Addressing management issues

Oct. 1, 2008

Insubordination in the lab

Q What constitutes
insubordination, and does failure to respond by a deadline qualify?

A Alton Sturtevant
advises: “Generally, insubordination is defined as the failure to submit
to authority. Examples include open challenge or refusal to follow
directions of a manager, showing disrespect for management, using
abusive language, or making threats towards management. Many actions or
on-the-job performance failures can be classified as insubordination per
this definition and the examples. Acts that may fall into the ‘gray
zone’ of insubordination are usually given latitude within personnel
policy manuals since the classification of the act or failure to act is
not always clear cut. The difference between a performance issue and a
policy violation can certainly be blurred, so the manager must evaluate
each occurrence fairly. The employee’s responsibility, however, is to
exhibit the proper level of professionalism required by the position and
the standards of the job. Conversely, management must be responsible for
ensuring that performance standards are well known and that deadlines
are carefully explained.

“It is unclear that failing to meet a deadline
would be insubordination rather than a performance issue. Responsible
managers must recognize performance issues or lack of ability in each
employee, and discuss these problems with the employee to ensure that
performance expectations are understood. This can be an informal meeting
or a more formal discussion with all points being officially documented.
If the person continues to ignore deadline instructions, then
insubordination would certainly apply.”

Larry Crolla explains: “If people were fired
every time a deadline was missed, no one would be left to work.
Insubordination comes into play when the deadline is missed in defiance
of established authority, not because the employee is a procrastinator
or did not understand the importance of finishing on time. When an
employee is capable of performing a task, realizes the importance of its
on-time completion, and has the resources to accomplish this but simply
wants to ‘stick it to you,’ he is in defiance. The problem lies in
proving this. Once someone is given a task, his manager would have to
make sure all of the above criteria were met and, quite possibly, have
issued previous warnings for completion of some other tasks before he
could threaten termination for non-compliance. I am not a lawyer; you
need to verify all actions with your personnel department.”

The dictionary definition of insubordination is the act of a subordinate deliberately disobeying a lawful order.

According to Marti Bailey: “Insubordination is the
direct refusal to fulfill a request made by someone with the authority to
make the request. Insubordination could take other, more passive forms. The
dictionary defines it as the act of a subordinate deliberately disobeying a
lawful order; the operative word here is deliberately. Deadlines are
missed for different reasons as well as for no reason, but if you believe
someone is deliberately not responding to a deadline — especially if the
case is not an isolated one — you may very well be looking at an act of
insubordination. Employees unhappy in their jobs or with their bosses may
reduce their productivity or the quality of their work, instigate
co-workers, become demanding — the list goes on. Basically, they try to
devise ways to make someone pay for their unhappiness. Since there are
limitless possibilities, your situation certainly could constitute an act of

“Talk with this employee to determine the reason for
his behavior. Scores of people fail to meet deadlines due to forgetfulness,
perceived higher priorities, or accommodation of past missed deadlines. What
makes you think this employee is deliberately missing this deadline?
Generally, when there is a deadline to be met, the people who need to
respond are given gentle reminders periodically to keep them on track. If
they have failed to meet deadlines in the past, it is imperative for
management to keep closer tabs on their progress in order to ensure the
desired outcome. If this employee has a history of missing deadlines, then
that should be reflected in his performance appraisals with a possible
performance-improvement plan enacted. If this is the employee’s first
missed deadline, then you need to have an open, honest conversation with him
regarding the need to meet expectations.”

Bottom line. Carefully determine if you are
dealing with insubordination or poor performance. Keep private notes on the
incidents that make you suspect insubordination until as you can consult
with your personnel officers about what action to take. Insubordination may
involve the need for legal expertise. Often an employee with a history of
forgetting deadlines may be just that: forgetful. A performance-improvement
plan can generally fix that type of problem.

In-house CE programs

Q Any tips on providing
interesting in-house CE programs for all levels of lab staff?

A Marti Bailey recommends:
“Remain open to any and all opportunities, including those that may not
directly relate to lab work. Broad-based learning is a positive experience
because it allows for improved understanding of issues that perhaps do not
affect the lab directly but
do have a significant impact on an institution as a whole. All
programs that are relevant to the personal lives as well as the professional
education of employees should be considered.

“Next, be aware of what is already available in your
institution. Working in an academic medical center makes the task much
easier for me because there are presentations available almost on a daily
basis and open to anyone. Find out how to access meeting schedules so that
someone in the lab can be aware of what is available and pass on this
information to the staff. Other educational sources that our lab uses are:

  • equipment/reagent vendors;
  • professional alliances;
  • reference laboratories;
  • state or county health department;
  • pathologists/pathology residents;
  • lab staff returning from professional meetings; and
  • physicians and non-physician practitioners.

