Brain Surgery, Corporate Culture & Leadership Consistency

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My husband, the love of my life, had brain surgery a few weeks ago.

The anticipation, wondering if it was benign or cancerous (it was benign), praying that the neurosurgeon would not suddenly get the shakes, being in a hospital away from home and having no family nearby all added up to make this one of the most stressful experiences I’ve gone through in a long time.

And while we were in the hospital, waiting for Marco to be admitted, something occurred to me.  This was a great opportunity to observe corporate culture.

  • First, I would experience it from the perspective of a customer (instead of as an corporate leader or HR pro or business coach).
  • Second, we would be exposed to all levels of employees: janitors, nurse’s assistants, charge nurses (responsible for all the activities in their unit during their shift), staff supervisors and doctors.
  • Third, we were going to be there for three nights and four days, 24/7.

It was the perfect incubator for observation. Would the corporate culture the hospital spent thousands of dollars and many man hours to create, translate into a consistent experience?


In the ICU unit, we had a nurse named Megan who explained everything to us. I’m not overstating this. From how each medication was going to help Marco heal, to showing me how to unfold the sleeper chair and set the locks on it so it wouldn’t roll away and everything in between. She made sure we were as knowledgeable about Marco’s situation as she was.

When she met us, she wrote her name and hospital cell phone number on the wipe-board so we would know who she was and how to get in touch with her.

She apologized for having to wake Marco up every hour.

When I asked her where the soda machine was, she asked me what I wanted, left the room and brought a Diet Coke back to me so I wouldn’t have to pay.

She lovingly patted my husband’s head when he was in pain and couldn’t have more pain killers.

She made sure we both understood that he was not to blow his nose for a month.

She brought extra blankets and pillows without us asking for them.

Watching Megan attend to my husband left me feeling comforted, safe and reassured. That was because of two things: She knew what she was doing and she genuinely cared about my soul mate.

Toni & Company

Toni was our nurse when we transferred from ICU to a regular floor.

In her first introduction to us, she wrote her name on the wipe board while explaining this was not her regular floor and that she was on loan from another floor. She didn’t write down her phone number.

We were transferred right around lunch time and my husband was ravenous. I asked Toni when we could expect lunch and her answer was “soon.” 45 minutes later, lunch had not arrived. I went to find her at the nurse’s station and inquired again. Her answer was, “It’s probably up on the ICU floor.” Another 30 minutes later, I left my husband to find her again and asked when his lunch was going to arrive. She sighed at me, asked all the other nurses where my husband’s lunch was and finally said, “I suppose I’ll have to go to ICU to get his lunch.” More time passed before we finally got his cold lunch.

Megan from ICU told us that if Marco got thirsty, extremely thirsty, we needed to call the neurosurgeon right away; it meant danger. The thirst happened during Toni’s shift. We told her five times over three hours what was happening, we told her the neurosurgeon wanted to be paged immediately if it happened. Each time I went to look for her (she didn’t come to us) she said, “Oh. Okay. I’ll call the doctor.” Finally, after 3.5 hours I went to the ICU floor, looked for Megan and told her what was happening. She immediately broke all protocol by leaving her floor to see Marco. She asked him a bunch of questions, her face got red and she said she was going to page the doctor right then. Five minutes later a sheepish Toni walked into the room ready to take care of him. She also told us that the neurosurgeon yelled at her on the phone.

It wasn’t just Toni either. None of the nurses on that floor wrote down their hospital cell phone numbers. When Marco got extremely thirsty he asked for Gatorade and another nurse said, “I’m sorry we don’t have any on this floor.” We weren’t asking for champagne for Pete’s sake! I asked several people if I could have a sleeper chair and the consistent answer was an apathetic, “I’ll try.”

Being on the ICU floor was like being at a Ritz Carlton. The last three days of his stay was like being at a charge-by-the-hour motel.

Organizational Consistency

What happened?  It was the same hospital system.  Each floor had the same motivational employee bulletin boards which reinforced the “competency of the month.”  The processes for responding to patients was the same on each floor.  And I’m sure they were operating from the same employee handbook.

Shouldn’t every employee take patient care seriously?

Obviously, the answer is yes. Yet I think one of the hardest things for organizations to nail down is consistency across their enterprise.  What happened last week reinforced three things every leader needs to understand and do something about:

  • An organization can have all the technical tools in place to create an incredible customer experience, but that is no guarantee that employees will use them.
  • Leaders, Recruiters and HR pros need to continue to focus their recruiting efforts on the technical and behavioral skills candidates present. One without the other is disastrous.
  • Great tools and employees with phenomenal technical/behavioral skills are lost without front line supervisors who know how and have the courage to hold their employees accountable.

It’s a three legged stool. Or is it? What other factors should be considered in creating a consistent experience? Why do you think there was such a stark contrast between ICU and the regular floor?

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Alicia Arenas

Alicia Arenas

Alicia Arenas, founder and CEO of Sanera, The People Development Company, is a distinguished business consultant, coach, corporate facilitator, and speaker.Prior to launching Sanera in 2008, Alicia was an accomplished Human Resources leader in corporate America working in Fortune 100 and 500 companies where she led Human Resources teams, mentored leaders, developed strategic operational plans and oversaw training and development at an enterprise level. Alicia earned her SPHR certification in 2001 from The Human Resources Certification Institute.


  1. First of all, we’re all so very happy that Marco is on the mend! I’ve experienced the same things when my own parents have been in hospitals over the years. In fact, when my mom was in for back surgery last november, the nurse manager spoke with me on the phone extensively about the situation and made herself very accessible. Thank God for that.

