MED e-care Blog

The Mask of Management in Long Term Care

By Len Fabiano  |  02 August 2017


Most nurses know that their actions, as well as their attitude, continually communicates to patients under their care. Many patients try to read something from our behavior or mannerisms that will tell them how they are doing. The same holds true for managers and their staff. Not all staff are open and assertive enough to ask what we think or feel about subjects pertaining to work. Instead they try to read from us clues that may give them that information.

A role playing exercise with direct line staff is quite revealing. Staff are asked to role play their managers and identify the problems they believe their managers experience. In many cases, certain staff will respond "We can't do that. We don't know what managers do." That is the key. Most nurse managers in long term care have been caregivers. They can relate to what their staff experience. In contrast, our staff have not been managers. Without that experience, they cannot easily relate to what we do or encounter.

Certain staff take our comments and actions literally. They can easily personalize what they hear us say or see us do. The mask of management represents the demeanor a manager must present to her/his staff that is objective, confident and open.

It also establishes a philosophy among the management team – we agree to disagree and agree to agree. At a management meeting for example, all managers must feel free to express their opinions – we agree to the right to disagree. However, once the team decides on a course of action, then all managers must follow it enthusiastically – we agree to agree. That sets an expectation that all will work as a cohesive group to meet the defined objectives. If some managers leave the meeting believing – "this isn't going to work,” then it won't. Our attitude colors the outcome of any initiative.

A further component of the mask of management is the ability to get "dirty." It is amazing to see a manager walk past something that has fallen on the floor, just to get a housekeeper to pick it up. Or a manager spends the time to find a PSW because a resident needs a Kleenex. If we cannot do what the staff do, then we are telling our staff that what they do is beneath us and not important. The ability to "get dirty" enhances management/staff relations and also teaches by example. 

Lastly, the mask of management encompasses one other side having fun in the work place. Encouraging staff to have fun in their job is not only an opportunity for them to release the ongoing emotional tension that can be created in this line of work, but it also adds a needed dimension in the quality of life for our residents. Fun is part of the job of all members of the facility. An effective manager is one who is able to relate to his/her staff at all levels, not just as the "boss.”


Excerpt from Len Fabiano’s book, Getting Staff Excited: The Role of the Nursing Manager (and Others too) in Long Term Care


Topic: in Long Term Care

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