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‘What steps did you take to improve the quality of care within the hospital during the past year?” “List your goals for the upcoming year.” “Define your major work accomplishments.” These demanding questions and imperatives whine, beg, and plead like hungry children with empty plates. “We want more,” they say, pounding the table with their fists, “More, more, more.” Oh, the pressure of the yearly evaluation.

I toss the five-page document into a drawer and hope it won’t gnaw its way out. I’m sure it’ll be less cranky after a good nap.

A week later, I remember the captive in my desk and retrieve it. I promptly feed it a proper diet of what it’s been clamoring for — my clear and concise answers. It doesn’t seem onerous until I reach the question, the burdensome one I don’t want to answer. “What one thing in your department of this hospital would you like to change?” It is the source of my procrastination and my consternation.

Why does this question vex me? Because if I could change one thing, I would upgrade the attitudes, uplift the morale, and revive the spirits of my fellow nurses. But I can’t write that. If I do, my manager will suggest that improving attitudes and edifying my coworkers is a fantastic goal, and she’ll write that on next year’s evaluation — in red ink.

Then she’ll want me to outline a plan for accomplishing this goal. I haven’t the foggiest idea how to do this, and the thought of trying makes my stomach ache.

Standing outside my manager’s door, I write about poor morale and slumping attitudes because the “What would you change?” area remains blank. Sure enough, the bad thing happens. I emerge from my evaluation as the leader of the Attitude Improvement Team (AIT). Where’s the Pepto?

Small steps to big change

It’s been said that in the political arena you can’t legislate morality. Similarly, in the workplace, you cannot force employees to be courteous or have positive attitudes. We began the first AIT meeting at my hospital, Moberly (Mo.) Regional Medical Center, by acknowledging these things and admitting the task before us seemed tough. Someone said admitting the problem was the first step toward the cure. We savored this morsel and considered it truth.

At the second meeting, we brainstormed and came to realize that nurses are by nature problem solvers. We unclog feeding tubes and insert IVs into threads. We persuade children to swallow putrid-tasting medicine and help motivate people to battle through devastating illness. It was an exhausting session, but at its end, we realized that affirming our strengths boosted the morale of the group. This catapulted us over the obstacle we once viewed as insurmountable and led us to action.

Lead by example. We decided the first place to start in improving attitudes was with ourselves. We vowed to do our best to think and speak in positive terms. When difficulties arose, we would view them as challenges that could be conquered. Making a conscious effort to speak and approach problems in a positive manner was refreshing and became habitual.

No complaining. Complainers love company and thrive when others join them in their misery. The AIT resolved to halt complaining in two ways. The first was to agree with complaints that had merit, but challenge the complainer in an assertive manner: “I agree. What do you plan to do about that?” The second strategy was to say nothing at all. Ugly words have a way of hanging in the air above the speaker like dirty socks on a clothesline. Silence sometimes helps the complainer realize the negativity is stinking up the place.

Develop a praise board. We set up a bulletin board with paper and tacks in the locker room. We explained at a staff meeting that the bulletin board was an opportunity to encourage and compliment one another. The “warm and fuzzy” notes did not have to be elaborate, merely true and heartfelt, like: “Jane, thanks for restocking the IV basket today.” “Marcie, you were terrific with that difficult patient.” It might seem dippy and trite at first, but it works. Having others notice your efforts, give you compliments, and acknowledge that you are a valued member of the team is very gratifying.

Were we successful? It’s hard to measure attitude and morale improvement, but the board is usually filled, which we think is a positive indictor. The atmosphere in our department certainly seems brighter.

Personally, success came in the form of enlightenment. I learned that thinking in a positive manner rubs off on others and enhances one’s reputation as a problem solver. I realized that a good attitude comes by conscious effort, not by chance. And finally, I will no longer be intimidated by those difficult questions on the evaluation form. I will conquer them by employing the same resolve I use in my everyday practice. I can do it. I am a nurse.

Tamera Beaverson , RN, has worked as a staff nurse in the areas of med/surg and infusion therapy and as a charge nurse in cardiac care. She works in cardiac rehabilitation at Moberly (Mo.) Regional Medical Center and is testing the waters as a writer. She adjusts her attitude daily.