Table 3 Representative Comments from the Top and Bottom 10% IR groups

Question 1: Please share something you have seen make a positive impact on the culture in your work area that you recommend continue.

 Top 10% IR

  Our nurse manager talked with all of us about how to handle a conflict with another employee. She always leads by example and practices what she preaches. As a result, we have been able to come to each other when we are having a conflict. That allows opportunities for us to handle it on our own. It seems to bring us all closer together.

  Encouraging the nurses to raise any questions/concerns they have. It averts errors in ordering, and also provides teaching opportunities when the order is what we intended.

 Bottom 10% IR

  We are so burned out that if anything positive happens we have not had time to notice it.

  CAN NOT THINK OF ANY POSITIVE CHANGES. HOWEVER, SEVERAL NEGATIVE COME TO MIND!

Question 2: Do you have any other comments, questions, or concerns?

 Top 10% IR

  This is a great place to work. The clinical staff are really a team. Everyone helps each other and they each create a positive environment.

  I am new here and felt very welcome and part of the team since day one. I feel very honored to work for this wonderful group. It feels like a group of friends who happen to work together more than co-worker relationships.

 Bottom 10% IR

  Feedback is rarely given to residents (attendings have other things to worry about) so the few instances when feedback is given have a disproportionate impact. We get feedback twice per year from the Program Director, and almost never outside of that setting (you almost never hear from attendings how you’re doing with/for their patients, in cases, in clinic, etc). The overall culture is to keep your head down and not rock the boat. This isn’t exactly conducive to raising issues when they come up. Despite generally difficult/stand-offish attending-resident relations, resident morale is ok because we all get along and work hard for each other.

  This place wants “yes people”. I feel upper management makes decisions and then only wants people who will implement the plans they already have made. My opinion counts for nothing. You are just the worker that helps them accomplish their goals.