Dear Steve,
As a nurse, I am responsible for precepting our new hires. In most cases, experienced nurses come to my unit and my job is to help them learn the policies and procedures unique to our unit and the hospital. The most difficult challenge is the “know-it-all” who is impossible to teach. We avoid these people in our personal life and regard them as arrogant, but how do I deal with someone with an unteachable attitude at work?
Signed,
Preceptor
Dear Preceptor,
Braggart, smarty pants, windbag, egoist—however you refer to this category of people, it still doesn’t change the fact that “No ones likes a know-it-all!” (one of my mom’s favorite sayings—just second to the all-time favorite, “Stop crying or I’ll give you something to cry about!”).
Most people figure they’ll just have to grin and bear the time they’re required to spend working with a know-it all. Or, when patience finally wears thin, they try to “help” the person see the impacts of their know-it-all ways. And while either the “grin and bear it” or “put them in their place” approaches might work in a social setting, at work, you can’t simply choose to avoid these folks. It’s your job to work with them—especially in your case.
My best advice to you is to change the way you go about trying to change these new nurse’s minds.
Typically, when we have information we want to impart, our preferred method is tell, followed by tell, and then we end up with, well . . . more telling. You get the point. Instead of starting and ending with tell, try to create an experience that will help them change their own minds. Here’s what I mean.
I asked my good friend, Jamie, who’s responsible for precepting new hires at Med/Surg Psych Forensics Unit if he’d ever been assigned to train a know-it-all, and if so, what he did. “Of course,” he responded, “I had one a little while ago. She was the toughest I’ve dealt with yet.”
She came to her new unit pre-stocked with all the knowledge, expertise, and information she needed for this new unit—at least that’s what she believed. He explained she had ten years of experience as a NICU nurse and was about fifteen years older than him. She spent a significant amount of time making sure he knew she was at least twenty years beyond him in practical experience, common sense, and all around skill.
Two very long days into a two-week precepting process and she was already discounting and ignoring almost everything Jamie had to offer. And that’s when he got smart. Instead of trying to verbally convince her he had something of value to offer, he decided to let her “solo” on a tricky, but non-life-threatening task.
She floundered. He made some suggestions and, finally, she listened. This direct experience was the catalyst to her asking questions and paying more attention rather than trying to prove she already knew it all. Jamie had no more need to convince or compel. His trainee understood there were things she’d need to know and learn to do well in her new position. In a very short period of time, she ended up changing her own mind.
Now, what made this work? When Jamie switched from telling to getting this new nurse to participate in a task that required knowledge she didn’t currently have, he created a direct experience for the new hire. People usually dismiss attempts at verbal persuasion but can’t so readily dismiss things they’ve experienced firsthand. These direct experiences are both more memorable and more meaningful.
So, what does this mean for you? Try precepting up front. Shift from a theoretical description of their role to a practical one. Instead of waiting for some type of direct experience to present itself, design a process so that one of the very first, if not the first, activities you engage in are direct experiences. I’m talking about simulations or actual tasks that represent the typical types of situations a nurse will encounter in your unit. It will allow you to see what skills they are bringing to your area so you will have a better sense of how to customize their overall precepting experience. It will also provide a great direct experience for the new hire to get a sense of how different your area is and where they’ll need to focus.
I think you’ll find that as you try to incorporate this idea, you’ll come to appreciate the Chinese Proverb which counsels: Tell me and I forget, teach me and I may remember, involve me and I learn.
Best of Luck,
Steve
One of my favorite reasons for reading these crucial skills cases is the reminder in nearly all the responses of “maybe the problem is not ‘them’, maybe it is ‘you’.” While I think Steve’s overall recommendation to change approach to more direct experience is quite good, I think the response left out an important consideration, which is that the TRAINER could be behaving arrogantly with a know-it-all attitude and some new nurses are less capable of handling it. It could possibly be the case as well that a new nurse actually knows better ways to do some things from previous experience and the trainer is unwilling to even consider that improvements are possible. Of course, someone with “crucial skills” would find a way to suggest improvements that minimizes negative reactions, but not everyone with great skills in a field also has “crucial skills” to match. Even if neither of these “it could be you” scenarios is actually true, I think it’s helpful to suggest them as possibilities to be explored.
