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Sunday, December 2, 2012

How to get along with your boss

So I've been doing this respiratory therapy thing for 17 years now.  I have never once ever had a patient complain about me, nor have I had a doctor complain about me either.  Yet my boss tends to find things all the time I screw up.  So what's the deal?

The deal is that the respiratory therapist and the RT Boss live in two different worlds.  As a therapist you're working with the patient, and you want to do whatever is necessary to benefit your patient regardless of cost.  You're first concern isn't making a profit, it's doing what's right.  So, in this way, if you get busy and forget to chart something, no big deal.  Right?

Your boss on the other hand has other ideas.  His job is to keep spending within the budget and to make sure all procedures are billed for and charted correctly.  So while this may not seem like a big deal to you, it is to your boss.  And, hence, this is where the conflict between boss and respiratory therapist comes into play.

So you were busy while running a blood gas, and as soon as you finished you ran back to the emergency room to do CPR.  Yet later on the laboratory boss is irate at you because you left a syringe filled with blood lying by the blood gas machine.  "This will never happen again," he chimes.

You were swamped all day and didn't get to sit down until your shift ended.  So now you're on overtime trying to remember everything you charted that day.  You feel good, like you accomplished a lot.  You go home satisfied.  The next day there's five notes taped to your locker, your boss is irate.

In short, your boss expects you to be perfect at charting, when the reality is everyone makes mistakes, everyone gets busy, everyone forgets.  And, most important, as respiratory therapists we put our patients befor our charting and cleaning up.  Your boss doesn't see how busy you are, all they see is what you didn't do. 

The reaction of RTs sometimes is to get mad at all the notes, at all the complaints, especially considering the doctors and patients are happy.

Now, if you say the wrong thing to your boss, he may perceive you as inconsiderate or lazy.

For instance, I once said, "That's not my concern."  That lead to a lecture.  "Yes it is your concern!" he bellowed.  "If you want to be more than just an RT you have to care."

And of course he was right.

So, what can you say when your boss puts you on the spot?  What will help allay the tension?

Here are a few tips.  Here we go!

1.  It's better to say nothing at all than to say something you'll later regret.
2.  Say something like "It's on my list of things to do."
3.  Bite your pride and say, "I'm sorry.  I'll work on improving my technique."
4.  Say something like, "Yes, sir!" and leave it at that
5.  Do not go on the defense, because it makes you look guilty. 

I think I'll leave it at that to keep it simple.  Now am I saying I always succeed at this?  Absolutely not.  I'm as flawfull as the rest of you (is that a word?).  When I don't follow these tips I usually regret it.


Anonymous said...

It should always be about patient care, but the bottom line for the hospital is the almighty dollar. I hate to say this, but healthcare is a business. It's an ugly beast that continues to put cost above the lives of their employees and the patients they serve. Would your boss still be just as upset if things that you forgot to chart on were still charged correctly?

Anonymous said...

How do you it might work if you and your boss were able to swich roles for a week?

Rick Frea said...

Yes, the bottom line of any business is money. Although if you don't put out a good product, your bottom line will be lacking.

Would your boss still be just as upset if what you forgot to chart on were charged correctly? Probably she would because good charating can get the hospital out of a lawsuit. I've seen it happen with my own good charting.

Rick Frea said...

If my boss and I switched. Well, there was a study done once where doctors had to do all the ABGs at one hospital, and all of a sudden ABG orders were cut by 75%. I'd imnagine things would change for the better if the RT boss saw things through our eyes. On the other hand, If I were the boss I'd have to leave notes for tx's not charted. Although I'm convinced I could do it and still keep the peace. My dad ran a successful business for 30 years and his workers loved him. I have to assume I'd be a boss like my dad.