    Consistent customer service is critical, and hospitals should certainly know better. I understand that there continues to be a nursing shortage but that’s no excuse for poor customer service.

    The “Megan’s” need to be in charge of training the “Toni’s”…

    1. Thank you Kevin. We are thankful for the great outcome of Marco’s surgery!

      As far as the “Megans” training the “Tonis,” I think that could be a good idea, especially if Megan enjoys training and is good at it. I would have loved to interview Megan and understand more about why she got into nursing, the challenges she’s overcome, why she loves her job so much and what her leadership is like. Of course, I had other things on my mind. 🙂

      If I could go back for non-medical reasons, I would dig more deeply in the differences between the two floors to vet things like level of experience, type of training (technical and people) they received, salary levels, differences in leaders, frequency of feedback. I have to believe all of those issues come into play.

      Thanks so much for your comment and for your prayers during Marco’s recovery.

  2. Wow, what a vivid picture you paint with your words, Alicia.

    Yours and Marco’s personal story evokes many emotions, including empathy (that you and Marco have undergone/are undergoing this very difficult personal trial), joy (that Marco is healing and that his tumor was benign), upset (that Toni was unsympathetic, unreliable and unresponsive) and frightened (when Toni and other nurses didn’t respond to Marco’s extreme thirst — scary!).

    I honor health care providers for the CRITICAL technical and personal care and service they provide. Their role is constant, intense and seemingly high pressure combining both scientific aptitude and extreme levels of customer care. NOT a fit for everyone. As well, the leaders in those organizations may not have the bandwidth (or perhaps resources) to facilitate the customer-centric environment essential for their nurses and other staff to deliver proper care, especially during a crisis (that’s scary, for sure).

    That is why your ‘bullet #2’ re: “Leaders, Recruiters and HR pros need to continue to focus their recruiting efforts on the technical and behavioral skills candidates present. One without the other is disastrous,” is so IMPORTANT. It’s important enough to be read 2-3 times.

    As well, you wrote that front-line supervisors should have the ‘courage to hold their employees accountable’ – this also is powerful. I would add, front-line supervisors should exhibit the qualities they require of their staff, and they should be willing (and available) to step in when their staff is overwrought or overextended which sometimes leads to the poor attitudes such as Toni exhibited.

    I wish I could extend the conversation as to why there would be such stark contrast between ICU and the regular floor — I just don’t have those insights. What I DO know, though, is that in my handful of experiences the past couple of years navigating the health care system / hospitals is that the results are akin to yours: personalities seem to vary; departments vary; even enterprise-wide reputations vary. Your having Megan as a go-to person when things escalated is great, but what if she hadn’t been accessible? That’s just plain scary.

    Thanks for your excellent and personal story at the TalentCulture blog!


    1. Jacqui, you raise some excellent points. It is a high-stress environment. And I can testify that the nurse:patient ratio was much larger on the regular floor than in ICU. In ICU, it was 1 nurse to 2-3 patients. On the regular floor, it was 1 nurse to 7-8 patients. I’m sure that had something to do with it as well.

      Being a leader is not for everyone. It means maintaining vigilance over the areas in which we are responsible. It means making tough calls. As you said so eloquently, it means living a good example and stepping in to help. It’s not easy being a good leader. And I think part of the reason why people who should never be leaders end up in those positions is because that is often the only choice employees have to make more money. That is why, IMHO, companies need to develop dual career tracks: one for leaders of people and one for technical leaders. But perhaps this is another post.

      Thanks so much for your insights Jacqui!

  3. Alicia – even knowing what has been going on this past month, it still brings up so many emotions as I read of what you and Marc have been challenged with. You both are very strong, and I continue to pray for Marc’s full recovery.

    Your 3rd point above hits home for me. The accountability. I think it’s critical that the front line supervisors hold their staff accountable. Sure, we all have different personalities, but there needs to be a level of consistency that we, as the patient, can depend upon. I’ve been in scary hospital situations with family before and it’s at those times we need to know we can count on the medial team(s).

    Great post my friend. Thank you for sharing!

    1. Michelle, thank you for your response. It has been a difficult journey but we have a lot for which we are thankful. And I’m so glad that despite the bad experiences on the regular floor, we did have Megan to rely on when we needed her the most. I hope that I can be a Megan in the lives of my clients.

  4. Good To Hear That Marco Came Through With Shining Colors!

    Your post is extremely timely for me as I am witnessing the same types behaviors during a recent stay at a hospital. I, too, shake my head how some nurses can be so helpful, and go the extra mile, and make you feel comfortable in a very uncomfortable situation. And other, well lets just say they make you feel like you are an inconvenience to their day! (and don’t get me wrong – I completely respect their work and the occupation – I know it isn’t easy)

    Your post was a good demonstration of how an organization’s vision/mission/purpose somehow doesn’t make it to everyone in that organization. And for the consumer, every point of contact is the organization’s chance to make a positive (or negative) impression.

    I commend you for the way you took a very personal situation and was able to create a connection with your thoughts on business culture.

    Well Done – Thanks – All The Best With Your Husband’s Quick Recovery!


    1. Steve, I’m sorry to hear you had a recent hospital stay.

      I think you hit the nail on the head when you said that every consumer touch point is an opportunity to reinforce or detract from an organization’s brand. It’s interesting to me that based on the comments, the experience we had seems to be universal across the medical industry. And truthfully, I cannot think of a an area in which a consistent customer experience is not just needed, but vital. Thanks so much for your comment and best wishes for a speedy recovery!

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