The Nation's Health + Blog. Blogging

Managing the Unmanageable

"Is it always a case of bad managers or are we bad at being managed?!"

Seriously, I'm so bored of people saying "Bloody management" time and time again. No doubt I'll get stick from people about my views on this but I'm fed up with hearing the same grumblings over and over again. Hearing about people who have apparently been 'run' for this and that. I'm yet to hear of anyone in my trust who was suspended or fired for something I wouldn't have suspended or fired them for. I'm also yet to hear about someone who got a totally unwarranted bollocking or warning about something. Obviously the management in my service isn't perfect, but is it anywhere?! It can only ever be as good as the individual in that position. You get some really bad managers and equally you get some really good ones. You get some really bad paramedics and equally you get some really good ones! That's life. It isn't a management thing. It's an individual thing. No one likes being told what to do, and no one likes getting in trouble. To me however, I think ambulance services have the impossible task of managing the unmanageable. And I'll explain why....

Let me break this down into the five main areas that managers are involved in. Lateness, sickness, dress code, compliance and times. Luckily for some people, once qualified, your clinical knowledge isn't really monitored but these five areas are. As a manager, I'm guessing it is their job to ensure all five are at the required level for the staff they are in charge of. If any fall below what is expected, then that must be dealt with. Why do people resist it?!

Lateness - People are late. It's a fact of life. In some jobs being late has little impact on things. In our job it prevents an ambulance starting. Managers really don't care if you are late once in a blue moon. It happens. We don't have ultimate control over power failures, cars starting and traffic. In 5 years I have been late once. The manager at the time told me 'good people have bad days'. I made up my time and it hasn't happened again. A hard stance happens when people are persistently late. I've heard people moan about being put on formal disciplinaries for lateness. 'I was only one minute late'. SO WHAT?! YOU WERE LATE! There is no excuse. If you are frequently arriving late that should tell you that you should frequently be leaving earlier. Yet who is the baddie?! The manager. Why? Because they are doing their job, following their protocol and ensuring their staff have a reasonable deterrent for being late.

Sickness - Sickness is THE biggest gripe when it comes to the way it's managed. I have written before about how it often seems the people who are off sick a small amount get in trouble and the ones off the most get away with it. Unfortunately, there is a system that can be played and boy, do people play it. The sick leave policy was brought in to combat the institutionalised sickness within the ambulance service. To put it bluntly, for far too many years, people were taking the piss. I found out quickly when I started that people planned their sick leave. If you took a long period of sickness each year you didn't hit the triggers for proceedings and were getting away with a months holiday basically. It really is frightening how many people are at it. Sure, it's a stressful job and like I've said before the mental health of staff isn't managed well, but how do you tell the difference between someone who is faking stress to get the summer holidays off and someone who is genuinely stressed?! You can't! So what you are left with is a strict sickness policy that prevents most piss taking, but in that large net, is left a few people who have had a bad year and are now in trouble! And who is to blame? The bloody managers who are doing their job! I went over the sickness limit, I had a rational discussion with my manager, that was the end of it! Basically, piss takers don't like having their freebies taken away and the managers get the blame!

Dress code - This is my biggest bug bear! I will say this once and once only. WE ARE A UNIFORMED SERVICE. It is quite simple. All our uniform is provided in generous quantities. We are provided with shirts, t-shirts, fleeces, trousers, socks, a belt, a utility belt, a stab vest, a hi-vis jacket, a hi-vis tabard, hi-vis trousers, a beanie hat, epaulettes and boots. WEAR THEM. The policy is quite clear from day 1. You wear the uniform you are given and nothing extra. One set of studs in your ears are permitted. No more. We are not in a fashion parade, we don't need flowers in our hair or funny t-shirts. Just wear the uniform like you are supposed to and do your job. Simple. We have epaulettes. Why don't people wear them?! We have belts. Why don't people wear them?! Tuck your shirts in, polish your boots, make your hair presentable and keep it off your shoulders. Don't come to work with 40 piercings in your face! It is not the place to show how individual or alternative you are. As far as I'm concerned any manager has the right to pull you up if you don't follow the uniform policy. It may be nit picking but if I was a manager I would be all over the uniform policy like a rash. We are representing the service in public and personal image carries credibility. If you look like a mess expect that to be mentioned in complaints.

Compliance - Unlike most jobs you can go months / years without have dealings with your management. You say hello in the garage but during your shifts they are not breathing down your neck. You are left to do your job. It is therefore hard to monitor your performance. It can't be measure with a 'Lives save 2 - 4 Lives not saved' quarterly figure. For this, and other reasons, our paperwork is monitored and audited. You are expected to get a certain % of compliance in various areas. If you don't you are given a print out of where to improve. If you persistently don't improve it will escalate. Sure, paperwork is a bore, but it has to be done. Deal with it. Build a bridge and get over it. It isn't rocket science. Yes, it is only a box you didn't tick. So just bloody tick it rather than blaming 'bloody management' for tell you to tick it! Simple!

Times - The other way we are monitored is our times. By times I mean how quickly we mobilise on calls, how quickly we get on scene and how long we spend at hospital after we have offloaded our patient. It is these times which is a bone of contention with many staff. Surely, as an emergency ambulance service it SHOULD be all about how quickly we get there. I see staff get jobs on a daily basis and dawdle over to their truck, then spend ages looking at the map (when the sat nav is already telling them where to go) and eventually bumble off to the call. This isn't good enough. There is no reason not to try and get there as quickly and safely as possible. Delays cause the service fines and in the long term, fines will cost staff. Sometimes traffic causes delays or a million other things out of our control but mobilisation is down to us. If you are too slow, a manager is well within their right to pull you up on it.

Then there is time at hospital and this is a culture thing. People need to get over the good old days where they did two jobs in a shift, had water fights in the garage and sat at hospitals for hours with other crews. Those days are gone. The service is busier than ever and cannot afford to have 8 ambulances unavailable because someone is telling a good story in the hospital car park. Like it or lump it, we do a job, hand the patient over and then have 15 minutes to get our coffee, go to the toilet and do whatever else is needed. Over a 12 hour shift that's over an hour we are getting. Sure, there are days and there are jobs where it goes over that for any number of reasons but an average takes that into account. It was amazing how many people managed it when there was money on it! Just sayin'. A managers job is to implement policy and manage staff who are not performing properly. Dragging heels at every stage makes that impossible!

There is so much resistance to any change within the service that sometimes it feels like there is no progress being made at all. I've heard horror stories about managers but in all honesty I've had about 12 since I started and none of them have caused me any problems. They have been accommodating and understanding. Maybe I'm just lucky or maybe the 'bloody managers' aren't as bad as the mess rooms would have you believe. What mustn't be forgotten is that where we answer to them, they answer to above and so on. They do what they are told. It's a shame that road staff don't do the same. People seem to feel the need to push boundaries, see what they can get away with, and make the job of managing them an impossible one.

Perhaps the fact that much of the service is still far too unionised and the Us vs Them attitude from the 1980s contributes. Maybe if we started working with managers and making positive changes everyone would be less stressed and angry. It is easy to get along with managers. Turn up on time, dress smartly, be polite to patients and don't drag your heels or take the piss with sick and they'll never have a reason to bother you! Or as I like to call it, 'Doing your job'! For now though, it seems that managers are going to be left managing the unmanageable.

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