veteran respiratory therapy managers offer tips to help...

You’re an excellent bedside therapist with great clinical skills and

an innate ability to connect with patients. You’ve won the respect

of physicians, nurses, and your colleagues in respiratory care.

And now there’s a terrific opportunity to lead the department. If

you’re a new manager in respiratory care, here’s some valuable

advice from managers who have found success.

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32 AARC Tımes January 2005

Veteran Respiratory Therapy Managers Offer Tips To Help

New Managers Succeed

The respiratory care profession has seen a lot ofchanges over the years. New technology, higher edu-cational standards, and a growing dependence on res-piratory therapists throughout the health care con-tinuum have all combined to make respiratorytherapy one of the hottest health professions for the21st century.

One thing hasn’t changed over the years: the wayRTs climb the ladder into department management.Since the profession began, supervisors have been

selected from the ranks of bedside clinicians. How-ever, the skills and attributes that make a great bed-side practitioner aren’t always the same skills andattributes that make a great manager. What do newmanagers need to know to ensure success on the job?To answer that question, we turned to three long-timerespiratory care department directors with proventrack records. Here’s what they have to say about res-piratory care management and what it takes to turnclinical know-how into managerial expertise.

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AARC Tımes January 2005 33

Who: Mark Mays, MS, RRT, direc-tor of respiratory therapy, The OhioState University Medical Center,Columbus, OH

How He Got into Management: “I started out as a staff therapist,

and all I ever wanted to do was be thebest critical care respiratory thera-pist around,” says Mays. “I nevereven thought about being a man-ager.” Of course, it was just that can-do attitude that made him a primecandidate for a management posi-tion. “Eventually I had an opportu-nity to try a shift manager position,and I liked it and seemed to do apretty good job.” From there he wastapped to head up a department at asmall hospital, then at a larger hospi-tal, and finally, at Ohio State.

The Hardest Part of the Job:“Managing details and keeping allour projects on track.”

Top Five Tips for New Managers:

1. Take time to meet individuallywith staff members. “Get their per-

spective on where the department isand where it should be,” says Mays,and seek out their opinions on thedepartment’s strengths, weak-nesses, and opportunities. He alsosays to ask staff about their ownindividual goals and interests. “Butbe careful not to make too manypromises,” warns the manager. “Atthis point, you’re just getting infor-mation. You will develop goalslater.”

2. Determine who your main cus-tomers are and meet with them individ-ually. Mays says this could includeanyone from the nurse manager tokey physicians. “Ask how well thedepartment has met their needs inthe past and what areas needimprovement.”

3. Conduct a thorough review of thedepartment’s monthly financial reports.Mays recommends going back atleast six months to see if the depart-ment has met budget and if not, whynot. “This may take a little work, andit will most likely require some con-versations with the folks in thefinance and purchasing depart-ments, but it’s a good idea to get toknow them anyway.”

4. Develop a strategic plan. “Ibelieve this is the most importantthing any manager can do,” saysMays. He suggests starting theprocess by meeting with youradministrator and learning theorganization’s objectives. Thenselect a few key staff members —supervisors and bedside cliniciansalike — to serve on a strategicplanning committee aimed atdeveloping key goals for the com-ing year. Pick a wel l-definedmethod for strategic planning(Mays recommends the modifiednominal group technique1), thenshare the results with staff andyour medical director and con-tinue to meet regularly with your

committee to see the goalsthrough to fruition.

5. Communicate regularly with staff.Mays says staff meetings, conductedonce a month or so, keep everyoneinformed of the department’s goalsand objectives. He suggests publish-ing an agenda for the meeting aheadof time so everyone can see what willbe discussed, then following uppromptly with the minutes of themeeting. It’s also important to meetregularly with supervisors, leadtherapists, and others in key roles.Posting these meetings on a depart-mental calendar, he continues, willhelp ensure they are well attended.

Who: Colleen Schabacker, BA,RRT, director of respiratory care,Cookeville Regional Medical Cen-ter, Cookeville, TN

How She Got into Management:Schabacker started out in the profes-sion as the education coordinator atan Illinois hospital, then spent a fewyears in home care before taking a jobas assistant respiratory care directorat a hospital in Tennessee. That jobquickly led to a 16-year stint as respi-

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Mark Mays, MS, RRT

Colleen Schabacker,BA, RRT

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ratory care department director atanother hospital, then her currentposition at Cookeville Regional.

