How Positive Leaders Impact Care

Have you ever worked for a boss who kept calm and positive even when under tremendous pressure? If so, you probably remember how that person’s attitude impacted the stress-filled environment in a very positive way.

Leaders carry an enormous amount of responsibility for multiple tasks in healthcare: budget, documentation, supervision, equipment, census, quality care, survey readiness, staffing—and the list goes on and on. It can be difficult to keep calm and remain positive. Some days, that’s almost impossible! When all these tasks and responsibilities are swirling about in the leader’s head, it results in enormous amounts of stress and negatively impacts both the leader and the working environment. Even though we may not walk around talking negatively, our body language often ensures that we’re wearing our heart on our sleeve. Dementia experts tell us that residents living with memory loss are often experts at reading body language. So, the people we are most passionate about caring for can be negatively impacted by our attitude.

Several years ago, while doing some consulting work with a memory care community, we were conducting a root-cause analysis on patterns of resident behavior. We noticed that when a certain staff member was working, there seemed to be increased behaviors. I asked the group if they believed the person needed more training, coaching, or resources to improve her performance. They all chimed in that she needed a “more positive attitude.” When she worked, the feel of the environment was negative. She complained about anything and everything all day long. No one wanted to work with her. It was clear that the problem was not a skills issue, but rather an attitude needing adjustment. Her attitude was resulting in poor resident outcomes because of the working environment she created for those around her. In a recent hospital study, a positive working environment was shown to increase satisfaction for both employees and patients and to improve quality of care. How does your attitude impact those around you?

A resonant working environment is an environment where it feels good to come to work and live out your passion for quality care. A resonant environment feels like the beautiful sound in your ears of an orchestra playing in an old church or Victorian music hall. You want to be there. You want to stay longer. You are in a better mood just listening to the harmonic sounds of the instruments. In contrast, a dissonant environment is one that feels uncomfortable. It sounds more like a fifth grade beginners’ band just learning the instruments. You want to escape. It is painful to your ears. It is more like the environment created by the negative staff member that resulted in poor outcomes for memory care residents.

Leaders must pay attention to the working environment and, whether we like it or not, we are ultimately responsible for the “feel” of it. In the healthcare environment of today, with regulatory changes, staff turnover, and survey prep, it can be daunting to remain positive. So how does a leader create a resonant working environment?

Here are four tips that can be helpful.

  • Assess your attitude. In a study by Bandura, researchers found that attitude “trickles down” from the leader. If you are in a good mood, staff and residents will be in a good mood. If you tend to be negative often, explore the parts of your life that may be impacting your attitude—professional responsibilities, personal life, unmet emotional needs, sleep deprivation, time away from work—and be proactive in addressing these areas. Conduct an analysis of your work. Are you using your strengths, or trying to be something you are not? Take a few minutes daily to refocus on the things that you are thankful for and that bring joy to your life.
  • Remove any obstacles to your positivity. Review policies, processes, and procedures, and make changes in ones that can be changed to create a more positive working environment. In healthcare care we have a regulatory framework that must be followed, but many times we create additional “rules and regs” that are not necessary. They can create a burden for enforcement, and impact employee satisfaction. Just because a few employees do not follow a policy, this does not mean that another policy is required. Often, an unwillingness to address difficult staff members or personal conflicts with others can be at the root of increased policies. Be flexible and adaptable with staff where possible. Allow as much autonomy as possible. Increased autonomy increases employee engagement and work performance. Avoid micromanaging and give the work back to others when you can.
  • Lead positively. Live the mission and vision of the organization. Frame your work and the work of others through that lens. For example, rather that disciplining a staff member for being late, per the policy, coach him on how his tardiness impacts the mission of delivering quality care to the residents and creates additional stress for co-workers. If our lives are driven by regulations rather than mission, it will be easy to lose our motivation. I consulted with an administrator I know for his leadership in culture change. He did not lead culture change with regulations but rather with employee engagement and asking staff for their input. He often says, “Regulations are an influencer for us, not a driving force.” His community has a long history of excellent surveys because the residents and staff are very happy.
  • Reinforce positivity. Celebrate your successes and those of team members. Help others develop and grow their skills. You can’t build a positive team overnight, but when you encourage positivity, you will discover how much more team members can achieve. Start all meetings and morning stand-ups on a positive note. Share a story about a patient success or just simply ask each person to share something he or she is thankful for. Reframe challenges as opportunities for learning and self-reflection.
  • Be kind to yourself. Being a leader in the healthcare environment requires heavy lifting. Take time to relax. Do something you love to do. Spend time with positive people. Take your break. Take a vacation. When you feel yourself becoming negative, stop and force yourself to breathe in deeply and exhale slowly. Focus on all that you have to be thankful for. Take a break from the busyness of the day and go visit with a patient. They are great reminders of why we do what we do!

The good news about positivity is that it is easily spread. It is one of the most contagious emotions! If you have assessed that you tend to be negative up to 50% of the time, try doing a root-cause of the times of day when it occurs. What are the precursors of that attitude? Change your schedule and/or routines to reduce the contributing factors. If nothing else, try offering a smile to everyone you encounter during the day. That alone can be contagious!

Dr. Linda Shell, MA. RN |

Dr. Linda Shell MA, RN, principal and co-owner of LindaShell.Com and Legacy Market Services, Inc, has over twenty-five years of experience providing education, leadership development and consultation to non-profit and for-profit senior care organizations.