3 reasons to start saying no (for healthcare managers)

In the past few years, there has been a lot of talk about self-care, boundary setting and burnout in healthcare—much of it directed at frontline workers providing bedside care.

Frontline managers, however, are often left out of this public discourse.

Frontline managers in healthcare are those who are responsible for leading a team of frontline workers, such as nurses. Their role may encompass hiring, scheduling, administrative duties and supervising the work of frontline workers.

If you are a frontline manager, you know better than anyone that the role can be widely misunderstood within healthcare and by the general public. You also know how demanding and draining the job can be.

We recently spoke to Kathy Howe, Executive Director for the Alberta Association of Nurses on our podcast Central Line: Leadership in Healthcare, about how the notion of “just working harder” is baked into the unwritten job description of this high-pressure position.

According to Kathy, working overtime, missing personal commitments and dedicating time to solving your staff’s problems have all become part of the cultural expectation of being a frontline manager.

But what happens when managers start to incorporate the word no into their daily work? What are the impacts of setting boundaries and making your life outside of work a priority? 

The answer is not that your team suffers. In fact, it’s quite the opposite.

Here are three reasons frontline managers should get comfortable with saying no at work, based on our conversation with Kathy.

1) Improve your team’s effectiveness and efficiency

We’ve all been there: sometimes it feels like it’s easier to just do it yourself rather than teaching someone else how to do it.

But the fact is, when you refuse to delegate tasks that don’t strictly have to be done by you, you actually end up hurting your whole team. Not only does it put more on your plate and pull your focus away from other priorities, but it also denies team members the opportunity to learn and grow. 

Even if it takes you more time to teach someone the first time, having another person trained up on the task will save you time in the long run.

The same goes for helping people with their tasks. While part of being a manager is guiding other people towards solutions, you simply don’t have the time to make everyone else’s problems your own. Practice putting problems back on the team member who brings it to you. Give suggestions and provide feedback, but don’t take it off their plate just because they brought it to you. Encouraging team members to problem solve on their own builds confidence, increases efficiency and frees up your time to do the things that only you can do.

2) Create systemic and cultural change

If experienced managers continue to take on extra work and long hours, and new managers follow suit, those habits become cemented in the workplace culture and normalized by the healthcare system.

It becomes “taboo” for a manager to leave work on time, or to take the weekends off, or to make commitments outside of work a priority. And in order to do any of those things, managers feel the need to justify their actions in order to curb feelings of guilt and shame.

The only way that will change is if managers themselves break the cycle. By setting boundaries, doing less overtime and prioritizing commitments outside of work, you can give your organization or institution a more accurate picture of the gaps that need to be filled and set more reasonable expectations for managers and frontline staff.

Plus, by modeling self-care and work/life balance, you will encourage other managers and frontline workers to give themselves permission to do the same, creating a healthier workplace for everyone.

3) Clarify your priorities

Setting priorities is key to a smooth and effective workplace, but sometimes it’s easier said than done.

If you’re struggling with clarifying your own priorities as a manager, start with the urgent vs. important matrix. Break your to do list into the following categories:

• Urgent and important: Keep at the top of your list and do it as soon as possible.
• Urgent, but not important: Delegate to someone else or automate if possible.
• Important, but not urgent: Don’t drop these tasks, but do urgent and important tasks first.
• Not urgent or important: Drop these tasks entirely.

Saying no to the tasks that don’t meet those requirements will give you a better idea of what, within your role, is actually a priority and which tasks really shouldn’t be a part of your job. And, the work you do to set your own priorities straight will both trickle down to your team and make its way up to your superiors. If a particular task isn’t important or urgent enough to be anyone’s priority, the relevance of the task or the capacity of the team may need to be reconsidered.

Stuck in a cycle of unhealthy work habits? Don’t be afraid to ask for help.

One of the most important steps you can take towards building a healthier relationship with your work, according to Kathy, is to ask for help.

Whether you spend time with others in management positions, ask your loved ones to hold you accountable to your boundaries or seek professional help in the form of a coach or mentor, positive social support is key to unlearning unhealthy habits and adopting more healthy ones.

TallTrees Leadership offers a variety of personalized coaching services tailored to help frontline healthcare managers improve their effectiveness at work while prioritizing their own mental health and wellbeing. We can help you identify your goals and how best to meet them when you book a free zero-obligation consultation. 

And, if you want to learn more about the power of prioritizing, setting boundaries and saying no, listen to the full Central Line episode featuring Kathy Howe.