By Jessica Melton, MHA, CEF Fellowship Class of 2018
President and CEO, Suburban Hospital, Johns Hopkins Medicine
Published in partnership with the American College of Healthcare Executives
Healthcare headlines are full of scary predictions about the gap between how many healthcare workers we need and how many we will have. Data from the American Hospital Association indicates there will be a shortage of up to 3.2 million healthcare workers by 2026. Hospitals are already struggling to hire staff (both clinical and ancillary). In fact, AHA survey data shows that “between 2019 and 2020, job vacancies for various types of nursing personnel increased by up to 30 percent.” These projected shortages are a result of many factors, and they are further complicated by a projected exodus of workers from the field due to retirements and burnout.
As if that weren’t enough, what about those who stay? An October 2022 article by the Harvard Business Review, “Quiet Quitting Is About Bad Bosses, Not Bad Employees,” suggests organizations are at even further risk due to a phenomenon known as “quiet quitting.” This is described as the act of “doing the bare minimum at work, to just get by.” Some have suggested it to be a defect of the “emerging” generations, a decline in societal work ethic, or perhaps a function of bosses who fail to connect and engage their teams. But are these fair, complete or even accurate descriptions of what our workforce is trying to tell us through their actions (or rather inaction)?
The narrative associated with quiet quitting is a return of old thinking that likes to blame the victim for systemic problems. It’s the blessed amnesia we all get for what it was like to be in the trenches or new at a job or an institution. What should our role be, as leaders, in challenging the narrative around quiet quitting and addressing the outdated and misaligned value sets that are preventing us from unlocking the best in ourselves and our workforce, especially women and underrepresented minorities? It is time for a reckoning.
I “quietly quit” five years ago. Since that time, I haven’t done less. In fact, I have probably done more, but purposefully. I have been more deliberate and impactful for my organization(s) by aligning my focus to our most critical priorities. I have been a better leader. By “quitting,” I mean that I have set boundaries and said “no” with tact, diplomacy and greater confidence to requests that did not serve me and our organization, or ultimately detracted from my ability to achieve our most important goals. With that said, I have also deliberately said “yes” with greater precision to what matters most to me and my organization. I quietly quit … yet more so than even before, I am described as someone who “goes above and beyond.” So then, what is quiet quitting?
The phenomenon we’ve labeled “quiet quitting” is a set of responses to thoughtless demands to keep doing more without asking whether what we are doing even makes sense. We seem determined to maintain practices and procedures that no longer have a clear benefit to the health of patients or our organizations, even while asking everyone to flex and take on new patterns. Quiet quitting is a poorly conceived term that doesn’t reflect a disengaged or lazy segment of our workforce, or even a horrible boss, but instead a failure to address the intersection of values and expectations in our workforces.
As leaders, we need to ensure our teams clearly understand their connection to our most pressing organizational goals. We need to ensure their roles are designed and empowered to achieve outcomes related to those goals. Importantly, we also need to acknowledge when their jobs (or our expectations of their jobs) have evolved significantly and are most accurately described by the one small line at the bottom of their job description: “additional duties as assigned.” When this one line describes the majority of their work or accounts for a new job on top of their existing role (“quiet promotion”) there may no longer be shared clarity on what they appreciate their role to be, what they are empowered to “quit” to reprioritize their new work, or what we now “quietly” expect of them and how it aligns to our priorities—leading to frustration, resentment and ultimately misalignment of values.
What we currently value (want) and what they previously valued (want) from their role may have shifted. If we are not pausing to have realignment and empowerment conversations when this occurs, our teams are at risk of “quitting” the work we really need them to do … and not all of the quitting will be quiet.