Clinic staff often creates its own chaos through behavior


Managers can teach staff many skills but often the most difficult lesson for employees to learn is they need to be aware of the chaos they consciously or unconsciously create.


Take-home message: Managers can teach staff many skills but often the most difficult lesson for employees to learn is they need to be aware of the chaos they consciously or unconsciously create.



Putting It In View By Dianna E. Graves, COMT, BS Ed

I have long preached to the staff that “you are the chaos you create” and to look at what is occurring around you or to you with a critical eye.

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Life’s lessons are the hardest lessons for your staff to learn. We can teach them the latest technology, help them refine their skills, and improve their communication skills with patients and each other, but we cannot get them to understand that what is occurring around them is often a direct cause of one thing: them!

I had a young technician who had been with us at least 3 years. She was smart, energetic, and extremely personable. She also had a type AAA+ personality.

Her skills were stellar, her exams right on the spot, and her exam times were appropriate. When she was in clinic, flow was never an issue. The problem was I had staff begging for a break from her.

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She was in everyone’s face, techs and doctors alike, continually with questions/comments like: “You love me most, don’t you?” or “Aren’t I the cutest?”

Some called her extra-extraverted to the nth degree-but I knew otherwise. She was an insecure person. Her constant need for attention was putting the wrong spotlight on herself, causing a negative effect.

In most cases when there is a conflict between technicians because of personality issues, I provide ideas on how to work it out and tell them, firmly, to move on. In this case-I separated them.

Two technicians had come to me and said, “She is a really good technician, but I am mentally fried after working with her. Please put me in another location away from her for the next few weeks. I need a break.”

After developing a game plan, I sat down with the AAA+ technician to get her to understand the chaos she was creating (whether intentionally or by mistake).

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When you are dealing with someone’s personality-their “core” being of what makes them who they are or perceive who they are-you need to tread carefully. You can shake their foundation if you threaten the base of belief of who they are.

I started with: “Please listen to me with an open mind, and understand I am doing this in a kind manner, but you need to shut up.”

Her smile disappeared, and then she smiled twice as wide and said: “I got it-OK.”

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“No, you need to shut up and get out of people’s faces. Stop asking, ‘Am I your favorite?’ and give people a breather. They all like you. They respect your skills. They know you pull your weight. However, they have gotten to a point they want a break from you.”

“What’s wrong with them?” she quietly asked, shaking her head. “If they like me so much, why do they want me gone?”

“They don’t want you ‘gone’-they want you away from them. You are a hyperactive person on your fifth Red Bull of the day.”

The smile was really gone, and my work began to help an excellent technician get off everyone’s “hit list.” Now, we could talk.

As a 50-something manager, trying to get into the head of a 20-something technician, my analogies are from a different time, my principles are from the past, and I have no clue what “drives” them.

Force won’t work and understanding is impossible. If I “mother” them, I’ll lose them. If I do a stern lecture, the walls will come up.

What everyone was looking for was a little peace and quiet. But in order to achieve that, I needed her to obtain some confidence. She was desperately seeking re-affirmation all day long from her co-workers, as well as from the physicians.

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There was a television show in the early 1970s, starring David Carradine, called “Kung Fu.” It was about a young man’s search for himself and truth. He was learning to seek his inner self, that violence and chaos were not the answer, and that he could control himself and his emotions to ensure that he did good so that his impact on others was also one of peace and calm.

He had a mentor, and his mentor called him “grasshopper” as a term of endearment. Each week, a life lesson was imparted from the mentor to the young “grasshopper.”

Carefully, I started: “When I was young tech, some might say I was a force to be reckoned with in the clinic-and not always in a good way. Maybe a bull in a china shop was a better description.

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“I wanted everyone to know I was there, and I wanted to be the best. Best at what? I had no idea-just better than you.”

The young technician smiled at this.

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“I soon realized that work was not a popular place because I wasn’t happy when I was at work. I didn’t think people worked as hard as me. I didn’t think anyone did as good a job at patient care as me.”

One day an older technician, someone
I looked up to, pulled me aside and said: “I am gonna pop you if you don’t back off!”

I was hurt, mad, worried-but I did listen.

During a long weekend, I realized I still could be the best at what I do, but I needed to appreciate that others were equally important-if not more important in some cases-in the roles they performed because I couldn’t do their roles!

My new mantra became: Make a presence without anyone knowing I was present.

The technician looked at me, and I could see she was listening.

“How do I do that?” she quietly asked.

I replied: “You need to learn to walk a mile on the beach-but leave no footprints.


“You need to be able to sit peacefully, and calmly, at times, so still that if a fly flew by, you could reach out and catch it and the fly would be shocked because it didn’t know you were even there.

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“When you are in clinic, you need to do your job the best you can without diminishing the job someone else does. If there is a bottleneck occurring, quietly get in there to help smooth it out without any fanfare or attention grabbing. Be comfortable in your own skin enough to tell someone else they did a great job-without expecting it in return.”

She was reflective for a bit, and then smiled a little and she headed back to work.

She did listen.

Maybe some concepts transcend generations after all. 


Dianna E. Graves, COMT, BS Ed


Dianna Graves is clinical services manager at St. Paul Eye Clinic PA, in Woodbury, MN. Graves is a graduate of the School of Ophthalmic Medical Technology, St. Paul, MN, and has been a member of its teaching faculty since 1983.






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