I was surprised when they called and asked me to come and teach a workshop called "Coping With Chaos."
Being a small urban hospital in the central part of the United States, they had been achieving moderate success by expanding their services with new clinics to meet the needs of their aging community. They also had focused on becoming more user friendly with a higher level of patient/customer service.
"What happened?" I inquired.
"We are going through a very rough time," the head of HR replied. "We experienced a time period of low census, and some people in executive positions panicked due to the numbers. So we closed one wing of the hospital and merged the medical and surgery floors for a more efficient use of our resources. I hope you can come soon.”
Fortunately, my schedule had an opening, and I agreed to come.
The morning I arrived to teach, I was surprised to find only 18 floor nurses at the workshop. I was told that I would be seeing 20-30 supervisors and part of the management team, along with only a couple of floor staff. As the day progressed, however, management never showed up, and only one supervisor dropped in for 35 minutes over lunch.
About an hour or so into the workshop, the root of the problem surfaced. Many of the floor nurses had not been against closing the wing; they simply wished it had been done in a respectful manner. As one veteran nurse of 19 years put it, "I came on shift at 11:00 p.m. at night to find a sign posted on the door of the wing of the hospital. It read: ‘Closed. Report to Third South. If you have any questions, put them in writing to the Nursing Executive before 7 am.’ We knew that the census was low. We just wish we had been included in the decision-making process and treated with respect.
"It was obvious once it had happened, that management had been thinking about this change for quite some time before they did it. Around here, nothing moves particularly fast. Why couldn't they have provided us with advance warning, or asked us for our insights into formulating these changes? We would have helped, but this method of decision making doesn't exactly encourage trust and participation.”
As we progressed, many feelings came out that needed to be expressed. So I pushed my teaching notes aside, and we dove in. But it was during lunch that the real healing began.
"We know what is most important," one floor nurse began, "Our patients and their care. We are willing to work hard. We just ask for a little more support and kindness. I guess we will have to start by supporting each other." Through hugs, tears, and open sharing, they worked through the changes and moved on.
At the end of the day, I reported what had taken place during the workshop to the HR Director. Her response was: "I know that these are valid insights, but they won't change how we do things. We have to run a lean ship now that change is coming so fast."
While I could recognize the external factors that led to the decision, it was also clear to me that employees were giving their all to do the right thing for the patients. At the same time, they were being denied meaningful strategic level dialogue and input into decisions that had a direct effect on their work lives.
Remember: Leadership without strategic dialogue is demoralizing and will not transform challenges into achievements. When faced with significant challenges, leaders need to manage endings as well as new beginnings.