OR: How Not To Manage a Respiratory Care Department
I could say that my managers were a bunch of micromanaging nincompoops who wouldn’t know quality respiratory care if it bit them on the ass. I could say that they’re a bunch of meddling fools who can’t let the staff do therapy or even show up without managing every single step of the way. I could say that they’re suffocating and terrible, that even though they’re nice people they’re terrible managers.
Instead, I’ll ask Scott Adams to talk to them. Here’s what he wrote about how he manages his own restaurant:
As a well-known critic of managers, I painted a big red bulls eye on my back when I started managing the restaurant. For the first year I was involved in the details somewhat, but primarily to establish an operating culture. I wanted to give them lots of flexibility to try new things, and even more freedom to fail. And I wanted them to feel like it was their own business.
I’m lucky because I have exceptional managers, with lots of experience, who appreciate the freedom they are getting. I think freedom partly compensates for the fact that restaurant pay isn’t the best. It’s a luxury not having your boss breathing down your neck. Apparently something is working because the restaurant quality is better than it has ever been, and January revenues were slightly up from last year despite the tanking economy. I’d love to take credit for that, but lately all I do is eat there.
The principles I tried to establish with the staff early on, that seemed to have stuck, include these:
- Have fun. Loosen up.
- Try something new. Often. Keep whatever works.
- No penalty for a new idea failing. Trying is the thing.
- Employees are more important than customers.
- Stop asking Scott for approval. Just do it.
- Managers get to see the financials.
- Being a jerk to coworkers is grounds for termination.
- Do whatever seems smart and fair to make customers happy.
- Watch the competition closely and borrow their best ideas.
It probably helps that the staff realizes that getting another job these days is a dicey proposition, and they all want to make sure the restaurant stays in business. When someone doesn’t pull their weight, the staff weeds them out on their own, either directly or indirectly.
Notice how he points out that one of his major roles was to establish an operating culture. The operating culture in Sunny Flats Respiratory Care Services is one of fear and a cynical devotion to our productivity tracking system. Our managers micromanage us to a T. They spy on us through our electronic charting, monitor our productivity with a deeply flawed system that allows one RT to have more work but fewer “units” than another RT who is slacking but has plenty of “units.” Our only hope for having a day that does not crush our souls or make us want to run into the hills and hide is to avoid the managers and generate plenty of productivity. The culture isn’t about treating patients or providing quality care; it’s about generating enough “units” to establish our budget. Nobody is happy any more. We all try to do our best and slog through, but morale is low and the managers are not helping.
Adams also mentions relaxing the atmosphere. Encourage innovation and bright ideas. Encourage people to think of new ideas, work out novel solutions for problems. At Sunny Flats, we do the opposite of this also. Management punishes or puts down those who point out problems or suggest ideas that Rock The Boat. Suggesting solutions is acceptable, but even if they are accepted they will soon be mired in paperwork and lost forever in the bureaucratic machinations of our administration.
Another key principle listed above is to value the employee more than the customer. In healthcare it might be slightly different, but the point is the same: employees need to feel valued and respected to be productive. At least in the RC department of Sunny Flats, we feel neither of those things. Our managers obsess endlessly about pleasing nursing admin, pleasing the financial people, pleasing the surgeons…in fact, our managers will bend over backwards for other managers or other departments, often at the expense of our own therapists. The exception seems to be when nursing unit managers ask for more RTs…then our managers go back to the “units” argument and tell them that we’re actually not working hard enough.
Mr. Adams, please, for the sake of all of us who work at Sunny Flats, talk to my managers. They don’t listen to us, the doctors, or anybody else; but maybe a celebrity could garner the attention needed to win them over to reason. Your strategy would not only make us into the most effective department around; it would improve the morale of dozens of people and greatly affect our patient care.
It’s our only hope.
OR: How Not To Manage a Respiratory Care Department
I could say that my managers were a bunch of micromanaging nincompoops who wouldn’t know quality respiratory care if it bit them on the ass. I could say that they’re a bunch of meddling fools who can’t let the staff do therapy or even show up without managing every single step of the way. I could say that they’re suffocating and terrible, that even though they’re nice people they’re terrible managers.
Instead, I’ll ask Scott Adams to talk to them. Here’s what he wrote about how he manages his own restaurant:
Notice how he points out that one of his major roles was to establish an operating culture. The operating culture in Sunny Flats Respiratory Care Services is one of fear and a cynical devotion to our productivity tracking system. Our managers micromanage us to a T. They spy on us through our electronic charting, monitor our productivity with a deeply flawed system that allows one RT to have more work but fewer “units” than another RT who is slacking but has plenty of “units.” Our only hope for having a day that does not crush our souls or make us want to run into the hills and hide is to avoid the managers and generate plenty of productivity. The culture isn’t about treating patients or providing quality care; it’s about generating enough “units” to establish our budget. Nobody is happy any more. We all try to do our best and slog through, but morale is low and the managers are not helping.
Adams also mentions relaxing the atmosphere. Encourage innovation and bright ideas. Encourage people to think of new ideas, work out novel solutions for problems. At Sunny Flats, we do the opposite of this also. Management punishes or puts down those who point out problems or suggest ideas that Rock The Boat. Suggesting solutions is acceptable, but even if they are accepted they will soon be mired in paperwork and lost forever in the bureaucratic machinations of our administration.
Another key principle listed above is to value the employee more than the customer. In healthcare it might be slightly different, but the point is the same: employees need to feel valued and respected to be productive. At least in the RC department of Sunny Flats, we feel neither of those things. Our managers obsess endlessly about pleasing nursing admin, pleasing the financial people, pleasing the surgeons…in fact, our managers will bend over backwards for other managers or other departments, often at the expense of our own therapists. The exception seems to be when nursing unit managers ask for more RTs…then our managers go back to the “units” argument and tell them that we’re actually not working hard enough.
Mr. Adams, please, for the sake of all of us who work at Sunny Flats, talk to my managers. They don’t listen to us, the doctors, or anybody else; but maybe a celebrity could garner the attention needed to win them over to reason. Your strategy would not only make us into the most effective department around; it would improve the morale of dozens of people and greatly affect our patient care.
It’s our only hope.