They Don't Pay Us 'Cause We're Smart

 Each day I watch the frazzle of management running from location to location to play their own version of "Whack-a-Mole."  One problem pops up and the manager/VP deals with it.  Then the next and the next and the next until it's time to go home.  When commenting upon the positions typically identified as "executive positions," a former, very pragmatic, CEO of mine used to say, "They don't pay us for being smart.  They pay us for putting up with this all day every day."   

Now, the executive who purports to have their act together will ruffle at this suggestion.  They will indignantly say, "I have my strategic plan and never deal in crisis management."  In all reality, they need to get a grip, and admit that it is what it is.  We live in a world of problems, and some of us are paid more than those who report to us because we are supposed to be the problem solvers.  If we don't solve the problems fast enough, they become bigger problems, and those problems create more problems which intensify the situation even more. 

So, a computer gets hung up or an employee is late getting to their assignment.  The patient's schedule is disrupted, and the dominoes begin to crash together like the waves hitting the White Cliffs of Dover.  Doc 1 doesn't get the information that he wants or needs at the time he is available to consume and process it.  Doc 2 doesn't get to Doc 1 because the queue is now twice as long and the system that should have been replaced a year ago is completely dysfunctional.  Doc 3 then explodes and the ripples make their way across the pond until they hit the shore, and, because every action causes a reaction, it sometimes feels as if a concrete block has been thrown into the puddle and the waves move even faster. 

On a bad day, there may be 29 or so disturbances ruminating around ranging from 1 to 7 or 8 on the Richter scale:  a late lab report, a misplaced label, an over assignment of tests for a nonthreatening diagnosis to provide additional protection from litigation, not even health threatening, just life consuming. 

Well, this week something very very disturbing, but certainly not life threatening, happened.  It's happened before.  I'll pray that it never happens again, but this type of incident makes me wonder two things:  Is nice an effective way to manage?  What would it be like to actually have things work the way you have been told they are, were or should have been working?  In other words what would it be like to be the President of a Hospital?

For three years, I have been publicly reporting on the progress of one of our clinical research initiatives.  It was a parallel initiative with one of our partners, and they continually reported to me how happy and successful both the clinical and research aspects of that effort had been.   For the past three years in every speech, every video, every interview and every pronouncement that I made, I included information about this work. 

Yesterday, I found out that it wasn't being done, that two physicians didn't particularly care for the technology involved, and so, independent of each other, they both decided to ignore the clinical use of this expensive piece of equipment.  When I asked how this could be, I was informed that it was mentioned a year or so ago that one of the docs didn't really like it, BUT... and this is the big but, no one ever said, "Both physicians have rejected this diagnostic equipment and, consequently, it is collecting dust."  Makes me think of the TV series Just Shoot Me.

As a teacher, it would have been interesting if the band director had just said to his boss, "I don't like the trombone.  So, I won't use it.  I'll only use what I want to use. " 

Whack-a-(Hospital) President!

Comments

[Mike]

I've been in nursing for twenty years now, much of it in the military and more recently on the civilian side. I have been a staff nurse, and an ICU manager and when I was on active duty I was the executive officer (2nd in command) of a 120 bed combat medical unit. Today I am a nursing supervisor with aspirations of getting to your level or at least VP of nursing. I too have experienced this same mind numbing experience several times and I shake my head over and over. Long ago I learned to follow up on people becuase they all tell you what you want to hear. You learn that the "it should have" "I think so" and the "As far as I know" statements all equate to you don't know and you have no idea. This forces you to find out yourself. I do not understand why folks can't just be honest. I have learned in my limited management life that few people want to hear the truth. It is a twisted poker game for sure. I for one tell it like it is which I suspect I have had difficulty with the interview process. Ah but there is hope. Sometime you just need to be hit in the head a few times to realize how the poker game is played.

[Vernon Dutton]

Hi, I thought ya'll might like to see this Graduation yearbook from Windber Hospital Training School for Nurses 1935. This was the first year the school had a Yearbook. Includes a photograph of Dr. Orris.

Vernon,
http://www.rubylane.com/shops/nursingpins

[bev M.D.]

Boy, you have captured both the nature of this experience and the fury it generates (in the mole-whacker) so well! As former Medical Director of 2 hospital labs for 21 years I am very familiar with this situation. People tell you what they want you to hear.
In this case, I would whack two heads together!! (: