BY: ROBERT L. VENINGA, PhD
Dr. Veninga is professor of public health administration, School
of Public Health, University of Minnesota, St. Paul.
Ten Strategies Can Help Increase Employee Satisfaction
More than half of U.S. working people view job stress as a major problem in
their lives, according to the National Institute for Occupational Safety and
Health.1 What's worse, more than 29 percent put themselves in the
highest stress category—"extreme or quite a bit"—the highest percentage recorded
since the Marlin Company, a workplace research firm, began surveying employees
on job satisfaction issues six years ago.2
The mood among staff members of health care organizations is equally troubling.
A 2001 study of 43,329 nurses at 711 hospitals revealed that a third said they
planned to leave their jobs within the next three years.3 More than
43 percent of them scored high on a survey measuring emotional exhaustion. Last
year the chairman of the American Medical Association's board of trustees said
in a speech that "physicians throughout the country have been pushed to the
breaking point" by exhaustion and intense frustration arising from the business
aspects of medicine.4
What strategies can strengthen morale in U.S. health care organizations? How
can health care leaders create an environment where work motivation is high
and job turnover is low?
10 Practical Strategies
Here are 10 practical strategies that can be implemented with minimal
Create an Ethical Work Environment If you want to build a great work
environment, focus on ethics. The reason is simple: Slightly more than half
of working Americans question their bosses' integrity; when they do, they are
likely to leave their jobs.5
The importance of being honest with employees cannot be overemphasized. Employees
hunger for the truth, and when they hear it are grateful. "I admire my department
head," a laboratory technician told me one day. "She is honest. I don't always
agree [with her], but I never have to worry about whether she is telling the
truth." Author Tom Peters was correct when he observed: "The boss who'll survive
is going to have to learn how to do this amazing thing—which rarely happens
in corporate America—tell the truth. . . . I really think that the great defense
in the world against cynicism is truth-telling."6
Is it possible to be honest when failure occurs? Several years ago, Ciba-Geigy,
the Swiss chemical firm, sponsored a major drug-research effort that had a potential
for large sales. Then a laboratory technician noticed something amiss in the
livers of test animals. Although the drug did have healing properties, it also
left in the liver cholesterol deposits that produced irreversible damage. Disheartened,
the research team canceled the project. Team members feared that the company's
management would see them as failures.
However, Frank Douglas, the company's head of research, acted quickly. He
congratulated the team for creating a climate that allowed a member with the
lowest status to raise an issue capable of derailing a major project. "By listening
and following through, you saved untold misery and substantial financial losses
that would have occurred if this drug wrongly made it to market," he told team
members.7 Douglas affirmed their success even in a failed undertaking:
"[I] will make sure you have the time to write up your learning for professional
journals and get the recognition you deserve for your fine work," he said. "Then
I'll reassign you to new projects."
An organization seeking to build strong work teams should be honest not only
about its positive aspects but its challenges as well. When failure occurs,
such organizations acknowledge it, learn from it, and move on.
Institute a Mentoring Program To build a great work environment, nurture
what might be called your "dormant" leadership. This is best done through a
strong, vibrant mentoring program.
Where does the word "mentor" come from? At the start of Homer's Odyssey
Odysseus, the king of Ithaca, is preparing to leave home for the Trojan War.
He asks his wise and trusted counselor, Mentor, to serve as protector and guardian
of the family. Odysseus is then gone 10 years, and during that time Mentor becomes
the teacher, advisor, friend, and surrogate father of Odysseus' son. Thus the
Today one of the fastest growing practices in management is the establishment
of mentoring teams that enable new employees to learn from those with experience.
The benefits are many. New employees learn the organization's mission, values,
and culture. They become acquainted with the complexity of the challenges facing
their employer. Best of all, through mentoring new employees come to understand
their own potential, as has been noted by Scott Adams, the creator of the comic
When I was trying to become a syndicated cartoonist [he has written], I
sent my portfolio to one cartoon editor after another and received one rejection
after another. One editor even called to suggest that I take art classes.
