Thursday, March 30, 2006

I just want it to be better....4/11

...my patients have been my reward.... I want...to be able to stand up for the patients, and do the right things, and not get beat up for it.

I just want it to be better. I know that's your goal too. ...a former PRMC nurse.



As I've said, the only way I can see the hospital(s) surviving is an employee ownership situation. North Campus is preferable because it would be a smaller-tighter running unit, and more practical in a later expansion.

The physicians have the possibility of pulling the greatest amount of funding, but the employees have to be vested to make it work and generate the loyalty, because right now, there is none.

One of the biggest faults that both McCu/StJo had was attention to detail, or lack of it when it came to finances. When they affiliated with larger corporations, their overall tone changed--the wrong way. Their philosophies were take it-or leave it to the physicians. In this area, that doesn't work. However, what compounded it was the fault--that was still there.

To make this work, someone has to be running billing like the billing manager from Red River; the people that are entering the orders have to be more mindful of the importance of their jobs, and be paid more because of it.

There are a number of things that could be corrected in the model that is in play, but Essent is firmly committed to the way they do business. And their arrogance is what will eventually be their comeuppance.

36 comments:

Anonymous said...

Well said, Fac_p. In medicine,as in politics, FOLLOW THE MONEY!

The city of Paris and the surrounding counties need to know there is a cancer within the medical community and it
can only be cured with a total resection of this disease.

The facts are quite clear: profit at any cost. Forget patient care; "We have a lock on healthcare in this region. We win by default." Quite a motto.

Fire or drive tenured employees out of the workplace and substitute them with new grads from the available schools. Read: lower costs.

New grads, as most know, need at least a year of steady employment before they can be hired by a "real" hospital. So, they will bite the bullet and try to tough it out for a year before moving on.

Don't be mistaken: Texas Work Force has the best interest of the hospital at heart. They work hand in glove to make sure most fired employee's don't receive unemployment pay. No matter the slim reasons for termination, TWF sides with E$$ent. So much for unemployment insurance. I just love a right to work state where an employee has little or no rights.

The few remaining "Directors" of the various departments are a joke. The jokester of all is in radiology. Actually, there are two....in the same department. Imagine that. Frick and Frack.

Andrew and JR have the perfect duo to do their dirty work in x-ray. Have someone question authority and they are gone. Try to save the hospital some money? Gone. Instill a little professionalism and pride in student's work: gone. They want robots, not professionals.

The ones left are those who are smart enough to keep their mouth shut no matter the circumstance or don't have the proper credentials to work at another Texas hospital. Those who question the obvious blunders are gone. What a place.

I can't wait to be a former employee.

Anonymous said...

If we do this, I hope we have learned enough from this blog.

When there is a problem--brainstorm it. Maybe it's best if we don't know where the idea's are coming from- that way, we don't shoot the ideas down because we don't like the person, or because the person is our competition.

Anonymous said...

Funny, the people in key places are either those that are marginably employable, cowed, or those that have something over them. There are exceptions to any rule, but not many.

Some fit in two out of three....

Anonymous said...

You know, some of the employees that are now department heads, used to be in my opinion, pretty decent people.

I just don't understand how Essent made them the people that they have become. How did they inject such awful values in these people?

It's like the Stepford wives in reverse. I wonder if these people can be reformed after the Essent Era, or are they ruined?

As far as what they have done to people in the Essent Era, I don't think many will forgive them enough to work with them again. I know that I would have a hard time ever working with my ex-director again.

fac_p said...

Fear and insecurity are powerful, motivational factors. If you hire people that are 'out of their comfort zone', they are more likely to be fearful of losing not just the position, but employment. That plays right into this organization's hands.

That fear and uncertainty can manifest itself in actions that alienate their former co-workers. They have little-to-none as far as management experience, and feel that they are constantly overwhelmed. Go back a bit to the Peter Principle.

"We have drugs for that..." attributed to a local psychiatrist

fac_p said...

Got to admit, when I saw those 'demotivators' from despair.com, I thought they were cute. I never thought that I could utilize them in so many posts. But, if the shoe fits....

Think I'll put in a link. You can save the pictures by right-clicking and choosing 'save as'.

Anonymous said...

I totally understand that. What I don't understand is how they have to know what they are doing is wrong, and their comes a point, where you have to stand up and say--This is wrong, I can't do it.

I guess when you have more to loose, it gets harder to stand up. I don't know. I was caught in the Peter Principle myself. After a while of not getting leadership from leadership (not even getting my calls returned) I took my ulcers and left.

Anonymous said...

Another one bites the dust...and another one gone and another one gone...another one bites the dust!

Another radiologoy employee fired! Do we see more temp techs in the future? Yes!

Four techs in CT on days now....Do we sense another tech will soon be biting the dust? Yes!

