Share this article on:

What can you do when work isn't working?

Donohue, Mary Ann T. PhD, RN, APN, NEA-BC

doi: 10.1097/01.NUMA.0000414862.31384.fb
Feature: Executive Extra

What can you do when work isn't working for you or your team members?

Mary Ann T. Donohue is the vice president and chief nurse executive at Jersey Shore University Medical Center in Neptune, N.J., and the president of the New Jersey State Nurses Association.

The author has disclosed that she has no financial relationships related to this article.



If I had to pick just one seminal book that influenced me the most as a leader, it would have to be When Work Doesn't Work Anymore by Elizabeth Perle McKenna, published in 1997.1 In it, she wrote that although Americans believe their work environment should be a wellspring of community, support, and recognition, very few of us are fortunate enough to actually work in such an environment. If we do, owing to the natural cycles of just about everything in life, the phenomenon may not last for as long as we would like.

Fast forward to 2012 when Huffington Post blogger Douglas LaBier observed that career success has a poorly understood and negative downside.2 Landing in an office with one's name on the door doesn't necessarily guarantee the level of happiness that we had first planned. After the initial glow and congratulatory pats on the back have worn off, a creeping sense of dissatisfaction may occur.

The downside, it would seem, has less to do with the long hours or even the stress associated with managing human beings and their personalities. Rather, it has more to do with coming face to face with a wide range of purely personal and individual emotional conflicts, including failed attempts to resolve the value and cost of the job to one's own time, energy, and spirit in terms of the daily grind of political conflicts; out-of-date management practices that seem to typify the most senior level administrators and, therefore, the most impermeable to change; and feeling constrained by others' unrealistic expectations of what your role ought to be. In short, the most palpable disconnect between worker and employer occurs when there's a cataclysmic clash in values.

Back to Top | Article Outline

Dissatisfaction guaranteed?

It can be argued that by the time we reach our current position in nursing management or administrative executive leadership, we've witnessed numerous examples of career highs, as well as the unsettlingly negative lows. We've celebrated fellow achievers who've been rewarded for their talent, experience, and years of dedication and commitment to a particular hospital, organization, or industry. And we've certainly had much to celebrate as a profession: There has scarcely been an era in which nursing has enjoyed more media attention. It has been gratifying that polls continuously demonstrate nursing as the most trusted profession in the United States. And, as reported by U.S. News and World Report, RN has been named the best job in 2012.3

However, what happens when there isn't a good fit between worker and workplace? Or, worse, what's the outcome when values clash in an organization once widely recognized for fostering an outstanding nursing environment? Even worse, how do employees deal with feelings of abandonment when they're separated from their jobs not by choice, but as part of a personnel reduction plan?

One study polled female managers and executives ages 35 to 49, noting that 87% of them wanted to make a major change in their lives but weren't exactly sure how to do so.4 Forty percent felt trapped, 60% were in some kind of counseling or therapy and, in a statistic that still staggers, 46% of them knew a colleague for whom antidepressants were prescribed at least once. Based on data from 200 interviews and 1,000 surveys, only 2% of women executives felt “very satisfied” with the work they were doing. How can it be that just when the peak of success is achieved, unhappiness results?

When the workplace fails us, our colleagues are there to help us interpret what's happening through the lens of collective experience and mutual support. So critical is the presence of a best friend at work that it's a visible item on the Gallup employee satisfaction survey.5 Unfortunately, when the workplace is on a downward cycle, everyone associated with it may be suffering just as much as you. Therefore, your colleagues may be unable to help themselves, let alone help you through a particularly difficult period of chaos and transition.

Back to Top | Article Outline

You're more than your job

So what's the solution to this malaise? For one, workplaces alone shouldn't and can't define us. My own observations have yielded the following: Those who tend to suffer the most disillusionment also seem to be the ones who are the most reliant and dependent on their workplace to satisfy nearly all of their professional needs.6 Surely nobody would point to one person as being capable of fulfilling all of an individual's personal needs, so why is it that we expect our workplace to do precisely that and more? Those who seem to survive massive changes on the job, moving away from pain and disappointment and toward success, do so with greater ease and at greater levels if their professional lives encompass more than the workplace alone.

Let's look at a few reasons why the most successful nurse leaders are nearly always active in one or more professional organizations. Early on in their careers, they were, like all of us, confronted with the obvious reality that they simply didn't have all the skills to perform to maximum advantage. Here, they were probably mentored by a respected senior executive to join him or her at a conference, meeting, or convention. Despite, or perhaps because of, the demands of our own positions, such occasions are usually opportunities for growth and an entirely fresh perspective. On the job, you may have to wait years for a coveted spot to attend leadership academies and, owing to the expense, only a few individuals can usually attend per year. Does it seem that it's just never your turn to go?

That's where professional organizations' regional meetings come in. The regional, or local, chapters of your specialty and professional organizations often have positions that are unfilled and waiting for someone to flex their leadership muscle. As you advance in that professional organization, other opportunities abound. For example, the American Association of Nurse Anesthetists offered leadership development “boot camp” to its state association presidents-elect so that prospective officers would step into the role with intensive resources, tools, and information.7 At the New Jersey State Nurses Association, we've offered numerous programs on leadership and hosted retreats to our board of directors that provide new knowledge easily adaptable to one's own individual unit, department, or facility.

Without the pressure of performing in your own paycheck-dependent position, you're free to test out new leadership techniques with a fresh set of eyes—yours as well as the others serving with you. When you're free from work-related restrictions, colleagues who don't work with you or report to you and happen to serve on an external nursing committee or board will undoubtedly share praise, as well as sound advice and valuable criticism, for what works and what doesn't in innumerable challenging situations.

Their ongoing support helps us grasp the paramount value of organizational involvement: Nurse leaders who happen to be employed in places other than our own have a refreshingly different world view. This works to maximum advantage when we join together to promote the entire profession and especially when we advance the aims and goals of safe patient care. We illustrate the broad spectrum of nursing practice in our lobbying efforts with our local and national legislators, advocating for positive workplace and staffing practices, and, in fact, strengthening the bonds of nurses everywhere. Moreover, our activities in professional organizations make us the workplace “experts” in state and national nursing matters as the agents responsible for the changes to which your home workplace must inevitably respond.

All heads will turn in your direction when you report how you met with your elected legislators on safe patient handling or the role of the nurse in healthcare reform and how this will impact your particular hospital in the here and now, as well as in the future. Reports, prepared in the plan-do-check-act format, can't help but garner respect when your name is linked with improvement in the broader context of the professional practice environment.

Finally, leadership leads to networking, which helps to move us beyond simply behaving as passive dues-paying members. It's these expanded connections and web of participation that do more to connect us to that wonderful new position that's the next step on the career ladder than patiently waiting for the advancement that our current workplace simply can't—or won't—provide for us. In fact, leadership experiences in professional organizations may help us summon the energy to make the decision to leave an organization that has done little to advance our own career interests or goals.

Even if the decision to separate from your workplace wasn't your own to make, the resulting dismay, sadness, and disillusionment will subside that much quicker when you mobilize colleagues who've worked alongside you and know you best to act on your behalf and help you land that next position. When connections have been established over a professional lifetime, more fulfilling advancement at a new facility altogether is also more likely. And for those of us choosing to stay and enjoy our current positions, those same colleagues may offer ongoing strategies for continued success.

Back to Top | Article Outline

Keep work working

In conclusion, we can more readily imagine and envision success and happiness when we've had more practice doing it. Remember these tips and keep work “working” for you:

  • Join a professional organization or specialty association if you don't already belong.
  • Mark your calendar for the next local or regional meeting; plan to bring at least one colleague or someone you might be mentoring.
  • Volunteer for one committee or work group.
  • Meet, either in person or electronically, with at least two or three individuals whom you met from the organization and keep in touch.
  • Bring a summary of the outcomes and work proceedings to a forum in your workplace.
  • Host a professional organization recruitment day at your hospital.
  • Remember, don't put all of your professional eggs in one basket. Be involved!
Back to Top | Article Outline


1. McKenna EP. When Work Doesn't Work Anymore. New York, NY: Bantam Doubleday Dell Publishing Co.; 1997.
2. LaBier D. Why today's workplace creates emotional conflicts: the dark side of success.
4. Morris B, Coxeter RM. Executive women confront midlife crisis.
5. Gallup Management Journal. Item 10: I have a best friend at work.
6. Donohue M. When work doesn't work anymore. The Institute for Nursing Newsletter. July 2010.
7. Shekleton ME, Preston JC, Good LE. Growing leaders in a professional membership organization. J Nurs Manag. 2010;18(6):662–668.
© 2012 by Lippincott Williams & Wilkins, Inc.