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By Stephen W. Earnhart, RN, CRNA, MA
CEO, Earnhart & Associates, Austin, TX
How many of you have been pushed, pressured, or suggested to overlook certain aspects of local, state, or federal regulations or behavior at your surgical facility?
Sadly, there are greedy individuals in our industry who will knowingly cut corners on quality or safety to make an extra buck or for personal convenience.
Know your internal policies and procedures. Most staff rarely read them even though they will sign a document stating that they read and understand them. Make sure you are right before you start a crusade that could be an embarrassment if you do not have your facts straight. There are a few examples of blatant corner-cutting:
What do you do when witnessing someone cutting corners? Speak up. Still, the problem is that the compromise in quality or safety often begins at the top. Sadly, once that top-down culture permeates a facility, it is only a matter of time before the entire program is infected and something disastrous happens.
Compromising safety or quality for the sake of profit or convenience is the beginning of the end of a surgical program. For individuals working in such a facility, there are options. When you suspect something is not right but everyone else ignores it, you need to act. Again, check the policy first.
If you do not feel comfortable confronting the individual or individuals, such as your administrator or department head, then you can bring it up at a staff meeting where your voice can be heard by all and not misinterpreted. Speak to several other staff members who also are concerned. Ask that your concerns be entered into the minutes of the meeting. If the leader of the meeting does not suggest it, recommend immediate action on the issue.
Not everyone is comfortable with speaking out this way. However, another way of dealing with a misguided group of leaders is to work within the system. Go directly to the medical director of the facility and voice your concerns. Hopefully, that individual is a person of ethics and will handle the issue properly. Other employees who join you add influence. Cite the regulation that is of concern.
You are morally obligated to speak up when you witness something happening that you know is not right. How many infections and deaths have happened in surgical departments because of greed and lazy personnel who get away with it because no one speaks up?
Still no results after you have tried everything to change bad behavior? Call Medicare and report what you are observing. Forget loyalty; you owe it to every patient to do the right thing. One phone call is enough for Medicare to respond. Your name is confidential. Think how much better you will sleep at night. And if you have to resort to calling Medicare or the state to report what cannot be resolved from within, it is time to find another job.
(Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Earnhart & Associates can be reached at 5114 Balcones Woods Drive, Suite 307-203, Austin, TX 78759. Phone: (512) 297-7575. Email: firstname.lastname@example.org. Fax: (512) 233-2979. Web: www.earnhart.com. Instagram: Earnhart.Associates.)
Financial Disclosure: Consulting Editor Mark Mayo, CASC, MS, reports he is a consultant for ASD Management. Nurse Planner Kay Ball, PhD, RN, CNOR, FAAN, reports she is a consultant for Ethicon USA and Mobile Instrument Service and Repair. Editor Jonathan Springston, Editor Jill Drachenberg, Author Melinda Young, Physician Editor Steven A. Gunderson, DO, FACA, DABA, CASC, Author Stephen W. Earnhart, RN, CRNA, MA, Accreditations Manager Amy M. Johnson, MSN, RN, CPN, and Editorial Group Manager Leslie Coplin report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.