Friday, August 15, 2008

"There is a powerful contemporary Christianism that admires Dives (Latin for rich man) and emulates him, and regards Lazarus as burdensome and reprehensible. Indeed, the supposed Christian revival of today has given something very like unlimited moral authority to money, though Jesus did say (and I think a literal interpretation is appropriate here if anywhere), "Woe to you who are rich!" (Luke 6:24). If this seems radical, dangerous, unfair, un-American, then those who make such criticisms should at least have the candor to acknowledge that their quarrel is with Jesus."

by Marilynne Robinson
from The Best American Essays, 2007 Edition, Page 219

Monday, August 11, 2008

The Gap (Part 2 of Looking At Workplace Psychological Abuse)

(For those who expected Part 2 to be entitled "Tell Everyone!" stay tuned, it's coming.
Part one was entered on this blog on April 11).

Most large businesses and corporations today have written statements spelling out rules or standards that employees are expected to follow. These standards go by a variety of names. There is often a "Mission Statement" and a "Basic Conditions of Employment." In addition there may be "Standards of Conduct," "Customer Service Standards," Principles of Conduct," or maybe the word "philosophy" is used in the title of a statement. Frequently these statements deal with ethical guidelines, or how employees are expected to behave. These documents may govern or provide guidance for actions and speech by employees in their interactions with each other, or with customers. They are written for a variety of reasons, including attracting customers and employees, preventing conflict, and especially protecting upper level management from legal action for problems that may occur.

Over the last few decades workplaces in the United States have experienced some troubling changes. While the salaries of CEOs and other top executives have skyrocketed, wages and benefits of the average worker have gone in the other direction. The average family with two full time wage earners today actually has less discretionary income than a family with one breadwinner a generation ago (Mark Ames in "Going Postal" Page 101). In one year, 1999, the average CEO salary increased by 37% while the average worker salary increased by only 2.7% (Ames, Page 91). Health insurance, pension plans, and vacation time are also diminishing, and in some places, disappearing altogether. Lay-offs, downsizing, and outsourcing has made employment for many Americans very unstable. This contrasts sharply with the trend in most other industrialized countries. Other industrialized nations have universal health insurance for their citizens. Minimum annual paid vacation in France is five weeks, and most western European countries are, in many ways, much more pro-family than the US. One example is that they offer new parents longer maternity and paternity leave, usually with a significant percentage of their pay. The average American works 350 more hours each year than the average European.

In spite of this trend of decreasing compensation and support for workers in the US, the written statements and standards of companies are more impressive than ever. Many corporations have written policies and standards governing the interaction of employees that sound almost New Testament Biblical in their stated concern for the employee. Unfortunately those are only written statements. In reality there is a massive gap between what is written and the actual behavior of management toward employees. My own experience is a powerful example of this gap.

From 1976 until 2006 I was employed as a respiratory therapist at Saint Alphonsus Regional Medical Center (SARMC) in Boise, Idaho. Saint Alphonsus is part of the Trinity Health system headquartered in Novi, Michigan with facilities in seven states. Trinity Health is the fourth largest Catholic Health system in the United States. For the last 28 of those 30 years I was a shift supervisor providing job assignments, and communicating changes in physician orders and many other responsibilities, usually for two to eight people per shift, as well as caring for respiratory patients myself, often in the Emergency Department.

Let me point out that I think the average person who goes to Saint Alphonsus probably gets excellent care. But that care comes from the employees who directly care for the patients. The vast majority of those employees are committed, dedicated, hard-working people who sincerely care about their patients and often go above and beyond the call of duty to provide timely and appropriate care, and they usually do it without necessarily expecting anything in return, often not even charging for overtime if they miss lunch or stay over to complete their care. In the thirty years I worked there I did that thousands of times, just out of commitment to the cause, to the place, and to my job, and I know many others have done the same. But with management, especially upper level management, the story is somewhat different.

