Are We Losing Good Managers Because We're Asking Them to Do Too Much With Too Little?

Sep 26

Before we ask why talented frontline managers leave, perhaps we should examine what we're asking them to manage.

THE CULTURE PRESCRIPTION™ | THE LEADERSHIP JOURNAL

By Sharra Schewee-Blair

I've spent more than two decades working in healthcare leadership, and I'm still managing many of the operational challenges I write about.

I understand what it's like to begin the morning with a plan, only to have that plan change before the day has really started.

A staffing issue needs attention. An employee needs guidance. A patient concern requires follow-up. There's an operational problem to resolve, a meeting to attend, and an organizational initiative that needs to move forward.

And somewhere in the middle of all that, we're expected to develop our employees, coach emerging leaders, improve performance, reinforce organizational priorities, and create the kind of workplace culture that makes people want to stay.

I'm not suggesting those responsibilities are unreasonable. They're important parts of leadership, and many are responsibilities I've willingly accepted throughout my career.

But I've become increasingly interested in a question that I believe deserves more attention.

Are we giving frontline managers the development, authority, resources, and organizational support necessary to meet the expectations we've placed on them?

I'm asking that question as someone who understands both the rewards and the challenges of the position.

And as someone who believes we have an opportunity to rethink how we develop and support the people responsible for leading our frontline teams.

When Everything Becomes the Manager's Responsibility

One of the realities of healthcare operations is that priorities rarely arrive one at a time.

I can begin the day with every intention of spending time on employee development, working through a departmental improvement opportunity, or completing an important project.

Then something unexpected happens.

And that's part of the job.

Healthcare operations involve people, and people don't operate according to our calendars. Employees have questions. Patients have needs. Unexpected circumstances require decisions. Organizational priorities continue moving forward regardless of what happens in our departments.

Over the years, I've learned that being an effective manager requires flexibility, sound judgment, and the ability to distinguish what needs my immediate attention from what can wait.

I've also learned that not every problem requires me to become the solution.

That's an important leadership lesson, but it doesn't eliminate the operational demands of the position.

There is a difference between a manager who needs to improve their ability to prioritize and a leadership position that has accumulated more responsibilities than one person can reasonably manage.

I think we sometimes overlook that distinction.

When organizations continue adding responsibilities without examining existing expectations, administrative support, available resources, and decision-making authority, even experienced managers can find themselves struggling to give every responsibility the attention it deserves.

Another class on time management might be helpful.

But it won't necessarily resolve a position that has been structured around unrealistic expectations.

For healthcare executives and organizational leaders, I believe this presents an important opportunity.

Rather than examining leadership effectiveness exclusively through individual performance, we should also examine the operational environments in which our managers are expected to perform.

Sometimes developing a manager requires improving their leadership skills.

Other times, it requires examining how we've designed the position itself.

Frequently, it requires both.

We Expect Managers to Develop People. But When?

Employee development is one of the parts of leadership I value most.

Throughout my career, I've had opportunities to mentor employees, encourage people to pursue professional goals, and watch individuals develop capabilities they may not have initially recognized in themselves.

Those experiences have shaped my leadership philosophy.

I believe one of our greatest responsibilities as leaders is to help people become increasingly capable, confident, and independent.

But developing people requires intentional effort.

It requires conversations that go beyond immediate operational concerns. It requires observing employees, recognizing potential, providing feedback, creating opportunities, and allowing people to develop through experience.

And it requires time.

As frontline managers, we understand how easily that time can disappear.

We can have every intention of conducting meaningful coaching conversations or spending additional time developing an emerging leader, only to have immediate operational needs demand our attention.

Sometimes those interruptions are unavoidable.

But when employee development consistently becomes something we do only after everything else is finished, we have a problem worth examining.

We can't consistently treat employee development as an organizational priority while structuring leadership roles as though development is optional.

I believe healthcare organizations have an opportunity to examine this more intentionally.

If developing employees and building leadership pipelines are organizational priorities, how are we helping managers make those priorities part of their actual work?

