For the last ten years, David Couper Consulting has worked with leaders in healthcare, especially those in nursing. Mid-level nurse leaders have always been in the middle of the demands from both executives and frontline staff. The pandemic has caused a challenging situation to become unbearable for many.

In some ways, they are the filling of a nursing sandwich. A sandwich can’t exist without any bread on top or the bottom, but the filling is critical.

Mid-level leaders have to understand both frontline staff and executives. They have to understand the frontline staff’s needs, manage them, schedule them, and often even cover them in emergencies and staffing shortages. They also have to understand the executive team’s strategy, budget, and overall vision and communicate it to their teams. Just like we always want something different in our sandwich and we demand high taste at a reasonable price, so healthcare organizations demand that of their nursing leaders. How can nurse leaders create high-quality outcomes while managing costs and come up with new ways of doing things while also working with the emotions and needs of the team?

It’s a tricky question with no easy answers. Humor me for a moment; if we take our cue from the sandwich, here are some things we can learn.

 Don’t let any one part of the sandwich dominate the other.

Not enough bread on the bottom, and the sandwich starts to collapse. Too much filling the sandwich falls apart. Too little filling you are left with all bread. With too much bread on top, the sandwich is top-heavy.

Partner with your executive team and frontline staff to have the proper ratios and staffing. Not easy, but it has to be a conversation and a goal.

Takeaway: No one part of the ‘sandwich’ can take over!

Good filling keeps people coming back.

Bread is critical, but people come back for the taste of the filling. You want to be the kind of manager whose frontline staff remember you – in a good way! We all want to be leaders whose team wants to come back for more. Retaining staff is even more critical with recruitment issues.

Takeaway: Make sure you listen to your frontline staff as much as you do your executive team, so you manage in a way that works for both of them.

Make sure you have a quality filling.

Keep on working on getting the best possible outcomes. Those cheap sandwiches you buy at a gas station don’t leave you coming back for more. The flavor is mediocre, and sometimes you can’t tell if it’s chicken or egg salad.

Takeaway: Make sure you continue to work on your leadership skills. Training, education, and mentoring are vital. It’s a tough job, and it can be a struggle unless you have development.

Nurse leaders, you are vital, and we appreciate you. Be the gourmet snack that everyone loves. Remember, you in the middle make the sandwich.