Then Sarah Gillepsie, an editor at United Media and one of the real experts
in the field, called to offer me a contract. At first, I didn't believe her.
I asked if I'd have to change my style, get a partner—or learn how to draw.
But she believed that I was already good enough to be a nationally syndicated
Her confidence in me completely changed my frame of reference; it altered
how I thought about my own abilities. This may sound bizarre, but from the
minute I got off the phone with her, I could draw better. You can see a marked
improvement in the quality of the cartoons I drew after that conversation.8
To transform itself, an organization must cultivate a new generation of leaders.
Who will benefit from this? Young employees will benefit, to be sure. But mentors
will benefit as well, as was noted by the philosopher Pierre Teilhard de Chardin,
who wrote:"The future belongs to those who give the next generation reason for
Be Passionate When leaders are passionate about their jobs, respect
is generated, and energy begins to flow through the organization.
To be sure, it is sometimes difficult to be passionate about one's job, especially
when problems accumulate. The mark of a great leader, however, is to not lose
one's enthusiasm; if enthusiasm wanes, there is a loss of respect.
In 2001 John Boles, the manager of the Florida Marlins baseball team, was
fired. This occurred one day after a player criticized Boles and his coaching
staff for their lack of major league playing experience. In explaining the decision
to terminate the manager's employment, General Manager Dave Dombrowski said,
"Boles felt that he had lost the clubhouse."10 Dombrowski went on
to say that when a leader loses the respect of his team, the future cannot be
No leader can afford to lose the "clubhouse"—the respect of employees. What
builds respect? Creative planning, skilled financial management, and providing
feedback in a timely manner all help. However, the best way to cultivate employees'
respect is to be passionate about the organization and its priorities. In 2000
Colin Powell, then a former chairman of the Joint Chiefs of Staff who was considering
a possible campaign for president, finally decided against it, saying, "George
W. Bush is passionate about politics. Al Gore is passionate about politics.
I'm not passionate about politics. I'm passionate about being a soldier."11
I say this with some feeling: If you want to build a great work environment,
be passionate about your work. I have yet to find a truly great hospital or
public health agency that did not have passionate leadership.
Give Employees a Break Insist that they take every vacation day awarded
to them. Why is this important? Many are exhausted from their job responsibilities.
According to the Families and Work Institute, 54 percent of employees feel overworked
and 55 percent feel overwhelmed by how much they are asked to do.12
To keep an organization renewed, break the routine. Send staff to professional
conferences so that they can be intellectually invigorated. Provide sabbaticals,
an increasingly popular "perk" for the employees of Fortune 500 companies.13
And insist that, when a vacation is taken, the briefcase is left behind. Why?
According to a survey conducted by Oxford Health Plans, one in six U.S. workers
is so overworked that he or she is unable to use up his or her accrued vacation
time.14 Forty percent of employees who do take vacations work
on them and are in daily contact with their employers.15 When they
return to their regular jobs, they find that the well of vitality has been barely
One important way of giving employees a break is to provide them with flexible
work schedules. Laurel Cutler, vice chairman of Foote Cone & Belding, says:
"I wish I had known sooner that if you miss a child's play or performance or
sporting event, you will have forgotten a year later the work emergency that
caused you to miss it. But the child won't have forgotten that you weren't there.
I learned it, but not in time for my own kids. I was a very good boss in that
respect though. By the time I had a number of young parents working for me,
I would tell them, 'It's more important to be there for your child.'"16
If you want to build a great work environment, encourage employees to take
vacations and tend to their families. So say the leaders of firms that consistently
turn up in lists of "America's favorite places to work." In such companies turnover
is low, morale is high, and employees say that their employer encourages them
to have a life outside of work.17
Preserve Some "White Space" The great violinist Itzhak Perlman was
once confronted by a fan who said, "Mr. Perlman, my son is studying the violin.