No crystal balls or tarot cards needed here! Look for any employee with more than 2 years experience and you can add them to the "Scratch List"...unless of course that experienced employee can play golf or rat on fellow employees!

Meanwhile, dear physcians of Paris, turn your heads and don't watch as healthcare goes down the tubes. There is none so blind as he who will not see.

Blanco said...

This week a friend of mine called me in tears...

3 years at the hospital and a good work record...

a single parent with a small child...

no criminal history at all...

her position is being eliminated, but admin assured her she wouldn't be without a job....

There are several jobs that fit her work experience and skills at PRMC but because of her PERSONAL poor credit rating they refuse to give them to her...

Admin instead offered her a ONE check severence package and then unemployment...(which they'd figure out a way to screw her out of anyhow)...

Here's the punch line...!!!

These jobs would involve collecting their precious $$$$ and though she's been a loyal employee in the past, they figure anyone that doesn't shop at Saks will rip them off.

Isn't it past time to really get organized???

Anonymous said...

Oh no, another song is going to be stuck in my weak, weak mind tonight.

Whoever that was that got fired, needs to throw a party tonight. It may feel bad, but trust me, its the best thing that could have happenend for you!

Anonymous said...

Hey 3:34

We ought to go ride around in golf carts and drink beer on certain days when certain people are out.

I stink at golf, but I do have this great ability to hit whatever I'm looking at. Water, trees, sandtraps and people. I also need to work on yelling FORE! It comes out as a whisper sometimes, I dunno why. I need to work on that.

Anonymous said...

"new grads need at least a year of steady employment before they can be hired by a "real" hospital."

I've already been offered more money by Baylor Dallas and Parkland after graduation in May. I would definately call them "real" hospitals...

I see an awful lot of new grad ragging going on...we're not all that bad ya know, and we're not all as inexperienced as you make sound, some of us are competent nurses. I realize that you should have a healthy mix of seasoned nurses with the new grads. Good units can't be run with total new grads or agency...but us new grads should be respected and appeciated for what we can and do contribute.

Anonymous said...

It's not that "new grads" are not respected, ideed, there is no disrespect meant . You do have skills and you will get experience - BUT, the experience you really need only comes with the trials of the field. Ask your self - if a nurse with 10, 20, 30 years experience is let go for no real reason - is this the hospital I want to work for? Hmmmmmm interesting question, is it not?

eyempissed said...

There is no disrespect meant to the new "grads". A good reflection question for them might be: "Do I really want to invest myself and talents in a hospsitall that lets 5, 10, 15, 20 yrs experience go - so that they can employ and take advantage of a new "grad?"

Anonymous said...

8:07

I agree with you. A mix is best. Don't take it personally. People are just mad at the situation.

A situation that could be bad for everybody involved. Experience is good, but so is new blood.

It's just aggrivating when you have spent time and proved loyal to your job, came in on your days off to help out etc.... and they pay you back by firing you, and replacing you.

Anyway, I have daughters facing what you are, and I hope and pray that people will not take their aggresions out on you or them. What's going on is not your fault.

I hope we can turn all of this around and make this better.

Anonymous said...

Talk about motivation to change...

We have to. Think about your children entering this hospital, as a patient or an employee.

Anonymous said...

I want to make it better...

I want to make it better,
I tell myself each day

As I prepare to meet the challenges,
of working here--this way

A house that's full of problems,
that saps the strength from me

In a shift that never ends,
while this place ignores my plea

I want to make it better,
a task I cannot do

'cause Essent Healthcare bought this house,
and cares not for me or you....

Anonymous said...

I think that the t-shirt contest just got won:

On the front: Picture of the campuses, over the top, written, "I want to make it better...."

On the back, "...without Essent"

Anonymous said...

If all the "new blood" leaves because Essent is so horrible, will it ever get better? If they are firing all the good experienced staff (as I admit I have seen with my own two new grad eyes) will it ever get better?

I love my job, I love being a nurse, I love being a nurse here to the community. And I dont want to leave.

I dont even pretend to like administration. And I definately dont agree with them on 99.9% of things. I go to work and CMA and protect my license.

I think they have a couple of good new clinical sups that will not get sucked into their money game. Both are excellent floor nurses first and foremost. And a great big AMEN was proclaimed on 3rd and 4th floors when they were hired.

Personally I dont see essent staying in Paris much longer. They know that they are not welcomed, they know that this is not going to be a profitable hospital. I just hope that when the sale happens that our good nurses and other staff will come back.

and I do take it personally, when I come to work and bust my butt, yet I see/hear no thanks for it.(not that I expected admin to) But so far what I do hear is all the "another new grad" comments.

I like the t-shirt...I think that there should be a nurse tearing down an Essent sign from the side of a building. Or better yet a nurse giving a kick in the a$$ to Andrew out the door.

Anonymous said...