“Make it a point to visit the websites of the
laboratory’s supplies/equipment vendors, its professional groups, and any
reference labs you may use. Many have educational offerings — some with an
associated cost and others free of charge. Check with your state or county
health departments for consultants, coordinators, and specialists whose job
is to educate the public in healthy lifestyles. Solicit your pathologists
and/or pathology residents to make presentations.

Case histories are always well received because of
their relevance. The staff can participate by making suggestions for
educational opportunities based on their lab experiences. Additionally, it
is not a huge task for a pathologist to collect the patient’s history and
diagnosis, and make it relevant to the role of the lab in the particular
case. Another thing about case-history presentations is that they can be
nicely tailored to the time available.

” Part of the responsibility of attending professional
meetings at company expense should include sharing information and knowledge
with the rest of the staff, thereby presenting a golden opportunity for
continuing education (CE). Your favorite physicians and non-physician
practitioners may be willing to make presentations to the lab staff. They
may ask for suggested topics, or they may have a program already prepared
that they could ‘tweak’ to the needs of the lab staff. Providing similar
training for the non-technical laboratory staff can be difficult. Many of
the programs geared to the technical staff also can be of interest to the
non-technical staff, so be sure to invite them. For office staff, you will
need to find relevant occasions to enhance professional development, some of
which may be available within your organization. Computer skills are another
important area for your office staff that you should not overlook.”

A wealth of valuable and timely information is being published
by and for the laboratory industry.

Larry Crolla recommends: “Try to get guest speakers
from other hospitals and, in return, offer to speak at their hospitals. Also
consider having a pathologist run a correlating session with lab data and
specimen pictures that illustrates the degree to which the lab findings and
clinical manifestations match the patient’s condition. Activities like group
exercise and team building can be educational and enjoyable as well. One of
your vendors may have an appropriate speaker to offer you that meets your
compliance standards.”

Alton Sturtevant concludes: “A wealth of valuable and
timely information is being published by and for the lab industry. Much of
the material is free and can be found in publications from the diverse lab
associations such as the College of American Pathologists, American Society
of Microbiologists, American Association of Clinical Chemists, Clinical
Laboratory Management Association, various proficiency-testing services,
trade journals like MLO, product vendors, and other sources. The
websites of the previously mentioned societies also have articles and
educational materials readily available for use in your educational
endeavors. New equipment usually comes with CD- or DVD-based training
materials that are quite good. Worthwhile materials can be purchased from
laboratory-related societies for use in your training efforts. Public
libraries have training materials that can apply to certain segments of your
employee base, such as management-related studies. The materials available
are suitable for all skill levels and job classifications, and vary from the
most technical and scientific discussions to specimen collection and

“The annual requirements for safety, compliance,
and related issues should be included in the CE requirements for the lab
personnel. Many of your employees will find that reading the written
material or viewing the CD or DVD material is interesting. For those who
do not, it is the responsibility of lab management to define required CE
for employees and to provide materials to help them recognize and meet
the requirement. Employees should participate in the programs to
increase their worth to the facility as lab professionals.”

Bottom line. Developing an in-house CE
program should be feasible with the wealth of knowledge available to the
lab from visiting speakers, in-house physicians, referral physicians,
equipment and reagent vendors, state and county health officials. The
list of educational support from lab-related professional affiliations
as well as lab staff returning from professional conferences is long and
varied. Try posting a sign-up sheet for those people willing to present
on requested topics. Explore and be creative because scores of
opportunities exist outside and within your immediate circle.

Anne Pontius is the president of Laboratory Compliance Consultants Inc.
in Raleigh, NC, and president-elect of CLMA 2007-2009. Send questions to
Ms. Pontius at
[email protected].

MLO’s “Management Q & A” provides practical,
up-to-date solutions to readers’ management issues from a panel of
laboratory management experts. Readers may send questions to the Anne
Pontius at
[email protected] . Unless
otherwise noted as “confidential” by readers, all queries will be
considered for publication without further notice to them. Names,
institution, city, and state will be removed before publication. The
following panel of laboratory directors, managers, and supervisory
technologists have provided their input in the answers given in this
column: Marti K. Bailey, MT(ASCP), work unit leader, Pathology, Penn
State Milton S. Hershey Medical Center, Hershey, PA; Lawrence J. Crolla,
PhD, consulting clinical chemist, Departments of Pathology and
Respiratory Care, Alexian Brothers Hospital, Elk Grove Village, IL, West
Suburban Medical Center, Oak Park, IL, and Northwest Community Hospital,
Arlington Heights, IL; and Alton Sturtevant, PhD, laboratory director,
LabCorp, Birmingham, AL.

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