Sleep Technologist Shortage: Can it be helped with mentorship and servant leadership?

There are so many issues facing the sleep industry today. Outside of concerns of reimbursement and payor requirement, the biggest factor impacting sleep labs appears to be lack of qualified sleep technologists to perform the tests, to instruct patients and to fill various roles requiring credentials. While there is clearly a supply and demand issue at play, there must be more focus on staff retention, management styles, and mentorship through servant leadership.

“Before you are a leader, success is all about growing yourself.

When you become a leader, success is all about growing others” – Jack Welch.

 Servant Leadership in the sleep lab

For the greater part of my 25-year career in sleep diagnostics testing, I was part of the executive management team at a large multi-site independent diagnostic testing facility (IDTF) chain of sleep labs in California. The company was owned by a private equity investment group and abruptly closed due to a series of issues, one of which was COVID. During this upheaval, I was able to witness things out of my control, but that left me disappointed in how the closure was handled; in my estimation, there was no concern for the sleep technologists and other positions, and I felt they were not treated well, many of them felt “discarded. This situation led me to question leadership choices and vow that if I were ever in such a position, I would not allow this type of treatment to occur. It also has made me a stronger mentor and leader. It became my honor and privilege to make telephone calls, write letters of recommendation, leverage relationships, and ensure that all credential holders found jobs during this difficult transition.

We have all experienced exceptional and poor leadership in our professional lives, sometimes probably wondering, “How did they get that job?”. We assess how we and others are treated. Were we treated fairly? Are the leaders condescending? Was our voice heard? Did we fear retribution, or were our ideas met with respect and consideration? Sometimes, things are out of our control due to business decisions that are made which just don’t sit right. We are left to ponder the characteristics of leadership. I pose here the concept of the servant leader in the sleep laboratory. I will also explore how mentorship and leadership go hand in hand.

Although the field of sleep health provides medical services to patients requiring diagnostic and therapeutic support, the reality is that sleep diagnostics testing is a business. As such, business managers can choose how to conduct their businesses. In my circle of technologists, a few have stated that private sleep labs are exploiting technologists, demanding that they work with higher than recommended technologists-to-patient ratios. With sicker patients, this could lead to unsafe patient care and put both the patient and technologist at risk.

In his book, The Servant as Leader, Robert Greenleaf says, “Servant leadership is a philosophy and set of practices that enrich the lives of individuals, build better organizations, and ultimately create a more just and caring world.” Servant leadership rethinks the traditional hierarchical model of leadership.

Hierarchical Leadership Model

Servant Leadership flips the model upside down, putting the key leader at the bottom in a supporting, serving position.

Servant Leadership Model

“Servant leadership takes on principles of communication, empathy, awareness, healing, persuasion, conceptualization, foresight, stewardship, commitment to the growth of people, and building community.” Let’s now explore what servant leadership might look like in a sleep lab using each of Greenleaf’s principles.

Communication is a two-way process that involves both talking and listening. Great organizations will listen to their staff and their patients to receive feedback. Sleep technologists are the face of any sleep business as they are often the only people patient-customers will see after scheduling. Actively listening to your technologists intently and acting in a meaningful way is a surefire way to have your staff feel seen, heard, and appreciated. The patient’s experience is more than satisfaction and begins with the first communication they have. Sleep technologists play a huge role in creating that positive experience. For management, learning about the patient experience is key to understanding and growing the business.

Empathy in the workplace is about getting to know your teams, their strengths and weaknesses, likes and dislikes. I never want to inconvenience a patient, but I also want to acknowledge that things will come up in the personal life of a sleep technologist. We need to understand that there will be difficulties in and outside of work, creating stress and anxiety, and making life difficult to manage.

Awareness is about understanding your strengths and talents, your areas of weaknesses and areas for improvement. Awareness is also about understanding the same of your team, as a collective team, and in every individual on the team. There are opportunities to pair complimentary technologists together or for perpetual learning from others within the environment. Not every technologist has the same set of hard or soft skills, and we can learn from each other. This is a form of mentoring. When deciding which technologist is assigned to which patient, try to create as much balance as possible in the workload to yield the best outcome for all patients.

Healing is not just healing physically from illness or disease but more from the holistic level through coaching, mentoring, and increasingly relationship-orientated leadership. Servant leaders can listen, understand, and provide healing through positive work environments, expressing value for employees, making people feel valued, and giving them the tools they need to succeed.

Persuasion is the ability to gain followers through collaboration, not through power, authority, or coercion. The totalitarian-authoritative-dictator management style with commandments like “do it or else”, is a thing of the past.

Conceptualization gives a clear understanding of where you are today and where your entire organization is heading in the future. Technologists want to be part of something big and empowering within the sleep community. Good leaders will share goals and visions with the team, and they will become more engaged and want to work hard towards your mutual goals.

