1. Section Editor(s): Hader, Richard PhD, NE-BC, RN, CHE, CPHQ, FAAN

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In an era of shared governance, self-scheduling, and unit-based councils, it's becoming more common to delay decision making to reach a positive or negative consensus from the team members before taking action. In many instances, it's appropriate to weigh all the options before taking action, but frequently the leader of the group must step in and make a crucial decision. Facilitating the decision will end stonewalling and move the group toward working on other key initiatives.

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When the same issue is repeatedly raised and there's no resolve, it's a call for the leader to make a decision, implement it, and move forward. All decisions aren't necessarily popular, but making no decision is far worse than temporarily setting it aside. Leaders unable or incapable of making decisions will quickly lose respect from staff members who view them as weak. The perception of indecisiveness can ruin a leader's credibility. The worst-case scenario? There will be a need to change leadership.


Many of us have been in meetings where the leader is confronted with a decision to make and he or she fails to do so. If you step back and analyze the meeting, there's often a significant amount of nonverbal communication going on between the participants. Typically, the scenario has participants holding their heads up with their hands and rolling their eyes, which simply means they've disengaged from the conversation. If this type of behavior continues, staff members will avoid the leader and work independently rather than as a team.


When should you step in and make a decision and when shouldn't you? Leaders should know when a decision needs to be made and attempt to utilize their persuasive skills to lead the group to a decision that will best meet the needs of the majority. If the leader is respected, staff members will heavily consider his or her opinion. Rarely, if ever, will staff members make a decision that's in conflict with the needs of their peers or patients.


To avoid indecisiveness, it's incumbent upon the leader to effectively and consistently communicate with his or her team. Communication should be frequent, bidirectional, and transparent, with no hidden agendas. Effective decision making is easily recognized by the staff because it's consistent and timely. Often, if the leader isn't available to make a decision, staff members will decide what to do based on the consistency of the leader's decision-making skills.


Leaders are faced with tough decisions on a daily basis. It's important for you to develop the skill to understand what requires an immediate decision and what can be delayed. Team members will typically adjust to a decision as long as the leader continues to support it and doesn't reverse or frequently change his or her mind. If you're consistent with decision making, both you and your staff will succeed and easily meet your goals together.



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