When Organizational In-Breeding is Disastrous
One of the things that I really harp on is the practice of organizational in-breeding. I am not here to say that it is always a bad thing, but just like any other application or promotion, due diligence must be practiced when finding your next leader. When an organization chooses to promote from within due to convenience or lack of talent pool, the effects can be disastrous.
It's no secret that I do not care for organizational in-breeding. That doesn't meant that I never see an instance where it is appropriate to promote from within. There are times when a loyal employee has bettered themselves and worked very hard to obtain the knowledge and skills needed to step up to the next level. These candidates are prepared, knowledgable, and well qualified. They may not have the level of degree desired, but they have the experience to prove that they are capable to perform the job. There are also the bonuses that come along with an internal promotion such as a sense of loyalty. When others see that someone who has put in the time and effort gets a promotion, you can conclude that your more driven employees will work even harder to further their careers.
The problem is that unlike many other fields, nursing administration is an entirely different beast. Managing nurses can be a very tiresome and taxing duty. It isn't because they aren't good people or hard workers, but because that administrator takes on many different duties and is tasked with leading people who tend to be strong willed and intelligent. There is also a huge gossip factor that follows the nursing field. In my many different experiences, one thing has always rang true, nurses gossip and tend to be very hostile towards their own kind. The reason for this isn't exactly clear. If I had to make an educated guess, I would say that it is due to the amount of time nurses spend with each other, the amount of stress that the job entails, and the constant obstacles that a nurse faces on a day to day basis.
When students are in nursing school, one of the first things they will probably hear from preceptors or professors is that the nursing profession is known for eating their young. Many nurses, including myself, are guilty to it at some point in time to some degree. Nursing is hard. It is hard on your body, your emotions, and you life outside of the job. This creates an environment that tends to foster negativity and hostility. It can be analyzed very simply, when you are tasked with taking care of someone who already has one foot out the door, who has time to teach someone the most basic tasks of the profession. Things that they should know, but due to many different circumstances, they have either forgotten or are not brushed up on the tasks. Some larger hospitals have combatted this problem by paying certain nurses to be preceptors. These nurses volunteer to train others and are screened to ensure that they foster an environment that is nurturing and compassionate. This doesn't entirely fix the problem, but it does level the playing field to some extent.
Someone new to nursing management is not near prepared for the job. Even a person with their doctorate who has spent many hours learning about nursing management and the many different ways of approaching it will be caught off guard in the beginning. Nothing can prepare you for the task, but you have to have the ability to adapt and learn as you go. It may seem as if by this point we are off topic from where we started, but it gives a background to my reasoning, so forgive the excessive wording, but I want us all to be well informed. This is where the points tie together. It is very difficult for someone to take charge of such a difficult position when they have so many personal relationships with other staff members. Literally in one day they went from a co-worker and friend to a boss, and now they have to think like a leader and not just a friend.
Friendships can be maintained, but a whole new balancing act has started because you must learn how to be an effective leader, implementing policies and procedures that may upset many or all employees, while trying to maintain friendships. I'm sure this dynamic exists in other fields, but I talk about the one I know. You may have to give your good friend a pay cut, terminate or lay them off, or introduce a policy that you know will be adverse to them. I find that this is a huge problem with organizational in-breeding because many people have difficult with being a friend and a boss. You could ask them and they would say they do just fine, but if their employees were asked they would have a completely different view. There are two sides to this, but when you take on the role as a leader you are doing so knowing that you will have to behave differently and will have to think about how each person views your actions. This can be hard to accomplish, and I feel that it is something that is a consistent problem with organizational in-breeding. If you were to list most common problems, this would be in the top. Rarely are you going to see an internal promotion that doesn't quickly have the word "favoritism" tossed around.
Now compare that to a person who is hired from the outside. This person will essentially meet each person at the same time. They will not have preconceived ideas about their employees, and each employee would ideally start off evenly. That is obviously the ideal situation, but it is much more likely when the person doesn't know any of the staff. This also can help the overall appearance of the administration. Whereas someone who is promoted from within has already developed a reputation with both good and bad qualities, the outsider is starting fresh and is essentially only known for their beginning actions and speeches. They have time to develop their reputation and the same goes for their employees, which can be an advantageous situation for all parties involved.
