Saturday, June 09, 2012

GNIE: Calling out a bully

A friend laughs and cries with you. A friend gives you support, but also calls you out when you veer off-course. 2 days ago, on Thursday, I had the unenviable task of doing the 4th duty of a friend. 


During Nursing Theory class, lecturer H decided to collect suggestions from the class for the semester 1 GNIE students who would be heading for their first clinical attachment under the GNIE course. Suggestions flowed on as lecturer H moved her focus from one side of the class to another. 

When lecturer H came to my corner of class, LP suggested that students should help each other instead of focusing on finishing their own task. 

My PRC classmate PY countered immediately that everyone has his/her own tasks to be done; if the person cannot even finish his/her own task, then he/she will delay everyone; so it is important to get one's tasks done before helping others.
[I took it that PY meant that helping others should be circumstantial, because personally I do not find PY selfish. That said, my interactions with her is limited to classroom activities.] 
PY then added that people should not talk about others behind their back; instead they should bring the issue out to the person involved [and talk openly and directly about it]. Lecturer H gave a quick "Aha!" look, and then she just noted down the comments but did not add any remarks.
Some background notes: LP, IJ, PY and a few other classmates were in the same clinical group. LP and IJ have LPN experience in Canadian hospitals, so when it came to clinical, they were the stronger players. Unfortunately, LP and IJ seem to have issue with one person or another from their clinical group at various points in time. The Filipinos in my sub-group would hear them complain every now-and-then over our lunch together.
I am in another clinical group with AP, IT, JC, PT and others. As AP, IT, JC, PT and myself are part of the Filipino lunch group, we have heard of the conflict in LP's clinical group. When we met up for clinical, AP, IT and I would remark to each other that we were glad that our clinical group is made of comparatively agreeable people and is rather cohesive. Even our current semester's Clinical Instructor remarked that we are an unusually cohesive group who helped each other out and waited for everyone to go for break together. 
Personally, I have minor issues with someone within my clinical group, but I try to close one eye and keep the matter confidential (between AP and myself) because I treasure the camaraderie within the group and I don't want to spoil it. I believe everyone in the group holds a similar approach.
When it came to IJ's turn, he gave some other suggestions. But knowing his issue with his CI, I recognized it as a veiled criticism of the CI. In the pursuing discussion, it became more and more obvious that IJ and LP were complaining about their CI. PT, another Filipino classmate who is in my clinical group, actually added oil to the fire by saying, "Ya, K is like that..."

Again lecturer H just noted down the comments but did not add any remarks. At the end of the feedback collection, lecturer H remarked, "That's all? I thought you guys are going to give me some tips on how to tackle the clinical instructors."
Frankly, I don't know if she was joking or being sarcastic, given that the other sub-group (in my class) had complained against lecturer H before. Nevertheless, I was disappointed that lecturer H did not use her position of influence to offer a neutralizing perspective. Yes, I recognize that as adult learners we are responsible for our interpersonal interactions, but I thought that a comment from her "position of authority" as a lecturer to counter the veiled attack would have helped, even something simple like, "You guys are adult students. You should know how to resolve conflicts amongst yourselves." But it did not happen, the fire was not doused.

We then had a short break. I took the chance tackle IJ's issue with his current semester's CI, KH. Both IJ and LP had been complaining about KH for the past few weeks. 

My clinical group had KH as our CI during the previous semester. My group had no major issues with KH as the CI. We were grateful for her support and flexibility. In fact, at the end of our clinical, my group gave KH a "Thank You" card and we celebrated together at a Japanese restaurant (she wanted to pay her share, but we insisted on treating her).

So I asked IJ what his issue with KH was. He said, "She is always here-and-there" [i.e. he could not find her]. To which I replied, "It depends on what you expect from the CI". I told him that my group like KH precisely because whenever a student requested for her check/guidance/support, she would follow the student to the client's bedside. I added (someone from the other sub-group told me) that another clinical group was unhappy in the previous semester because they (allegedly) had a CI who declined to supervise students by the patients' bedside, always sitting at nurses station instead. I followed with asking IJ, "Have you raised this issue with KH?" To which he replied negative. LP joined in and said that there was no point (in raising the issue) since they had only a few of weeks of clinical left, and they would rather just "suck it up". I told them that, if they were upset enough to complain in class, then they should raise the issue with KH and talk with her face-to-face.

Next I asked IJ if he had any other issue with KH. Then he said that she was picking on himself and LP. I asked, "What happened?" IJ said that he and LP were only a few minutes late one morning, but KH "talked" to them about being late right after that. IJ then cited that they were technically speaking not late since the report has not started yet. Further, IJ claimed that other students who were later than them were not given the "talk". Thus, KH was not being fair in handling the students.

