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Painful Leadership Mistakes: Lessons Learned from Disciplining Nursing Staff · Nurse Leadership Dumpster Fire

• speaker-0: We've all been fighting this cough this whole week, so if we all, if either one of us starts having a cough, it fit. That's why I'm sorry. You were talking on Instagram early when we started doing content. You did a video about why disciplinary is speaker-1: you you speaker-0: challenging as a leader and you got a few comments on that and I wanted to see I guess a little bit more in depth about what you meant when you were talking about what makes it so challenging. speaker-1: think because a discipliner can be complex, right? One of the things that makes it challenging for me is oftentimes I can see that, oh, there's a reason behind why they're doing X, Y, or Z. And so like, may chat with them or give them the benefit of the doubt. And that's great. Like we should, everybody's human. I'm a human. I make mistakes. I do the wrong thing at times. don't, I'm not always perfectly professional or whatever. You're right. No, definitely no. I'm probably. a little bit less professional than I should be. But it's not intentional. It's just kind of how my personality goes and how I connect with others. speaker-0: You're to be your authentic self. Yes. And if you're being your authentic self, you're going to be a little weird. speaker-1: Yes, 100 % and I definitely am. the challenges are knowing the right timing to address situations. I would say early rather than late or at least start the conversations early and document them. The other challenges come with like just the weight it puts on your shoulder to have to follow through. speaker-0: Yeah, it's, and I don't not, I can't speak for other like community hospitals, but in our system, a lot of the onus in the workload is on the supervisor. The supervisor is responsible for doing all the evidence finding and interviewing people. Our HR supports us, but it's very time consuming to do it. And so it can feel like a huge burden as well. But when you're saying. speaker-1: and investigations. speaker-0: that it's good to do it early. Are you saying that because of experience? Yeah. speaker-1: I have learned a few lessons along the way, especially like trying to give someone the benefit of doubt because I understand why they're behaving a certain way or ⁓ different scenarios of like, they think you run into situations. How do I say it? Kindly like where people think they would be better at your job. And honestly, they might be like, I don't think that's wrong. The way I see it is like we're a team. So if you think you have a better idea, please bring it to the table. Let's talk about it. And then let me give you my explanation as to why I chose the pathway I chose. But not doing so has led me to deal with some people that are undermining. ⁓ What is that word? I can't think of it where they do not respect authority. speaker-0: Physiological Defiance Disorder. speaker-1: I mean, it does seem like that, but also I think we all have a little bit of that in us. speaker-0: Just a little anti- That's not what I was going to say. speaker-1: That was the word I was thinking of. I was thinking of insubordinate type behaviors that I was shocked by. I didn't have proof of some of it, but I could sense some of it was happening. And then after people had moved on or changed roles, I found out how insubordinate they were actually being. And I was kind of like, wow, that's really disappointing. I should have just figured out and documented way more and been way more upfront, but that's okay. speaker-0: Yeah. I think for me, like one of the other challenges is especially true if you become the supervisor of an area that you worked on as a staff nurse, because it's very challenging to come up to your, who used to be your peers and say, you're out of line, you shouldn't have done that. And they can often feel like, who are you to tell me like, you're just my peer. And it's that dynamic of like shifting the perspective of. Okay, I was your peer, now I'm your supervisor. And just because we were friends or we got along doesn't mean that I can't hold you accountable when you're doing things that are detrimental to the patients or to the staff around us. But I've totally been there where I'm like, because I know these people, because we knew those staff really well. And it could be easy to say, no, they're just having a rough time in their lives. And that's why they're behaving this way. But I think what we both learned, at least I know I've learned, is that that often will exacerbate the situation instead of giving them an allowance. It almost like can give people permission. And then if you try to hold them accountable later, it can come across as like, what do you mean? I didn't know I wasn't allowed to do that. Or I didn't, you never told me this was a problem or. Yeah. I feel so blindsided and so I think you're right. Too early is better. speaker-1: and document the conversations. And how I, one thing Sydney and I talked about