Essentials of Nursing Leadership and Management, 5th Edition

(Martin Jones) #1
chapter 6 | Getting People to Work Together 83

that a behavior has been judged satisfactory or
unsatisfactory. If the message is negative, it should
include both suggestions and support for change
and improvement (Box 6-5).


Provide Both Positive and Negative Feedback


Leaders and managers often neglect to provide
positive feedback. If questioned about this, they
often say, “If I don’t say anything, that means every-
thing is okay.” They do not realize that some peo-
ple assume that everything is not okay when they
receive no feedback. Others assume that no one is
aware of how much effort they have made unless it
is acknowledged with positive feedback.
Most people want to do their work well. They
also want to know that their efforts are recognized
and appreciated. Kron (1981) called positive feed-
back a “psychological paycheck.” She pointed out that
it is almost as important to people as their actual
paychecks. It is a real pleasure, not only for staff
members but also for their leaders and managers, to
be able to share the satisfaction of a job well done
with someone else. Leaders and managers should do
everything they can to reward and retain their best
staff members (Bowers & Lapziger, 2001). In fact,
some claim that the very best managers focus on
people’s strengths and work around their weaknesses
(DiMichele & Gaffney, 2005).
Providing negative feedback is just as necessary
but probably more difficult to do well. Too often,
negative feedback is critical rather than helpful.
Simply telling someone that something has gone
wrong or could have been done better is inade-
quate. Instead, make feedback a learning experience
by suggesting ways to make changes or by working
together to develop a strategy for improvement. It
is easier to make broad, critical comments (e.g.,
“You’re too slow.”) than to describe the specific
behavior that needs improvement (e.g., “Waiting in
Mr. D.’s room while he cleans his dentures takes up


too much of your time.”) and to add a suggestion
for change (e.g., “You could get your bath supplies
together while he finishes.”).
Unsatisfactory work must be acknowledged and
discussed with the people involved. Too many
managers avoid it, not wanting to hurt people’s
feelings (Watson & Harris, 1999). Tolerating poor
work encourages its continuation.

Give Immediate Feedback
The most helpful feedback is given as soon as pos-
sible after the behavior has occurred. There are sev-
eral reasons for this. Immediate feedback is more
meaningful to the person receiving it. Address
inappropriate behavior when it occurs, whether it is
low productivity, tardiness, or other problems.
Problems that are ignored often get worse.
Ignoring them puts stress on others and reduces
morale. Resolving them boosts productivity, lowers
stress, increases retention of good staff, and ulti-
mately results in higher-quality care (Briles, 2005).

Provide Frequent Feedback
Frequent feedback keeps motivation high. It also
becomes easier with practice. If giving and receiv-
ing feedback are frequent, integral parts of team
functioning, such communication will be easier
to accomplish and will be less threatening. It
becomes an ordinary, everyday occurrence, one that
happens spontaneously and is familiar to everyone
on the team.

Give Negative Feedback Privately
Giving negative feedback privately prevents unnec-
essary embarrassment. It avoids the possibility that
those who overhear the discussion misunderstand
it and draw erroneous conclusions. A good manag-
er praises staffers in public but corrects them in pri-
vate (Matejka, Ashworth, & Dodd-McCue, 1986).

Be Objective
Being objective can be very difficult. Evaluate peo-
ple on the basis of job expectations and the results
of their efforts (Fonville, Killian, & Tranberger,
1998). Do not compare them, favorably or unfavor-
ably, with other staff members (Gellerman &
Hodgson, 1988).
Another way to increase objectivity is to always
give a reason why a behavior has been judged as
good or poor. Consider the effect or outcome of the
behavior in forming your conclusion. Give reasons

box 6-5
Tips for Providing Helpful Feedback


  • Provide both positive and negative feedback.

  • Give feedback immediately.

  • Provide feedback frequently.

  • Give negative feedback privately.

  • Base feedback on observable behavior.

  • Communicate effectively.

  • Include suggestions for change.

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