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I have worked in my organization for over 8 years and have worked for several different leaders/managers during this timeshare. There have been leaders come that have not been able to gain the trust of staff, and as a result, I also saw them go. I have seen the other end of the spectrum as well. The leaders that base their relationship and interactions with their staff on a trustworthy foundation, is able to maintain a healthy, strong relationship that will continue to grow stronger and stronger.
As long as the leader continues to work to prove heir trustworthiness, the staff will continue to remain engaged and focused, all working towards the same goals as the leader. Trust is something you may have one minute and then lost in the next, often times, without even knowing it. For this reason, I believe the book The Speed of Trust, is one that every new and seasoned leader should read and refer to in times of challenges, whether it be a specific situation or staff that are really testing the leadership. Our organization Just recently built a new facility. As with any change there have been many growing pains along the way.
Our Journey has been extremely satisfactory but has also been very trying. The experience I would like to explore is one off new manager in our organization. I have been a leader on my unit as a charge nurse for several years and was the interim manager for 8 months as well. Being a new leader had many challenges along with it, one being the trust of my staff. With all the doors that got slammed in our faces, we had to persevere with dignity and determination to provide the best possible scenario for our patients. But it was not an easy road. One challenge that we have had since the opening of this new facility is staffing.
When we opened the new hospital, the old one did not close. This was where I was the leader of what remained a very fast-paced and acute care medical/surgical unit. We have been blessed at both facilities with many patients. Often times with all the beds full at both locations. The principle of reputation, market trust is something that our organization has built. It has been somewhat of a struggle for all staff, including leaders, to make the right decision of here staff needs to be. The new facility has lots of resources including a separate IV team, a separate code team, and a rapid response team.
Our facility did not have a separate team for this; rather the Nurse Leader (ML) in 2 areas; the house supervisor and the physicians make up these teams. These additional roles that have been added to the Nurse Leader’s plate adds to their everyday challenges and struggles, especially when staffing is stretched to the bare minimums, which was happening daily and the staff were not feeling supported. Our nurse leader model that we follow calls for a Nurse Leader (ML) for every 18 patients. In the new facility the nursing units are made up off 36 bed unit. Each of these units when full gets 2 ML.
The old facility has a 24 bed unit and a 16 bed unit. Together they get 2 ML. Both facilities having several open positions and staffing normally cannot fill all the openings. As an organization we needed to come together and figure out what is most fairest and most efficient way to divide staff up that provides quality safe care to all of our patients, not Just the patients at the new hospital. As new leader, it was even more important for me to keep the respect and trust of my staff by being their advocate in times of need, but I also had to remain open-minded in dealing with my co-workers and other leaders within the organization.
One solution would be to have unit responsible for their own staffing. A pro to this is having the unit manager take accountability in making sure staffing is adequate. At the same time we ask is it what is best for the patients? It could require staff to work over their compliment including up to 16 hours at a time. Will staff be more upset and leave? How will this affect our patients’ outcomes and quality of care? Will the integrity of the hospital lessen due to the exhausting and overwhelming staffing situations?
Another solution would be to sit down and talk about staffing as whole and together come up with the best solution and send staff where the most desperate need is. A pro to this would be that everyone can see the “big picture” and see what everyone else is working with. One of the problems with this is if a unit gets staff to pick up to make sure they have a ML without an assignment, there is a good hence that they will get pulled to balance out the numbers, most likely deferring staff from picking up extra time. Will staff quit picking up?
Will this lead to leaders not being accountable for their staffing needs? Another solution was to have all the directors and managers sit down and discuss exactly what needs to be done to help the critical staffing situations. By doing so, it was determined that nobody really understood what everyone was responsible for. As leaders, this was our responsibility to make sure that everyone understood. In neglecting to do so, we were demonstrating behavior that could be interpreted as “not caring” or “not seeing all the hard times they were going through”.
This opened up our eyes especially mine. I learned that I need to make sure that I improved my communication with the staff and make it known what the expectations are so that everyone sees the whole picture. This helped them come to grasp with the staffing, by knowing why we are doing what we are doing. I understand that everyone benefits from having a ML without an assignment and when you work hard to get the staffing numbers where they need to e and someone gets pulled to another unit it does not feel good.
However, it is not about how it feels, it is about our patients. We need to make sure we have the right staff in the right place at the right time. This needs to be communicated well with staff so they can better understand. During this time of change in our organization, I have learned that I need to communicate better with staff. Building trusting relationships and gaining the respect of my staff was a huge priority for me, but I also needed to develop and maintain trusting legislations with the other unit leaders within the organization.
I was very fortunate to work with such great leaders that all helped me see how they manage their area and as a result, have gained a lot of knowledge on what makes a great, fair, and respectful leader. The information I learned from reading The Speed of Trust and the information from this course will only help me grow as I continue to work on creating and building trustworthy relationships with those in my organization and also in my personal life.