Quality and Initiative (Rant)

[anticoagulationurse]

Before I came to Home Health I worked for a not for profit (ya right) hospital system. Seems there was ALWAYS some annoying new "Quality Initiative", competition for national awards, or JHACO thing going on. Lame as it was to constantly be dealing with the latest pep-rally or added job requirement, I have to say it served a purpose. My co-workers and I had little choice but to participate and consequently the focus was on quality care. It was second nature to aim for the highest standard at all times. Imagine that.

Now I work for a private corporation and in almost 2 years I have NEVER heard the word, "Quality" from the supervisors, the trainings, the study modules, mission statement, or from other co-workers. And it shows. My personal work ethic has not changed much. I still really aim to provide quality care to the patients and a value for my pay at the company and have maintained my usual excellent work and productivity. But, I have to say my initiative to "go the extra mile" is pretty much kaput since I started this job (what's the point!). My attitude is shameful. I feel like it's pointless to put forth the effort to try and improve and fix and revamp things or offer my ideas and suggestions.

I love my work. However, I am indifferent toward the corporation, but the local office is generally pitiful. 90% of my "supervisors" seem to be total self-important losers with a title, and the ones who don't get fired or quit in exasperation seem to tread water and generally be as unproductive as possible to give the appearance of being swamped all the time. Never mind, "What can I do to help you or make your job better?" I have offered good, sound suggestions and various supervisors tell me, "We'll take that into consideration at the next blah-blah meeting." But NOTHING EVER, ever, ever comes of it. To get a new piece of equipment or address a process problem takes at least 3-5 attempts to get heard. The squeaky wheel and only the squeaky wheel gets the grease. There seems to be absolutely zero accountability of any clinician unless the issue or concern is regarding or affecting payment in some way.

That's my rant, thanks for listening.

[caliotter3]

I have felt the same way for years. Just have to be careful that your own downslide in view does not affect your performance to the point of jeopardizing your own practice. It is truly disheartening to be reprimanded for showing initiative.

[tewdles, RN]

Working for private, for profit HH can be very challenging. Too many become obsessed with the money at some point and the accumulation of wealth becomes (at some point) a higher priority than providing exceptional care.

The result is generally that the professional staff are asked again and again to do more for no additional compensation. This leads, inevitably, to a significant portion of the staff experiencing burn out, feeling used, abused, and unsupported as they focus their concerns on the patients.

[anticoagulationurse]

This might sound bad, but with a couple of exceptions, the only employees who have been there for any respectable length of time are those in management. Another interesting observation about THAT is that all of them are in their 50's. Is it possible they are chasing people away that might make them feel threatened in their jobs? Maybe this is why the high clinician turn over (among other reasons).

What do you think?

[caliotter3]

It certainly is plausible. Anyone competent and with integrity would be threatening to them.