Member Voices

The Work Beneath the Work

Recognizing the invisible workers who hold our organizations together.

In 2020, we called them essential.

We put signs in our yards. We said thank you. We celebrated people for showing up.

Then normal returned, and for many of them, so did our silence.

One of them works in my building. She knows all 50 of our residents—their needs, their likes, their dislikes. She has never let a resident miss a shower or a meal. She often knows something has changed with a resident before any test shows it.

Every month, she takes her own money and hosts a luncheon for the women who live in our community.

She comes in every day. She smiles.

She will never receive an award. Her name will not appear in a newsletter. She will never sit in a boardroom.

But her work touches our residents' lives every single day.

That is the work beneath the work. It is the labor that supports everything else. And too often, the people doing it are invisible.

It Is Everywhere

In healthcare, people quickly recognize physicians, nurses, executives, and clinical leaders. Their work is important. But healthcare does not function because of clinical staff alone.

It functions because someone prepared the food, cleaned the room, stocked the supplies, washed the linens, worked overnight, and came in when another person called off.

The same is true everywhere. Our grocery stores depend on farmers, field workers, truck drivers, warehouse teams, and stockers. Our restaurants depend on dishwashers, prep cooks, and delivery drivers. Our businesses depend on custodians, maintenance workers, and people throughout the supply chain whose names most customers will never know.

We enjoy the finished product.

They live inside the process.

We Notice the Work Most When It Stops

When staffing is short, we notice. When supplies are unavailable, we notice. When a building is not cleaned, we notice.

When everything runs smoothly, their work becomes almost invisible.

The absence of recognition does not mean the absence of value. Some of the most essential work is successful precisely because we never have to think about it.

Someone else already did.

I am guilty of this. As a leader, I am ashamed of it.

Dignity Should Not Depend on a Job Title

We have created hierarchies that confuse compensation, education, or title with human value. They are not the same thing.

A chief executive may have more authority than a custodian. That does not make the executive more worthy of dignity.

Organizations love to talk about strategy.

Frontline workers execute it.

They are where policies become practice. They are where safety standards are either followed or ignored. They are where the promise an organization makes to the public either becomes true or falls apart.

Appreciation Cannot Be Seasonal

During COVID, we suddenly recognized the people we had overlooked. But real appreciation cannot appear only when we desperately need someone.

It should show up in how leaders speak to employees, how schedules are created, how concerns are heard, how workloads are managed, and how people are compensated.

Not with empty praise. Not with a generic pizza party. Not with one appreciation event a year.

Behind Every Metric Is a Person

Census. Revenue. Quality measures. Those numbers matter.

But behind every metric is a person. Someone came to work tired. Someone stayed late. Someone trained the new employee. Someone caught an error before it became a problem.

Leadership means noticing that.

What I Am Doing About It

I respect their time off, and I encourage people to use their PTO.

I try not to penalize people for having a life.

I try to be flexible because I understand that everything is expensive right now.

And sometimes that means I stay at work until Uber prices come down so a staff member can afford to get there.

There Is No Small Work

There is no such thing as insignificant work when that work serves another person.

Learn someone's name. Acknowledge the night shift. Recognize the person behind the scenes. Treat every employee with dignity.

And when you are in a position to lead, remember that the organization does not run because your name is on the door. It runs because people at every level keep showing up and doing the work.

We don't need another round of signs. We need to remember what we said when we needed them most.

The people we notice the least are often doing the work we depend on the most.

And they deserve to be seen.

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About the Author Tarita Dooley, MHA LPN Executive Director, Priority Life Care, LLC

Tarita Dooley is an Executive Director in long-term care and geriatrics with over 20 years of experience in healthcare. Based in Grand Rapids, Michigan, she has held her current role for nearly two years and has been with her company for more than five years. She holds a bachelor's and a master's degree in Health Administration and Health Management from the University of Phoenix, where she is also pursuing a…

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