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SDS managers share their biggest headaches
By Stephen W. Earnhart,
President and CEO
Earnhart & Associates
As a manager, what is your greatest challenge? What cause your greatest headaches and takes the most of your time? In an informal and anonymous poll of a number of my friends in the business, I decided to stretch my friendship and ask them these questions:
Here is the setup: There were 12 participants. All were RNs. Three were administrators in multispecialty for-profit surgery centers.
Three were nurse managers in different multispecialty for-profit surgery centers. Three were directors or department heads in not-for-profit, hospital-owned surgery centers without physician investors. Three were clinical nurse managers in different not-for-profit, hospital surgery centers without physician investors.
All had 48 hours to think about the question. Responses were verbal so they could be completely open and honest. Here are the questions and responses.
1. What single problem in your facility causes the most serious problems or consequences that you deal with on an ongoing basis?
Since sexual harassment still seems to be an issue — I thought this went away a long time ago — it is important for each person to review the department’s policy and adhere to it. What some might consider innocent banter, others find offensive — so re-learn the rules!
All said they are in situations in which their budgets are decided by some hospital official who doesn’t understand the business. Is there anything you can do? Oh, yes: Plead your case. Cite comments by your surgeons that they will leave and create their own center if things get too tight around your department. Convince your uppity-ups that it is far better to spend a few more dollars on staff now than contend with a flight of experienced staff and disenchanted surgeons.
2. What service in your facility is the most difficult to work with?
3. What one thing would you change in your area if you could — right here, right now?
Memory is fleeting, so make sure the people that matter most know that you do not accept it. A second response was "for-profit surgery centers." A third response was "all managed care plans, programs, contracts, and anything else that has the word contract’ in it."
A second response was "poor rate of pay for staff." Want a raise in this environment? Do something to earn it; showing up for work doesn’t get it anymore. Put together a list of improvements that you can effect, which will save the hospital money. Put actual dollars saved beside each item. Tell your boss that you would like to head up a task force to implement the improvements. You think that won’t work? Try it!
A third response was "lack of proper incentives for staff members to be efficient." (FYI: They are out there!) Probably the best incentive is to send your staff home when their assignments for the day are complete — with pay! Why not? You are paying them eight hours to do something. If they can do it in five hours, and make the surgeons happy with the rapid turnover, why not? You have absolutely nothing to lose by trying it.
With the small number of individuals involved, this survey was hardly scientific — but it is insightful. Face your challenges head-on before they lead to low morale, lawsuits, or worse!
(Editor’s note: Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Contact Earnhart at 5905 Tree Shadow Place, Suite 1200, Dallas, TX 75252. E-mail: email@example.com. Web: www.earnhart.com.)