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Sunday, October 27, 2013

Here's how I deal with verbal blunders

During the course of life every person will do or say things that they shouldn't.  It's just a fact of life that this will happen.  Sometimes these things can be brushed under the carpet, although sometimes they have a significant impact on the future course of our lives.

Recently I was in the emergency room right at the end of my shift.  I was already burned out from performing various procedures, and kind of irritated because many of what I was ordered to do, in my opinion, wasn't even necessary.  So as I was ready to walk out the door of the emergency room, the unit secretary said, "Hey Rick!"

Yes, surely, my blood reached a boiling point.  I bluntly said, "What's wrong with this one?"

A mom walking down the hallway heard me, and said, "That's my daughter in there, it's not a 'this one.'"

"Oh shit!" was all  I could think, and I walked away to get my work done.  There was no doubt this was going to come back to haunt me.  Now normally I wouldn't write about this kind of humiliation on this blog, although I think there is a lesson to be learned here, on the part of RTs, RT bosses, and those who run the healthcare industry.

First of all, we RTs are pawns in the healthcare process.  We are the face of the profession. What we do or say is what our clients -- the patients and their friends and families -- see and hear.  It is from us, not from administrators and bosses, who form the impression of our institutions.  For this reason, regardless of how pointless we may see what we do, we must maintain a pretty face, and say pretty words, when we are anywhere near where any of our clients might see or hear us.

And yes, as evidenced by my blunt statement of irritation, we all flaw sometimes.  My boss called me a few days later as I expected, and said, "Were you in the emergency room around 7 p.m. on Monday?"

I honestly said, "Yes I was."

She said, "Did you say 'What's wrong with this one?"

I said, "I did" And I was provided with the usual lecture of 'You have to be careful what you say' lecture.

I said, "Yep, I know.  I know I should be careful what I say."

Note, however, that I did not say I will not do it again.  I know that I probably will at some point in the future.  It's just human nature.  However, what I did do was apologize and apologize vigorously without adding any further incriminating evidence.  

For the most part I said, "I did" and "I know it was wrong."  I did not reiterate, did not refer to the past, and did not say what I would do in the future.  This was significant, and it was done this way due to my past experience and education -- mainly from experience.

I did not say anything else.  I did not make excuses.  It is my belief that if you make excuses, it only makes you look guiltier.

However, for the sake of this blog, I will delve into the excuse area.  Why did I blow up?  Why was I irritated?  Well, there were a variety of reasons.
  1. End of shift
  2. Tired/ sleepy
  3. Tired/ burned out
  4. Tired of stupidity
  5. Irritated
  6. Burned out
  7. Irritated
  8. Tired of stupid doctor orders
  9. Burned out
End of shift exhaustion there's nothing anyone can do about without decreasing hours, and since hospitals are open 24-7, and I want to work a full shift of weekly hours, there's not much that can be done there.

Tired due to burnout, stupidity and irritation there is something that can be done.These side effects of work are the direct result of people who have no clue about respiratory therapy make decisions for the respiratory therapist  And it's the direct result of RT bosses and administrators not wanting to make waves, so they let doctors get away with whatever.   

Many RTs are apathetic and burned out because doctors order stuff that is not needed.  They order it because they are ignorant, and sometimes they order it because they are forced to so the hospital can get reimbursed.  Some times they order stuff so the family thinks we are doing something -- the placebo effect.  Sometimes they order stuff because people in Washington make regulations effecting the hospital.  

Doctors order things because they are automatically checked on an order set.  They order breathing treatments for all pneumonia patients even when breathing treatments don't cure pneumonia.  They order ABGs and EKGs for all people with suspected sepsis, even when there's no need for it other than reimbursement.  All of these result in extra work that burns us out.  

It's simply true.  And since RT Bosses are overwhelmed by it all, it's easier to ignore it.  The result is RT Apathy and burnout, and this results in irritation at end of shift due to ignorance and stupidity.  The result is grumbling and griping, especially near the end of shifts.  And, from time to time, our grumbling and griping will be heard by the wrong person, or we'll carry it out too far.  

Thankfully, my RT Boss understands all this.  He knows he is powerless to it.  Yet he also knows that the person who complained must be called back, and some form of lie must be said to sugarcoat the blunt statement by the RT to make the hospital look better than it really is.  The RT must apologize and apologize vigorously, and the RT boss must do the same for the patient -- he must apologize and apologize vigorously.  
Now that this person is probably someone who will never be happy is another blog post.  Yet what happened is that I created needless stress and work for my boss.  And for that I apologize.  Through the course of life such will happen, and sometimes these situations can make life better so long as they are dealt with in the appropriate manner.  
Update:  I discussed this with my boss the next day, and he said that this is the purpose of customer relations, to prevent things like this. You should be careful what you say in front of others."

 To this I thought the following: "All the customer relations in the world wouldn't have prevented me from getting burned out and irritated about yet another stupid doctor order.  All the customer service in the world wouldn't have  prevented me from grumbling and being overheard.  All the customer service in the world wouldn't have  prevented my burnout and irritation. That is not what customer service is." 

Yet the avoid conflict part of my brain kept my inner thoughts silent.  

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