From The Floor
Are You a Type A or a Type B Nurse?
A successful nursing team has a blend of task-oriented and nurture-oriented nurses.
Many years ago, when I was director of nursing at a hospital in East San Gabriel Valley, CA, I was confronted by patients and patients’ families expressing grievances during the 1500–1900 shift. For some reason, this shift had a high number of complaints. I knew that the nursing staff on this shift was both competent and efficient, so I wondered what the problem could be. I set about observing the nurses as they worked. It didn’t take long to realize that the problem wasn’t so much the nurses’ skills, but the way in which they executed their work. For some reason, this shift had a disproportionate number of nurses who were task-oriented, which was at the heart of the problem.
Individuals exhibit both a variety and a continuum of behaviors, but many of us have certain traits that mark us as either a task-oriented or a nurture-oriented person. It is one of these two modes that defines how we organize and execute our work. Being aware of your predilection can help you work more smoothly with your fellow nurses, customize your interaction with patients and their families, and be more effective as a nurse.
The task-oriented (Type A) nurse will usually have a To Do list, with an idea of how much time each task will take. This nurse will plan breaks and mealtimes around a schedule of work responsibilities. She is usually praised for her organizational skills.
The nurture-oriented (Type B) nurse is more focused on the interpersonal aspects of her work. Her focus is on meeting the emotional/spiritual needs of her patients. The task itself is secondary. Problems generally arise when the ratio of Type A and Type B nurses are out of sync, as this can lead to subtle, and not so subtle, conflicts among the nursing team, as well as complaints from patients and their families.
A Type A nurse may:
• Fight to get one of the limited number of scales available to weigh her baby, rather than wait until later when there is less demand;
• Get that patient out of bed and sitting up in the chair at the designated time, even if the patient is engaged in some other activity;
• Change the dressing of the patient’s open wound, even though housekeeping is in the room vacuuming and doing other cleaning tasks;
• Arrive 15 minutes or more before the shift is set to begin;
• Collect all the necessary equipment for the lab tests ordered, even if the labs don’t need to be sent in until end of shift—12 hours later; or,
• Being determined to start that IV even if it means sticking the patient too many times .
A Type B nurse may:
• Arrive late for the start of her shift because she is busy talking to everyone in the nursing office, cafeteria, hallway, and parking lot;
• Know the entire life story of each and every one of her patients;
• Leave the bay supplies more depleted, or in more chaos, than when she arrived;
• Be looking for the supplies needed to draw the labs that were due in the lab 20 minutes ago;
• Know that it just isn’t her day to start a patient’s IV if by the third attempt she has still been unsuccessful;
• Be overhead saying, "but it’s an organized mess."
So, which type makes the perfect nurse? If your answer is both then you’d be right. A strictly Type A nurse is the nurse caricature that we all dread and hate—this is the Nurse Ratched stereotype that dogs our profession to this day. Meanwhile, the Type B nurse is the one we all dread to work with because she is so busy with the "touchy-feely" side that no tasks get done. Nursing teammates are often left to do her work in addition to their own.
What Managers Can Do
The best nursing model is a blend of the two types. Most of us shift between the two types, adjusting our style as needed. Problems arise when we become stuck in one style of behavior. We may not always be aware of our proclivities, but our fellow coworkers generally are. Neither scenario is an example of bad nursing. The solution lies in a strong manager who can identify the traits of her nurses and try the following solutions:
• Redistribute the mix of personality types, ensuring that one type does not dominate.
• Hold in-services for the nursing teams so they can learn to identify and integrate their styles into their work.
• Help over-strong Type A or Type B personalities learn to moderate their behavior so their style does not overwhelm the other nurses, patients, and themselves.
As a nurse, knowing what personality trait you are likely to exhibit, especially in moments of stress, can help you do a better job. No one style is always superior to the other. However, knowing when and how to morph from one style of behavior to the other can help you perform more effectively, and interact better with the other members of the nursing team.
Geneviève M. Clavreul, RN, PhD, is a healthcare management consultant and a former Director of Nursing.
This article is from workingnurse.com.