The Hardest Part of the Job:“The most difficult thing aboutmanaging a department for me waslearning how to deal with the staff,”says the manager. “I expected every-one to come in, do their job, do itright, and get along with oneanother.” Reality, she says, is oftenfar from that ideal.


1. Support your staff. “You must bethere for your staff and allow them tobe involved in changes,” says Sch-abacker. “If they are not involved,they won’t ‘buy in.’” For example, shesays, “Let them decide how to makethe treatment sheets easier. Letthem decide on various pieces ofequipment.” If you involve staff indecision-making, emphasizes themanager, they will “do their very bestto do everything you ask of them.”

2. Provide competitive salaries, bene-fits, and schedules. A manager whosupports staff in terms of appropri-ate pay, shift differentials, educa-tional opportunities, and other keyissues of employment, says Scha-backer, will be rewarded over andover again with a harder workingstaff. “You are their primary voice inthe administration,” she reminds.

3. Never embarrass an employee infront of others. The time to addressshortcomings with your staff, saysthe manager, is one-on-one in youroffice, not in front of other staff,nurses, or physicians. “If you have aproblem with what they have done,you must still defend them the bestyou can to others,” says the manager.“If your staff thinks you are going tobelittle them in front of others, theywill not be your staff for long.”

4. Be fair. “I’ve always said that ifthe hospital policy says respiratoryhas to wear purple on Thursdays,then everyone will wear purple onThursdays,” says Schabacker with alaugh. “You have to follow all poli-cies fairly with no exceptions.”That’s particularly important, shecontinues, when it comes to policiesgoverning absenteeism, tardiness,and paid time off. “Set your policiesin stone and do not falter. This letsyour staff know you are fair.”

5. Stay up to date on industry trends.“You’ve got to keep up with thejournals, new equipment, newmedications, JCAHO standards,etc.,” says Schabacker. “If you’renot on top of these trends, youreally can’t know which directionto take your department in.” It goeswithout saying, she continues, thatmanagers need to be members ofthe AARC® — but she also empha-sizes the importance of gettingstaff to join the Association as well.“Not only does the AARC helpkeep everyone on top of things, itdefinitely portrays professional-ism.”

Who: Tom Trenis, RRT, director ofrespiratory care and neurodiagnos-tics at Carilion Medical Center inRoanoke, VA

How He Got into Management:Trenis calls his entry into manage-ment the “typical progression wesee in respiratory therapy.” Hestarted out as a bedside practitioner,then was promoted to shift supervi-sor. From there, he wanted to spe-cialize in ICU care, so he took a jobas clinical educator for his depart-ment, which eventually led to a posi-tion as ICU manager. “I have pro-gressed into different directorshiproles since,” says the manager.

The Hardest Part of the Job:“The most difficult aspect of man-aging is gaining the necessaryhuman resource skills. They arequite a challenge, and you learn byyour mistakes — but it’s veryrewarding once you understandwhat you are working with.”


1. Listen to your employees. Treniscalls staff “your eyes and ears of thedepartment” and says managersneed to learn active listening skillsso they can better understand staffand how they react to certain situa-tions. “Utilize participative man-agement whenever possible,” hecontinues. By involving staff in deci-sion-making, he says you’ll growyour department and surroundyourself with talented individuals.

2. Stay tuned clinically. He’s notsuggesting managers carry a work-load, but Trenis does believe it’s crit-ical for managers to stay currentwith the literature and cutting-edgemodes of care. He also believes it’simportant to look outside thedepartment for opportunities.


Tom Trenis, RRT

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Often one of the first orders of business for a new manager is recruiting new staff. After reviewing countless applications, conducting interviews, assessingperformance skills, and completing all the other necessary processes, you’ve finally hired the “cream ofthe crop” for your department. As a leader, you are veryproud that you and your team have been able to attractand hire such high-quality therapists. Now you canbreathe a sigh of relief that it’s all behind you. But wait,attracting the best and the brightest is only part of thejob. Now that you have several great new hires, whatmust you do to keep them?

First, it is very important to open up the lines of communication with staff, says Quint Studer, founder and chief executive officer of Studer GroupSM (GulfBreeze, FL), an executive coaching and national learningfirm. Studer is a former president of the Baptist Hospital,Inc. in Pensacola, FL, and was named one of the “Top100 Most Powerful People” by Modern Healthcare in itsAug. 26, 2002, edition.

