The Middle Child (Manager) Syndrome in Healthcare

Are you a charge nurse? A Recruitment Manager? A laboratory head? Or do you know someone who is?

These are the leaders who are in the middle management. They are not CEO’s and directors. They are not staff either. But they stand somewhere in between these extreme levels in the hierarchy. While it’s true that being in the position carries with itself some prestige, honor and a pay grade higher than those of the staff, lives of middle managers aren’t at all that easy.

Being in middle management is like experiencing middle child syndrome where you don’t get the same attention as the youngest (staff) and the same privileges as the eldest (top management). They get to be in the middle where at the one end employees scream under-staffing, pay cuts, diminishing benefits, over fatigue and lack of opportunities for self-enhancement and career growth, and at the other end big bosses lay out goals that are near impossible to achieve. These are the managers who are left to explain to the staff about budget limits, regulatory mandates, and consumer satisfaction. And yet, in those circumstances that they cater to both ends, their own working conditions are neglected.

While the employees have them as their voice, middle managers have a weak voice of their own.

Middle managers lack collective power because of their smaller number in comparison to front-liners. Another reason is that their priority is to balance the demands of both the top management and the staff, stifling the need to cry out their own needs in the process. And then there is “hybridization’ of roles within the hierarchy. Those with hybrid positions have both clinical and organizational roles. Hybrid managers are like personnel half dressed as direct patient handlers and as head of patient services, for example. They look across the hierarchy, and they hardly find anyone in the same situation as they are.

To who then do they lay out their suggestions and complaints? Surely not to the majority. Somewhere in that part of the organization, most of the time, what they voice out get lost.

Will their voice be lost forever?

Certainly not. There are ways these issues can be addressed. Sometimes the solution to matters like these lies not within the organization but from experts outside of the hierarchy. It may seem ironic but external consultants can be more efficient troubleshooters and solution finders because they are more objective, are neutral, and see things from a different perspective. This is especially true if a common platform will be made available to them that will facilitate easier communication with top leaders in their organization.

In fact, services like these are available if only they know where to look. ManageUP, for example, whose expertise lies in workforce development offer services that can benefit not just the staff, but the middle and top management as well.

Solutions to Middle Management Predicament Placed at Their Own Hands

Which services can middle managers benefit from? Ultimately, from services that will make their lives as middle managers easier, like these below:

Healthcare organizational transparency and closed loop communication
Hear and at the same time be heard. Understand those you lead and be the ideal liaison. Have the top management see what you do and be heard of what you want to say.

Real-time change management
Are there changes to protocols? Roles? Or policies? There are management tools available that enable new processes can be implemented, measured and tracked.

Automation
Need to tell your staff of recent changes to policies the soonest possible time? The automation of information dissemination and feedback would mean time and effort saved.

Centralized document management
Allocate precious time to more worthwhile causes instead of digging into emails or records. Have information ready, clear and concise for you and for everyone to utilize.

Feedback communication
“Constructive” criticisms do not have to be unnerving to your staff and to you. Learn to provide and receive feedback that can pave the way for continuous quality improvement and also serve as a great avenue to fine tune delegation processes, setting of limitations and allocation of resources.

In summary, middle managers play a crucial role in the attainment of organizational goals, yet there are so many challenges that keep them from performing their best. They are wedged between top management demands, and employee and client satisfaction. But help is available. It can be truly beneficial if middle managers are given a voice of their own loud enough to heard and understood.