5 Things Your Nursing Leaders Wish They Could Share With You

 

The environment in the healthcare industry at this time is turbulent and chaotic, at best. Changes in the healthcare laws coupled with a labile economy is forcing many organizations to explore strategies to control costs, some of which may included changes to service lines or even cost containment at the bedside. Nursing leaders will need to be at the table when these decisions are made and oftentimes conflict arises in the fact that this information cannot be shared with staff until they have been fully vetted and strategies have been selected and plans created. Conversely, it is not uncommon for staff to feel out of the loop or even betrayed with some of the decisions that they hear. I asked 35 senior nursing leaders throughout the country what are the top five topics that they would love to share with their staff but cannot.

Internal politics

All organizations, regardless of type or size, have internal politics that must be navigated by the nursing leadership. Nursing leaders need to be savvy in both the awareness of the political landscape but also in the way that environment is managed by them. This may mean alliances with individuals that can help the nursing leader advance the mission of the nursing organization. At times, these alliances may not be seen as positive by the staff and in certain situations may be perceived as being “sold out” by the nursing leadership. This is not the case; nursing leadership has the best interest of their organization at heart and needs to work the system for positive gains for their staff.

Upcoming change and strategy

All plans and strategies begin with ideas. These ideas are discussed and evaluated for the extent of their outcomes on the organization. Many of these ideas will be profitable, many will not be profitable, but most of them will affect the staff in some way, either positively or negatively. For the most part many of these will not be considered after the initial review. At the time of discussion, however, this information cannot be shared with the staff, especially if it would create conflict or fear in the staff and then ultimately be discarded from consideration. This would create problems unnecessarily. For these reasons, even though the nursing leadership would like to communicate these ideas, they cannot.

How leaders really feel about changes and orders that come from above

There are times that strategies are decided or changes made by the top administration that is not palatable to nursing leadership. Changes to paid time off, salaries or layoffs may fall into this category. Even though the nursing leadership is not happy with the decision, it becomes more important to support the staff through these unpopular decisions, especially when they have no chance of being revoked, regardless of the potential problems with them.

Nursing leaders are afraid of the future as well as the staff

A strong leader needs to lead with confidence and conviction. Human beings all have fears of the unknown or concerns for the future; however, you will not be able to read that in a strong leader. The nursing leaders that I spoke with were all afraid of the effects of healthcare reform on their nursing organizations, such as a need to reduce staff or eliminate divisions or service lines. These decisions, although potentially necessary, will affect lives of many staff members. Another common fear among these leaders is the outcomes of consulting engagements and what will be expected of the nursing division following their analysis and recommendations. The more confident and strong the leader is the more comfortable and cared for the staff will feel.

What leaders really do

Just as staff nurses may feel that nursing leaders do not appreciate their roles or how hard they work, the same thoughts exist in the minds of the nursing leadership. An effective leader will work hard and unconditionally support their staff oftentimes in an environment of hostility. It is not appropriate for leaders to whine or complain about how hard they work in their roles, however, as the environment continues to become more unsettled, their roles are getting harder and more complex.

There were many other topics that this group of nursing leaders stated that they would like to share with their staff, but these were the top five and the ones that caused the most conflict in their hearts and minds. What is important to remember is that everyone in the organization plays a critical role in its success regardless of what position they are in. It is important to remember that all nursing roles have challenges. It helps to mentally try to walk in the shoes of all those we work with and to try to appreciate the inherent conflicts. All of the nursing leaders represented in this article spoke of the sincere caring and respect they have for their staff and the fact that their sole responsibility is to make sure that the nursing division is supported and appreciated by all in the organization.