Healthcare Training Institute - Quality Education since 1979

Section 24
Effective Strategies for Replying to Poor Me, Physical Symptoms, and Negative Body Language

Table of Contents | NCCAP/NCTRC CE Booklet

The “Poor Me” Diversion

The most common “poor me” diversion is for the other staff member to try to shut off your request for support by perhaps playing the martyr. The message conveyed to you is, “You are so unfair! You are causing problems for me and make me unhappy and stressed.”  Actually the "Busy and Short" reply discussed previously is a "Poor Me" diversion.

How do you respond to a staff member who habitually cries “poor me” when he or she does not provide you with the support you are requesting?  First of all, don’t buy into their “poor me,” “busy and short” distraction by feeling guilty for making your request!  How do you do this?  Remember…
A. you have carefully analyzed your department’s need for support
B. you are sure you have the facts about the other staff member lack of support and that these facts are accurate
C. you have carefully chosen your words for your request for support
D. you will have made your most considerate and tactful statements in the script developed in the previous Sections.

However, many Activity Directors with whom I have consulted buy into the guilt trip laid onto them by the “poor me,” “busy and short” reply.  The end result is the residents suffer because the Activity Director feels too guilty to make requests of staff members whom she may view as overworked and underpaid.  To counteract your case of the “guilties,” when nursing or other staff say they are “busy and short,” in your mind objectively label it as a “poor me” diversion to decrease the stress of their job.

Reframe their “poor me,” “busy and short” distraction by asking yourself the following questions, “Is this department head or staff member using the "poor me" or "busy and short" diversion subtly to attempt to control my behavior by trying to make me feel guilty for my request for support?”  To maintain a friendly atmosphere when you receive the “we are so busy and so short-staffed today. (i.e. poor me)” reply, you, as mentioned previously, can cushion your Broken Record statement by prefacing it with statement of empathy.  Such as…
 “Yes, I know three CNA’s called off today so A and B wing staff are really rushed.”  Then go to your Broken Record script.  “The problem is I am unable the check Effie’s attendance record again, and I have a concern about CMS compliance.”

After stating the above, try to get agreement regarding a course of action. Try to limit their “poor me” reply regarding how hard your request has made their, or their staff's, work load by promptly replying with the above before they add on too many gory details. Listening to their “busy and short” story may once again make you feel guilty for having requested something which, by your previously reasoned calculations, you had a perfect right to ask for.  So what do you?  Change the topic.  Or leave the room.  Then, perhaps, do something nice for yourself, like taking a mini-vacation at work.  How?  Simple.  Run warm water on your hands in the rest room to relax yourself.  Look at a tree just outside a facility window. What else can you think of?  Write them below.

If you are running warm water over your hands, envision your case of the guilties going down the drain with the warm water.  The “poor me,” “busy and short” diversions or other forms of sulking generally will gradually subside.  How?  You may ask...
A.  …by your not listening to them.  How?  Change the topic or leave the room.
B.  …by the other staff member realizing you are still going to make your request for support and their subtle guilt “poor me” trips, or perhaps not so subtle “poor me” trips, are not detouring you from requesting what needs to be done. 
Just remember you can be your own worst enemy if you feel guilty about expecting this department head  or staff member to follow through with what you have requested.  I realize this may be a challenge for you, because the fact is, on that particular day they most probably are very busy and working short handed due to call-offs.  But don’t make their problem become your problem.  By that I mean feeling so guilty about your requests for support, that you stop making them.  And you know as well as I do what suffers…  the quality of life for your residents.  You are their advocate.  To paraphrase an old adage, sometimes being an Activity Director requires being a “squeaky wheel” to get the oil.  Get my drift?

Schedule a separate meeting
If the staff members extensive “busy and short” tales of woe prevent communication, then break off your current script-delivery with the following. For example, “I can see you have concerns about CNA's having the time to re-arrange shower schedules to accommodate activity attendance.” As with “not now” diversions discussed earlier, set a time for another meeting. State, “Let’s talk about this at another time.” 

Email
If the excuses they are making as to why they cannot change the shower schedule continue in that meeting, you could write your request as an e-mail. Then they can do all the poor me excuse making they want as they read your e-mail.