In January of 2004 I became the target of a workplace "bully," an adult version of the school yard bully that many of us had to deal with in grade school, junior high, or high school. This psychologically abusive co-worker began to target me with chronic misbehavior that included among many other things, withholding information I needed to do my job and refusing to communicate with me. Refusing to communicate with a co-worker in a hospital setting endangers patients, since clear, succinct communication between health care workers is necessary to provide timely and appropriate care. In so doing she intentionally created and maintained a hostile, high-stress work environment.

To keep this entry as short as possible I will simply add the following three facts about this ordeal. First: Her "bullying" continued for over two and half years until I was forced to resign because I was seriously injured and becoming disabled by the chronic abuse. Second: She adamantly refused to participate in any kind of resolution process to try to resolve the problem. I offered to participate in any kind of process involving either direct or indirect communication including the use of a professional mediator, but she refused to participate and continued to behave in an abusive manner toward me, jeopardizing patient care and causing serious injury. Third: Management intentionally gave her permission to refuse to participate in any resolution process. At no time did any member of management require her to discontinue the abuse, or change her injury-causing behavior toward me. Therefore nothing was done to address the problem or to provide me with a safe working environment, relative to the occupation.

The problem should have been very easy to resolve. The bully was violating multiple "Customer Service Standards" every shift we worked together. These standards include encouraging employees to discuss problems with co-workers before reporting them to management and instructing employees to listen to anyone who wants to talk to them. The "standards" include strong statements such as "treat each person the way you want to be treated," and treat each person as if he/she is the most important person in the facility." Anyone who acts as a bully is violating numerous Customer Service Standards as well as the Basic Conditions of Employment.

Trinity Health has their own Standards of Conduct with equally clear and positive emphasis on respect, kindness and also requiring honest and clear communication. However for the purpose of this entry I want to look at just a small portion of the 20 plus pages of the Standards of Conduct which you can find at under "Organizational Integrity."

This section is on Page 13 and entitled "What Should I Expect from Trinity Health?"
It includes the following statements. should also expect Trinity Health to:

1. Treat you with honesty, dignity, fairness, and respect.

2. Provide you with a meaningful work experience.

3. Provide you a safe and supportive work environment free for harassment, intimidation, or

4. Provide a respectful work environment that allows you to freely ask questions, seek
clarification when needed, and raise issues and concerns in good faith without fear of
harassment or retaliation

5. Have your requests for information, input, or assistance responded to in a timely manner.

(I added the numbers for easier reference)

Sounds great, doesn't it? Reading that list would give any employee a sense of security, hope, and optimism about working for Trinity Health, right? Now read what happened to me and you will recognize the significant gap that exist between these promises and the actual practice of management at Trinity Health.

I was the target of a bully for over two and a half years. By the time I left I was partially disabled by the chronic psychological abuse. Although I'm no longer dealing with any disability I still have to cope with the effects of PTSD over four and a half years later. The bully jeopardized patient care every shift we worked together. Her intentionally malicious behavior toward me started abruptly when she found out that I did not share her religious and political beliefs. A year after the problem began I was diagnosed with Post Traumatic Stress Disorder (PTSD) as a result of the work abuse. The diagnosis of PTSD was made by Saint Alphonsus, as occurring on the job at Saint Alphonsus, and I have that in writing from Saint Alphonsus. There was never any question about the cause of the PTSD injury.

I reported the patient endangering behavior of the co-worker and the discrimination against me to management numerous times. Nothing was done to address those problems. I reported the PTSD injury to management more than two dozen times over a period of approximately two years. The respiratory care department manager specifically told me, both verbally and in writing, that my injuries were "petty," even though PTSD is a potentially life threatening and disabling injury, as any veteran of Vietnam or Iraq can confirm.

The CEO and the chairperson of the Bioethics Committee never responded to my reports of being abused and injured, this in spite of the fact that the Bioethics Committee chairperson was a surgeon whose patient I had been at least three times in the past!