documenting conversations is like, what do you mean? Like we just, I just told them they should follow up with an email and send it to them of say, Hey, I just wanted to revisit the conversation we had today and to make sure that I got this correctly. But I just wanted to be clear that I did ask you do X, Y, and Z, or that we consider that these behaviors are no longer acceptable. One thing that's really tricky is the feeling of being hypocritical. when you were up here and you are now like, maybe there's some things you didn't know where it gets the rules and then you're in leadership and you find out and you're kind of like, well crap, I have done that. I didn't know either. It was never told to us by a previous supervisor or whatever. And now you have to hold everybody accountable to something that you also engaged in. That sucks. Cause I think we experienced that. That's really hard because now you feel like a hypocrite, but you're not. It's just kind of in the way you present it too. speaker-0: Yeah. Do you have an example of a time that you're thinking of? speaker-1: I was thinking of just some of the rules. For example, sometimes shopping on your downtime, looking at your phone, playing games, like that can easily get out of control. But maybe it's something everybody engaged in before, but maybe now it's a problem. speaker-0: We didn't work on this unit, but I remember going to a unit and like language the way that people spoke was there was like a lot of foul language and a lot of crassness and sarcasm and It was mostly I think in good fun Like I don't think it was offending the staff but like looking back and thinking what if a patient heard them talking like that like that could have been pretty embarrassing But it was just like you're right like speaker-1: And it does happen sometimes. speaker-0: the culture can get so pervasive. And then if you're the supervisor and you're trying to come in and like realign, like you kind of can come in and sound like you're just the nagger and like you're, just are complaining about things that. speaker-1: had been normal forever and it's fine. Like, why are you in here messing up our culture? We're having a great time. And it's just trying to send the message of like, I get it, but we can do better. speaker-0: Yeah, I was gonna say like, what do you think is a good way, like when you are in that situation, how do you navigate that so that people still respect you? speaker-1: Listen. I will typically say, look, I'm also complicit in this behavior in the past and I just take ownership and I'm like, I think we all need to revisit our own actions and behaviors and improve them because we can all do better. And that's kind of how I try. I'm not always good at it. Another thing I sometimes do is I actually undermine myself. This is what I did early in leadership that I found that came back and got me. When I was trying to realign people or trying to get them on board with something, I'd be like, I know it's kind of dumb, but we got to do it. And I get it. But sometimes me saying that was like, well, yeah, I kind of like set that tone and that happened a few times for me too. trying to just take ownership and set like, we have to do better. That's fine. I even actually had a conversation with some physicians once and they were really frustrated about a change. And I finally just paused and I was like, okay, just tell me all about all your frustrations. They're like, well, speaker-0: doesn't matter. speaker-1: I mean, and they just kind of unloaded on me and then they kept saying sorry and I was like, don't say sorry, like get it all out and let's see what can we do. And then at the end I was like, what are two things that I could advocate for that would feel like this would change would be more successful for you as physicians? And then they kind of just looked at me like, and I, cause I don't know, just stuff like. speaker-0: Well, I think you're just shifting the narrative from let's just sit around and complain about it to what can we take action on? And I think that's important too in any type of like culture shifting is like what can I take action on and do I need to take action on it? And like trying to bounce that out. And sometimes I think especially for you and I, we have to talk that out. Yes. Back to your resources. Find a person that you can safely talk through. the situation so that you can try to discern and that person's not necessarily going to give you any advice, but it helps you to just like conceptualize what's actually important and why do I need to make this a priority so that you can get clear in your head so that when you have to go back and talk to the staff and be like, this is why we're doing this or this is why I have to take action on this because it's a safety risk or. Here's the cascade of events that might happen if this continues down this pathway. speaker-1: Yeah. I think that's important for sure. I don't know. I think I've definitely made a ton of mistakes around this specific topic. Not recognizing setting expectations early was one mistake I made