The Calm After the Storm: Road Warriors Share How They Gain Staff Trust
Being an Interim Director of Surgical Services satisfies many an itch; love of travel, schedule flexibility, and always being on the cutting edge with skills and tech, to name a few.
However, there are numerous unknowns going into a new assignment. Namely, how will the staff receive you? Will they embrace you with open arms or erect a wall of defense? But gaining the trust and confidence of staff is arguably the most essential hurdle an interim must clear. Our 2022 Road Warriors share their strategies on how they lower the temperature and get everyone on the same page.
Anne Ertel, DNP, MSN, BSN, RN
Be Visible
“One strategy I’ve used is that I’m very present. I’m not behind closed doors. I’m meeting people, open, attentive, and listening. I say in the beginning that this is about meeting your needs and reaching your goals. This isn’t about my agenda. Of course, sometimes stakeholders disagree on what the priorities should be, but the most important thing is to realize that you’re there to help them attain their goals. You’re there to support them.
I also ask the administration to give me two days with no meetings so I can meet people and they can ask me questions. That communicates that I value their ideas and concerns. It increases stress when they don’t see you because you’re in all these high-level meetings.”
Gayle Fox, MHA, BS, RN
Showing Your Credibility
“Interims are accustomed to being dropped into the seven levels of Hades all of a sudden, right? The typical situation is that there have been huge leadership gaps. My style is very relational.
I don’t come in with all these changes right away. Part of what I do is get into the department from the beginning. I have a meeting with the staff, give them my background, and then I will ask them, ‘So do you think that I’ve got the background and skills to do this role?’ That usually leads to a bit of humor.
Another thing that makes them feel comfortable is seeing you have credibility. They understand that you know their world. That you were at the table scrubbing cases as a nurse. I may not be as fast and skilled as I was when scrubbing all the time, but I could still do it if I had to.
And part of that is also storytelling. Giving them stories like, ‘Ohh gosh, when I had this experience or I had that experience.’ That gives you a humanness that allows them to trust you.”
Sheila Grumbach, MSN, BSN, BLS, CNOR, RN
Listen Up and Follow Up
“Some organizations just had temporary director vacancies while others have experienced a rapid succession of leadership turnover. I tell the staff all the time. I understand you have a lack of trust. It’s hard to believe that someone is going to be here and that it’s going to be a long-lasting change.
It does not matter what we say; it’s through our actions, our consistency, and our fairness that we’re going to earn their trust. We have to show them that we’re committed to them, however long that is.
Make yourself available. Never be too busy. Let them know they can talk to you about anything. Make rounds. I carry my notepad with me and write down notes because I can’t remember everything people tell me. I say, ‘Those are some really good ideas so let’s look at how we can make that happen.’ Saying that has a very calming effect. And I’ve had someone come to me and say, ‘Well, I had some concerns, and so and so told me to talk to you.’ Take the time and listen and then circle back with feedback: ‘I’m not able to do anything about that right now, but I’ll get back to you.’ That’s what they need. Listen and follow up.”
Warren Nist, CER, CIS, CHL, CRCST
Overcommunicate
“Start incorporating them into solving whatever issues that we need to solve. Letting them know that you’re on their side, that they’re going to be an intricate part of the process. It slows down the fears that we are coming in to clean house.
Knock down some of the barriers that are high impact on them and maybe even find some low-hanging fruit by solving a minor problem. That lets them know that you’re there to make things better.
It takes a while, and some people trust you much faster than others. And then you have those cynical people who think, ‘Well, he’ll be gone soon, and we’ll just go back to doing whatever we were doing.’ You need to show that’s not going to be the case. Typically, we’re not involved in the replacement process. But if somebody is coming in to replace you, be knowledgeable about that as well. Let them know that person will pick up where you left off. Keep that communication flow rolling. I tend to overcommunicate, but I think that’s sometimes a good tool. When you’re coming into a new location, you want to keep staff out of the dark.”
Jerry Thomas, MBA, BSN, CNOR, RN
Don’t Make Assumptions
“A lot depends on what they want you to do. I can think of an instance where I was brought in because I, quote, ‘Had the reputation of being a hired gun.’ That can be good and bad. That assignment was truly the most sensitive location I have ever walked into. There was a physician who had an explosive temper. Okay, I’ve seen this before. But you can’t just walk in and make assumptions. Either this physician is unstable, or something else is going on. So yes, he had an explosive temper, but then we find out that the reason is that he was being sabotaged in the OR. Uncovering all that took assessing the situation and some creativity. But when it was clear who the real source of the problem was, they were relieved of their duties. I came in and saved a physician’s livelihood.
You need to have a calming effect and be approachable when you come in. Be friendly but hold everyone accountable and don’t take sides. Watch everything, but don’t make snap decisions unless it is a matter of life and limb. It’s similar to the nursing assessment process: evaluate, diagnose, make a plan, and implement it. The door is always open, and I will listen. I understand that people have been burned by leadership. I look for small wins where they realize, “Wow, this guy is going to help us.’ And it works.”
Carisa Brewster
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