Are you being controlled?
Would it help you to think of the “poor me” excuse making as simply another behavior that is controlling you and preventing the two of you from solving the Culture Change compliance or staff support challenge?  Staff’s “poor me” excuse making is interfering with the development of a supportive interdepartmental relationship that is intended to result in provision of a higher quality of resident care.

The “Physical Symptom” Diversion

Even though this may happen rarely, a second type of “poor me” diversion, in addition to “busy and short,” is the staff member’s display of a distressing physical symptoms when you make your request for support.  These symptoms may vary from claims of mild headaches and stomachaches to feigned chest pains, muscle cramps, dizziness, and so on. Symptoms of illness are some staff members' way of responding to stress.   Like the "busy and short" diversions, such symptoms may be attempts to manipulate you.  The result of the perhaps feigned or faked symptom is to help the other staff member escape taking the supportive action you are requesting.

However, don’t spend time debating whether their reported symptom is physical or psychological. Just don’t let repeated use of the symptoms keep you from making your request for support.

Real or Controlling?
The superficial performance of a symptom “on demand” may indicate that the other staff member is using a description of their physical problem like the "poor me," "busy and short" excuse to forestall your request for them to make a change. So what do you do if you have reached your limit regarding the same repeated physical complaints when you make a request for support?  As suggested in the previous section, an e-mail can be a very useful way to get your request for supportive action across without having to listen to complaints about their ailments caused by job stress.

List the name of an employee who you feel uses physical symptoms as diversions from your requests for them to take action to gain support for your Activity Program.

If the other department head complains of a headache every time you start to request staff support in the area of, for example, CNAs providing activities to residents, consider:
1. Suggesting you schedule the meeting at another time when they feel better.
2. If this meeting is the one scheduled at another time, and they still have a headache, briefly state, “I am sorry you don’t feel well.”  Then return to your script requesting support. 
3. If you find yourself feeling guilty for trying to conduct business with an “ailing” person; reframe their ailment by asking yourself, “Could this be an unconscious diversion the DON is using, to decrease her stress level, caused by my requesting CNA activity involvement?”

Negative-Body-Language Diversions

Different from the physical symptoms or a “poor me” diversion is the display of very negative body language when you make your request for support. The department head's or staff member’s face, body, and tone of voice may convey the message that your script is hurting, angering, boring, stressing, etc. him or her. The staff member may glare at you, stare at you, look daggers through you, scowl, squinch up his or face face, smirk, etc. He or she may cover his forehead and eyes with his or her palm, as if to say, “Oh Lord, don’t tell me you’re going to start on that again!” One reason the unsupportive staff member will use such negative body language is to perhaps unconsciously attempt to punish you for making your request again or even for the first time.

Strategy #1 – Commenting Briefly
You have two basic options for a reply. First, you can explicitly recognize the feelings expressed in the other staff member’s body message. You can say, “I get the impression my request for the medication schedule change upsets you. I can perhaps understand why because the Medication Nurse will have to make a special trip back to Herbert’s room to give him his medication after the activity. However, I, as well as Mr. Jones (the Administrator) feel it is important to comply with CMS Culture Change guidelines.”  This is an example of an “agree… but” type of reply.   Of course, you would allow time between sentences for the staff member to reply should you deem appropriate.

The preceding script contains an identification of the others feelings and empathizes with them somewhat, but allows you to continue with your script after acknowledging the message his or her body language conveys.

Strategy #2 - Ignoring
As an alternative, you can simply ignore negative body language, and continue through one of the scripts you have developed in the previous Sections.  There are, of course no rules stating you must respond to someone’s body language. So, just keep delivering your script as though you had a warmly receptive audience. After all, it’ll be over in a few minutes and perhaps by commenting on their negative body language, this may act as a reinforcement for it to continue.

Strategy #3 – Exploring and Expanding
If a negative-body-language reaction is something you have learned to expect, and is in itself a distressing behavior that you’d like to see changed, you might add something like the following to the above script.  “… I can see by the fact you have creases in you forehead you seem upset…
A.  Would you like to talk about that now.”
B.  Are you upset with what I am saying or is there something else going on?”
C.  You seem upset.  Are you?”

Through trying various combinations of these three strategies, use your intuition or gut-level feeling to decide which one strategy or combination of strategies is best on a particular day at a particular time for this individual.