What a Nursing Home Taught Me About Leadership

My mother is two months away from turning 100. She lived through the Great Depression and WWII, along with ten siblings in a tiny house. But these challenging life experiences were nothing compared to the greatest fears she has expressed over the past few decades. First, fear of missing her hair appointment. And next, fear of having to live in a nursing home. Well, after a recent fall and broken femur, she has now experienced both of these fears at the same time – she is permanently living in a nursing home, and she hasn’t had a hair appointment for two months! Two months of almost daily visits to see her have provided me with some lessons on leadership from the place I least expected: the nursing home.

1. Social interaction is as important to overall health as medical treatment is.

Wheelchairs, oxygen tanks, medical carts, blood pressure cuffs, daily medicine, and stethoscopes are important. Withhold any of them and serious problems can quickly arise. But withhold social interaction, and a different set of serious problems will arise – depression, anxiety, and loss of the will to live. My mom watched a lot of TV when she was living independently. But she hasn’t watched any in two months because there are always people around. Nurses, aides, meal delivery, roommates, and people gathered in the dining room. The thing she feared most had an unintended positive consequence – dramatically more social interaction. My family, my brother, his family, our friends, and I have provided my mom with daily visitors. But as one resident reminded us, no one ever visits her. She is ALONE. And that is far more anxiety-producing than living in a nursing home. We all need people. Some need a lot, others only need a small tribe. But everyone needs people and a sense of community. And every leader should make this a priority in their organization because a healthy social culture will bring out the best in their team and benefit their customers.

2. Not all people have the same gifts and talents.

When the gift of sensitivity was being dispensed, I was likely busy cutting the grass. There are people who are compassionate caregivers. There are people who are great at doing tasks. And there is a smaller minority who are good at both. I am a task guy. I get things done. I solve problems. But I am pathetic at compassionate caregiving. I have noticed the diversity of talents in the nursing home as well. Some staff do the task well. They are nice, but they do not have the warmth and compassion that others have. They were doing important tasks and did them well. However, there are some who excel at compassion but may not be as good at remembering all the details of what needs to be done. This is the power of a team. Not every person has to excel at every aspect. Their talents can complement one another to produce a greater outcome than any one of them could do alone.

3. Details matter.

Every organizational enterprise ultimately boils down to details. Hundreds of them. We just completed the Accelerate Leadership Intensive - a leadership development program for new managers. To prepare for and facilitate this three-day intensive for a dozen emerging leaders required countless details, each of significant importance. Sending directions. Setting up the room. Scheduling meals. Arranging swag boxes. Coordinating speakers and trainers. Making hotel and flight arrangements. Creating presentations. Printing notebooks. If one detail is dropped, it can result in negative outcomes. The same is true in the nursing home. Register blood pressure and body temp. Keep track of hearing aids and dentures.  Ensure oxygen is connected and working. Change clothing. Ensure appropriate meals are provided. Check the patient’s weight. These are just a few of the myriad details that must be managed successfully in the nursing home. Successful organizations and leaders always remember – details matter.

4. Communication prevents confusion.

I have heard organizations called many things, but seldom are they called “simple.” Running an effective business, professional services firm, social service agency, or nursing home requires extraordinary communication. Communication is how customers are best served, mistakes are reduced, and staff are less frustrated. For example, in the nursing home, there are numerous “chefs in the kitchen”, people who have a role to play in providing services to residents. This includes insurance companies, doctors, nurses, aides, housekeeping, billing, food services, physical and occupational therapists, families of residents, and the residents themselves. When any one part of this complex web of communication breaks down, confusion and conflict can arise. Each part is interconnected with the other parts and needed for efficient and effective operational service. A wise leader works to ensure that communication is flowing without obstacles in their organization and that everyone knows what they need to know to do their job well.  

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Jay Desko is the President & CEO of The Center Consulting Group and brings experience in the areas of organizational assessment, leadership coaching, decision-making, and strategic questioning. Jay’s degrees include an M.Ed. in Instructional Systems Design from Pennsylvania State University and a Ph.D. in Organizational Behavior and Leadership from The Union Institute.

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