7 Ways to Voice Criticism Without Being Negative A Guest Post by Anna Johansson

Multiethnic Group of People with Feedback Concept
Multiethnic Group of People with Feedback Concept

Criticism is sometimes treated as a dirty word, but think about two indisputable facts about our lives: nothing is perfect, and the only way to improve something is to find and correct its flaws. Knowing this, we can infer that everything should be open to criticism, and that criticism is necessary if we ever want to improve anything. It may not be fun, to give or receive, but if you want to make things better in your career, your relationships, and your life in general, you have to fight against the stigma of criticism and learn to give it without being negative.

How can you do this?

1. Remove the focus from the individual

The second your criticism becomes personal, the events become hostile. Stop this scenario from playing out by removing your focus on the individual (even if your focus is actually on the individual). This is best illustrated with examples. Let’s say you’re working on a team project, and one of your members isn’t delivering his updates on time. Instead of saying, “you’re not good at delivering your updates on time,” reposition the criticism to something like, “I would work more efficiently if I had your updates on time.” This becomes less of an attack on the individual, and more of an unbiased view of the situation as a whole.

2. Be specific

One of the most important qualities of effective feedback is specificity. The first part of this “specifying” process is all about identifying what it is you actually want to criticize. For example, if you feel like your work environment is hostile, walking into your boss’s office and claiming “this office is terrible” isn’t going to help anything. Precisely indicate what factors and items rest at the root of your issues. For example, “there’s a lack of efficient communication between supervisors and subordinates” is much more specific, and identifies a key area that needs work. Productive discussion can then take place.

3. Get it out

Most of us are used to playing social games where we dance around our true meaning with ambiguity and indirect references. Forget those social minutiae when delivering your criticism–they aren’t going to help you. You may think you’re softening the blow, so to speak, but what you’re really doing is injecting ambiguity to obscure your meaning. Passive-aggressive comments like “some of us prefer to get to work on time” or ambiguous comments like “I think maybe you could stand to plan your morning a little better” bear little meaning, and may even be irritating. Just come out and say it: “your punctuality needs improvement.”

4. Frame your criticism with compliments

Let your recipient know that you aren’t just trying to put them down; frame the negative elements of your critical feedback with compliments. This is a bit of a psychological trick, preventing the recipient from suffering a blow to her ego, but more importantly, it shows that you’re paying attention to the total picture, not just one element. For example, you might say, “Great work on that project! Your writing was crystal clear. I think it could use a little more research to back up your facts, but overall, it’s on point.”

5. Offer suggestions

Criticism without a suggestion is like being a navigator, telling someone they’re headed in the wrong direction, and refusing to tell them which direction is the right one.  don’t do this to your recipients. Give them at least a few options for potential development, or they might not take any effort to improve on their own. For example, you could say, “your scope documents sometimes come over as ambiguous. Could you start using a consistent format? Would it help if I came up with a list of questions for you to ask the client?” Offering your own help is always a good thing too.

6. Recognize your own subjectivity

Human beings are incapable of being objective, no matter how much we try to convince ourselves otherwise. Indicating your own subjectivity, and your own proneness to human error, will make you appear more humble, and therefore more sincere in your delivery. It doesn’t take much to imply this–a simple aside is more than enough. For example, you might say, “I’m not an expert on the subject, but I believe your plan is missing a few key details.” Don’t deprecate yourself, but admit a degree of uncertainty unless you’re absolutely sure of yourself.

7. Practice what you preach

This is a general best practice that will improve your reputation, but it’s important to acknowledge in the context of giving criticism. If you align yourself to the belief that criticism is necessary and everyone needs it, you need to be able to take it as much as you dish it out. Demonstrate your full commitment to criticism by accepting criticism of your own work. Learning to take criticism is an art in itself, but as long as you make yourself open to it, you’ll set a better standard for your entire team.
It’s a sad fact that most people still take criticism as an insult or as a “bad thing” in general. But if you frame it correctly, even the staunchest opponent will find themselves able to recognize that you’re doing this for their best interests. This doesn’t always make it easy to give or easy to take, but it does produce the best possible scenario for what is, ultimately, a necessary exchange.




Cover Story: Bullying in the Workplace A Guest Post by Don Sandler


The topic of bullying has gotten a lot of attention in recent years as the negative effects of the bullying suffered by children have become more apparent. Children are being encouraged to report bullies and stand up for friends who are bullied. Unfortunately, children aren’t the only ones who are suffering at the hands of bullies. Bullying has long been an under-the-radar problem in the OR, but it is starting to attract more attention in the health care industry.

It’s going to take courageous souls willing to speak up and courageous hospital leadership that’s willing to implement regulations with teeth and enforce them in order for bullying in the OR to stop.”
– Phyllis Quinlan, PhD, RN-BC

How Prevalent is OR Bullying?

This is due in part to The Joint Commission identifying “intimidating and disruptive behavior” in a Sentinel Event Alert as fostering medical errors and contributing to poor patient satisfaction and preventable adverse outcomes (Issue 40, July 9, 2008). Also, studies are revealing just how prevalent bullying really is in the OR.

