I am a new NHA in a center less than 60 days, and oh my word, are functional, autonomous, confident, and able department heads important. All it takes is one or two squeaky wheels and the entire operation is at risk.
Right now, I'm following in the footsteps of two predecessors who micromanaged. I'm at a point where I just want to line everyone up and say "Look. This is how it's going to be. You are on my bus or not. If you are not, let me know now. Otherwise, get it together."
I have to control my intake at this point, because I can't get five minutes without a knock on my door to hear about how many cases of washcloths needed to be restocked, or that a PRN cook was hired today, or that the activities director needs to know how I want her to decorate the dining room for the upcoming birthday party.
I make rounds twice a day, so my office time is extremely valuable. Right now my paperwork is backed up a month, and I'm working 12 hour days. If I come in early or stay late, I'm found. It starts at 7 a.m. and does not stop until I leave.
It's a work in progress to empower these folks, and it is starting to wreck my nerves. But, we will get there.