cm.rhe

6S You really ought. wanRII or how not to motlYate people70 Is oncology nur.lng the challenge you',. looking for?73 LelrnlngOpportunlties78 Opportunities 10< nursing

YOU REALLY OUGHTA WANNAOR

HOW NOT TO MOTIVATE PEOPLETraining is a wonderful thing - If someone needs training. But, too often,nurses call for help with a performance problem that training can't solve.

If your nursing staff refuses to "turn patients every 2 hours," If yourhousekeeping stafldoesn't make the beds property, chances are theysliN wonYdo these things properly afteran expensive, Informative training session. Readon for ways to make non-performers "wanna" perform.

BY ROBERT MAGER AND PETER PIPE

PEOPLE DON'T 00 THINGS for zillions ofthe darndest reasons, leading to all sortsof problems. And when there are prob­lems - caused by differences betweenwhat people do and what someone wantsthem to do - the common solution is 10inform or to exhort, or both. We say."I've got to teach him ..." or "She

ILLUSTRATIONS BY JACK FREAS

really must change her attitude .... "Sometimes the solution is to provide

information. But when a person knowshow to perform and still doesn't perform,you can teach or exhort until your socksfall off and not solve the problem.

For example: A principal says,"We've got to teach these kids not to

Nursing76. August 65

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66 Nursing76. August

write on the toilet walls. ,-Well, what would you put into a

course on Non-toilet-waD writing? CanOtyou just see the curriculum?

Monday: Introductory Non-writingTuesday: History of Non-writing

Wednesday: Toilet AppreciationThursday: Famous lohns and Their

Dastardly DefacementFriday: Pot Power

What at first seems to be a trainingproblem turns out to be something en­tirely different. The school children'speri'ormance discrepancy is clearly notdue to a lack of skill. They cOllld stopwriting on the walls if they wanted to, so(raining is clearly not the remedy.

The key for determining that trainingwould not be helpful is the little phrase"oughta wanna" and its many varia·tions. Whenever you hear someone say(usually while shaking their head):

"He just isn't motivated.""She just doesn't want to do it.".. She simply doesn't care . .."He's too lazy to do it.""He doesn't have the right attitude:'"She oughta wanna do it.""I'm too busy to do it."''I'm not allowed to do it:'"That isn't my job.""They'll fire me if 1 do it.""They'lI laugh at me if I do it.""Not now, honey . . . later:'

.. . almost certainly. no amount of in~

formation, no amount of exhortation, isgoing to change the situation.

What's needed is a change in theconditions or the consequences re~

sponsible for nonperformance. Gener­ally. these boil down to four commonsituations:

I. It is punishing to perform as de­sired.

2. It is rewarding to perform otherthan desired.

3. It simply doesn't matter whetherperformance is as desired.

4. There are obstacles to performingas desired.

Let's look at chese one at a time.

IS DESIRED PERFORMANCEPUNlSffiNG?When desired peTformance leads to un~

desirable results. people have a way offinding other ways to go.

For example, consider the case of the"rate buster" - the nurse who worksharder than anyone else. Is she reveredby her coUeagues for her skiU or her in~

dustriousness? It's more likely that she

From the book. ANALY"lING PERFORMANCE PROB·LEMS. by Robe" M3i~rand Peter Pipe. Copyright@I970by Fearon Publishers. Inc. Reprinted by permission orFearon Publishers. Inc.

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will soon perceive the group's attitudetoward her as punishment for perfor­mance, and she'll slow down to the levelof the group ... or be pushed out of it.

Or remember how it was when youwere a student ... Did you ever attend achool where the consequence of know­

ing your subject or of showing your intel­ligence was ridicule from other students.where the "in" thing was IIO( to dohomework and flot to make good grades,where diligent students were considered"eggheads" and "brains" and worse?

And how about life in the hospital?Patient who cannot get out of bed areprovided with a call button with which tosummon help. Occasionally, however. apatient will resist pressing the bulton forlong periods of time - even though ingreat distress.

Why? Is it possible butlon-pushingcansomehow be punishing?

You bet it can! Pushing the bunon maysummon a grouch who bursts into theroom with a "What now?" or "Not youagain?" It only takes a few such experi­ences for the weakened patient to find iteasier to tolerate his distress than to pushthe button for help.