I was a little puzzled but I decided to share based on my groups' experience with KH. First of, I asked, "Did you agree on a specific reporting time?" IJ replied negative. I told IJ that my group had established an agreement to report by 7:20am (actually, it slowly shifted to 7:25am by the clock at the clinical unit). Nevertheless, KH had been flexible with the late comers so long as we inform her (e.g. send a text message or verbal message from our classmates) of our situation. [Indeed, a few in my clinical group, including me, had done so in the previous semester, without any issue.] Thus I suggested that IJ bring up the matter directly with KH and to establish a benchmark for punctuality. IJ started wriggling his way out of establishing a reporting time with KH, to which I countered with an explanation on the need for a benchmark for an objective approach to Performance Appraisal.
In my 1st IT job, my company provided excellent training, including many in-house training videos. One of the most beneficial ones I watched was on Performance Appraisal. Basically for Performance Appraisal to be done objectively, one has to establish the KPI (Key Performance Indicators), how to measure the KPIs and the (measurable) standard to meet for each grade. Then the employee and supervisor each makes their evaluation of the employee's performance based on the agreed standards. Finally, the 2 meet together to discuss the grades, and for any discrepancies, to explore the causes and negotiate the grade. 
I shared how using that tool greatly benefited me in one situation. We were mostly young (under 30's) folks in the team at that time, including my supervisor J then. Another female colleague CML had some issues with me over a male colleague that she had fancied. I was in the development team reporting to J, while CML was in the testing team reporting to KT. CML spread negative comments and gossips about me, especially to J who was infatuated with CML back then. When it came to performance evaluation, J initially rated me 4-5 on all KPIs and gave me an overall grade of 4+ (on a scale of 1-5, 1 being "outstanding" and 5 being "needs improvement"). At each KPI, all J had was CML's comments and feedback, and his personal opinions to support his evaluation. I was aware that J, as a newly promoted supervisor, was keen to be seen as fair. Thus, I challenged J to specify the SMART objectives as per the company's Performance Appraisal approach for each KPI. He took several hours to do it, but when he was done, I showed him the evidence that I met all his criteria cited. At the end, my KPIs were mostly rated 1-2 (I think there was only 1-2 items with a rating of 3, meaning "Met Expectations") and the overall grade was 1+. We were originally scheduled for a 1-hour review of my performance appraisal, but it took 8 hours instead. We finished at 12-midnight. I might not have liked J personally any better, but at least he earned some respect from me for putting in the effort to be objective.
With that example, I re-iterated how important and effective it is to establish objective standards. IJ wriggled again. To which I cut straight to the chase and asked, "Look, you want to pass the course, right? So why don't you establish measurable objectives upon which you would be evaluated?" At which point, IJ went tangential and started accusing/labelling KH, "But she is...". To which I replied, "It doesn't matter". The cycle of "But she is..." and "It doesn't matter" repeated for several rounds. Until IJ finally gave up.
I wonder if IJ realized that I was using the "Broken Record" method of assertive communication on him. We learnt that in GNIE semester 1.
I concluded our discussion with a re-iterated suggestion that IJ and LP speak openly and directly to KH about their issues with her instead. I recognized at that point that IJ and LP were, for some reason, unwilling to acknowledge their parts in causing the issues and role in resolving the issues. I told IJ that it was not good of them to bring up their issues with their CI indirectly during class (with another lecturer/instructor) instead of speaking directly to KH, the CI involved. IJ tried to excuse/justify his actions, stating that he would never mention names.


After lunch on Thursday, we had nursing lab with the lab instructor JNT. IJ and LP started asking JNT questions about what should and should not be done. E.g. "Do nurses percuss the abdomen?" E.g. "Should we auscultate the abdomen before or after palpation?"

On their own, the questions seem like innocent clarifications of nursing skills. However, knowing the background issues driving their questions and from the tone of their questions, I recognized that they were seeking another avenue to complain about CI KH.

JNT answered both questions in their favour but did not stop at that. She deduced from the follow-up commentary from IJ and LP that the questions were related to conflicting instructions from a CI. JNT started asking questions and making statements that were critical of the conflicting instructions. Then she started playing the "student advocate" role* and asking the class if they had any issues at clinical. IJ and LP immediately took the bait and started giving negative comments about their CI. There was an awkward pause. Then IJ asked, "Come on guys, back me up!" and another classmate from his clinical group spoke in agreement. JNT then fished for more and more details. Finally, she asked, "Who is your instructor?"

At which point, IJ hesitated for a split second and then slowly replied, "KH."

JNT then said that she would raise the issues on their behalf to the person in-charge of clinical posting. That person is away at the moment, but JNT promised that she will follow-up with her. In addition, JNT said that she will also raise the issues with the Course Co-ordinator L. After some other side matters, JNT declared a break.
[*Note: This afternoon when AP came to bunk over at my place, we discussed what happened on Thursday. Both of us find JNT's behaviour beyond what is appropriate of a "student advocate". We both think that there is more to JNT's motive than simply being a neutral advocate. It is not the first time that JNT had been "fishing" for "tinder". It first happened when there was a complaint against lecture H and she asked "How did your theory class go?" The week after the incident against lecturer H, she fished for complaints about clinical. This Thursday, her nose sniffed blood in the air from IJ and LP.
AP said that it seems that JNT has something at the back of her mind but AP could not figure out what it is. I gave a guess that based on the 1st semester's lab lecturer LA's information, it is hard to get a regular/permanent job from the university. Even LA, who had been getting good performance reviews for years of contract work with the university, is still not offered a permanent position. Maybe JNT's behaviour is symptomatic of workplace politicking.]
At which point, while a few classmates were streaming out of the classroom for the break, I turned over to IJ and LP and said sternly (in the presence of the other Filipino classmates and JNT), "You know what? You guys should seriously have a face-to-face talk with KH if the issues are bothering you that much. What you're doing is [a form of] bullying. Why do you go around complaining and complaining (to others) instead of talking to KH directly?"

