Stepwise Success : Career Development

Mind the Glass

Scott Warner — Wed, 25 Nov 2009 11:24:00 GMT

An optimist will tell you the glass is half-full; the pessimist, half-empty; and the engineer will tell you the glass is twice the size it needs to be. - Anonymous The lab tech will tell you it's not properly labeled, but that's another blog. Merriam...(read more)

Teachable Moments

Scott Warner — Wed, 14 Oct 2009 10:25:00 GMT

Much was made of the President's "beer summit" last July, a meeting between a black professor and the white policeman who arrested him, something the Wall Street Journal labeled a "teachable moment." Aside from wondering what kind of beer goes best with...(read more)

Write Thyself

Scott Warner — Fri, 09 Oct 2009 10:55:00 GMT

It wouldn't surprise me if most laboratories have more written procedures than all other departments of the hospital combined -- shelves of them in worn, bursting binders. Printed or scanned, that's a lot of writing. And I'll bet the procedures are all...(read more)

Don't Hate Your Job

Scott Warner — Wed, 19 Aug 2009 10:00:00 GMT

Some of you hate your job. Maybe not all of it or all the time, but some of you would quit if you could. You hate the pay, the hours, the weekends, working Christmas, being on call, having your opinions dismissed, and (most importantly) your boss. But...(read more)

Buying and Selling

Scott Warner — Wed, 05 Aug 2009 10:10:00 GMT

I conduct every interview the same. I describe the job, ask a list of questions, review the applicant's resume, and then answer any questions. Most don't ask anything. If they do, chances are the answer is on our website or in the job description. There...(read more)

A Good Job

Scott Warner — Mon, 27 Apr 2009 10:13:00 GMT

The Bureau of Labor Statistics (BLS) report on unemployment is enlightening. A table lists different categories of the unemployed. The "official" rate is a percent total of the civilian labor force. That's 8.5% as of March. But the total including "marginally...(read more)

The Purpose of Discipline

Scott Warner — Tue, 16 Dec 2008 13:39:00 GMT

"The purpose of discipline," a nurse once told me, "is to correct behavior." According to one article in HR Magazine, the purpose of discipline is "to create and maintain a productive, responsive workforce" to "rehabilitate" employees. And one human resources expert on About.com insists it isn't about punishment, but about helping the employee "to overcome performance problems and satisfy job expectations."

Where do I begin?

First, if we're talking lab rats getting periodic electrode jolts at the end of leads implanted in their brains to make sure they turn left in a maze, then, yes, "discipline" can "correct" behavior.

Second, if those few employees who really are intractable or incompetent can't be fired outright, then perhaps progressive steps--oral warning, written warning, etc.--may convince them to change their behavior, at least in your presence. (How often does that really happen? How often is "discipline" a legal cover for the employer?)

The above words--correct, productive, responsive, performance--hint that the purpose of discipline is to maintain a behavioral status quo the employer defines, making the potential for abuse enormous. And every employee with a pile of bills at home knows it.

A stick is always a stick, in other words.

Alternative words are listen, understand, enlighten, inspire and even partner. An employer's responsibility doesn't end with defining "standards" of behavior. The larger scope of the work environment, from hiring to mentoring to rewarding, needs to enable "correct" behavior. A manager who writes up an employee without first listening to all sides and looking inward is cheating the employee, the organization and especially the patients.

It may sound like armchair psychology, but if people are the most valuable resource, they should feel valued. This means eliminating a culture of fear ("correcting" behavior) and establishing an open culture of collaboration. Wouldn't it be wonderful to view your manager, your pathologist or your CEO as a colleague? Wouldn't it be wonderful to not be afraid to report an error? Wouldn't it be wonderful for all parties involved to say, "How can we do better?"

Millennials and Perennials

Scott Warner — Thu, 20 Nov 2008 13:11:00 GMT

According to a Wikipedia article about them, 97 percent own a computer, 94 percent own a cell phone and 76 percent use instant messaging. Morley Safer described them on 60 Minutes as arriving at work around noon in flip-flops, expecting a manager to talk to them like a TV therapist instead of a boss. They are educated, ambitious and connected. They are Generation Y, the so-called millennials, those born in the eighties just entering our workplace.

