By Dr. Anthony Policastro

We deal with employees from various businesses on a regular basis. One of the things that we sometimes forget is that these individuals want to do a good job. Sometimes that does not happen. The tendency is to blame the individual. It may not always be the individual’s fault.

I used to give leadership talks in the Air Force. One of the things that I often said is that most people do not get up in the morning with the attitude that they are going to work to be a jerk.

I told my managers that if someone was not doing the job we wanted them to do, the first thing we needed to do is look at ourselves. We need to ask if we trained them correctly. We need to ask if we motivated them correctly.

Over my nine years as a commanding officer I saw many examples of how managers had failed on one front or another.

I had a midwife working for me. She had been a practicing midwife her entire career. She was very good at delivering babies. However, she felt she stood a better chance of promotion if she showed managerial skill. She was assigned to our hospital as the nurse manager of the OB unit.

It was clear early on that she needed more training to do the job correctly. I called her in and suggested that she become the assistant nurse manager on the medical/surgical unit for a period of time. Once she had learned how to manage a unit, we would move her back. She did not want to do so. 

Six months later the biannual inspection team came in. They rated 172 areas in the hospital. The OB unit was one of three areas rated unsatisfactory. I had to remove her from the unit. I had to send her back to delivering babies. I had to write a poor performance report. She never had another promotion. 

The question was if the blame was solely hers. She did not want to move to the medical/surgical unit. However, I could have forced her to do so. That was a mistake on my part. I knew more about what would happen than she did.

When I moved to my second command, I had an ER that had three hour waits for the patients to be seen on a routine basis. I called in the ER director to discuss it. He made it clear that most ER patients did not have emergencies. Therefore if he made them wait, they would not come back again. 

That was faulty logic. We did a survey of our ER patients. Over 75 percent of them were there because they thought they had a real emergency or could not get a timely office appointment. It was not because they were abusing the system. 

I clearly needed to motivate the ER director. One day I called him into my office. I had six charts for him to review. All six were patients who had left the day before without waiting to be seen. All six had serious complaints. I asked him which of the six did he think died when they left the ER. They were all patients who had illnesses serious enough to kill them. He could not tell but realized that what had happened was a dangerous situation. Fortunately, none of them had died. However, I got his attention.

By the time I left that hospital, the average time for a patient to enter the ER, be seen and sent out with treatment was 42 minutes. I had little to do with the details of that. It was the ER director who made that happen.

The bottom line is that when you deal with a front line employee that does not seem to get the job done right, it may not be that person’s fault. They may not have been trained properly. They may not have been motivated properly. They probably didn’t decide that morning that they were going to go to work and be a slug.