Don’t ignore the gorilla in the room: Poor morale

By Stephen W. Earnhart, MS
President and CEO
Earnhart & Associates

When I bought a boat, I was looking for a retreat, a place to escape from the world’s problems. Well, the idea of having a retreat never worked. What did happen was 9/11 and everything that followed through the Iraqi War and this SARS [severe acute respiratory syndrome] mess.

We all are just a little bit off right now. Many outpatient surgery managers give me similar comments: Things are not like they used to be. The fun is gone. I just don’t care anymore. We have a morale issue here, ladies and gentlemen. In fact, 20% of respondents to last year’s Same-Day Surgery Reader Survey said that morale is their most challenging problem, which means morale tied with documentation/paperwork as the second biggest challenge overall. (Recruiting staff ranked No. 1.)

I share many of the same emotions. And yes, things are not like they used to be, but the fun is not gone, and we still do care. It is OK to feel like this — to a point. I had a surgeon yell at me last week. It was a misunderstanding, actually. He thought I was the pathologist. (If he knew I was a consultant, he might have stabbed me!) However, the fact that he yelled at me is not the important thing. The important thing is, I yelled back! I’m not meek by nature, but in my profession, it is not a good idea to yell at anyone — especially someone who pays the bills.

But doesn’t it seem as if everyone is just a bit short fused right now? I think it is healthy to admit it and openly discuss it in staff meetings. There is an expression that says, "When you have an 800 pound gorilla in the room with you, you had best not ignore it." Well, we have that gorilla in the operating room right now, and it needs to be addressed. I know that there are many other issues out there right now, such as the HIPAA regulation. (There must be something else my tax dollars can be spent on besides the Health Insurance Portability and Accountability Act of 1996.) But the fact is that morale is much more important in our facilities than we give it credit for. Poor morale leads very quickly into apathy, and apathy leads to carelessness and mistakes.

What can we do about it? Plenty! First, talk about it. Open up a staff meeting with the statement that, "This is not fun for me anymore! Does anyone else feel like that?" I think you will be surprised. Often just getting the issue out in the open and addressing it can be enough.

This might be a great time to repaint the facility or department with a bright color. If that isn’t feasible, just paint the lounge. Splurge on things you haven’t in the past. Walk around with a pocket full of movie tickets to a comedy showing at the local movie house. Have a joke contest at the next staff meeting and announce that the employee with the best joke will receive $10. Have an "applause meter" or a version of the Gong Show to judge the jokes. It is time to lighten up — without taking our eyes off the bottom line.

(Editor’s note: Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Contact Earnhart at 5905 Tree Shadow Place, Suite 1200, Dallas, TX 75252. E-mail: Web: