It is early 2009, we are in the middle of the worst world economic crisis for decades and supposedly the sky is falling in. So what would possess someone of generally sound mind to give up a regular healthy salary and a secure professorial position leading a wonderful department? Worse still, then to move over to ‘the dark side’ of independent consultancy.

It can’t be for adulation, that’s for sure. Have a quick google check on ‘consultant jokes’ and you’ll find that they run a close second only to lawyers. Q: “What’s a consultant?” A: Someone who borrows your watch then charges you $1,000 to tell you the time”. You get the gist.

It’s all about opportunity and possibilities

This move and the establishment of Philip Darbyshire Consulting is all about opportunity and possibilities, yes for me personally, but more so for the people and organizations that I will be serving. Despite the prevailing gloom, this is more than ever the time for optimism, hope, courage, enthusiasm and the vision to see that these difficult times too will pass. Until then, health care and professional education do not have the luxury of an interim mourning period or moratorium on progress.

Is your organization now fully committed to dumbing down its staff?

Over the last decade I have worked with some truly wonderful organizations – hospitals, universities, health care providers and non-government organizations – all across the world, in Europe, Australasia, Asia and North America. In these organizations there are clinical, educational and executive leaders who will not be standing around wringing their hands in despair and battening down the hatches until the good times magically re-appear. They will instead be continuing to improve their organizations and the people who work there for the ultimate benefit of their students, patients and clients.

Health leaders today face a stark, it simple question. It is this:

‘What health care, service provision, professional education and development, research, ethical, technological or knowledge translation challenges do you face in your organization that need staff to be LESS motivated, engaged, questioning, knowledgeable and educated?’

If you can think of any, then and only then might you consider that ‘cutting back’ on research, education and staff/organizational development makes any sense.

And your strategies and mechanisms for retaining your best staff are?

Let’s start by being optimistic and assuming that your organization has these. Then let’s be Pollyanna-level optimistic and assume that everyone in the organization from CEO to the cleaners knows what they are and appreciates the role that they personally play in creating this diffuse but definite concept of your organization’s climate or culture.

“Our staff are our most valuable resource” has to be one of the biggest slices of managerial apple pie on any organizational plate. Countless strategy and policy documents have this mantra up in flashing lights, but where the rubber hits the runway, things are not quite so encouraging.

Health care across the world is facing a nursing retention crisis. For far too long this has been seen as a bit of a ‘soft’ issue, not quite as managerially sexy as waiting lists, infection rates or ‘throughput’ times and something that can be easily palmed off to minions in HR. No longer. The rude awakening is now for any hospital or health service who thinks that their reputation or glossy advertising campaign is going to see them through.

In the Weekend Australian (Feb 21-22, 2009, p.1), Professor Christine Duffield from the Centre for Health Services Management in Sydney, highlighted research showing “a likely shortfall of 40,000 nurses by next year”. This is not because we can’t train and educate enough nurses, it is because staff find so many of our hospitals and health settings to be such toxic or tedious places to work in.

This is a theme that I’ll be returning to again and again as the importance of a challenging, stimulating, friendly, supportive, encouraging, respectful and caring workplace cannot be over emphasised. Or perhaps I should just say, ‘should’ not be.

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