StuckintheMiddleHowtothrive– notjustsurvive– beingamiddlemanager.

ElizabethKester,MSN,RN,MiddleManager

Learningobjectives

Identifystrategiesandskillstonecessarytobecominganeffectivemiddlemanager.

Revised:Identifystrategiesandskillstonecessarytothriveinyourrole

asamiddlemanager.

Middlemanagement• Typically fall below the 3rd or 4th level in the organization

and act as bridge between senior leadership and team

members

• Figurehead – formal representation of unit

• Leader – mobilize interest, energy, new initiatives

• Liaison – link others outside of vertical chain of command

ManagingattherightlevelVice President

focus almost entirely on building the company of the future, both by visualizing what the company will need to be, and by coaching their directors in innovation and

change management.

Directorsfocus half on structuring the work of their departments and coaching their managers' performance, and half on change initiatives that require coordination with their

counterparts

First line Managerfocus on producing results and

improving day-to-day operations.

Awholenewmeasuringstick“Suddenly an individual who has spent their whole life measuring their success according to their own personal accomplishments must now become accustomed to gauging success according to the accomplishments of a team over which they may not even have direct control.”

~Captain David Marquet

Employee Engagement Survey Time!

Pressure

• Pressure from bosses to achieve their/organization objectives– Senior leaders set aspirations and strategy, middle managers translate

strategy into concrete plans and communicates with team members – Get it done

• Pressure from teams whom don’t always see the value in the larger objectives– Team members view you as their voice -“you are working for/on

behalf of us” – Things “would be better” if you fought for us– Get it done

“Mmm,mmm,ba,da,Boom,boom,ba,bay,boom,boom,boom,ba,bay,bay…”~DavidBowie

Powerdifferentialsinroleidentity• Complicated and dynamic; shifting cognitive gears

– When managing the team, we engage in a more assertive high-power behavioral style.

– When interacting with our superiors, we naturally adopt a more deferential low-power behavioral style

• Micro-role transition – Exiting and entering roles that have very different

power differentials

• Avoid frequent and recurring transitions in one day

CompetinginterestsA busy day in L&D. All but one triage bed is full. Staffing is very tight. MFM calls the Resource (charge) Nurse to let her know that a transfer is on the way from a community hospital. The Resource Nurse expresses concern about taking the transfer.

MFM says the patient is coming, regardless, and then leaves the unit.

The Resource Nurse feels powerless and frustrated.

Staff meeting, Resource meeting, OB leadershipmeeting, one-on-one with medical director….

Heavylifting• “Barbell” approach by many organizations where skill development is focused

on new managers and senior executives – leaving the middle (managers) weak.

• Common for mid-level management learning to be comprised of disjointed short courses.

• Only 15% of North American and Asian companies that felt they had enough qualified successors in their pipeline for key leadership positions.

Taskmaster

Theotherstuff

Okay,that’salot….nowwhat?

Photo credit Imgflip

• Ditch the ‘change in hard’ mantra!– “change is only hard for the unready”– “Suffering is optional – stop arguing with reality”– Evolution is good!

• Move from resistance to readiness– Avoid cultivating helplessness

“Ifyouarguewithreality,youlose(butonly100%ofthetime)!”

The C word

~CyWakeman

Don’tjustsurvive- thrive!Invest in yourself• Read, practice, network, be curious!

• Attend lengthier, comprehensive executive education courses. Continue to advocate for your development (coming to PLF is a great start!).– Organization of Nurse Leaders– AWHONN Emerging Leader program– Synova NICU Emerging Leader Fellowship

• Blending of experiential on-the job learning, coaching, and feedback with formal training.

• Know your network of resources to get results (it’s not always who you think)

• Stay engaged: Team building that focuses on problem solving (escape the room, obstacle coarse, etc.)

Findyourpeople

ReferencesBeehr, T. A., & Glazer, S. (2005). Organizational role stress. In J. Barling, E. K. Kelloway, & M. R. Frone (Eds.), Handbook of work stress (pp. 7–34). Thousand Oaks, CA: Sage.

Bradberry, T. (2016). Are you a seagull manager? Retrieved from https://www.forbes.com/sites/travisbradberry/2016/05/04/how-seagull-managers-make-everyone-miserable/#6dca1abf6d54

Byrnes, J. (2005). Middle management excellence. Harvard Business School. Retrieved from https://hbswk.hbs.edu/archive/middle-management-excellence

Conway, E., & Monks, K. (2011). Change from below: The role of middle managers in mediating paradoxical change. Human Resource Management Journal, 21(2), 190–203. doi:10.1111/j.1748-8583.2010.00135

Kath, L.M., Stichler, J.F. (2012). Predictors and Outcomes of Nurse Leader Job Stress Experienced by AWHONN Members. JOGNN, 42, E12-E25; 2013.DOI: 10.1111/j.1552-6909.2012.01430.x

Manion, J. (2011). From management to leadership strategies for transforming health. (3rd ed.). San Francisco: Jossey-Bass.

McKinney, R., McMahon, M., Walsh, P. (2013). Danger in the middle: Why midlevel managers aren’t ready to lead. Retrieved from http://www.harvardbusiness.org/sites/default/files/PDF/17807_CL_MiddleManagers_White_Paper_March2013.pdf

Regan, L. C., & Rodriguez, L. (2011). Nurse empowerment from a middle-management perspective: Nurse managers’ and assistant nurse managers’ workplace empowerment views. The Permanente Journal, 15(1), 101–107.

Wakeman, C. (2010). Reality-Based Leadership: Ditch the drama, restore sanity to the workplace, & turn excuses into results. San Francisco: Jossey-Bass.