You have worked at Memorial Hospital since you graduated from nursing school. Your school roommate, Maya, has also worked at Memorial since graduation. In your first year, you and Maya were assigned to different units, but were both transferred to the oncology unit 6 months ago. You and Maya work the 3-11 shift and it is the policy for the charge nurse duties to alternate among three RN’s assigned to the unit on a full-time basis. Both of you were among the nurses assigned to rotate the charge position. You have noticed lately that when Maya is in charge, her personality seems to change; she barks, seems tense, and anxious.
Maya is an excellent clinical nurse, and many of the staff seek her out in consultation about patient care problems. You have, however, heard several of the staff grumbling about Maya’s behavior when she is in charge. As Maya’s good friend, you do not want to hurt her feelings, but as her colleague, you feel the need to be honest and open with her.
Describe what, if anything, you would do?
I would first meet with the coworkers talking about Maya and inform them that I desire to assist them in addressing their concerns but, at the same time advise them that their gossip is not helpful as well as likely against the policy, and advise them to stop promptly. As Maya’s good friend, I have a responsibility to her. Friends look out for each other, they sometimes are the only ones that can get through those difficult personalities, or just pure stubbornness when others cannot, for example, work colleagues which whom Maya may not share the same level of trust and closeness with. Navigating the conversation may necessitate a certain strategy but nonetheless, a conversation should be had. “Often, friends and colleagues are essential for emotional support, guidance, and renewal”, (Marquis & Huston, 2021, p. 484). I would try to talk to Maya in a private conversation where she feels comfortable talking to me and letting me know how she feels. I would clarify with the other nurses if they have already attempted to discuss their concerns with Maya, as this is always encouraged if the employee feels comfortable enough to be vulnerable, and have these types of conversations. I would not necessarily mention that others speak about her, this may amplify her stress but focus more on how she is feeling and how that may be reflected in her actions when in that position at work. It is my and Maya’s job as leaders to make sure we hear our coworkers and advocate for them when they are in need to give them the support they need to be successful. I would ask Maya about her distressing techniques and reflect back on the importance of self-care. I would ask Maya to tell me about her self-care routines and what she is currently doing to balance her life when not at work. What is she doing for fun? What makes her smile? Is she doing these activities often enough to feel satisfied and refreshed when she comes to work? Also reminding her of the importance of leaders identifying when they are discouraged. The attitudes and energy displayed by leaders and managers will affect these same aspects of their subordinates, (Marquis & Houston pg. 484). According to Ellis (2018) managers should take time away from work to remind themselves why they are in the profession in the first place when they notice themselves feeling overworked or burned out. Taking the time to rest and reflect allows them to return to work with a refreshed perspective. I would remind her that she is a leader, she is there for support and to help other nurses achieve their best level of care when she is a charge nurse. “KISS” (Keep It Simple Stupid) it, and go back to basics.
We still have to deal with the issue at hand with the other employees so I would write down the complaints of the other nurses. After, I would discuss the concerns with our manager to make a plan for me (as her peer) to bring these concerns to her attention. We are both new nurses, and these days are going to be challenging this is expected as we become more acclimated in our roles. I would remind her to not be so hard on herself, as it can cause her unnecessary anxiety, just reflect, learn from it and move forward. There might also be a need to move towards constructive discipline with a verbal warning. The goal of a verbal warning is not to intimidate or worry Maya but to discourage unwanted or inappropriate behavior. As Maya’s friend, i would feel comfortable coaching her on more appropriate ways of leading our team. Also, if the employees state they have already tried talking with Maya, if the behaviors do not change or worsen afterward, this will need a formal intervention which is most appropriately done by our manager. However, for best practices and the least invasive options, peer intervention that is verbal should be done first (Marquis & Houston, 2021).
Explain the possible reasoning why Maya’s behavior is different as a charge nurse vs. a being a clinical nurse. (Performance eval or motivation issues?)
Taking on the responsibility and role of being a charge nurse can make additional stressors in making sure the unit runs like a well-oiled machine. Initially, Maya may feel intimidated by the workload and responsibility of being a charge nurse, and if so, it is imperative that she recognizes this, speaks up, and feels comfortable seeking help and assistance when needed. There could be many reasons why Maya feels the way she does and it would be helpful to try to figure out what is going on from a professional standpoint but also from a friend’s point of view. Maya’s recent behavior change while she is a charge nurse could be related to a lack of motivation. “Motivation is the force within the individual that influences or directs behavior” (Marquis & Huston, 2021, p. 469). While it is true that she has previously proven herself to be an excellent clinical nurse, there is a possibility that she lacks the motivation to embrace the role of charge nurse. Motivation can occur intrinsically or extrinsically. Intrinsic motivation at work involves “putting effort into a job that is interesting and exciting” (Breed et al., 2020, para. 12). Extrinsic motivation involves one’s work behaviors being guided by if that behavior will result in reward or punishment (Marquis & Huston, 2021). Maya may not be intrinsically motivated. “This type of motivation is regulated by personal enjoyment, interest, or pleasure, and it involves the performance of an activity for the inherent satisfaction of the activity” (Breed et al., 2020, para. 12). When put into this situation, as Maya’s friend, i would feel comfortable coaching her on more appropriate ways of leading our team. Out of respect for Maya as a coworker and friend, when hearing other nurses comment negatively about her, it would be a good idea to maintain professionalism by putting a stop to it and encourage others to speak to her rather than discuss amongst each other. It appears that Maya does not enjoy the charge nurse role, so it manifests in her personality change when it is her turn to be charge. However, when Maya is in charge, she is also in the role of a leader, where she should practice the element of mastery, having the desire to be better through practice, repetition, and feedback (Sherman, 2016). Doing this step will help prevent a hostile work environment and encourage respect for Maya as a clinical nurse. This will also help Maya gain some confidence in her leadership abilities as right now her tension and anxiousness is making her appear otherwise. This could be due to her fear of not performing well in her role. As evidenced by how Maya speaks to the other staff members. When Maya is in charge, she could also approach the staff with openness and express a willingness for change and a willingness to receive feedback.