Hospital Impact—One nurse's move from 'hammer' to heart-centered leadership

A nurse known as the "Hammer" is good at "laying down the law" and holding people accountable, but that role is one that comes at a cost.
headshot of Thomas Dahlborg
Thomas Dahlborg

How many people can say they coached a hammer?

Recently, I had an amazing coaching experience with an incredible nurse leader known as the “Hammer.”

  • Need a nursing unit to expedite a discharge to improve patient flow from the emergency department? Call the Hammer.
  • Need to modify staffing to ensure optimal coverage on multiple units? Call the Hammer.
  • Need another nurse leader to do something that he or she doesn't want to do? Call the Hammer.

“Tom, I am used to being the Hammer. To go to a nursing unit and lay down the law and ensure that law is adhered to. And I am good at it. If you need something hard done, that is where I come in. I get things done.”

And the Hammer also had a reputation. In fact, a reputation that I became aware of prior to our first meeting.

“Tell me more about being the Hammer. Tell me how being the Hammer makes you feel?” I asked.

“Tom, I feel a sense of accomplishment when my objectives are achieved,” he replied.

“And?” I pressed.

And then, after a long pause, he added: “I also feel that I have lost who I am. I have lost my sense of self as I play the role of the Hammer. And I feel those who I interact with see me only as the Hammer, as the bearer of negativity, as the person who is delivering bad news. And Tom, although I don’t show it … it hurts. I am just trying to do what is right. And you know the old saying, ‘if you have a Hammer (or in my case … if you are the Hammer), everything looks like a nail.’”

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I could see the anguish in this nurse leader.

“You recently accepted a new leadership role,” I said. “Tell me more about that.”

“That is just it. I have a new opportunity. An opportunity to really lead … rather than to simply be a transactional leader. And I want to be more than the Hammer. I want to be a true leader.”

This nurse leader and I continued our discussion. We discussed how he felt physically, mentally, emotionally and spiritually as he played the role of the Hammer. We discussed what he did incredibly well—and how that helped others—and where there were opportunities to evolve to the next level as a leader.

We discussed the power of mindfulness as a leader, including the importance of awareness, presence and acknowledgment.

And we discussed how when we evolve beyond mindfulness to “heartfulness,” we truly embrace the essence of leadership and connect at a whole new level with our team—and with ourselves.

“But Tom, how can I lead from my heart and still be a strong leader, still set clear goals and most importantly, hold people accountable?”

This question wasn’t new. And as I have said many a time to many a leader, this is often the challenge identified by their peers—especially in nonprofit and mission-driven organizations. And thus, I shared the following:

As we evolve to ‘heartful’ leadership, it remains incumbent upon each of us to set clear goals, to lead and to serve our team, and yes, to hold our team (and ourselves) accountable. It may seem contrary to do so, but when we do not hold folks accountable we are doing a disservice to them and to all we serve. (In fact, we are neither leading or serving). We are not serving them in a way that positions them for growth so that they can better serve others. In fact, we are actually positioning them to be lesser than their full potential. And is that true leadership?

“I never looked at it like that,” he said. “No. No it is not. I thought to be heartful meant to be nice. And nice meant to be lenient and not hold accountable. This is a whole new perspective.”

Only when we truly connect with one another at a heart level do we optimally engage. This is when the “what” and the “why” that many leadership books highlight intersect. This is where ego gets set aside and purpose reigns. Only when we lead from a place of action and from a place of service to others will the real change take place.

Throughout the healthcare system (and other sectors as well), many believe we can instill this change and engagement through financial incentives. Yet research shows these impacts are short-lived at best and lead to less engagement, as the focus turns to monetary rewards rather than care and service.

Being the “Hammer,” I explained, may accomplish short-term goals, yet it also leads to disengagement among your team and the loss of your authentic self. “Does that resonate?” I asked.

And with a slight nod and a simple “yes,” the Hammer began his journey toward becoming a “heartful” leader.

Thomas H. Dahlborg, M.S.H.S.M., is an industry voice for relationship-centered compassionate care and servant leadership. He is a keynote speaker, author, consultant and adviser and is the president of the Dahlborg Healthcare Leadership Group.