Another reason I don't want to get into management.... the loss of skills. The more time you spend in that office away from patients, the more you lose the ability to prioritize, be flexible and deal with the staff "in the trenches" versus in the office. The loss of perspective is staggering. Even at the ED Coordinator level it is amazing. We have coordinators that cannot even put a patient into the system and triage them. I feel like they should be a clinical resource instead of just "in charge." They should be up on the protocols, equipment and policy and truly be THE resource for the department. Are they....? Nope. Very seldom do they have to do anything with staffing. When they do they are either in triage or in charge. Again, a loss of perspective.
I feel very strongly that we are defined by our actions. Not just what we do, but how we treat people. I don't pretend to be an angel. I have had my share of fuck-ups. I have an Irish temper that has gotten away from me from time to time. I have a mouth that makes cops and sailors blush and can throw down a 'tude with the best of them. However, the patients love me because I talk to them like they are people. I try to take care of the staff and I learn people's names. I know that one of my favorite residents has a husband in med school and she doesn't seem him often. When he is in town I tease her about ho-ing it up. I know that the housekeeper has lost a son and grandchild within the last year and has been having a difficult time. I have been the first to look at a UPT and to watch someone decide their marriage is over. As a manager....do you look at that? Negative. Its all about what one person says versus another and the bottom line.
Speaking of the bottom line... what are we willing to sacrifice for it? I know that times are tough. There are more patients than ever and fewer people to take care of them. So what gets the axe? In my institution it seems to be anything having to do with morale and staff safety. Our annual Christmas party was cancelled. The physicians still got bonuses though. We can't get metal detectors, but we have opened a new area of the department so we can see even more patients. Staffing sucks, but we still can't get scheduled overtime. Scheduling sucks.... but who needs someone clinical to do the scheduling when a secretary can do it? We are forever running out of things (pt meals, blankets, IV pumps). When there is shit weather we can stay there.. they can't guarantee a bed, but there might be a stretcher you can use. The physicians get to bill by the patient too. So why go on diversion when we can just start stacking patients in the hall? I seriously saw patients in the triage room with an attending Saturday night. I triaged them, wrote them up, called him, he saw them, did his paperwork, wrote scripts and I discharged them. Did I mention it was only myself and the screamer nurse? She kept sending them my way.... and I kept tearing through. Saw 6 patients that way in an hour. In addition to the ones that were triaged and sent to the waiting room. Then (naturally) the computers went down for the next 6 hours. Gotta love that bottom line!
No crazy stories to share today. Have been exploring why I am where I am and what needs to change. No answers yet. I have been lucky to differentiate between the friends who have got my back and those that were more interested in what I could do for them. Like my grandmother always said... its just another FGO (fucking growth opportunity).
One would think that with all this opportunity I'd be taller by now!!!