Are we providing practical tools and ongoing development?

Are we helping managers identify responsibilities they can appropriately delegate?

Are we examining administrative demands that consume time without necessarily adding value?

And are we evaluating managers in ways that recognize their contributions to developing other people?

These questions matter because the development of our future workforce depends, in part, on the capacity of today's leaders to invest in them.

The Hidden Cost of Being Everyone's Problem Solver

Earlier in my leadership career, I believed being a good manager meant having the answers.

If someone needed help, I wanted to provide it. If something wasn't working, I wanted to fix it. If a problem appeared, I felt responsible for finding the solution.

My intentions were good.

But eventually, I recognized that my approach wasn't always helping the people I was leading.

Sometimes I was unintentionally teaching employees to depend on me instead of developing their own judgment.

That realization changed how I approached leadership.

I began recognizing that my responsibility wasn't simply to solve problems. It was also to develop people who could solve problems.

I still believe that.

But there's another dimension to this conversation that deserves attention.

What happens when the organization itself has created an environment in which the manager is expected to be everyone's problem solver?

What happens when responsibilities aren't clearly distributed, employees don't understand their decision-making authority, or routine operational issues consistently require management involvement?

Even managers who understand the importance of delegation can struggle when the systems surrounding them don't support it.

This is where leadership development and organizational development intersect.

We can teach managers how to delegate, coach employees, and build confidence.

But organizations must also establish clear responsibilities, appropriate decision-making authority, and operational processes that support those behaviors.

Otherwise, we risk teaching leadership principles that managers cannot consistently put into practice.

And when managers become the default solution for every problem, we create another concern.

Operational dependence.

If everything requires one person's involvement, that individual can become a bottleneck. When they're unavailable, the department may struggle to operate with the same confidence or efficiency.

Developing employee capability isn't simply about helping managers manage their workloads.

It's about building stronger teams and more reliable operations.

Frontline Managers and Frontline Supervisors Need Different Kinds of Support

I also think we need to be more intentional about distinguishing frontline managers from frontline supervisors when discussing leadership development.

Both positions are essential to healthcare operations, and both require strong people-leadership skills.

But their responsibilities aren't always the same.

A frontline supervisor may spend much of the day providing direct oversight, coordinating employees, managing immediate workflow challenges, reinforcing expectations, and supporting the daily performance of a team.

A frontline manager may have broader responsibility for departmental performance, staffing decisions, budgets, operational planning, employee development, performance management, and implementing organizational initiatives.

These responsibilities vary by organization, and the distinction isn't always reflected consistently in job titles.

In some healthcare settings, frontline managers are performing many of the same immediate supervisory responsibilities while also carrying broader departmental accountability.

That's an important distinction when designing leadership development programs.

A newly promoted supervisor may need substantial support transitioning from individual contributor to people leader. They may be learning how to conduct difficult conversations, provide feedback, delegate responsibilities, and navigate their new relationship with former peers.

A frontline manager may need those same capabilities while also learning to balance operational performance, organizational expectations, resource allocation, and the development of other leaders.

And experienced managers have development needs, too.

Our development shouldn't stop simply because we've been in leadership for years.

As responsibilities evolve, organizational priorities change, and new challenges emerge, we need opportunities to strengthen our capabilities and learn from other experienced leaders.

Leadership development should reflect the actual responsibilities of the position, not simply the title assigned to it.

I believe this is an opportunity for healthcare organizations to create more intentional development pathways for supervisors, new managers, and experienced operational leaders.

Rather than assuming everyone needs the same leadership curriculum, we can begin by understanding what each group is actually expected to accomplish.

Are We Developing Managers or Simply Giving Them More Responsibilities?

I've participated in leadership development opportunities throughout my career, and I believe formal leadership education has tremendous value.

It introduces us to new concepts, challenges our thinking, and provides tools that can improve how we lead.

But I've also learned that understanding a leadership concept and applying it during a difficult operational situation are two different things.