because I, when we first went into our roles and you were doing the interim or details, chief level position or director level in our area. And I was doing the manager and I had just been the assistant manager at the time. I didn't set my expectations. I was just kind of like, let's just keep the ship going where we were trying. And so later on, I was kind of like, I never set my expectations and I've just been kind of like trying to keep the ship going. And I think that's some of the things that got a little out of hand. One of those being over-trusting some of my staff. speaker-0: Yeah. ⁓ yeah. Been burned there. speaker-1: Yeah, I didn't realize that and it was my fault actually and I didn't realize actually till this trip Cindy and I were talking and she said something about like how so and so did this thing and our overtime budget went like way off. Well, I had trusted my timekeeper and my assistant manager at the time to be doing the timekeeping and to not let me worry about it. And I would check in occasionally and do stuff, but like I assumed they were doing the things they were both trained to do by me and they weren't. They took liberties. speaker-0: And then because we hadn't communicated that there had been a change in the process. so previously, Teresa would do, she would do the timekeeping and she'd be like watching it very closely and she'd be cross checking everything. And so I trusted that it was getting done correctly because my experience of working with Teresa was that she was very detail oriented. And so I even took a back seat as well to say, oh, I know trust his style and So this is probably correct. And so I didn't really question a lot of the things that were going on until I looked at like a bigger picture of it. And then I was like, ⁓ shit. got a little out of hand. And so then went, so then Tressa ended up moving to a different position and I had to come back in and sort of reset the playing field for everyone. And ⁓ they didn't like it. speaker-1: And I felt bad because I didn't even know that that happened. was like, I had heard some rumblings of it, but I didn't understand what was going on. was like, what do you mean? Like I didn't do that. And I was like, I didn't realize that those people took that trust I had given, but I realized later that I was like, I would never rehire those. speaker-0: Yep, that, yes, and the person that was contributing to that, I did not hire for a position and that person got very upset. And I think, yeah, sometimes... speaker-1: I mean that alone, that loss of trust alone is like, I can't have you being in my management group if I can't even trust you to do something you were told to do. speaker-0: Anyway, it reminds me of just to flip a little bit. So, Tressa and I have both had some turbulent relationships, personal relationships in the past. there's this phrase, and I'm probably going to mess it up, but it's like, when someone shows you who they are, believe them. First time. And I think that we did that in our job experience as well, is like, people would show us a behavior. speaker-1: Yeah, the first. speaker-0: And you'd be like, well, I don't love that behavior. But you're like, but that's probably not them. I believe that they are a better, you know, they have better intentions at heart, but then they do it again. And you're like devastated and disappointed. And it's like, well, why are you surprised? You watched that happen and you did nothing about it. So here we are. And now you have a big dumpster fire. speaker-1: Yep. Gosh, and that's where I think some of our biggest mistakes really become. We did do a really good job. I'll say that overall, we did a really good job shifting the culture and creating a positive environment, but we did allow some negative behaviors to spread further than we intended. speaker-0: I think that we were really good at nurturing and this is my phrase of the year and nurturing and fertilizing the garden, but we were not weeding. And then I've also been experiences where I was only weeding and I forgot to go back and nurture and fertilize the rest of the garden that I wanted to flourish. And so it just goes to show that like, this is not a easy job. It's not, there's no black and white to this. speaker-1: No, we did not weed well. speaker-0: to this role, it's really an art form and you're always tending one way or another and you know, like, where's our pockets of toxic behavior and clean those up and where's the people who maybe are feeling neglected and we got to nourish them and we got to build them up and build your succession planning and enrich your staff. But like you really have to be doing it all all the time and sometimes can feel like an impossible task. speaker-1: It does definitely feel like an impossible task sometimes. One of the thoughts I had that I was thinking of like putting myself back as a bedside nurse and reflecting like at my leadership and when it comes around disciplinary, there's always this feeling of like, can't do this. This is me as a bedside nurse. ⁓ we can't do anything right. Like with that negative type of attitude at times, not always. I don't always have a negative attitude, but sometimes I'd be like, huh, yeah, I guess we have been doing that. shouldn't, but just trying to remember that you are going to get some pushback. no matter what. You're either going to get pushback from your staff that recognize you should be holding people accountable, or you're going to get pushback from the staff that need to be held accountable. speaker-0: And if you're coming into a position that you're taking over and the culture has really been allowed, it's been neglected, I would say. I have a couple of managers now that have taken over areas that I think had been neglected. And she has been one of them that I'm thinking of. She's been really great at setting consistent expectations and really like holding people to those expectations. And it's been really difficult. There's a lot of pushback. people are angry because they aren't seeing the bigger picture as to she's trying to create a healthy culture for everyone. And the people that have been participating in this negative culture are really good at painting a different picture and a different image of what's going on. Oh yeah, I've seen that. And it just, you know, like, I think luckily she's got a very strong core, you know, it's like, I want to just wrap my arms around her all the time and be like, you're doing the right thing. It's okay. You know, the staff are just angry and that you are doing the right thing. You're protecting patients. You're leveling up care. You're nourishing the staff that are really there for the right reasons that want to give good, positive patient care. but I just, I, I watch the. I watch it just like eat at her. And I remember because I remember her being there too. speaker-1: I do. I do remember that as well. think it's a challenge. Being in leadership is challenging. Being a nurse is challenging. They're hard jobs. And I think it's just important that if we set our expectations earlier, then the staff know what to expect. It's really hard when you do make the mistakes of not setting those expectations early. And then you try to hold them accountable because you realize how... Because there are certain things you'll feel like you shouldn't have to say, but you do. Yeah, you do. It's unfortunate, but you do. And it also sets you up for better success and the staff for success because then they know what your lines are. speaker-0: And really at the end of the day, it's about you being clear about what your boundaries are. Because I think that if you don't really sit down and get very concrete about what you will tolerate and what you won't. And like, what is the unit that you want to create or what is the work environment that you want to create? Like that is such an important piece of you getting clear. Because once you're clear, it gets easier to decide. Yeah. When do I need to take action? When do I not? But if you don't ever sit down and have that conversation with yourself, then you might be like, why is this happening? And it's like, ⁓ I never decided if I was okay with that or not. And here I am by default saying it's okay, but I'm not really okay with it. But now how do I backtrack? speaker-1: I think when those things do occasionally occur, think it's okay to say, you guys, didn't recognize this would even be an issue. I'm so sorry, but this is not allowed. I can't handle this. Like this is not something I think is good or safe for the patients or for you or for your career or any other whatever reason it is. But just, I think sometimes just taking ownership over your own mistakes is... speaker-0: No, and I love that about you. Like you always are very good about saying, guys, like I. speaker-1: That's my fault. I didn't know I screwed up, but I definitely did. Yeah. speaker-0: like now we got to pivot. And I think you, what you've been talking about this whole time is just like that very clear communication. And I think I don't think we've said this out loud, but it's really explaining the why behind why, why are we going in this direction and making sure everyone is clear. And like you said, avoiding those things like, well, it's dumb, but speaker-1: Have we talked about splitting at all? Cause one thing I think we did better, we did pretty good at, and I think this came from working in a previous management role where there were like a couple people in the role and like, I would have a conversation with someone, but I didn't like maybe let the manager know like I was or whatever vice versa, you know, and staff sometimes will do the mom dad thing. So one thing we got better at is like, Hey, I spoke with so and so, sending emails or sending texts or something about like if something came up that was out of the ordinary, or if we didn't do it reaching out before we answered questions or whatever, being like, Cindy would be like, hey, did you say so and so could do this? And I'd be like, no. It's weird how people will twist your words too. Because like, even recently someone said, oh, well, so and so said that you said this, this and