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Coaching or mentoring as early performance management strategies can turn challenging situations into opportunities for change, says Helen Chin
MOST NURSES, for most of the time, do their jobs well and respect their colleagues. Occasionally, however, some perform and behave poorly.
Such poor behaviour and performance can occur for various reasons. Some nurses are overwhelmed by the volume and scope of their work, are frustrated by a lack of opportunities for education or career progression, or feel underappreciated or insecure in their work. Others have home and family crises or financial difficulties to attend to.
All of these are experiences that can hinder performance and affect behaviour at work, and their effects can be far reaching. For example, if one team member becomes ineffective, divisions can arise in the rest of the team. This in turn can reduce mutual trust and respect, and lead to a shared disappointment and anxiety among team members.
To contain this collective anxiety, team members often attempt to blame individuals or exclude them (Menzies Lyth 1988). As a result, interpersonal relationships among team members suffer, leading to a reduction in team effectiveness and a corresponding rise in patient morbidity and mortality (Borrill et al 2002).
Nurse managers should not underestimate the urgency with which they should tackle performance and behavioural issues. But they should also be aware that, in doing so, they have several management interventions, including preceptorship, clinical supervision and peer review, available to them.
These interventions are not mandatory however, and some authors claim they lack clarity of purpose and outcomes, and that their implementation can be patchy and difficult to achieve (Chin 2003, Driscoll and Cooper 2005).
Other mechanisms, such as professional regulation, the NHS Knowledge and Skills Framework and organisational pathways, are also available to help individuals learn and develop.
Too often, nurse managers implement strategies to improve performance and behaviour only after significant incidents occur (Grote 1995).
Maxfield et al (2005) suggest that, in some healthcare organisations, the precursors to behavioural and performance problems are often recognised far in advance of the incidents themselves, yet the culture of silence is such that they go unchallenged.
In these organisations, colleagues can witness poor behaviour in others, such as disrespect, dismissivcness, the cutting of corners, sabotage...