Ready for Work

Chapter 2


Ready for Work



Themes to Consider



image Act and look like a health care professional.


image Become someone other people look forward to seeing at work.


image Understand how your appearance affects your success.


image Fit in well with a variety of different people.


image Represent your employer to its customers.


image Develop self-reflection to change your habits and improve your performance.



Modeling Business Etiquette



Sticks and stones may break our bones, but words will break our hearts.


—Robert Fulghum





The Purposes of Business Etiquette


The first purpose of business etiquette is customer care. To each and every client or patient or family member with whom you interact, you are the facility you work for. Much of your customers’ judgment about your employer will be based on their judgment of you.



image Journaling 2-1


Recall the last time you sought health care, whether at a walk-in clinic, a dentist’s office, or a physical therapy appointment. Describe your impression of the facility. Recall the workers you interacted with. How were you treated? How did these interactions contribute to the overall impression you have of the facility?


The second purpose of business etiquette is to do your part to make your facility a great place for you and your colleagues to work. A sense of business etiquette contributes to the smooth flow of operations in an environment that is often stressful and chaotic. Business etiquette contributes to clear communication, mutual support, and, ultimately, the delivery of quality health care. This requires flexibility and open-minded acceptance. For example, today’s workplace is comprised of four generations (discussed more thoroughly in Chapter 7). You have to be able to step outside of your own generation and interact professionally with people of all ages. Aside from people of different ages, you will likely encounter clients and colleagues from dozens of different ethnic, national, and cultural backgrounds.




Skills to Improve Your Business Etiquette


Conversation at Work


The “rules” of polite conversation are pretty much the same at work as anywhere else. In health care, where people work closely together, and the pace of work can vary, conversations about nonwork topics are not only common but also practical. Conversation builds relationships and makes work more enjoyable and rewarding. Much of the richness in life has to do with the quantity and quality of friendships you have in your life, and conversation is the fabric of friendship.


Unfortunately, many people don’t have good conversation skills because they have never worked to develop them. Virtually anybody can become a better conversationalist by mindfully following a few strategies and techniques. For instance, paying someone a compliment is a great way to start a conversation. Then, ask questions and take a sincere interest in the answers. Ask “open-ended” questions that can’t be answered with a simple, conversation-stalling yes or no. To ask open-ended questions, take Kipling’s advice:



I keep six honest serving-men


(They taught me all I knew);


Their names are What and Why and When


and How and Where and Who.


—Rudyard Kipling


Interestingly, people rate others who actually speak very little as good conversationalists. That means that good conversationalists are good listeners who ask a few good questions. People like to talk about themselves if they have an interested listener. It works the other way around too. When you are asked an open-ended question, don’t be afraid to reveal something about yourself. This “self-disclosure” is the kind of back-and-forth that creates friendships. When you open up, trust develops and friendships form.


If you have a sense of humor, use it. Sometimes it is hard to know whether it is appropriate to joke around, but you can always test the situation by using a little self-deprecating humor, which will never offend anyone. You should also reflect on topics you know about, so you always have something to talk about, and more importantly, to ask about. Common conversation topics include books, movies, sports, travel, food, music, and hobbies.


At work, however, it is inappropriate to discuss controversial issues. Avoid topics such as politics, religion, immigration, abortion, or divorce.



Respecting Professional and Personal Titles


We may live in a free and equal society, but business etiquette demands that we honor each person’s rank, status, and accomplishments. Nowhere is this more apparent than in the etiquette of introductions. In health care settings, where professionals work in teams and patients are usually new to the maze of professionals they encounter, it is important to know how to properly introduce people to one another. In fact, this is such a rarely seen skill that, if you can master it, your ability will mark you as a person of refinement and excellent manners.



Professional Titles

Physicians, of course, should always be addressed and introduced as Doctor. In our society, physicians and surgeons are always accorded the title of Doctor. Even if you are on a first-name basis with a physician, you should still refer to her and address her as Doctor at work.


