Key to survival: changing attitudes
Key to survival: changing attitudes
By Stephen W. Earnhart, MS
President and CEO
Earnhart & Associates
Dallas
Like it or not, change is occurring in the operating room, and all that once was is no longer. Job security is gone. Being a registered nurse myself, I understand all too well that being a manager or employee in an OR today is not like it was yesterday, and change is coming faster than some would like.
This change is catching many good people off guard and scaring them. Those who are most vulnerable to the new changes and loss of security are closest to the top of the heap: senior-level nurses, directors, and supervisors. These are the people with the most to lose, and they will either fight it to the bitter end or are in a position to encourage and facilitate the changes. Who do you think will survive?
Over the summer I made presentations at operating rooms across the country about the changes in the industry, what the staff can expect, the impact of ambulatory payment classifications, regulatory changes, and physician surgery centers. The talk focused on the change, how it could affect them personally and professionally, and how they could assist in the change.
During the Q&A period after each talk, the anger from the staff came out. The most common responses from all the communities were:
• "I have a family to support — they are not cutting my hours or pay!"
• "Why should we have to accept fewer hours if the physicians start their own surgery center?"
• "I have worked here 22 years — this hospital owes me!"
• "These docs are just greedy and want more money!"
• "This hospital doesn’t care about nurses anymore; it is just the bottom line!"
And on it goes . . . .
After being stung by the venom of these meetings the first few times, I came to expect the response and could handle the questions better. But I was also struck with how self-focused we’ve become. We don’t understand the full picture of what’s happening in our industry. The hospital or organization did not solicit the reimbursement changes — it affects them as a business and personally as the managers and staff.
Hospital management is not a good career path anymore. They are dropping like flies. Why? Because business decisions need to be made regarding money in and money out. Most staff hate it when you cite "business decisions" to them. However, they need to understand that health care is business — and it is business of the highest magnitude. The staff need to respond to these changes with appropriate business mentality instead of emotion. ("This hospital owes me . . .!") No one owes anyone anything. Each day is new, and we must stop resting on past performance. "How have you helped us today?" is the new management battle cry.
There is no job security — accept it. If managers and staff can’t contribute, eventually they will be replaced with someone who can. That’s brutally honest, but true. "Contribution" consists of managers finding ways to make it work — not sitting in a staff meeting telling everyone their private financial problems. Top administrators and CEOs want to hear how new ideas will work — not why managers think they are "stupid." Jobs are being lost and will continue to be lost. Managers and staff should reassess what they want to do with their career. The operating room may not be for them anymore.
Physicians who start their own surgery centers are not greedy. They are looking for ways to maintain their standard of living. Keep in mind that managers and staff at your facility probably haven’t had to take a pay cut. Your surgeons have taken countless many in decreased professional fee reimbursement over the past few years. How many times have they complained to you about their cutbacks? Probably not much — if at all.
It’s time to examine attitudes to changes that are here and that have yet to arrive. The operating room is not for everyone — it certainly is not for those who passively subvert new ideas and initiatives of others. There is a changing attitude among administrators and CEOs. They are tired of explaining to managers and staff why it is all changing and how they can make their employees feel better with less. They are past that and are looking for those individuals who see it and adapt to the change. Be among those who do!
(Editor’s note: Earnhart can be reached at Earnhart and Associates, 5905 Tree Shadow Place, Suite 1200, Dallas, TX 75252. E-mail: searnhart @earnhart.com. Web: www.earnhart. com.)
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