For example, in a study conducted by the Association of periOperative Registered Nurses (AORN) in 2013, 59 percent of perioperative nurses and surgical technicians reported witnessing coworker bullying on a weekly basis, while 34 percent reported witnessing at least two bullying acts per week.

Bullying was also consistently listed by respondents to the 2015 OR Today Readership Survey as a problem in the OR. For example, Carol Giese, MSN, RN, CSSM, CNOR, the manager of surgery and anesthesia at CHRISTUS St. Michael Health System in Texarkana, Texas, noted that lateral violence is among the top five most pertinent issues for OR nurses and surgical techs.

“I have observed this lateral violence in the OR throughout my entire 30-year career in perioperative nursing,” says Giese.

A study conducted by the Robert Wood Johnson Foundation revealed that nurses are more likely to be bullied if they’re young, working on the day shift or working in an understaffed unit. It identified a number of ill effects of bullying in the OR, including poor work group cohesion, more work-family conflict, and poor relations between nurses and surgeons.

Defining OR Bullying

So what exactly constitutes “bullying” in the OR? In the Sentinel Event Alert, The Joint Commission states that “intimidating and disruptive behaviors include overt actions such as verbal outbursts and physical threats, as well as passive activities such as refusing to perform assigned tasks or quietly exhibiting uncooperative attitudes during routine activities.”

These behaviors “are often manifested by health care professionals in positions of power,” the Alert continues. “Such behaviors include reluctance or refusal to answer questions, return phone calls or pages; condescending language or voice intonation; and impatience with questions.”

Why does bullying occur in the OR? Obviously, the OR is a high-stress environment, and some surgeons just aren’t good at controlling this stress. Workplace bullies tend to want to be in control of all aspects of the work environment, and this certainly holds true for bullying surgeons in the OR.

Phyllis Quinlan, PhD, RN-BC, the president of MFW Consultants, says that the problem of bullying in the OR goes back many years.

“For a long time the attitude at hospitals was to keep the surgeons happy no matter what because hospitals couldn’t afford to lose them,” she says. “It was the Golden Rule: He who has the gold makes the rules.”

Quinlan says The Joint Commission’s Sentinel Event Alert about bullying was a turning point in the issue of bullying getting the attention it deserves.

“In fact, this led to the ‘stop the line’ practice in the OR in which anyone in the OR has the right to speak up and stop the procedure if they don’t think something is right,” she says. “Before this, heaven forbid if anyone questioned a surgeon.”

ChrysMarie Suby, the president and CEO of the Labor Management Institute, says that bullying in the medical profession, and in the OR specifically, is not uncommon.

“In my work, I see it coming from three sources in the OR and other perioperative units: patterns of condescension, secondary bullies who have learned how to survive in the organization, and institutional bullies,” says Suby. “The latter are managers, charge nurses, supervisors, service line directors, and C-suite and administrator-level leaders who bully those below them.”

“I have seen different variations on bullying in the OR every since I first became a perioperative nurse in 1991,” says Diana Lopez-Zang, RN, CNOR, the director of system perioperative education at Northwell Health. “A big reason for bullying is the hierarchical environment in the OR.”

Lopez-Zang says she has actually seen surgeons throw instruments in the OR, and one time an OR nurse was hit in the ankle with a dirty instrument.

“Mostly, though, bullying consists of verbal abuse by surgeons, including cursing,” she says.

“Bullying in the OR is still a problem today that I think it’s going to take some time to resolve due to the long history,” Lopez-Zang adds. “Unfortunately, I don’t think it’s getting much better yet — anecdotally, I’d say it’s about the same as it’s always been.”

Solving the Problem

According to Suby, awareness of the problem is a good first step toward minimizing and eventually eliminating bulling in the OR.

“However, nothing will change and the problem will only get worse if nothing is done to intervene,” she says.

The Labor Management Institute offers hospitals a Schedule Best Practice Audit© that can identify scheduling and staffing behaviors that demonstrate workplace bullying.

“We see frequent examples of OR staff who are being bullied via unfair scheduling practices,” says Suby. “It is usually new nurses and those with less seniority who are bullied in this way.”

Once your hospital has conducted a scheduling audit, address the findings of the audit and involve human resources and professional committees to be sure that discipline policies are being used and codes of conduct enforced.

“We often find that organizations have these in place but victims are being intimidated from using them,” says Suby.

“With the audit’s findings in hand, hospitals can provide education and training to help fix scheduling and staffing conflicts at their roots,” she adds.

Quinlan says that solutions to OR bullying can be narrowed down to two main things: peer pressure from others in the OR to stop bullying behavior, and HR regulations, policies and procedures that create a zero-tolerance environment for intimidating, disruptive and uncivil behavior.

“Education and remediation are also needed to put a stop to these behaviors that can put both OR personnel and patients at risk,” adds Quinlan.

In fact, she says that families of patients are starting to report conflicts between surgeons and perioperative nurses due to concerns that these conflicts are putting their loved ones at risk.

Taking a Stand

The good news on the OR bullying front is that younger perioperative nurses who are entering the field today are less likely to tolerate bullying than many nurses may have been in the past, according to Quinlan.

