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How would you handle these prickly management problems?

Laboratory managers must constantly attend to complex personnel dilemmas and other sources of grief. Test your managerial skills on the tough situations presented here.

YOU ARE the lab manager at Barnegat Bay Memorial Hospital (BBMH) in suburban New Jersey.(*) Having just returned from a weeklong management conference, you stop off at the lab on Saturday morning to get a jump on Monday. Glancing through the mail and messages piled high in your in-box, you see that Monday is going to be a very bad day.

Some painful situations have materialized in your absence. Your hospital administrator wants you to investigate an allegation that your laboratory is responsible for medical waste washups. A sales rep hopes to bribe you into purchasing his analyzer. Various parties have made written complaints about questionable test results, rude employees, sexual discrimination, and Bible studies conducted in the workplace. Staff friction seems to have reached an all-time high.

Does this sound like the real world of clinical laboratory management? You bet it does. Unfortunately, management textbooks rarely teach us how to handle such tough situations. Yet a poor decision may hurt our facilities--not to mention our careers.

* Your assignment. This article constitutes a clinical laboratory manager's in-basket exercise. In puzzling over realistic situations, you'll be forced to examine your management style and principles. When you have completed the assignment, ask yourself whether your techniques need rejuvenation.

Pretend you are lab manager Maria Rodrigues riffling through her problem-ridden in-box. Read all the correspondence first. Decide which problems to handle directly and which to delegate. Place those you'll deal with yourself in order of priority. Then develop a workable solution for each. Will you answer by memo, telephone, or meeting? Whom will you contact first? Will you consult your institution's personnel department, legal counsel, or other resources, such as a union committee.

Following the usual rush for decision making, complete the exercise within two hours. If you wish, share your impressions and solutions with colleagues. Since there are no right and wrong answers, none will be provided in this article.

* Reaping rewards. One of the toughest challenges of being a manager is to devise workable solutions to difficult problems in a short time. While this responsibility has drawbacks, the ability to touch others' lives and initiate dramatic changes in the workplace can also lead to intellectually stimulating and rewarding days.

A number of successful workshops have been held with these materials. Groups of six to eight are seated at round tables and provided with paper, pencils, and paper clips. Each item is discussed until consensus has been reached. A different person is then designated to present to the entire assembly the group's response to each problem. This arrangement provides an opportunity for public speaking as well as group dynamics and negotiation--all important management skills. The entire program is limited to three hours. During the presentations it soon becomes apparent that many good solutions may be found for the same problem.

Experienced managers as well as laboratorians who are in line for promotion to management would do well to examine their responses to the kinds of prickly situation they may face one day--and learn how not to get stuck.

* Background. Before you begin, review some background information about your employer. BBMH is located in Jakes Branch, N.J. Hospital business expanded rapidly with the town when casino gambling came to nearby Atlantic City in the 1980s. The new business brought an influx of service workers to the area, many of minority races. Affordable housing caused this small town's population to swell almost overnight.

When medical waste splashed over the New Jersey shoreline and national front pages in the summers of 1988 and 1989, the local economy began to suffer. BBMH, which had grown from 109 to 260 beds in a decade, now started to lose money. The hospital is now taking major steps to modernize management and cut costs. A personnel consultant has advised administrators to hire more women and minorities in middle and upper management to reflect the community's ethnic diversity. This direction, along with your talents, led the hospital to hire you, a Hispanic woman.

The structure of your laboratory is simple. Reporting to you are three section chiefs (in microimmunology, chemistry, and hematology-blood bank-coagulation), one chief technologist, and 50 full-time equivalents. The laboratory's pathologist director concerns himself with few administrative duties but provides medical information when needed. Starting with you, here are the three key players:

Maria Rodrigues, M.H.A., MT(ASCP), laboratory administrator. The fourth daughter of an impoverished couple who moved from Venezuela to Union City, N.J., in the 1950s, you worked hard (on scholarship) to earn a B.S. in medical technology and professional certification. At your previous place of employment, a large urban hospital, you were promoted to assistant lab administrator. Your sights high, you obtained a master's degree in health care administration at night. After a divorce two years ago, you have been raising your daughter, now age 10, on your own.

You answered a classified advertisement in MLO for a position as laboratory administrator at BBMH and won the job--a new position created upon the departure of a chief technologist of 23 years' standing. Your first mandate was to increase laboratory profits and efficiency. After only six months you have made substantial headway.

Charles T. Applegate, chief technologist. Charlie received his training in the Army during the Vietnam War. The son of a prominent local citizen--a former mayor and former member of the hospital's board of trustees--Charlie thinks of himself as having come from "the old school" of experience. He bitterly and publicly opposes the promotion of medical technologists holding what he calls "fancy degrees" above those with hands-on experience only. The state allowed the laboratory to grandfather Charlie as a supervisor despite his limited formal education.

Charlie openly takes extended breaks and lunch hours. He makes it clear that he resents reporting to a Hispanic boss, especially a woman. At every opportunity he undermines your authority. For Charlie, who was probably a good worker 20 years ago, complacency has given way to apathy and poor performance.

Donald J. Woods, MT(AMT), section chief, chemistry. Don was promoted to his current position soon after you arrived. Like Charlie, Don was trained in the Armed Forces; however, Don passed the HEW test some years ago and later received MT(AMT) certification. He is completing a bachelor's degree at night.

Don likes to get things done. He felt stifled during Charlie's tenure but thrives under your leadership. He recently restructured the chemistry section, which is functioning better than ever. Charlie feels threatened by Don and tries to undermine his authority, too.

Don shares his strong religious beliefs with others whenever the chance presents itself. Most of his staff now attend services at Don's church and participate in his Bible study and prayer sessions during lunches and breaks.

Now face your in-box, starting on page 25, and take action.

* All institutions and persons named in this article are fictional.

Dr. Brown, a member of MLO's Editorial Advisory Board, is director of microbiology, health, and environmental affairs at Roche Biomedical Laboratories, Raritan, N.J. Johnson is regional technical training coordinator at Roche Biomedical Laboratories, Burlington, N.C.
COPYRIGHT 1992 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1992 Gale, Cengage Learning. All rights reserved.

Article Details
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Author:Brown, James W.; Johnson, Lisa G.
Publication:Medical Laboratory Observer
Date:Nov 1, 1992
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