When the Worker Becomes the Foreman

You know what fact I find strikingly interesting? The fact that more and more agencies these days - and surprise surprise, I'm talking healthcare here - have the higher up levels being run by individuals who haven't been in the trenches of their field for decades, or even worse, ever.

Take nursing, as an example. In the common emergency room, a chaotic mix of nurses, doctors, ward clerks, and custodial staff keep an always swaying ship afloat through any means possible; double shifts, stretching limited resources, you name it, they've tried it. Then, when they finally get a system going that's shaky at best, but somehow working, Mr. Joe Boss comes downstairs from his office and sees the fray, comments on all the things that need to change, and promptly spins on his shiny patent leather heel and disappears once more. Mt. Olympus throws down an order, and the mortals scurry frantically to fill it.

This is what I don't understand. I do not understand how policies and procedures for some place as life and death as a hospital can be made by individuals with degrees in Business Administration, Finance, or something along those lines. Furthermore, I don't understand how some politicians think that walking through a ward of a military hospital, handing out a few American flags, somehow means they are in touch with the United States healthcare system and its growing problems. How can you justify taking away or cutting back a resource you have never had to use? How can you start swinging the axe to staff, when you have no idea what they do for your organization in an up close and personal capacity? And finally, how can you claim to worry "about the sole, utmost care and concern for the patient", when you have never looked them in the eyes, or held their hand?

You can't, and shouldn't. You should throw on some scrubs and get in the trenches once in a while, or leave it to those who will.