“Many Generation X and Millennial perioperative nurses have taken a stance on what’s right and wrong,” she says. “They often tend to be a little more idealistic and they want to stand up and make a difference for the profession.”

“It’s going to take courageous souls willing to speak up and courageous hospital leadership that’s willing to implement regulations with teeth and enforce them in order for bullying in the OR to stop,” says Quinlan. “Nothing’s going to really change until these things happen.”

Originally featured in OR Today, May Issue    http://ortoday.com/

4 Tips to Ensure That You Fuel Your Caring Nature From a Full Heart and Not Fumes


Dearest Caregiver

  1. Acknowledge and Respect Your Compassion Nature

Most people have the capacity to feel empathy for another person when there is a tragedy such as a plane crash or mass shooting. Some people have the capacity to rise to the occasion and offer a helping hand to someone in need. However, very few people have the ability to mobilize their compassion into the action we call caregiving.

The uncommon ability to be a caregiver is the highest form of generosity. It is a gift and it needs to be honored for the gift that it is. This means that you must respect your caring nature by taking really good care of yourself as well. All too often, caregivers put their own needs last. Granted, this extra effort may be needed on occasion.

Putting yourself last time after time can mutate your awakened heart in a toxic sense of self-sacrifice. Remember, putting your caregiver-self first is an act of selflessness and it is healthy. It allows you to keep your compassionate heart full and ready to serve.

  1. Ask and Accept Help

The responsibilities that accompany your role as caregiver can be daunting. There always seems to be a relentless list of things to do, appointments to coordinate, and care to be rendered. You are gifted with a highly evolved sense of the duty, responsibility and loyalty. However, these qualities can channel you into a life of isolation if you resist asking for help.

Asking for help is not a sacrilege. It’s honest. No one, no matter how dedicated or organized, can manage alone. Many folks like yourself resist asking for help because they feel that they do not want to impose on benevolent friends of family. The irony is that these same folks are often trying to find a way to lend a hand without sending the unintended message that you are not doing a good job.

No everyone can do hands-on care but most everyone can do something. I encourage you to investigate support networks such as Share the Care. This non-profit organization trains groups such as family, friend, neighbors, and church members to create Care Circles. The goal is to surround the person in need of care and their primary caregiver with a sense of community and support.

A calendar and task list is set up so that everyone can weave their part of the caring into their daily life. Who does the food shopping? Who transports to the doctor’s appointment and when? Who mows the lawn, etc. I ask you to please consider this option so that you can pace yourself. Remember, caregiving is not a sprint. It is a marathon and it takes a team to keep you in the race.







  1. Stay Connected with Friends

It is often said that laughter is the best medicine. Without a doubt, this is true.  However, the demands and realities of constantly caring for others can often leave you struggling to find a reason to smile let alone laugh. Fatigue is your worst enemy. It can leave wanting to “crash” and be alone during any down time. Please resist this temptation. Yes, the extra effort to get ready for some social time with friends may seem daunting but the payoff is priceless.

Caregiving is what you do not who you are and it is your friend who will keep you connected to the outside world. Friend will often listen and just let you vent without judgement. Friend can show you the exit sign out of your head and your relentless thoughts centered on caregiving and reintroduce you to the rest of your life. Friend can help you keep a perspective on your situation so that the frustrations of caregiving don’t fester into pain and resentment.

Friend can make you laugh until your side ache and you find yourself hoping you don’t wet your pants. In short, they are often your lifeline. So please don’t let go. Socializing may need to me modified. Lunches and matinees may replace dinner and a movie. You may not be able to leave your home, so the party may have to come to you but however you arrange it, stay connected.

  1. Don’t Confuse Endurance with Resilience

So often we torment ourselves with the notion that as soon as you get past this latest hurtle in life, all will be easier. In reality nothing gets easier. No sooner do you exhale from meeting one demand than the next burning issue presents itself. So we hunker down and call upon our endurance to meet the next challenge.Here is where the danger lies, in a caregiver’s endless ability to endure.

You see, we mistake endurance for resilience. Endurance is a coping skill intended to be called upon when things become exceedingly challenging and stressful. Endurance is the ability to deal with unusual pain or suffering and continuing to function. Our ability to endure is intended to be maintained for only a fixed amount of time until a situation is resolved. It was never intended to be used as an everlasting source of fuel for life.

Resilience, however, is the ability to withstand the stress and challenges of life while remaining centered and fresh. Resilience is a healthy reserve of personal fuel that can be accessed to maintain a state of equilibrium, not only to rise up to overcome the crisis of the moment. Resilience is like dropping the engine of your life into second gear so you can maintain speed as you go uphill.

Developing a resilient mindset means understanding you can only thrive in a lifestyle of perpetual generosity, such as a caregiving, when you give from the excess of your energetic fuel tank and not from the fumes. It means that regardless of the demands of a situation, you are addressing that situation from a place of fullness.

The true lesson here is to embrace the fact that choosing a mindset of endurance is choosing only to survive. Choosing a temperament of resilience is embracing living life fully each day. So explore what it takes to develop a resilient nature that is ready, willing and very much able to serve, regardless of the circumstances surrounding that call to care.

Blessings, Phyllis