Silent Leadership in Healthcare: The Everyday Leaders Without a Title:
Why the People Leading Quietly Are Holding Healthcare Together

Transforming Healthcare Coaching Podcast — Episode 98: Silent Leadership in Healthcare: Unveiling Every Day Heroes. Transforming Healthcare Coaching® coach Gillian Faith, MS ACC SHRM-SCP CPQC interviews podcast co-host and coach Klaus Grim, PA-C CPC ELI-MP.

Klaus Grim: "where you are is where you are meant to be." You are leading in ways that is powerful, it's inspirational, and needed in healthcare and in this world, and that you are capable and confident. It's about growth, and it's about wanting to make positive impact and change. And I think you can see those people, you can see those silent leaders every day. If you just stop and just think and just look and look around you, I am sure you'll catch those people

Gillian Faith: So nobody ever pulled Klaus aside and said, "Hey, you're a leader." No title, no ceremony, no corner office. But every single shift he has been making decisions that change the trajectory of someone's day, and sometimes it's their life, and he didn't even see it. If you've ever felt like leadership is something that happens over there in the C-suite or behind a closed door, this conversation might change that for you.

Klaus Grim: Hello everybody. Welcome to the Transforming Healthcare Coaching Podcast, and I'm Klaus. I'm a PA that practices in emergency medicine and a coach with Transforming Healthcare Coaching. And today, I am being interviewed by Gillian Faith. And Gillian, why don't you introduce yourself to the audience really quick. And then why don't we get into this beautiful topic of silent leadership.

Gillian Faith: Yeah, so my background's in rehabilitation services, both the UK and the US. And also, in management and executive leadership coaching, and now team coaching as well. So, happy to be here today with you, Klaus, and I'm curious, can you take us back to a moment early in your career where you were clearly leading, but if someone had actually called you a 'leader', you may have questioned them and wondered what that was really about.

Klaus Grim: Yeah. Over the past few years, Gillian, I think we've explored this concept of leadership so deeply — within our clients, within ourselves — and for the longest time, I never resonated with this title of leadership or leader, and always attributed that to a title or position that somebody may have. And over the few years I've been diving into this reflection of: "we are leading in so many capacities, even though we may not have that leadership title."

Gillian Faith: Leaders,

Klaus Grim: With titles are extremely important. We need them.

Gillian Faith: But

Klaus Grim: we also have to remind ourselves that there are people leading on the floors, leading patients' lives, leading their own lives when we're not even aware of it, and making so many positive differences in healthcare. So, I would've laughed if somebody had told me 'you're a leader.' a few years ago I'm being like, "what are you talking about? I'm just a practicing clinician on the floor, working with the team and with patients."

Gillian Faith: Yeah, it's funny you should say that because, I think that happens every day in healthcare. people are just going about their work and it's very important work and not really thinking about the term 'leader'. And like you're saying, if we were to call these people leaders, they may question, "am I really a leader?" And they are leading themselves every day and probably silently leading teams and leading families, as they go about their everyday work.

Klaus Grim: Yeah, and I never actually researched the term "silent leadership." It was just something that came very resonating to me. When kind of planning a podcast episode to talk about something that I think is so important, I think you just said it's that word 'silent', it's not needing the recognition oftentimes or it maybe wanting the recognition it's just maybe not received But it's exactly what you say is right. Sometimes our leaders are not aware. When I say 'leaders' here, I'm talking about specific title or position. that we are leading in so many different ways, We are going out there to talk to patient families — giving them updates, discussing appropriate treatment plans, when a sick patient comes in, acting quickly to making sure that they're getting the best care in appropriate treatment right at that moment to guiding our other team members, in these critical situations.

Klaus Grim: I think a good example of this is when we call it 'timeout.' when all internet goes down, EMR goes down, and we have to kind of write our notes and still practice care with not the same resources that we normally have. And in those moments, there's so many times of silent leadership, the person who's writing the patient's name on a label, instead of like using a computer to print it out to putting patient's names on a board or their complaints so that things are organized. So, I think this word 'silent' is so resonating because there's leadership that is happening every day on the floors, in the clinics that we don't speak about.