In fact, any health professional who has earned a doctorate degree in his or her profession should be addressed as Doctor, unless he or she directs you otherwise. Thus, an audiologist with a PhD or AuD, a nurse with a PhD or DNSc, and a Respiratory Therapist with a PhD should each be called Doctor. You can always clarify the role of a doctorally prepared health professional to a patient by explaining the person’s title or role. You can say, “Dr. Appleton is the Assistant Director of Nursing here.” Or, “Dr. Loring is one of our Anesthesiologists.” Or, “Dr. Harris manages the Speech Therapy Department.”


Needless to say, when you are introduced to someone with a Doctor in their name, whether the person is a physician or any other doctorally prepared health professional, they may use their first name in their response, but that is not usually an invitation to call the doctor by his or her first name. If you are introduced like this:


“Dr. Tolland, this is Jim Holtz, the new Medical Assistant,” and she says, “Hi Jim, I’m Monica Tolland. Welcome aboard,” you should assume that she is just being friendly and is not inviting you to call her by her first name, unless she specifically says so. You should reply, “Thank you, Dr. Tolland. It’s nice to meet you.” If that is where it ends, then she is Dr. Tolland to you. See Figure 2-1 for a diagram on appropriate uses of titles.


image
FIGURE 2-1 Professional and personal titles.



Making Introductions


The main rule about introductions is that you introduce the most important person, or the person with the most authority, first. Gender and age do not matter. However, you must remember this: The client or the patient is always the most important person. So when a client or patient is involved, you say:


“Mr. Adler, this is Dr. Berthold, the physician on duty today. Dr. Berthold, this is Saul Adler.”


“Ms. Christy, this is Ms. Izzo, the Radiologic Technician. Ms. Izzo, this is Callie Christy.”


When a patient is not involved, you revert back to the rule of the person with the highest title being introduced first, and say:


“Dr. Apollo, this is our new Surgical Technician, Sue Hale. Sue, Dr. Apollo is the Chief Resident.”


Custom puts physicians and surgeons at the top of the status hierarchy, so introduce them first, even if the other person holds a doctoral degree, and say:


“Dr. Yang, this is Dr. Harold Reading, the new dentist for the clinic. Dr. Reading, Dr. Yang is a neurosurgeon here.”


“Dr. Harvey, this is Dr. Bette Ringden, the Psychologist from the patient’s school. Dr. Ringden, Dr. Harvey is our Psychiatrist-in-Chief.”


This elegant way of introducing doctors enables the physician to choose whether to address the other person as Doctor, which gives the other person the opportunity to state their naming preference.


Very often, the circumstances will prevent you from making the full introduction. You may start out by saying:


“Dr. Hamid, this is Dr. Randall Whitaker, our new epidemiologist,” and Dr. Hamid may jump in and say something like, “Hi, I’m Noori Hamid. It’s nice to meet you, Dr. Whitaker.” At that point, you have done your job, and you can let the newly introduced people settle on protocols for titles and first names.


When you introduce a patient to a doctor correctly, the rest of the introduction is out of your hands. If you say:


“Mr. Quirk, this is Dr. Clark, one of the Primary Care Physicians,” and the Doctor interrupts to say, “Hi, Mr. Quirk. Bob Clark,” and the patient says, “Nice to meet you, Bob,” it is acceptable to move on.


Introductions can be confusing at times, mainly because most people are over-eager to make a good first impression. Protocols for making proper introductions are summarized in Box 2-1.



Box 2-1   Protocols for Introductions





image What If?


1. What if you have to introduce someone, but you are not sure of their title or role?


2. What if you have to make an introduction, but you forgot the name of someone you are supposed to know?


3. What if a colleague’s name is difficult?



Reliability in the Workplace


Can people count on you? Can you accomplish tasks on time and discreetly? For one thing, punctuality is absolutely essential in health care. The whole operation depends on getting things done on time. Health professionals and patients usually work on an appointment basis, and colleagues who have put in a full shift expect to be relieved on time. However, punctuality is not simply a matter of arriving on time. For example, many tasks have to be performed on a strict schedule. Vital signs may need to be taken at precise intervals. Input and output charts have to be maintained on a careful, timely basis. Meals are usually served at specific times. Breaks are scheduled to ensure a smooth workflow while giving every employee a break from their routine.


