Stuck in the Middle

Strong organizational culture starts with a strong leadership culture

During a lively discussion at a workshop session on staff burnout in the middle of the pandemic, a brave middle manager in the back of the room shouted out during Q&A, “What about me?! I’m more burned out as a leader than I’ve ever been.”

Nearly every head in the room nodded in hearty agreement.

Studies by Gallup and other major research organizations document the fact that an employee’s manager is by far the most influential factor in their engagement, loyalty, and retention. The relationship between frontline employees and their boss supersedes every other factor of employment. That includes compensation, benefits, and even elements of the work itself.

This is the second installment in our series Stuck in the Middle, which takes a fresh look at the challenges facing frontline leaders in today’s labor market.

Better supporting and retaining frontline staff has to start with better supporting and developing the leaders they work for. Beyond overall workplace culture, there is an important question every organization should be asking: “What is our leadership culture?” In other words, how do we take care of the people who are most important to our frontline team, especially during challenging times.

Following are three key questions related to leadership culture in organizations.

Do middle manager have a voice?

Frontline staff usually believe that the further you move up on the leadership ladder, the more ability you have to speak up on issues that are important and concerning to you. For middle managers, we’ve seen that’s not always the case. Whether stated or implied, frontline leaders often feel they have to toe the line once they are part of “Management” and not voice disagreement or concern.

Having a voice and some level of control over your day-to-day work is a well-recognized aspect of engagement for frontline staff. The need for that voice and control does not magically go away when you become a manager.

Of course, managers who consistently undermine important change initiatives for the organization are harming themselves and ultimately their teams. Telling staff that “I don’t agree with this, but upper management is making us do it,” actually diminishes confidence in the manager and the entire organization.

But there is a constructive way to give managers voice. In highly functioning organizations, leaders at every level see the benefit in soliciting ideas and opinions from those who report to them. They create a psychologically safe atmosphere of trust and open communication, allowing the managers they supervise to share different points of view.

When a decision is made that a manager disagrees with, their superior explains the rationale behind the decision. Then they transition the conversation to, “Let’s talk about how I can best support you in implementing this change and addressing your concerns.”

Do middle managers feel appreciated?

Lack of recognition is one of the six root causes of burnout (along with voice/control, fairness, community, workload and purpose). But I’ve often heard senior leaders and physicians brag, “Hey, I don’t need that ‘atta-boy’ stuff and silly pats on the back,” implying that recognition and appreciation is only for the weak who lack confidence. With all due respect, my experience tells me that they are either lying or kidding themselves.

Everyone appreciates it when someone notices that they’ve gone above-and-beyond or made a significant impact on the experience of a patient, family member, or colleague.

Among the best, most supportive leadership teams, appreciation does not just get expressed in one direction on the organization chart. Peers and subordinates express sincere appreciation to one another just as often as their supervisors. From personal experience, even CEOs appreciate it when someone notices the contributions and sacrifices they are making for the organization!

Does the organization nurture a strong middle management peer support system?

In multiple organizations we’ve worked with during and following the pandemic, many frontline managers humbly told us that they only got through the prolonged crisis because of their peers. Frontline leaders should always feel as if they can confide in their supervisors. But sometimes nothing is quite as reassuring as going to the office of a peer, closing the door, and saying, “I’m struggling and could use some help and advice.”

Given the inherent stress in health care, everyone needs a friendly ear sometimes to talk through a problem, share an emotionally challenging experience  … or just vent. Great leaders at all levels of an organization provide that psychologically safe space for their colleagues.

A healthy leadership culture is critical to developing a strong organizational culture that encourages staff from the frontline to the c-suite to be fully engaged. Just like the staff who report to them, leaders at all levels deserve to be in a workplace environment where they feel fully engaged, personally fulfilled, and sincerely appreciated for the contributions and sacrifices they make every day.