Lead With Intention

Three priorities every new nurse manager should establish when starting a new role as a leader in health care operations

By Robert Trim ’01, MBA, RN

Clip art showing the outline of a face with an eye, ear, nose, and brain around the outside edge.First Priority:

Watch, Listen, and Learn 

As a health care operations director, my first priority when stepping into a new health care operations setting is to observe the status quo before implementing anything. People in established clinics or departments have a way of doing things that has worked. They’re not interested in some shiny, new director of operations walking through the door and implementing the flavor of the week approach to their perfectly serviceable processes. Do no harm, right? Instead, an operations director’s first priority should be to watch, listen, and learn. 

You can’t direct what you can’t see. No new operations director can expect success by sitting in their office and answering emails. The kind of knowledge the director needs comes from the field. A wise director visits the clinics and departments and plans to spend many days there, watching, listening, and learning about the operation, the people, and the processes. 

It’s important to take notes, meet people, and listen way more than you talk. This is the time to gather information, observe, start relationships, and to discover the methods in place, view the department or clinic’s metrics, and above all: reserve judgement. 

Sure, the health care operations director must implement changes, but not for change’s sake and not right away. Take the time to understand people as individuals first, and caregivers and providers second. Also, learn their roles, observe what’s going well, and note what barriers stand in the way of their mission of delivering great patient care. This isn’t just a great beginning, it’s also the ongoing behavior of a successful health care operations director. Make this your first priority and you’ll have strong working relationships built on trust and the foundation for change management. 

Clip art showing two hands clasping.Second Priority:
Build Strong Working Relationships
Look closely at the famous NASA photo of Buzz Aldrin on the moon and you’ll see the image of Neil Armstrong in Aldrin’s space helmet. After all, to take this portrait, someone had to be in front of the camera and someone had to stand behind it. Even though these two crew members were by themselves on the moon’s surface, they weren’t alone. Michael Collins piloted the command module that orbited the moon. Even more scientists, mathematicians, and engineers worked on the mission from Earth. NASA estimates over 400,000 people helped Armstrong take his giant leap for mankind. Armstrong, Aldrin, and Collins had faith in that team to land them on the Sea of Tranquility and to get them home again safely. Strong, empowered teams are at the heart of any successful organization and health care is no different. To deliver on the mission to improve patients’ health and wellness, health care operations directors need to trust in their teams and empower those people to make decisions. 

Building trust is a gradual process. It’s based on listening and communication. It is created by acknowledging stakeholders’ pain points, responding promptly to concerns, and collaborating on real, lasting, meaningful solutions. 

Trust has to be earned. It’s about knowing that the next person in line won’t let you or the mission down. As a director of operations, I know that we’ve hired the right caregivers and providers, and I have confidence in them and their belief in our mission to improve patients’ health and wellness. Because I oversee several sites and departments as a health care operations director, I can’t be everywhere and must delegate tasks and trust our people. My teams know that I have faith in them to solve the problems they can and escalate those they can’t. I believe in them and I’m happy to support them and the decisions they make. 

Armstrong, Aldrin, and Collins didn’t complete the Apollo 11 mission on their own. No health care organization fulfills its mission alone, either. My second priority as a health care director of operations is to make sure that I have strong relationships with my people and that they feel empowered to take action on behalf of our patients. 

Clip art showing a flexed bicep.Third Priority: 

Discover and Use Team Members’ Strengths 

Years ago, I learned to sail on Madison’s Lake Mendota when I was a student at UW–Madison. Sailboats always fascinated me because I appreciated the boat’s ability to harness the power of the wind to send a sailor racing across the water. The wind will blow, so why not channel that energy to speed forward? My third priority for new health care operations directors uses this same principle: harness the power of individual team members’ natural strengths, channel those efforts in the same direction, and watch how the health care operation’s results speed forward. 

Over a decade ago, I attended a Great Manager program at Gallup University, where I learned about Gallup’s strengths research (now Clifton Strengths). Researchers interviewed many leaders and discovered that there was no one correct way to lead, manage, or find success. In fact, they found 34 strengths or talent themes. People didn’t have just one strength; they have a combination of the 34 to varying degrees. The top five strengths are a person’s signature themes, but the next five are important, too. The trick is to recognize that everyone
has strengths and to guide them toward activities they like, are inclined to do, and would probably do willingly if someone just extended the invitation. 

My last few operations management positions haven’t been at strengths-based organizations; however, I still looked at my team members to discover where they excel. One of my caregivers was terrific at organizing things and I’d often see her straightening pens and pencils just so, fixing brochures into neat stacks, and moving break room items to improve the room’s functionality and use. I asked her how she’d re-organize the department’s space and she was delighted to contribute. I’m sure one of her strengths is “arranger.” 

A notebook and pen with the word "priorities."Another person was the most tactful supervisor with whom I’ve had the pleasure to work. The rapport she had with colleagues, direct reports, and providers was the envy of everyone, including me. Prickly physicians adored her. Unhappy patients talked to her and were pleased with her and the organization. She’s the person I relied upon to manage rollouts of new policies and ideas. I’m certain that one of her signature themes is “woo.” 

The list goes on. When I’m observing departments, talking to individuals, interacting with teams, and listening to caregiver and provider concerns, I’m always on the hunt for each person’s strengths. Some are analytical and love to pour over data; while others have empathy and connect with patients so well. Everyone has something unique and valuable to contribute to the team effort. 

When a health care director of operations focuses on people’s strengths, it de-emphasizes the weaknesses. I think it’s better to put my energy, and the energy of those I lead, into what people do well. Harness that energy — energy that would be there no matter what a leader does or doesn’t do — and channel it into the health care organization’s sails. All of our unique abilities, focused on the mission to improve patients’ health and wellness, can be the natural power behind an operation’s success. 


A three-part series originally published in December of 2017. Reprinted with permission from the author.