The Perils of Perfectionism in Nursing

Rose O. Sherman, EdD, RN, NEA-BC, FAAN


Am Nurs Journal. 2020;15(3) 

In This Article

Abstract and Introduction


Jackie* is a director of quality management at her organization. She prides herself on being a perfectionist in every aspect of her life, so she's surprised when feedback on a recent 360-degree evaluation indicates that her direct reports and peers find her difficult to work with. Their observations include "She edits all written work done by others (often with comments that don't add value)" and "She rarely fully delegates projects to her staff without a significant amount of micromanagement." Jackie also has been tagged as indecisive; she believes her deliberative decision-making approach avoids errors. Jackie's supervisor asks her to review the evaluation and develop an action plan to dial down some of the perfectionist tendencies that are impeding her effectiveness.

Jackie's challenges aren't unusual for those who pride themselves on being perfectionists. Perfectionists usually can't see that a threshold exists to adding value to conversations, projects, or written work. Beyond a certain point, their ideas aren't value-added and their behavior becomes frustrating to others who are trying to complete a task. Ultimately, perfectionism can derail a leader's success. Jackie's exacting standards make it hard for her to let others do their job. She frequently decides to do the work herself so that it will be "done right." The outcome is that she's overloaded with work, and her team members aren't growing in their roles.

Perfectionists like Jackie have the mistaken belief that every job or project has a perfect outcome. They set an unrealistically high bar for themselves and others. No matter how much work has been done on a project, they may feel that it's not good enough and continue revising their work and that of others. In a chaotic and rapidly changing healthcare environment, maintaining this level of control is an illusion.

By their nature, perfectionists want to make the very best decision and frequently believe that even better alternatives exist. Failing to act in a timely manner may mean forgoing critical strategic opportunities and can result in turnover of frustrated staff. Jackie's supervisor is wise to push her to examine the perils of her behavior and to dial down her perfectionism. But behavior change will be challenging because perfectionism may be deeply rooted in feelings of anxiety and insecurity.

*Name is fictitious.