Hey! Stop and think new grads! You are a veritable baby in the medical community. Whoopee! The difference between book learning and practical application is like day and night. And yes, I am aware of clinical rotation. BUT! that is a very structured setting. You better have a seasoned individual around you when you enter a hospital setting for a position. Because it will be through their knowledge and EXPERIENCE that you will be able to build on what you have learned in school. Be that nursing, radiology, lab, etc. And about that word...RESPECT. You have to earn it. Novel idea, huh?

Anonymous said...

1:57 post

I disagree. I give respect, and I expect respect. The people that do not show respect to others, are the people who do not respect themselves.

Experience is another issue. Respect what level a person is on, and make expectations accordingly.

Novel idea, huh?

Anonymous said...

We have yet to earn the DIS-respect that is shown. We havent even been given the chance to show what we can bring to the table. It might be more than some people think. For some of us, nursing school isn't our first rodeo in the career world. And good judgement isnt something pinholed just for people with "experience".
Not to mention some of the new RN grads who have been LVN's for 5-10-15 yrs...guess they're green too?

Yes, skills & judgement get better with experience.....most of the time. But laziness, inflexibility and burnout are also very prevelant in "experienced" employees. Resistance to change is also not a good thing either....but it IS something shown in some "experienced" staff.

Anonymous said...

6:23

I agree with you. That is why I love new blood. When you are burned out, or working around a bunch of burned out blood and a new nurse comes in, it's refreshing.

Be careful others attitudes don't rub off on you, and please try to help the burnt out staff through it-- with a smile or a laugh, or a joke. You'd be amazed how much it could do for someone. Speaking from experience, some of those nurses have been through hell.

I know its really hard if they are being disrespectful.

Anonymous said...

Actually, the new grads bring entertainment to the workplace. It's like a bunch of puppies exploring and testing new skills. You kind of remember what it was like for you...or at least you should.

Every job, every supervisor, and every co-worker leaves a bit of themselves in you. Let's hope it is a good experience all around. When it isn't, you can tell.

This is not the place for puppies, this is a place for the junkyard dogs, that know when they can plant their feet and dig in, or retreat when the rock or shoe is thrown at them.

This is not what I would recommend as a first experience.

Get some 500+ bed med center that will train you right, 'cause currently, you have the basics.

Get the direction from a good environment, because this will just beat you down.

In a couple years, you will have something significant to contribute, and hopefully we will have a hospital and community that will appreciate it.

Anonymous said...

You know, I was just talking to the nurse that trained me, and thinking about what a great experience that was for me.

I see so many traits that I loved in her, that were instilled in me--just by her direction.

Find someone you admire-- get on their shift, and learn from them. It will be the best gift you can give yourself.

Anonymous said...

One of the first things that a new owner needs to put in place is counseling. The employees have been put into a situation not dissimilar to Vietnam:

You can't tell the friendlies from the infiltrators.
You are constantly taking fire.
The rules of engagement change constantly.
You don't get the support that you need in life and death situations.


Nurses in support areas in the war developed PTSD. I'd say we're in a combat zone.

Anonymous said...

An excerpt that will never be said by a PRMC director:

I report to my boss, but I work for my people.

Before you think, “I wouldn’t have said that if I were her,” hear me out.

This phrase is about taking care of people and being a selfless leader. When I walk through my door every morning, I’m not thinking about what I can do to impress my boss but what I can do to help my people.

Does it mean my boss doesn’t matter? Of course not! I am still responsible to him, I still answer to him and I still need to keep him informed. However, I don’t exert all of my energy on him. I save it for my people. I take care of them, they take care of me and I can take care of my boss.

So what does it mean when I say “I work for my people”?

It means that whenever I do anything, it is to help them out. When I review...performance reports...I put an equal amount of time and effort into all of them.... ...I make sure it is the best submission possible and we are recognizing the right people.

When I discipline people, I make sure it is fair, equitable and appropriate. I set standards and expect my people to follow them. When people want to talk, I make time for them and listen to what they have to say. I speak my mind even if I don’t tell them what they want to hear.

I try to make things fun, even...staff meetings. I give people honest feedback and I take theirs in return. I let them know what I expect, when they’ve done well, when they haven’t quite hit the mark and what they need to do to improve. I let people do their jobs and trust them until they give me a reason not to.

Most importantly, I genuinely care about their well being and try to convey that in everything I do. The minute this seems phony, I lose credibility.

Now, about my boss. Don’t get me wrong; My boss is very important and I don’t mean to belittle him in any way. After all, he signs my report and if he really wanted to he could make my life miserable. My point is I do not show up to work every day trying to impress him.

The energy I spend doing that takes away from the energy I could be spending helping my people succeed. If I take care of my people, they will get the job done, and the more professionally satisfied they are, the better they will perform. The better they perform, the better I am fulfilling my responsibilities to my boss.