Gillian Faith: Right. And if you think about some of the core strengths of powerful or impactful leaders, you know, trust and respect are integral to being a good leader. And imagine, most of the time, if not all of the time, families and other team members are trusting and respecting you as you go about your clinical duties.

Klaus Grim: Yeah, totally.

Klaus Grim: yeah, I think it did. Trust is is a huge thing. And as leaders with titles, we are constantly, giving trust to our team members to lead when we're not there.

Gillian Faith: Right. And you mentioned titles and so, clinical manager, clinical leader, titles or no titles How do you think not having a title makes somebody show up differently?

Klaus Grim: Well, that's a great question. I think it changes the focus of your role, whether you're in, healthcare. And I think, when you don't per se have that leadership title, you're not acting in ways for recognition. You're doing it because you authentically, truly care about what you're doing. Because you could also say, "eh, that's not my role, that's not my job, that's not my duties. I don't need to do that." and I think as a leader, oftentimes you have to show your results. You have to show what your leadership is doing for your departments and your teams and your employees for the higher ups in organizations, but when you're silent per se, not with your technical duties, it's done for a completely different reason.

Gillian Faith: and we can probably all think of people in teams that we currently work with, or teams that we've worked with in other situations where, you can put a name to that image that you just described. You know, the silent leader that just goes about doing their job but doesn't have the title.

Klaus Grim: Yeah, and I think about that all the time, when I'm working in the emergency room, or the urgent care. one of the nurses, you know, giving the patient education, answering questions that sometimes it's just so much easier to say: "can you just go into the room Klaus and just talk to them?" But they know the answer to those questions or when critical situations come up, right? they're acting on that on their own, capabilities and within their own scope and not relying on somebody else to do it. You might be the charge stars, you might this, but it's all about communication. It's about growth, and it's about wanting to make positive impact and change. And I think you can see those people, you can see those silent leaders every day. If you just stop and just think and just look and look around you, I am sure you'll catch those people. And how they are a pleasure to work with oftentimes.

Gillian Faith: Yeah, that was going to be my next question is: what do you think the traits are of these silent leaders? What do you think makes them successful in their positions? And you've just talked about some of them, but can you elaborate on any of those?

Klaus Grim: Well, I think they bring positive energy. Let's start with that. It may be tough for them sometimes, When there's maybe 40 people in the waiting room, or you guys are falling behind, whatever it may be, Disaster, leftover rights coming through. but they're not there saying, "Ugh. I hate my job. there's so much problem." they're working on solutions, They're navigating, they're communicating. and they're listening too. When you speak up and say, "I need help with something." They're there. They're the ones that you know, you can call to when things are not maybe going right. and sometimes you don't even need to call on them. You just see them. You just see them they're just doing, they're constantly doing. I think that's probably what I would say they're constantly doing. it may be a slow day slow department, but they are actively doing stuff to still keep things prepared for maybe worse scenarios. But they are constantly doing something that says, "we want to make sure we're providing the best patient care." And they're doing stuff to say, "I want to make sure my team's successful, and that we're doing the right things."

Gillian Faith: Right, because one of the functions of a leader is to help all their direct reports or their team to rise up and become leaders as well. when you think about leadership presence, what comes up for you?

Klaus Grim: So when we talk about silent leadership, I think where sometimes the differences show up. The silent leader may not resonate with that leadership title as we talked about, or that leadership resonance. And so they may not exhibit the same professionalism that you may see in somebody who wears a leadership title. They may not be dressed in the suit or dressed in the nice clothes. They may have hair from their dogs on their scrubs. they may still be very sarcastic and playful in the workplace that sometimes you don't always see with those who hold leadership titles, but they are still the people that you can count on and are there in these moments of crisis that can handle these situations and communicate and really are somebody that I look up to, or I see, like I said, doing very important work that I think, those with leadership titles really recognize, that they're needed on every day when they're not there.

