Dear Evil HR Lady,
I am a nurse anesthetist and have been employed with a small anesthesia group for one year. The anesthesia office manager and the head anesthesiologists gave me my one year review. In the review it was commented that I performed below my peers for intubation. When asked for specific examples they were unable to give me any. I asked if there had been a bad outcome for a patient as a result of my intubation. They responded no. All I could think to say at the time was that I believe that I have good intubation skills however would be glad to write down anytime I was unable to get an intubation. Perhaps my perception was wrong.
We then moved onto regional skills. The group hired me knowing I had little to no regional experience and they were fine with that. After my six month review they changed their mind and decided that I needed regional skills. I responded by attending a 3 day seminar held by my professional association. I have since been trying to gain regional experience at work, but have had little opportunity. Our practice is small and we don’t do regionals frequently. On my one year review they stated that they were very concerned that I had not been able to master regional techniques. Again I have fallen bellow my peers.
Prior to this job I had been employed for 8 years and always had wonderful reviews. I am at a loss as to know what to do. I have thought of meeting monthly with them to review specifics incidences that involve my practice that has them concerned. Do you have any thoughts?
Well, I know nothing about anesthesia other than epidurals are a sign that God loves me, so these answers will be general. But first a question: Who was the best president during your lifetime?
Have an answer?
Good. Now sit down and write a list of 25 things that he did that you liked. Too many? Try 10. Still too many? Probably. Just because you can’t come up with examples on the spot doesn’t mean that your favorite president wasn’t awesome, and that you couldn’t find 25 things if you had a bit of time to peruse his Wikipedia page. Humans often don’t retain the exact information, but rather simply add a negative or positive mark towards a person or incident or thing. That means that sometimes when you say, “Well, I loved President Palmer the best!” you can feel somewhat stupid when someone inquires further, “What did he do that was so awesome?” Our brains remember the awesome (or negative) feelings and creates an overall picture, but we don’t know the details.
That as a really, really, long way to say, you may have some problems. Just because they can’t immediately identify them, doesn’t mean they don’t exist. (Although, to be honest, if you’re going to give someone a negative performance review, you should have a list of the things they did wrong sitting in front of you, because otherwise it looks like you’re just being negative.) So, you need to consider the possibility that you aren’t as good as your peers at intubation.
Additionally, since you know you’re not as good at regionals as your coworkers, you know you have some work to do. You don’t want to lose this job, but the reality is, they probably don’t want to lose you either, since recruiting and training is a pain in the patootie. So, ask directly, “I’d like to improve my skills at intubation and regionals. What can I do to make sure that happens?”
Then listen to their responses. And do what they say, even if you think they are absolutely nuts and you could teach classes in intubation. Because, even if you are perfect, the perception is that you are not. It could be that you do it differently than they do, which their brains interpret as “worse.” So, be willing to listen and learn. Also ask them to point out, directly after, if they see something. Volunteer to do all the regionals in order to improve your skills. Ask if you can observe your coworkers. Take a seminar again if you can.
The point is to demonstrate that you are taking them seriously, even if they are off their rockers. (Sometimes people just don’t adjust well to new coworkers, and sometimes there are personality clashes and sometimes work can be like re-entering junior high school.)
And, while you’re at it, document what you’re doing, and comments that coworkers, patients, doctors and nurses say about your skills.
Chances are, if you show willingness to learn from your coworkers you’ll be graded higher, even if your skills were good to begin with. But on the off chance that they aren’t, learning from them will also help you to perform at a higher level.