Once a problem i identified as an ex­ample of "performcmce is punishing,"' itbecomes plain that the solution is ,rol to

hand out more information. The solution r~~~~~~~~~~~~~~~~~~~~~~~~~~~::::~:1must reduce the undesirable results andincrease the de irable results ofa desiredperformance.

Take meeting·attending behavior, forexample. Time is wasted waiting forlatecomers. But people persist in cominglate. no matter how often instructions aregiven or exhortations are delivered.Plainly. this isn't a training problem. Toget at the true problem, you have to a k:"What's the consequence of performingas desired?"

What are the results of coming ontime? Well, you have to sit around andwait for latecomers,

What's the result of being late? Themeeting starts almost as soon as you ar­rive.

Thus. punctuality is punished and tar·diness is rewarded.

These examples are designed to re·mind you of a simple truth about humanbehavior:

People learn to avoid the things they arehil with! It doesn't matter whether theyare hit with a club, an insult, humil.iation.repeated failure, frustration or boredom.If someone feels he will be punished, oreven that there is a risk of being punishedwhen he performs as you desire, he willavoid doing it your way whenever hecan.

Nursing 76, August 67

So next time someone "oughtawanna," ask yourself (or, even better,ask that person) whether it isn't un­necessarily punishing to do it your way.

IS NON·PERFORMANCEREWARDING?There's a whole world out there justfilled with people who are not doing asyou would like. Most behave lhe waythey do because they feel that their wayleads to more favorable consequencesfor them than does your way. If you wantthem to do differently, you will have toinvent a way to reverse things so thatyour way leads to rosier results.

Take the head nurse with the ineffi­cient team. "We've got to teach thathead nurse to delegate authority," saysthe supervisor. "Teaching independenceis her responsibility."

But the head nurSe didn't need teach­ing. She had attended two courses inleadership and management, and sheknew a1l about delegating. Still, shedidn't delegate, and the shift floundered.

Why doesn't she delegate when "sheoughta wanna'''] Ask instead, what doesshe get out of keeping full control?

Status! Anyone who wants to knowwhat is going on has JO talk to the headnurse. She i the queen bee on her floor;

and by keeping her subordinates hover­ing around her, she'll stay that way. It ismore rewarding (in her perception) notto perform as expected.

Consider this case: How often, whenyou have guests, do you rush over towhere the kids are playing quietly in acomer and say. "Hey, kids, you're doinga great job of playing quietly in thecorner"? Ordo you, like most of us. waituntil they stan acting up and then rushover to scold?

If attention from parent is viewed byyour child as desirable, what must he doto get it?

An old adage says: It's lhe squeakywheel that gets the grease. Mighl this notbe why peopre sometimes feel that theymust do something other than "sittingquietly in a comer"? When you forge I to"glow after good" as well as "growl afterbad," you risk making the growl a rosierconsequence than you intend.

One last analogy: Suppose you'rewalking in the park and you come upon aman standing in front of two plants andmuttering to himself. He is u.sing a water­ing can to water one of the planls. Youask him what he is doing.

''1'm trying to make tlillt one grow,"he replies, and points to the other one.

"Well," you might ask, pUZZled, "if

you want thllt one to grow, why are youwatering this one'!"

.. Because it oughta wanna grow any·how!"

Wacky? Of course, but how manytimes have you ignored your good per·formers?

Since people tend to do those thingsthat brighten their world, the moral is:Water the performance you want to grow.

DOES PERFORMING REALLYMAllER?Sometimes a performance discrepancycontinues to exist neither because theperformer doesn't know how to performnor because he isn't motivated, but be­cause it simply doesn't matter whetheror not he performs. Nothing happens ifhe takes the trouble to perform as some­one wants; nothing happens if hedoesn't.

The laws of behavior tell us that whena performance is not followed at leastperiodically by an event the performerconsiders favorable the performance willtend to disappear,

For example, the supervisor com­plains. "Reports don't get in on time," or"Reports are haphazardly done."

"The reports are sloppily done?" youask.

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ARE THERE OBSTACLES TO "The staff. We get logelher and dis-PERFORMING? cuss the progress of each student."Have you ever said to yourself, "I could "Js the student present?"do this job perfectly well if only the "Certainly not.".$#@o/~ telephone would stop ringing "So the results ofthe written exam areand those idiots next door would stop visible to the student. bw the results ofpestering me so I could concentrate for thesubjecth'eevaluationsareim'isiblt>tofive minutes at a time"? him?"

