Hi Josh, thanks for join­ing us. First of all, tell us a bit about how you became a manager.

I was work­ing in an ED in Wol­lon­gong and need­ed a change. I joined an agency and end­ed up in Aurukun for a six-week con­tract in 2007. I realised quick­ly that remote work was exact­ly the type of work I want­ed to do.

When the oppor­tu­ni­ty came up to back­fill in the manager’s posi­tion, I took on the role almost by default because I had been there for a while. A full-time oppor­tu­ni­ty fol­lowed. I thought I would give it a go and see how I went. I nev­er planned on being a man­ag­er, but once I got into it and hit a sweet spot, I found that I real­ly enjoyed it – and that’s why I have con­tin­ued doing it for so long.

How did you find the tran­si­tion from clin­i­cian to man­ag­er?

It was hard for me to sit in an office when I knew what was hap­pen­ing out in the clin­ic. It was dif­fi­cult not to step in and do things. One of the big lessons I had to learn was how to del­e­gate in an appro­pri­ate way and allow peo­ple to find their own solu­tions to prob­lems with­out being too directive.

Over­all though, I think my clin­i­cal back­ground worked in my favour. All roads lead to the Direc­tor of Nurs­ing (DON) in Cape York com­mu­ni­ties. I felt com­fort­able being in that role because I had first learned the ins and outs of how the clin­ic works, and I was also lucky to have estab­lished rela­tion­ships. I knew where to go to find answers. I wasn’t com­ing in blind.

All roads lead to the DON. How do you man­age the pres­sure?

It just means I need to man­age my fatigue bet­ter – to be more self-aware of the signs of fatigue in myself, mak­ing sure my own ​‘cup’ doesn’t become emp­ty. I need to be dis­ci­plined with my self-care rou­tine, get reg­u­lar breaks and have in place localised poli­cies and pro­ce­dures about when to con­tact me after­hours. It is a lot of pres­sure, but I’ve got an excel­lent team around me and good rela­tion­ships with­in the com­mu­ni­ty, so that pres­sure is not all on my shoul­ders – it is spread.

What is the work­load split in your role?

80% man­age­ment and 20% clin­i­cal.

Obvi­ous­ly, clin­i­cal skills remain impor­tant.

Yes, for sure. When the real­ly big stuff hap­pens, the team looks to you for sup­port and guid­ance, espe­cial­ly if a med­ical offi­cer is not present.

It is real­ly impor­tant I main­tain clin­i­cal cur­ren­cy – that I am able to step up to the mark when need­ed and direct peo­ple, so that when there are major med­ical emer­gen­cies going on I know the skills mix in my staff and I can direct and appoint accord­ing­ly in those situations.

I am a man­ag­er but first and fore­most, I am a clin­i­cian. That became so appar­ent dur­ing COVID, when my 80/20 work­load swapped around the oth­er way. I was 80% clin­i­cal and 20% man­age­ment. That’s the beau­ty of hav­ing a DON on site – we can fill in the gaps when needed.

What about the 80%? What new non-clin­i­cal skills have you devel­oped?

The abil­i­ty to effec­tive­ly com­mu­ni­cate my mes­sage. Every­one com­mu­ni­cates in a dif­fer­ent way, and you have to be able to under­stand oth­er people’s com­mu­ni­ca­tions styles, as well as your own.

This involves com­mu­ni­cat­ing to my staff and also to peo­ple out­side of the clin­ic, includ­ing upper man­age­ment. Being remote, peo­ple in the cor­po­rate offices do not always have the same ease of over­sight like they would in a hos­pi­tal, where they can sim­ply walk down to the ward.

There­fore, as a mid­dle man­ag­er you have to main­tain and con­trol the flow of infor­ma­tion – keep­ing upper man­age­ment informed and shar­ing any con­cerns. In order to elic­it the nec­es­sary response and ensure an appro­pri­ate reac­tion, it is on you to con­trol the flow of that infor­ma­tion.

On anoth­er note, one of the things peo­ple enjoy about work­ing remote­ly is the cama­raderie and the team­work. As a man­ag­er you have to be part of that team, but also sep­a­rate in order to hold peo­ple account­able when nec­es­sary. Try­ing to be a man­ag­er and people’s col­league and friend, inside and out­side of work, has been a big learn­ing experience.

Have you found it cre­ates a con­flict between your per­son­al and pro­fes­sion­al selves? How have you dealt with that?

That’s right. One of the things I’ve had to real­ly under­stand is my own bound­aries, and where those bound­aries start and end. Not just with staff, but with com­mu­ni­ty as well.

I some­times have to make deci­sions on con­tentious things, and I have to be trans­par­ent and also con­sis­tent in order to treat every­one fair­ly.

How do you achieve that con­sis­ten­cy?

By being a val­ues-based leader. If you under­stand what your val­ues are you can defend them, not just to your team and com­mu­ni­ty, but to upper management.

Tell us a bit more about the impor­tance of val­ues, in your expe­ri­ence.

Ear­ly on in my jour­ney as a man­ag­er, I realised that I need­ed to have a clear idea of my pro­fes­sion­al val­ues. I val­ue easy access to health­care and I val­ue com­mu­ni­ty-appro­pri­ate deliv­ery of health­care, among oth­er things, but I felt these two were the most impor­tant to me. Once I felt I under­stood these in myself, I was able to go about artic­u­lat­ing these to my team – not in words, but in the way I act, in the way I make deci­sions and the way I treat those peo­ple around me.

Hav­ing a clear bea­con like this to guide you must be help­ful when you are man­ag­ing sig­nif­i­cant respon­si­bil­i­ties?

Exact­ly. If your val­ues align with the organisation’s, then you will find that the deci­sions you make on the ground will be sup­port­ed.

You’ve just out­lined a range of essen­tial skills and per­son­al qual­i­ties that a man­ag­er needs to devel­op. How did you devel­op these – ​‘on the job’ or via addi­tion­al stud­ies?

I did my Mas­ters of Lead­er­ship & Man­age­ment not at the begin­ning of my time, but in the mid­dle. It con­sol­i­dat­ed a lot of things I had learned along the way. It was very dif­fi­cult to jug­gle work­ing and study­ing full time, but I’ve no regrets about it.

A lot of my learn­ings have also come from being reflec­tive with my peers, the oth­er DONs on the Cape – bounc­ing ideas off them and talk­ing to them about their expe­ri­ences, mis­takes and learn­ing.

Final­ly, I have to men­tion the pro­fes­sion­al rela­tion­ship I have with the senior Indige­nous health work­er. Ours is a rela­tion­ship based on the mutu­al respect and shared val­ue sys­tem that I spoke about before. Karen has been an inte­gral part of my jour­ney over the last sev­en years, and I have learned an enor­mous amount about inte­grat­ing the community’s cul­ture into the way we deliv­er health ser­vices. If all man­agers had a Karen beside them, I think we would be clos­ing the Gap in no time at all.