In addition to punctuality, discretion and confidentiality are essential to the practice of health care. The HIPAA law of 1996 requires that certain private medical information (PMI) be kept confidential, encoding in law what has always been an ethical responsibility for health care professionals. To protect your patients’ medical information, file medical charts promptly and keep them away from anyone not directly involved in the patient’s care. It is completely inappropriate to talk about a patient in a public place, inside or outside of your health facility. Whether in an elevator, walking down a corridor, or having lunch in the cafeteria, do not use the patient’s name in conversation.



Little Courtesies


The simplest acts of courtesy can create a positive impression and attract people to you with very little effort. For example, a smile and a handshake are among the most open and welcoming gestures you can make. Similarly, saying please when you ask for something, whether it be information, some help with a task, advice, or some teaching, is all it usually takes to get positive results. Afterward, thanking people for their help makes them glad they gave it, solidifies relationships, and paves the way for future help.


Another easy gesture of courtesy that can go a long way is that of addressing people by their name occasionally when you are speaking with them. Don’t overdo it, but don’t neglect names either. Dale Carnegie, who wrote How to Make Friends and Influence People, said that no sound is more pleasing to a person than the sound of his or her own name.


Next, you can earn a lot of respect by simply developing the habit of picking up after yourself and others. Health care facilities generate many little puddles of disorder, whether they are unfiled medical records, rain tracked in through the main entrance, or the leftovers from a medical procedure or treatment. You don’t need to be the custodian, but everyone will appreciate your effort.



Practice random acts of kindness and senseless acts of beauty.


—Anne Herbert


Practicing random acts of kindness and paying it forward are two concepts from popular culture that express the idea that, if you do something nice for someone with no expectation of ever being repaid for it, two things will happen. First, the world will be a better place. Second, good things will come back to you. At work, your kindnesses will make your workplace a better place for everyone, and your reputation for kindness will repay you in ways unexpected and deeply rewarding.



When Someone Is Having a Bad Day


Let’s face it. Some days will be tougher than others. It doesn’t matter what is causing the bad day, whether it is a personal problem or a troubling issue at work. What matters is how you respond on these occasions.



Smooth seas do not make skillful sailors.


—African Proverb



Tackling Your Own Bad Days

If you are experiencing a bad day, you can try several strategies for maintaining a positive, professional approach at work:



* Let work be therapeutic for you. Even on the worst day, there are many positive aspects of work, such as the people you enjoy seeing, or specific activities you like tackling. Consider throwing yourself into your work as a means of shoving your other problems and concerns to the back of your mind.


* Act “as if …” Even if you don’t feel like it, act the way you wish you felt. Act as if you are friendly. Act as if you are enthusiastic. Force yourself to smile. Chances are that your mood will get swept up in the act, and your day will go better.


* Stop and reframe. Cognitive psychologists urge people to reframe their outlook to gain a new perspective. Can you reframe your perspective on your problems by imagining how much worse they could be? Can you make a problem smaller in your mind by telling yourself that you will deal with it little by little until it’s solved, just like the vast majority of problems you have ever encountered? Can you put the problem out of your mind by telling yourself that there is nothing you can do about it while you are at work, and you will confront the problem later at an appropriate time? If the problem is a work-related conflict, try simply resolving to take the high road rather than engage in disputes that are likely to be both petty and short-lived.


* Practice mindfulness and relaxation techniques. Every time you have a quiet moment, close your eyes and take some deep breaths to clear your mind. If you are feeling irritable, pause before you respond to someone and choose your responses thoughtfully. Without sharing too many details, explain to your co-workers that you are having a bad day and appreciate their understanding.


