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Video Tip: Creating a Healthy Work Environment | J ...
Creating a Healthy Work Environment
Creating a Healthy Work Environment
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This ASG video tip is sponsored by Braintree, maker of the newly approved Soufflave and Soutab. Case one is a senior level nurse has become passive aggressive regarding her assignments within the unit. It's reached a point where many of the physicians actually start requesting other nurses to work with them rather than her. Some have complained that when she's in the room, they notice that when they're pushing her to get more efficient, she moves a little slower and the day winds up being two hours longer than other nurses. And when the nurse is confronted by the nurse manager about expected times, she mentions that if she gets this job assignment changed again, or she gets fired, she's going to start thinking about hiring a lawyer. But you know, Debbie, I know you've had given us a talk about some of the strategies to handle a nurse such as this, John and Nisa may have also experienced situations like this. And, you know, there's obviously, you know, you always have to find out, you know, from the perspective of the nurse, why she's having this type of behavior. I think a lot of it is, you know, investigating or just making her recognize this is what's going on. This is what's happening. And then finding out, you know, does she realize that this behavior is causing problems? And you know, is there something behind why this behavior is showing up? I'll open it up to Debbie first. So yeah, I would agree with you. It seems like there's something going on like behind the scenes, you know, and as a director and working with my managers, I think, you know, the best thing, as you mentioned, was is to, you know, talk with her and ask her, you know, what, how does she feel things are going? Is this in every physician's room? You know, there's some physicians that won't work with certain nurses, right? So what's the cause of that? What's the reason behind why number one, why she feels that, you know, that we aren't being on a time schedule? And then the physician, obviously, you want to know, what is it that they're seeing in the room? Is it that she's playing on her phone? Is she, you know, just not being observant of what's happening in the room? So I think that we need to, at this point, sit down with her and kind of see where she feels things are going and how things are going. And she may come out and just tell you, you know, I'm not happy here any longer. I feel like you're putting too many cases on for the day. It's, it's gotten too busy and it's more, you know, it feels like a, you know, a cow through, you know, go through it and, and hurt everybody through, you know, I think we need to address what's making that nurse have a change of heart in her work ethic. I completely agree with what Debbie said. I would hearken back to my, my talk, and I would say, be curious and not judgmental and sit the nurse down and maybe it's her arthritic needs and she can't push the stretchers as quickly as the 20 year old nurse who just graduated from nursing school. So ask those questions, really hear her, hear the nurse, hear her issues, let her verbalize what exactly is going on. Point number two is just consider across the board metrics for your unit. So in our unit, we have a sign that says 14 minute turnover from one case to the next. And the nurses know it's in every room posted in every room. The nurses know this is what we're aiming for and make sure your expectations are spelled out and the nurses will come to you and tell you, Hey, your expectations are ridiculous. There's no way we can make that work. But I think if you've got equal expectations for every nurse in every room, your odds of getting everybody to step up to the challenge are much better. I also completely agree with, with both of you. And actually, while I was listening to Dr. Eisenberg read this question, I was thinking about the, the be curious and use compassion remark that Dr. Kabilian made during her talk. And this is exactly where that would apply. And you know, this may even be a situation where, hey, careers evolve and what used to be great and fun and satisfying for this healthcare professional may not be any longer. And it's not about making this person fit into the environment. If there's another environment that might be more satisfying for her career wise at this point, then the best thing for all involved might be for us to help her find what that is. And she may be eternally grateful for that and may even help us to recruit her replacement. And that's not a joke. She may know another nurse and that nurse may be at a point where he's saying, Hey, you know, I've been in the clinic environment for a long time, and I've been wanting to try procedures. So I'd love a shot at that. Well, then maybe they trade places. And so it's not about making what's now a square peg fit into a round hole. It's about how to be helpful. And I think that's what Debbie's nailing down here. Thank you for all that input. I really think that, you know, trying to come up with a solution involves everyone on the team and sometimes good for the physicians who are in the room to kind of say, Hey, I noticed, you know, this is an issue for me. And is there something I can do to help