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 I came across one entry, an unpublished letter titled, Dear Hospital Administrators.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:QuoteIf 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. Down Vote Up Vote × About ServantLeader 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. 3 Articles 42 Posts Share this post Share on other sites