Health Chaos

One of the most difficult tasks that I have had as a manager is hiring and firing staff. I would like to share a few tips.

 Hiring: trust your instincts at the interview. Have a second interview. Try to avoid phone interviews. We all make such different presentations in person.  Don’t ask all the questions. Keep the forum open and encourage questions and comments. It is not even worth your time to contact references, but if you do, the only question worth asking is “would you hire this person again?” Be wary of letters of inquiry that say “I am the perfect person for your position”. Nobody knows this but you! Walk them through the work area;  introduce them to the current staff; show an applicant  the potential work area.

 Seriously consider the employee’s orientation. Make it thorough. Meaning, introduce a new employee, or an applicant,  to staff. Give them a packet that you created with the agency’s (of whomever) history, needs, current situation, mission, goals, funding sources. Include a list of staff with phone numbers and email addresses. Include a detailed, long list of acronyms. Tell them where to park, where to get lunch. Tell them the good and bad (yes; the bad things too) that they should be aware of. Make it clear that you have an open door…any time…

 And as I have said before, have the workspace CLEAN AND PREPARED. Have flowers. Be welcoming. Have the keys ready.

 Firing is much more complicated. One may have to go through all the union rules, and civil service rules first. One must document and document and document, while mentoring and trying very hard to save the employee. And it is best, when the day comes, to make it as pleasant and supportive as possible. I would suggest forgetting an exit interview, unless you really plan to listen intently and be willing to make changes in how you hire, supervise, manage. I would also suggest that you offer to be supportive, provide a reference that you feel that you can comfortably provide, and make suggestions that  will be helpful, not critical. I have had employees, upon firing, who cried and thanked me. Be prepared for this possible scenario too.

 Good luck

In my years of experience as a nursing supervisor, coordinator, manager, I have learned a few things (self taught,  by experience; not in the books, not in classes) that have been very valuable and that I like to share with my colleagues.

Keep in mind that the role is to be supportive of the professional growth of the staff. That means encouraging them to move on, to grow, not stay with you forever.

Keep in mind that a micro manager is not good; sometimes the more freedom that you give staff, the more they will knock their socks off to help you.

Keep in mind that regularly scheduled staff meetings are very important for team building and loyalty. Weekly. And generally my experience has been that the longer the agenda, the shorter the meeting. The shorter the agenda, the longer the meeting goes on. It is the time to give staff the liberty and respect to share ideas and experiences. I have never felt that staff meetings should be just a forum for announcements and dictates, but rather for their agenda and participation as well.

Keep in mind that you need to get to know each staff person well. Have individual meetings to understand their goals, needs so that you can make adjustments. Don’t just meet with them to dictate schedules and do the annual reviews. And speaking of annual reviews, do let the staff do a self review, then compare your notes at the face to face discussion.

 Keep in mind to not be rigid about time schedules and dress codes. Make reasonable adjustments.  The staff have a life outside “work” and they will reward you with dedication and going beyond the call of duty when needed.

Keep in mind to treat your staff to nice thank you gifts. No paper stars or certificates or plastic roses. How about making sure that they have an equipped and welcoming desk on their first day. And include a vase of flowers, for the men too!! And introduce them to all the other staff. I once accepted a position that did not last more than a month. I was told that there would be a welcoming breakfast for me. Well, it never happened. No one introduced me to the other staff.

Keep in mind  that a thorough, considerate welcoming and orientation is essential. Don’t start throwing acronyms. Provide a packet that includes the mission and history of the agency, a staff list with names, phone numbers, emails, positions. Provide a list of acronyms that explain whom the staff will interface with. Provide a list of relevant agencies. How about a rolodex full of essential numbers, along with paper, pens, phone, computer, and whatever else is immediately needed.

Keep in mind to try to personalize the interview, and not ask the same boring 5 or 10 questions that do not really help you get to know the candidate.

Keep in mind that the exit interview might not be worth anyone’s time. Unless you are genuinely willing to listen and respond and make changes.

I have an unemployment hearing with a judge on August 1st. Now that will be a challenge I am not used to. I tried to find info about the judge on line, but could only find her office number. So here is what i plan to say, if they even give me the time of day…