this about policy. was like, no, I said there isn't a policy. said, and I couldn't remember, so double check the policies. And that's what I said. And they were like, well, they said that you just said it was OK. And I was like, why would I say that? And so I screenshot my messaging to that person and sent it back. was like, this is exactly what I said. I was like, why do people twist things? And I don't think they mean to. It's just their interpretation of what you speaker-0: Sometimes people just hear what they want to hear. Yeah. Because they're looking for a specific answer and if you aren't getting the answer they're looking for, they're going to just keep hopping around until they can find the answer that they want. Yeah. So that's, agree. we would do, sometimes we would start group chat texts. And so like if one of us was talking, then the other one could see the conversation. And then that helps with the other person knows. I told Teresa, so don't try to go ask her the same question when I'm not there. Or we would email the staff and we would always cc each other on our emails because that transparency that the staff feel like there's a unified front, that's half the battle, speaker-1: Yeah, even even at times if I didn't agree or she didn't agree we would still just be like, okay Well, I don't think this is the best idea, but we're gonna go with it cuz I don't know right and sometimes you're just like, I don't know speaker-0: Or you could be like, I don't know the whole story. I think, you know, if you, don't know what her rationale was, or like, there's probably more to the story, you should probably just go talk to her. speaker-1: Yeah. And just kind of figure it out. And usually there is most of the time, I think for the most part, or even a lack of foresight. Like maybe I did make a decision and you're like, but did you think of? And I'd be like, no, or vice versa. Right? So just kind of that clear communication, not only to and with staff, but among your other management team ⁓ and making sure that you're creating a united front in all areas of communication. speaker-0: ⁓ I think in my current role, this team is really good at whenever. So things will come down from national all the time and then we'll decide at our local level, how are we going to handle it? And I remember experiences and previous roles where something would come down and then it would just be like, everyone figured out or this is there'd be like one statement of this is the guidance and it just get forwarded, but there'd be no discussion. How are we going to present this to staff? What is our, you know, take on what does this mean? This team I'm in now is really good at making sure that we don't communicate anything out forward until we come to an agreement within our smaller team. And that way when we communicate out, we're all sending the same message because we inevitably cover each other. And so if I have a different interpretation of a rule as my coworker, that's going to just create drama. speaker-1: It does. Because then you essentially are like, well, that's not what, that's not what. And it's not even on purpose. Because you're just like, ⁓ that was not my interpretation. And then now the staff are like, hold on, what's going on? And then that creates confusion. And then they see, they start pitting people again. speaker-0: Yeah, no, I've seen that. Like I've seen even at the manager level, I've seen managers try to pin me against another associate chief nurse for whatever reason. Like I might have just interpreted something differently and they're like, well, that's not what so-and-so said. And so either they think I'm not following the rule and she is or vice versa or she's being overly critical and I'm not. I have had to like really be careful when people ask me questions to say, hold on, let me get more information first and then I will come back. And that way I can try to loop back in that person and say, I want to make sure that the message I give them is consistent with whatever you've said to them. speaker-1: I agree. Anyways, we just thought we would hop on, have a conversation, share our thoughts. This is kind of how our conversations often go. And we share like our memories and our themes. It's also how we grow. identify, ⁓ shoot, I didn't even know I did that, like types of things that we can grow. speaker-0: Yeah, so we've been on this journey. started in central Oregon and went to Crater Lake and then we went down to Northern California and we went through the Redwoods. And now we're kind of on our way back and we're going to hit another spot in central Oregon before we head home. But this whole week, you know, which was for fun, but we've been, it's been nice for us to be able to just walk and talk and process. And we talked about how Doing things like this really helps our brain unravel some of those things. And I think we've both been doing that a lot this week. So we wanted to share with you some of the musings that have come out of our discussions. speaker-1: So thanks for sharing with us and have a lovely day. ⁓