I recently received a heavy metal coin in the mail from the hospital I work at per diem. It was accompanied by a trifold letter thanking me for my hard work during the pandemic and ended with a “we are all in this together” statement. It explained the coin too. Likening it to soldiers being honored with metal coins for acts of bravery.
I didn’t work much at the hospital this past year. I had enough to keep me busy with my practice. I also felt that the hospital left a lot to be desired in terms of infection control measures in the psychiatric hospital. I felt safer working remotely at my practice.
But there were many essential frontline workers working day and night caring for COVID patients. Caring for NICU patients during a pandemic. Caring for maternity patients who had to give birth alone wearing a mask after their partners tested positive.
I opened and read the generic letter, held the coin, and though of the scene in the Office when the CEO of the company, Robert California, looks at the regional manager Andy and says, “Sometimes I think you don’t know me at all,”
If you’ve seen The Office you know it’s satirical. It’s a commentary on how every one lower on the totem pole from management feels that management doesn’t actually know them at all.
I felt this viscerally holding that coin. I felt affirmed with every atom of my being with my decision to leave hospital and agency work full time and venture into the risky world of self employment via private practice. The few times I’ve worked at the hospital I thought I would have lost it if I was working there full time this past year. And the nurses and doctors and respiratory therapists working there full time for the past year deserve more than a worthless coin and generic thank-you letter.
I’m going to give the example of how I treat my employees. Because I’m a big bad boss now. My employees received everything necessary to do telehealth at home. Headphones. Lifted desks. Second monitors. Printers. Scanners. Anything they needed I got them. I screen all their calls and messages and deal with whatever I can on my own without bothering them. If they ask me to intervene and discharge some one I do it. No questions asked. Because I trust their judgement. For Christmas I gave my part time employee a bonus. I gave my full time employee the option of a cash bonus or tax exempt options like insurance premium, HSA contribution, student loan payment, etc.
I ask for their input on what charity to give to locally whenever I make a donation through the business.
I give them positive feedback whenever I get it from clinicians and patients. I pay them an extra hour a week if I know it was heavy on administrative time outside of client time. I say thank-you whenever I ask them to do something and they do it. I have never bought them pizza. I have bought them sushi and nice chocolate and wine and beer. I’ve given gift cards to restaurants and Amazon for nurses week.
One of my friends who is an APRN asked how much money I make from my employees. I told her I don’t make much because I didn’t take on employees to profit from them. I took them on because I wanted other prescribers to practice with me. And when I decided to take on employees I made a conscious decision to never treat them the way I had been treated by my employers and managers in hospital systems and private practice. I want my time that I spend doing their billing and scheduling and call backs to be covered. But aside from that I’d rather invest leftover money back into my business and subsequently back into my employees. Because I know what it feels like to work myself to the bone. Giving literal blood, sweat, and tears to a system that rewards you with pizza and a coin.
My fourth full time employee came on recently and took time to decide to increase to full time. The reason she gave for doing so was because she knew that the first two employees both started at less hours and both have continuously increased their hours in the past three years, one to full time and one to part time. She said that spoke to the business in terms of retention and in terms of them continuing to give more to the business. That moment felt good.
I despise how hospital systems cry poor. All the time. I didn’t get consistent raises my first eight years as a nurse. I felt powerless to fight for them. The systems were designed for us to fail to get increases. These are billion dollar organizations. Not million. Billion. Tell me they can’t give their employees something bigger. Why not cancel all current medical bills being held by their employees? Why not cover their health insurance premiums fully for at least a month? Why not provide free or discounted care for their employees? Why not pay 1000.00 toward every one’s student loans? Why not skip their CEO’s bonuses and give it back to their staff? Why not invest in their front lines essential heroic workers?
On the other end are burned out healthcare workers who think they don’t or can’t have better or more.
You can. You just have to work for it and you have to be willing to take risks.
Before the coin. Back before the pandemic back in 2017 when I opened my own practice. I put a 2$ fake paper bill from my hospital system on my wall. It’s still there. Taped over my desk. I treat employees of the system who recognize it and always ask why I have one of them taped on the wall. I encourage them to read the message on it. They lean in and then understanding dawns and they inhale sharply. Then they turn to me in disbelief. I nod. “Thanks for saving the life of a patient.” They always say it out loud. Like they are reading it wrong.
I nod again. “But I mean like you actually saved some one or it was just a close call?” they stammer trying to disbelieve it still.
“The patient was blue. I cleared her airway. I was told by multiple people there that day and after the patient would have died if I was not there.” Then they always nod their head and shrug their shoulders in resignation, “I believe it. 2 bucks. And a fake 2 bucks. That’s all we are worth around there.”
The two fake bucks that can only be used at the cafeteria of that particular system was not the first nor the last time I was let down by an employer in healthcare. But it was the first time I remember feeling resolute in my decision to get the hell out of there. I knew I needed to be somewhere that valued a patient life and my ability to save it. The coin six years later affirmed that decision.
To all my healthcare provider friends reading this. I see you. I know what you give every day. I know what it takes away from you. I’m sorry you are not valued more. But know that you are valued by me. I see you. You are not alone. You deserve more. If you are reading this and you have any say or control over how employees healthcare systems are treated: do better.
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