Today more than ever, the healthcare sector faces growing pressures that will further tax its capabilities and inhibit its ability to meet growing consumer demands. Significant challenges of healthcare organizations include: financial pressures, increasing competition, staffing shortages, employee and patient safety concerns, and a significant increase in the consumption of healthcare related services (Kovner & Neuhauser, 2004). Overcoming these challenges will require that leaders of healthcare organizations seek creative strategies to improve and maintain high performance of employees. With that being said, it becomes obvious that improving and maintaining high employee morale is a key factor to consider in the pursuit of organizational success.
The behavior of individuals employed by an organization is driven by employee morale which may be defined as the spirits of a person or group as exhibited by confidence, cheerfulness, discipline, and willingness to perform assigned tasks ("Definition of Morale," 2000). According to Finger (2005), morale is more influenced from the top down than from the bottom up. There is no single factor that consistently explains good or poor morale. Rather, a combination of related factors results in good or poor morale. In addition, morale may be thought of as a group phenomenon but an individual matter. Group morale depends on the morale of each individual in a group. High morale in a group means that most of the people in a group have a good sense of “esprit.” Esprit refers to liveliness of mind or spirit; sprightliness ("Defintion of Esprit," 2000). According to Finger (2005), in order to improve the “esprit” of a group, the morale of each individual in the group must be improved, which is best achieved through the personal missionary work of the manager. Robert K. Greenleaf (1996) refers to this as servant-leadership. Greenleaf’s teachings indicate the servant-leader is servant first, after which a conscious choice brings one to aspire to lead. The servant leader ensures that other people’s highest priority needs are being served.
The High Cost of Low Morale
Morale can be the fuel that drives an organization forward or the fuel that feeds the fires of employee discontent, poor performance, and absenteeism (Ewton, 2007). With low morale comes a high price tag. The Gallup Organization estimates that there are 22 million actively disengaged employees costing the American economy as much as $350 billion dollars per year in lost productivity including absenteeism, illness, and other problems that result when employees are unhappy at work.
According to the CCH Unscheduled Absence Survey, employers have failed to make significant headway against the costly absenteeism problem that takes billions of dollars off the bottom line for U.S. businesses. The nation’s largest employers estimate that unscheduled absenteeism costs their businesses more than $760,000 per year in direct payroll costs, and even more when lower productivity, lost revenue, and the effects of poor morale are considered ("CCH 2007 Unscheduled," 2007).
The Consequences of Not Addressing Morale Issues in the Workplace
Leaders who fail to address morale issues in the workplace face the following: decreased productivity, increased rates of absenteeism and associated costs, increased conflicts in the work environment, increased patient complaints and dissatisfied consumers of care, and increased employee turnover rates and costs associated with hiring and training replacement staff.
Causes of Low Morale
Leaders of healthcare organizations spend their time, resources, and energy seeking out the best and the brightest employees the job market has to offer; however, once these individuals are hired, management doesn’t always know how to bring out the best in them. Instead, these individuals often remain status quo when in reality their potential is far beyond status quo. Unchallenging environments with little or no opportunities for professional growth and advancement often lead to low employee morale (Workforce, 2006). In addition, other leadership related competencies that contribute to low morale in healthcare workers include poor communication, lack of empowerment, lack of energizing staff, distrust of management, poor interpersonal relations, and inflexible working conditions (Dye & Garman, 2006). Of further mention, situations that can lead to low morale include: departmental layoffs or closures, labor negotiations and contract disputes, high employee turnover rates, changes in leadership, and unclear expectations and corporate direction (Workforce, 2006).
Signs of Low Morale
Healthcare employee morale or the lack of it is dependent upon a meaningful, productive, fulfilling relationship between staff and management. Satisfied healthcare employees display visible signs that include: cheerfulness, attentiveness to the needs of their patients, the willingness to go the “extra mile” and a positive attitude to those that they encounter. In addition, patients will comment on such employees through patient satisfaction surveys. Employees with low morale will display signs that include: increased absenteeism, conflicts with co-workers, insubordination, decreased productivity, disorganized and unkempt work environments, routinely complaining about seemingly insignificant work related issues, and increased patient complaints in regards to the employee’s behavior (Contemporary, 1999). Leaders can help bring morale issues forward by allowing staff to voice concerns as a group in staff meetings, through employee feedback surveys, or through employee suggestion programs.