IJ and LP both looked surprised, as if it never occurred to them that their actions/behaviour were those of bullies. LP then gave excuses that, "If we complain (to her), she would fail us?"

To which I thought, "Obviously they do not trust on the professionalism of their CI. It's a sad reflection of their own mindset." Nevertheless, I replied, "You can document that you have made a complaint to her, then she cannot fail you because of that."

IJ or LP (I cannot recall which) asked, "You mean like in the anecdotal notes?"

I said, "No. Like document down for the record."

The above excuses and counter-argument went several rounds. Finally, they kept quiet, but I could tell that they were not ready to hold their peace yet. Anyway, break was over soon enough and lab lesson continued.

At the end of the day, I didn't feel like talking to anyone, especially not the Filipino gang, so I headed out quickly.

On the bus journey home, I decided that I have to reinforce my point. Thus, I sent IJ a text message.
"Hi IJ, I seriously think that you and LP should consider raising your issues directly with KH. As your friend I am ashamed of your actions this afternoon. Gossiping about someone behind their back is bullying. Remember how angry you and LP were when the other group complained about H to L behind her back? Is there any difference between that and what you're doing now? I hope for and expect more maturity from the both of you. WD"
About 1/2 hour later, I got a reply from IJ.
":) thank u for making me aware of that [WD].. i hope itll (sic) all work out for me. it is a stressful situation, so im thankful for your guidance in this process. sorry for having acted inappropriately, it will not happen again."

When I logon to Facebook late on Thursday night, I saw that IJ felt vindicated by JNT's replies to his questions earlier that day and posted the following on FB (around the time when I sent him that text message about bullying).

IJ: RNs don't percuss. LoL

WD [replying late that night] : Such regulations are specific to legislative zones. In UK, they do. In Singapore, some with modern training do. I was trained in Health Assessment by someone who ever worked in UK.

WD: Which is also why we need the GNIE programme. Standardization of RN scope, skills, roles & responsibility in the Canadian context.
[Note: I grabbed the opportunity to drumroll about the benefits of the GNIE program. IJ and LP have been and are still complaining about the need for GNIE and stirring others' frustration over the program. In fact, both of them were so frustrated about the perceived "discrimination against foreign nurses" that they were trying to write on that theme for their Sociology assignment.]

Today (Saturday), AP told me that over dinner on Friday, she also talked to IJ about not going overboard in his complains. AP suggested to IJ to "suck it up" and show the CI some respect if he wanted to pass. [Note: AP did this independently, she didn't realize that I had sent IJ a text message on the matter.] IJ seemed a little less defiant this time, asking AP if it was that bad. AP said to him that his words do hurt others sometimes. Then according to AP, unlike IJ's usual habit, he did not complain about a ginger slice in his drink at the Japanese restaurant.

Getting LP to turnaround would be more difficult. AP and I agreed that IJ is a smart person and LP, on the other hand, wasn't quite so. To quote AP, LP's behaviour is that of a typical Filipino - complaining and gossiping about issues. I would reckon that without IJ's chorus, LP is unlikely to push her agenda further because LP has enough street-smarts to know that she is unlikely to succeed without IJ's brains.

Neither AP nor I know how things will play out. We both hope that things will work out for IJ, LP and their clinical group. Once again, we concluded that we are blessed to be in our clinical group which seems to have no major issues. *Fingers crossed* and *knocking on wood*.


[Addendum on 14-Jun-2012]

IJ informed me today that he had spoken with his Clinical Instructor KH and set-up some agreed benchmark standards for the clinical performance evaluation. Apparently KH agreed that she should have done that right at the beginning of their clinical rotation. IJ told me that he was concerned that he only had 2 weeks left on clinical to meet the standards (and wondered if he might be penalized for the earlier weeks' variances from the post-dated standards). I re-assured him that from my clinical group's experience with KH, she is unlikely to fail him just because they had not set-up those standards until this late in the clinical rotation. I advised him to just do his best to meet those agreed standards over the final weeks of clinical and he would probably be alright.


  1. WD, jia you!

    Your entry shows such maturity and resilience that it puts me to shame.

    There's so much I can learn from your "experience". Haha.

    I go swimming when I can't cope with life too. It certainly lifts my spirits!

    All the best with your GNIE course!

  2. Hi theblankbox,

    Thanks for visiting and your encouragement. Thanks also for reading through that super longwinded entry, haha :-D

    To borrow a Christian saying, "Everyone has his/her own cross to bear", so there is no need to feel shame. You probably have your challenges that I would be wowed by.

    Yeah, I agree, there is something about moving about in water that is very therapeutic. So we share something in common.

    Thanks for your well-wishes! All the best to your life pursuits too!

    Cheers, WD.