Confessions of a Hospital Administrator w/ Principles to Share from Major Lessons Learned

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John Mitchell, SPPR

John Mitchell, SPPR

John W Mitchell


On January 1, 2014, I made a post to titled “Confessions of a Hospital Administrator”*, a social networking site. In the article I discussed servant leadership principles that had served me well as a hospital CEO in creating a great workplace culture and an engaged work force. These four points included:

  • Get Out of Your Office
  • If You Want a Problem Solved, Ask the Nurses.
  • Protect Your Nurses
  • Remember – What Happens in a Hospital is Not About you

I was surprised by the response. The article received over 2,000 views and several pages of comments. I realized that the level of disengagement in most hospitals was even worse than I had supposed. Some of the comments included:

– “Sorry you are a former CEO – we need more like you.”

– “My hospital is looking for a new CEO.”

– “I found this article inspiring. It is nice to know there are STILL value-aligned CEO’s.”

– “I currently work as an RN at a very prestigious, but small university hospital and staff morale is in the dumps. It would be awesome if our current administrative team read this.   They have been gutting the nurses morale for years, firing a director of nursing just about every two years for 16 years.”

– “This should be compulsory reading for all management.”

And so on. I was contacted by a nursing journal in New Zealand with a request that I write an article based on this post – New Zealand! Nurses everywhere want to feel inspired when they come to work. Let me be clear – I didn’t develop this leadership style to be popular. I evolved towards this leadership style because I noticed when I empowered staff they would work twice as hard with better outcomes, compared to when I felt I had to make all the decisions and tell them what to do. Trusting nurses to agree to the right metrics and to solve problems is the easiest way I know to be in charge of a hospital.

This is more than a bunch of happy talk. At Grays Harbor Hospital in Aberdeen, WA, I was able to turn around a struggling hospital in two years relying on these principles. The hospital had its first $1 million revenue month in its history and went on to do it 10 more times while I was in charge. In 2009 my executive team and I EmailSignaturewTag2bwere named Top Leadership Team in Healthcare for mid-sized hospital by HealthLeaders Media for turning the place around through great workplace culture.

But this is rare. In two subsequent leadership positions including an organization in which I had served for 5.5 years as a COO, I was unsuccessful in duplicating this success. The leadership for whom I worked did not value these principles, despite the operating success I achieved. In my last leadership position I found deep rooted dysfunction. When I told a long time doctor that he could not yell at the staff he was literally speechless. In his long career, it was evident that no hospital administrator had ever broached this issue with him.

I finally left hospitals and embarked on a successful freelance and consulting business, but there are days I miss serving nurses and patients. It takes a leap of faith for hospital leaders to empower the staff who lay hands on patients.   Most leaders have learned through command and control, where they have to know all the answers to every problem. This is an exhausting leadership style and will not work over the long haul.  Ask the people who do the work through servant leadership. They are waiting to help you and your organization succeed.

John W Mitchell writes for a wide range of clients, from healthcare to craft beer. He lives and writes on the Western Slope of Colorado, where on most days his wife loves him more than her horse. He will publish his first novel “Medical Necessity” in 2015. If he manages his day right, he can be found in the late afternoon sipping a craft beer and reading a good book. See more of his work under the Portfolio or Blog tab at




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9 Responses to Confessions of a Hospital Administrator w/ Principles to Share from Major Lessons Learned

  1. Pingback: Confident Voices in Healthcare Top 10 Posts for 2015

  2. Great post! There is a big distinction between management and coaching. Empowering others is a direct result of coach approach leadership. I’m am a HUGE supporter of using the Coach Approach. It not only empowers the nurses/staff, but also empowers the patients since the behavior eventually is modeled. It’s a WIN-WIN-WIN!

    • Beth Boynton, RN, MS says:

      I so agree, Jill and thank you for your comment. John’s approach has a potential rippling effect out to patients and families! The whole world will be better off as leaders become more collaborative and respectful listeners!

  3. Beth Boynton, RN, MS says:

    Thanks, Jessica. I agree and suggest we social share the post, send links to leaders, and/or print out copies and slide them under the doors of CEOs, DONs, CNOs and Nurse Managers. We can positively influence the demand for this kind of leadership!

  4. Beth Boynton, RN, MS says:

    John, I can’t thank you enough for this validating and wise post. I don’t want to speak for all nurses, but I do believe in general we want to speak up and help find solutions for safe quality care and are grateful for leaders who listen and help to build collaborative channels so we can do the best for our patients, teams, and organizations.

What are your thoughts?