And by coincidence he is studying the same composer and composition that you
played tonight. Why is it that when my son plays this piece it doesn't sound
the same as when you play it? After all, you both use the same set of notes!"
Perlman is reported to have said: "It's not the notes that count, but the space
between the notes." Quoting Perlman, the organizational theorist Richard Oliver
goes on to say that "the space between the notes is the 'white space' in an
organization, the way things really get done rather than the way the policy
and procedure manual says they are supposed to get done."18
Of course, "notes" are important. But equally important is giving employees
the freedom—the "white space"—they need to accomplish their goals in the context
of the organization's priorities. That's what 3M, St. Paul, MN, does and why
it is perceived as one of the most innovative companies in the world. Scientists
at the company are allowed to spend up to 15 percent of their work time on their
own projects (the enormously successful Post-it Notes were developed in this
way by a 3M researcher). If you want to have an organization that operates at
peak performance, leave your employees white space.
Share the Credit Robert W. Woodruff, president of Coca-Cola from 1938
to 1956, was a visionary leader who made his company's product popular around
the world. Woodruff's most memorable advice on leadership is inscribed on a
marble wall at the Atlanta-based firm's entrance: "Man can accomplish great
success if he doesn't care who gets the credit."19
Several years ago, the Health Administration Department at the University
of Minnesota was designated one of the top such programs in the nation. During
a ceremony announcing the designation, the department chair praised everyone
in the room by name and indicated how each had contributed to winning the award.
Seeing that their contributions were recognized, members and employees of the
department felt a deep sense of pride.
On July 15, 1982, Don Bennett, a Seattle businessman, became the first amputee
ever to climb Mount Rainer. Aided by a team of people who were determined not
to let him fail, Bennett climbed 14,410 feet on one leg and two crutches, though
it took him four days to do it. When asked to state the most important lesson
he learned while climbing the mountain, Bennett said without hesitation, "You
can't do it alone."20
Health care leaders who want to create great work environments know they can't
do it alone. When performance slides, they shoulder responsibility themselves;
when success is achieved, they make sure that the credit goes to others.
Build a Community When told that most North Americans pipe water into
their homes, a Nigerian woman grew somber. "How do the women speak to one another?
If I didn't talk with the women at the village well, I wouldn't know about their
We sometimes forget how important a sense of community is to employees. Yet
it is well documented that what employees seek in a workplace is a sense of
respect and a feeling of being connected to others.22
Can a sense of caring be developed in large organizations? Is it possible
to create a climate in which employees recognize each other's worth and celebrate
the joys of work as well as the disappointments? The answer is a resounding
yes. I think, for example, of Federal Express, which has made extraordinary
efforts to build loyalty throughout the company's ranks. FedEx employees believe
that the firm's success rests on their shoulders. The result is a sense of caring
that begins in the executive suite and runs from middle management to the drivers
faithfully delivering their parcels. In 2002 a FedEx employee named Steve Gibes
died at the age of 30.23 His supervisors and co-workers wanted to
do something special in his memory, for he was a valued employee. Gibes' casket
was carried to the cemetery in a FedEx truck, the logo of which was covered.
Behind the lead truck came a fleet of FedEx vehicles transporting employees
to the funeral. FedEx provided transportation to any employee wanting it, which
meant that schedules had to be adjusted for 75 of the company's routes. That
morning 50 drivers had gotten up at the crack of dawn in order to finish their
routes in order to attend the funeral.
The story tells much about Steve Gibes. But it is also the story of a company
that shows compassion. If you want to transform your workplace, build community.
Do it for humanitarian reasons, but do it also for the bottom line. One important
reason why employees leave an organization is that they don't feel that they
belong or, to put it another way, that they don't feel a sense of community.24
Show kindness. Express appreciation. Celebrate meaningful events. When you do
those things, a sense of pride bubbles forth throughout the workforce.
