I’ve talked before about how nurse practitioners inevitably find themselves in positions of leadership. As healthcare providers, we direct a patient care team from nurses to medical assistants, phlebotomists, and office staff. Our education, focused on clinical content, often leaves us unprepared for this role. The managerial aspects of working as a nurse practitioner can be frustrating and stress inducing. A patient care team that’s not on the same page creates an inefficient, disorganized environment. Implementing one simple leadership trick, however, just may change it all.

Last month I read Coaching for Improved Work Performance by Ferdinand Fournies. The book was packed with helpful insights for those finding themselves in leadership and managerial positions. While Fournies’ writing focused primarily on leadership in a traditional business environment, his advice was directly applicable to my career as a nurse practitioner.

My biggest takeaway from the book was the idea that employees overall want to excel. Incorrect or inefficient behaviors typically occur because the employee doesn’t even realize his or her behavior is an issue. As managers and leaders, however, we incorrectly assume that employees who don’t measure up are lazy, sloppy, or have poor attitudes. The trick to leading more effectively? Simply let the employee know his or her behavior is a problem. I’ll share an example from my own clinical experience.

Working triage in the emergency department can be a real drag. Patients aren’t feeling well and are naturally anxious to be placed in a room. Triage nurses have the unpopular position of serving as gatekeepers making sure the most critical patients are treated first. To vent frustration, or in an effort to add some lightheartedness to the work day, some nurses in my department place comments about patients in the ‘notes’ section of the chart. While these comments aren’t downright derogatory, they are certainly sarcastic and hands-down unprofessional.

I’m not against having a little fun on the job, but typing negative comments into a patient’s chart doesn’t do anyone any favors in my book. Sure, these are ultimately deleted, but you never know who is watching and what may or may not incidentally become part of a patient’s permanent record. Should a clinical error or malpractice allegation be made regarding the patient’s care, the nurse’s comments would undoubtedly be made public and potentially have a disastrous effect on the outcome of the resolution. Not to mention, as a provider, I don’t like my impression of a patient to be negatively colored before I walk in the room. My initial impression of the situation was that these nurses had poor attitudes about their jobs and were being somewhat negligent about their work performance.

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Concerned about the situation, form both a moral and legal standpoint, I expressed my concern to the triage nurses. They hadn’t thought about the issue from the provider’s perspective, that their actions may have legal implications. They immediately saw how these comments affected me as a healthcare provider as well. The comments stopped, and the (mostly) lighthearted atmosphere we keep at work was not sacrificed.

When an issue in your practice is eating at you, before you judge the employee involved, speak up. Chances are, your coworker may not realize his or her actions are causing a problem and that he or she will be wiling to modify the behavior going forward. As nurse practitioners, we find ourselves in leadership roles. Part of this responsibility is giving our coworkers the guidance and tools necessary to succeed.

Do you feel prepared for the managerial aspects of your nurse practitioner role?


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