We’re Great Clinicians With No Time To Be Great Leaders (Lesson 1)

On a recent visit to a site, I asked a team of 90 staff members how many leaders were at the facility. Their answer was one.

When I asked, “What about the nurses and the deputy services manager?” their response was, “No they’re all clinical.” The belief that nurses and deputies could not also be leaders meant that all leadership issues were viewed as the responsibility of the service manager.

Technically, there would have been 16 leaders on this site with 90 staff, but everybody saw only one. This belief is common within aged care organisations, and it creates a massive bottleneck of issues that often don't get dealt with.

Everybody, at every level, is relying on one person. As a result, service managers are burning out—they’re feeling completely overwhelmed. If everybody believes that there's only one leader, and that none of the challenges that arise within the site can be managed by anybody other than this one leader, then this is the inevitable result.

Of course, the perception that the service manager is the only leader is not only coming from the frontline and clinical staff—it’s also coming from the service manager themselves, as well as from further up the chain. Even the executives feel that RNs and ENs are not leaders. They may rationally understand that these roles have leadership components, but it's not always demonstrated through support that actually makes these people leaders within the organisation. For instance, clinical staff may not be provided with the requisite training or the self-belief to fulfill leadership roles.

Receiving training in these leadership skills would provide RNs and ENs with the ability to diffuse situations, give feedback, get people on the right track, and give them direction—not just in a clinical aspect, but across the board. It would allow so many issues to be resolved at the point at which they arise and enable the site to run far more efficiently.

 More Than Just Clinical

RNs and ENs know how to lead clinical conversations and give directions in clinical matters. They might have learned how to communicate with families and give information to clients and carers, but they may not have learned the art of leadership, which requires two-way communication.

One sticking point is that nurses often feel that carers don't respect them and therefore they're not going to listen to what they say. Their belief is that carers don't see RNs and ENs as leaders, and so it makes it impossible for the people holding these positions to be respected as leaders.

A lot of the leadership programs that organisations put their staff through are targeted at service managers and people at executive levels. By upskilling frontline workers—RNs, ENs, and even selected carers who have some of the qualities that will help them to take on a leadership role—organisations can help to ensure their top-level staff are not overwhelmed.

This also helps to address problems at a grassroots level, so that things are quickly and efficiently resolved, before they either grow out of proportion or get added to an ever-growing pile of issues—which inevitably need to be addressed by a very small number of people whose time and attention would be better served by overseeing the organisation or site, rather than getting swamped with the minutiae.