UNEMPLOYMENT HEARING, AUGUST 1, 2007

• Except for technology, I was overqualified, overeducated, and over experienced for this position.
• My 39 year career has been in public health or academia (sometimes both at the same time). This is where my heart is and where I thrive, contribute, and can be creative. I am trying to develop “connections” and “find leads” in these areas and believe that I will find something. I just need to expand to a broader geographic area.
• I was unemployed for a short time (8/04 until 3/05) because my temporary position ended. I did not collect unemployment at that time.
• The position was advertised as nursing supervisor. However, I was expected to be a clinical expert and fill in for nursing staff. I was expected to use clinical skills that I do not have and have not practiced since I was an undergraduate student. This is not where my professional strengths lie. Since I left the position, it is now advertised as Nursing Lead, a clinical position. I did not in any way misrepresent myself in the interview process, and my curriculum vitae are very clear and accurate as to my education, abilities, and experiences.
• When I arrived in this position I sought out several staff, since they did not have the respect and consideration to introduce themselves to me. And the usual comment I received was “wow; I am surprised you were hired, since our director only wants us to hire “fill in ethnic group”. Yet I was expected to be culturally sensitive, which I have needed to be in all of my positions and have always supported, and taught that ideology.
• My communication from the unemployment offices has always referred to an incorrect address. There is no such place.
• My most recent communication from the unemployment offices has also referred to “name withheld “as my employer. I have never heard of, nor met, this person.
• I also have been misquoted as to why I left my position. It was NOT for personal reasons, but rather due to “our management and communication styles are incompatible”. I spoke, at length, in my exit interview, about how I felt this position should be represented, because I felt that it was misrepresented to me. I have noticed that it is no longer described as a nursing supervisor position, but now rather as a “lead nurse” to provide nursing services.
• As one can tell from my curriculum vitae, I am very well educated and have been employed for 39 years as a health professional in high expectation capacities and have been extremely successful prior to my move to Washington.
• I now find myself disconnected from a world in which it is “connections” that lead to the best positions. I feel that I am getting “closer”.
• Since I was the victim of a major lay off at (insurance company) in October of 2006, I have applied for more than 150 positions and have had several interviews. And I have also accepted two positions that were not a good match for me, technologically.

I just recalled a horrible memory from a recent interview . “Do you have blahdy blah certification?” and I said no I do not. But what I wanted to say is I do not need any certifications. I already have 3 professional degrees and 38 years of experience. But she said that if I was hired ( which I won’t be) that I would need to take 70 class hours (at my expense) to get some nonsensical certification, within the year. Well I am not getting the job anyway; no fear. So here goes my next blog entry into HEALTH CHAOS.

So having degrees from major universities is not enough now. Because now some entrepreneurs have figured out how to provide special certifications to nurses, for lots of $. (yes; make money; that is the object). Anyone who has a degree from approved universities, big name places like the ones I went to, don’t need more certifications. That education (required for certification) is inherent in a professional degree program. This recent concept of certification is a scam.

Why are potential employers asking me how much time I need to take off? What is the point here? Are they concerned about abuse of “time off benefits?” I had an experience in my last position, where, as a supervisor, I was told not to approve anyone’s request for time off because several of our staff had resigned, and a new computer progam would be initiated during the end of year holidays.

Why would any agency initiate a new computer system during a holiday season? Nuts! Oh, I think, in this case because there were “connections”. It was a down time for the computer company too. So let’s make a deal! We don’t care about your staff’s feelings, requests, needs. We just all want to make a financial deal. And the inexperienced manager has no concern for her staff.

Oh; a little comment. I quit that position. But apparently the gossip was that I got fired. I like fulfilling work, which means I often take too little time off.  In my 20 years at Stanford University I took 2 three week vacations to leave the country. And even then I couldn’t leave it alone and kept checking back. My preference was  long weekends and “ field trips” with my sons.

As most of us have all heard, keep a resume to one page; you can send a more comprehensive cv (curriculum vitae) as well, depending on your background and profession. Some employers want to see both.

Now the corollary!

More and more I see “job descriptions” that do not follow the same rule that they expect applicants to follow. They tend to be “run on” documents that talk about the organization (why? You can look at their web site if you are that interested), they talk about their values (why? Wouldn’t you expect a health or social service agency to have some altruistic values?).

I would like to see a description of a position that could succinctly tell me what they would expect of me; not a laundry list of all the things I might get asked to do in a pinch, like clean the kitchen sink. So I guess this has gotten me to refine, more and more, what I want to ask when I interview the folks that are interviewing me, when we get to the point of “do you have any questions for us?”  “yes; as a matter of fact, I do”.

• Tell me, in a few words, what you expect the person in this position to be responsible for?
• Is this a clinical position, or is it a supervisory, managerial, administrative position?
• What is your management style? Please be specific. They probably already asked you what kind of management style you do well with. I know that I do not appreciate a demeaning micro manager. Please trust me to do my job already.
• Tell me, right up front, the idiosyncrasies of your agency, so that I don’t spend my first year second guessing. What is great here? What are the problems here?
• And, in the case of community health, which is my specialty area, “what are your relationships in the community? What do you want to accomplish?” “which community based organizations to you interface with?”
• And since I love to recruit and mentor students, I would need to ask “how open, interested are you in recruiting and mentoring students in related health and social service professions? Do you encourage and support this?”