A recent survey finds millennials want to choose their technology and are disinclined to follow company IT policies. There is a disconnect between what an organization provides and what these workers demand, who more often than not prefer instant messaging to face-to-face interaction or even e-mail.

You may have interviewed them already. They expect, but more importantly are likely to be attracted by, not just new technology but also choice suiting their needs. For an industry where the lowest person on the ladder gets the night shift and AM draws in the bargain, that's a challenge.

Those of us already working are likely to be over fifty. We have stuck around year after year--let's call us "perennials"--and we are, perhaps, less ambitious than our opposites. We prefer face-to-face interaction and eschew "instant" communication. Technology is a tool, not an extension of ourselves. Education is one thing, but experience often separates leaders and followers.

We perennials are in for a shock if we expect millennials to pay dues or listen to experience. According to one consultant, they need mentoring, opportunity and a fun working environment. Their personal activities are as or more important than work. "A rigid schedule is a sure-fire way to lose your millennial employees," she writes.

The last few people I've hired are over forty. But I can see internal customer service--how we treat others in our workplace--becoming as important as how we treat patients to attract and keep these new workers. This should be interesting.

Overcome Your Fear of Public Speaking

Scott Warner — Thu, 25 Sep 2008 13:22:00 GMT

Below snakes, Americans fear public speaking more than anything else, according to a Gallup poll. It's a fear that stands out on a list fraught with danger. Snakes and dogs bite, after all, and people fall from heights. But talking?

I'm lucky -- I actually like public speaking. But 40 percent of respondents ranked public speaking their number one fear, women slightly more (44 percent) than men (37 percent). For some, there is nothing quite so paralyzing as standing before a group of silent, expectant faces.

If you're afraid of public speaking, you may not know why. A phobia -- in this case glossophobia -- is by definition a persistent, irrational fear that compels us to avoid the situation or behavior of which we are afraid. Chances are there isn't any reason that makes sense.

There are ways to manage, if not overcome, irrational fears. I've never heard picturing people in their underwear works -- you might not want to, anyway -- but a "just do it" approach might. The worst that could happen often doesn't.

According to this, the key is to keep your presentation moving. Avoid fiddling with your computer, don't apologize and don't stop. Actor Jeff Daniels' mike died during a live broadcast on Country Music Television in 2005. He kept talking until the connection was repaired. The audience, Daniels said, doesn't really want you to fail.

I've found that once begun, a presentation rolls along on its own momentum, like a ball down a ramp. The audience will often catch the ball if it drops.

As a profession less recognizable than nursing, we need to be seen as more than phlebotomists and button pushers. We need to speak up! Public speaking venues -- board meetings, department head meetings, job fairs, local schools -- are opportunities to sell who we are and what we do. A fear of public speaking shouldn't keep us from speaking up.

If it helps, one in five people are petrified of needles. Go figure.

Great Ideas

Scott Warner — Mon, 22 Sep 2008 14:39:00 GMT

Where do great ideas come from? One group may brainstorm to solve a problem; another may ask peers to find out what already works. In a creative environment, one idea sparks another as a group works together to discover a unique solution. This is not only productive but energizing, leading to even more great ideas.

As a pathologist once told me, "If you have a great idea, give it away." The effect can be like dropping a ping pong ball into a roomful of ping pong balls sitting on mousetraps: it causes a chain reaction. Before you know it, everyone has ideas. People are talking about new approaches, new ways of doing things, and new perspectives.

But as a marketing director once told me, "The pull is always down." In many environments, people are inherently pessimistic, disinterested, or just working for a paycheck. According to Gallup, only a third of employees are "engaged" and have a drive to be innovative. There is little difference between for-profit and non-profit hospitals. Most people, it turns out, are going through the motions.

But it doesn't have to be so. There are places to work where there is a "buzz" of ideas. These are the places where meetings are not droning lectures but active discussions. Where solutions-real solutions-happen every day on the front lines with or without management. Where, surely, most employees are engaged. And where, most importantly, we all want to work.

