Vol. 6 Issue 1 Page 15
Radiology Question & Answer
A Promotion/Demotion Dilemma: Department reorganization can injure pride and rattle morale
Q: Jonathan was hired by Midtown Community Hospital to assume the position of radiology administrator. Upon his arrival, he was introduced to Louise, a 62-year-old woman who has been the department’s assistant manager to the three administrators before Jonathan.
After two weeks, he noticed that Louise really serves only as a senior technologist, and has neither desire nor ability to act as a true assistant manager. Jonathan was comfortable with this until he realized that his department needed a structural reorganization to solve problems and increase efficiency. He feels the need to reassign Louise so that Catherinea young, aggressive go-getter who has been a technologist in the department for five yearscan take over as assistant manager.
Catherine is by far the better choice to be assistant manager, but Louise has been in the position for so long that Jonathan feels he will be rocking the boat a little too much. What can he do for Louise in her remaining three years before retirement? How can he keep this maneuver from destroying her morale and giving himself a heartless image?
A: Jonathan must base his decision on what is best for the department and for the hospital.
Since he believes Catherine is qualified and capable of assuming the responsibilities of assistant manager, he needs to provide her with the support she needs. Catherine needs the opportunity to make an ally of Louise and to turn to her experience for support.
Louise has worked in the department for a long time and has probably earned the respect of her peers. Therefore, Jonathan must approach Louise in a way that she will be part of the decision, as opposed to making her feel like she’s being demoted.
He needs to have a heart-to-heart talk with Louise. He should explain the long term goals of the hospital and the time and dedication it will take to achieve them. He needs to detail the plan to create a senior technologist’s position and discuss the importance of those responsibilities. Jonathan should tell Louise that he wants her to fill this critical position.
Then he should discuss the new responsibilities of the assistant manager’s position, emphasizing the long-term goals and the need for someone who can make those goals a priority, emphasizing her pending retirement.
It will be critical for Jonathan to enlist Louise’s help in training a new assistant manager. A good way to earn Louise’s support is to include her in the selection of a candidate. He and Louise should discuss all of the employees who may be suitable, including Catherine. Catherine, after weighing everyone’s positive attributes and faults, would still be the logical choice. This will help Louise feel as if she is hand-picking her successor instead of being replaced. He should then ask Louise for help in training Catherine, explaining that for the good of the company her help is critical.
Jonathan also should include Louise in projects such as quality programs, to allow her to maintain dignity and a feeling of self-worth. Finally, Louise’s salary should be maintained, even though her title is being changed.
–Sharon Dowdy, MS, RT(R)
A: It is important to examine the intrinsic problems surrounding such staffing issues to shed light on how they can be approached without backlash and headaches. Complex systems, whether biological, physical, social or cultural, are multipolar in nature. Many variables contribute to the overall whole. With problems like crime, drug abuse and the welfare system, there are many sides to the issues that cause intense debate and division. Our own discipline, the medical community, is not immune to such debates: euthanasia, philosophies of therapy management and, as in this scenario, appropriate staffing decisions. This situation is not uncommon and has the potential to create controversy.
In a profession that teaches, for example, protocols for mA settings, there seems to be few vehicles that foster an understanding of the human condition and how to handle stress, angry patients, overwork and management decisions that may cause tension among employees.
Obviously, Jonathan has made the command decision: Catherine is the better candidate for assistant manager. The down-side is that Louise may feel overlooked or stepped on as a result of that decision. Jonathan’s job description man-dates things like selecting protocols and deciding which supplies will provide the best studies, but elements of human resources is much more involved. Staff and patients are not supplied by the lowest bidder.
In order for the department to run smoothly, he must consider the human factors. This point may be obvious, but it may be overlooked. As members of a staff, we are all asked to treat patients as whole human beings, healing the mind as well as the body. This, of course, over time may prove difficult due to the nature and pressures of our line of work. Jonathan must remind himself of these things even when he is busy with committee meetings and budget concerns.
Louise, like her patients, deserves to be treated with respect and courtesy. Therefore, Jonathan shouldn’t spell-out the reasons for his decision. Laying out all the pros and cons for her to agonize over seems particularly cold, and while he is accountable for his decisions, he need not justify everything to her. Such complex systems can become the battleground for confrontation, and in this case, it might do her more harm than good.
It is important for Jonathan to bring the staff together for such an announcement, instead of distributing a memo. In the staff meeting, he can compliment both Louise and Catherine concerning their achievements, and he can field questions directly. Also, it is important to talk to Catherine privately about making the transition easy for Louise, since she may feel uneasy dealing with Catherine as a new immediate supervisor.