AORN J O U R N A L MARCH 1984, VOL 39, NO 4

Managing Upward UNDERSTANDING YOUR Boss

Emily H Boegli, RN

hat is upward management? Man- agement is getting things done W through people, and upward man-

agement can be defined as getting things done through those who supervise us. This concept has been used effectively by the Japanese. Con- trasting management in Japan with that in the United States, a Japanese economist said,

Our system is rather like an electric train with each car having its own motor, whereas your system is more like a long train drawn by two or three strong locomotives with no motors in the cars. You tell your workers to follow. We like people to have their own motivation-and move together.’

Emily H Boegli, RN, MA, is an education research specialist at Memorial Medical Center, Savannah, Ga. She earned a bachelor’s degree from Wake Forest College, Winston-Salem, NC. She graduated from Baptist Memorial Hospital School of Nursing, Mem- phis, Tenn, and earned a master’s degree from North Carolina Central University, Durham.

As staff nurse, or as a manager, a better under- standing of types of leadership and the steps in managing upward will help you develop power that you can use on your job. Learning to use a handy little tool in upward management-the written proposal-will also help you get things done.

Hegarty describes two different approaches to management.* The adversary approach, “us- against-them’’ or “get-them-before-they-get- you,” is acommon tactic. Manipulation, schem- ing, and deceiving are techniques used to get things done through others. But what happens? People who are deceived or manipulated are re- sistant. They begin to resent the manager and ultimately seek revenge. On the other hand, there is the team approach. For example, when people participate in the establishment of a pol- icy or a rule they are more likely to follow it. Drucker calls this participative management. “We” make the decisions, “we” enforce the rules, “we” take responsibility, “we” are im- portant and powerful, and “we” shall succeed. The team approach results in more cooperation, togetherness, and commitment.

Denominations of Leadership

H egarty defines four denominations of l eade r~h ip .~ No leader has all the characteristics of one leader type, but

may have a combination of characteristics. How does your boss fit in?

0 The Drive leader is demanding. He or she threatens and punishes. She may be driven by fear or low self-esteem. She is more concerned

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If we are to enhance our self-image, we must go with our strengths,

avoid situations in which we fail.

about the task than the persons doing the task. The drive leader is unable to keep creative people as creativity would be supressed. Persons who wish to keep their jobs may show superficial loyalty but talk behind her back. Staff soon lose initiative and motivation, and the adversary ap- proach is inevitable.

0 The Default leader plays numbers and poli- tics and probably gets the job that way. The default supervisor paints a nice picture for the prospective nurse, promises her much, but aban- dons her once on board. The abandoned em- ployee is less successful, and the default leader then fires her and hires another. They love to hire and fire. The default leader is concerned with finances more than with individuals, yet the most expensive item in the hospital budget is salary and wages. The default leader is generally not an expert in the field she manages and has tremen- dous problems with communication. This type of leadership results in low motivation, low energy, low morale, and, ultimately, the adver- sary approach.

0 The Draw leader has skills in dealing with people. He or she seeks to draw out the best in people. This means an understanding of each person’s strengths, weaknesses, values, and skills as well as their likes and dislikes. This manager relates to each as an individual. He or she makes assignments on the basis of strengths and promotes success. The draw leader seeks to improve the work environment and encourages staff to evaluate their own work. This type of leadership results in employee support and in- stitutional success. What makes bosses look bet- ter than the success of their staff?

0 The Develop leader recognizes and de- velops people. He or she knows the organiza- tonal goals and communicates them. Her self- confidence and job commitment are evident to her staff and result in a basic trust. The develop leader could expect a turnover of those on their

way up but would always have a “strong bench” of good people prepared to move into leadership positions. This type of leadership results in a happy staff and high performance. Both the draw leader and develop leader are comrqunicative and emphasize the employee. What greater asset could a leader possess?

Steps in Managing Upward

ight steps will help you to develop skill in managing upward. E Step 1. Know, accept, build, assert,

and control thyself. Control of anything must be preceded by a thorough understanding of what you wish to control, whether it be micmrga- nisms , the enemy, your child, your boss, or your- self. Once we understand ourselves, we must then accept who we are and what we are. What greater gift can anyone possess than a good self- concept? If we are not satisfied with what we are, we live in a country where we can build or grow.

We must constantly strive for personal and professional development. Once we know who we are, what we are, and where we are going, then we can assert ourselves. If we are to en- hance our self-image and be successful, we must go with our strengths, avoid situations in which we will fail, and construct a reputation for being right. Self-control is essential if we are to suc- ceed in any type of upward management.

Step 2. Understand and promote your boss. How can you understand your boss? First, learn to listen. Listen to what is said, what is not said, what was meant to be said, and what was said to others. Observe how your boss is groomed.