All three managers from department, human resources, and senior management ordered me to not talk about the injury with co-workers, even though telling others what happened to me is an excellent way to raise awareness and thereby help prevent others from also being injured.
A vice-president told me to just let the abuse "pass over me;" whatever that means.

The employee relations manager was especially toxic in his behavior toward me. I met with him three times to try to discuss this problem, and the injury, but he refused to listen to my side of the story even before I met with him the first time! He conducted two investigations, both clearly manipulated to obtain pre-determined results. He promised me a written report of the first investigation, then refused to provide it even though I requested it several times. He promised me a meeting with the department manager to discuss the results of the first investigation. It was never scheduled. He promised me I wouldn't have to work with the abusive co-worker anymore. The promise was broken in two months. In July of 2005 he even threatened to fire me for reporting the PTSD injury to him! In the third meeting with him on October 4, 2005, red-faced and bellowing at me across the table in a tiny office, he ordered me to lie about the PTSD injury if anyone asked, and threatened to fire me if I reported any more problems with the abusive co-worker to either him or the department manager, or if I discussed the PTSD injury with anyone in the department.

Those traumatic experiences with the employee relations manager demonstrate a few facts about Saint Alphonsus and also Trinity Health. One: at that point not just the co-worker, but management also was engaging in the abuse and aggravating the PTSD injury. Two: denial is a chief tool of St. Alphonsus and Trinity Health when it comes to dealing with problems management does not want to address. Three: this experience also demonstrates that Saint Alphonsus is a "punitive authoritarian system," that is a system of management in which one or more people in management actually derive pleasure and satisfaction out of hurting those in the hierarchy below them.

From my experience that's the reality of how Saint Alphonsus Regional Medical Center and Trinity Health responds when problems occur in the workplace. The statements above are the promise and the ideal, but there is a massive chasm or gap between the promises in the written statements and the actual reality that one experiences in the workplace. The gap is so large that, in reality, there is no connection between the two. From my experience there was no sincere attempt made by anyone in department or upper level management to address the abuse I was targeted with, and provide me with a safe working environment. The statements and the entire Standards of Conduct are just a public relations stunt to attract employees and customers. I know of others who've been treated the same way at Saint Alphonsus including people who were fired for reporting unethical and patient endangering behavior by a physician, for being injured on the job, and also terminated for having to be on bedrest due to a difficult pregnancy. Firing someone for those reasons may not be illegal, but it is injury-causing behavior and should not be a part of any Christian organization, or the part of any responsible health care business. It also violates their own standards. Even before I reported the abuse and the PTSD injury to the employee relations manager, another employee warned me that I would be retaliated against, simply for reporting the problem. That's exactly what happened. I also reported the problem and the PTSD injury to a vice-president at Trinity Health and received no assistance, not even a response for months.

I was abused and injured on the job at Saint Alphonsus and it occurred with the knowledge, approval, and participation of upper-level management, including senior management.

The problem of management at Saint Alphonsus and Trinity Health not only allowing employees to psychologically abuse and injure their co-workers, but actually participating in the abuse and adding to the injury is every bit as serious a problem for the Catholic Church as the pedophile priest problem. Texts on bullying and psychological abuse in the workplace document that the emotional harm done when one is the target of a workplace bully as I was, can be just as severe as the emotional harm done when someone is raped, tortured as a prisoner of war, or shot at repeatedly in a war zone.

Let's look at # 5 above for a minute. That's the statement that promises "a timely" response to requests for assistance. I first reported the PTSD injury to management the first week of January, 2005. It's now more than three years and eight months since and I have yet to receive a written or verbal response from any member of management addressing the PTSD injury. See what I mean by a "gap. " Or perhaps they just have a different definition of "timely."

Leonard Nolt

"Listen to your critics, but never let them be your judges."

Linda Nafziger-Meiser

You've probably heard the quote, "An eye for an eye only ends up making the whole world blind," by Ghandi. Here's my expanded version of the same concept: "An eye for an eye and a tooth for a tooth only ends up making the whole world blind and on a liquid diet."