Great pay and benefits, low expectations, no accountability, and you’re likely to get promoted soon.

You wouldn’t expect to see an ad like this, and yet, if you’re not careful, this might be exactly what you are attracting and retaining in the workforce. If you frequent healthcare organizations as I typically do, you’re likely to experience a range of encounters—hopefully more good than bad. Unfortunately, some of my recent experiences have been more bad than good. You’d think that with my extensive experience in healthcare—as a nurse, an administrator, and now a consultant—I would have seen it all and there wouldn’t be much that could still shock me. And yet there is:

• Staff who walk right past full urinals on the over-bed tables without making a move to empty them shock me.
• Physicians and other clinicians who fail to express empathy—or worse who express disdain—for their ailing patients shock me.
• Staff who ignore patient and family needs while they tend to their own shock me.
• Poor attitudes and rude behaviors that are allowed to persist shock me.
• Staff members who continually whine and complain about the amount of work they have right in front (or perhaps to) patients shock me.

You’ll notice that the examples I’ve listed here aren’t evidence of clinical incompetence as much as they are evidence of failure by the individual to care and failure of leaders to hold these individuals accountable. I don’t know which is worse! The failure to care and connect on a human level with the very person seeking care is an egregious failure on the part of the organization. After all, our patients are turning to us when they are sick and, often, frightened. And at times, rather than helping them, we may cause them additional stress and frustration through the experiences they are having with staff who are supposedly there to help them.

Lately, my experiences (and there have been many) have made me wonder if some of these organizations are literally recruiting slackers, whiners, and jerks—because that’s who seems to be on their staff! But I know this can’t be so. There are very likely some common reasons for why their staff creates such a negative patient experience: 1) Poor hiring screening, 2) No clear standards (expectations), and 3) Lack of accountability. Yet there have been some moments of hope thanks to shining stars.

In addition to the slackers, who appear to be many, I’ve also encountered a number of individuals who try to “make up for” the lack of caring, concern, and commitment of their colleagues. Many of these individuals have been nurses. Some have been doctors. All have made a lasting impression. Still, they shouldn’t be placed in a position where they have to make up for something lacking on the part of their colleagues. A good staff person, regardless of the role, can make up for so much—but shouldn’t have to! These good staff members shouldn’t be the exception; they should be the rule. And the only way to build a culture of consistency is to hold every person accountable to a high standard and be brave enough to terminate those who are unwilling or unable to uphold the service standards.

You may be thinking that this situation can’t exist at your healthcare organization. I hope you’re right, but I’d be willing to bet that you aren’t. In fact, I frequently ask leaders if they would be willing to bet even 5 percent of their salary on whether or not patients get a consistently positive patient experience throughout every department of the organization. Not once have I had anyone challenge me or take me up on those odds. I’d bet that if you walked the halls of your healthcare facility as a patient or visitor, you would find pockets of these same kinds of negative behaviors I describe above.

How do you combat these behaviors? Don’t allow it! Stop hiring—and by all means stop retaining—slackers, whiners, and jerks. Point out behaviors that fall below standard. Tell them what you expect vs. what you’re getting. Coach them to change their behaviors, or help them find new opportunities elsewhere! Your patients demand and deserve it. And your reputation depends on it.

Remember: What you permit, you promote…. More about that next month.