Not too long ago I was formerly employed at an Optometrist’s office. It was supposed to be an easy job that allowed training on the job while I tried to figure out what I wanted to do with myself. It had the perks of Friday afternoons off and wearing scrubs to work, which is basically like being employed in pajamas. I ended up working there for three years and although working at the front desk doing patient care is not considered the most sophisticated of jobs it taught me much more about organizations, collaboration, and life in general than I thought it would. It was not long after I left the eye doctor’s office that I began my Master of Science in Leadership. I was gung-ho that all of the dysfunction that I witnessed would be the building block for what I would learn to fix and prevent in the future. It is funny, what is said repeatedly about time is true; it has the power to smooth away all of the particulars that felt like they would stay with me forever. It is much more difficult to think back than I thought it would be, but there is enough left to scrape together a time when collaboration would have improved my decision-making.
The way the office was designed was that the front desk received the patients, checked them in, handled information and insurance, and prepared the charts and the scheduling. The ophthalmic technicians or “techs” would do the work ups on the patients to take down vitals, take measurements on the auto refractor, dilate the eyes, and fill out the charts, basically get the patient ready for the doctor. The doctor would conduct the examination. If the patient needed glasses they would take them to the Opticians and if not, they would check out at the front desk. The problem with our office was a lot of things. So many girls and it got very catty. There was no official leadership designation and everyone thought they were in charge, we were always told to work it out amongst ourselves. There also was a lot of tension and lack of respect between the three departments. Each group thought they were the most important, when it reality I was always saw it as a triangle. No matter how you flipped it around, we were all needed to do the job and could not do it without each other.
Each Thursday morning we had an hour long meeting where we discussed where the office was financially for the month and there was a lot of transparency with our numbers. Ultimately our office was cramped and on top of each other. To get to the new office, something many said they wanted, then we would have to keep making leaps and bounds in our numbers to get there. I think many would think of themselves during the hard work because it was always more work demanded and lack of incentives to go with it. The attitude in the office was very negative.
My attitude was that I was usually left last in the office and we would leave when the last patient left sometime around when the office closed. Sometimes this would end up being a little later depending on what type of appointment was scheduled. I wanted to help the patients because that is what we are there to do. The more we see, the more money we would make. The better care we gave, the better their experience and hopefully would help our reputation in the community to be the best eye doctor’s office. In our tiny town word of mouth is everything. Because everyone wanted to get out the door as soon as they could no one on the staff wanted extra patients on the schedule, but the doctor was always happy to accommodate the patient’s needs, if that meant more that was okay. I was always trying to add patients in if they really needed it; I was not really in the business of saying no. In terms of decision-making this is where collaboration was paramount. I could not get the patients through their appointment on my own. After repeatedly being met with scorn about adding in patients when I would try to ask and smooth it over eventually I just started doing it without asking. We were there to work, to do a job, and how someone felt about it was on them at the point. I started to feel that if you hated being at work that much then maybe you should not be doing the work at all. It was a frustrating time for everyone.
I remember a specific time when I added someone in who I had gone through the phone triage process to see how severe their eye issue was and added them in. I remember trying to coordinate with the techs and they were mad. The opticians felt that since it was an eye problem and not an examination for glasses that they didn't need to be there, and the doctor was glad to see the patient. The patient ended up having an eye issue, but it was fortunate it was not a retinal detachment, something the symptoms might have been pointing to, and with those you never know until you have the doctor see the patient. What is sad was that because it was not one hundred percent emergent I was met with eye rolling and disdain from my colleagues who acted like they could not be troubled.
Constantly in that environment of patient care I had decisions to make multiple times a day, every day. Together when we came together in a collaborative mood we did our best decision-making. The are several reasons why collaboration would improve the decisions. First, with the other stakeholders in the office being involved, the patient would have a better experience. You can tell if someone wants to help you or not. Getting everyone in agreement is the best way forward. Secondly, when we could openly discuss the decision to see someone last minute, the technicians have special insight into what that patient’s issue might be because of how closely they work with their medical records. Additionally, when we work together we can meet our goals, but it takes us all working like a machine with all of the parts in harmony to achieve it. Also, by collaborating we could have created a supportive environment for each other. Lastly, by working together we could improve and evolve how we make decisions for these and other situations. Working together is always much better than against each other.
Ultimately in times when collaboration did not seem possible and I added patients the objectives were met in theory, but there was something tangible missing when you held the other stakeholders hostage to staying at work even ten or fifteen minutes longer. I believe if the doctor would have designed a better structure other than working it out ourselves this could have improved the function of our office and the outlook we had. He was an important stakeholder that was often missing from these decisions that could have added value. Even if he gave his approval it would not change the attitudes as soon as he went back into the examination room. When the cat is away the mice are so unruly! Forget about playing, but there was a lot of that, too.
Reflecting back on this situation, I used force to get the objectives met by putting the patient on the schedule and dealing with the backlash when it came. It did not start out like that, but as time passed it became the culture to do things that way to get anything accomplished. I have not since acted like that, but I have also not been in that type of atmosphere since either. This week during another assignment, A632.7.2.DQ we discussed listening for a vision of resolution. Stewart Levine lists several questions that could help during a conflict to test the vision to see if you are ready to test your preliminary vision. Several of these could improve my decision-making in the future if I was met with this type of situation again. Three things that I could have done to improve making these decisions develop from the ability to ask these questions such as: Does the preliminary vision fit everyone’s view of the outcome? Does the preliminary vision take care of all specific concerns in the situation? What needs correcting or adjusting? (Levine, 2009). Additionally, I could have communicated better the responsibility we each shared by being a part of the medical community and our duty to our patients and why I felt pulled do act in the ways that I did by putting the patient first and my needs last. Also, Chambers (1998) provides an important strategy for conflict resolution in terms of dealing with multiple stakeholders:
Emphasize shared responsibility and participation. Establish very clearly that successful resolution and outcomes are the responsibility of all parties involved. Resolution does not have to be inflicted; it can be negotiated. Everyone involved has a responsibility for successful outcome. Flexibility and commitment are enhanced when shared responsibility is emphasized and accepted. Successful resolution is a collaborative effort. (para. 6)
Something I discovered this week about listening for a resolution that I also explored during A632.7.2.DQ is that telling my story and listening for my collaborators stories are the best way to understand each other. Without being heard we cannot go through the cathartic process of saying what is important to us and what is bothering us (Levine, 2009). We were all so frustrated that we stopped trying to talk at all and just communicated through our actions and non-verbal communications. If I learned anything from this it is that no matter what is going on it saves more time overall if you just stop and talk about it instead of letting everything build up and explode later, which will take up more time even if it occurs later than the time taken early on to communicate with each other.
References:
Chambers, H. E. (1998). Conflict resolution. Executive Excellence, 15(10), 6. Retrieved from http://search.proquest.com.ezproxy.libproxy.db.erau.edu/docview/204633448?accountid=27203
Levine, S. (2009). Getting to resolution: Turning conflict into resolution. (2nd edition). Williston, VT: Berrett-Koehler Publishers.
The way the office was designed was that the front desk received the patients, checked them in, handled information and insurance, and prepared the charts and the scheduling. The ophthalmic technicians or “techs” would do the work ups on the patients to take down vitals, take measurements on the auto refractor, dilate the eyes, and fill out the charts, basically get the patient ready for the doctor. The doctor would conduct the examination. If the patient needed glasses they would take them to the Opticians and if not, they would check out at the front desk. The problem with our office was a lot of things. So many girls and it got very catty. There was no official leadership designation and everyone thought they were in charge, we were always told to work it out amongst ourselves. There also was a lot of tension and lack of respect between the three departments. Each group thought they were the most important, when it reality I was always saw it as a triangle. No matter how you flipped it around, we were all needed to do the job and could not do it without each other.
Each Thursday morning we had an hour long meeting where we discussed where the office was financially for the month and there was a lot of transparency with our numbers. Ultimately our office was cramped and on top of each other. To get to the new office, something many said they wanted, then we would have to keep making leaps and bounds in our numbers to get there. I think many would think of themselves during the hard work because it was always more work demanded and lack of incentives to go with it. The attitude in the office was very negative.
My attitude was that I was usually left last in the office and we would leave when the last patient left sometime around when the office closed. Sometimes this would end up being a little later depending on what type of appointment was scheduled. I wanted to help the patients because that is what we are there to do. The more we see, the more money we would make. The better care we gave, the better their experience and hopefully would help our reputation in the community to be the best eye doctor’s office. In our tiny town word of mouth is everything. Because everyone wanted to get out the door as soon as they could no one on the staff wanted extra patients on the schedule, but the doctor was always happy to accommodate the patient’s needs, if that meant more that was okay. I was always trying to add patients in if they really needed it; I was not really in the business of saying no. In terms of decision-making this is where collaboration was paramount. I could not get the patients through their appointment on my own. After repeatedly being met with scorn about adding in patients when I would try to ask and smooth it over eventually I just started doing it without asking. We were there to work, to do a job, and how someone felt about it was on them at the point. I started to feel that if you hated being at work that much then maybe you should not be doing the work at all. It was a frustrating time for everyone.
I remember a specific time when I added someone in who I had gone through the phone triage process to see how severe their eye issue was and added them in. I remember trying to coordinate with the techs and they were mad. The opticians felt that since it was an eye problem and not an examination for glasses that they didn't need to be there, and the doctor was glad to see the patient. The patient ended up having an eye issue, but it was fortunate it was not a retinal detachment, something the symptoms might have been pointing to, and with those you never know until you have the doctor see the patient. What is sad was that because it was not one hundred percent emergent I was met with eye rolling and disdain from my colleagues who acted like they could not be troubled.
Constantly in that environment of patient care I had decisions to make multiple times a day, every day. Together when we came together in a collaborative mood we did our best decision-making. The are several reasons why collaboration would improve the decisions. First, with the other stakeholders in the office being involved, the patient would have a better experience. You can tell if someone wants to help you or not. Getting everyone in agreement is the best way forward. Secondly, when we could openly discuss the decision to see someone last minute, the technicians have special insight into what that patient’s issue might be because of how closely they work with their medical records. Additionally, when we work together we can meet our goals, but it takes us all working like a machine with all of the parts in harmony to achieve it. Also, by collaborating we could have created a supportive environment for each other. Lastly, by working together we could improve and evolve how we make decisions for these and other situations. Working together is always much better than against each other.
Ultimately in times when collaboration did not seem possible and I added patients the objectives were met in theory, but there was something tangible missing when you held the other stakeholders hostage to staying at work even ten or fifteen minutes longer. I believe if the doctor would have designed a better structure other than working it out ourselves this could have improved the function of our office and the outlook we had. He was an important stakeholder that was often missing from these decisions that could have added value. Even if he gave his approval it would not change the attitudes as soon as he went back into the examination room. When the cat is away the mice are so unruly! Forget about playing, but there was a lot of that, too.
Reflecting back on this situation, I used force to get the objectives met by putting the patient on the schedule and dealing with the backlash when it came. It did not start out like that, but as time passed it became the culture to do things that way to get anything accomplished. I have not since acted like that, but I have also not been in that type of atmosphere since either. This week during another assignment, A632.7.2.DQ we discussed listening for a vision of resolution. Stewart Levine lists several questions that could help during a conflict to test the vision to see if you are ready to test your preliminary vision. Several of these could improve my decision-making in the future if I was met with this type of situation again. Three things that I could have done to improve making these decisions develop from the ability to ask these questions such as: Does the preliminary vision fit everyone’s view of the outcome? Does the preliminary vision take care of all specific concerns in the situation? What needs correcting or adjusting? (Levine, 2009). Additionally, I could have communicated better the responsibility we each shared by being a part of the medical community and our duty to our patients and why I felt pulled do act in the ways that I did by putting the patient first and my needs last. Also, Chambers (1998) provides an important strategy for conflict resolution in terms of dealing with multiple stakeholders:
Emphasize shared responsibility and participation. Establish very clearly that successful resolution and outcomes are the responsibility of all parties involved. Resolution does not have to be inflicted; it can be negotiated. Everyone involved has a responsibility for successful outcome. Flexibility and commitment are enhanced when shared responsibility is emphasized and accepted. Successful resolution is a collaborative effort. (para. 6)
Something I discovered this week about listening for a resolution that I also explored during A632.7.2.DQ is that telling my story and listening for my collaborators stories are the best way to understand each other. Without being heard we cannot go through the cathartic process of saying what is important to us and what is bothering us (Levine, 2009). We were all so frustrated that we stopped trying to talk at all and just communicated through our actions and non-verbal communications. If I learned anything from this it is that no matter what is going on it saves more time overall if you just stop and talk about it instead of letting everything build up and explode later, which will take up more time even if it occurs later than the time taken early on to communicate with each other.
References:
Chambers, H. E. (1998). Conflict resolution. Executive Excellence, 15(10), 6. Retrieved from http://search.proquest.com.ezproxy.libproxy.db.erau.edu/docview/204633448?accountid=27203
Levine, S. (2009). Getting to resolution: Turning conflict into resolution. (2nd edition). Williston, VT: Berrett-Koehler Publishers.
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