Everything communicates – everything a new leader says and does and doesn’t say and doesn’t do. Most new leaders get that. But many miss the unintended consequences of what they do and say and don’t do and don’t say on people they think are not directly affected.

The lesson is that everyone is watching and everyone has the same question, “What does this mean for me?” In the absence of receiving a clear message directed to them, they’ll imagine the worst.

Here’s what a surgical nurse anesthetist said about the start up of a new head of finance at his medical center. Pay attention to the stress caused by what happened to his colleagues even though he was “safe” himself. Imagine how the people at risk felt and feel.

Tell me about the new leader’s predecessor?

Very personable. After a single meeting he would remember your name and call you by name in the hallways and cafeteria.


He did end up retiring. Maybe he wasn’t prepared to make the difficult decisions to make the medical center strong – particularly with the changes in healthcare.

How did you feel about the new head of finance?

Nervous. I knew his work history. That was shared. He was coming to us from somewhere else. He wasn’t from there. He obviously went there to do a job. And he’d been there for a few years. His work history before that was similar – at least as people talked about him. So I got the perception that he was probably a hatchet man.

And you were nervous because….?

Because obviously he was brought into our hospital for the same job. (I had the least seniority in our group). So if they were going to make cuts, it would probably be me.

But even if it wasn’t me, seven of us cover 24/7 with five people during the day. The breakdown means way beyond 40 hours each. So my concern is that even if I survived the cuts, would I want to work here? It was a quality of life issue.

When they were looking at our group, I told him that I was neither interested in losing my job nor in working more shifts if they chose someone else.

Before I worked at this hospital I worked at a metro hospital. I’d been there a year. And they went through hard financial times and I was one of the ones cut because they cut by seniority. So it was a real concern.

How did it play out?

It’s currently playing out.

He has made changes that has affected the regular nurses more than surgery and mainly left us alone. But they have closed nursing stations and merged nursing stations. They’ve laid off nurses. They had nurses rebid their jobs. Now they are re-negotiating the contract. Once the contract is open they can change anything.

The rebidding of jobs is a really big deal. They did it by seniority. By turn you had 20 minutes to choose a new job – not necessarily your old job.

The Operating Room and Emergency Room were safe because of the required training. But it still caused a lot of conflict.

Do you feel safe now?

I actually do. We are staff for the medical center. They cut the anesthesiologist and outsourced anesthesiology to a group. I was concerned that they were going to cut us or make us form a group and do our own billing with our own financial risk. Nurse anesthetists have a harder time being financially viable.

But for now, the new group has been there six months. They’ve been great to work with. They cannot do it with less than seven of us. Brought the new group in for their business mindedness. They’re only there during peak hours. We support them and are the cheaper option for off-hours. So it works.