If you have the sense that the interviewers are interested in you, ALWAYS  ask for a walk through to see your potential working area and meet some of the staff. That will give you a lot of clues about whether this is a good fit for you. Can you sit in a tiny cubicle? Is there a window? Is everyone disgruntled, or happy? Can you were sandals in the summer? Are you attached to a head phone and facing a computer screen all day? (I cannot / will not / could not do that ever again!).

To be a productive employee, you need to be respected. You need a supervisor who doesn’t just give orders, but has your professional growth at heart, whether in the agency, or helping you to move on to your career goals.

INTERVIEW QUESTIONS:

Last year, at the age of 60, I left a position to take a managerial position for yet another insurance company. And eventually I was the subject of a lay off due to corporate downsizing, and took another position, found by an aggressive head hunter, and was bamboozled into a position that was not right for me, or for them. That lasted one month; didn’t even finish the orientation!

What I have learned: I cannot work for corporate America. We are not a good fit. I have always enjoyed, despite funding challenges, working for non profit public health and academia, which is where my heart lies.

I have mentored many health professional students during my 38 years as a health professional. And I have many friends and colleagues who have had long phone conversations and numerous emails shared because they truly felt that I helped them through the job search and interview processes. So I would like to share my experience with you. I hope it will help.

What we “do.” our ‘work, factors so much in our identity. Yet we “lose” work for many reasons: lay offs, getting fired, quitting for necessary reasons, or just plain can’t stand it. How do we look for new work?  One needs to look at your profession, education, any credentials, but also how your skills and knowledge are transferable to another occupation…

And then there is the interview, and the second interview. If you are not offered a second interview and are just offered a position, please do ask for a second interview, and please do use some of the ideas listed below. And by the way, if you live in a big city, ask the potential employer for their recommendations of where you should park, during the interview.

• The position (don’t say job; makes you sound like a slave) description to…what is the position REALLY? Job descriptions are often long and tedious and don’t really say WHAT the position is really responsible for. 

• What is the composition of the staff? Team orientation?

• What is the composition of the patient/client/member and community base? (socioeconomic, ethnicity, language, geography)

• May I meet my potential co-workers, colleagues?

• How did you determine that you needed this position filled? What would you like the person in this position to accomplish? Not a new position?

• May I see the organization chart?  How, where do I fit in?

• What is the working environment? Cubicle? Office space?  Is the team located together? May I have a walk through and meet the staff with whom I would be working?

• What do you really want someone in this position to do? A team member? An on-call consultant? A leader?

• How would I interface with other staff?  Who will I be working with on a regular basis?

• How does the staff get along? With you? Team spirit? Will I have the opportunity to affect this?

• Why would I like to work in this program? Is this a stimulating and challenging environment where I could not only share my knowledge and experience but continue my own professional growth as well?

• Computer skills needed? Outlook? Can you please show me/ demonstrate the computer programs which I would need to use? May I see you demonstrate the computer programs that I would be using?

• Just as you are interviewing me, I am interviewing you. If I am hired, I would like this to be the best for all of us.

• I look forward to promoting team feeling, team growth, as well as individual growth.

• Tell me about the strengths, weaknesses, needs of your program

• I want to feel enthusiastic about going to work each morning, and look forward to returning the next day.  This is what I am looking for in a position.

• Who will provide my orientation, and educate me for my position? For how long?

• Who will be my direct supervisors/managers? What is their style? Micro managing or trust me to do my work?

• Salary negotiations: never say I could live on $00,000. Tell them what the highest salary you ever received, and what you think you deserve. They would be HAPPY  to pay you $8.00/hr. You are worth a lot more!!!

• Why do you think I am qualified for this position?

• Do you reimburse parking, public transportation? Why not? Alternatives?

• Working days, hours?

• NEVER RESPOND IMMEDIATELY WITH “OH; I WOULD LOVE THIS JOB; THANK YOU FOR THE OFFER”. Instead say “let me think about this and I will get back to you in a day or two; I want this to be a good fit for both of us”.

• Tell me about your dress code. When I was a manager I have always told staff to just be clean, neat, and professional. But this philosophy may not work in corporate America. In my last position I was complimented one morning by a supervisor (not mine) who admired my corduroy overalls. By the end of the day, a manager handed me a dress code policy (one of three for this company) that stated that corduroy was taboo. And overalls too. And then I was told that velour was also out. But none of the 3 dress code policies was clear. And I quickly learned who the snitch was.)

• Which leads to: sorry to say: you need to find out slowly who you can trust to say anything to. You will not know for a long time (a year?) who the real players are and who will be reporting on you. I truly hate to say “don’t trust” but I need to say it LOUD AND CLEAR. Be careful.

• Don’t make the head hunter happy. He/she does not have your interests at heart.

