You Will Be Hated: An Open Letter to Aspiring Nursing Home Administrators

Dear Aspiring Nursing Home Administrator,

You will be hated.

It's an inevitable truth and unfortunate reality. Even for those of us with "considerable people skills" that like working with people.

It's one of the reasons I pursued my license to run Nursing Facilities. I wanted to love on and remind our seniors their lives still matter.

I wanted to work with people who care about people.

I also like having a say in decisions, being able to influence teams, impacting the communities I operate in, and I really like being liked.

I can't help it.

Some blend of nature vs. nurture created this thing in my brain that makes me want to get people to like and trust me (especially if I can tell they really don't want to like me).

There's this weird thing that happens though, when you are the decision-maker for a company with 150+ employees serving customers that are injured, sick, or dying... that have just lost their sense of self and dignity.... that are spending their first night away form their spouse in 50 years.... whose families are sure there is more to be done... during the middle of a pandemic (need I keep going?) - You sometimes end up, as I like to call it, "Undesirable #1."

I struggled with this for months.

I signed up to be the source of inspiration and joy, not the face of the "who-can-I-blame-for-things-I-can't-control" club.

What I probably could have brushed off for a while eventually grew into something much more consuming and much more difficult to ignore. The unanticipated outcome of holding this particular leadership mantle came at me from multiple angles:

From patients and residents wanting more control and freedom in their lives...

From families scared and angry that their loved ones may not make it...

From employees feeling unjustly held accountable...

The list goes on.

Those first couple of years I felt immense internal tension - This can't be MY fault. Why would they think I don't also want what's best for them. This is obviously not something remotely in my control. Why are they mad? Why does it have to be so stressful all the time?"

It was Fr. Richard Rohr's words while being interviewed by Brene Brown on her Podcast Unlocking Us that started to shift things for me.

"...but it’s so many people who are talking to me and raising their hands, waving in the room, they weren’t dealing with me, they were dealing with their dad. And they needed to change me, because they hadn’t met me yet. They assumed all kind of things about me, and because I’m white and American, clergy, so I can understand, but so many people were dealing with their issues through me. Now, once I learned that, and I stopped resenting it and fighting it, and began to allow it, I can let them hate me, I can let them mistrust me, the doors broke open of committing counseling relationships, but if I would try to defend myself in vulnerability... Basically the healing relationship was over."?

Fr. Richard Rohr, of course, was speaking to the prevalence of father wounds in today's world and how he often felt the people he was pastoring were taking out their "daddy issues" on him, the next nearest father figure. He goes on to describe the profound inner-shift it took to stop trying to defend himself, attempting to remind the people that he was not at blame.

It was only once he started allowing people to express their anger and hate in his direction, that he was able to make incredible progress in their counseling relationships.

Listening to Brene and Fr. Richard's podcast moved me to tears during my commute that morning. I hated when I realized what I needed to change internally and encourage in my teams.

I needed to move away from the typical "win and succeed" mindset and toward a posture of "be willing to be hated to make a meaningful impact."

In one of the most regulated industries in the USA, Administrators and leaders are inadvertently groomed to take a defensive "let-me-show-you-how-we-are-actually-not-at-fault" approach to complaints and audits. So, not only was this asking a lot of someone with a personality like mine, it was also asking me to completely change a posture held by the vast majority of those in the industry.

During our morning meeting that day with my department heads I shared the insights I gleaned from the podcast episode. Specifically, I requested our team to start asking ourselves what's at stake during those tense interactions - their dignity? or their ego?

After a great discussion with the team, I posed the following questions to our Director of Nursing and our Human Resources Director:

"What if you allow them to just hate you for a minute?"

"Would you be willing to not correct them in order to better reach them?"

I will never forget the tears on our Human Resources Director's face as he considered these questions.

The following weeks the difference in the air was immediately noticeable.

From uncomfortable conversations with employees that had stepped out of their integrity to conversations with crying daughters about hospice care decisions, allowing them to point their hate, fear and anger at me for mere minutes allowed for vulnerable and meaningful conversations to take place. You know what surprised me most? These conversations were almost always followed by a handshake or hug with an apology and display of gratitude. Turns out anger is almost always a secondary emotion.

So, to the aspiring Nursing Home Administrator: If you are going to wear the mantle and make hard decisions, You WILL be hated. How are you going to respond?

To the administrator continuing to show up day in and day out, I see you. You are doing incredible work. You are making a difference every day.

Many Blessings,

A Former Nursing Home Administrator