Balancing Compassion with Professional Expectations

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

What is the leadership balance between feeling compassion for staff who have been through so much with professional expectations? This was a question that a critical care director recently asked me. Her staff, she explained, is understandably burned out as an outcome caring for so many COVID-19 patients. They feel a collective loss of the way things were in their lives and are grieving. Some of the behavior she is seeing now is quite negative and unprofessional. She has tried to provide staff with some additional days off to re-energize, but some need much more to regain their resilience.

I pointed out to her that her question indicated that she already believed some staff was crossing a line. Balancing compassion for what has happened with expectations that staff behaves professionally is tricky for leaders today but is essential. It could be that some staff are completely burned out and need a mental health referral. This assessment would be the first action that I would recommend in this situation. It still does not excuse bad behavior. The consequences of this director not acting to correct disruptive behaviors could lead to a normalization of negativity in the culture.

In a recent interview with Bonnie Clipper, Dr. Renee Thompson offered some excellent advice for nurse leaders when a staff member’s behavior has moved to a place where it is disrupting teamwork on the unit. Below are the talking points that she suggests using the following case example:

Rhonda is an experienced critical care nurse. She has had challenges accepting the numerous policy changes around PPE that have occurred in her ICU. Carol, the unit manager, had another update on PPE, which she shared in a huddle this morning. Rhonda announced to the group that she was fed up with the incompetence of an administration that had endangered their lives during this crisis and stormed away from the huddle. One of her co-workers commented to the group on how negative Rhonda had become in the last month. The negativity was impacting teamwork on the unit.

Carol schedules a private conversation with Rhonda. She begins by telling Rhonda that she has appreciated her contribution over the past three months and understands her frustration concerning the many policy changes around PPE. We are all frustrated and concerned, she shares, BUT the behavior that you exhibited after huddle this morning was not professional. She follows with these talking points suggested by Dr. Thompson:

In a crisis, we see the best in people and the worst in people.

I need you to be your best today.

None of us has the energy to spend on negativity.

Do I have your commitment to change your behavior beginning today?

Cy Wakeman would take this one step further with her reality-based leadership approach. She advises that we sometimes fail to hold staff accountable for bad behavior stemming from their ego issues. Her question to this critical care nurse would be – given what happened at the meeting – what would great look like in this situation? We can be empathetic but still hold staff accountable.

Read Rose Sherman’s book – The Nurse Leader Coach: Become the Boss No One Wants to Leave