They are taking care of me by enabling me to take care of my boss. If my boss notices, that’s great! If not, my reward is in knowing my people are taken care of, motivated to show up to work every day and doing their best.

To me, all the recognition in the world is worthless if I am making my people miserable in the process.

Maybe it just boils down to priorities. I feel an effective leader thinks “people first,” not “me first.” Good leaders take care of their people because they know their people will take care of them. When their people take care of them, leaders can take care of their bosses. Good bosses will see this quality and in turn take care of the leader. Pretty neat how that all works out!

Selfless leadership has worked for me. Maybe it will work for you!

Anonymous said...

01:42 PM Post.

Well put. If there were more leaders with this attitude, we could not help but succeed!!!!

All you hear around PRMC these days is a sucking sound!

Anonymous said...

Just goes to show that there are other places where the people are appreciated, not just the balance sheet.

Yes, you have to have the one to keep the doors open, but without the first, no one wants to come through them....

Anonymous said...

If you worry about the people, the numbers come. If you worry about the numbers, the people get lost...learn it, live it and be successful....former AF Recruiter

There are no problems, only opportunities to excel....

Anonymous said...

For those of you who are jumping between The Paris Site and Citizens For Paris, Texas, you might be interested to know that there are striking similarities between what is going on with PRMC and the City, not the least of which is the new rule in the city personnel policy policy that says (paraphrased) if you don't go along with the plans and goals of the city, you'll be disciplined. "Disciplined" is not defined but it could mean anything from a written reprimand to termination.

City employees just received (or will shortly) a list of changes to the personnel policy. Most of those changes deal with lateral transfers, demotions, dimissals, etc. It doesn't take a rocket scientist to see what is about to happen with the City, probably another round of layoffs and subsequent lateral transfers to fill newly vacated positions.

The cancer that 12:14 spoke of has metastasized to the City of Paris. I know this isn't the site for this information, but it is uncanny how similar both situations are.

Thanks for the forum.

Anonymous said...

1:42

There used to be some leaders at Christus that were this way--I kind of think you were one of them.

PRMC won't let you lead this way now. In fact I think they have made these leaders this way--I don't think it was their choice really. They created little Frankenstein's in thier image.

Who you spend time with, starts reflecting on you. Lie down with dogs and get fleas.

Anyway, I think you are a great example of a boss 1:42. I do respect these qualities. The boss I have now at another facility has these qualities.

I'm starting to gain the weight back that I lost in the concentration camp of PRMC.

Anonymous said...

I hope Ms. Mock, JR, Andrew, et al read the 1:42 post. Na, wishful thinking.

The cancer within E$$ent can not be cured by surgery, chemo or radiation treatments. The cancer can only be cured by one thing...death... to a corrupt company mentality that thinks the citizens of this community have to come to them for medical care. How wrong they are.

Anonymous said...

I wonder just how things are at other Essent facilities. It can't be all bad, or the corporation would have fallen apart earlier.

Why is it so bad here?
Was it the interim team that set the tone?
Was it the hangers-on that carried over the Monty infection?
Was it just because they were in such a deep hole that they figured shock therapy was the only solution?

Or is the atmosphere the same in the other locations, just not as publicized....

This blog is unusual, to say the least. And in surfing other locations, I haven't heard a peep. Of course the level of repression might not have created such a need.

Whatever the reason, thanks for the outlet.

Anonymous said...

I have been through other mergers that I thought were horrible at the time----but they paled in comparison to the Essent experience. By a long shot.

Anonymous said...

Company Policy Changes

The following policy changes will go into effect immediately.

Dress Code:
It is advised that you come to work dressed according to your salary.

If we see you wearing Prada shoes and carrying a Gucci bag, we assume you are doing well financially and therefore do not need a raise.

If you dress poorly, you need to learn to manage your money better so that you may buy nicer clothes, and therefore you do not need a raise.

If you dress just right, you are right where you need to be and therefore you do not need raise.


Sick Days:
We will no longer accept a doctor's statement as proof of sickness. If you are able to go to the doctor, you are able to come to work.


Personal Days:
Each employee will receive 104 personal days a year.
They are called Saturday & Sunday.


Toilet Use:
Entirely too much time is being spent in the toilet. There is now a strict three-minute time limit in the stalls. At the end of three minutes, an alarm will sound, the toilet paper roll will retract, the stall door will open, and a picture will be taken.

After your second offense, your picture will be posted on the company bulletin board under the "Chronic Offenders category."

Anyone caught smiling in the picture will be sanctioned under the company's mental health policy.


We are here to provide a positive employment experience.
Therefore, all questions, comments, concerns, complaints, frustrations, irritations, aggravations, insinuations, allegations, accusations, contemplations, consternation or input should be directed elsewhere.

Thank you for your loyalty to our company.

My former PRMC supervisor sent this to me. I thought I was off the hospital's distribution list.