A classroom can teach us how to approach a difficult conversation.

The actual conversation is where we discover how well we've learned.

We can study delegation, communication, accountability, and conflict resolution.

But applying those skills while managing staffing challenges, competing organizational priorities, and the complexities of human relationships requires experience.

It also requires opportunities to reflect on that experience.

That's why I believe ongoing mentoring and practical leadership development deserve greater consideration.

Imagine a newly promoted frontline supervisor who has access to an experienced operational mentor.

Someone who understands the realities of managing employees, balancing immediate priorities, and navigating situations that don't have straightforward answers.

Someone who can ask thoughtful questions, offer perspective, and help that supervisor develop sound judgment without automatically providing the solution.

Now imagine extending that same philosophy to frontline managers.

What if managers had opportunities to work with experienced healthcare operational leaders who could help them navigate increasingly complex responsibilities?

Not someone who replaces their direct leader, human resources, organizational development, or other established organizational functions.

Someone who complements those resources by helping managers translate leadership education into everyday practice.

I believe there's considerable value in creating those opportunities.

But mentoring should never become a substitute for addressing organizational problems.

We shouldn't expect a mentor to help someone become more effective at managing responsibilities that were never realistically structured in the first place.

Effective leadership development requires us to understand the difference between an individual development opportunity and an organizational challenge.

And sometimes, both exist at the same time.

Sometimes Retention Is an Organizational Design Question

When a talented manager leaves an organization, it's natural to want to understand why.

Compensation, career advancement, leadership relationships, personal circumstances, and work-life considerations can all influence someone's decision.

I don't believe every departure should be interpreted as an organizational failure.

Sometimes people leave because they've grown and are ready for their next opportunity.

As someone who believes strongly in developing people, I consider that an important distinction.

But I also believe we should examine the environments we're asking our managers to lead within.

Are expectations realistic?

Does the manager have appropriate authority to make decisions?

Are responsibilities clearly defined?

Do operational resources align with expected outcomes?

Are managers receiving development that reflects the challenges they actually encounter?

And does organizational leadership have a realistic understanding of what managing that department involves?

I think that last question is especially important.

From an organizational perspective, a new initiative may appear to involve a relatively straightforward change in expectations.

From an operational perspective, implementing that initiative may involve workflow adjustments, employee education, scheduling changes, additional documentation, communication challenges, and ongoing monitoring.

Each individual initiative may be reasonable.

But frontline managers are responsible for integrating those initiatives into operations that are already functioning.

Understanding that cumulative impact is important.

Healthcare executives and organizational development professionals have an opportunity to examine these conditions alongside the individual development needs of their managers.

Doing so may reveal opportunities to improve both leadership effectiveness and retention.

The Connection Between Organizational Development and Operations

One of the areas I'm particularly interested in is strengthening the connection between organizational development and operational leadership.

I see considerable value in both perspectives.

Organizational development professionals bring expertise in leadership competencies, learning strategies, organizational behavior, assessment, and the design of development programs.

Operational leaders bring firsthand knowledge of departmental responsibilities, workflow demands, staffing realities, and the decisions managers face every day.

Neither perspective should operate independently of the other.

Consider a development assessment that identifies delegation as an opportunity for improvement.

An organizational development professional might recommend education, coaching, and opportunities to practice delegation.

Those interventions could be entirely appropriate.

But an operational leader might identify another contributing factor.

Perhaps the manager lacks clarity about which decisions can be delegated.

Perhaps the department doesn't have an established process for distributing responsibilities.

Perhaps staffing limitations have created an environment in which the manager regularly assumes tasks that would otherwise be handled by other team members.

Or perhaps the manager genuinely needs to develop stronger delegation skills.

Understanding the difference changes the intervention.

This is where I believe collaboration becomes especially valuable.

Rather than designing leadership development exclusively around generalized competencies, we can combine those competencies with an understanding of the operational environments in which leaders work.

We can examine individual leadership behaviors while also considering organizational expectations, resources, processes, and support systems.