How do we get there? I think giving away ideas, great or not, is one answer. And management needs to encourage this, seeing ideas as catalysts rather than threats. The end of every meeting can be a round-robin of suggestions. Brainstorming sessions, message boards, suggestion boxes, and even email are good-anything that works. Such open discussions can generate a buzz, changing a workplace from mediocre to great.

No one wants to work in a laboratory or hospital that leaves one drained, dull-eyed, and dreading returning to work. We all want to work at a place that is exciting, progressive, and filled with great ideas.

Meeting Fatigue

Scott Warner — Mon, 15 Sep 2008 20:02:00 GMT

The other day at work, I joked we needed to form a committee to appoint a sub-committee to develop an agenda for yet a third committee that would, in time, determine the definition of 2 p.m. We all waste time in non-productive meetings when we could be taking care of patients.

How many meetings are a droning list of procedure reminders, administration demands or the ranting of one person who hijacks the agenda? How often is a meeting consumed by complaining instead of discussing plans that really fix problems? Too many, too often.

A 2005 study proves the obvious: too many meetings are stressful and lead to burn-out. And burned-out workers who are overburdened and overwhelmed are more likely to be tardy, absent, perform poorly or quit. Enough is enough, sometimes.

Meetings can be exhausting. Here are a few reasons for meeting fatigue:

Reason	Effect
not the right people	"Why am I here?"
not on time	"People are always late." or "This meeting takes too long."
no clear purpose	"Why are we meeting?"
no agenda	"What are we meeting about?"
no structure	"Who will control the complaining?"

The problem may be organizational, as this consultant points out. Starting on time and focusing on an agenda are important. But it's also important to review the meeting, part of the "Seven-Step Meeting Process." A meeting needs to do something.

If a meeting leaves people feeling confused, drained or frustrated, then something went terribly wrong that should be fixed before the next meeting. Perhaps, more structure or a timekeeper is needed. At least, it should be clear to people exactly what the meeting is about.

Maybe--just maybe--we don't need to meet so often. Until that happens, I just hope I can attend enough meetings to decide what time it really is.

It's All About the Nurses

Scott Warner — Thu, 19 Jun 2008 15:36:00 GMT

Nurses are tough. Physically demanding, the work often requires them to work in cramped, confusing, emotional and dangerous situations. As the most visible caregivers in a hospital, they probably don't take enough credit for what goes right with patient care.

But--let's be honest--nurses get much of the blame. More precisely, they receive the emotional brunt of a mistake: the anguish of a family member, the frustration of a coworker, the ire of a doctor or the rudeness of a telephone call. Tough, indeed.

As the largest labor pool in a hospital, nurses also enjoy the most bargaining power in a union, the most seats at a department head table, the most resources in recruitment and retention, and (on off shifts) even authority over the whole house--laboratory included.

Much of the time, it's all about the nurses.

Maybe so. It can be frustrating to be a lab tech, at times, when dealing with nurses on issues like specimen labeling, patient identification, quality control on bedside glucose meters, or the best time to collect a specimen. Their culture can seem to dominate a hospital.

Lab techs are, in a word, underestimated. The unrelenting nature of dexterous precision combined with multitasking has to balance speed and accuracy. Lab work depends on understanding large, complex systems that interrelate, in vivo or in vitro. The bench worker has a culture of jikoda associated with Toyota Lean production systems that stops all work on a bench when an error is found or even suspected. The solitary authority of the lab tech goes largely unsung.

But we each see healthcare through our professional prism. Surely, to the nurses it's all about the doctors or even the laboratory some of the time. The old saw about walking a mile in another's shoes comes to mind. Although, I wouldn't want to do it where nurses are concerned. My feet would hurt.

Your Culture

Scott Warner — Mon, 05 May 2008 16:44:00 GMT

Imagine in the near future, a job applicant asking, "What is your culture here?" Your first thought is Duh, it's a laboratory.

But with the pressures on healthcare, you may already be hearing plenty of talk about your organization's "culture." Even if you haven't, it exists and is important. In a way, it affects everything within your work environment.

