No Excuses

I attribute my success to this-I never gave or took any excuse.”

Florence Nightingale


I was publically thanked today for doing my job. No, really. By two of my coworkers, actually. It sort of took me aback just a bit.

Over the Christmas holiday a couple of patients, being human like we all are, forgot to get their medications squared away before the clinic was going to be closed for a total of five days running. They panicked, thinking that if they ran out of medications it could come to no good (probably an accurate assessment showing some degree of insight), so they contacted the clinician on call. She, doing her job, texted me, asking if I would consider calling in the medications for these folks.

I was in Atlanta, probably in my bathrobe or at best a pair of shorts and a t-shirt, but reach me she did, and respond I did in kind.

It took a little finagling (it was Christmastime, after all), but the scripts were duly called in, the clinician relayed that to the patients and everyone was free to go forth and celebrate.

This was no onerous task. It was no superhuman feat. It was good care provided when asked for, best practice response, and the kind of support that builds trust not only between team members but between providers and patients as well. Why would I not respond exactly like this, every time the scenario occurred? Nowadays, I try to do just that. A few short years ago, that might not have happened. Why? Come back in time just a few years with me and let’s take a look.

In the days of yore, the old paradigm saw us working pretty standard 8:30 AM to 5:00 PM clinic days, with a half hour to an hour off for lunch. We were on site then, everyone knew that everyone who worked there was in the building,  and it was not really very hard to find people.

There were phones on site, but they were the most basic back then, having two lines, maybe three if you were lucky. It was not uncommon in those days to have to wait for all the little lights to go off so that you knew you had a line open to make a call. There was no voicemail. There were pads of various sizes of yellow sticky notes that were used to leave messages everywhere, from doors to desktops to coffee cup handles.

Communication in the office was largely word of mouth. In other words, if you wanted to speak with someone, you actually had to (gasp) go find them and talk to them! Oh, you could also write a letter or a formal memo that had to go through the office courier to get to the party you sought.

The key thing was, the hours were 8:30 to 5, and that was when most of the work got done. If you did not reach your party and state your case and get your business done within those hours, chances are nothing was going to happen before 8:30 the next morning.  When quitting time rolled around,  most folks headed out toward home, and they did NOT want to be found or hassled or hounded before they came back to the office the next business day.

As you might imagine, this lead to frequent missed contacts, unfinished business, lost sticky notes, and poor outcomes sometimes.

Flash forward to 2017. The new paradigm. Meet the new boss, same as the old boss, but with a few technological and logistical enhancements.

We now have much more flexible business hours, with some folks working until seven or eight at night, and many jobs requiring weekend hours. It is hard to define “after hours” now, especially if you work two very different  jobs like I do, one of which involves shifts of six to thirteen hours and can last until one in the morning.

Our phones are now internet based, meaning that I can have a physical phone on each of my four desks in three separate offices, but all I have to do is sign in with my number and a passcode and all my previously programmed information and my voicemails follow me wherever I am, with little work on my part.

I have had an iPhone since 2007, and my life lives on and in that little pocket computer. All of my contacts, my to do list, my calendar, my schedules all live on that phone. It is with me from the time I wake up until I lie down to sleep at night.

For that reason, voicemails are now ridiculously easy to leave, in multiple places if necessary.

I now have Skype for business open on my computer desktop all day long, so I have yet another way to communicate in real time with my coworkers. I can send a message in real time and chat with someone, instead of sending an email and waiting perhaps all day for a response.

Word of mouth and actual productive conversations are still necessary and effective, but one must be more proactive to make them happen now. Memos and physical letters among coworkers hardly exist anymore.

We are living an “always on, always connected” life in 2017. I am almost always accessible, but it quickly becomes apparent that if I do not decide on what the appropriate limits are for that availability, it will most assuredly be abused. Limit setting is key.

So, the bottom line is, in this day and age, to say that I never got the message from my coworker about the patients who needed medications called in, or that I had not checked my voicemail one single time during the Christmas holiday would simply not fly.

If I put myself out there as available and willing to respond, then I must make good on that promise, build trust that I will do what I say I will do, and allow my patients and coworkers alike to benefit from the trust that builds over time.

In 2017, there is simply no good excuse to do otherwise.


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