you? Is there, you know, being that curious person, instead of just complaining to the nurse manager might help mitigate some of this as well. I know that we have some additional input from our audience. Maybe some other questions, Eden, can you help us with that? Yeah. And picking up on the same note that we're on, Angela writes, and if it is physical, what do you do? We still need to continue to move the room. Older nurses can't expect to take longer rooms all the time because they physically can. It turns into other nurses saying management is not being fair. So what are your thoughts on that? I can tell you what I would do in this situation, you know, in talking to the nurse. And like I said, you know, she's, as you've mentioned earlier that, you know, maybe her knees hurt. Maybe she's had a knee replacement, you know. And I've had nurses who have, you know, had these issues, you know, having been in the same practice for so long. And you know, sometimes they get an actual reduced work note from their physician, right? That they can no longer stand for more than three hours at a time or whatever that may be. If they do have that, if you have the opportunity to offer them a position, as Dr. Martin mentioned, somewhere else in that practice or in that company, I think that's the time then you start working towards that, you know, people transition and progress and there's always a succession. So it's a natural order that we tend to slow down and not able to be able, speaking personally, to do as much as we could before. And so I think that opportunity, and this comes with cross training, right? This comes back with adding those skills in as you're having someone in your company. Maybe they go to a triage line for nursing and they're making pre-op calls. You know, I think the company, if it's a valuable employee, can look at other options to place that person. And you know, people will come and go and, you know, some nurses don't like to do anything but work in the procedure room. So I think that's where you kind of, you know, work with what staff that you have and the personalities of everyone there. And if this is indeed someone that is valued, I think that, you know, you'll find a space and support from others for that nurse. John? Thanks, Gerard. I just want to make mention that, you know, we're all healthcare professionals here and I think it's important for all of us, regardless of which part of the team we come from, to remember that we work in one of the most stressful industries there is out there and a lot of impairment of various sorts can come about as a result of that and we never know what's going on at the personal level at home. So back to Dr. Kabilian's point of compassion and curiosity, you know, is it really a work issue or is it just easier to frame it as a work issue when the real problem is with personal health or personal mental health or with stressors at home or in one's personal life? It may actually not be about the stretcher or about standing at all. It may actually be because there's no one at home taking care of a sick child or something like that. So be compassionate and curious, as Dr. Kabilian mentioned earlier, and seek out, you know, is it something that you can actually help with that has to do with nothing at work really, but with something outside of work? It's a tough, tough field we're in. Yeah, that's, that's, those are great comments and one of the other things that I would also suggest thinking about is, is this a time to rethink the process of how, you know, room turnovers take place? Do you reconstruct the way that patient turnover occurs? Do you bring in a nurse navigator who, you know, they get input from the nurse in the room that, you know, there's a patient about to be brought out to the recovery area. They can start making room for that patient to come out and send in perhaps a roving technician or a roving staff member to come in and help with some of the physical components of moving patients out so that the nurse who has that, you know, that physical disability doesn't have to do that. And maybe you can incorporate that in all of the rooms just to make, you know, everything fair so that, you know, the nurses who are doing some of the physical stuff don't feel like they're being imposed on in a different way than a nurse who asks for, you know, a certain disposition regarding their work environment. So those are things to focus on in addition to, you know, the personal issues.
Video Summary
The video discusses a case of a passive-aggressive senior nurse causing issues in the unit, prompting physicians to request to work with other nurses. Strategies to handle such behavior include understanding the nurse's perspective, addressing underlying reasons, setting clear expectations, and considering alternative roles within the company. It's important to be compassionate and curious when dealing with potential personal issues affecting work performance. Suggestions include rethinking patient turnover processes to alleviate physical strain on nurses and ensuring fairness in workload distribution. Overall, a collaborative approach involving empathy and open communication is crucial in resolving workplace challenges in a healthcare setting.
Keywords
passive-aggressive behavior
senior nurse
physician relationships
workplace challenges
healthcare setting
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