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Healthcare Training Institute - Quality Education since 1979

Section 25
Effective Strategies for Replying to Apologizing and Debating

Table of Contents | NCCAP/NCTRC CE Booklet

The “Apologizing” Diversion

After describing the other staff member’s area of non-compliance to something previously agreed upon and how you feel about it, you may be interrupted by excessive apologies. The other staff member may berate or humble him or herself, saying he or she is to blame for it all, and promises to have residents transported, change medication schedules, have CNAs provide activities, etc.

The problem for you with this diversion, like with the “poor me,” “busy and short” diversion, is to avoid feeling guilty for having caused the other staff member to be so apologetic. The tip-off that you have been possibly manipulated by an excessive apologizer is when you notice yourself saying, “Oh, I guess it’s okay,” or “Really, I’m sorry, I didn’t mean to imply you had not followed through. Don’t be so hard on yourself.” You really think the staff member's or department head's behavior regarding their lack of follow through causes a problem, but you are embarrassed by their excessive apology.  Thus you try to stop their excessive apology by stating "It's okay!" when actually it really is “not okay” with you.

Remind yourself that this encounter began with your feeling that you were the injured party in this relationship due to their lack of doing something that had been agreed upon earlier. The apologizer’s excessive self-recrimination may be a manipulative tactic (like "poor me" and "busy and short") to make you feel sorry for them.

So what do you do?  Easy… shut it off.  How?  Often you can use a raised open palm that says “Enough!” to stop the apologizer, or just change the subject directly by saying, “Let’s talk about these three residents being transported tomorrow to Sing-A-Long.”  Then get another agreement to the area of support you are seeking.

While staff who blame themselves excessively and over-apologize may resolve to quit their unsupportive behavior immediately, they may not stick to that resolution. They probably still need the help of reminders from you, perhaps via post-its at the nurses station and e-mails, in order to stick to their agreed upon action.  Don’t let the other staff member’s apologetic resolution preempt, or substitute, for a change of a specific unsupportive behavior.

The “Debating” Diversion

Some unsupportive staff members are very analytically minded, and thus are excellent debaters who are quite good at arguing against your requests for support. How does the “debating” diversion work?
1. One telltale behavior of a true debater’s reply is to ask you lots of questions; “Are you sure CMS states all staff are to do activities with residents?  How are you going to get George involved?  Doesn’t the activities staff do activities with the residents any more?”
2. A second telltale behavior of a true debater’s reply is to give counterarguments towards your views or proposals. Let’s consider these separately.

Suppose the other staff member interrupts your script by a string of “why” questions: “Why do you feel that way?” “Why do you want CNAs to do that?”  “Why” questions require stating the cause or justification for your request for support. You can often answer simply by restating your Broken Record script. For example, “My department needs to comply with CMS guidelines.”

Because debating can be a reaction to asking for support, practice answering “why” questions directed at your script lines. Practicing your script will be dealt with in detail in the following section.  However, avoid providing long-winded detailed justifications, since that only provides more material from which a true debater can create additional arguments. Also, the more impromptu lines you say under stress, the more likely it is that you will sound like you are over explaining, are defending you position, thus are insecure about the validity of your request.
.
If the other staff member pushes you with a series of “why” questions, stop them with a Broken record statement, as mentioned earlier, like “The facility needs an activity program that is in compliance.”  You take this simple stand and you state it as the “ground floor” or first premise which for you needs no further justification.

Counterarguments
To deal with a counterargument (as opposed to a “why” approach) you will need to repeat or paraphrase your own point or argument until you can get it across. For example, the other staff member may say something way out in left field, like “Insurance prohibits CNAs from doing that.”  Of course, this makes no sense, because who can argue with a CMS guideline?  But let’s say they come up with bizarre counterargument based upon an area where you have no knowledge.  All you need to do is:
1. Before rephrasing your point,
2. Acknowledge the counterargument by noncommittal phrases such as “That may be, but my point is . . .“ or “That’s your view, but my view is. . .”

Your objective here is to get an agreement for behavior change, not to win a debate. The other staff member may have superior logic and eloquence, but you have administrative support and federal government guidelines on your side.

Summary

The preceding Sections have outlined thirteen diversions staff may use when you make requests for support.  However, I would like to repeat a previous section of this Manual, because it bears repeating.   

Rather than viewing these thirteen defensive diversions staff uses for defending their actions  
1.  as excuse making
2.  by taking it personally that other things are more important than your activity program
3.  by being defensive yourself
4.  or by interpreting the response as a put down or putting you off... 
view their statements as merely a way of detouring you or diverting you from your goal of staff support in whatever area you are seeking.  View their excuse as a sort of smoke-screen created to avoid the discomfort of change and discomfort regarding asking their staff to change old habits or old behaviors. 

Let’s face it: people, in general, do not like to change even if the change is a better way and for the good of the residents.  Can you see how, with your Culture Change compliance requests, this nursing staff member, for example, may feel behind the eight ball?  For example, your DON may be the one that has to play the “heavy” regarding telling her Charge Nurse about the non-compliant CAN, who did not transport a resident or provide them with the activity you left in the resident’s room. 

Since in general people don’t like to change, a major portion of this Manual has dealt with various detours, distractions, or diversions staff communicate to you in order to protect themselves from the stress of the change you are requesting.  You use diversions… they use diversions … I use diversions… we all do. 

As I previously states in Section 6, the word “diversion” is the most neutral term I could think of for the verbal dance between activity director and staff that occurs when you request support and do not get it.  If you can think of a better word to describe this verbal dance, so to speak, besides “diversion,” use it. 

If you do, even at a minimal level, your negative self talk will be conveyed in negative energy projected towards the very individual from whom you are seeking support.  Instead, as Anthony Robins would say, “upgrade your vocabulary”.  Insert your own positive adjectives into the last column.

So in the future when you ask staff to donate something or attend the pitch-in or Halloween party or change a schedule, if you do not receive support when you discuss this with the staff member, listen for the diversion they reply with.  Any reply that is short of saying “Yes (I will attend the Halloween Party.)” is probably some form of a diversion.  Here are the thirteen types of diversions for which you have received specific strategies to change a diversion into a supportive action on the part of the Department Head or staff member.  Diversions include the following list, but are not limited to these thirteen.