Professional Pontificiation

I realize I've been a bit of a slacker on the whole posting thing. Mea Culpa. (For anyone who doesn't know this phrase, you obviously are not a Catholic...look it up.) Its not like I've been completely somnolent. I actually have been doing quite a few worth while things with my time. For instance, I made an incredible bourbon marinated flank steak, chile lime roasted corn, and spinach salad the other night. I also polished my antique brass bed for when my mom comes to visit next month. (Incidentally her buying of the plane ticket was like manna from heaven; a much needed bright spot.) And I have been doing some part time consulting work.

I'm doing the whole "general" terms thing now after my readership exploded with past co-workers from my previous place of employment. Call it a Dooce-ism. (Again, if you do not know what this is, you obviously do not spend enough time surfing the internet and/or at least checking out my links of my favorite sites.) Another aside: I actually had my exit interview a la third party telemarketer last night. It was quite rewarding to actually give an honest review. I said what I meant: I love, LOVE, the CEO and would work for her directly anytime in my life. (Note, I said "directly" meaning that I would report to her.) She is bright, passionate, strategic, and a great person.

Anyhoo, this whole consulting this has been a blast. I've been able to do what I think I do best: diagnose organizations, apply brief solution focused interventions, coach individuals, and teach. Its rather funny how fate tempts you once you think you have things all figured out. For instance, just last week I was talking to a girlfriend telling her how happy I am right now with my career opportunities. I don't feel this driving need to always excel and keep raising the treadmill speed. That is quite a difference from my previous way of living. Wouldn't cha know not even 20 minutes later I got a call from a head hunter asking me to apply for a senior position with a health care org. As I was debating this over the next 24 hours of even putting my hat into the ring, the recruiter called and said that the company changed their mind and decided they wanted a RN. This is the bane of my existence as a MSW in a health care world.

Many organizations claim they are interdisciplinary. And for the most part, they are when it comes to patient care. There are docs, nurses, physical therapists, respiratory therapists, social workers, dietitians, chaplains, etc who all contribute to the whole of the patient and family. However, it is rare to find a health care system that promotes the same disciplines trusted with patient care into leadership. Most of those at the top are nurses. And you wonder why exactly we have a nursing shortage...it doesn't take a brainiac to figure this one out.

The nurses have done an incredible job lobbying themselves as the gatekeepers for monitoring care throughout all levels of an organization. I will say that my profession sucks at lobbying even though one of our hallmarks is to be advocates...hard to do when the majority of professionals are introverts.

To me, this doesn't make sense. MSW actually outranks both MD's and RN's on an academic standpoint. MD is just another bachelors, seriously look it up. And to be a RN, you just need an associates. I only point this out because the medical world is largely entrenched in hierarchy, including academics. Just look how teaching hospitals outrank community based facilities on every scale.

My next contention point has to do with the skills the job requires. I would argue that MSWs are much better equipped to handle leadership than RN's any day. (Note: I say this while the majority of my health care leaders are RN's including my old CEO. Only 3 are MSW's and 1 is a MHA.) While nurses are incredible at procedures (you wouldn't catch me doing a Foley cath) and monitoring progress according to their senses (vitals are all based on what you can hear, see, feel), MSW's are truly skilled in people. What motivates them? How do you plan strategic change? How does transformation occur? Looking at organizational systems in micro, mezzo, and macro levels simultaneously. These skills are what higher levels of leadership and administration demand. The other aspects of business, like financial skills, well, both of our educations suck at that. It is just something you learn on the job.

I actually had ruled out applying before the recruiter called me back, but I decided to push the point to see what the rationale was. Yes, I was just making a point and was hoping just to get the hamsters in their heads to run on the wheel a little bit faster. I asked for the job description and their reasoning. They said that the RN might have a better understanding of medical patient care, although with the job description medical patient care was not a component. More than anything I just found it fascinating.

Women may still be facing a glass ceiling, but in health care only the RN's hold the key to the executive boardroom.