And we can develop programs that don't end when participants complete their classroom education.

Programs that include practical application, mentoring, reflection, reinforcement, and opportunities to measure progress.

That's the kind of collaboration I believe can strengthen frontline leadership development.

Where The Culture Prescription™ Fits

My interest in this work isn't based solely on studying leadership.

It's also the result of spending more than two decades practicing it.

I've experienced the challenges of managing competing priorities, developing employees, navigating difficult conversations, implementing organizational initiatives, and recognizing when my own leadership approach needed to change.

I'm still learning.

And I'm still working in the operational environment that continues to shape my perspective.

That's an important part of why I created The Culture Prescription™.

I wanted to build something that connects established leadership principles with the everyday realities of leading people.

Something that recognizes that leadership education is valuable, but that developing capable leaders requires more than teaching concepts.

Through The Culture Prescription™, I'm developing leadership education, coaching, mentoring, and organizational consulting services that reflect that philosophy.

The process begins by understanding what leaders and organizations actually need.

Sometimes a leader needs additional education.

Sometimes they need coaching, mentoring, or opportunities to practice a particular skill.

Sometimes they need greater clarity about their responsibilities or additional support from their organization.

The Culture Prescription's five leadership pillars—CONNECT, VALUE, CLARIFY, IGNITE, and LEAVE BETTER—provide the foundation for developing the human side of leadership.

But those principles must operate within organizational environments that support their application.

Not replacing the development resources organizations already have.

Complementing them.

Bringing operational experience into leadership development, helping leaders apply what they've learned, and supporting organizations as they examine the relationship between individual leadership capabilities and operational expectations.

I believe there's an opportunity to build development programs that are both educationally sound and operationally realistic.

Programs designed with an understanding of what frontline leaders actually experience.

And programs that continue supporting those leaders long after their formal education is complete.

Before We Ask Why They Leave

I don't believe organizations can eliminate every challenge associated with frontline leadership.

Healthcare operations are complex. Unexpected situations will occur. Priorities will compete. Difficult decisions will remain part of the job.

And some degree of pressure comes with accepting responsibility for other people and organizational outcomes.

I understand that firsthand.

I also believe managers have a responsibility to continue developing themselves, strengthening their teams, and learning how to navigate those challenges effectively.

But organizational responsibility matters, too.

We can hold managers accountable for their performance while examining whether we've provided the conditions necessary for them to succeed.

We can create development pathways that recognize the different responsibilities of supervisors, new managers, and experienced leaders.

We can connect formal education with practical application and ongoing mentoring.

And we can strengthen collaboration between organizational development and the operational leaders who understand the realities of frontline management.

I don't think the answer is to lower our expectations of frontline managers.

I think we need to be equally intentional about developing and supporting them as we are about defining what we expect them to accomplish.

So before we ask why a talented frontline manager decided to leave, perhaps we should ask a different question.

What did we do to help that manager succeed while they were here?

And for those of us still doing this work, perhaps there's another question worth asking.

What conversations do we need to initiate today to help create better conditions for the leaders who will follow us?

Because developing the next generation of healthcare leaders isn't simply about preparing people to accept leadership positions.

It's also about creating organizational environments in which they have meaningful opportunities to succeed.

ABOUT THE AUTHOR

Sharra Schewee-Blair is the founder of The Culture Prescription™, an author, and a healthcare operations leader with more than 20 years of leadership experience.

Her professional background includes ambulatory healthcare operations, frontline leadership development, mentoring emerging professionals, and supporting organizational initiatives focused on leadership development, workplace culture, and high reliability.

Sharra is the author of The Culture Prescription: Leadership Practices for Connecting, Valuing, Clarifying, Igniting, and Leaving People Better Than You Found Them

Through The Culture Prescription™, Sharra develops practical leadership education, mentoring, coaching, and organizational consulting resources that connect established leadership principles with the realities of operational leadership.

Sharra Schewee-Blair https://www.cultureprescription.com