Observe the time of day and day of week when she is most approachable. Friday afternoon may not be the time to discuss a big problem. Timing and method of approach have more far-reaching effects in the fulfillment of a request than the nature of the request itself. Observe how your

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boss relates to others-your peers or her boss. As you come to understand your boss-what makes her tick and what ticks her off-then you can concentrate on the approach and the timing.

People have good qualities and bad qualities. No one is all good or all bad. Look for those good qualities and forget their weaknesses. Behavior modification suggests that we look for and con- stantly reinforce good qualities while ignoring weaknesses. Punishing weaknesses only brings attention to them and leads to further weakness and failure.

Once you understand your boss, look for his or her strengths and reinforce them. You will probably notice further development of those strengths. This can lead to trust and support, which is important in any employer/employee relationship. To go one step further, promote your boss by telling others how great she is. Your strengths and weaknesses are different from hers. Match your strengths with her weaknesses and seek her help for your weaknesses. Loyal opposition can be helpful too. When you see your boss about to make a mistake, and you know something she does not know, tell her. No one is right or at their best 100% of the time.

Step 3. Support your institution. Before you can support your institution, you must under- stand its philosophy, purpose, and goals. This understanding should precede the acceptance of a position. Knowing and following policies and procedures is important not only for legal rea- sons but also to set the example of leadership. If you do not agree with a policy, there are steps that may be taken toward review and possible change. If you cannot bring about change, accept the policies as they are or find a position with an institution whose polices you can accept.

Loyalty is important. To manage upward, you must demonstrate an interest in the larger man- zgement issues of your boss. Be identified with positive results and constantly seek to better your

Step 4. Create and maintain effective working relations. Hegarty said it is as much the respon- sibility of the managed as it is the manager to create and maintain effective working relation^.^ We must constantly seek ways to help. Some

group’s results.

ways to enhance working relations are: (1) stay away from what is not your business; (2) keep personalities out of conversation; (3) keep de- partmental concerns within the department; (4) avoid gossip or small talk; (5) accentuate the positive; (6) demonstrate professionalism; and (7) set the boss up to win.

Step 5. Listen to, not against. There are sev- eral things to consider here: (1) begin with clear and positive intentions; (2) match tempo with tone; (3) combine content and feeling; (4) relate without repeating ( 5 ) beware of double talk; (6) hear it out; (7) evaluate, don’t judge; and (8) learn to say no.

Step 6. Do versus done unto. There are two kinds of people in the world-those who do and those who are done unto. Are we on the offensive or defensive? If you can follow steps 1 to 5 , then you are probably a doer.

If you get into dissension, make it construc- tive. If a crisis exists, face it at once, or better still, prevent it. Learn to become a part of the solution, not a part of the problem. What should you do when a problem exists? Write it down. Many times, if a person comes to you with a problem and you tell him or her to write it down, the problem diminishes in significance or even disappears. As you read over the description of the problem, assign ownership. Whose problem is this? Is it mine to solve or someone else’s? Next, gather all the data you can find relating to this problem. When reviewing the data, deter- mine alternative approaches to the solution. The biggest decision is which approach to take. With data gathered, you are ready to implement your plan and evaluate the results. On the basis of your findings, plan what to do the next time.

If you want to use participative management, let your employees identify the problems, gather the data, and determine alternative approaches. Then you will be ready to make the final deci- sion. It works, not so much because it results in the best decision, but because it is a team ap- proach.

Step 7. Use your power. Everyone has access to power. There is power in knowledge and ex- pertise. It is this potential that drives nurses to specialize.

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“YOU can significantly reduce communication breakdowns by putting as much

as possible in writing. 9 7

Recognition and support of another provide power in any relationship. The gift of communi- cation and persuasive reasoning is especially powerful. There is power at the fingertips of one who knows who she is and where she is going, and one who is able to communicate clearly these goals and expectations.

Before moving on to the last step, go back to your description of your boss, and on the basis of the seven steps in upward management discussed above, list some techniques you would use with your boss.

Step 8. Managing the “write” way. Hegarty says, “You can significantly reduce communi- cation breakdowns by putting as much as possi- ble in writing.”5 If your boss won’t listen, maybe he or she will read. She may be a visual learner. I learned to write my ideas in logical fashion and to defuse the language by using a proposal format. Why does putting it in writing work?

