facilitator/mediator, or perhaps you could suggest an outside facilitator/mediator to the management staff, providing the name and possibly the cost for this unique service. What do you have to lose by suggesting this service? It will certainly show that you are part of the solution and not part of the problem. Please let me know in a few months how you are doing. Good luck. ❏ Victoria Hekkers, RN, BS, is the president of Hill Street Group and a certified case manager, mediator, and Myers/Briggs trainer. She welcomes questions, comments, or concerns at [email protected]. Reprint orders: E-mail authorsupport@ elsevier.com or telephone (toll free) 888-8347287; reprint no. YMCM 328 doi:10.1016/j.casemgr.2005.08.009 November/December 2005
TCM 35