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A Good Place to Work
Adam Grant wrote an op-ed piece for the New York Times[1] which advised people looking for a new job to ask about the culture of the new job before taking the position. He quoted a thirty year old study of organizational culture which observed that there were generally seven stories organizations told that defined their culture and identified the answer to important questions. The first four are: Is the Big Boss human? Can the Little Person Rise to the Top? Will I Get Fired? How Will the Boss React to Mistakes? As Mr. Grant points out, these stories deal with three fundamental issues: justice, security, and control. The other three questions are: “Will the Organization Help Me When I Have to Move?” “What Happens When the Boss is Caught Breaking a Rule?” and “How Will the Organization Deal with Obstacles?” His advice to the new job seeker is: It’s always tempting to look for a great culture, but since bad is often stronger than good and toxic behaviors wreak more havoc than positive behaviors breed joy, it’s probably wiser to first rule out the worst cultures. When stories suggest that an organization is wildly unfair, unsafe or immovable, cross it off your list. And beware of joining a company with a bad reputation in the hopes that you’ll be the exception: the rare little guy who rises to the top. Rather than changing a cutthroat culture from the bottom, many people end up counting themselves lucky if they walk away without permanent scars. For those who work in hospitals and healthcare organizations, the notion has been summarized in the phrase “the just organization.”[2] Of course, the fact that the phrase has been coined and brought into wide use is proof of Mr. Grant’s observation that bad cultures and toxic behaviors are widespread. I recommend the original article, but for our purposes, I am going to quote from near the end of the paper. How does one create a work climate that values peoples as ends rather than means, that uses consensus-style decision-making process, and one that seeks “win-win” solutions to problems than “win-lose” outcomes. The most important single action a manager can take is to model and reinforce those behaviors. No better way potentially exists to teach employees to behave ethically than to do so oneself, and publicly reward others who do so as well (and punish those who do not.) Perhaps this is just a longer statement of the Golden Rule, but the interesting question to me is why are so many healthcare organizations struggling with these issues. After all, taking care of the sick and the hurt demands ethical behavior, so you would think it might “come naturally” for healthcare organizations. But it does not. As those organizations have become big businesses and are “professionally managed” rather than being directed by physicians, nurses, and local citizens, the ethos of Big Business has crept in with un-intended side-effects. How can you tell? I suggest finding out if the CEO and the top leadership speak in terms of “head-count” and “FTEs” or do they think in terms of the staff in a given unit? I suggest managers hide behind the anonymous terms, because it is painful and difficult to realize that decisions made mean that real individuals are going to have to be let go, moved, or replaced. And each of those individuals is going to be upset. I talked to a consultant once who said when meeting with a new organization, he liked to get to appointment early so he could chat with the secretary in the outer office while waiting for the “boss.” He would then mention her by first name and look to see how many of the people in the room had any idea who he was talking about. How would you do in that conversation? Do you notice the staff, or just the power brokers? When making decisions, do you think about the impact on individual workers, or just “the unit?” Are you doing your part to make your organization a just workplace? Happy Holidays. 21 December 2015 [1] Grant, Adam. The One Question You Should Ask About Every New Job. 19 December 2015. http://www.nytimes.com/2015/12/20/opinion/sunday/the-one-question-you-should-ask-about-about-every-new-job.html. [2] The basis for this notion is laid out by Karen L. Newman, The Just Organization: Creating and Maintaining Justice in Work Environments. Wash & Lee Rev 1993;50:1489. Accessed at http://scholarlycommons.law.wlu.edu/wlulr/vol50/iss4/8. |
Further Reading
Culture Matters The scandal at the VA shows the importance of choosing performance measures wisely and the need to consider organizational culture in applying standard management techniques. Horizontal Violence and Nursing Staff Turnover A recent study shows horizontal violence - conflict between nurses in a hospital - is common and a major cause of job dissatisfaction and intention to leave. What can be done about it? Measuring Teamwork Measuring Teamwork is difficult, but important if healthcare systems are to invest in their development. This article reviews the literature and provides suggestions for action now. Organizing for Success The Keystone Cooperative ICU Project obtained major improvements in safety. The 'soft science' lessons need to be applied more widely. |