Gillian Faith: Yeah. And as you say that what's coming up for me again is the trust and the respect. So whether you have the title, whether you're wearing the suit or not, if you can gain the trust and respect of others, it will always put you in a leadership position whether you realize it or not.

Klaus Grim: And these are talking points as you just mentioned that these are moments where people feel stuck in their positions. They feel like, "oh, I'm going nowhere. I'm just a nurse. I'm just a PA. I'm just a physician. But you are so much more, when you start to maybe resonate with some of the silent leadership, or if you want a true leadership title, these are moments that you can speak to. "This is what I did." Come with confidence, you know, you're the one that did this. this is what you do every day when you go to work. And that speaks volumes. that's what leaders need is that ability to act quickly, have that presence we just spoke about, have those qualities. now it's just the title and a few other aspects.

Gillian Faith: So if we notice there's somebody on our team that is a natural leader but doesn't have the title, how can we help them gain some awareness or perhaps think about what the next step in their career could be?

Klaus Grim: Oh, that's a great question. As somebody who's still practicing full-time as a PA, in the emergency room and urgent care, One thing that I think I could do would be to ask them: " "How are you in your role? How much of leadership resonates with you?" I think it's curious because I've done the reflective work in order to kind of have this awareness and understanding, but I don't know if many people have, and this is a good waking up point that I've never really asked some of my colleagues how much they resonate with leadership. But I think with that question in mind, that might be something that triggers them or motivates them to say, "Hey! maybe there is something else more for me." I think oftentimes we're just not aware of how we're showing up every day, and that other people see you as a leader. And I think, you or somebody who's working in healthcare who either embodies this silent leadership or sees this silent leadership in your day-to-day, One thing I always do is, I recognize people for the work that they do, the charge nurse to the floor nurse, to the physician. I appreciate, different moments and situations and I think, appreciation and validation and acknowledgement go a long way. That's one way to kind of do it. But I think, the next step would be, as I just mentioned is: "how much do you resonate with leadership? Because in my eyes, you're leading in such capacity that is such a great role model for other people. How interested would you be to advance in your career maybe and lead others from a leadership title that could make some great difference?"

Gillian Faith: Right. And I think sometimes it's confidence, isn't it? Somebody may have the skills, but they just may not have the confidence in themselves to actually take the jump to the next level. so Any thoughts on how people who may have silent leadership going on can help grow confidence if it's something that they need?

Klaus Grim: Working with a coach is really helpful because these are moments where you get to speak to somebody about where you are currently and where you want to be, and it may be very messy and hazy and there's a concept of being a leader may not even be something that's on your mind, but when you start to unravel the way that you show up every day on your job, that concept might come to fruition. and then, to unpack that even further, to say, it's that confidence you just mentioned. How can you be more confident in this silent leadership that you embody? Or how much of this leadership do you not want to be silent anymore? How do we step out of the silence? probably a question I could ask in the future coaching relationship is: "how can you step out of the silence here, and allow that to unravel in somebody?" Because again, it is completely unique for everybody how to develop confidence. But as coaches, we love to believe that everything starts with awareness. And if you're aware that you are leading maybe silently, not silently, that's the first step to start to make progress.

Gillian Faith: So I'm curious, Klaus, you know, you went through coach training, so what difference did that make to you in terms of how you view yourself as a leader?

Klaus Grim: when I went to coach training, it was more so actually just for me to free myself from some, symptoms of burnout that I thought I was experiencing and likely was experiencing. And as I had experience with a coach, in my PA education. And never was intended to create a career out of this and to use the coaching skills, on with other healthcare professionals and leaders. But I think what I've gained from this experience of being coached and working with others as a coach and going through coach training was, that reflection piece is huge: to really look inside, to question yourself, you know, on how you show up every day and who you want to be, and seeing things from different lenses. I think it's the hardest part from all of us is we see ourselves as we show up every day, but sometimes we have to step back and start to see things from other people's side. When I go into a patient encounter, oftentimes nowadays, I try and see things from the nurse. How does the nurse view this? How does the nurse view me? Am I confident? How does the patient see me? Do they see me confident in my role? And I think when I start to see things from the way other people could see me. it does shape a little bit about how I can future approach certain things and how I can grow and develop. I think the biggest thing is that you have to be in a growth mindset saying that you want to grow, not change who you are, but just live to your fullest potential. And or maybe grow into somebody that you're interested in being. We all have different visions of who we envision us to be, tomorrow or in the future. we just have to really start to take those micro steps towards them.

