8 Simple Steps for Management and Employees to Improve Their Department

I remember a time when ER medicine was the most amazing career known to man.  Fast-paced problem solving is purely addictive.  It’s an adrenaline rush matched by no other.  I also remember a time when ERs felt like a gigantic team.  Working together to solve a problem in an opinionated, highly charged environment…ahhhhh, the good ol’days. 

Now, ER nurses and physicians feel like baby birds in a nest, their necks stretched out as far as they can go, just waiting on someone to force the food of information down their throats.  There is no more collaboration.  There is no more opportunistic think-tank.   

Management teams are at their wits end trying to solve problems when the easy answer is right there, within their reach.  Here are a few simple ways management can improve a department:

1. Truly give ownership to the staff.  (Physicians, Nurses, and Techs) That is all it would take.  No more threats of being sent home without pay.  No more threats of being fired because we work in an At-Will Employment State. Employees who are paranoid are less productive and have bad attitudes.
2. Make them BELIEVE that you BELIEVE in them by trusting their opinions.  Don’t belittle them by poo-pooing their concerns behind their backs.  It always gets back to them.  ALWAYS.
3. Make them feel valued by listening to them.  Show that you have listened by making change. Nurses, Techs, and Doctors are in the trenches. They know the truth about the issues.  Managing by metrics can only get you so far.
4. Make them feel like a part of the team by keeping them in-the-know, instead of in the dark.  The most effective management teams I have been a part of have been truly transparent.  It may not be your preferred management approach, but type-A personalities generally need the “Why” attached to changes. If a rule doesn’t make sense, it will not be welcomed with open arms.
5. Avoid the terminology EFFECTIVE IMMEDIATELY.  This is a dictatorial approach to change that is rarely perceived in a positive light.
6. Do everything in your power to make it feel like a light-hearted place to work.  Laugh, be honorable, allow friendships to build.  When people feel loyalty to each other, they will always go the extra mile.
7. Stop managing one by managing all.  Seriously.  Remediate those who fall short and leave everyone else alone.
8. Build an environment of trust. Keep your word.  It’s that easy.

The problems in ER Medicine aren’t just problems with the mismanagement of its employees. It is time that staff members begin to hold themselves accountable for what they are contributing to the disease that is overtaking our field.  We, as staff members, need to understand that we are often times part of the problem. Here are a few things that bedside staff members can do to improve our departments.

1. Bring a positive attitude with you to work.  Sometimes in life we have to “fake it ‘til we make it.” If you are having a rough time, don’t poison the rest of your team.  Chances are that if you simply focus on the good, by the end of the shift you will be smiling, too.
2. Choose your battles.  Don’t buck every change that comes your way.  Doing this only makes management perceive you to be negative and unwilling to change.
3. Do your best, every single day. A systematic approach to the care that you give will make this task an easy one. 
4. Stay the course.  Don’t be an employee who lives with “one foot out the door.” Be dedicated.  Commit to stay to endure the ebbs and flows that your department will undoubtedly experience.
5. Get involved. While often times it can feel that you aren’t being heard by management, sometimes it’s just a battle of wills.  Don’t be afraid of retaliation.  If you are handling yourself in a professional manner, things will go your way. 
6.  Focus on your patients. They are the real reason you are there.  You love helping people in crisis.  If you didn’t, you wouldn’t be in the field of ER medicine. 
7. Be the kind of team member that you would choose to work with.
8. Don’t tear people down, build them up.  It doesn’t matter if you have been in this field for 2 months or 20 years, we all still have things to learn.  Embrace each other.  Acknowledge the special gifts that we all bring to the team.

I cannot imagine my life without ER medicine.  It is because of this, that I am committed to making it better.  Leaving isn’t an option for me.  I hope that you feel the same.  I look forward to walking this path with each and every one of you. Together, the future of ER medicine doesn’t have to seem bleak.  Together, we can heal the world.