Confessions of A Hospital Administrator: My Job Got Easier When Nurses Got Happier

That hospital administrator you don't like is probably more stressed and scared than you are. But it doesn't have to be that way for either of you. Nurses General Nursing Article

Confessions of A Hospital Administrator: My Job Got Easier When Nurses Got Happier

I was reading through the ongoing Winter 2016 Nursing Article Contest at allnurses. I came across one entry, an unpublished letter titled, Dear Hospital Administrators. A sentences that particularly stood out:


If you want to improve customer satisfaction you must make sure your nurses are happy. Ask any nurse and this is what he or she will tell you. Happy nurses equal happy patients.

This letter broke my heart - not just for the nurses, but for the administrators too. Because I'm here to tell you they are unhappier than you nurses are, but they just don't know any better. At least at the end of the day you have the ethical pride that comes from helping patients. You make a hands-on difference. But the average hospital administrator leaves at the end of the day feeling like a dog that has been trapped on the freeway.

Here's why: most hospital administrators are taught to be command and control leaders. A command and control leader is taught they are the problem solver, the idea person. If they can't figure it out, they are a failure. So most administrators scramble every day to hide the fact they can't meet such impossible leadership standards. This is why they piss-off nurses and everyone in a hospital because no one can manage that much detail. It's why they stay off the floors because they don't want to hear how they are failing you.

The best day in my career was when I figured out that if empowered the frontline to tell me how their job should be done, my day got a lot easier. Not only do nurses, therapists, housekeepers and the kitchen staff know the solution to the problems they face every day, when it is their ideas to make changes, it works. I learned that nurses are smart people who will quickly find a work-around to my lousy idea to fix a problem or improve efficiency.

Here's what happened when I created a bottom, up culture: I worked a few hours less every day; I was called at night a lot less often; profits went through the roof because nurses and patients were happier; quality and outcomes put our hospital in the top 15 percent in the country; and I got a standing ovation from 300 employees who lined the hallway from my office to the front door on my last day.

Changing culture is easy to say and hard to do. Because it means command and control leaders have to make the transition to servant leaders. Servant Leaders share decision-making. They create such an environment through a shared set of values and behaviors. It takes about 18-24 months to make this transition if its done right. But here's the kicker - it means that nurses have to hold each other accountable to these new standards. And not every nurse makes it because there are some people who thrive being employed in a dysfunctional work culture.

In my next post I'm going to talk about some strategies that you can take to start building an inspired workplace culture in your hospital. It can start with you and your department. Then when your performance metrics begin to get noticed by your Administrators and they come around to ask what's going on, you can smile and say - "It's because we're happier."

Don't be surprised if your command and control leader wants to be happier too.

John W. Mitchell is a retired hospital administrator and author of the hospital novel “Medical Necessity”. In 2009, he and his administrative team were named "Top Leadership Team in Healthcare for Mid-Sized Hospitals" by HealthLeaders Media.

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I am so happy to read this. As a new manager recently promoted from staff level RN, I know what frustrates nurses. Of course as a manager, I know and understand the business concepts of an organization. I have been saying this all along, happy nurses equal happy patients. Of course you cannot make everyone happy and the truth of the matter is you may have to let go of "bad staff". I want my nurses to be happy coming to work - I can see and sense the excitement with me as their manager however, It is important that I hold them accountable. This was very inspiring to read.

Specializes in Administrator inspired by nurses.

Thank you Cyndylou. The best moment in my career was when a unit secretary who did not speak to me for the first two years told me that, for the first time in 25 years, she looked forward to coming to work. That's when I knew I was on to something. Creating an inspired work force is the easiest way to be in charge. A servant leader still holds people accountable, but to standards the frontline agrees upon.

Thanks for this! Administrators are generally a difficult read, but your post help to de-mystify them.