fight rmDear Director: I recently had a nurse yell at me in front of everyone at the nursing station because I didn’t clean up after repairing a lac. It was an incredibly busy shift; I threw out the sharps but wanted to get back to work quickly so I left everything else for her to clean up. It had already taken her an hour to get everything out of the locked supplies closet so I could do my work. I think her behavior is inappropriate. What should I do?

72-Hour-RMDear Director, 
My CEO is concerned about our ED’s quality because we’ve experienced a recent increase in our 72-hour returns for admission. As an ED chairman, I know that quality is about more than one metric, so how seriously should I take this? 

UpstairsDownstairs RMHow many clinical shifts does your chair need to work in the trenches in order to stay current with what’s happening in the department?

open-book-prevDear Director,

I get paid based on my productivity, but I don't trust that my company is paying me accurately. How can I check? Do I have the right to look at the books?

comm-prev1Leadership is about having a vision and implementing a plan. Communication is the integral ingredient that links your vision to action. In order to provide the best and most efficient healthcare, particularly in a growing environment, everyone must be on the same page and I suspect you feel a constant need to update your team about the changes that are occurring. So the question becomes how do we get our colleagues to listen and retain the pertinent info?

Dear Director, I’m finishing residency and starting my first job. I’m pretty good but want to make a good impression and not screw up. What advice can you offer about getting started on the right foot?

director-90Dear Director,

My chairman tells me I need to see more patients. I’ve been doing this for a long time, and, believe me, I really am working as fast as I can. Now, I’m being told that if I don’t speed up, I could lose my job. Are there any tricks to being faster?

Dear Director, I keep hearing that the federal government is getting into the Patient Satisfaction business through something called ED-CAHPS. Is this like Press Ganey? I just want to focus on clinical excellence and patient safety - satisfaction seems to be all about fluffing pillows. Is ED CAHPS real and if so, how can we prepare?

Dear Director, I want all of my docs to sit on some hospital committees, but I hesitate with some, not knowing if I can trust them. What makes a physician good at representing the department? Is it a quality that I can teach?

Dear Director, I’m an experienced physician who is thinking of switching to a fixed overnight schedule.  I’m wondering your thoughts on the benefits to this and any potential risks to my career.

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