Develop a Sanctuary There are two types of sanctuaries, public
and private. In a hospital, a public sanctuary might be a room set aside,
giving visitors a place to pray or meditate. At the center of the University
of Minnesota's Academic Health Center is a small chapel that is used every day.
On September 11, 2001, the chapel had a steady stream of employees. Physicians
meditated with nurses; executives prayed alongside custodians. The chapel was
a refuge in the time of storm.
Every organization needs a public sanctuary—a place of quiet and renewal.
Today we are all so surrounded by fax machines, pagers, cell phones, and other
similar devices that we have trouble finding the time or place for reflection.
In 2001 Amtrak received so many complaints about cell phone use during an early-morning
commuter train run to New York City that it added a "quiet car."25
Riders liked the idea so much that some 20 additional "quiet cars" have since
been added to the Washington-Boston route.
We all need "quiet cars" in our lives—places that help steady the mind and
calm the soul. Such sanctuaries may be public: a chapel or meditation room,
for example. However, the more important sanctuaries are private ones: a sustaining
e-mail message from a friend, an inspiring prayer, an encouraging note from
Ronald Heifetz is one of the world's leading authorities on leadership. He
knows from his own experience the importance of sanctuaries. He told an interviewer:
"One sanctuary that I recently developed for myself involves getting an e-mail
that's sent out by a rabbinic friend, who's a mystic and a biblical scholar.
Every day he sends out an interpretation of one word from the Bible. It's just
a few screens long, but as I'm going through my e-mail every day, I take a few
minutes to read this thing, and it roots me in a different reality, a different
source of meaning."26
Periodically all of us need to be rooted in a different reality. If September
11, 2001, can be said to have left a positive legacy, it is that Americans are
seeking to redefine their priorities. "In this age of terrorism I can intellectually
accept that I could end up in a pile of rubble," a New Yorker told a reporter
soon after the attack, "but I can't accept that I would be in that rubble not
having lived life to its fullest."27
Create a Cause, Not a Business We now come to an important strategy
for transforming organizational life: reaffirming the importance of our healing
mission. Unfortunately, in a world where financial constraints loom large, it
is easy to forget what the French call raison d'etre ("reason for existence").
Some critics suggest that the raison d'etre of health care—caring for
sick or injured people—is being lost.
Of course, health care is in one sense a business. But it is the business
of helping others. How do you keep the vision of healing the sick and caring
for the less fortunate alive? Health care leaders must manage by spending time
with employees, giving them encouragement, and reminding them of the importance
of their work. But it is also essential to reward those who quietly and without
fanfare are keeping the vision alive. Who are these people? One is the middle-level
manager who works tirelessly to achieve the organization's mission. Another
is the development officer who strives to augment the revenue streams. Still
another is the nurse who gives compassionate care, often without being given
recognition for it. Yet another is the receptionist who realizes that the tone
of her voice is part of the healing process.
There is a difference, one business executive has noted, between the "leader
by title" and the "leader by profile."28 Leaders by profile are those
who exert the biggest influence on the organization: They are the people who
get things done. Sometimes high-profile leaders have humble job titles. But,
because they get things done, they are the ones who should be rewarded.
Remember: Spirituality in the Workplace Matters In 2001 a Gallup Poll
asked Americans if they felt a need to experience spiritual growth. Seventy-eight
percent said yes, a big jump from the 20 percent who had said that in 1994.29
Nearly half of the respondents said they had occasion to talk about their faith
in the workplace in the previous 24 hours. "Spirituality in the workplace is
exploding," said Laura Nash, a Harvard Business School research fellow who has
followed the topic for a decade.30
Why the interest in spirituality? Employees want their values and religious
traditions respected. They want sanctuaries where their spirits can be healed.
And they want interpersonal conflicts settled. Today 32 percent of all employees
face serious conflicts at work, often with their supervisors.31 Such
conflicts reduce productivity and undermine morale. What's more, they wound
those involved in them, leaving a trail of hurt and spiritual discomfort.