Addressing Low Morale through Servant Leadership
According to Schuler (2004), most people who experience low morale in the work environment blame the leadership or their immediate supervisor. Several leadership related competencies that can contribute to morale issues in employees if lacking include: communicating vision, energizing staff, trust, loyalty, and developing teams. Leadership related competencies can be addressed through servant leadership. Greenleaf, (1996) proposed that “the great leader is seen as servant first, and that simple fact is the key to his greatness”. In addition, Greenleaf emphasized that leaders who practice servant leadership are more likely to be trusted. In order to improve morale in the work environment leaders need to create a culture of trust in an organization. According to Shein (1992), leaders have the ability to shape and influence the organizational culture through: role modeling, the way they allocate resources, how they reward employees, and by the criteria they use for recruitment, promotions, and terminations. Levin (1999) emphasizes that a climate of trust exists in organizations when managers do what they say they are going to do and are consistent in their actions. According to Dye & Garman (2006), managers can earn trust and improve employee morale by being accessible, authentic, fostering openness, and by role modeling.
Effective communication is another essential leadership competency when it comes to improving low morale in healthcare employees. Communication that lacks clarity, focus, important details, is too infrequent, lacks meaning, and does not allow staff to respond and discuss their concerns can contribute to morale problems in the workplace. To help prevent morale issues in the workplace leaders need to spend time communicating their vision to ensure that “everyone is on the same page”. In addition, highly effective leaders will communicate widely and allow their messages to be discussed in person or at staff meetings. Allowing employees the opportunity to respond and ask questions helps to improve morale by making them feel that their thoughts and opinions are important (Dye & Garman, 2006).
Energizing staff is a third important leadership competency that can be directly linked to low employee morale. Dye and Garman (2006) refer to energizing staff as the activities leaders pursue to heighten levels of motivation in the people with whom they work. Servant leaders can energize staff by setting a personal example of good work ethic and motivation. In addition, servant leaders speak and act enthusiastically and optimistically about the future. They help others recognize the importance of their work; are enjoyable to work for; and have a goal oriented, ambitious, and determined working style. In order to improve morale, leaders who energize staff need to be aware of what motivates individual employees, understand individual goals and priorities of employees, and recognize and celebrate employee successes. Recognizing and celebrating staff success does not have to be costly. Leaders can serve the needs of employees by writing thank you notes, thanking them in person, hosting a departmental luncheon to honor the staff in which the leader prepares the food and serves the employees, or by offering to cover the employee’s work load allowing the employee to leave work early or take a day off. Small tokens of appreciation can go a long way when it comes to improving or preventing morale issues.
The ability of a leader to develop and maintain a highly effective team is another important leadership-related competency that, when lacking, can lead to employee morale issues. In order to improve morale issues, leaders need to be proficient in developing cohesiveness of the team. This can be accomplished by increasing the frequency of interaction among team members, providing opportunities to discuss group goals and how they can be best achieved, and by developing a healthy sense of competition against other teams. In addition, servant leaders refer to themselves as a member of the team and work to build a sense of “we” when it comes to goal setting and working through conflicts. Leaders can improve morale by including staff in individual and team goal-setting and by developing team-based incentive programs (Dye & Garman, 2006).
In the busy and stressful environment of healthcare institutions, leaders must remain focused on ensuring that patients receive the best care possible and employees remain motivated and enriched by their work. Accomplishing both can be a difficult and challenging task for health care leaders, however, leaders who take the time to understand what motivates one individual staff member from another can energize staff by recognizing and celebrating their accomplishments often through inexpensive and simple measures to include: thank you grams, employee of the month awards, luncheons, and staff recognition days. In addition, leaders who serve their staff by “pitching in” when it comes to patient care can also energize staff and improve morale by setting a personal example of good work ethic and motivation, which in return, can help others recognize the importance of their work. Finally, employees that recognize the importance of their work stay in touch with the service orientation that brought initially brought them to the health care field. In addition, it allows them see how their efforts have paid off when it comes to the patients they serve (Dye & Garman, 2006).
Nicole Fink is a graduate of the Master of Health Administration program at Roberts Wesleyan College. She wrote this article for her Organizational Leadership class, taught by professor Steven M. Hays, MSHA, CMPE.
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