“More than 25 percent of employees who leave healthcare positions do so in the first 90 days of employment,”says Studer. “It’s very important that you schedule several one-on-one meetings during the ‘honeymoonphase’ to find out what is really on the minds of your newemployees. Do this successfully and you can cut yournew employee turnover by 66 percent.”1

Studer suggests scheduling these meetings at the 30-and 90-day marks. The following is an outline leaders canuse for both 30- and 90-day meetings. Start by lettingnew hires know that you are glad they are part of theteam. Let them know that you care and that you valuetheir input and ideas, then ask:1. How do we compare to what we said we would belike? This question will open a dialogue for clarifying thenew employee’s expectation level and will give you agood perspective on whether you are delivering what youpromised.2. What is going well? Give the new hire a chance tofocus on the positive aspects of the job instead of thenegative ones. As a manager, you will gain a unique perspective on what matters to people.3. What employees have been helpful to you in yourfirst 30 days? By asking this question, you can discoverwhich employees are valuable in the retention processand recognize and reward them for helping new hireslearn the ropes. Once other employees see that the

employees are beingrewarded, they mayalso get involved.4. I noticed you cameto us from _____. Arethere things you didthere that might behelpful to us? Askingthis is a great way toharvest great ideas.New hires may bereluctant to offer inputfor fear of alienatingco-workers. By askingthe question, you getgreat new ideas forprocess improvementand the new employees feel as though they made a valuable contribution.5. Is there anyone you know who might be a valuableaddition to our team? At this point, your new employeesare likely still in touch with former co-workers. If they arehaving a good experience with your organization, and youare still hiring, encourage them to let former co-workersknow. This is an effective recruiting method; one hospitalCEO has even provided phone cards to new hires specifically for this purpose.

“Getting people on board during the first 90 days iscritical to their long-term tenure with your organization,”says Studer. “These 30- and 90-day meetings, which aredesigned to ask very specific and relevant questions,really do work to keep more employees.”

One more key element of retention, according to ChloeO’Loughlin of WCWH Limited of Vancouver, BC, is to givethe new employee a mentor who has worked at the facility for a long time.2 A mentor can be an invaluableguide during the orientation period and will help make thejob of retention much easier for the manager in the longrun.•

REFERENCES1. Studer, Q. (2004). Hardwiring excellence: Purpose, worthwhile work,making a difference. Fire Starter Publishing.2. O’Loughlin, C. (Last accessed Nov. 4, 2004). Attracting and keepinggood employees [Online]. Available: www.hrvs.ca/hr_practices/pg004d_e.cfm#new. HRVS (Human Resource Voluntary Sector).

Enhancing Staff Retention: What Good Managers Do in the First 90 Days To Keep New Hires


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“Diversify your staff to take on addi-tional responsibilities that are notnecessarily traditional to respira-tory therapy.”

3. Understand health care economics.“It is very important to understandthis topic if you want to get the sup-port of your administration,”emphasizes the manager. First andforemost, managers must recognizethe fact that they work in an indus-try where costs are increasing whileincome from primary payers isdecreasing. “Do your homework onissues that affect your departmentand how you can offer services at themost efficient level while maintain-ing the highest quality possible.”

4. Continue your education. Sincemost RT managers enter manage-ment without any formal educationin the area, Trenis believes it’s essen-tial for managers to further theireducation, whether that’s by takingclasses offered by your organizationto help you better understand finan-cial or other issues or by going backto school to earn a business degree.“Even if you have been managing adepartment for awhile, the formaleducation helps put all the pieces ofthe puzzle together.”

5. Stay active in your professionalorganization. “This has to be one ofthe most valuable assets to a man-ager of respiratory care,” says Trenis,noting the AARC provides a wealthof educational resources managerswon’t find anywhere else and unpar-alleled opportunities to connectwith key decision-makers across thecountry. “The network you build isgoing to pay off many times over,”says the manager. •

REFERENCE1. Ryerson University. (Accessed Nov. 16,2004). The nominal group technique[Online]. Available: www.ryerson.ca/~mjoppe/ResearchProcess/841TheNominalGroupTechnique.htm

veteran respiratory therapy managers offer tips to help...

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