Answers to your questions about job responsibility

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

The questions this month from the field are all similarly in the area of job responsibility and requirements. Some are serious, and some silly, but all sometimes (sad to say) are true. See if you see your question(s).

Issue: Licensure requirements.

Question: I just moved to Texas to work with a local physician group to start up a surgery center in that state. They said that part of my job would be to get the facility in planning licensed by the state and Medicare-certified. Since I have never done this before, I was just curious as to the accuracy of what they told me. They said the entire process should not take more than a few weeks and that I could do it in my off-hours. Does that seem reasonable to you?

Answer: Well, how much are they paying you, and what state did you move from? Actually, the entire process takes us about 2,500 person-hours and about 1,100 pieces of paper. While it certainly can be done in your off-hours, I would not expect to have any social life for a while. Seriously, licensure and certification have grown incredibly complex over the years. You might want to ask for an assistant or two.

Issue: Room turnover.

Question: (An excerpt from a telephone job interview with this new nurse): I just graduated from nursing school, started working at XYZ surgery center, and am looking for a better work environment. The XYZ ASC requires that all the nurses become house cleaners and clean the operating rooms between cases. How rude! If I wanted to become a maid, I would not have spent four years in college to get my BSN. What do you offer at your centers?

Answer: All that, and we actually encourage the professional staff to save money on profit sharing by emptying the trash at the end of the day as well. (She hung up on me.)

Issue: Locker room space.

Question: Why is the men’s locker room always bigger and have more lockers than the women’s in operating rooms? There are more of us (females), and we are there all the time. We need more locker space or have to double up. What’s the deal?

Answer: There are more male architects? Actually, that is a result of planning that does not include clinical input. Sorry — but that happens more often then you would realize.

Issue: Post-op phone calls.

Question: Our hospital requires that the nurses make a postoperative phone call to patients who had surgery the previous day. This is an incredible waste of an RN’s time and should be performed by the front-desk personnel — not the professional staff. What are your thoughts on this?

Answer: Read this anonymous definition of a professional, and then ask me again who I think should talk to the patient:

A professional’s work involves making judgments in situations in which even knowing all the facts does not make the right course of action clear. Recognition of the difference between a profession and other forms of occupation is credited to the Greek doctor, Hippocrates, who lived 2,500 years ago, but the current range of different professions did not begin to emerge until the 19th century. Professionals normally have a code of ethics. They keep their knowledge and expertise up to date, and they are paid to enable them to devote their time to using and improving their skills.

(Earnhart & Associates is an ambulatory surgery consulting firm specializing in all areas of surgery center development and management. Do you have any questions? Contact Earnhart at 3112 Windsor Road, Suite A-242, Austin, TX 78703. E-mail: Web: