Cranky Nurse Leaders; Don't Become the Monster You Worked For

THIS ARTICLE IS BEING RE-RELEASED FROM 10/31/16

Whoa, apparently I hit a nerve when I released The Epidemic of Entitlement in Nursing, and some people are assuming that I equate experience with good leaders. That is so far from the truth, and we all know what happens when we assume. Time can jade those crotchety old leaders who think it's "my way or the highway." Time's are a-changing in healthcare, and we have to put as much hard work into being a good boss as we do into getting to that title in the first place. For Round 2, I present...

Improving Workplace Culture in Healthcare…and How NOT to be a Monster Boss

I find it’s only fitting for today that I start this article with a spooky story. The following is an actual conversation I had between a candidate and myself, and is not for the faint of heart. 

Me: "So what was the reason you left the hospital?"

Candidate: "I worked with the same hospital for ten years, and last year they hired a new director for our unit. All seven people on the leadership team told our Chief Nursing Officer that we didn’t think that he would be a good fit for us, but our CNO assured us he was “the one” for the job. On the director’s first day, he told us “If you don’t like how I do things, you can leave.” And most of us did. Five out of seven members of management left within the year."

Me: "If you could give me the ultimate reason why you think everyone is leaving, what would it be?"

Candidate: "People don’t want to work in a negative environment where they are not appreciated, or even seen as necessary…"

I wanted to get this horror story out of the way, so we can pave the way to happier tales. Healthcare is changing more drastically than ever before. Bundled Payments, the Star Ratings adjustment for 2017, and new EMR roll outs to name a few. So what can we control? We can control the culture we create in the hospital. Culture is the character and the personality of the organization based on the sum of its values, beliefs, behaviors, and attitudes. Let’s deconstruct what makes a great hospital culture.

YOU CAN’T HANDLE THE TRUTH! Oh wait, you can.

Everyone in healthcare who has been in it for a minute knows about the Studer Principles. Every hospital wants to be “on the path,” and excellent leaders know the foundation is investing in the nurses that staff the front lines.

“I round on my staff twice a day at least,” said Nicole, an ICU Director who has been with her hospital for twenty six years. “You’ve got to be transparent with your staff, because it makes them feel safe. They trust me because I tell them the whys behind every hospital initiative, every plan, and lay it out on the table for them. Because they trust me, they tell me everything going on in the unit. They have a voice, and I don’t just hear them…I listen with action.”

Leaders truly want their employees to do well at their job, but that sometimes requires having not-so-easy conversations. Delivery is the key in communication…and genuine concern for their wellbeing is the foundation. “You can’t get a pulse if you have a prescribed list of questions…” said Tora, another ICU Director. “You’ve got to have that human connection with your staff. They aren’t robots. Treat them with respect, and it will be reciprocated. Respect is honesty.”

Coach often and honestly to get the immediate buy in for the development of your staff. The number one reason why people leave their job is because of their boss, but the second is due to lack of development within their role. When you give people a sense of direction on their career path, they feel invested and will want to advance within the organization that helped get them there. When you leave people to aimlessly wander….of course they choose the exit lane.

Your Employees are Coding Due to Lack of Engagement…10 CCs of Challenge…STAT!

“I’m bored out of my mind here,” said Jason, an Emergency Room Director. “All of the decisions come down from administration, and I have no say in the department. They’re stuck in the prehistoric days of healthcare, and these fossils won’t relinquish any control to the leaders in their units.” Yikes, Jason was not a happy camper. He told me how even the slightest suggestion of process change was squashed by administration. I asked him what impact has that had on his hospital. “It’s bleeding employees, census is down, and patient satisfaction is in the toilet…but they don’t see that a change needs to happen? It doesn’t make sense.”

There are six main leadership styles, and it sounds like Jason’s bosses are part of the commanding group. This leadership is based on a lack of trust and failure to delegate, and is has the lowest probability of success in an organization. So what leadership style has the best outcome? The democratic leadership style has shown to be the most effective because it draws from everyone’s knowledge and skills. As they say, “it takes a village.”

One director told me about the safety huddles her and her staff address every morning. “Everyone tells me what problems are happening on the unit, but only brings it up if there can be a solution. Two heads are always better than one.” Jessica the Surgical Director said. I spoke to another leader who wants to be a Chief Nursing Officer one day. “My dissertation was based on fall prevention, and once my boss knew that was a passion of mine, she put me in charge.” JoAnn said. She’s been a Med Surg Director for several years. “My program is now being implemented hospital wide, and I’m thrilled!”

Empower your nurses to engage in the acts that got them to love nursing in the first place. Unleashing the leadership potential someone has will not only benefit their own personal growth, but the results of the hospital as well. Listen to their long term goals, and give them the tools to accomplish it. If a nurse wants to take a crack at changing specialties, let them try. Each challenge is a rung on the personal ladder we’re all trying to climb. Let them be the solution to your problems. After all, the weight of the world is too heavy for one person to bear.

Recognition: It’s the Little Things

Long ago in a galaxy far, far away…I was not a healthcare recruiter. I was in the retail sector of the workforce, and I had a Monster Boss. She was condescending, manipulative, and drove results out of fear. It was the week following Black Friday, and I had worked an open to close every day. She called me one morning, and started with the robotic pleasantry of “Good morning, how are you?” And the moment I told her I was fine, she came back with “You know…I was disappointed you weren’t number one in the region. I’m just unsure of your dedication, Krista.”

She never mentioned the fact I was number two. I’m obviously not there anymore. That might have been the worst month of my career, and I left that job for another one with less pay. Monster Boss was an inspiration to me, and I’m grateful for that experience. We sometimes learn who we should be, and who we should not. It was a lesson in appreciation, and recognizing when someone is going above and beyond. A thank you can go miles, and the effects of positive reinforcement can make a permanent impact that transcends to others.

Michelle, a Telemetry Manager, has made a “Moments of Excellence” program to recognize when staff in her unit are going above and beyond. “I drop a thank you note in their box, bring by little chocolates when they’re caught doing something great. People want to be acknowledged when they exceed expectations. If we ask our patients to do these dang surveys, why shouldn’t we do the same for our staff, and attend to their human needs as well? All it costs is time, no monetary incentive required.” I asked her if there was one thing I could relay to hospital administrators, what would it be. “Remember people’s names” she said. “I am not just an ICU Director…I am not results on paper. I am a person, treat me like it.”

To Sum It Up

The invisible architecture of any solid organization is its people. Some buildings are constructed with the bottom line in mind only…and money can’t buy happiness. Compensation is never the main reason why people leave their job. Other organizations tower over the competition, because the legend of their incredible culture attracts talent far and wide. Be the hero you want people to hear about, don’t be a Monster Boss. I speak to healthcare professionals for hours a day…and when I ask them about other hospitals, I hear one of two things:

“I hear that organization is awful and would not like working there. I love where I’m at and would never leave!”

Or 

“I hear that place is great. I’ve been thinking about making a change…can you get me an interview with them?”

Which way would you like your employees to answer me?

-Written by Krista Whiting on 10/30/2016, Graphic Credited to https://www.digitalbossmonster.com/ 

If you need the help of a recruiter, whether it is to attract the best talent or look at new opportunities in healthcare, email me immediately. 

Go look at my current job openings, or tell me about an opportunity that I should keep in mind for you.