Health care workplace becoming chaotic
Marie McIntyre
Q: During my career with inner-city hospitals, I have watched conditions gradually deteriorate for both staff and patients. Nurses have no time for breaks, and mandatory overtime has become the norm, with eight-hour shifts routinely turning into 10. Some of our best people have already left, and others are thinking about it.
Most health care employees chose this profession because we enjoy serving our patients. However, we currently spend so much time on other activities that patient interaction is minimal. And since we are now required to carry phones, conversations with patients are constantly interrupted by calls and texts.
Because nurses are in a central position, we can also see how fragmented medical services have become. When different specialists are involved with the same patient, they never communicate or coordinate medications. Many errors result from this lack of collaboration.
As patient satisfaction scores decline, management just keeps telling us to improve our customer service, but that is impossible with the current system. How can we get someone to fix these issues?
A: You and your colleagues are certainly to be commended for doing important work under trying circumstances. While the health care system has become more challenging for everyone, many inner-city and rural hospitals are having a particularly difficult time, largely because of a lack of funding and leverage.
As administrators try to do more with less, the resulting stress lands directly on the staff. But despite these systemic difficulties, management does control local policies and practices. Therefore, they should be able to assist with some of the issues you describe.
Problems created by inefficient work processes, poor interdepartmental coordination and annoying cellphone interruptions may be quite obvious to employees. However, managers are frequently unaware of stafflevel concerns, so the first step is to get their attention.
Gather some people from different disciplines — including at least one physician — and prepare a list of the most significant problems, describing their impact on patient care and suggesting solutions. Request a meeting with administration and ask your most influential and articulate group member to serve as spokesperson.
Unfortunately, this intervention won’t resolve the societal issues affecting your hospital. However, a positive response from management might improve working conditions enough to encourage people to stay.
Q: My new manager doesn’t understand our work and yells at people when he gets upset. Several employees have left since he arrived, and I have considered leaving myself. Before giving up, however, I have decided to send a letter to human resources complaining about his management style. What should I say in that letter?
A: Under most circumstances, complaining about the boss in writing is a bad idea. If you feel your HR manager could be helpful, discussing the problem in a calm, professional manner is likely to be more effective. Should a negative letter fall into the wrong hands, it could easily come back to haunt you.
Also, you should never become the solo messenger delivering a group complaint. When several people describe the same problem, they generally have more credibility and impact. So instead of writing a lonely letter, ask some equally disgruntled colleagues to join you in requesting a meeting.