Decision Making Has Always Been In My DNA — Regardless If I Have The Right To Make The Call

by | Aug 4, 2023 | Blog, General, Professional Skills

I was in management for over thirty years in my hospital’s pharmacy department. I made a lot of key decisions. 99% of the time; they were good decisions. However, I’d be the first to admit that I had a few bad ones.

When I left my last hospital, I got a job in a career school. I taught students to become pharmacy techs. I was also a career representative that helped students with things like writing resumes and preparing for interviews. This enabled my students to find a job.  I worked in the career school for eight years.

As an instructor in one department and a career representative in another, I was a staff person in each of these departments. Both areas had managers make important decisions that guided the departments.

 But I was a staff member- not the manager. It was my boss (the manager) who ran the department. I soon realized that it was hard to go from the management mentality to the staff member mentality. It was tough to change mindsets.

I’m very analytical in nature.  I’m a very logical person. I try to see things from all sides before making a decision. I also try to see the big picture. I always tried to figure out how my choices would affect not only what happened today but how they would impact events several months from now. That’s why I was very successful during my career as a pharmacy manager.

There were times while I was working at the career school that a decision had to be made.  At those times, my boss made the decisions— all the decisions.  I didn’t always agree with my boss’s decisions. It wasn’t the choice that I would have made had I been the boss. But I wasn’t the boss. And it wasn’t my judgment to make.

But as a previous manager, it’s tough to get out of that mindset. So I kept telling myself,  “I’m not the manager. It’s not my decision. It’s someone else’s decision to make

Calling To Help The Patient

My second pharmacist job was at a hospital.  I was there for eighteen years.  I enjoyed working at the hospital.  I’ll admit it had its moments.  But it was a good place to work.

The hospital was ahead of its time.  We performed innovative procedures.  The physicians provided their patients with cutting-edge therapies quite often found in the literature and not necessarily in the package insert.  These therapies were performed by these doctors long before they became commonplace.

One afternoon, the chief physician of the neonatal intensive care unit (ICN) came to the pharmacy. Since my boss was out that day, I spoke to the doctor. The doctor had a patient and his family with him.  The patient was a nine-year-old boy.

It seemed that this family just came from Europe— Switzerland, to be exact. The boy had been treated in Switzerland and our doctor had unique treatment protocols to treat him in the United States. The patient and his family did not speak any English. They only spoke French. But this was a Swiss version of French (Swiss French) as opposed to a more common French dialect.

The doctor explained the therapy which he was going to use to treat the patient.  He was going to use medications approved in the United States. But he did have several vials of the drug used to treat the patient in Switzerland. He also had the drug’s package insert. Unfortunately, both the vials and the package insert were written entirely in the “Swiss French” language. The doctor didn’t speak Swiss French. Neither did I. No one on my staff did either. Thus, it was impossible to interpret what these things said. The doctor wanted to know if I could get him any information about the medication.

I took the package insert and vials from the physician and examined them. As I stated, they were written entirely in Swiss French so I couldn’t read them. But at the bottom of the package insert, I noticed a logo.  It looked like the logo of a well-known pharmaceutical company.  I looked up their phone number and decided to call the company on the phone.

I was transferred from department to department a couple of times. Eventually, I spoke to a woman in the company’s medical library department.  She wasn’t very helpful. But she did give me the phone number of the company’s corporate office in Switzerland.

I called Switzerland. I was transferred around a lot from person to person.  The problem was twofold— first, they needed to connect me with the correct area. But second, I spoke English, while they spoke Swiss French. No one could understand what I needed.

Finally, I was transferred to a man in the Research and Development Department of the pharmaceutical company.  I was thrilled! The man who answered the phone understood everything that I was saying. He spoke perfect English.

He told me about the medication, as well as stated what was written on the vials. He was also going to send me a new package insert for the drug (in English). He asked for my fax number. Ten minutes later, the English version of the package insert arrived at my machine.

I gave the information to the chief physician.  He was ecstatic and quite impressed. He didn’t expect that I would call Switzerland, let alone be successful in getting him what he needed.  He stated that this would greatly help his patient.

The next day, I went into my boss’s office to let him know what happened.  As I sat there reciting my story, my boss sat quietly and listened. Eventually, I got to the part where I said, “I called Switzerland.” 

My boss stopped me right there and said, “You called Switzerland?”

“Yes,” I responded.

“Okay,” he replied.

