I was visiting the emergency room of one of my former hospitals. I was looking for a particular nursing instructor, who used to work there. I walked up to a male nurse.
“ Excuse me,” I said, “I’m looking for a nursing instructor. She teaches and oversees the Patient Care Technicians (PCTs).”
“What is her name?”, he asked.
“ I don’t remember it,” I replied, “But I worked with her about 6-7 years ago. So she must be working here for about 10 years.”
He paused and replied, “Ten years??!! No I’m sorry. We don’t have anyone working in the ER who have been here for 10 years.”
I’m surprised. I always thought retaining good people was important. At one of my former hospitals, they (either Administration or Human Resources) would calculate the average retention rate for every department. They did this by adding up everybody’s years of service in the department and dividing it by the number of people in that department. Then every year or six months, I would review this retention rate and see if it improved. If it didn’t, I would have to provide steps to make it better.
It really wasn’t more than an exercise (sometimes in frustration), but nevertheless I did it.
Every employer has some turnover. However, in today’s market, I don’t think employers do everything possible to retain good people.
My dad worked in the same school system for 39 years. He started as a teacher, became a guidance counselor, became an assistant principal, and finally, a principal. As I stated, all in the same school system.
In my 39-year career, I worked in 6 different systems, which included 4 hospitals and 2 schools. I’m not unique. This is the norm. In today’s society, few people stay in the same job or system for a long period of time.
Is it necessary to retain good employees? Most employers might say “yes”, but they do certain things that make employees leave. Here are several factors that employers must do to retain good employees.
1.) The Need for Money
“Money isn’t everything— it’s the only thing.”
When I worked for a career school, I used to downplay money. I would tell the student to take a job regardless of how low the salary was. I would tell the student to work for several months and get some experience. They the student should get another job with a larger salary and quit.
This is great for the student. But for an employer who has to hire, train, and eventually lose an employee, this is not so good. However, most employers set themselves up for this turnover failure.
By paying a low salary, the employer literally encourages the employee to leave when another job with more money comes around.
Now I’ll admit that it’s tough to justify paying a huge salary to someone who is just starting out with no experience, but consider the following:
I worked with two employers. The first employer hired new grads (with no experience) for $11/hour. The second employer hired new grads for $18/hour.
In which facility is a grad more likely to stay? Obviously, the second employer has a better chance of retaining the good employee.
2.) The Importance of Probation
When I hired a new employee to work in my hospital pharmacy, they were immediately put on probation. They didn’t do anything wrong!
There were three negative aspects about my hospital’s probation status. These were
- A new employee could be fired for any reason or no reason at all.
- A new employee was paid 10% less until they were no longer on probation.
- A new employee was not eligible for holiday pay. If they worked a holiday they did not receive an additional day off. Also, they had to use their personal time bank or a weekend day off to be off on a given holiday.
I felt that probation should be more that just a bunch of negatives. I made certain that my version of probation, addressed the following aspectsA
Competency involves the following two things:
- Can the new employee perform the job?
The answer should be “yes”. If not, the new employee should not have been hired.
To better determine a new employee’s skills, I developed a checklist for every position in my pharmacy department. This was not an evaluation of how well they did their job, but instead, if the new employee was capable of performing certain pharmacy tasks.
The new employee would be observed by myself, a supervisor, or another staff member who would check off the various pharmacy tasks and sign the list.
2. Is the new employee’s critical thinking acceptable?
A new employee pharmacist was assigned the task of checking premixed IV solutions. It was his job to affix a patient label with the name of the product to the commercially prepared solution.
After several of hours of work, the pharmacist approached me. He stated that “something didn’t seem quite right.” He said that he wasn’t sure if he was performing the task properly. However, he didn’t want to bother anyone. So instead of asking and clarifying the situation, he continued completing the task in the way he thought it should be done.
He was fired that afternoon.
Pharmacy is a unique profession. Mistakes can result is serious consequences.
It is essential for my staff (old and new employees) to have outstanding critical thinking skills. Thus, when performing any task that “didn’t seem quite right”, it’s necessary to stop and ask for assistance.
I was in the IV room with one of my pharmacy technicians. We were calculating a medication to be added to an IV solution. I was performing the calculation manually, and wrote “265/83” on the page.
Before I used a calculator, I estimated the answer would be 3-point something. The technician, on the other hand, picked up her calculator, and punched in the numbers.
“15.6,” she said.
“No, try again,” I replied.
“No, I got 15.6,” she said as she waived the calculator in front of me.
“How did you get 15.6?” I asked.
“ I divided 265/83 and got 15.6”, she replied.
I don’t know what frightened me more. The fact that she thought that 265/83 was 15.6 or the fact that she had so much faith in what the calculator said.
My pharmacy was filled with technology. I had machines that selected medications, prepared IVs, and calculated doses. These devices did provide the right answer most of the time. But they were only as accurate as the people that operated them.
This is why I told my staff that they must not become complacent. Our technology makes life easy by providing answers in a prompt manner. But my staff should not always rely on the answers that these devices provide. Instead, they must think about the answer they receive to see if it makes sense.
Imagine a new employee starting the first day of their new job. They’re encouraged to ask questions. So they do. At first, its viewed as a positive thing. After all, they’re new people; they ask questions because they want to learn.
