‘Example is not the main thing in influencing others. It is the only thing’ - Albert Schweitzer

I remember my first week in the first senior healthcare management job I ever had. I was 22 and had got this job at a relatively young age in those days. Any ideas of pretentiousness were quickly dispelled by events.

I discovered that I had walked straight into something of a mini crisis in the Transport department. The Transport department consisted on one van driver and a relief driver who covered in the absence of the full time driver. My arrival coincided with a long spell of sickness for the relief driver and then after I had been in post for less than a week the full time driver went sick. I was assured this was not linked to my arrival!

Although my job was of course much wider than merely managing the transport it was nevertheless a small but important part of my duties and so I was immediately on the spot.

I had numerous demands from all the other departments who had been awaiting my arrival as the new hospital manager and yet there was a mini crisis in one small department.

I searched around and asked people what were the contingency plans for such an event. There were no plans as this had never happened before.

I suddenly became aware that I was alone here and had to do something. The only solution I could think of was to 'become the van driver' for a week until the regular driver came back to work after his sickness. And so my new smart office clothes that I had been proudly wearing for just three days were hung up and I donned the overalls and tunic of the van driver. I read the shift duties and asked around to become familiar with the duties. I was loading dirty laundry and unloading clean laundry I was a courier service delivering post and blood samples between hospitals and health centers. I was a 'people carrier' transporting nurses back and forth to the neighboring town for their training sessions. At the same time I was trying to fit in learning about other and bigger elements of my exciting new job.

Although this was not exactly how I had envisaged starting my career as a manager I still remember it well and I think it stood me in good stead for future challenges.

Having ‘been there and got the tee shirt’ I felt in a good position when challenged about the efficiency of the department – I was speaking from an informed position.

Over 20 years later when I was managing mental health services we had a staff crisis owing to industrial action and a work to rule.

I was telephoned by the Manager of a residential unit for Older People with mental health problems to say that the weekend coverage was stretched to breaking point and there were concerns that patient safety may be at risk unless we could approve overtime.

We were not allowed to pay overtime and so I offered to work two 12 hours shifts on the Saturday and the Sunday as an unqualified Nursing Assistant if it would help. The manager of the unit was grateful if a little suspicious about my motives and agreed that I could provide a pair of hands for two shifts to help cover the immediate crisis.
Those two days were as informative and instructive for me as any in my whole career and I learned so much. Working alongside the front line staff in such difficult circumstances was a profound experience that I will never forget and although I had always prided myself in how much I felt I could empathise with front line staff, this experience proved to me that we never truly know what it is like until we do it.

Moving on another few years I started a job as a Locality Manager and I wanted to get a feel for what it is really like to work as a District Nurse or Receptionist or Health Visitor and so I planned to spend at least one day working with a member of each of the professions I was accountable for. I planned it in partnership with the professionals concerned and there were a few cynical people who again were presumably suspicious of my intentions and motives. On the whole though I was received very well and again I found the learning to be very special. I felt privileged to be able to share the time with those staff and I am convinced it gave me much greater awareness of some of the things they have to deal with in the everyday sparring that goes on. There is simply no better experience than ‘doing the job.’ When circumstances dictate you have to ‘get your hands dirty’ and remember where you came from and why you are there.

I feel it should not be something we only do as leaders when there is a crisis. I would suggest all leaders or aspiring leaders would be well advised to build into their regular regime some time spent alongside their front line staff.

Leadership Lessons

‘Walking the talk’ means getting your hands dirty. You never lose the responsibility of making sure the job gets done. Your credibility is linked to how dirty you are prepared to see your hands become.