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By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

How many of you have seriously considered leaving your role?  I recently asked this question during a session with nurse managers, and I was not surprised to see 80% of the hands in the audience go up. While we are not seeing massive turnover in the nurse manager ranks year over year, the turnover rates among newer managers within their first four years of leadership have increased. CNOs tell me that they can see their managers struggling in this turbulent healthcare environment and want to implement the strategies that will be most helpful in retention.

That brings me to the recently released “Trends and Innovations in Nurse Manager Retention“ a collaborative effort between Laudio and AONL. The report is on insights from Laudio’s platform, which includes data on more than 200,000 frontline employers and AONL-led interviews with nine nurse managers.

Their key findings include the following:

1. Nurse managers are most likely to exit management and return to a frontline team member role within their organization within their first four years as managers. On average, the annual management exit rate for those in their first few years on the job is between 10% and 12%.
2. The average annual nurse manager organizational exit rate is 7.5%, though it can be as high as 12% for managers with around three years of experience.
3. Nurse manager turnover is disruptive to staff. It is associated with a 2—to 4 percentage point increase in average RN turnover in the year following the transition.
4. Most managers (89% of the leaders interviewed) rated a healthy work environment as their top priority, focusing on physical and psychological safety. This was followed by promoting leadership development, early identification and development of future leaders, and addressing the complexity of the manager role.
5. Managers wanted more flexibility regarding their schedules and the structure of their roles. This includes a four-day workweek, job sharing, and more administrative support when the manager is absent.

One interesting finding in the Laudio data set is that 50% of nurse managers have 3.5 years or less of experience, with the most common tenure being one year (21%). They are early in their leadership careers, and there is a significant risk that many won’t stay past the four-year mark. When nurse manager turnover occurs, the most likely replacement is a frontline nurse working on the unit (37% of the time) or an assistant manager (20% of the time). This speaks to the need to develop strong leadership bench strength by investing in emerging leader programs.

The report recommends that nurse executives focus on four key areas to promote nurse manager retention:

1. Ensure a healthy work environment
2. Promote leadership development
3. Identify and develop future leaders early
4. Address manager role complexity

While none of these recommendations are new, the report highlights a pressing need to address them to avoid future nurse manager turnover. Many nurse leaders are currently working on strategic priorities for 2025. Nurse managers are the linchpins for staff recruitment, retention, engagement, and achievement of performance metrics, so addressing their needs is a wise investment to improve many other aspects of nursing practice.

© emergingrnleader.com 2024

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Little research exists about the stress of technology on nurses in practice today. I would encourage you and your staff to participate in this research.  Study Link

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

During almost every workshop I conduct, nurse leaders today express frustration about working with some staff who make things so difficult in the work environment. Consider the following example from a critical care manager:

I am new, so maybe some of my staff are testing how far they can go in conversations with me before I lose my cool. Several nurses on my team complain about everything from their schedules to patient care assignments. No matter how much I try, they are snarky and sometimes disrespectful. I confront them about their behavior, but this wears me down. I dread having these conversations because they lack emotional intelligence and the ability to accept feedback. The role is hard enough without the additional challenge of leading some difficult staff. 

The truth is that we can all be challenging at times.  The difference between difficult staff and others on your team is that they do it more often. It becomes a pattern of behavior. They may have been given feedback about their behavior but have not changed consistently.  Part of what motivates difficult people is that they often can wear people down (as in the case above) and get what they want.  You may not be able to change the difficult person’s behavior, but you can change how you respond.  By learning to disengage effectively, you will avoid getting hooked into the difficult behavior cycle.

Difficult Personalities Types

Dr. Louellen Essex identified the following four different types of difficult personalities:

• The Volcano—These individuals are abrupt, intimidating, overbearing, arrogant, prone to personal attacks, and highly aggressive in their approach to getting what they want.
• The Sniper – These individuals are highly skilled in passive-aggressive behavior, take potshots, engage in non-playful teasing, are mean-spirited, and work to sabotage leaders.
• The Chronic Complainer – These individuals are whiny, find fault in every situation, accuse and blame others for problems, are self-righteous, and see it as their responsibility to complain to set things right. They rarely bring constructive ideas to situations.
• The Clam—These individuals are disengaged and unresponsive. They close down when you try to have a conversation, avoid answering direct questions, and don’t participate as team members.

Tips for Dealing with Difficult People

You can probably identify the personality types of some of the difficult people you deal with from the list above.  The more significant challenge is how do you respond to the behavior.  Here are some suggestions:

1.  Don’t try to change them – generally, you are experiencing well-established behavior patterns with difficult people.  Any change in behavior with a difficult person will only come if they take accountability for it.  You can point out the behavior, but it is not your responsibility to change it.

2.  Don’t take it personally – the behaviors you witness from difficult people reflect where they are personally more than anything you may have said or done.  They may be sick, tired, or have extreme emotional problems.  When you see an explosive reaction to a minor situation, you can be sure that there are strong underlying emotions that the person is experiencing.

3.  Set boundaries – let the person know that you will respect them but expect to be treated with respect in return.  Don’t tolerate yelling; if necessary, tell the person that you must remove yourself from the situation.

4.  Acknowledge their feelings – you may disagree with their point of view but acknowledge that they appear very angry about a situation.

5.  Try empathy – recognize that being stuck in a place of negativity or anger must be challenging. Compassion can sometimes (but not always) help de-escalate explosive situations.

6.  Hold your ground -remember that you teach others how to treat you, so don’t open the door to challenges.

7.  Use fewer words – less conversation is often more effective with difficult people. Use short, concise messages to drive your point home, and set a time limit on how much you will engage in the discussion. Avoid using the word “attitude” because this will be viewed as very subjective – focus instead on the behavior.

While these tips are only guaranteed to work sometimes, you may find them helpful in many situations.  The key to managing difficult people is driving your reaction to the situation. Ultimately, the only behavior you can truly control is your own.

Read to Lead

Louellen Essex and Associates  (2006)  DealingwithDifficultPeopleWorkbook

© emergingrnleader.com 2024

Brand New Workshop for 2024 – Leading in the New World of Work.  Click on Flyer The New World of Work Workshop

Bring the Nurse Leader Coach Workshop to Your Facility Virtually or Onsite. Click Here for the Nurse Leader Coach WS Flyer

We are pleased to partner with the New England ONL again to present the Nuts and Bolts of Nursing Leadership next month. You don’t need to be an ONL member to register. We have one session for nurse managers and a second for emerging leaders. These highly interactive and highly rated sessions present the latest strategies for leading in our new world of work.

If you have any difficulties registering, contact me at roseosherman@outlook.com.  Registration Link 

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Every new generation uses unique terms that may or may not be familiar to their leaders.  Consider the following story from a nurse manager:

Several months ago, several of my new nurses told me that I was “brat’.  I don’t have kids, and initially, the word brat seemed derogatory to me, but they assured me that this was a huge compliment.

This nurse leader is not alone in learning to adapt to a new vocabulary. Since communication between generations is more critical than ever, TollFreeForwarding.com has created a TikTok Slang Dictionary to bridge the generation gap and hopefully improve workplace communication. In case you’re having trouble understanding your Gen Z staff, here are 10 of the most used phrases from their dictionary:

Language like so many other things in the workplace evolves over time.  Staying abreast of these changes is an important part of improving your leadership communication.

© emergingrnleader.com 2024

Brand New Workshop for 2024 – Leading in the New World of Work.  Click on Flyer The New World of Work Workshop

Bring the Nurse Leader Coach Workshop to Your Facility Virtually or Onsite. Click Here for the Nurse Leader Coach WS Flyer