Managing the Good, the Okay, and the Downright Ugly!
It is an interesting fact of work life that many staff members believe their attitude at work is the fault of someone or something outside themselves. As a nurse manager one of your greatest challenges is to manage attitude in the workplace. This chapter introduces the concept of attitude, discusses the power it can have on the quality of care, work life, and workplace relationships, and provides tips for influencing positive change.
In this chapter, you will learn:
1. The impact of attitude in the workplace
2. The 35/55/10 Attitude Scale: the good, the okay, and the downright ugly!
3. Basic strategies for managing attitude
WORKPLACE ATTITUDE: GOT SOME?
Attitude (with a capital A) in today’s workers is pandemic and is best summed up by Antonio, a character from the popular 1990s sitcom Wings, who said, “Gaze fondly upon today for tomorrow is bound to suck worse!” Negative attitudes may be a by-product of change in the workplace and reflect what is really happening at a deeper level with respect to staff’s feelings, perceptions, and behaviors. Most often, such attitudes emanate from feelings of low self-esteem, powerlessness, low level of trust, a sense of betrayal, disrespect, mental and physical exhaustion, and mismanagement. More recently, compassion fatigue has surfaced as potential cause for negativity at work.
Attitude is a choice. Regardless of our circumstances at work each of us has the power to choose our attitude. The only time we are not held responsible for our attitude is if we are psychotic—and there are medications to treat that! The ability to thrive in a changing workplace largely depends on the attitude staff members choose in response to what is going on in each individual’s internal and external environment.
THE 35/55/10 ATTITUDE SCALE (THE GOOD, THE OKAY, AND THE DOWNRIGHT UGLY)
Change comes in the form of a staff attitude menu with choices that include the good to great, the okay and so-so, and the downright ugly. The percentage breakdown on the Attitude Scale: 35/55/10. Although unscientific, this schematic works well a gauge for measuring potential staff attitudes! The numbers reinforce the fact that most of your staff, when led by excellence, will eventually manage whatever changes come their way. But a few never will and they may give you more than one sleepless night.
The 35% With Good-to-Great Attitudes
Nurses working part-time, in community settings, or in 9-to-5 practice settings appear to be the happiest of all. They readily admit that they can “Come to work, do my job, and at the end of my shift leave the politics behind, and feel good about what I’ve accomplished.” Many other nurses actively avoid getting caught up in the gossip and backbiting, and are able focus on patient care. They skilfully manage peer relationships and try to “get along with everyone.” When they find themselves in uncomfortable situations (e.g., gossip, bullying, or compromised practice), they will do the right thing. These nurses are your role models for demonstrating healthy workplace relationships and meeting practice standards. Your recognition and support is vital to keeping them motivated and engaged in their practice. Be mindful of the optics of recognizing these staff, as their colleagues with negative attitudes may perceive your behavior as favoritism. They can then target the individuals as “teacher’s pets” and make work life difficult for these nurses who are just trying to do their jobs.
THE 55% WITH OKAY-TO-SO-SO ATTITUDES
When change initiatives are ramping up, pressure on you and staff increases in various ways, staffing is generally tight, and most staff members are in survival mode. There may be evidence that application of the professional standards of practice is weakening. Professional nursing care is at risk of becoming task focussed and routine oriented. Patient/client-centered care, continuity of care, and nursing care plans may also become casualties. The consequence of all these stressors is potential violation of practice standards through omission, placing nurses’ licenses on the line.
At a time like this, nurses are vulnerable to the negative attitudes of a few, but powerful staff. When negativity abounds, most staff cope by trying to “go with the flow” to avoid trouble or causing problems. This survival strategy can lead to their unwitting participation in creating toxic workplaces. For example, when there is bullying in the workplace, individuals who are not directly involved know what is happening but say nothing for fear of rocking the boat or risking the wrath of the bully. In adopting this stance they become bystanders and accomplices in the bullying process.
When nurses experience negative attitudes and behaviors among their colleagues, they often feel that they should do or say something. However, they may be reluctant to do so for fear of disrupting the relationships on which they regularly depend. Others feel unsure about what to say or how to handle negative and toxic situations. They rarely realize that the negative attitudes also have an impact on the quality of patient care by impairing communication between team members. Although staff may be vulnerable to negative influences at this time, they are equally open to positive ones. This is particularly true when nurse mangers deal with unacceptable behavior and create opportunities for staff to talk about what respectful, accountable, and professional attitudes and behaviors look like.
The 10% With Downright Ugly Attitudes
Some staff have a high need for order, predictability, and control. They prefer to follow specific routines, work with their chosen group of individuals, and take breaks at the same time no matter what. Organizational change can pose a huge threat to those who require stable environments. No matter how many explanations or how much time they have had to digest the change process, they will never accept what is going on. They will not change! Nurse managers will spend an inordinate amount of time trying to convince, cajole, and influence their behavior. It will not work! They see no role for themselves in helping create stability; they believe that it is the manager’s and everyone else’s job to “fix it.”
MISERY LOVES COMPANY
Staff with miserable attitudes need company to fuel their fire and are expert at recruiting a following. Their attitude often reflects pride in holding steadfast to the “old ways,” refusing to accept change, and seeing themselves as purists (real nurses who may actually resurrect their old nurse’s cap for added effect). They do their best work behind the scenes, when the nurse manager is out of sight. In many instances they are seen, especially by physicians, as the stars of the workplace, the “terrific nurses”—the epitome of efficiency and excellence. That is debatable.
A TOUGH CHALLENGE
Despite the fact that they do not support the direction in which the practice setting is heading, those with ugly attitudes often refuse to leave or transfer. The hang on, convinced that “things will get back to normal.” Some have very little insight into how their attitude is affecting their colleagues or patient care. Others, who are close to retirement, may have a sense of entitlement and believe that their attitude is not a problem: It is “just the way I am.” When this attitude prevails, other staff members learn to work or “pussyfoot” around them and will even defend or make excuses for their behavior.
Downright ugly behaviors present nurse managers with huge personal and professional challenges that can test the manager to the point where he or she may want to leave! In the end, however, after being managed from a performance perspective, some staff with toxic behaviors may have to leave. They lack either the self-awareness or the desire to improve their attitude. If these individuals are not managed, they along with their cohorts will ultimately threaten the quality of care and the ability of other staff to thrive. Caution: Challenging a particular staff member’s attitude is one of the most difficult performance management issues and must be managed carefully with lots of documentation; time for remedial action; alignment with the standards of practice, code of ethics, and organizational values; and a high degree of courage and confidence on your part.
FAST FACTS in a NUTSHELL