We need the hierarchy in healthcare yet in many places it is a very destructive force. If we are going to have safe care, healthy workplaces and rewarding careers we need to ask ourselves and each other; What makes the hierarchy healthy? What are your thoughts about making the hierarchy a healthy one?
In my opinion we need the hierarchy for clinical decision-making and related use of expertise, but not for egos, power, status or dare I say, even money. We need to work collaboratively so that everyone’s expertise and best efforts are supported and brought forth for every patient. Think of it as the hierarchy being the structure and the collaboration as the process. The former requires knowledge and skills where the latter requires respectful communication and emotional intelligence. Healthcare professionals must be adept at both. Yes, physicians may lead more often than not and yes the nurses’s assistant will follow more often than not, and nurses will be leading and following almost all the time, but we must all be able to do both! And with respect and grace.
Collaborative leaders who understand this dance of being in charge while listening and following as necessary AND supporting staff to bring their best to the table will be making a huge contribution to creating the ideal healthcare organization!
There are many activities from improv, applied improv, or medical improv that can be used to practice the leadership and followership necessary to jump into either role and switch between the two in the dynamic unfolding of providing care!