Same-Day Surgery Manager

Comments on anesthesia and finding good staff

By Stephen W. Earnhart, MS
Earnhart & Associates
Austin, TX

Statement: I heard you speak in Dallas a couple of months ago, and you said that anesthesia can help to make or break a surgical environment. I still am offended by that remark. My staff and I work hard to make our department the best that it can be and with no help whatsoever from our anesthesia department. They just come in, do their cases, and leave. They do not interact with the staff, clean up after themselves, or do anything to help make this a better department.

Response: Unless you hear screaming up and down your sterile corridor, I would say that anesthesia is doing their job.

Statement: With reimbursement changing for much of our GI procedures, we have had to make difficult financial decisions in our center that have affected much of the staff personally. We have reduced our staffing by three nurses and one receptionist, eliminated free Friday lunches for the staff, and gave up our Christmas party this year. It seems unfair that we have been singled out for these reductions.

Response: Health care still is a sector in the U.S. job market that enjoys remarkable job security. Look at other companies in the news that have cut back on staff and expenses to stay competitive in the marketplace. While we all hate to see these reductions, it does help keep the overall industry "healthier."

Statement: I have always enjoyed your commentary on dealing with difficult employees by simply terminating them and hiring someone else. Lately, I don't know. It just seems like it is getting more difficult to find good staff. Maybe I should invest in trying to "fix" the ones I have.

Response: Staff, good staff, is more difficult to find — I agree. Some staff members just need a little bit of time to adjust to the work environment and meeting the expectations we put upon them. How much time does that take? How much time do you spend waiting for them to "get it?" I am not a patient person, and I think in terms of weeks, not months. Others are willing to give staff members more time to adjust. Obviously, that is a judgment call on your part. What offends me is when time is taken away from a productive individual who has a great work ethic and positive influence on the rest of the staff who is neglected for a disruptive staff member. Personnel that need a little bit more time than average to adjust to your center are in a different situation; and you are right, they deserve the chance to have time to adjust. But, disruptive, manipulative staff members are unprofessional and have no place in a good surgical environment. The sooner you remove them, the better.

Statement: I work at this hospital as an instrument tech and never planned for it to be more that just a job. I read Same-Day Surgery newsletter all the time and like it. Even though I have only been here for a few months, the more I see, the more I am impressed by the job the nurses and the rest of the staff do here. Sometimes we (in the instrument room) hear the nurses talking about their patients, and you can tell they are genuinely interested in them. Some of the staff are sort of rude to us or don't notice us. They don't seem to be very happy in their jobs. But for the most part, the rest are dedicated to what they do and seem to really enjoy it. I am thinking of making a career in this field based upon what I see.

Response: We never know who is watching and listening . . .

(Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Contact Earnhart at 1000 Westbank Drive, Suite 5B, Austin, TX 78746. E-mail: Web: