Nursing

Problem employee pulling everyone down? Deal with the situation once and for all

Nurse Leader Weekly, March 6, 2006

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Problem employees make life difficult for everyone and can harm a unit's recruitment and retention. In her presentation, "Dealing with 'Bless Her Heart,' " at the 2005 Nursing Management Congress in Orlando, FL, Sharon Cox, RN, BSN, MSN, dealt with this heavy subject. Cox used the term "Bless Her Heart" (BHH) to identify such problem employees, who may be technically competent and respected by patients and physicians, but whose peers are frustrated and annoyed by their behavior. She says these are the employees for whom others make excuses and workarounds, and who impair the unit's morale.

Cox says that too often people compensate for the inadequacies of problem staff and the situation does not improve because it is never openly discussed. She says no one talks about the "elephant in the room."

Identify the problem

The first step to making life better is to identify the "elephant," says Cox. "Stand beside it, paint it red, and talk about it."

Cox identified the following signs and symptoms for when a unit has a BHH:

  • A pattern of making excuses for BHH
  • Morale/productivity is better when BHH is on vacation
  • Staff work around BHH or compensate for his or her inadequacies
  • Staff would not want BHH to interview prospective staff
  • No one openly talks about BHH's behavior
  • Families and physicians are supportive of BHH, but peers are frustrated
  • BHH's pattern of behavior has gone on for several years

Talk about the problem

Cox says the first step is to not avoid the situation, but to confront BHH directly. She recommends using the DESC model when confronting the problem employee:

  • D escribe the behavior: The manager should comment that the employee is oblivious to others, only focuses on his or her patients, and does not participate in teamwork.
  • E xplain the effect: The manager should explain the results of the employee's behavior (e.g., patients and families suffering because employees do not work as teams).
  • S tate what you would rather have: The manager should state what changes the employee needs to make (e.g., helping other staff).
  • C hoice/consequences: The manager should tell the employee that he or she has choices about whether to act differently and that the choices made will affect the choices the manager will make. Explain that the situation cannot continue as is.

Source: Patient Care Staffing Report, March 2006. HCPro, Inc.



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