The next point is associated with qualifications. In my personal experience, internal promotions tend to lead to under-qualified people obtaining top level positions. As stated before, some are qualified and have proven it either via education or experience, but many aren't held to the same standards that an external candidate is. For example, the accepted standard for a nurse manager is a bachelors degree with at least two years in a leadership role. This is about the same through any facilities, although we are seeing a trend from bachelors to masters, especially in the larger facilities. If you were to walk in a semi-small to small hospital and speak with nurse managers, if they have them, you would quickly notice that there are many who don't even have a bachelors degree. This is a constant battle in the field as there are many without a bachelors who will constantly say that the bachelors does nothing and that nurses who have a bachelors are if anything less talented than their counterparts with two year degrees or certificates. Unfortunately for them, they are just completely wrong. Facilities want nurses with at least a bachelors because that degree has taught them many leadership tools that they would have otherwise not acquired. The bachelors prepared nurse is taught nursing as well as leadership, and there are many out there that are living evidence of the benefits the degree allows.
I always make the analogy that a degree is like a tool box. I think it is safe to say that almost every person who has obtained their R.N. can continue their education as far as they want. So we look at a bachelors, masters, and doctorate as a tool box. One is pretty basic, the next is a bit more complicated and fancy, and the last one is the set that only pro's buy. None the less, they are just tools, and without the knowledge of application, they are useless. The person who obtains the degree must be able to apply the knowledge they have learned (tools) to their duties. My point is that anyone can go buy a toolbox, but only certain individuals who have learned the trade and trained in the field can actually use the tools to complete a project. I could go to the store right now and buy an awesome toolset, but if I don't have the knowledge of how to use them, they are completely useless, so yes you need the degree, but you also have to have the personality and knowledge to be able and apply what you have learned.
So as we go back to the hospitals, those who were internally promoted are more likely to not have to tools required for the job. It's not that they don't have the ability to do it, but without the degree (tools), they have no way of knowing what to use and how to use it. Some will make it through and be successful, and many will then continue their education to obtain higher education knowing that they don't just want it, they need it.
When you compare that to hiring an external applicant, you see that the process is usually more strict and qualifications are less flexible. If you are looking for either someone who is internal with all the qualifications, or an external applicant with the required qualifications, you are essentially refusing to lower the bar despite the costs and time associated with it. Too often an organization utilizes internal promotion for no other than its mere convenience. When you lower the bar, you are essentially letting your employees know that you are more concerned with your businesses finances and time than you are their wellbeing. It's pretty apparent at this point that when it comes to qualifications, organizational in-breeding doesn't have to be a bad thing if the same standards are kept, but far too often the standard is lowered out of desperation. We all know that hiring a head hunter isn't cheap, and many times if you can't find someone quickly you are looking at a pretty high salary with even more money spent to move the applicant and such things. This is where leadership has to bite the bullet and realize that just as college kids learn when they shop at Dollar Tree (love that place), you tend to get what you pay for.
Another issue with organizational in-breeding is that when you hire from within, you are more likely to have someone who has a biased view of the problems, or doesn't really see the need for any change. I know from personal experience, when an internal promotion is made they tend to keep loyalty to their group of friends despite whether it is the right thing to do. I'll tie this in with a quick story. I once worked at a facility where I saw a terrible external and internal promotion, all in the same year. The external applicant was given a role that typically required a master's degree, and this particular person didn't even have a bachelors. I say the promotion was external, but this person had worked at the facility for a couple of months, but was essentially the only person that didn't live in the town. When they power changed, several employees who had been getting away with very sub-standard care were eventually terminated or ran off. The ways in which this was carried out were not very ethical or fair, but at the end of the day these employees were not performing as they needed too. Fast forward a year and this person is let go due to constant turnover and terrible leadership, and about anyone could have predicted this as there was no knowledge or skills for leadership there what so ever. No one besides administration will know why, but the new director was chosen over another (external-ish) applicant who had a higher education and more leadership experience. The most probable reason was convenience, continued control, and the fact that the internal applicant lived in the town and had done so for a very long time so they didn't really have to worry about turnover.
