Tell me, what the fuck ARE your values?

A few years ago, I was selected from the employees across our health system to be part of a committee that would create the new Values for our organization. (This was a shocker to me, because I’m a pretty outspoken person about the organizational things that I don’t agree with.) Not only were we creating the new Values, but we were creating the behaviors that would exemplify them. This was a big campaign. I was really proud to be a part of it. We presented it to the Executive Leadership, but the real test was the buy in of the front line staff. I think that’s probably one reason why I was chosen. If staff saw I was on board, then there must have been something to it. After all, I’m pretty critical of things and very direct. I don’t take things at face value, and people know that.

Our organization had gone through a lot of changes. It had gone from a community hospital to one of the largest health systems of our specialty in the nation, a Level I trauma center, in a little over a decade. But with the changes in US healthcare, came the need for our specialty to make significant changes from previous practices. In the face of these changes, my organization ended up significantly reducing staff several years ago. This impacted morale considerably. It didn’t help that the current CEO of the health system was not seen as the friendly “dad’ type that the previous CEO of the community hospital version of the organization was. Trust became an issue for many of the people who had been there for years.

Anyhow, the organization continued to grow and became increasingly top heavy (40 VPs). For a while, I saw where some of the upper management might have made sense, and I tried to explain the business rationale to my clinical co-workers why more VPs were brought in, even though their co-workers were let go. But after so many, it’s hard to justify. About three years ago, we were told we needed to cut a couple hundred million dollars, but that we were otherwise fine. (WTF?) Now, very recently we found out that the system has not been doing well over the past couple of years for reasons related to the changes in healthcare.

I have been dissatisfied with work for the past year or so, because I felt that the organization had not been as supportive of my program as they should be, there was a lack of understanding and unwillingness to take the time to try to understand it. They used it when necessary, when they needed something shiny and high tech to show off, rather than understanding that it could be a way to enhance cost reduction through quality and patient safety. I was also beginning to feel that they didn’t sincerely hold the values that I had helped create.

Today, about 1% of our organization, was let go. This included my boss, S.. I now answer to a man who has little understanding of what I do. He is also someone who I feel lacks integrity, who will do what he feels necessary to advance his career at the expense of others or to dodge responsibility. In a meeting with a VP, he had stated I never gave him information with regard to whether my program could accommodate a program of his. I responded that, actually, I had told him that we did have that conversation, and I had told him I could accommodate the nurses. I then turned to the nurse beside me to verify that this conversation did indeed take place, because she was there too. She did. (Slimy fucker. Him, not her.) I knew he pulled this kind of shit, and I wasn’t going to let him do it to me. I was also going to let everyone else know he did it, and that I don’t tolerate it. So fuck meeting/coaching etiquette; I wasn’t going to allow that.

I have been thinking about moving on for a few months. I know that after working at two large Level I trauma centers, affiliated with universities, I can’t go back to a community hospital setting. My boss, S, had told me that the only “negative” she received in the reference calls from Hopkins was that I can’t be allowed to get bored, because that is when I will move on. I’m afraid that a community hospital will not challenge me enough. I think I may have possible options with a couple of med schools that have new centers opening in 2018. But I would love for my current organization to just get its shit together. I love this particular specialty, and most of our population is uninsured, an otherwise under-served community. This matters to me.

I thought before that maybe I would end up leaving at some point in the next couple of years, but this seems to really hammer that home, making the need to move on more urgent. This whole thing saddens me, because I put so much of myself into this program. I took something with no structure and shaped it, grew it, added process improvement, increasing its utilization at least 25% every year. I was very happy here at one time; I believe in the mission and the values of the organization. But I don’t believe in staying where you aren’t happy, and I don’t know if I can regain my happiness.  I can’t afford to be in a place that might send me into a downward spiral. I guess we will see where I eventually land. I will keep hoping that they will get their shit together.*

And people say I’m not an optimist.
*Of course, there’s more going on than what I’ve mentioned here to further decrease employee morale. 

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