Foresight enables leaders to understand the lessons learned from the past and outcomes of prior decisions, to inform the likely outcome of future decisions. Talk to your teams about what has gone right, and what has gone wrong; what are your wins and your losses. As part of your accreditation, you are already putting together performance improvement plans (PIP); share this with your team. Only that which is measured can be improved.

Stewardship is how a leader guides their organization throughout the journey. They work for the greater good of society. They have an authentic ethical focus on more than just profit. Patients go to sleep centers to feel better, not just to be diagnosed. Sharing with team members how you are helping patients and the good your organization is doing to improve the world. If sleep apnea is your primary area of focus, consider sharing with your team how many sleepy drivers you have helped take off the road or how many more accidents there could have been in the world if not for their direct contribution.

Commitment to the growth of people is essential to being a servant leader. Jack Welch once famously said, “Before you are a leader, success is all about growing yourself; when you become a leader, success is all about growing others.” Try to see the intrinsic value of your staff beyond what they do for the company. Encourage them to obtain credentials, attend meetings, and continue to grow in the industry. If the time comes when a great tech has outgrown what you can offer as a company, do not hold them back. Support and encourage their growth and be as selfless as possible.

Building Community is one of the best things servant leaders can do to engage credential holders. Sleep is a niche profession, and there needs to be more outreach and acknowledgment to these amazing credential holders. I highly encourage you to join and attend your national and state sleep societies and to encourage your staff to do the same. Additionally, patients diagnosed with sleep disorders also need community. Successful sleep programs will bridge these unique communities.

Combining Mentorship and Leadership

As noted above, being a great leader often combines leadership and mentoring. A mentor can be another technologist, a manager, or a CEO! In addition, some professional organizations provide mentoring programs to connect the mentee and mentor together, along with providing training. According to Bally, mentoring is necessary to retain nursing staff, and it can also apply to the field of sleep health. According to the American Academy of Sleep Medicine, there is a growing lack of qualified sleep professionals, including technologists. In many ways, the technologist forms the center of the sleep health practices, thus it becomes imperative to provide mentorship, job growth and leaders to engage the next cohort.

Summary and Conclusions:

I have tried to provide a personal journey and hope you learn from my experiences in a private sleep laboratory setting. While differences may exist between hospital- and academic-centered facilities, the qualities of a servant leader apply to each. There are no “one size fits all” solutions to such a complicated topic in such a complicated industry. I often hear private sleep lab owners saying that they “cannot compete against hospitals and universities” when it comes to pay and benefits. But if your credential holders have genuine opportunities to pursue work at these more desirable institutions, then it is logical that continuing business operations under traditional means may, in fact, create the exact labor problem that you were trying to avoid.

Servant leadership in any aspect of healthcare is a powerful approach that fosters a culture of compassion, empathy, and collaboration. By embracing this philosophy, sleep labs can create an environment where the needs of patients, employees, and communities are prioritized. In advocating for the credential holder, it is essential to recognize the transformative impact they can have on staff retention, leading to improved patient care and organizational success. Their commitment to serving others, combined with their expertise and dedication, elevates the standard of care and inspires those around them, and as a result, will be a place that naturally attracts and retains credential holders.

Although I used my learnings/references throughout, I did not cite them as this article provides more of a personal perspective and narrative; however, I have some of the links I learned from below that you might want to access.

Source: Jonathan Sherrill, BS, RPSGT, RST

This article first appeared in SleepWorld Magazine Nov/Dec 2023 issue.

References:

1. Davis, C. Servant Leadership and Followership in Healthcare Webinar (March 5, 2019) https://www.youtube.com/watch?v=uJkb3kzjDUU&t=968s. Accessed 11/13/2023.
2. Martin M. What is Servant Leadership https://www.youtube.com/watch?v=3dS7FpUUbY8&t=45s. Feb 7, 2019, Accessed 11/13/2023.
3. Tenny, M. 10 Characteristics of Servant Leadership Business Leadership Today. Accessed 11/13/2023.
4. The Servant as Leader, Robert Greenleaf
5. George, Bill, and Warren Bennis. Authentic leadership: Rediscovering the secrets to creating lasting value. John Wiley & Sons, 2008.
6. Bally, Jill MG. “The role of nursing leadership in creating a mentoring culture in acute care environments.” Nursing economics 25.3 (2007): 143.
7. Norris, S., et al. “Mentorship Through the Lens of Servant Leadership: The Importance of Accountability and Empowerment.” NACTA Journal, vol. 61, no. 1, 2017, pp. 21–26. JSTOR, https://www.jstor.org/stable/90004100. Accessed 13 Nov. 2023.