But as their questions continue, it becomes exasperating. Staff members try and avoid the new employee. Managers begin having their doubts. Maybe these new people aren’t as good as they seemed to be. Because if they were, they wouldn’t ask all these questions.
As the day wears on, the new employee’s questions becoming more and more annoying. By now it’s a complete turnoff for everyone. In fact, by the end of the day, since the questions persisted, the new employee was terminated.
This actually happened.
I was a career services representative for a school. One of my medical assistants was starting a job in a doctor’s office. She was a very good student and knew her stuff. That’s why she was surprised when she was terminated at the end of her first day.
As she explained, “They encouraged me to ask questions. So I did. I wanted to know everything. At first they were very receptive. But soon they became very irritated. After a while they were ignoring me. I decided to stop asking questions. But I guess it was to late. They already formed a negative opinion about me.”
She continued, “ At the end of the day, the doctor called me into his office and said they wouldn’t be needing me anymore. I was devastated. I only asked questions because they told me to.”
My pharmacy encouraged new employees to ask questions. This was seen as a learning experience and a way for the new hire to gain knowledge. Each and every question was welcomed and answered in the best manner possible. In addition, new employees were never judged by the amount of questions they asked.
In my hospital pharmacy, I provided each new hire with a form about their probation. The form listed the hospital’s rules. It also discussed 1) competency and critical thinking, 2) complacency, and 3) the need to ask questions. By being up front about probation, we retained good pharmacy personnel.
3) The Illusion of Training, but...
The best training session I ever attended was when I learned Microsoft Excel. I had about ten people in my class. Each student had their own computer with the latest version of Microsoft Excel.
The instructor used a workbook and and overhead projector to demonstrate different aspects of the program. I used these concepts to create an Microsoft Excel spreadsheet on the computer.
It was truly a hands-on experience.
I have my doubts about today’s training. I feel it’s done improperly. Most times, training occurs when we throw a massive amount of material at someone in a short people of time. Then we expect them to be experts and are disappointed when they’re not.
New hires must be trained properly. They must be trained in the proper setting on the actual equipment that they are going to use. Furthermore, they must be given ample time to absorb the material. If not, new employees may not learn the information properly. They may become frustrated and eventually resign.
3.) ...Thou Shalt Not Cheat
I found a job for a student who was a pharmacy tech graduate. It was a pharmacy associate position in a chain store pharmacy. She started as a cashier in the cosmetics department. However, she was promised that she would be moved to the prescription department once she completed her training.
Her training consisted of twelve computer videos each about thirty minutes long. Following each video, she was required to pass a test regarding the material presented. The videos could not be viewed at home, but only on the computers at work.
The store was extremely busy. Quite often, it was difficult for her to find time to watch and complete the training videos.
I went to see her six months later. She was working in the store’s prescription department. We met after her shift.
“I’m working in the prescription department”, she said, “ And I’m really annoyed.”
“Why?”, I asked, “Isn’t that what you wanted?”
“Yes,” she replied, “But I’m making far less than any of the other pharmacy technicians that work back here in the prescription department.”
I was surprised.
“Why is that?” I asked.
“Because they’re cheating,” she replied, “ You see, I’m still a pharmacy associate which has a lower pay scale than a pharmacy technician. So when it gets busy in the prescription department. They move me here. I do the work of a pharmacy technician, but I don’t get the title or the money.”
“Why not?” I asked.
“Because I never finished my training” she said, “The video training can only be completed at work and they won’t schedule me any time to complete them. So I end up working in the prescription department as a pharmacy associate for less pay.”
A month later, the pharmacy graduate quit her job. She got a new position as a pharmacy technician for more money.
The chain store was devastated. But it was their own fault. They created an impossible training session that pigeon-holed their employees into positions of lower titles and salaries. Then they cheated and had them work in the more qualified jobs.
4.) The Concept of Employee Rewards
My boss wanted to motivate myself and her staff.
“If we hit 70%,” she said,” I’m going to the spa and get free massage tickets for everyone.”
I never needed rewards to do my job. But if you’re going to try and motivate me— I prefer extra money or time off. I don’t find free massage tickets an incentive.
I managed over 70 employees in my pharmacy. I prided myself in knowing what each person wanted. I found it very easy to motivate my staff. I also found it very easy to reward them as well.
Most of my pharmacy employees wanted to feel appreciated. They wanted to be treated with respect. They wanted to be acknowledged for a hard days work. A simple “thank you” meant a lot to my staff.
I was always very busy in my role as Pharmacy Manager. But, I made sure that my staff members knew that they were always appreciated. From the first day that they were hired, I always pointed out the good things that they accomplished.
In one of my other articles I stated that hiring an employee is a long, tedious process that generally takes several months from start to finish. One does not want to go through this process a second time (and sometimes one may not be allowed to go through the process a second time).
But retaining a good employee, once they have been hired, is just as important. An employer must do everything possible to keep good pharmacy employees. This must be done not only for a few months, but for the long term as well.
Daniel Shifrin, R.P., M.S. is a recently retired pharmacist who enjoys sharing his insights about hospital pharmacy. He is proud to own one of the largest collections of Pharmacy Stamp First Day Covers.