Consensus and Majority Rule are Siblings not Twins

     Just because you are not in charge, it doesn’t mean you are not a leader.


         I’ve thought a lot about working in groups and leadership lately. I think it’s important for nurses to respect the skills necessary to do either. In a perfect world, all nurses, or at least all the ones I work with would.  In my dream team-nursing unit, every nurse communicates his or her needs and patient care concerns clearly and concisely. Every nurse stays focused on the present situation, without bringing past history or personal issues to work. My first-rank draft pick teammates respect each other and never say anything hurtful about a coworker. In my dream team unit, passive aggressive behavior doesn’t exist, because nurses speak openly about their feelings and concerns. My dream team colleagues and I would never have a lapse in judgment or make a mistake.

     Anyone out there know where I can find a job like that? Anybody? Bueller?

     I was speaking with someone about leadership in the workplace. She says she goes along with the majority’s decisions, even if it’s not what she believes in, because that’s consensus.  That feels wrong to me. While I admire this person’s willingness to put her own beliefs aside to move her department’s work forward, I have concerns. First, what if the majority is wrong? Second, why would a group lack concern for the feelings of one of its members, if the goal were to develop a team working effectively together? Lastly, what are the effects on a team member’s performance and psyche that regularly has their needs and concerns ignored? At what point will habitual sacrifice transform a willing team player into a nurse whining, “No one ever listens to me”?    

     News Flash: No one will ever listen to you if you don’t speak up. You have to speak your mind. I know it isn’t easy for everyone, but like learning to start IV’s, it gets easier with each attempt. It’s tempting to go to your “nice” coworkers for help with uncomfortable staff dynamics instead, but eventually you will wear out these people too.

      As for leaders, if you say things like, “The problem with you…” or “This is your problem, not mine…”, you are promoting passive-aggressive behavior. Eventually, this coworker who appears weak, will consciously or unconsciously create a situation that may sabotage positive clinical outcomes. No one wants that.

    Majority rule says, “This is how we’re going to do it, and you will do it this way or else we will __________ (fill in the blank). Common nursing punishments for peers who don’t comply are shunning, refusing to help them (leaving patients at risk), rudeness, and belittling them to other coworkers.

         In comparison, consensus is the voice of reconciliation achieved through sincerity. Consensus says, to the minority, “This is how most of us want to do it, but we don’t want to alienate anyone on our team. What can we do to make the way we are going to do things easier for you? What concessions can we give you to make the work flow well for you too?” 

     I do not work with my dream team, and neither do my colleagues. Our patients depend on us, so we work together as a team to move each shift forward. Some shifts move easier than others do. Each morning we start the clock over, leaving the past where it belongs, and play a new game.

Drawing Lessons: Dishwashers and Forks in Perspective I

Tines Downward (2009) photo: JParadisi

Tines Downward (2009) photo: JParadisi

     The other day at the nurses’ desk, my colleagues had a conversation about which direction to put forks into the dishwasher.

     I’d never given the topic any thought before. Hmmmm. Should I have a position on this?  Why has this question never occurred to me in the twenty years I’ve owned a dishwasher? Do other people think about forks and dishwashers, or  just nurses? Our one male nurse was not working that day, so I couldn’t ask him if this is a gender issue. 

     There were two opposing views. Some of the nurses feel that forks should be loaded into the dishwasher tines downward, because this prevents the tines from coming in contact with the fingers of the person unloading the dishwasher after they’d been washed.

     The second group feels forks should be placed tines upward in the dishwasher. That way the tines don’t get stuck down in the plastic basket holding them, making removal of the fork from the basket easier and more efficient. These nurses also feel that debris is better removed from the tines in this position.

     Hmmmm. I wonder if there are any studies on this? Are there best practice benchmarks for dishwasher use?

     Puzzling over this, it occurs to me that there is at least a third way to place forks into a dishwasher. They can be laid on their side in the tray in the top shelf of the dishwasher. They get clean that way, they don’t get tangled in the basket, and the handle is easily accessed to prevent touching the clean tines when removing the forks. 

   I am reminded that when I am presented with a problem, rarely are there only two answers to it.