The Wellbeing Gap - When Leadership Says One Thing and Does Another

When Policies and Practice Don't Match

As nurses and midwives, we often hear about the importance of workplace wellbeing. Organisations invest in wellbeing programs, employee assistance services, resilience training and mental health initiatives—all of which can play an important role in supporting staff.

Yet one of the strongest influences on workplace wellbeing is often overlooked: leadership behaviour.

Every health service has policies designed to promote safety, fairness and consistency. These policies help guide decision-making, clarify expectations and create a framework for respectful and supportive workplaces. However, when leaders don't consistently follow the same policies expected of staff, it can create confusion, frustration and significant stress.

The Impact of Mixed Messages

Many nurses and midwives have experienced situations where the written policy says one thing, but the reality of day-to-day practice feels very different. When this occurs, staff can find themselves caught between following documented expectations and responding to informal directions or behaviours from leadership. Over time, this uncertainty can erode confidence and create anxiety about whether they are meeting expectations.

Why Trust Matters

The impact extends beyond individual staff members. Teams function best when expectations are clear and consistent. When leadership messages change, or when policies appear to apply differently depending on circumstances, trust can begin to deteriorate. Staff may become hesitant to raise concerns, less engaged in decision-making processes, or simply exhausted from trying to navigate mixed messages.

Leadership Shapes Culture—Whether Intentionally or Not

Importantly, this is rarely about individuals intentionally doing the wrong thing. Leadership roles in healthcare are complex and often involve balancing competing priorities, workforce pressures and organisational demands. However, even well-intentioned decisions can have unintended consequences when they are inconsistent with established policies or organisational values.

Psychological Safety Requires Consistency

For nurses and midwives, workplace wellbeing is not only influenced by workload and staffing levels. It is also shaped by fairness, predictability and psychological safety. Knowing what is expected, feeling supported to meet those expectations, and trusting that policies are applied consistently all contribute to a healthier work environment.

Moving Beyond Blame to Solutions

So what can organisations do?

Rather than focusing on blame, it is often more productive to examine patterns and organisational risks. Staff feedback, workforce data, absenteeism rates and turnover trends can provide valuable insight into how leadership practices are affecting workplace culture and wellbeing. These conversations are most effective when framed around improving systems and supporting both staff and leaders to succeed.

Leading by Example - Leadership development, reflective practice and open communication also have an important role to play. When leaders actively model organisational values, communicate transparently and demonstrate accountability, they help create workplaces where staff feel respected, supported and psychologically safe.

More Than a Policy - For nurses and midwives, the takeaway is simple: wellbeing is not just about the programs an organisation offers—it is about the culture people experience every day. Policies matter, but it is leadership behaviour that often determines whether those policies come to life in a meaningful way.

Creating Workplaces Where People Can Thrive

When leadership and policy align, trust grows. Teams feel safer, more connected and more engaged in their work. Ultimately, creating mentally healthy workplaces requires more than written policies—it requires leaders who consistently model the values and behaviours that those policies are designed to promote.