I’ve heard it said that each hospital really operates as four distinct entities. There is the daytime hospital, the nighttime hospital, the weekend hospital, and finally the holiday hospital. What makes the difference and why is it so palpable in many organizations? Over the weekend, I was visiting my mother in a hospital where she had never before been a patient. My husband had been there with her the two previous days and also accompanied me on Saturday. He was the one who noticed the whiteboard hadn’t been updated in 24 hours, and after two staff encounters he said, “It was nothing like this during the week.” I asked what was different, and he said, “There seems to be a little chaos, and the aids aren’t as in-tune with your mom as the ones we had on Thursday and Friday. They don’t seem to notice that she only hears well on one side when they talk to her.” Not having a comparison, I felt everything seemed fine. Not remarkable, or bad, but just OK.
After his remark, I started to dissect the experience (I can’t help myself; after all, I run a medical mystery shopping company.). Here is what I noticed once I thought about it: When we entered, there was no one at the front desk to greet us upon entry. Even though it was only 1:30 p.m. on Saturday, the gift shop was closed, so I didn’t have the option of buying a card or gift. So between those two things, there wasn’t an impressive feeling of welcome. In fact, the player piano sat unattended yet playing out a song—a metaphor for the weekend hospital experience. I noticed scraps of paper scattered all along our pathway that remained there when we left at 5:00 for the evening. When we arrived on the unit, the unit clerk never made eye contact as we exited the elevator and entered the unit. And finally, we waited all day for a specialist who never arrived, requiring my mom to stay at least one more day as an inpatient.
Maybe these things would have all happened during a weekday, but according to my husband, it seemed like a totally different place than what he’d experienced previously. Neither of us commented on these observations to my mother, but she noticed. When the PM shift nursing assistant arrived and ducked her head in to say hello, my mom actually asked her to come in and put her name on the whiteboard so she could keep them all straight. The standard had been set, and even if no one else was holding the team accountable, my mom was on the job! When you cite your mission, vision, values, and standards, remember that there’s not caveat or disclaimer stating that weekends, nights, and holidays are exceptions.