Health chaos goes on. Last week I had facet joint injections with steroids to hopefully, take away spinal pain caused by scoliosis and spinal compression fractures. And I have tried calling the clinic back to try to schedule subsequent injections to the right side of my spine. But why is no one returning my calls, after 3 days? I left messages for the staff who were supposed to be helpful. No calls returned. This is embarrassing to me as a health professional. Is this what my profession has been reduced to? Yes. There is a dumbing down of the nursing profession which I find disgusting.

So how do you find work in this profession that is worth your time, deserving of your education and experience? Seems that insurance companies are the only viable places to look for work in Seattle. Sure, you can apply for other positions that seem to be creative, but then you find out that they “really liked you” but had to hire an internal applicant, or they just don’t know who they want or what they want this “who” to do….well. can’t help out there, since they aren’t asking me, though I bet I could if they asked my opinion. It seems so clear that I could help them take another look at what they really wanted to do with their program, or what they wanted to hire someone to do.

Then there is the thought of retirement and health care…so apparently medicare starts at age 65. but social security allows you to collect benefits at 62. so unless you have worked for some local, state, or federal government job for 30 years or more and are “vested” (like working for an auto union for your entire life), how do you pay for health care? At the time in your life that you need health care the most.

Got scared last week when seen by the doc who did the spinal injections. He detected a heart murmur. Well no surprise in a post menopausal; woman. But I got out my stethoscope and could not hear it; neither could my internist. And as she said, with a woman as slender as I am, it is easy to confuse breath and heart sounds. By the way, the physician who did the spinal injections was amused that he had never treated someone who weighed less than 100lbs. I weighed 99 that day. But I am supposed to weigh 108. I had better eat a lot of rich foods for thanksgiving!

I am in a frenzied madness of looking for employment. There are two concerns that I would like to share: how to share your resumes (and/or cvs aka curriculum vitaes) and how to read these crazy job descriptions.

Everything one applies for requests a resume. They seem to not care about a cover letter and/or a cv. I feel it is very important to send an individualized cover letter with every job application that states your qualities and interests. I submit my “short resume” which is two pages long, as well as my ten page curriculum vitae which some employers appreciate and request.

On the other hand, I am really disappointed by the quality of the job perspectives I find on some job search engines (not their fault). These job descriptions are sometimes lengthy, disorganized, want you to do everything. I find these job descriptions to be so unprofessional, that I have to bite my cheek and apply anyway. These descriptions include everything in addition to cleaning the kitchen sink. Why don’t they describe the half dozen activities that they truly require? If they cannot do that, the employers do not really know what/who they are looking for and create a junk basket of words. Which means if you accept the position, it will be awhile before it is clear what is really expected, which frustrates the employer, and does not bode well for your initial evaluation.

Even though all the recruitment folks recommend that you submit a brief resume, my experience is this: if you have had a long professional career, submit a lot of information, but make it interesting and readable, in small doses i.e. cover letter, short resume, and your lengthier cv (curriculum vitae).

Best wishes.

[tags]looking for employment,curriculum vitaes,recruitment,evaluation[/tags]

The ridiculosity of recruiting for positions when it is clear the employer wants an internal candidate…

I have experienced several situations in which I have applied for positions in which the job description stated that an internal candidate was preferred who “knew” their system. This generally involved positions that required familiarity with the institution’s research protocols. And I have had the misfortune of applying for positions where this was not stated.

Sometimes during the interview I was told that they would prefer to hire someone who already knew the internal operations of their organization. Why are they wasting my time and theirs?

And at other times, after interviewing well, I was called, only to be told that they “really liked” me but that they had to hire an internal candidate. This has been true for civil service positions, or those that required union membership, or “frozen” positions, usually in public health.

Isn’t this all a bit unfair, unscrupulous, and abuse of my time and integrity? Their time too, though I don’t need to care about that…

Today I had a great interview, for an hour and a half with a manager who was developing laryngitis. I felt bad and should have offered to get her a bottle of water, since I brought one for me. But we were both too busy talking to drink water, which was good. I am being invited back for a second interview with two other persons. And this time I have to have the courage to say “I realize that interviewing and selecting a candidate is difficult. Just as you are interviewing me, I am interviewing you as well. We want this to work for all of us. I don’t want you to waste your time; neither do I want to look for another position from the first day that I am employed by you, which is an experience that I had”.

It is so important to welcome, introduce a new employee. And I spent a year, out of financial necessity, with an insurance company who did not do that. From my first day I knew that my decision to work with them was a disaster, and I began searching for another position.

Speaking of “positions”: think about what you are looking for. Do you want a job, which implies, I believe, unskilled labor, or do you, as a professional, want a “position” which implies bringing education, experience, integrity to your work? And watch your language: do you want to work “for” them, or “with” them?

[tags]ridiculosity,internal candidate,civil service positions,public health,interview,interviewing,insurance company[/tags]