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Sunday, May 13, 2012

The natural progression of satisfaction

I remember way back before I was hired as an RT, back when I had a new job every summer.  I remember observing how the people who worked for five or more years tended to be apathetic and disengaged from their work.  These people spent a lot of time complaining. 

I saw the same thing when I was hired as an RT.  My coworkers acted like they hated their work.  They often complained and were slow to get up when their pagers went off.  I didn't understand this because I was absolutely passionate about my work.  I even remember thinking once I loved my job so much I could work every day.

What I observed was what is referred to as the natural progression of satisfaction.  Most of the people who complained, I observed, were those who had worked for over five years of the same job, doing the same tasks, caring for the same customers. 

Those who were the happiest were those who were new on the job -- like myself.  Little did I know my own satisfaction would remain high for a while, yet it too would slowly dissipate.  Yes, I too became infatuated with apathy and I too became disengaged in my work.

This disengagement results in a reduction in the quality of your work.  It's something bosses want to reduce, and therefore it's been studied by experts. 

When we first get a job there is a new excitement.  We are learning new tasks and we are excited as we get better and faster at it.  We feel as though what we do matters, and the better we are at it the more satisfied we become.  The quality of our work is high.  Our customers are satisfied with our work.

Yet then time happens.  What was once challenging now becomes a redundant procedure.  You become educated and learn some of what you do isn't needed.  You learn shortcuts that make the job easier, and you start to simplify your speech so each customer hears the same things from you.  Instead of treating each customer unique, you treat them all the same.  You, in essence, become an automaton.

What happens is your job becomes routine.  Routines result in shortcuts.  Short cuts cause quality to be diminished.  Instead of feeling the need to run to a code you walk.  You are relaxed when you should feel an adrenaline rush.  When a sense of urgency is replaced by routine this is akin to working in a factory spending the entire day wrapping paper around cigarettes.

Think back to when you first got your job as an RT.  When your pager went off you were eager to see what your message was.  You rushed to complete the job, and you were eager to provide your services.  When you were done you were eager to discuss what you did with your coworkers.  You cared about your work.  You were proud.

Then over time, after learning that many of the patients you care for don't even need to be in the hospital, after realizing most doctors have no clue what a bronchodilator does, and after realizing most nurses want breathing treatments for all dyspnea, the thrill of your job wears out.  You start working just so you can get a day off.  When you do work you can't wait till the end of the day.

We still care about our patients, yet much of our concentration has shifted from what we can do to benefit our patients to just doing your job as fast as you can so you can get back to your game on the Internet.  You are good at what you do, and too good.  The task has become routine.  You take shortcuts, and the quality of your work diminishes.

Many RT bosses have no clue about the natural progression of satisfaction.  Many know about it because they were RTs once too, yet because they are now above it they don't care.  Others learn about it and work hard to try to prevent it.  They want to prevent it because they want quality to remain high. 

Quality comes from pride. So the goal here is to keep RTs proud of their jobs.  This reminds me of a recent encounter I had with my boss.  I was called to assess a patient who had aspirated and was now short of breath, and I advised the nurse that a breathing treatment wouldn't be of any use.

Regardless of my recommendation, 20 minutes later my pager went off with the message:  "Breathing treatment needed on that patient STAT!"  My boss happened to be standing next to me when my pager went off, and I said, "Sometimes instead of thinking nurses just order breathing treatments."

"You should be proud of your job," my boss said.  "You should want to do things you're asked to do."

I said, "I would be proud if my recommendations were respected.  When I recommend one thing and the nurse completely ignores what I recommend, that makes me not proud.  It makes me feel disconnected.  It makes me feel that I don't matter."

So what can my boss do to keep RTs proud of their work?  I think the simplest thing to do is to listen to what we say, and respect what we recommend.  We all spent two years in RT school to become experts on the lungs and how to treat respiratory diseases.  We spend every working day with respiratory patients developing skills. 

I think all that is needed to make an RT proud is to respect us.  All we want is to be treated like the professionals we are.


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