Managing Cultural Drift

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

We had a strong culture, but it appears we no longer do. It is a familiar story I hear today from nurse leaders. Before the COVID pandemic, many health systems had strong cultures reinforced during new staff onboarding.

The last two years have been a completely different story with high turnover and few nurses on units who have tenure in their organizations and can pass the norms and values of the culture to new employees. Gallup research shows that in recent years, definitions of work culture — “how we do things around here” — have changed tremendously.

The American Psychological Association defines this phenomenon as cultural drift or the gradual, uncontrolled changing of culture over time, with its distinctive norms, values, and behavior patterns. Culture develops either by design or by default. Lapses in teamwork, loyalty, and professional accountability can happen gradually in cultures if values are not reinforced.

That is what is happening in many health systems today. We see a normalization of professional behaviors not congruent with a culture of quality, safety, and inclusion. The situation has been complicated by the number of mergers of health systems whose cultures are often very different.

In contrast, a culture by design means you’ve stopped and thought about what kind of culture you want in your organization or department, and you’ve built the workplace accordingly. You teach, protect and reward the values you want to see.  Sam Silverstein reminds us that it takes work, and leaders need to:

• Define the culture

• Model it

• Teach it

• Could you protect it?

• Celebrate it

Gradual evolutions in culture can lead to significant changes in your employee and patient experiences. The only way to address the cultural drift we see in health systems is to be proactive in acknowledging and managing it. The more mediocrity is allowed to occur, the harder it is to initiate a cultural change. New norms and values become hardwired, not necessarily ones you want moving forward.

Fighting Cultural Drift – Advice from Gallup

1. Be authentic to who you are. In our experience working with clients, leaders are often tempted to fit their culture into a predefined box. In reality, every culture is a complex mix of attitudes, values, beliefs, and ways of working: No two workplace cultures are identical. So, leaders should measure the strengths and weaknesses of their one-of-a-kind culture to determine the most fundamental and valuable aspirations for their organization.
2. Don’t see culture as a stand-alone initiative. We’ve repeatedly found that the best leaders consider their purpose and brand when designing their culture. When leaders embed a vital sense in their work culture, they make that purpose central to how work gets done — not just inspiring words.
3. Collect feedback from employees about your culture. In Gallup’s experience, influential leaders listen to their employees (via qualitative and quantitative feedback) when shaping their culture. When you measure culture in your employees’ language, you can shape that culture in a way that’s authentic to your people. Giving employees a voice promotes engagement, commitment, and ownership.

Rebuilding a strong culture takes time and patience. It is time well invested as we know that strong, healthy cultures promote retention and a sense of belonging. You will find great suggestions on how to begin the process in the work of Joe Tye and Bob Dent’s book, Building a Culture of Ownership in Healthcare.

© emergingrnleader.com 2022

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