It forces clarity. Not only do you have to know what you want, but you must be able to communicate it. It puts both communicators on the same wavelength. It provides documentation. It serves as a guide to action. It has been said that “studies prove what common sense tells us: The more time we spend in advance planning on a project, the less total time is required for it. ’16 It provides copies to be sent to those who count. But be careful not to go around the boss but use the copies to add weight and breadth. It provides an avenue for follow-up. It is an outlet for creative and assertive people. It prevents the loss of a good idea. It is an excellent time management tool.

use a written proposal: Investigate, prevent, or solve a problem. Example: You have three new nurses in orientation. The time it takes to train them is equivalent to three persons working for six months but without benefit to the de- partment, which results in a severe staff shortage.

0 Meet a need of an employee, patient, the institution, or your department. Example: You have just upgraded a staff nurse to a leadership position, but she has had no for- mal training for the job. You will need to assure that you can send her to a course or seminar for that training. Enhance productivity, efficiency, or qual- ity of care. Example: You would like to implement the AORN standards of practice for perioperative nursing and find it neces- sary to convince your administration. Save time, equipment, supplies, or money. Example: Surgery has to be cancelled due to a lack of a laparoscope or another piece of major equipment. Provide training or education. Example: Our AORN chapter submitted a proposal to both the bachelor of science and associate degree nursing programs at a local college for implementation of Project Alpha. It was accepted and implemented and resulted in the filling of all RN full-time equivalents in the operating rooms of all three local hospi- tals.

Guidelines for Writing a Proposal

t must be clear, complete, consistent, accountable, realistic, and relevant. Avoid I using emotional words such as “all,”

“never,” and “always.” To: Direct the proposal to the person who will

Here are some suggestions for possible ways to have the authority to act. d- 6 5 9

A O R N J O U R N A L MARCH 1984, VOL 39, NO 4

From and date: This information is essential for documentation and reference. Subject: Your subject should be specific and very clear. Objective/proposaVend product: Simply state what you are proposing. For example: Im- plementation of a four-hour surgical asepsis training program for all medical students rotating through our operating room by January 15, 1984. Rationale/reason/justification: Explanations and supportive data are essential to support your proposal (ie, case histories, statistics, cost analyses). This is where the work comes in be- cause you must justify your proposal. Benefits and limitations: Expectations, advan- tages and disadvantages should be anticipated and clearly stated. This lets your boss know you have done yourjob thoroughly. A solution to one problem often creates other problems. Antic- ipate and address these problems. For example: Purchasing a new piece of equipment will neces- sitate inservice education for its use. Plan: The plan is the most important section because it is a step-by-step plan for implementa- tion with deadlines for each step. If the proposal is approved, this section will serve as your guide and calendar. Summary/closing statement: Finishing touches or your request for action may be in- cluded in this section. CC (carbon copies): This is where the power comes in. Example: The proposal our AORN chapter submitted for Project Alpha was carbon copied to the dean of the college as well as all three directors of nursing representing hospitals in our area. It brought astounding results. Below the line: This section is designed to bring quicker results. It serves as a good time man- agement tool and provides documentation. It also promotes feedback from the supervisor.

We have power-we only need to recognize it. But recognition must be preceded by a clear understanding of who we are and where we are going. It requires both commitment and perse- verance. Hegarty sums it up by saying, “Manag- ing your boss means understanding your boss and managing yourself. ”

The joy of power comes when we are able to use it, and a steady source develops with use .0

Notes 1. Frank Gibney, “Japan’s economic secret,”

Book of the Year (Chicago: Encyclopedia Britannica, Inc, 1982) 466.

2. Christopher Hegarty, Philip Goldberg, How to Manage Your Boss (Mill Valley, Calif: Network Inc, 1983) 5.

3. Ibid, 84. 4. Ibid, 4. 5 . Ibid, 185. 6. Edwin C Bliss, Getting ThingsDone: The ABCs

of Time Management (New York: Bantam ed, 1978) 126, published with permission of Charles Scribner’s Sons, New York, 1976).

Contaminated Gauze Causes Infections A high incidence of donor site infections for burn patients developed during a three-week period at the Intermountain Burn Center of University Hospital, Salt Lake City. After culturing the fine mesh gauze used to dress the graft sites, it was found that the inner layers of gauze were contaminated.

The gauze was provided in 1% inch diameter rolls and was steam sterilized by central processing before use. The graft site was wrapped first with the gauze, and the remainder used for the donor site. When the sterilized fine mesh gauze rolls were cultured, the outer layers were sterile but the inner layers had the same staphylococcus organisms that had been isolated from the donor site infections. isolated from the donor site infections.

From this, it was concluded that the density of the roll of gauze impeded steam penetration. The manufacturer of the gauze was informed of this finding, and now the rolls of gauze are gamma irradiated before shipment. There have not been any donor site infections since this practice began.

conference and was abstracted in the American Journal of Infection Control.

This was reported at an infection control

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