How Do We Deal With A Passive-Agressive RNl?

Question:

I work in a small hospital in an endoscopy area that employs two full-time RNs and the rest either part-time or per diem. For the most part, we all work together very well, and enjoy our jobs and patients. However, one of the full-time nurses is extremely passive-aggressive and her behavior is detrimental to the morale of the unit. If one of us is not doing a job the way she thinks it should be done, she goes to administration. The way her complaint is presented is that what we are doing is time-consuming and wasteful. Her complaints are petty and demeaning. She is constantly undermining the other full-time nurse and the rest of us. She deliberately does not communicate information to the rest of us so that she can manipulate the situation to her advantage and to make herself look better and make the rest of us look bad.

When we are questioned, we say we weren’t informed and her response is that she did inform us, that we just didn’t listen, which is untrue. She moves things around so that she is the only one who knows where something is, again, to make herself look better. When she is not there or is on vacation, the unit is much more relaxed, everyone works together to get the job done, and the day is much more productive. What can we do to make her understand that her job is not threatened, that we are all excellent nurses, and that there is more than one way to do the job ‘right’??

Please help — our supervisor is of no help at all. When we go to her, it’s more of a “venting’ session” and nothing gets resolved, no suggestions are given, and nothing changes. This nurse is also an excellent nurse, but her insecurities cause her to feel the need to control every aspect of the work environment and that is making us all miserable. Thank you for addressing our concerns!

Signed,

Makes Our Life Miserable


Answer:

Dear Makes Our Life Miserable:

You have two problems: a controlling coworker nurse and a superior who fails to assert authority. Before I make suggestions for approaching these problems, let me suggest that labeling one’s coworkers with terms such as passive/aggressive (P/A) probably does more harm that good. Leave it to the professionals to define and diagnose. It better to deal with the behaviors that annoy and make your work less effective and pleasant. Not incidentally, in the Synopsis of Psychiatry 8th ed., Baltimore: Williams & Wilkins, an employee with P/A is “characterized by covert obstructionism, procrastination, stubbornness, and inefficiency” and by intentional “forgetfulness and stubbornness . . . especially in response to tasks assigned by authority figures. These individuals obstruct the efforts of others by failing to do their share of the work.” Your controlling coworker strikes me as aggressive but not as passive. She doesn’t shy from doing what is assigned and necessary, at least in her opinion. Whether or not I have interpreted you correctly, the point is not to label but to deal with the behavior. A direct approach is for you and your coworkers, who find her bossiness and/or tattling to the supervisor irritating, is to say so. She asserts herself because that works for her. Apparently, none of you have said, “Joan, stop! Thank you for your suggestions, but when you think things should be done differently, let’s have a time-out session to determine what is less than efficient and if there is only one way to do a task.” From what you say, several of you are frustrated and angry about what seems to be bully behavior. If more than one, possibly three or four of you circled Joan, outside of the hearing of a patient, and spoke your minds at a time she spoke in an undermining way, she could not complain that none of you voiced anything about her bossing. Another approach is to assertively enlist your supervisor in shaping work group communication that is civil, effective and engaging. State that you and several of your coworkers are distressed that venting about complaints has not made working with Joan any easier. Say that you and others have put in writing the dos of how your work group might communicate most effectively and also communication don’ts that make for less than a cooperative and pleasant working relationship. Inform your super that several of you are bringing this do and don’t list to a staff meeting. At the staff meeting, after distributing a copy to all present, invite their modification and adoption. Be sure to conclude such a skull session by scheduling a time to review them after a trial of two weeks or more. If your supervisor doesn’t want you to put a do/don’t list on the agenda, at least she will realize that you are serious and most likely she will propose an alternate solution.

The difference between a work group and a team is that a team has frequent skull-sessions in which it is ok for all to talk openly about how well they are or aren’t working together. The fact that your aggressive coworker has complained and consequently her complaints have been brought to you is ample evidence that you are not working together happily. Conflict about how things should be done is to be expected and can serve as an opportunity for collective involvement in the continuing challenge of quality improvement. Don’t allow this opportunity to be missed and this conflict to sour you all. Rather, use it. Use it to motivate you to realize that working together with hands, head, and heart takes and makes big WEGOS. It is obvious that your work group is not a team and is not enjoying the enriching experience of big WEGOS. And you won’t without confronting the frustrations you are having. Shape the kind of working environment you want.

William Gorden