That's a perfect example ofa situation "Yes. But visible or not, it's the sub-in which ajob would get done more effi- jective evaluations that are really impor­ciently if the condition were changed - tant: and that's what the students oughtwithout need for instruction. to be intere ted in."

Other examples are not so obvious. . .. You can imagine how difticult itConsider the plant manager of a was to restrain from asking. "Jf they're

dynamite factory overseas. He called in .!hJJl important, why keep them ,"ch 11 bigthe ~ training director and told him, secret?""These people are lazy, They sleep on Might your relations with others im­the job, and don't come to work regu- prove if they could know how you reallylariy. You teach them to be motivated." feel about their performance?

The training director went to the site, In summary, if it looks as though alooked around. talked to people, and re- person knows how to perform butviewed employee records. And he found doesn't perform. look for obstacles Ihatthe answer to non-performance in an un- might be getting in the way of his per­expected place - the medical office. forming as desired. Look for lack of au­More than 600/0 of the employee inques- thority, lack of time, or Jack of tools.tion were suffering from a disease that Look for lack ofdirect information aboutshows up in symptoms of sleeping sick- what to do and when to do it.ness! There wasn't anything wrong with Above all, keep in mind that ifhe cantheir skill or motivation, and training do it. but isn't doing it, there's a reason;wouldn't have done much good. As it and the reason is more often an obstacle

was, onoe they were cured, all was well. l~t:h:"n:::a:::la~c~k:o~f:::in~te~r~e~s~t~o~r:m~o~ti:v~a~ti~o~n:.~JThus, if performance discrepancies

appear not t9 be due to a lack of skill ormotivation, look for the obstacle.

Sometimes the obstacle is the absenceof something. Take the case of the stu­dent who left the examination sheetblank. "Your attirudt> is terrible," saidthe teacher. "Can you give me one goodreason why you didn't fill in a singleanswer on this test?"'

·'Yes.""Well?""I didn't have a penciL"Another form of obstacle that is sel­

dom identified as such is absence of in­formation about what is wanted.

The faculty of a medical school oncecomplained, "These students will arguefor hours over haifa point on our writtenexams. Yet it isn't the written exams thatare important. It's the subjectiveevaluations the statT makes of the stu­dents that are important."

"When is this evaluation made?""All day, everyday, our staff members

are noting and evaJuating each student'sactual performance. We note how heperforms with patients in the clinic. withother students. and with staff, and howhe performs in the lab."

.. How do you consolidate the resultsof these subjective evaluations?"

"We compare notes.""Who does?"

"They certainly are. And Ihey don'tcome in on time. ,-

., Why not, do you suppose?""The head nurses just don', seem to

carer',. What happens if the reports afe

late?""Well, then I have to run myself rag­

ged to get them organized in time or Ihave to explain to the Nursing office whyI am late with my reports."

"No, no. W/~al happens to the peoplewho submit the late reports?"

"Well, nothing, .1 guess. But theyoughta wanna get them in on time and ingood shape'"

"Don', you call/hem or send them amemo to tell them they have not melexpected standards?"

"No.".. You don't send the reports back [or

them to correct?""Heavens, no. There's never time.".. So it really doesn', mailer 10 the head

nurses whether ,heir reports are welldone and on time?"

"No, I guess not. But they oughtawanna do them right."

Contrary to what many people be­lieve. wagging your forefinger at some­one and telling her, "You oughtawanna," does not qualify as a universalincentive to action,

How often have you heard nurses onone shift (3-to-tt, for example) blameanother shift for leaving a lot of work? Ifwe questioned the 3-to-11 shift, the con­versation might go like this:

"They always leave the lunch trays.We've complained and complained but itdoesn't do any good."

"And what is tht> result?""The result is that we spend our time

cleaning up after lunch. That's theresult!"

"J understand. But wltat's the result tothe morning shift?"

"Oh, we complain to them:'"And then what? What happens ifthey

do clean up the trays? Does somethingfavorable happen if their performanceimproves?"

"Certainly not! You don't think we'regoing to reward them to do somethingthey oughta wanna do anyhow, do you?"

In summary. when you're dealing witha case where illooks as though a personcould perform if he had to or wanted to,one of the things to look for is theconsequences of doing it. If there aren'tany, then the remedy that suggests itselfis to arrange one.

When you want someone to perform insome particular manner, one rule is:Make it maller,

Nursing76, August 69