Why Feedback Fails - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, FAAN

“Good feedback is hard to come by. It is difficult to give, difficult to elicit and difficult to receive”. Sylvia Ann Hewlitt

If you ask any nursing leader about challenging parts of the role, the issue of having to give negative performance feedback is high on the list of least favorite leadership activities. Too often, it gets put off until the annual review and then staff members are shocked when they don’t receive the outstanding performance evaluation that they expected. Feedback is especially challenging when it involves issues around communication, attitude and dress. A manager recently told me about a discussion with one of her staff about a need to have a more professional appearance that ended badly. The nurse, she told me, arrives at work looking like she has just rolled out of bed – very unkempt with wrinkled scrubs and uncombed hair. “It is my practice to try to be sensitive about feelings so I did try to carefully temper what I had to say but letting her know that she is a good nurse”, she told me. “The nurse told me that I was completely focused on the wrong things and that I should be more concerned about some of the incompetent staff on the unit….there was no happy resolution here.”

Why Feedback Fails

So what went wrong in the scenario described to me by this nurse leader? In her new book Executive Presence, Sylvia Hewlitt points out that feedback about one’s appearance is hard to give and hard to take because it is so emotionally fraught. The situation becomes even more challenging when there is a lack of trust between the leader and staff member. If the behavior is long-standing and never before pointed out to the staff member, it can also be perceived as the “leader’s ” issue. To be effective, feedback has to have three components:

It is timely so the recipient is clear on what the problem is.
It addresses one discreet behavior so the recipient knows what to correct.
It is explicit in it’s guidance so the recipient knows what they need to do to course correct.

Effective leaders let their staff know in advance that they will be giving them feedback and even encourage them to proactively ask for it. Hewlitt recommends that leaders give frequent discreet pointers rather than a semi-annual download. Never impart feedback when you are angry. Pointing out the good first does tend to build trust. In feedback sessions, it can be very useful to ask a staff member for three things they do well and then three areas where they need to improve. For use in the specific example above, Hewlitt provides the following important guidance:

1. Catch people when they are getting it right especially in the area of appearance when they are dressed the way you would want them to be – “you look very professional today”.

2. Let them know you have their best interests at heart – ex. what I have to say may not be easy to hear but I am telling you this because I want you to be professionally successful.

3. Discuss appearance in the context of personal branding – ex. you are known for your exceptional professional skills and concern for patients …..every message you send should support that including your appearance.

Giving good feedback is an art that takes practice. It is not a bad idea for a leader to rehearse with a colleague in preparation for a session that is likely to be contentious. The goal is to stay calm, stay positive and remain focused so that the message is received and the feedback does not fail.

Read to Lead

Hewlitt, S.A. (2014). Executive Presence. New York: Harper Business

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