Leading from The Middle – Every Initiative Depends on Effective Front-Line Managers

It’s time for organizations to build effective front-line teams and that means understanding the challenges facing front -line managers and giving them the tools and skills to succeed!

Every important organizational initiative – patient safety, cost-containment, employee engagement, new technology adoption –  depends on front line managers.

These initiatives fail if managers can’t lead, organize, problem solve, motivate their teams, and create a culture of accountability.  Fortunately, more of our clients realize this and are investing developmental resources in front line managers.  These projects make a real difference for the managers, for patients and for other staff.

Being a Nurse Manager is Hard!

Being a nurse manager is difficult.  You have to navigate between leading frontline staff and pleasing senior leaders.  Often, being “sandwiched” between these two entities is tricky because they have different goals.  Staff are focused on  patient care, and daily operations.  Meanwhile, senior leaders have to look through a business lens and manage workforce costs, productivity, bed occupancy, revenue and expenses.  

In my recent work with nursing managers, I hear the following common frustrations: 

• They have clinical skills but have had no training on basics manager and leadership skills
• They feel like they are being asked to serve two masters with competing agendas
• Patient safety can be compromised when executives favor the bottom line and don’t appreciate the issues facing the staff
• Managers gets distracted putting out daily fires due to lack of leadership support, and staff shortages
• They are not well-equipped or experienced-enough to manage unhappy physicians – who can be disruptive, territorial and unprofessional – creating animosity and a lack of trust.
• Issues with other departments, particularly when roles aren’t clear, and overlap. 
• Nurse managers are, on the whole, highly, considerate and motivated to do the right thing.  They tend to function with a high level of empathy.  Being highly considerate, though, they often struggle with difficult conversations and  don’t know how to command the respect they deserve.
• Female nurse leaders are at times bullied or harassed by their male bosses or egotistical doctors.  (See our recent blog about the unique challenges facing female physicians)

It Starts with Self-Awareness

Organizations often commit resources to developing senior leaders.  With a small investment, they can deploy scalable resources to make managers more effective and have substantial positive impact.  Just like when we work with leaders, we start by giving nurse managers tools to improve their own self-awareness.

Nurse managers that are not self-aware may automatically handle the challenges listed above in ways that not only don’t serve the organization, but also impede their own career success and make it impossible to create a positive work culture for their teams. 

Managers can become frustrated with their employees and the system and not appreciate the role they are playing in excurbating the issues! 

 Once one person is different in the system, the whole system is different. It’s easier for the manager to change their own behavior once they improve their own self-awareness and have the tools to change their behaviors.. Effective nurse managers are able to;

• Be fair yet firm with employees
• Give clear instructions
• Delegate appropriately
• Engage in difficult conversations professionally, and in a timely manner
• Encourage and empower their employees
• Act as “Head Learner”
• Advocate for themselves and their people, while meeting the needs of the “business” of healthcare.
• Bring together different departments for the greater good
• Build powerful teams (See our recent blog on building high-performance teams)
• Create a culture of psychological safety.

The Results

When we invest in managers, through targeted training and coaching, they report:

• More effective communication among managers and their teams
• Better team cohesion
• Enhanced team trust
• Less time putting out fires

Once a manager has the tools and a road map, they can hone these skills and become a powerful leader.  It’s a disservice to managers when organizations fail to provide the basic training and support they need.  The result: frustrated managers, frustrated physicians, unmet goals, poor employee engagement, and retention.  It’s time for organizations to do the work to build effective front-line teams and that means understanding the challenges facing front -line managers and giving them the tools and skills to succeed!

To learn more about our approach visit us at www.j3personica.com

Jena Jake, M.A., is the Executive Vice President of Coaching.  Learn more about our entire team!