So again we have a transition of power, well this person is a great example of the loyalty problem. This person survived the purge of employees when the predecessor took over, and had one heck of a chip on their shoulder from it. The new director started with the thought that there were 3 to 4 positions that were unjustly terminated and of course who doesn't want to work with their friends? This person did not have leadership experience, had only worked at this one facility, and was going to school at an online college that made Devry look like Harvard. I am a firm believer that true leadership is something that is learned from a very young age. In other words, some have it and some don't. Needless to say it didn't take a rocket scientist to figure out this particular person did not have the skills needed to be a leader.
It didn't take the employees long to start noticing what a bad decision this had been. Instead of being an advocate for the department, the new director was consumed with their own schooling and personal life, and didn't have much time to implement true leadership. I think that this was actually a calculated decision from the administrator as it was a great way to control a department and incorporate a figurehead that you could manipulate better than a marionette. There was no ambition with the director at all. It was essentially like an actor being surrounded by "yes" men. This was one more person that would fall in line and do as they were told. There was good pay with good hours, and the new director wasn't about to complain. The issue was that because the director had very limited power and could not have their time consumed with ways to better the department, it became very easy to focus on personal goals and aspirations. Remember the purged staff? Well they slowly began to return. The employees felt the sting as they saw their own director, one who had promised to be and advocate for positive change and to be different than the past, turn into a person who was worse than their predecessor.
As you could imagine, slowly staff started to leave or be forced out. The morale at the facility hit an all time low. With the first one, the staff were able to be a team to fight for the good because their prior director was so bad it became something they bonded over. This time you had someone who had friends on the inside, and had a long standing reputation there, so the staff was afraid to speak of anything because they couldn't figure out who was and was not feeding the new director information. One of the most immature things a director can do is act on gossip. I do feel that gossip does need to be addressed from time to time, but if you don't actually see the problem yourself, leave it be. When a director addresses gossip that they cannot prove or at least have some idea that it is real, they are no better than those who are doing it. They may feel that their intentions are good, as they are trying to squash a rumor, but it can also create tension with employees when they feel that petty talk is being treated as legitimate problems. This is a great example of how the director did not possess the most basic leadership skills. A true leader would be sure and listen to things that were said, but before acting on it or talking with the staff about it, a good leader would investigate into the issues and make sure that there is actually some truth to it. Again, an external applicant would most likely not hear this kind of petty gossip as they wouldn't have all these different relationships there, or would not pay much mind to it as they should be confident in their leadership. Addressing rumors and petty gossip can be a necessary evil of the job, or it can make you look intimidated and weak. After all, if you are given the position, are you really that worried that another person is "out to get you" ? I would have very little concern as I am confident in my style and practice of leadership.
The final thing I will touch on this time is the fact that internal promotion can be counterproductive to basic American values. America is a melting pot, filled with many different cultures and ideas. When you practice organizational in-breeding, it has the same effect on your facility as does in-breeding on genetics. You are keeping the status quo and not opening the door for new ideas. Change is hard, and any leader knows that, but sometimes it is necessary. When you don't bring in that leader with experience from other places and new ideas, you are shutting out so much possibility for your department. There is no better way to learn than by experience, and chances are if that external applicant has experience at multiple facilities, they have seen leadership that is effective and good for all, and leadership that is toxic. The reverse is true of an internal applicant that is the result of organizational in-breeding, they have only seen one way and whether good or bad, it's all they know.
Just like anything, organizational has its good and bad qualities. I personally feel that the bad tends to outweigh the good, especially if due diligence is not taken when vetting the potential applicants. Change is scary and many do not like it, but if you work in the medical field you quickly learn that change is inevitable. It is a part of life and definitely a part of the medical profession. We have grown as a profession because of change, and you can drag your feet all you want, but when it gets bad you tend to realize how behind you have gotten because of the defiance to change. When the time comes to pass the torch, not allowing fresh and new ideas has disastrous consequences for the facility and its reputation. Many times, especially after a terrible period of leadership, a fresh new face can be the answer to the many problems that have manifested. Practicing organizational in-breeding only masks the problems, and tends to create many more for the future.
