Dealing with a Competent but Difficult Nurse: Strategies for New Managers

Entering a new management role can be daunting. One challenging scenario many managers face is how to handle an employee who performs well in their role but struggles with their interpersonal skills. This is especially true in healthcare settings, where maintaining a positive and professional environment is crucial. In this article, we will explore effective strategies for managing a talented but difficult nurse, focusing on communication, documentation, and progressive discipline.

Understanding the Employee Strengths and Challenges

Before addressing any behavior issues, it is essential to acknowledge the nurse's strengths. They likely possess valuable skills and knowledge that contribute positively to the department. It is important to recognize these strengths, as it sets the stage for a more collaborative discussion. For example:

“Thank you for your hard work and dedication to our patients. Your skills are truly unmatched and your knowledge has been invaluable to our department.”

Once you have acknowledged the nurse's strengths, it is time to address the areas where they may be causing problems. This involves identifying specific examples of their behavior and using their own words when possible. Be sure to document these interactions, as they will be crucial for future discussions.

For instance:

“During the patient triage on [date], I noticed that you were dismissive to the patient about their concerns. They were very upset and mentioned feeling ignored. Can you tell me how you perceived the situation and what you would do differently to handle similar situations in the future?”

Communicating Effectively and Documenting Interactions

Conducting scheduled conversations with the employee can help ensure that the feedback is consistent and constructive. It is important to provide positive feedback before discussing any issues. This approach is effective because it frames the conversation in a positive light, making it more likely that the employee will be receptive.

“I want to start by praising you for your exceptional skills and the value you bring to our department. Your medical expertise is greatly appreciated, and your ability to resolve complex issues is a true asset.”

During these conversations, gently touch on the issues, if at all, the first time around. The second time, you can delve deeper into the problematic behaviors and ask for their perspective. This allows the nurse to feel heard and gives them an opportunity to express their concerns.

“I noticed that you spoke harshly to a patient on [date]. It’s important for us to maintain a positive and professional environment. Can you share your thoughts on what led to that situation and how you would handle it differently moving forward?”

Maintaining thorough documentation of these interactions is crucial. It provides a record of your efforts to address the issues and supports any further actions you may take. Share these notes with your supervisor and HR to ensure alignment with your facility’s progressive discipline policy.

Implementing Consequences and Support

Should the behavior continue, it may be necessary to take steps to manage the nurse's responsibilities. This can include:

Reducing direct contact with customers by transitioning the nurse into more administrative tasks.

Rescheduling the nurse's shift to minimize their availability to customers.

Having the nurse train or supervise interns, which can also provide them with additional support and diverse responsibilities.

By implementing these strategies, you can help the nurse manage their workload and potentially reduce challenging interactions. It is also important to maintain open two-way communication and to offer support if the nurse is willing to address their behavior.

Conclusion

Managing a competent but difficult nurse requires a delicate balance. Acknowledge their contributions, address their behavior constructively, and implement necessary changes. Staying consistent and documenting all interactions is essential. While the road may be challenging, these strategies can help you establish credibility and create a positive, professional environment.

Best wishes in your management journey!