She was too busy fighting crocodiles…
She had reached the end of her endurance and felt empty, sad, anxious and defeated – and still didn’t want to give up. It had been another bad month with 10 staff short. Anne (not her real name) was on the floor more times than managing the unit. She was now so far into the minutia that she could no longer see her way out of it. The saying “so busy fighting off the crocodiles that you can’t drain the swamp” was made for Anne’s situation.
“I just can’t see this changing” she cried. “I don’t know what else I can do – I am already working over 12 hours a day, working weekends…”
She is pulling these herculean hours because she still cares deeply about her unit, her staff and her patients – but it is only a matter of time before she doesn’t. And while she continues to plug the gaps, doing the vacant shifts herself, her boss is blissfully unaware of how serious and precarious her situation is. While Anne is so busy doing the work, she has no time to change it – no time to prepare a case for getting more people to do the work that needs to be done.
Anne is not alone. I know so many nurse and midwife managers at all levels in the healthcare sector who have expressed similar despair. The thing is that the system is not really designed to meet demand – certainly not in its current form – so they are fighting a losing battle unless they change it.
So, what can Anne do? Here’s what I would suggest Anne does:
- Fight for some dedicated time to prepare her vision for a better future and a strategy to achieve it. This means blocking out at least a day – preferably away from her unit.
- Prepare a very detailed, clear picture of what is needed to meet the expected demand on her unit. There are 2 steps in this visioning work:
- What is expected of her unit – check out the organisation’s service plan, strategic plan – and, if relevant, statement of priorities.
- What workforce is needed to deliver these services – realistically!
- Identify the gap between her current situation and what is expected?
- List what strategies and resources are needed to fill these gaps. Could be more people, but it might also be redesigning how work is arranged and who does it. Anne will need to be creative – and be open to ideas from her staff and even her boss.
- Do a cost – benefit analysis for at least the first 2 options:
- Doing nothing – Set out what can be achieved realistically within current resources. The costs are the current issues that Anne is experiencing because of the gaps. If things are seriously bad, then one of the real risks must be that people will leave, including Anne!
- Implementing her strategy – The costs of Anne’s strategy needs to outweigh the cost of doing nothing.
- The third alternative – this option is the one that might emerge from the conversation she has with her boss that is even better than ‘a’ and ‘b’.
The point is, that Anne needs to do and say something, or nothing will change. Taking this approach, Anne explores the situation a little more dispassionately and can present it in a way that is compelling, and in a language that is hard to ignore. And of course, if ‘Do Nothing’ is the option her boss choses, then Anne’s path is clear – she accepts the current situation and stays, or she doesn’t accept it, and leaves. Because in the end, we have only 3 choices when we are faced with a bad situation – we change it, leave it, or stay and completely accept it.
Let me know what you think and if you have any other suggestions.
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By the way, if you want to know how to prepare a workforce plan for your unit, and the most effective strategy for attracting people to fill the gaps, then get ready to join us on the Clinician 2 Empowered Leader Journey.
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The Journey is perfect for nurses and midwives who want to learn how to manage with less stress and more confidence. The journey will take you through the critical competencies needed to manage a team, resources and yourself! You’ll get the know-how, videos, tools and templates that you can apply to immediately help you in your work. And of course, there will be a community of people who can share your journey with you.