A Seriously Dysfunctional Hospital Unit

October 18, 2017

“I’m miserable working in this lunatic asylum,” Jan blurted out. “I’ve never seen anything like what’s happening here, and nothing I do makes a bit of difference.”

“Wow. Sounds bad. What’s going on?” I wanted to know.

Jan recounted the story of the new nurse who had been threatened. “I have her resignation letter right here on my desk. The bullies on the unit won again,” Jan said angrily. “And this is the tip of the iceberg. I’ve lost every single new nurse I’ve hired since I took this job eighteen months ago. I’m not sure why I’m staying. My husband and friends all tell me to quit, but I’ve never given up on anything in my life.”

“Sounds like there’s a lot more to the story than this latest incident,” I suggested.

“My first week on the job I was handed an employee file by the person who keeps track of time and attendance. She told me ‘You need to suspend this employee today because she’s been late too many times.’ I didn’t have a clue how to do that then, but I’m damn good at it now.”

“It’s been one battle after another trying to clean up this mess,” Jan told me as she began to spill her heart. “A few days ago I was called into a meeting with a unit clerk and her union representative because the clerk was refusing to file any of the paperwork. ‘It’s not my job’, she was insisting, because her job description didn’t specifically mention filing duties. ‘Not my job’ is standing operating procedure on the unit.”

Jan was on a roll now, “In fact, I had to have HR change the job description for the housekeeping staff. They were refusing to strip the beds when the sheets needed changing. The housekeepers demanded that the RN’s do it because they said that their job description stated they were only required to ‘make the bed.’ These people are crazy. The inmates are running the asylum!”

“Those are a few examples of the ‘just say no’ culture,” Jan continued. “Not long ago the techs refused to clean any equipment the physicians used because they thought the doctors should clean up after themselves.”

“The issues with staff never end. Last week I got called in the middle of the night because there was an argument with a patient’s family member,” Jan told me. “A husband had put a tray of food out in the hallway because it was making his wife, who was in labor, nauseous. Her nurse stormed into the room and demanded to know who had placed the food in the hallway. The man tried to explain why he’d done it, but the nurse made him go pick up the tray and take it down the hall to the place it was supposed to go.”

“When the couple complained, I was told by HR to fire the nurse. But I was the one who took heat from the rest of the nurses for not defending their friend,” Jan raved on. “I tried to talk to the nurses about the importance of patient satisfaction, but they tell me, ‘The patients should count themselves lucky we’re here, otherwise nobody would be taking care of them.’ A group of them even went to HR to file a complaint against me for being unfair and firing that nurse for no good reason. Thankfully HR already knew the real story.”

“And the craziness has spilled over to the doctors as well,” Jan fumed. “When we were preparing for the Joint Commission inspection, I took the patients names off the doors to their rooms to comply with HIPPA requirements. One of the gynecologists stormed into my office and screamed that I was creating an unsafe patient environment because she couldn’t tell who was in which room without checking at the nurse’s station first.”

Jan’s face was beet red. “I can’t take this much longer. My heart races. My temper flares. I’m working as many as 80 hours some weeks, bringing in food, even picking up staff in my 4-wheel drive during snowstorms. But all I get in return are complaints and criticism. I’ve tried going to Karin, but she won’t back me up. She’s been friends with a lot of the senior staff for years and has been letting them get away with this crap. Now I understand why the nurse manager who was here for five years before me gave up and let staff do whatever they wanted.”

“I have to say I’m confused about how being positive could possibly change the outrageously negative people on my staff,” Jan asserted. “In the beginning, I tried to be positive with them; but they literally laughed in my face and continued to do whatever they want. I can’t tolerate what they’re doing.”

Fast forward 18 months: Jan’s unit wins award in a major academic medical center for being “most improved.”

  • Job engagement jumped from 3% to 87%
  • Job satisfaction rose from 1% to 85%
  • Patient satisfaction increased by 50%

Read how she was able to align with a handful of staff to lead this turn-around in PROPEL to Quality Healthcare: Six Steps to Improve Patient Care, Staff Engagement and the Bottom Line.

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Dr. Tom Muha is the Director of the PROPEL Institute. As the science of optimal human functioning has emerged, Dr. Muha has been at the forefront in the study of how people involved in healthcare systems can achieve the highest levels of success and satisfaction. Research at major academic medical centers has shown that applying the PROPEL Principles empowers healthcare professionals to achieve remarkable results.

For more information regarding Speaking, Coaching or Consulting:

Website: www.PROPELinstitute.com

Contact: drtommuha@PROPELinstitute.com




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