Getting Out of the Drama Triangle as a Leader

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

A new nurse manager recently asked me how she can turn down the heat of what has become a drama triangle on her unit related to professional accountability. Stephen Karpman first described the drama triangle in the 1960s. It is a model of dysfunctional social interactions and illustrates a power game that involves three roles: Victim, Rescuer, and Persecutor. Each part represents a common and ineffective response to conflict.  The nurse manager’s story is a good illustration of this drama triangle.

I presented during a staff that we were either missing or failing to document essential elements of basic nursing care, such as ambulating patients and tracking intake and output. Quality Management was tracking these documentation omissions. My staff immediately moved into victim mode focusing on our staffing shortages as the problem. The nurses contended that the “persecutors” – our quality management staff- should leave their computers, come on units, and walk a mile in our shoes. I immediately moved to “rescuer” mode and stated that I would look into ways to streamline documentation. I did two things I should not have done. First, I needed to be more clear from talking about professional accountability. The second was that I took on the responsibility of looking into how to streamline documentation rather than empower staff to try to solve the problem.

This new manager is not alone as scenarios like this play out in countless clinical areas nationwide. Nurses in some situations assume themselves as powerless to change conditions and blame others (often leaders) for what is happening. They may seek for rescuers to solve the problem for them.  Nurse leaders feel extreme guilt about what is happening and intervene as rescuers on behalf of the victims and try to save victims from perceived harm. Persecutors blame the victims and criticize the behavior of rescuers without providing appropriate guidance, assistance or a solution to the problem. They are often critical, good at finding fault, and control with order and rigidity.

Escaping the Drama Triangle

The first step to escaping the Drama Triangle is to understand what it entails, be aware of your role in a particular circumstance, and be watchful to avoid taking one of the three roles.  Part of the challenge for this new manager is that she defaults to the rescuer role and serves as the intermediator between the prosecutor (the quality department) and the victims (the nursing staff).  Instead of being the rescuer, she could move to coach where she works to empower staff to become part of the solution.  She could encourage the quality department to attend one of her staff meetings to focus on developing solutions instead of criticizing or blaming. The manager should step back from this conversation and avoid jumping in. This means she needs to learn to be more like Yoda and less like Superman. Drama triangles are never easy but staying in them prevents conflict resolution and rarely results in good outcomes.

© emergingrnleader.com 2023

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