Throughout my 25-year career, I’ve witnessed quite a few leadership vacuums. It’s what happens when a team lacks clear, accountable leadership or chain of command. Sometimes it’s a physical absence where leadership unexpectedly resigns or retreats with poor succession planning in place. But sometimes, it’s a much slower burn where leadership might technically be present, or at least play the part, but be absent in all the ways that matter, leaving teams to fend for themselves without direction or feedback.
Healthcare is unique and leaders are also up against a moving target of new technology, shifting regulations, staffing shortages, and evolving patient needs. Ultimately, no matter your industry, a vacuum means that nobody’s steering the ship. Or that ship has a leak. Decisions that should take days or weeks can stretch months or even years. Coordination between departments or with clients can completely break down, and in the case of healthcare, those who feel it first are often our patients.
The Heart of the Problem
Feedback, or rather a lack thereof, is often at the center of chaos of leadership vacuums. A leader’s core job is to keep everyone on the same page about what’s working and what isn’t. Not to mention what’s coming down the line! When people lose that sense of direction, it creates pervasive uncertainty. Naturally, the mind fills up that leadership void with worst-case scenarios and assumptions, turning what could be a simple staffing gap into the sense that the bottom could fall out at any moment. In some cases, that threat is real, jobs are at stake, and people’s well-being suffers.
A Diagnostic Test and What to Do With the Results
Vacuums of accountability can create a real crisis of clarity, purpose, and connection, so if you’re dealing with one, I’m so sorry but know there is hope! When strategies and initiatives belong to no one (or, just as bad, to everyone), that should be a big, red warning sign.
Naming the issue is the first move toward fixing it, so if you’re still not sure if this is what you’re dealing with, here’s a quick diagnostic test: think of a live problem you’re dealing with at work, ask yourself who owns the outcome, and if the answer is “I don’t know,” “no one” or “we all do,” that’s a clear indicator of your result.
Here’s what you can actually do if you find yourself floating in a leadership void:
Act
When you find yourself in a vacuum, lean into over-communication. There is just too much space for mixed signals and casual misalignments to risk assuming you’re on the same page with people. And build a coalition around you—others who sense the void and are feeling its effects. Define and protect your scope of work. Whenever it comes to indecision, claim what is yours, make decisive calls regarding coordination, and keep moving. In clinical settings, this might mean being the one who insists on closing the communication loop between shifts or departments.
Observe
Whenever possible, observe and document the issue. A good record can help you make the vacuum visible to people who aren’t inside it with you. If it becomes necessary, you can bring that information to someone who might have the overhead to help. Make note especially of any examples of organizational paralysis: activity without progress, meetings that produce more meetings, and busyness that never yields a return.
Plan
One of the most unsettling realities about a leadership void: eventually, something fills it. But that something is not always an improvement! So, make yourself ready for whatever or whoever moves in to fill the void. This could mean you prepare to make a larger change or a transition, or you prepare for what your job might look like when other top talent steps away and responsibilities shift. No, it doesn’t always come to that, but it’s still worth having the forethought.
Step in (Maybe)
Offer and support interim solutions, but don’t rush to fill the void prematurely. For some people, this could be a real chance to step up. But ask yourself honestly whether the drive to lead is coming from ambition or anxiety. Those two can look similar, but lead to different outcomes. Whichever it is, acknowledge problems as they surface, and push for feedback wherever you can get it. And give it, too! Restoring that loop, even informally, is the single biggest step you can take to make a void survivable.
And if you are the one stepping in temporarily (or more permanently) to lead, treat it as a chance to build the next layer of leaders around you. So instead of always plugging the hole yourself, mentor others and share what you’re learning in real time.
What Do You Do?
Something always fills the vacuum eventually. Is that solution going to be positive or negative? Could that solution be you? Or could you encourage other team members to share their ideas, coordination skills, and abilities to unite and inspire? If there have been some poor, yet long prevailing patterns within the team, this could be a chance to break them, and improve a less than satisfactory status quo.
I don’t say any of this to romanticize the leadership vacuum though, or to paint it as some kind of golden opportunity; it is a very real issue with very real costs. But in some cases, it can also be an opening for you to pursue your goals, improve the lives of your co-workers (and possibly patients), and make a positive difference within your organization. You won’t always get to choose whether a vacuum opens up beneath your feet. But it’s possible you could get some say in what moves in to fill it.