On the other hand (In defense of a new hire that might appear to be a “know-it-all”): it is important for a new hire with experience to show confidence and competence. Aren’t we hired for our KSA (knowledge, skills, and abilities)? Isn’t that what the interviewer wanted from us? I have been in the situation of coming to a new job only to be trained on things everyone in the profession already knows. This means we have to waste everyone’s time by listening politely and waiting for new and relevant information, or speak up and ask for training on the things that are truly relevant, appearing to be that “know-it-all” that no one likes. Literally, I have been “trained” on something as basic as confidentiality; something we’ve all been trained on multiple times.
My comment is that a know it all is probably craving new skills and challenges. Your suggestion to give them a challenge and let them show where the gaps are is excellent!
Your answer is interesting because as a nurse educator I would use my Crucial Conversation skills to give feedback to this person. A person who is a “know it all” can be very dangerous in a high stakes area like nursing. I would want to let them know that being part of the team means listening and learning from others. There are some low stakes areas where you can let someone “fail” but that is very hard for nurses to do because they are concerned about what is best for the patient.
There is a flip side to this situation, that the instructor needs to consider as well…. There are times that people are sent to training for things that they do, in fact, already know. It can be really painful to go through a training session on something you already know 95% of, just to learn the one or two things you don’t
Ideally, for someone who’s experienced in the field, there should be a way for someone to potentially “test out” of a course (with a “test” not necessarily being of the paper-and-pencil variety…in fact, the example you gave in your article is a variation on this, and, in that case, the nurse failed to “test out”). Of course, pre-tests aren’t always feasible…in that case, it’s important to pay attention to that seeming “know-it-all” to see how much of that might be true. If they really do seem to have the knowledge/skill already that you’re trying to train, discuss with your manager whether they really do belong in the course or whether it might be more effective if you scheduled a separate, SHORT, session with the “know-it-all,” or provided some kind of job aid, to catch him/her up on the couple of things they might not know.
If neither of those options are practical, but you’re fairly confident that the person really is knowledgeable/skilled in the subject, then you can try a different tack….use the “know-it-all” as a kind of trainer’s aide. Give him/her the chance to share what he/she knows, or demonstrate a skill the group needs to learn…in other words, make the “know-it-all” an ally, instead of an enemy. If you don’t want the “know-it-all” to monopolize the conversation, give him/her a task to do for the class — maybe ask him/her to create a written list of tips he/she has learned about the subject through his/her experience, which can then be shared with group later as a handout (after you’ve reviewed it to make sure the info is accurate).
There are lots of other strategies you can employ…but, the point is, it’s important to also look through the eyes of the “know-it-all” and see what you can do to make their experience a positive one, as well (or help them to get out of an experience that holds little value for them).
Thank you so much for your very interesting articles. I really enjoy reading them and learn such a lot from them. In response to the “know it all” question: Like you, I teach post-graduate students and often they come to class with many years of experience. I think it is important to acknowledge what these people contribute to the group and celebrate it. Some are embarassed to be back at Uni learning amongst younger students. Some are a bit egotistic but, in almost all cases this kind of behaviour comes from a need to reaffirm self. Therefore I try to patiently answer the questions of the class “know it all”; acknowledge the value of their contributions; then use the opportunity to extend the discussion to others so that they don’t monopolise the air time too much, to the annoyance of others in the class. This means I don’t have to set up situations that might embarrass them. After a while I find that most “know it alls” quieten down because they feel that their knowledge is recognised and appreciated, and they feel less of a need to “display”.