Production, Production, and Production!

In our current system, health care, medicine, anesthesia, and even nursing have become a lot more of this production-based approach to taking care of patients. In reality, it is tough to put a pin on who is to blame, and how to fix this is even more challenging. While this issue is solved by forces bigger than us, we must continue providing care, staffing our practices, and making a living.

It is also true that our health care system has changed forever after this pandemic in ways that we still don't know. We know that staffing is a problem in almost every sector, regardless of how much money we continue to add to the hourly rate.

In anesthesia, salaries have increased substantially compared to pre-pandemic levels, and temporary employment is being compensated exceptionally well. Unfortunately, this level of compensation is not sustainable for multiple reasons but mainly because anesthesia revenue has continued to decline decade after decade. Yet, anesthesia services continue to increase, and patients are getting sicker and living longer. Therefore, staying in the black requires much more creativity than simply financial means.

This article speaks to a specific topic of employee morale that I have been able to experience personally. As a business, anesthesia companies must turn to other aspects in their arsenal to ensure they stay competitive and sustainable. We are all busy in our operating rooms, seeing our patients and doing so while also bitting the clock, so we are not blamed for delays. We don't have time, energy, or the interest to stop to ask how our colleagues are doing. We don't have the time to ask that new graduate how their first month of practice has been. We don't have the time to ask that oldtimer about that problematic case that I might have to do in the future. I actually and inadvertently have been asking my co-workers, "how are you doing?", "How is the practice treating you?" or "Have you encountered any issues lately?". This practice started as a matter of breaking the ice with new practitioners. I realized that people were just like faucets, ready and appreciating to engage in conversations about a problematic surgeon, a case, their weekend, and random situations as soon as I opened the dialog.

It has not always been cheerful conversations. Sometimes is pure venting and complaining. I have occasionally found myself explaining processes that seem irrational and arbitrary to most people, but they are necessary to check boxes in a departmental report. But, this practice has been universally helpful when I see the same colleague the second and third times. It is not me coming to them anymore, but they feel comfortable asking me for advice about a technique. Or they want my feedback about an uncomfortable interaction with a surgeon or a circulator. This brings me, on a personal level, a lot of satisfaction. Still, I hope it also gets my fellow anesthesia providers a feeling that they have someone they can approach about anything without judgment. Because, just like them, I don't have all the answers, which is no point. The point is to listen and to be there for them at least to say, "well, that sucks."

What are you doing other than paying more to reduce your turnover and improve your employee satisfaction, to keep more money in your budget?

Jonathan Alvarado, ARNP, CRNA

https://hbr.org/2019/02/the-surprising-power-of-simply-asking-coworkers-how-theyre-doing?utm_medium=social&utm_campaign=hbr&utm_source=LinkedIn&tpcc=orgsocial_edit