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How Should a Nurse Manager Deal With Difficult Nurses?

by Ellie Williams

As a nurse manager, the way you handle problem employees influences your team’s performance as well as the respect you get from your staff. If you don’t address misbehavior promptly and firmly, you risk undermining your authority. In addition, if one difficult nurse is permitted to push the boundaries or mistreat patients or fellow nurses, this could compromise employee morale and patient safety. Be clear about what you will and will not tolerate, while also demonstrating respect.

Set Firm Boundaries

Make it clear you won’t allow difficult behavior from your staff, and that you expect employees to treat you with the same respect you give them. If a nurse raises her voice or becomes confrontational, end the conversation. Don’t interact with her until she’s ready to calmly continue the discussion. She’ll realize she can only make progress if she behaves civilly. In addition, you’ll demonstrate that you won’t accept disrespectful behavior from employees but are willing to hear them out if they conduct themselves professionally.

Limit Your Interactions

Don’t engage in a lengthy conversation with a difficult employee. The longer you allow her to make demands, issue complaints or push her opinion on you, the less authority you have. Don’t give her a chance to dispute or question you. If you must give her instructions or ask her a question, keep the conversation brief. This shows her that you have the final say and that she can’t get her way by bullying others or causing trouble.

Understand Her Perspective

An employee’s difficult behavior might not be deliberate. She might have trouble coping with challenging or stressful situations, or she might feel overwhelmed or intimidated. This could cause her to act out in inappropriate and unprofessional ways. While you shouldn’t condone this behavior or let it slide, take a moment to see where she’s coming from before you take action. You might discover that she doesn’t need punishment but compassion. Her negativity could trouble her as much as it does you, and if you acknowledge her anxieties and show empathy, you could defuse a potentially volatile situation.

Handle It Privately

Reprimanding a nurse in front of others can make the problem worse by making her feel singled out or humiliated in front of her peers. If you must offer criticisms or take disciplinary action, meet with her one-on-one. If you want a witness, ask a fellow nurse manager -- not another staff nurse -- to sit in on the meeting. The employee might be less likely to be defensive or confrontational if she doesn’t feel the need to save face in front of her colleagues.

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