Respiratory care departments are full of kind, compassionate people who only want to help people breathe easier. But as any therapist knows, it only takes one staff member to sow the seeds of discord in other members of the staff. And when that discord grows, it can have an adverse impact on the careers of everyone involved.
Fortunately, respiratory care managers work hard to keep negativity out of their departments so that the rest of the staff can thrive.
The job no one wants
“No one says to themselves during a job hunt, ‘What I really want in the job I am looking for is a place that is filled with negative, back-biting, non-team players!’” said Scott Reistad, RRT, CPFT, FAARC, a hospital respiratory care specialist with Philips Respironics who spent 30+ years in respiratory care management. “Everyone wants a work environment that is fun, with good friends at work.”
Reistad says departments that are full of conflict are challenging places to work even for those who try to distance themselves from those who are engaged in the conflict, and that can lead to turnover. But he emphasizes there is both positive and negative turnover in any department, and the positive turnover — i.e., when a toxic staff member leaves — is often just what the department needs.
“Interestingly, in my 32 years in management, though I had to fire many people, typically this was the breakdown: one, the person I fired was mad at me; two, the friends of the person I fired were mad at me; and three, the vast majority of the staff members were secretly happy/relieved that this toxic person was gone,” Reistad said.
He suggests managers set expectations for positive behavior beginning in the interview itself by giving examples of what positive and negative behavior looks like. He also says managers must give their staff a chance to bring up issues that arise within the department in an open way so that they can be resolved before they lead to conflict.
But the bottom line is, don’t let negativity take hold. “Partner with your HR team, as each hospital always has some kind of cultural norms or mission statement that would include attitude,” he said. “If you allow negativity to continue then you will go down a road of having more negativity.”
One-on-one meetings help
According to Rusti Wilson, RRT, department director at PMH Medical Center in Richland, VA, negativity in a department can cause lasting damage if it’s not addressed. She believes all departments have high, middle, and low performers and when low performers develop a negative attitude, they bring the middle performers down and that causes the high performers to leave.
When counseling low performers, she recommends managers be direct and to the point.
“Keep in mind, low performers have sharpened their skills at avoiding taking responsibility and have outlasted some managers,” Wilson said. “That is why they need to repeat the direction and understand the consequences if they don’t. Also, don’t let them take the counseling off track and place blame somewhere else. If they can’t be moved up, they need to be moved out.”
She tries to head off problems by meeting one-on-one with all her RTs to discuss performance issues and address any issues that do arise immediately, so they don’t get out of hand.
“Nothing in their evaluation is a surprise,” Wilson said. “I set clear expectations that need to be met and what the consequences are if they aren’t.”
Accentuate the positive
Shawna Murray, MEd, RRT, isn’t a manager herself — she serves as a system learning business partner at Intermountain Health in Salt Lake City, UT — but she has strong opinions about how they can best battle negativity in their departments. It all centers around accentuating the positive.
“We have windows in our homes and offices because we want to be able to see the wider view,” Murray said. “In the same way, RTs need to be able to see opportunities for growth outside of their current position. Managers create a positive environment and attract the best RTs by enabling them to see the best in their current position and additional opportunities.”
She reminds managers that employees give the best years of their lives to their managers and their organizations and they trust that those managers and organizations will make it worth their while.
“When employees feel that they are being treated as a department or institutional commodity, that trust has been betrayed and they’ll look elsewhere,” Murray said. “Honoring that sacred trust every day by looking for opportunities for employees to grow creates a positive environment and attracts the best employees.”
Approach with transparency
After 20 years in management, Herb Owrey, RRT, RPFT, RN, has learned that negativity is best approached with transparency. He shares information about organization and department finances with his staff to let them know why some things can be done and others can’t and when he hears rumors, he faces them head-on. He admits his own mistakes and apologizes for them too.
“I make a determined effort to not become defensive if approached with a complaint or criticism,” said the executive director of the perioperative and respiratory service line at West Tennessee Healthcare, Jackson Hospital, in Jackson, TN. “I also try to recognize good work. If they do something above and beyond, I recognize them with a card and in our shift huddles, even if they are one of the negative ones. This shows to them and the entire team there is no favoritism or discrimination.”
Owrey goes out of his way to give his staff members a hand with their day-to-day clinical work too, to show them that he understands what they do for their patients. Whether it’s giving a treatment, starting oxygen, cleaning equipment, or helping with ventilator care, staff appreciate the help.
“It shows you’re not above them, you care about them and love respiratory care,” he said. “This pays huge dividends in trust.” Getting out there and working in the trenches also helps him better understand staff concerns when they do arise.
A true story
Terry Ellis, Jr., BS, RRT, respiratory care clinical manager at Erlanger Health System in Chattanooga, TN, has a true story about one of his best employees that he tells all his new employees to drive home the damage negativity can do to the people they work with. The RT came to him one day asking to talk, and had this to say —
I have loved working here for several years now, but the past three or four months I have hated my job! I have hated being at work and have even gotten to the point where, on my days I off, I would dread coming to work the next day. After discussing these feelings with my spouse, we discussed the possibility of changing hospitals, possibly doing a travel assignment or even getting out of the RC field altogether. We sat down and made a pro and con list to try to figure out what was causing these feelings, and after looking at the list on paper I realized I don’t hate my job. I LOVE MY JOB! I love the people I work with, the way the docs trust us and allow us autonomy with our patients, and the opportunities we have to make a difference in a patient’s care and their life . . . The problem lies in the fact that there are a couple of employees in the department who are constantly negative about everything. They are cancers and need to be excised before they contaminate the rest of the department! Now when I come to work, I will socialize with them, but as soon as a negative word comes out, I leave and go find a patient to take care of so I can make a positive difference.
Ellis says he never ever wants another employee to feel that way and he works hard to limit negativity wherever and whenever it arises.
“I take great pride in having a department full of qualified, engaged, and positive therapists,” he said. “I try to make sure my therapists have all the tools and staffing they need to be able to provide excellent care and excellent customer service to our patients and families. They have to know how much you care about them!”
Nip problems in the bud
Holly Tull, BASM, RRT, respiratory care manager at Yakima Valley Memorial Hospital, in Yakima, WA, sums up the crux of the problem for most managers. “Negativity draws others into the same pattern like a tornado. Be polite but call them on it in the moment so they can realize the sound of the statement they just used, reconfigure, and make it positive.”
Nipping problems in the bud can go a long way toward keeping negativity at bay in any department.