Safety Culture & Virtue 9: Managers (7 mins)

How does the administrative wing respond to scrutiny? We are wired to have a fight or flight response, but surely there is a better way for managers to handle pressure? Today's podcast looks at examples of great managers who kept a pulse on the frontline and gained credibility in the boardroom for the knowledge they gained.

Key Points:

-frontline expectations

-responding to scrutiny

-building credibility

Transcript

When my husband was in college, he was a manager for a big box store. The night shift was increasingly tardy with offloading freight and restocking shelves, and they complained that it was too much work. So he called them all off for one night shift but asked them to arrive in the morning for a meeting. He moved all the freight and stocked all the shelves that night all by himself and had it finished before they arrived. When he explained to them what he had done, he told them that he liked having a staff of five to unload because it was less likely to cause injury, and they had the budget to do so, but if anyone felt that they could not complete the work on time, he would be happy to take another look at his staffing plan. After that, the team completed their work early and even started to help with setup tasks for day shift. They also respected him. They let him know if anything seemed “off” or if they thought a problem might come up with a product change.

My husband is a brilliant man, but he has never seen himself as too good for hard work. And don’t we all love and admire that kind of approach? In retrospect, I can see that one of two results could come from that decision. Either he would be able to show his staff that the job is completely do-able and that they actually have a very good deal and a generous boss, or he would find that the work is untenable for reasons he simply didn’t know about.

I’ve heard of auto manufacturing giants secretly working the factory line and discovering safety issues in the nuts and bolts of their top vehicle, and those findings saved lives and dollars both, but the immediate managers had thought it was a small and unimportant thing to mention when there were other fires to put out. By identifying the issue and making changes, they elevated the employee voice and set a new standard for managers to not dismiss staff complaints. That’s why managers working a shift on the frontline is today’s virtuous safety practice.

Managers cannot be there every moment, and most managers today are totally overwhelmed by their workload and expectations. So this is podcast is about setting some realistic opportunities to obtain vital safety information that could save you time and money rather than add to your existing burdens. These few shifts on the frontline can be a refocusing moment where all the swirling paperwork and demands become crystal clear and true-north priorities that are set by mission-critical moments you didn’t know existed.

Now, a lot of managers go into management because they physically cannot work the frontline anymore. I get that. But there are still things you can do to help that will put you in the frontline environment. Answer phones, complete an admission assessment, reconcile the med cart, or ask for a list of follow-up tasks that staff are struggling to complete like pharmacy e-faxes and discharge education packets. And if you are physically able, even half of a shift back on the floor can reignite your passion for healthcare and remind you why you loved this job in the first place. There’s nothing like having someone’s grandmother call you an angel just for showing up and doing your job.

Now, there is another option, and too many managers follow this path, and it leads to ruin. What is it? Hiding. Hiding from staff, hiding from problems, living in a constant fear of being scrutinized and then fired. But the sure way to get scrutinized and fired is to not do the job you were hired to do. If you feel like hiding, don’t just go through the motions, but sign yourself up for a shift and then write some notes about the experience. Your staff will respect you, and you will undoubtedly make important discoveries about yourself, your team, and the work you manage.

And if, perhaps, you feel that it’s been too long and you wouldn’t be able to do the job, kudos for your honesty. In this situation, it is wise to assign yourself to one of the preceptors on your unit, and pseudo-train with them. They may be nervous having the boss shadow them and ask questions, but it will give you a chance to hear the things that no one will tell you in a boardroom.

This assessment item is an assignment rather than a yes/no answer. Go and signup for a shift on the frontlines, just once. If you do, give yourself a point. If you hide away and avoid the subject, no points. Because avoiding these experiences by hiding in an office or staying well away from the staff you manage can create situations where your decisions are poorly informed. Creating effective feedback loops can help with this dichotomy, but facing it is even better. And showing up to work will give you more credibility as a manger than any title, degree, or endorsement ever would, while providing an undercover view of the real work that you supervise.

Finally, if you are truly concerned, due to some physical ailment for example, that it would be unsafe to work on the frontline, plan a shift as a customer. Role play as a patient. Plan with the house supervisor to experience an overnight stay in one of the beds, eat the food, and watch the clock that doesn’t move because the batteries were never replaced. Live the experience of the people you serve and talk to staff in the early hours of the morning. While it is not the same as showing up to work, the undercover patient is also an insightful option that will undoubtedly reveal things you’ll never find in a leadership report.