Gillian Faith: Yeah. I love what you say about reflection, having the awareness and then being able to reflect on what's working or what have you learned about yourself and how do other people view what you do?

Klaus Grim: Yeah, if I could add on that, I think reflection is hard. I'm going to be honest with you, it comes off very cliche when we talk about reflection, You know, sit down on your journal, journal every night, And these are great things. I'm not going to put fire to something that's doesn't work. It works to reflect, but some people are not writers or time is a big thing. And so, this is something that works for me even is, is to talk out loud with somebody. That's my reflection. Talking out loud to somebody who's unbiased, who's able just to hear me and just reflect back to me my own words. I mean, that's reflection, I think, on drugs, because it's somebody else who's saying things back to you that you maybe you're just not hearing yourself say. I think that's a plug for my reflection is having somebody you can speak to, is always helpful. Whether it be a therapist, a coach, a friend, a family member is huge.

Gillian Faith: Yeah. And I think, reflection comes up for me in a couple different ways. on the drive home, after a shift, we can be reflecting on, what happened, what lessons we learned. If we had to do something over again, would we have done it differently? And then there's the reflection that you're talking about in a coaching session where it's actually, very, very powerful for a coach to reflect back what they're hearing because sometimes we tell ourselves stories about ourselves because that's what feels good, but it's not necessarily always true, and I've experienced that personally. So, I think reflection is very, very powerful. And so we're talking about coaching, but there's lots of mentoring programs out there and peer mentors and things like that in the hospital systems. So can you talk about what is different between coaching and mentoring?

Klaus Grim: what's different is mentorship, oftentimes is shedding advice based off of your own experience. So, I'm a mentor oftentimes to a lot of PA students, and a lot of times the questions that they're asking me are things that I've experienced personally and that I could shed advice to. though I as a coach, I can now lean in into several different techniques to really help them, come up to those answers themselves without having me telling them what it is that I did. but, a lot of times. Those peer to peers, I think oftentimes are more so, used as shedding light to different experiences in, in different ways of thinking, as a result of their own journey. Whereas coaching is really though as a PA when you come to talk to me. I'm not shedding my PA background on you. I am listening who understands your terminology can resonate with your language and your experiences. and if it's beautiful in essence where it's like, "I don't have to explain to you that I'm coming home from my drive work and it's eating me away about certain patient cases. I get it." And so what is it that you need right now from me? How can I support you? So, I would say that's probably the biggest difference that I could speak to,

Gillian Faith: Yeah, that makes sense. Thank you for sharing that. And if you could think back to a situation, a clinical situation, where you had to just get through the shift and you weren't necessarily thinking of yourself as a leader, So if you could go back, Klaus, and talk to the version of yourself who didn't feel like a leader, the one who was just trying to get through a shift, what would you tell him?

Klaus Grim: I would say: "it's okay for you not to have that awareness." Let's start with that. I think, that acknowledgement and that validation is huge. I would say, "where you are is where you are meant to be," number one. And that you are leading in ways that is powerful, it's inspirational, and needed in healthcare and in this world, and that you are capable and confident, and you are a leader? I think, it's shouting that almost: "you are a leader." and I think it would've taken some time to grasp onto that and, Feel the definition but I think that would probably have been my first step would be to really feel and embody that. and I remember back to myself back then, it was uncomfortable. And I think that vulnerability and uncomfort was important. and it's only natural in order to really release the inner leader that you are.