Finally, realize that bad times don’t last forever and resolve to make the next day better.



image Journaling 2-2


Reflect on your personality. Are you naturally friendly and outgoing, or are you more of an introvert who has to make a conscious effort to be friendly? Were you raised to be polite, or is politeness a skill you still have to develop? Are you the kind of person who says, “Just tell me the rules, so I know what to do?” Or, are you a bit of a rebel who needs to know the “why” behind the behavior before adopting it? Once you have thought about these traits, describe the challenges you may face when adopting a positive attitude toward business etiquette.




Social Networking and Business Etiquette


You probably have a work-related email account and are expected to communicate via email promptly and professionally. Your employer may even have a presence on such sites as LinkedIn, Facebook, and Twitter. In this age of hackers and security breaches, many companies find it necessary to employ filters and monitors that help to ensure responsible Internet use at work. Familiarize yourself with your company’s written policies about Internet use, email, and professional social media. If no written policy exists, ask your supervisor what the acceptable practices are at your place of work.


In addition to security vulnerability, employers are as aware as the rest of us that the Internet can chew up a lot of time. Use your computer and Internet access at work only for business purposes. It might be permissible to check your personal email while on a break, but you should not be spending time on Facebook or other social networking sites. Using the Internet and social networking sites for your own interest while at work is contrary to the professionalism you are trying to build.



What You Can Expect From Your Workplace


What you can expect from your employer is usually codified by labor law. What you can expect from your colleagues is determined more by general behavior expectations. However, this distinction is not absolute.


Your employer must avoid all discrimination by either colleagues or supervisors. You cannot be sexually harassed or treated unfairly because of your gender, race, ethnicity, age, sexual orientation, disability, or religion and beliefs. You do not have to tolerate physical or verbal threats, coarse language, bullying, or gossip. Your employer must also provide fair compensation and adequate benefits, including time off. You have a right to a safe and drug-free work environment in which your personal information is confidential. Any criticism of you or your work must be delivered in a private and appropriate setting. Your employer’s Human Resource professionals ensure compliance with occupational laws and can serve as mediators when disputes or conflicts arise in order to protect both you and your employer.



image Journaling 2-3


Think about people you know at work whom you would never want to offend—not because they are powerful or intimidating—but because they are decent people who try to do their best. Describe the behavior and traits of these people to illustrate why they command such respect.



Case Study 2-1   Rookie


Stuart was the latest hire as a drug counselor in a drug treatment clinic in Madison, Wisconsin. He had been the first new hire for quite a long time and the rest of the staff had a strong bond with one another. Stuart learned all this on his first day, when everyone started calling him “Rookie.”


The title was fine at first, but it began to annoy him. He actually had more education than many of the other counselors, and had worked with addiction cases for many years. He didn’t see himself as a rookie.


After the first week, he found himself pacing around his living room as he talked to his wife. They had a good life in Milwaukee, with many friends and solid reputations at work. He agreed to the move to Madison because his wife, Antonia, a Master Teacher in Milwaukee, had been hired as a principal in Madison. And now, he was being called Rookie, and it looked as though it was going to stick. “I can’t seem to connect with these people,” he was saying. “They’re nice enough to me, but I’m not part of the scene. It’s like they speak in code about experiences they’ve all shared, and I’m on the outside.” He shook his head.


“Who do you think should break the ice?” asked Antonia. “Who should take responsibility for it, you or them?”


“Oh, both of us. They have a responsibility too.”


“Yes, they do. But you’re not them. You can only do what you can do.”


On Monday, Stuart decided to be more proactive. He picked up the staff room, which seemed to be in a perpetual state of disarray. He volunteered to run an activity group when one of the regulars became ill. A couple of people noticed the cleaned-up staff room. “It’s good to have a rookie around,” one person told him.


That night, Antonia asked who the leader was.


“The leader?”


“Yes, the person everyone else looks up to. The one whose opinion seems to matter more than others.”


That would definitely be Schechter. She was quiet, but she commanded respect. The next day Stuart took an opportunity to sit down next to her while she was taking a break in the day room.


“What’s up, Rookie,” she said in her gruff way.


“Not much,” said Stuart, “but I thought you could explain something to me.”


She looked at him without responding, so he forged ahead.


“We have a lot of tough clients around here. Some are hard and kind of unapproachable, but you don’t seem to care. You just go up to anybody and start talking, and pretty soon there’s a good exchange going on. What is it about you?”


Schechter proved for the first time that she could actually smile. “I don’t care how hard they are. They don’t get to come here and be unapproachable. Neil Young said ‘Every junkie is a setting sun.’ These people don’t have many of their nine lives left. They’re not going to get much further down the road if they’re just hard and unapproachable. That’s not an option for me.”


“For you?”


“Look Rookie, I lost my brother when I was fifteen. He was my only brother, and he was the only one who cared about me. He was hard and unapproachable. I knew him though. Underneath. I knew that’s not the way he really was. But he didn’t get any help, and he was dead before he was nineteen. I’m not giving these guys here a pass just because they’re unapproachable.”


Stuart told her he was sorry about her brother, and he wasn’t giving any passes either, and he went back to work. Actually, Stuart felt the same way as Schechter did. He always had. He knew he was doing nobody a favor by letting them evade their issues. He was good at getting into people’s faces. He could turn on an intensity that got people’s attention, and he could use his body to maneuver a client into a suddenly serious conversation. Stuart had a cool, quiet voice that commanded attention, and he used his skills to get past a client’s exterior and into the real issues. So he was on the same wavelength as Schechter, but he hadn’t had to lose a brother to get there. He respected her for telling him that. And he was glad they had the same outlook in common.


Later that day, she called him “Rook.”


On Wednesday evening Stuart came home to find Antonia collecting bags of flour and sugar on the kitchen counter, with bars of butter and unsweetened chocolate. She was going to make cupcakes for her faculty meeting the next day. Stuart said he would help her, because he wanted to make some extras for the gang at work.


At the staff meeting on Thursday afternoon, the cupcakes put everyone in a good mood. “Hey Rook,” said Ted, “what are these sprinkles, Prozac?” Everybody laughed. Sarah said that a man’s stomach is the shortest distance to his heart. “No,” said Schechter. “It’s his chest,” and everyone roared. Stuart stayed afterward to pick up the staff room again, since he had made the mess today.


On Friday morning he found Schechter again on a break in the day room.


“Hey Schechter,” he said, sitting down. “Do you actually have a first name?”


“Yeah,” she said.


Stuart sat there in silence, gazing at the plaster swirls on the ceiling. He thought that if he could just stay silent for a few seconds, she might expand, but she didn’t.


“That’s OK,” he said finally. “I’m sure that Bono and Moby have first names they wouldn’t tell me either.”


“My first name is Deborah,” said Schechter. “But you can call me Shecky. That’s what they called my brother. I can see you know what you’re doing.”


“Thanks, Shecky. You can call me Stuart.”


“Not Stu?”


“No. When you call me Stu, you take the art out of Stuart.”


Schechter rolled her eyes. “I was going to ask you if your wife made them cupcakes. Now I know she didn’t.”


“Actually, she did,” said Stuart, and they had a good laugh.


At the staff meeting the following Wednesday, it was Stuart’s turn to make his first case presentation. He had made these presentations hundreds of times before, and this one was no different, except at the end, he said, “I want to thank everybody for making me feel at home here. I feel like I was the first person that ever got the nickname Rookie here. I want to thank you for making me feel special. From now on, you can call me Stuart.


“With the art,” chimed in Schechter.


“Sure, Rook,” said Ted, and everyone laughed. But that was the last time anyone ever called Stuart “Rookie.”


Except for Antonia.


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Apr 8, 2017 | Posted by in MEDICAL ASSISSTANT | Comments Off on Ready for Work

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