When the Going Gets Tough… the Tough Get Going

It's like clockwork every year... a new strain of influenza hits us like a shot to the back of the head with a baseball bat.  Inevitably, there is always a strong respiratory component associated with the virus that cripples both the patients and the hospital caregivers who serve them during their hospital stay.  While hospitals attempt to budget for this increase in patient volume during flu-season, the reality of the situation is that most healthcare organizations aren't built to sustain volume surges of any significance for prolonged periods of time. 

At my hospital, we're looking at an increase in patient volume of 123% of plan.  On any given day; on any given shift, we have needs to increase staffing levels by almost 2 therapists per shift (compared to budget).  While that may not sound like a lot, envision what it would be like if your department had a 10% vacancy rate to boot? 

When the initial surge hits, many employees are excited about the opportunity to cash in and make significant amounts of money through overtime.  Three weeks turn into six weeks, which turns into three months, and before you know it your staff are burned out, and people are calling in sick on a daily basis for a mental health day.  While the logical choice would be to use agency staff or travelers, many organizations frown upon that because of the cost.

Enhancing the size of your PRN staff is another viable solution, but for many of those employees, they too have full-time jobs and have other commitments as well.  So what's the solution?  While there are many answers, most of them come at a significant financial expense to the organization.  When the dollars aren't there and treatments loads start to reach unbearable levels, what do you do?  

The reality of the situation is that there may not be an answer... there's no light at the end of the tunnel; no pot of gold at the end of the rainbow.  Sometimes the only real thing you can do is be there for your staff.  While many staff members expect you to roll up your sleeves, throw on a lab coat and carry a full treatment load yourself; sometimes that's not even a reality.  When volume is high, everyone carries the burden.  In addition to the high treatment loads, there's more equipment that needs to be purchased, schedules take twice as long to post, and payroll Mondays are crippling to the spirit of a manager. 

All this, and there's still meetings which must be attended, QI projects to oversee, and personnel issues which must be addressed.  Despite the rather bleak outlook on things, there's one thing a manger can always hang there hat on... strong leadership.  While there may not be much you can do to diminish their workload, the one thing you can provide them with is emotional support and hope that things will eventually get better.  Whenever you have the opportunity; be visible on the floors, thank them for a job well done and let them know that their hard work has not gone unnoticed. 

Make sure they have adequate resources, equipment and supplies.  In these situations, sometimes it's the littlest things that go a long ways.  If you have the time, personally send them thank you cards, and if your organization allows it, provide them with a gift card or two. In times of despair, it's not always the money that brings people back day, after day, after day, but rather the sense of obligation to their patients and to their colleagues. 

When staff members sense that management cares about them as individuals and recognizes their efforts, they will give superhuman efforts and offer 120% of themselves to the organization.  Employees want to be part of something extraordinary.  With strong leadership, managers can make the ordinary, extraordinary.  

"Heaven and hell are right now... You make it heaven or you make it hell by your actions."

                        - George Harrison