Toxic Nursing, 2nd Ed. Cheryl Dellasega

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СКАЧАТЬ At this point, the manager must address this issue with both Maggie and Alice. Because Maggie is angry and feeling betrayed, these emotions must be addressed. It is also important for Maggie and Alice to meet to discuss the situation.

      Maggie may need some coaching to help her manage her intense feelings of anger and betrayal, while Alice needs coaching regarding her inability to keep information in confidence. Working on ways to re-establish trust is imperative not only to maintaining the relationship between the two nurses, but also to maintaining the integrity of the unit as a functioning whole. The manager’s role is not to get involved in the personal relationships of the staff, but to assist all staff in maintaining relationships that are professional and support the overall workings of the unit.

      Assisting staff in recognizing the difference between professional and nonprofessional communication is crucial and must be reinforced in circumstances like this one. It is important for the manager to help Alice understand that this indiscretion makes others question her ability to keep information confidential. Confidentiality is essential in healthcare settings.

      –Melissa Snyder

      This situation provides a good opportunity to apply rules protecting patient privacy to standards we set for coworkers. If the facts of this situation were slightly different, Alice would have violated HIPAA laws about privacy of information.

      Respecting a person’s request for confidentiality is part of a trust relationship, and trust is integral to teamwork. Team-building and morale activities can help everyone move forward with a better understanding of ways to support and respect each other.

      The influence of body language as part of communication is important. Something as subtle as rolling your eyes or sighing loudly can turn a neutral message negative.

      If the opportunity presented itself, I might also have a conversation with Alice or Maggie to see whether the relationship between them can be repaired. There’s no way to undo the damage, but it might be possible to forgive and move on.

      –Cheryl Dellasega

      reflections

      Good news is hard to keep to yourself. Sometimes when we gossip, it’s not necessarily malicious—we’re just so excited to be part of something new, fun, and exciting that the words tumble from our lips. The problem, of course, is that this type of behavior can cause serious dysfunction. Have you ever experienced a similar situation? Was there fallout in your unit? What did you do to address it?

4.4 Rumors

      scenario

      Tanya, an RN in the ER, is on break during a slightly slow day shift. She decides to catch up on texts. While composing a message to Dean, a nurse on the evening shift, she gets a call and stops to respond to it.

      The caller is Sonya, who wants to share some news with Tanya: Susan, the ER nurse manager, is going to be “replaced” by the end of the week. Tanya has had a rocky relationship with Susan, so she considers this good news and can’t wait to text Dean. As soon as she stops talking to Sonya, she texts Dean: “Guess what? That b---- Susan is going to be fired!”

      Accidentally, Tanya sends the text to Deandra, who is one of Susan’s best friends. Deandra instantly contacts Susan, and learns that Susan is, in fact, being promoted and another nurse manager designated.

      nurse leader insight

      In this situation, Tanya’s behavior is extremely unprofessional. Two key issues seem to be occurring simultaneously within this scenario. First, the use of technology in communicating information must be addressed. Within a matter of minutes, Tanya has managed to involve four other nurses in her unprofessional and inaccurate communication. The second issue involves the derogatory terms used in sharing the information about a colleague.

      With regard to the first issue, as the nurse manager, it is important to discuss professional and unprofessional communications both in person and via technology. The most critical message is the need to confirm the accuracy of all information before sending it forward via technology. Because of the speed of communication, inaccurate information can be distributed to known and unknown sources within seconds—and it cannot be easily corrected when new information emerges. Tanya must be reminded of this. It is also important to discuss this issue with the entire staff so that everyone recognizes the power and the detriments of communicating through technology.

      With regard to the second issue, this language is unprofessional and disrespectful. Even though the message was intended to be a personal communication, it quickly became a more public message. Tanya’s professional reputation is in jeopardy, and a sincere apology by Tanya to all involved individuals is necessary. The nurse manager should directly address this issue with Tanya and recommend that Tanya apologize for her actions as a first step to rebuilding a professional relationship with Susan and Deandra. Again, discussing the very gray area between personal and professional communications is important. Nurses should be encouraged to always err on the side of caution, especially when sharing information that may have an effect on others.

      –Melissa Snyder

      Technology can hurt as much as it helps. Many helpful applications can simplify our lives, but the rapid pace of conversations can also lead to messages with inflammatory content being sent to the wrong person. In this situation, Tanya clearly made a mistake, and the sooner she apologizes, the better.

      Because this issue occurred during work, it’s a good opportunity to discuss acceptable downtime activities. Establishing a policy for use of personal cellphones and other technologies during work time can prevent more problems with this behavior, but the guidelines would have to be very explicit and consequences for violations clear.

      On a higher level, this situation presents an opportunity to address what is likely to be an institution-wide challenge. If other administrators are willing to cooperate and create a policy that will apply to every employee, the intervention will be more powerful. There might be a need to collect data on other types of tech issues that can also be addressed by administrative leaders.

      –Cheryl Dellasega

      reflections

      Obviously, there’s a lot that’s less than ideal about Tanya’s behavior. On a broad level: what institutional/unit culture do you think made Tanya comfortable 1) texting at work, 2) calling a colleague a b—tch at work, and 3) spreading untrue gossip? Do any of your behaviors perpetuate that culture? If so, what can you do about it?

      On a narrower level: If a nurse on your unit ever sent an inflammatory text or email to the wrong person in error, what action would you take? Does your organization have a policy on the use of cellphones during work hours? If not, should it?

summary

      Gossip is a fundamental part of human behavior. We gossip at home and at work, often with different intents. It’s not always bad: sometimes we gossip because we’re excited to share some good news or say a kind word about someone else. Often, though, we gossip with malicious intent. We say things that are untrue, exaggerated or unkind.

      Gossip and negative “trash talk” can take on a life of their own, poisoning a unit and spilling into other venues such as home and leisure activities. Often, the consequences of gossip aren’t clearly understood, nor are the ways to address it, but limiting the fallout of negative talk is imperative.

      Given СКАЧАТЬ