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Stop Tolerating Bad Managers

Rebecca Hendren, for HealthLeaders Media, October 11, 2011

There are three steps executive leadership can take to change a culture. These steps set behavioral expectations not only for nursing managers but for all employees.

1. Create a foundation of trust 

“The first responsibility of healthcare leaders is to create conditions for trust,” says Bartholomew. “This can only happen when all staff are held accountable to the same rules.” A hospital’s culture will change only when everyone sees that the same rules apply to everyone, from the housekeeping staff to nurses to managers to surgeons.

2. Demand better behavior

Explain what behavior is acceptable and what is not, from shouting to gossiping. Don’t limit only to what is said out loud. “Ninety-three percent of all communication is non-verbal,” says Bartholomew. “Call out all non-verbal behaviors.” This includes eye-rolling, sighing, making faces, and ignoring, which can be as damaging as something said out loud.

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4 comments on "Stop Tolerating Bad Managers"


Jennifer (10/30/2011 at 12:02 PM)
I found this article and response comments frustrating on levels. There are those managers who continue fail to meet performance expectations and they should be coached and counseled appropriately up to and including exiting the organization. I have fortunately met very few of those people as a staff member or a leader but they are frequently the ones the physicians like and go to bat for. There is more to explore when discussing "bad managers". Executives who have bad managers might need to look no further than in the mirror. Lack of support, lack of mentoring and failure to communicate and set expectations is a commonly voiced frustration of front-line managers. Combine that with a huge workload including productivity, documentation,risk,financial/regulatory audits,multiple performance reviews and working with staff who frequently make more money for much less accountability. Its not surprising nurses are not interested in leadership roles given what the job entails. Management is the art of getting work done through the contribution of others. Managers are often told by senior leaders; its their responsibility to "get staff" to do things. Many of us know how effective those kinds of directives are. To really change the culture of healthcare executive leadership could start investing in manager selection, development and performance management. Look realistically at span of control and workload for managers and consider flexible schedules and other creative ideas for salaried managers to increase their satisfaction and retention. Managers are employees too- take the time to find out why they are failing, what motivates them and the tools they need to be successful.We might have less "bad managers" out there than we think.

Darlene Hall (10/13/2011 at 1:15 PM)
Too often, as with poor patient satisfaction surveys, staff nurses are blamed for the low scores rather than the managers themselves who are not part of direct patient care. The new healthcare reform has changed healthcare reimbursement based upon patient satisfaction/experience thus causing a decrease in nursing workforce in some instances. This in turn, leads to a top heavy facility with managers that try to create nurses who are completely submissive, afraid, and are controlled. Unhappy nurses leads to unhappy patients.

John J Simon III (10/12/2011 at 12:27 PM)
I understand that this is a nursing site but I think all patient care leaders need to be strong representatives of compassion not only towards their patients but also to each other. We need to have those crucial conversations while creating the atmosphere of trust. Bad behavior on the part of authority can be a safety issue. If an employee sees something at the initial point of being potentially unsafe and does nothing for fear of reprimand we might be performing RCA's.