Down the road from our home lives a fellow who likes to burn rubber. Every Sunday evening, he gets liquored up, jumps in his pickup, and delights in squealing his tires up and down the road. He makes a lot of noise, scars up the pavement, puts himself and other people at risk, and disrupts the peace of those around him all at the expense of his tires and his vehicle. He's a big wheel.
Some employees act like big wheels, too. They make a lot of noise, put people at risk, and disrupt the peace of the workplace. The scars they leave are emotional (on their coworkers and supervisors) and disabling (on the morale of the team).
The empowered healthcare manager doesn't hire big wheels.
Big wheels don't let on they are big wheels when looking for employment. Once they're in the house and start feeling comfortable with their new surroundings, they start scarring, disrupting, risking, and making noise. It's their nature.
The role of the empowered healthcare manager is to let the air out of their tires. Immediately. The first time big wheels make their true nature known is a test to see if you object. They know their actions are objectionable because behind them is a wide swath of plundered relationships. They're waiting to see which category you fall into: those who object or those who tolerate.
Managers tolerate. Empowered managers object.
There are two ways to let the air out of any tire. You can either depress the valve and let it slowly deflate or you can slash the sidewall and destroy it for good. Use the valve first. Counsel the employee, establish expectations, set consequences, and monitor closely. Empower your staff to be your eyes and ears and let the big wheel know it. If it works, the wheel will help move your department forward along with the others that give you traction. If it doesn't it's time to slash the sidewall with termination.
By depressing the valve first, you've not only done yourself and your staff a favor by applying the necessary motivators, but you've done the problem employee a big favor, too. Life isn't easy when a person is over-inflated.
We all know what dogs do to big wheels.