What can be done to diminish such conflicts? Respecting individual differences
is a starting point. Seeing the best in colleagues helps. From my perspective,
however, the most important thing that can be done is to keep in focus our calling:
healing and providing hope for the ill.
- Cora Daniels, "The Last Taboo," Workforce, October 28, 2002, p.
- "Nurse Burnout Worsens and Conditions Deteriorate," Nurse Week, May
14, 2001, p. 10.
- William F. Sasser, "A Passion to Heal," Vital Speeches of the Day,
April 1, 2002, p. 364.
- The Hudson Institute and Walker Information surveyed more than 2,000 full-
and part-time workers. Fewer than half (42 percent) said they believed their
company deserved their loyalty. Slightly more than half said they would recommend
their place of employment to a job seeker. See Robert L. Veninga, "Five Ways
to Rebuild Trust," Executive Excellence, October 2001, p. 5.
- Tom Peters, "My Secret to Success Is to See around Short Corners" Workforce,
August 2000, p. 60.
- William Miller, "Building the Ultimate Resource," Management Review,
January 1999, p. 43.
- Quoted in Steve Guarnaccia, "My Greatest Lesson," Fast Company,
June-July 1998, p. 83.
- Quoted in James Conlon, Lyrics for Re-Creation, Continuum Publishers,
New York City, 1997, p. 14.
- "Marlins Fire Boles, Sub in Tony Perez," USA Today, May 20, 2001,
- Quoted in Ira Blumenthal, "Imperatives of Leadership," Executive Leadership,
April 2001, p. 10.
- Quoted in Robert L. Veninga, "Staying the Course: How to Stay Optimistic
in Challenging Times," Promotion & Education, vol. 7, 2002-2003.
- Kevin Dobbs, "Knowing How to Keep Your Best and Brightest," Workforce,
April 2001, p. 37.
- "Too Busy To Rest," Minneapolis Tribune, March 20, 2001, p. D1.
- George Will, "Bush's America Is Working," Newsweek, August 6, 2001,
- Quoted in Sue Shellanbarger, "Executives Reflect on Past Choices Made for
Family and Jobs," The Wall Street Journal, December 31, 1997, p. B1.
- William C. Miller, "Responsible Leadership," Executive Excellence,
May, 2001, p. 3.
- Richard Oliver, "Reinvent Yourself Daily," Management Review, March
2000, p. 10.
- Blumenthal, p. 19.
- Robert L. Veninga, "The Search for the Sacred: How to Find New Meaning
in Your Career," Journal of Nursing Administration, January 1996, p.
- Quoted in Natasha Krahn, "Under Vine and Fig Tree," The Other Side,
July-August 2001, p. 4.
- See Robert L.Veninga, "Five Ways to Rebuild Trust," p. 13.
- See Dale Dauten, "Are You Going to Work till the Day You Die?" Minneapolis
Star Tribune, January 23, 2002, p. D2.
- A. Elangovan, "Betrayal of Trust in Organizations," Academy of Management
Review, July 1998, p. 47.
- "Author Explains Why He Wrote 'Turn It Off,'" USA Today, April 16,
2001, p. 1b.
- William C. Taylor, "The Leader of the Future," Fast Company, June,
1999, p. 37.
- Katy Kelly, "Looking for Meaning in the Ruins," U.S. News & World
Report, October 8, 2001, p. 52.
- Gregory Nelson, Dimension International, Bridgeville, PA, as quoted in
Dale Buss, "When Managing Isn't Enough: Nine Ways to Develop the Leaders You
Need," Workforce, December 2001, p. 45.
- Marc Gunter, "God and Business," Fortune, July 9, 2001, pp. 59-66.
- See Robert Wuthnow, "The Power of a Few to Lighten Your Load," Spirituality
and Health, Summer 2001, p. 47.
Copyright © 2003 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.