orm_may-2024 - 14

Leadership
gent leader avoids making a hasty decision
by setting aside their frustrations
with the situation and recognizing the
employee's emotional state. " You can
then better understand how your decision
will affect the employee and the
organization, then decide what is best
for both, " Bowen says.
Finding the 'why'
Among the first steps
toward remedying problematic
behavior is understanding
the reasons
for it. " If I don't find the
'why,' I can't do the
next step where I coach,
mentor, and motivate, "
says Denise Waslo,
associate executive director
for perioperative
sues and those related to competency
issues. For behavioral issues, general
points of advice from OR leaders include:
* Start simple. Simply stating what
a leader has observed can prompt
the employee to provide a reason
for the problematic behavior, Duran
says. For example, she might say,
" It seems you are angry with every
decision we're making, " and in response,
the employee shares the
reasons why. In fact, many employees
will correct themselves once
they're aware of a problem.
Denise
Waslo, MSN,
RN, CNOR,
CSSM
services at Long Island Jewish Valley
Stream in Valley Stream, New York.
If the problem behavior
Janet
Duran,
DNP, MSN,
MHA, LNC, ST,
RN
is sudden and out
of character, it may be
due to external forces
such as a family illness.
In addition to a more
empathetic approach,
employee assistance
programs can help. One
example is courtesy of
Janet Duran, DNP, MSN,
MHA, LNC, ST, RN. As director of surgical
services for Fisher-Titus Medical
Center in Norwalk, Ohio, her scope of
responsibility includes eight ORs, two
endoscopy rooms, the postanesthesia
care unit (PACU), a hospital outpatient
department, and an ambulatory surgery
center (ASC). When an experienced
nurse turned in a specimen with the
wrong patient name, she pointed out
that she knew he was good at his job
and asked what was going on. Fortunately,
the employee was distressed at
the error and sought help through the
employee assistance program.
Overall, problems tend to fall into two
camps: those related to behavioral is14
OR
Manager | May 2024
* Consider the possibility that the employee
does not recognize a problem.
Straub advises making room for selfreflection
to help solve it. " If they are
willing to move forward with improvement,
then that's somebody you invest
in. " Phrases such as " Help me
understand... " or " Can you share
your thoughts on... " can help draw
people out and reveal the extent of
their self-awareness.
* Tackle toxic behavior promptly- " in
real time, " as Bozzelli puts it. However,
she also emphasizes the importance
of objective data to outline
specific examples of what needs to
be improved. If the manager did not
witness the problem behavior, consulting
those who did could reveal
useful insights.
* Recognize that behavioral issues
could be rooted in frustration about
insufficient growth or boredom with
routine. In that case, Bozzelli says it
may be helpful to give the employee
a project to work on. " If they have
potential and their competency is
good, maybe they need to see what
an asset to the organization they
are, " she says.
* Identify any " rewards " motivating
problematic behavior to understand
the situation better, Waslo says. For
example, a nurse who is unwilling to
help coworkers with new equipment
may relish the feeling of being considered
an expert.
* Remind employees that their behavior
can set an example for others,
Ulrich recommends. She might say,
" We need you to be a positive role
model because new employees seeing
this behavior are going to ask
themselves if they want to work here
if people are so negative. "
Competency issues may seem easier
to diagnose and treat than behavioral
issues, but there are always exceptions.
Even the most experienced OR nurses
can encounter difficulties upon joining a
new organization, Straub says. Perhaps
the nurse was enticed by the organization's
weekend program and interviewed
well, but lacks the necessary skillset.
Or a surgical technologist may have difficultly
working in a level 1 trauma center
as opposed to a community hospital setting.
Additional training may be effective
in resolving these situations.
General advice for competency issues
includes:
* Extend orientation for nurses who are
entirely new to the OR, Straub recommends,
as long as lack of competency
does not create a safety
issue and the employee has the
right attitude. " If they're willing to
learn and have that fire in their belly
to continue, then we go the extra
length and continue investing in that
person, " she says.
* Consider the possibility that problems
are rooted in a dysfunctional
nurse-preceptor relationship, Ulrich
says. For example, the preceptor's
teaching style may not match with
the employee's learning style. Resolving
the issue might be a matter
of encouraging discussion between
the parties or even changing preceptors.
She adds that having someone
other than the preceptor
to meet
with informally also can be helpful
for new employees.
* Moving a staff member to a less
complicated service line can help
them " really grow in their confidence, "
Bozzelli says.
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