Health Chaos

I believe, from my years of experience, that health professionals, more specifically supervisors, educators, mentors, and managers have a very hard time admitting mistakes.

In how they handled a difficult client/patient. In how they handled strife in staff relationships. In how they handled their supervisory role when they should have been more inquisitive, supportive, rather that critical and demeaning.

In how they handled staff meetings. Staff meetings to me, are for sharing new information, but more importantly for team building. The more the staff talks and shares, the better. You will learn a lot! I have found that frequent staff meetings are extremely important. And the longer the agenda, the shorter the meeting. And the shorter the agenda, the longer the meeting. Staff is often very pleased to have a forum to be heard and respected.

A good manager, supervisor, mentor always gives the benefit of the doubt, and then shares similar experiences in order to help the staff persons grow, rather than become angry and disillusioned.

This concept leads somewhat to evaluations of staff. Why not allow “self evaluations” on which you can comment. Do not make these events a crisis and frightening. Make them a growth experience for both of you. Don’t make them long and tedious. See if you can prepare a somewhat brief, and to the point, evaluation. Just as your initial interviews should be. Let the staff talk. You will learn a lot more that way. Generally forget exit interviews. When that time comes, egos might be so bruised that you don’t hear the truth. I have occasionally left before the exit interview. I knew I would not be heard anyway. And I once had a lengthy interview, trying to be honest about the management style, and after I left several staff were laid off and/or fired and/or left because they couldn’t stand the place.

So what kind of manager/supervisor/mentor do you want to be?  One who is rigorously honest and willing to listen, grow, be even more supportive of your staff? Do you want your former staff to not fear asking you for references? Do you want to be respected and respectful?

Do these really go together? Of course not!  

I once thought that my little 2 year old grandson, like many other little children, were overly dependent on their pacifiers. (that  may be because my sons rejected pacifiers; though one son was dependent on his thumb, or biting his nails, and the other son on breastfeeding till age 3 years! for comfort).

 As you have probably heard, childhood lead poisoning is back in the news. I worked as a case manager in childhood lead poisoning for 4 years, not so long ago. We found out about lots of tainted imported toys, and food treats.  So I am now much more supportive of pacifiers! Better to put that in the mouth than a leaded toy.

But, PLEASE remember to wash those little hands before eating snacks and meals!!!! just in case the toy played with before meals and snacks had lead in them!

 Lead poisoning is something you need to be concerned about if you live in an old house, in an old city. Worry if you live in a big city on the east or west coast, or even an old city in between. If you are doing any renovation to an old house (tearing out the wallpaper, scraping paint) do consult someone from your local  health department, specifically environmental health.

 Why be concerned about lead? Because its ingestion  or inhalation can lead to serious developmental problems in little children whose brains are rapidly developing and susceptible to toxins. And how do they get lead in their bodies and brains? Scraping paint for renovation. Chewing fingernails that scraped lead painted walls. Chewing on windowsills in old houses. I did that when I was 2 years old. I am lucky to have some brain cells left. Oh. I also loved that sweet smell of lead in gas stations. Glad that is gone now!

 Beware of Mexican candies and those beautiful painted pots and imported toys. Beware of toys from China. Beware of using Kohl from India on eyelids. There is a lot more to tell you. Stay tuned.

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.

JOB APPLICATION SECURITY

APPLYING FOR WORK: WHO DO YOU TRUST WITH YOUR PERSONAL INFORMATION?

APPLYING FOR WORK? WHY WOULD YOU WANT TO GIVE REFERENCES UNLESS YOU ARE A SERIOUS CANDIDATE?

More and more, one is required to provide more and more personal information on applications. I don’t like handing over all of my professional credentials, or my social security number. And why do the potential employers need to do credit checks? And I refuse to give references until I feel quite confident that I am a serious candidate. In fact, some employers, like insurance companies, are only allowed to say that he/she worked here. That’s all. When one is on a serious, active job hunt, we don’t want to misuse or abuse our potential references with calls to them that are just something the HR staff must do, and wastes everyone’s time.