Roy Exum
When a disgusted group of Erlanger Hospital’s Executive Medical Committee sent a unanimous “No Confidence” letter to the Hospital’s Board of Trustees last month, it was long overdue. Every member of the Erlanger “family” knows the truth and, when Sunday’s Times Free Press had a lead story on the terrible nursing shortage, I read it twice to make sure I had not overlooked the first and foremost reason for such a preventable calamity – gross mismanagement at the middle and upper levels in nursing at the top three hospitals in Chattanooga comes from within. Please!
At Erlanger the great majority of doctors will tell you why retention of RN’s is so bad. It is because at Erlanger they are treated so badly. The doctors see floor managers abuse the nursing staff every day … forced overtime, off-day call-in, crummy hours, verbal bashing, and a horrendous method of “indentured servanthood” that was supposed to have been eradicated after the Civil War – so was slavery.
Here’s how the ‘con’ works. Bouncy Becky, let’s say, is a recruiter’s dream. She’s got a great demeanor, an honors education, and confidence galore. She’s a prize catch so shifty Jerome (his right front tooth will glitter if he catches the light just right) gets Becky off to the side, shows her $20,000 in spanking new $100 bills, and whispers a $20K signing bonus is yours. Right now, if you’ll sign “an allegiance form.”
“What’s an allegiance form?” asks Becky, because what she really sees in the satchel is a better car, a wedding dress, a weekend with her No. 1 squeeze’ at the beach, student loans coming due, so she signs the two-year contract when – in fact --- she will soon find a 24-month sojourn in the Silverdale jail will be more fun.
“I’ll be honest with you,” Jerome will say. “Our biggest nightmare is when we put $20 grand of trust in a new hire and two months later our new nurse skips town. We trust you, oh yes we do, but what you are signing has a scale based on 24 months against your $20,00 bonus. That’s only fair, right?”
Becky signs up and is not only an “indentured servant” – no way in the Kingdom for her to buy herself out of the contract after she’s spent the entire bonus, and, because she can’t, Erlanger becomes a slave owner to Becky and others just like her. The inexcusable managers can - and now allegedly do -- assign her to a floor where ‘due to the shortage’ there is just one other nurse for 24 beds. She’ll have to work four more hours at catch up and any overtime is denied. (“You are too slow and that’s not Erlanger’s fault.”)
In short, every doctor and nurse can see Erlanger is its biggest enemy because it runs off so many good people. Becky is nothing; just a number, another warm body to satisfy the government regs, but what every nurse really wants left Erlanger about 20 years ago – managers who care. The hospital’s Board of Trustees is a laugher the way it allows shoddy management to beat on its nurses. Truth is the trustees care less about the nurses and the proof is right before your eyes. Check the latest pay raises; there is no merit system or other measures that reward individual excellence, which makes the across-the-board pay increases hollow.
What would I do to fix Erlanger’s nursing shortages? It’s easy, just flip the thousands Erlanger uses for recruitment into retention. Drop the “indentured servant” trick. Instead of giving Becky $20,000 start her off with just $4,000. “It’s yours – no strings – but if you leave prematurely, you have to give us your signature you will not work in any medical capacity within 100 miles of Erlanger,” then add, “If you are still here in six months, you’ll get a second $4,000 and so-forth until your first two years are fulfilled. Then let’s sit down and decide what’s best for both of us going further.”
Don’t you see how the thing ought to work? With the pay-up-front, no-strings arrangement, Becky is still in control. By relinquishing control, the hospital will be forced to take gigantic steps – long abandoned -- in retaining the nurses. The Board of Trustees is now negligent in determining why good and valuable nurses bolt from Erlanger all the time. Up until now there is proof the board has grown ineffective as a decision-making body so, again that ‘No Confidence’ letter was on purpose.
Volkswagen is going through the same mistrust issues right now. After VW escaped a determined UAW bid, let’s remember it was by fewer than 100 votes. Volkswagen employees are unhappy, bullied by management, some mistreated. If I was in charge of VW, it would take less than a day for me to prove the American principle that happy employees make better cars.
VW is moaning because it claims it can’t find ample labor force when I say they’ve got one right before their eyes. The key to employment is making a worker happy when he/she gets there and happy when it is time to leave.
If Erlanger and/or VW were a sports team, neither would win many games because they don’t understand a Board of Trustees will never win a game – the players are the ones who do. And when you allow those around you to become complacent, and take vendetta-like advantage of your “players,” you will most assuredly end up as a loser.
royexum@aol.com