At first, I thought he was amused that I (or anyone) would decide to call Switzerland. But thinking back to that day, I said it so matter of factly that I think he sort of expected that this was something that I would do. Because that was always my style, this was the type of decision I made when I was in charge.

Volunteering At The Information Desk

I volunteer at one of my former hospitals now. I’ve been volunteering ever since 2018. I help out at the hospital’s information desk. When a visitor arrives at the information desk, they are either going to visit a patient or they have an appointment. If they’re going to visit a patient, they get in line. Then when it’s their turn, they get directions and a pass to visit their patient.

There are also those visitors that have appointments at one of the hospital’s departments. These departments include neurology, speech & audiology, admitting, medical records, dental clinic, etc. Many visitors do not know how to get to these areas for their appointment. It’s my job to assist them. Thus, I walk them to the various departments.

Being a volunteer at the information desk is basically a stress-free position. I really don’t have to make any major decisions. Therefore, I leave all the decision-making capabilities up to the three women that man the information desk. I generally abide by what they say because they are responsible for running the information desk. They make the decisions— not me. But there were times when I wished that I made the call.

Like the time a man and woman came wanting to visit a patient. The couple had gotten a call from the chaplain. The chaplain wanted them to come to the hospital immediately because the woman’s mother (the patient) was dying. Getting through the line and getting a visitor pass doesn’t take more than ten minutes. But I thought the procedure should have been circumvented because of the extenuating circumstances. I was even willing to walk the couple upstairs to the nursing unit.

One of the workers behind the desk said, “No.” She said that everyone had to wait their turn and get a visitor pass. That was the rule. I didn’t agree with her or the rule. However, I said nothing because it wasn’t my decision.

Having My Decisions Overruled

It’s tough when my decisions aren’t honored. I’m used to stating what action needs to be taken and then having others listen and follow my choices. But as I drifted out of the management realm, other people assumed the authority to make the calls. I didn’t always agree with their decisions. I listened, but it wasn’t the way I would have done things. However, I learned to live with it, but I wasn’t happy.

I remember when I was asked to be on a hospital committee after I had retired.  It was a group that wanted to improve things for the patient and their families. One of the topics on our agenda was seeking new members for our committee.

I came up with the idea of having a table near the information desk. In addition, each of the current committee members and I would take turns standing by the table for an hour or so. This way, we’d pitch our committee’s benefits to visitors as they entered the hospital. We’d also be there to answer any questions as well. I felt this would be much more personal than having just a table with brochures on it

I was overruled. The chairman of the committee decided to go with an idea where the brochure would be reproduced on a large screen TV that sat in the corner of the lobby. He hoped that passersby would be drawn to the TV screen, and that would create interest. It’s been several weeks after the meeting and this still hasn’t been done.  In fact, nothing has been done.

Expecting the Joint Commission

The Joint Commission (JCAHO) was coming to inspect my hospital.  JCAHO is a regulatory organization that grants accreditation to healthcare facilities. They perform a hospital-wide inspection. This can be very stressful for every person in the facility.

I always prepared a lot for the JCAHO inspection. I educated my staff. I made sure my policies and procedures were up to date. I ensured that everything was being done properly. Between the work and the cleaning, it was always challenging to get ready for the JCAHO inspection. But since I’m now only a volunteer, I have no responsibilities as far as getting staff members ready for the inspection. However, it’s kind of fun watching everyone else go crazy! 

The JCAHO inspection usually occurs every three years. That being said, to me it made more sense to do things over the three-year period rather than waiting for the last month. However, the cleaning had to wait until the last minute. But as I said, it’s kind of fun watching everyone go crazy. I couldn’t believe we had housekeeping people clean the tops of the Purel dispensers in the hallway!

Prepping My Staff

When I was pharmacy manager, the JCAHO inspectors questioned staff people. They asked them standard operating procedure questions to see if their answers were consistent. As I stated, I am not a manager. It’s not my job. But I decided to ask the women at the front desk some fire safety questions.  (After all, you can take me out of the manager position, but you can’t take the manager position out of me.). 

Of the four women, none of them knew the location of the nearest fire extinguisher or fire alarm pull box. I also asked each woman who they would call to report a fire. I felt this was a fair question. However, I was disappointed when I received four different answers. I don’t know if I found it more disturbing that they didn’t know or that someone didn’t prepare them properly.

But as I’ve learned to say, “I’m not in charge. I’m not the boss. It’s not my job!”


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