Building Trust in Your Leadership

By Rose O. Sherman, Ed.D, RN, NEA-BC, FAAN

New leaders often wonder why it takes so long to build a trusting relationship in their new roles. Trust is a bedrock of leadership. As Warren Buffet has noted, trust is like the air we breathe- no one notices when it is present. When it is absent – everyone notices.” Building trust is a slow and delicate process, and it’s largely an art few have mastered.

Watching Elon Musk take over the leadership of Twitter over the last few weeks has been a master class in what not to do. Instead of inviting employee feedback, he has clarified that his word is the law. It is not working out well as valued employees are exiting in large numbers. Warren Buffett said it best when he said the key to being a great leader is “the willingness to confess mistakes and invite others to do the same.” Leadership vulnerability is so important, yet many new leaders like Musk fear their competence will be questioned if they are vulnerable.

I think this is a mistake that also happens in many healthcare settings. Our industry is a hot mess, and many historical strategies are not working. A recent Deloitte survey revealed that fewer than half (45%) frontline clinicians trust their organization’s leadership to do what’s right for its patients. Even fewer, 23%, trust their leadership to do what’s right for workers. These two types of trust—to do right by patients and to do right by workers—are highly correlated and associated with significantly lower clinician burnout. This lack of trust is the elephant in the room (severe staffing shortages in all parts of healthcare), and it is challenging to move forward without rebuilding it.

Recently a nurse leader who took a new position told me that she was following a leader who was not trusted by the staff. She elaborated by saying that when I sat down and did one-on-ones with staff, I was shocked at how guarded they were. I even said to them – you seem to be reluctant to talk. They told me they had no trust in any of the leaders in our facility. There was a lack of transparency about the unit’s challenges, and the staff was judged to be very negative. 

She asked for suggestions. She seemed relieved when several of her colleagues admitted they were confronting similar issues. Below are some of the strategies we talked about to build trust with her staff:

• Admit you are new and don’t have all the answers – you need the help and support of staff.
• Present clearly to staff what you control and can’t control as their leader.
• Listen carefully to the concerns of staff.
• Tell staff about your leadership journey and help them to know you better.
• Close the loop quickly on challenges that are brought to you.
• Coach staff to make decisions and empower them to solve problems.
• Address any immediate anxiety that staff might have about what you will do as a leader.
• Find out about the goals and aspirations of your staff.
• Be transparent in your communication and be open to feedback.
• Acknowledge quickly any missteps you might make in your transition.
• Solve the small problems that make the work harder.
• Seek every opportunity possible to recognize and thank the staff for all they do.

Nursing leadership is hard right now – especially for those new to their roles. Open communication and transparency will help build trust, but it takes time, sometimes longer than you would like. The progress for this leader is likely to be incremental, but if she implements what we talked about, she will see a shift in the unit culture.