A culture can be thought of as a set of values that guide behavior of employees. Does the culture in your laboratory reflect your hospital's values? How effectively does senior management influence the behavior of employees? One measure may be how closely behavior aligns with the organization's mission, vision and values.

Here is advice for applicants regarding corporate culture: "The bottom line is you are going to spend a lot of time in the work environment--and to be happy, successful and productive, you'll want to be in a place where you fit the culture." The author suggests asking key questions about how decisions are made, team building and behaviors that are rewarded. It suggests reviewing a company's annual report, Web site and to arrive early for an interview to observe employee behavior, demeanor and appearance.

For an applicant, it's smart shopping. For your laboratory, it points out the obvious: a happy, productive environment is a deliberate choice made by employers. A culture is planted, nurtured and occasionally weeded. As an industry shortage looms, these workplace environment issues will become more critical as people have a choice where to work.

Such applicants are really asking what kind of place is this to work? Perhaps, it's another sign the value of work is changing, as I've written here. But it's important to imagine cultural clues an applicant perceives during an interview.

Think about your answer to the interview question posed above. Think about what your answer would be now versus where you would like to see your laboratory. Are they different?

Other Managers

Scott Warner — Fri, 02 May 2008 15:07:00 GMT

Becoming a manager means changing your peer relationships. Instead of competing with another work silo, you now need their cooperation. It is essential to transition from the subordinate-supervisor relationship to this new peer setting to complete projects and achieve success.

A new manager can't do it alone. As this article from the Harvard Business School suggests, seeking assistance is essential to growth--superior and lateral, internal and external. Building relationships in an organization helps ensure success. And while your experience is different from a nursing manager, advice and emotional support are invaluable.

To be sure, "intractable" attitudes are hard to schmooze away. Nurse managers can perceive themselves as more qualified or authoritative. Other departments with more access to physicians can isolate your laboratory. But it's often what happens on the floor that can determine your success in dealing with other departments. It's what makes building relationships with other managers so critical.

For instance, when a physician complains about your laboratory at a nursing station, is your department defended? Incident reports can offer clues. If a nurse manager writes up an adverse treatment event as "The lab did it!" there probably isn't much time spent defending your laboratory. This is a relationship problem as well as a system failure. Fixing the latter won't help the former.

One solution is to develop lateral relationships. Seek out counterparts in other departments to ask for advice, share information or just chat. Social settings--even the hospital cafeteria--are non-threatening environments in which to meet. I make a point to walk through nursing stations at least once a day to see what's going on and if I can be of help with anything. It helps make my job easier. And maybe--just maybe--the laboratory is defended once in a while.

A New Work Perspective

Scott Warner — Tue, 19 Feb 2008 17:03:00 GMT

Law and medicine careers may be losing self-respect, according to this article in the Dallas News. While these professions are still solidly supported by pay, security, schooling and responsibility, there is a sense that their status is waning.

Excerpt:

This decline, Mr. Florida argued, is rooted in a broader shift in definitions of success, essentially, a realignment of the pillars. Especially among young people, professional status is now inextricably linked to ideas of flexibility and creativity, concepts alien to seemingly everyone but art students even a generation ago.

"There used to be this idea of having a separate work self and home self," he said. "Now they just want to be themselves. It's almost as if they're interviewing places to see if they fit them."

Arguably, such a shift may be more noticeable in high-profile professions. There are a number of spins. For the laboratory, this means recruiting students who may have different assumptions than previous generations. There may have existed a want for a steady job, a prestigious career or a stepping-stone to other professions. "I just want to be myself" is a new paradigm.

I wear a dress shirt and tie at work, for instance. Why? Because it is my work self. My home self is different in many ways, dress being one example. Will the new generation of laboratory technicians and technologists be different?

It's easier for someone of my generation to dismiss this as a change in "work ethic," when there may be something more fundamental going on: a new perspective on the value of work.

If this is correct and professional status has become a matter of personal expression, then this changes what working in a laboratory means. This will echo in recruiting strategies and, ultimately, in how laboratories are managed to ensure the best patient care possible.