1. Haggard, Ann PhD, RN,BC, Column Editor

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After the column on needs assessment, I received an e-mail from an East Coast perioperative educator expressing frustration with the results of asking, "Is this an education issue (staff do not know how to do it) or a management issue (they know how but are not doing it)?" He writes, "The problem is that managers do not want to take responsibility for management problems and continually point fingers at the educator."


Does this sound familiar? How many times have you felt frustrated with a manager's response to a performance problem? The answer for most of us is, "a lot." The usual scenario goes as follows: Employee(s) is/are not performing to standard; manager(s) request(s) inservice class/self study to "fix the problem"; educator grumbles to himself or herself, "If only the manager(s) would counsel/fire/hold accountable the employee(s), the problem would disappear."


I knew it would sound familiar. Unfortunately, grumbling to oneself rarely (I would guess never) solves the problem. Are there solutions? In that prior column, I talked about using root cause analysis (RCA) as a tool, possibly combining it with Mager's performance problem analysis as a way of helping managers identify causes and required solutions for performance problems. However, that assumes that respect and free and easy communication are both part of the climate. What if neither is present? How can you tell if a problem with respect/communication exists?


When organizational problems occur, do other departments seek out the input and advice of the staff development department? Are the educators known and respected throughout the hospital? When staff development is seen as a full and vital partner in hospital endeavors, using RCA for problem analysis is easy (in fact, educators often lead/facilitate RCA meetings). However, if education is thought of as a necessary evil, and its participation is not sought or wanted, a climate nurturing frustration and resentment on all sides can exist, and that leads to the ideas and suggestions of educators being marginalized.


Respect and communication sound so easy, but of course they are not. Staff development departments work long and hard to earn both. I believe it boils down to visibility, volunteerism, and values demonstration (I think I just invented the three Vs).


Visibility. The type of visibility is really crucial. "Negative" visibility occurs when the only time educators are seen is in classes or strolling around the hospital chatting with people. My rule of thumb is always to have a definite purpose when going anywhere in the organization-and to be sure people see me accomplishing it. When making unit rounds, do educators read charts and talk about patient problems with the nurses? Do they offer to help turn patients or answer a light if staff members are overwhelmed? That one-to-one interaction is golden.


Volunteerism. Is the hospital starting a new task force? Get at least one member of the staff development department on it. Is the board interested in something new? (You do go to board meetings, don't you?) Offer to research information, make calls to contacts in other organizations, or summarize findings for whatever administrator is following up on the request. Look around the organization for projects/problems/opportunities you can help with or even scut work that needs doing. It is the best way to keep yourself and your department perceived as valuable resources, not as invisible women/men.


Values demonstration. This needs to be top priority. Problems between education and line management tend to go way back. If you find yourself in a situation where people's mindsets are negative, you will usually find both "sides" mired in snide comments, gossip, and sarcasm. Take a week to really concentrate on what people are saying. Do you hear a lot of, "Well, what do you expect from her?" or, "Why on earth doesn't someone fire him?" or even, "This is the worst bunch of managers I've ever seen!" Statements like this poison entire organizational cultures.


I believe that we in staff development deeply value positive communication, so it is up to us to demonstrate that value. Meet with staff and tell them that you have noticed some negativity being voiced around the organization (include a couple of real-life examples-from yourself, if possible). Ask everyone to make a conscious effort-and for a while it really will be an effort-to change their behavior. Whether talking with department members or to others, concentrate only on positive statements. Do not allow "venting" behind closed doors-research has shown that venting does not relieve anger; it rehearses it and makes people angrier. To change a habit, you have to keep performing the new action, not backsliding into it when you are among friends. Ask every staff member who reports to you to remind you and others if negativity starts creeping in. Another tip: Do not fire off a litany of complaints when you go home. Sarcastic or bitter commentary about work when at home reinforces the behavior and makes it harder to kick the habit at work. Trust me-your family is sick of hearing you complain about your job.


Once you are modeling the behavior you value, volunteering to help others every chance you get, and being visible as a positive resource for the organization, you will gradually begin to receive back the behavior you are modeling. This will happen slowly, but it will happen. As that reciprocation occurs, doors to collaboration will open that were closed before. Then, your next project can be finding ways to help managers take the actions needed to change unacceptable employee behavior. However, that is another column. See you next time!