Gillian Faith: And whether you're a silent leader or a leader with a title, we don't always have all the answers. I think you would probably agree with that. so, having the psychological safety on teams to be able to speak up and say: "I don't know the answer to this," or "can somebody please help me with that?" I think that's very important, and I think psychological safety is something right now that many leaders are aware of. And I know that I've worked with some leaders who are trying to create more psychologically safe teams so that people can speak up without fear of being, you know, made to think that they're not worth the position or they don't have the potential. So do you have any other thoughts on psychological safety and how it might show up for somebody that is rising up in leadership?

Klaus Grim: Yeah, I think you just said it. I think it's very important from the, those with the leadership title to really foster an environment for that psychological safety to be able to come speak to them about anything. Because a lot of people will keep things in or they they won't say things out loud. And this actually shows up on clinical situations all the time. Afraid to reach out to your attending or the provider, about a certain thing because that question might feel stupid. But I always tell the people I work with, "there's no sense saying it's a stupid question." if it's something that's on your mind, it's on your mind for a reason, say it out loud because you don't want to make a mistake. You have people's lives in your hands. so come forward with it, and then next time you may not feel the need to ask that again. Who knows? but I think it comes from embodiment from the higher ups first, and so that it trickles down into your silent leaders, your individuals, and your teams.

Gillian Faith: Yeah, that's a really good point. So, given that you've embraced your leadership while you're, working in your clinical situation, what does thriving look like for you now, now that you have this awareness?

Klaus Grim: Well, I think for me it looks like showing up to my work knowing that what I am doing is important and personally speaking not needing the validation that sometimes I think, with silent leadership, if you don't have this underlying awareness, is that that's what you're doing. You're may be seeking acknowledgement and validation for the things that you do. And for me, it's, I know why I am doing it, and it's for me, it's for my patients, it's for my teams, and that feels good to me. So for me now, showing up to a shift with this understanding that I am a leader, it makes me more confident. It makes me more confident and I'm a little bit more positive at work. I'm not as drawn into some of these challenges and catabolic energy that sometimes can ensue in a healthcare environment and team. And I'm able to better embody more positive energy, more growth mindset, I find that to be toxic in a good way. Toxic in a way that people are saying, "Hey, I'm very interested in that." I want to be happier in my career. And so I think as coaches, when we were first started working all together, you know, Lily and I are still practicing full-time. we try and show up in these ways every day so that we can start to help healthcare one person at a time by us being that role model.

Gillian Faith: Yeah. and I love what you say about lifting other people up. because` I always think it can just take one person on a team to drag the whole team down. if they show up with a not positive energy, but it also can take one people to lift a whole team or, to lift individual members of a team. And I think that's really wonderful what you say about trying to show up every day with that mindset. And you've mentioned positive energy, growth mindset, and, all really good things if we can look through that, lens, because How we view the world and view our situation, really changes the thought processes that go on in our mind

Klaus Grim: Yeah, And

Gillian Faith: can really impact the work that we do every day.

Klaus Grim: Yeah, totally agree. And I will say it's challenging sometimes, but it is well worth it and the journey took a while and it's still part of my journey. and I always encourage those who are interested to step out of challenge mode, into solution mode to, really take that time for yourself. So thank you, Gillian, for letting me speak to silent leadership and something that's become much more important for me over the past few years.

Gillian Faith: Yeah. So I'm curious as we come to the end of this, what would you like listeners to walk away from this conversation we've had today?

Klaus Grim: I think it would be to start to observe yourself, and observe your team members, and to see where you may see some silent leadership and see if that resonates with you. and what does that awareness do for you? Does it make you want to become a leader with a title? Does it make you want to be more fulfilled at work? Does it make you cringe? Be okay with whatever comes up and shows up for you. And, here at Transforming Healthcare Coaching, we always want to be supportive of you and hear what your thoughts are with it. So leave us a comment, you know, reach out to us, book a free discovery call if a coaching journey sounds important for you. And we'd love to hear more. So thank you Gillian. And again, if anything resonated with you guys today, please like, subscribe, send us a comment. We really appreciate that. It gives us, motivation to create more episodes that are completely resonating to you. So thank you.

Gillian Faith: Thank you, Klaus.