Managing Difficult Nursing Staff

Being a nurse leader is challenging today, but managing difficult staff makes it even more stressful. These are the nurses who you dread having conversations with because they lack emotional intelligence and the ability to accept feedback.  My advice is always to enter the conversation with good intentions.

We can all be challenging at times.  The difference with difficult people 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 and get what they want.  You may not be able to change the difficult person’s behavior, but you can change how you respond to it.  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.
• The Clam – these individuals are disengaged, unresponsive, 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 bigger 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 help to 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

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