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Hospital leaders: Show your gratitude to front-line staff

February 13th, 2013

by Thomas Dahlborg

I recently had an opportunity to be a healthcare customer and, like each other time, learned a great deal.

As my wife and I entered the facility and got in the long check-in line, we noticed a packed waiting room of nervous patients. Upon arriving at the glass "bank" window that separated the check-in employee from the patient, I was coldly handed some paperwork to complete and directed to find a seat.

My wife and I eventually did find a couple of empty seats and again made note of the number of people gathered in mass for the same procedure. Part of me said, "Great, clearly this is the place to be." They perform high volumes of this procedure and thus must have perfected the process.

This thought did not last long.


A harried worker rushed into the waiting room and called out, "Christine? Is anyone here for Christine?" At this, an older gentleman got up and said he was here for Christine but she had just gone in ... is she okay? The employee stammered, looked around, put his hand through his hair and eventually realized and shared that this was actually the wrong Christine. He then proceeded to share details of both "Christines" within earshot of all in the waiting room.

Eventually my name was called and I followed a nurse into her office for a pre-procedure check in. She checked my blood pressure, asked questions and collected responses. She then complained that this may take some time because "the EMR does not allow for an easy way to insert responses." I told her I understood and not to worry as I was not going anywhere.

Interestingly she stopped, took a breath, looked me in the eyes for the first time and said, "Thank you, you are very kind," and apologized for the delay.

We continued our sharing and once all information was gathered and loaded she put her hand on my elbow and escorted me to the pre-op holding area. She was very kind; once I was settled she made sure I was warm, had all I needed, and then a second time thanked me.

I waited in the holding area for quite some time and eventually the waiting room employee came in to set up my IV. He made little eye contact and appeared quite distressed. I eventually made eye contact with him and simply said "You seem really busy. Is this the norm? Are you okay?"

And much like my nurse he slowed down, took a breath and shared that today was another very busy day and he was having trouble catching up. He shared and we discussed his challenges and I empathized.

He then set up me my IV perfectly and I thanked him and let him know how much I appreciated his help. He looked up, made eye contact again and then quietly asked me if there was anything else he could do for me. At this point my nurse came back and also asked if I needed anything and then put her hand on my foot, smiled lovingly, and gave words of encouragement.

I have written a number of blog posts specific to the importance of trusting, honoring, caring, empathizing, listening, leading and serving front-line staff. And through this patient experience I have further seen the effect of not doing so.

What I witnessed was the nurse and the individual who helped me with my IV were both caring front-line workers who were on autopilot and disconnected from themselves, their passion for healing and their patients.

I also found these healers needed to hear "thank you." Thank you from a patient in this case, but even more so to hear thank you (and feel gratitude) from their leadership both in words and in actions.

They need healthcare leaders to lead and to serve. To listen to the challenges they are facing and collaboratively develop solutions to address them. For leaders to care and say thank you and together truly fix the broken healthcare system.

Thomas H. Dahlborg, M.S.M., is vice president for strategy and project director for the National Initiative for Children's Healthcare Quality (NICHQ), where he focuses on improving child health and well-being.


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