Managers in long-term care facilities have multiple responsibilities in the governance and operation of their organizations, and they therefore have both the means and the responsibility to effect positive change and growth in employee service provision. Shared competence of all staff must be encouraged as the healthcare field continues to change and becomes more challenging. With reimbursement rates decreasing, managers must allow for an integration of knowledge, judgment, personal qualities, skills, values and beliefs.
Certainly a manager is responsible for ensuring that the job gets done, and done correctly, but micromanaging can be a costly management style. What is micromanaging? It is managing with excessive control over personnel and their duties in an organization. Not only is it inefficient and costly to have staff members perform discrete, separate and often redundant tasks—micromanagement itself denies the patient or resident the fullest quality and continuity of care available.
Are you guilty of micromanaging? When you delegate a task to a staff member do you give them the opportunity to complete it in his or her own way? Having a manager review and redo a task so it is “good enough” can be demoralizing and insulting.
During focused discussion groups at one LTC facility, an employee gave his impression of micromanaging: “Micromanaging to me can give employees the idea that their manager doesn’t trust them because the manager is too controlling and constantly trying to tell them what to do and how to plan their day. You lose employee creativity based on the situation and employees might feel that they can’t express themselves or share ideas with their bosses.” When deciding if you are a micromanager, ask yourself the following questions:
• Do I insist employees do thing my way?
• Do I criticize more than compliment?
• Do I redo work that has already been done?
• Do I watch over my staff as they complete their tasks?
A “yes” to any of these questions is a surefire way to de-motivate your staff by making them feel incompetent and undervalued. Especially in long-term care this type of managing can lead to significant staff turnover.
Nationwide turnover figures for LTC nursing staff has been calculated at 94%. This incredibly high turnover rate is an area LTC managers have to consider on a daily basis. Reasons for the high turnover rate include low wages, lack of recognition and respect, heavy workloads and working conditions requiring physical and mental endurance. Interestingly, it was found that higher wages did not necessarily lead to greater job satisfaction.
LTC facilities historically have functioned on an authoritarian model. Indeed, recent studies have indicated that resistance to senior leadership ranks as the most significant barrier to cultural and collaborative change in the field. The idea of relinquishing control may be intimidating to many in upper management. Strategies to decrease turnover need to focus on increasing employee satisfaction through programs that recognize quality work. Small steps can easily be made through interactive staff activities and programs focused on celebrating individual efforts at quality care.
When employees feel needed, respected and are recognized for their importance to the organization, they are more likely to provide service with increased enthusiasm, commitment and capability. Poor employee morale and an oppressive work environment decrease quality care and also limit the growth potential of the facility or department.
Micromanaging does have its place. It can be advantageous in situations requiring dedicated training such as orienting new employees, addressing controversial issues and taking on special projects. However, continued use of the management style can generate negative consequences. Empowering employees to meet their full potential can be successfully accomplished without micromanaging.
Improving morale with programs focused on celebrating individual efforts at quality care can have effects of not only reducing turnover, but also encouraging staff to provide warm and effective care. This, in turn, increases the residents’ perceptions of quality service, which leads to greater profitability as the public recognizes the excellence of care offered.
Today’s healthcare field is a rapidly changing environment. Frontline workers are often the “face” of the company that is presented to the residential community. This can include a diverse portion of the workforce—from housekeeping to nursing to dietary staff. All workers in the LTC facility form an integrated continuing care system. Management that encourages collaborative partnerships creates a dynamic, caring philosophy that empowers all those within its reach.