Maintaining Trust With Frequent Policy and Practice Changes

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Front-line leaders tell me that recent frequent changes to organizational policies and practices have left staff reeling. We know from Gallup research that the four qualities that staff look for in their leaders are trust, stability, compassion, and hope. COVID-19 is creating challenges in two of these four qualities – trust and stability. I have to work hard to control the negative feelings that staff have about the changes that have been implemented in our health system; one nurse leader recently acknowledged. Trust has taken a major hit. Some of what staff considers to be in our core values have been called into question such as:

Quality and safety above all else is our major concern – (and now we reuse PPE with no end in sight to this practice change, and some units don’t have it available at all).

Our employees are the heart of our care – (and now we furlough them with no pay).

Patient and Family-Centered Care is what we provide – (and now we have no visitation and leave staff scrambling to use their phones to connect with family members).

We empower staff through a shared-governance model – (and now our unit councils and shared governance groups are no longer meeting to discuss practice changes).

We believe in the importance of life-long learning – (and now we have suspended tuition reimbursement and furloughed education staff).

COVID-19 has led to some changes that leaders never expected to make. But these changes get tricky when you have had a substantial stake in some core values that don’t seem to staff to be necessary at this time. Leaders have needed to pivot in response to changes in the environment. And realistically, you may need to change again. So how do you negotiate these treacherous waters without losing staff trust? The following are some strategies:

Be able to communicate the reasons why you have had to pivot from your core values and strategize with your managers how to communicate these pivots to staff.
Be transparent in your communication – if you said something two weeks ago and now your message is radically different – admit it openly.
Allow staff to ask questions – if you can’t do a face to face staff meeting – do a ZOOM town hall.
Make clear what are your sacred values and will not change – and don’t waffle on them.
Describe any new directions that you see the organization needs to take and what that could mean in the future.
Demonstrate confident humility – admit that this is a very challenging time and that you have to make decisions you had hoped never to have to make.

Virtual Workshops for Nurse Leaders are now available. Learn more at Virtual Workshops

Read Rose Sherman’s book – The Nurse Leader Coach: Become the Boss No One Wants to Leave