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08.12.2017 Opinion

Re: Dr. Dordoye's 4 Page Apology Letter To The Hon. Minister Of Health

By Francis Ayim
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For the records, the staff of Ankaful Psychiatric Hospital has a history for being committed to their work even long before Dr Dordoye took up as hospital director. They continued to work even when there were general industrial strikes and continued to work even when sister hospitals agitated regarding inadequate funds and resources to work. Though these nurses work in one of the most strenuous and stress provoking environments, their Commitment has been unflinching. These are the group we are talking about. This commitment of ours was undoubtedly noted and professed by the fact finding committee sent to the facility.

The hospital director (HD) starts off by creating the impression in paragraph 1 that nurses are the group unhappy with him but captures in paragraph 3 of his apology letter the numerous petitions received by the CEO of mental health authority from staff about the poor leadership style of the director who constantly trampled on their human rights.

This statement makes it particularly clear that, not only nurses are unhappy but the entire staff at the facility. This statement also defeats the created assertion that the organizational unrest started with the petition of PNG on an “orientation schedule” in his so called apology letter.

He talks about orientation through various departments outside job description as being normal in his estimation but this is incorrect same way to borrow his thought; working outside job description is incorrect.

The honorable minister
a. orientation is not rotation
b. Orientation is personalized and therefore incorrect for an employee to receive an orientation in departments outside their job description even if it is one day. The reason why a job description is important during an orientation is to prevent work outside job description or role conflict. The deputy director of nursing service (DDNS) In-charge in a meeting with the HD and Ward In-charges stated emphatically that in her initial roster, kitchen, laundry, environment, estates and stores were not part but, it is he the HD who ordered her to add those places. Minutes of that meeting is on every ward, but HD failed to add that to his accusations dubbed "apology letter".

c. Research on occupational stress has cited role conflict as a stressor. Why therefore will you stress nurses who have already rotated same wards during their service with another rotation in the name of orientation at the same facility.

Secondly, you may also note in paragraph (3) an impression created that PNG insisted there were no other grievances when they met management. To give clarity, the answer was in relation to “any other management decision” and not in relation to him as hospital director as matters regarding his conduct and style of leadership had been a matter for dialogue at several levels. He insinuates in this paragraph that, though staff members had been cautioned on the use of petitions but instead to use verbal dialogue to address concerns they failed to heed. Interestingly he failed to bring to the knowledge of the honorable minister and the good public the many dialogues held both among management and staff to resolve the many issues leveled against him which on several occasions he promised to change but became a nine-day wonder.

In the same paragraph, the HD (Dr Dordoye) sort to suggest that the decision on PNG's petition was management's wisdom but surprisingly “Dr. Dordoye ACCUSED THE ADMINISTRATOR AND DDNS I/C FOR BEING BEHIND THE ACTIONS OF PNG AT THE CENTRAL REGIONAL MINISTERS OFFICE". It is worthy of note that, this whole staff issues were spearheaded by PNG local (because Nurses were majority) independently, "without the knowledge or consulting any management member",

He defines the petition in paragraph 4 of the letter to border on “disciplinary measures and systems management he had put in place since he assumed leadership”. Kindly bullet these few things from this statement

  • These disciplinary measures and management systems are ones he instituted and not management.
  • These measures are personal and not necessarily organizationally sanctioned. So as to whether management agreed or not, as to whether it conformed with organizational statutes, he had no regard for that. A man imposing himself over the system. Popularly noted in his speech….”This is what I believe in”.
  • Ironically he has not instituted any disciplinary measures apart from his bad leadership style.

Note this statement from his closing remarks “l admit I sometimes went overboard". Overboard does not mean within organizational statutes. This means flouting and breaking organizational rules to achieve personal goals. Note key to organizational administration is separating personal goals from organizational goals.

He adds in paragraph 6 that nurses are generally unhappy with new systems to improve health care delivery and cites prescribers weekly meeting as an example. Surprisingly the hospital director recounts a request by nurses to have deputy in-charges take part in clinical meetings as an expression of unhappiness or dislike when one would have thought it would be a welcoming idea for the director who wants to promote learning. He rather kicks against the request with the explanation that it will reduce focus. Meanwhile no continuous professional development has been organized for nurses ever since he assumed office. He has on some occasions refused to make funds available for training calling it a waste.

Before Dr Dordoye took over, Physician Assistants (PAs) and Nurse Practitioners(NPs) have worked within their Job description, attended to both general and psychiatric cases, and worked tirelessly to absorb overwhelming number of patients, yet without any incentives or remunerations, but never complained; they also worked under supervision of 2-Specialists. Again, PAs/NPs were put on 1st-On call duty, & Specialist 2nd On-call, in case of any emergencies at night. PAs have always contained all emergencies, and refer any case beyond their competencies or based on scarce resources upon consultation with Specialist accessible. The Big question is, how then were the PA’s/ NPs working like doctors?

In paragraph 7, Dr Dordoye only got concerned with an excuse duty rather than the life of the staff which almost got lost in the line of duty as a result of an asthmatic attack if she had not been rushed to a nearby facility (Ankaful General Hospital). When he is aware that the lady is asthmatic, the episode happened during the night shift, PA’s are first on call during the night as captured earlier. Dr Dordoye on one occasion like this queried a staff for calling him during the night and not a PA as he is a consultant. Again, the PA mentioned in this paragraph, was given 2-wks excuse duty by a House Office instructed by a Consultant after a surgical operation, something he failed to bring to your notice, honorable minister. He did not even call to check on how your prescriber (NP) was doing, but Dr. Dordoye follow up to rather question the judgment of the consultant.

Working and schooling among nurses is a global phenomenon. Nurses run a shift work system, a work schedule practiced all over the world and not only in Ghana. Nurses hence work at least 8 hours daily for 5 days and have 2 days off which is even more when they run night duties (which is 12 hours). This allows them the flexibility to pursue academic laurels using the remaining hours of the day (morning or afternoon) or their days off and have these lawfully acquired certificates used for upgrade after working for a number of years. Meanwhile not all staff nurses school for purposes of an upgrade. Now the hospital director is not happy with academic pursuit of nurses and other staff because according to him, “we become more litigant after school". He rather uses working hours, government fueled vehicle to teach at University of Cape Coast.

He also failed for instance to touch on the fact that he wrongly took the said staff he was trying to evict to court and got slapped with a fine.

The hospital director also claims he has empowered the internal auditor in terms of repairs and purchasing. Well you could also ask him what was she doing then and what significantly different is she doing now. Then ask him how well he has empowered the procurement system and officer of the facility when for instance items are purchased without his knowledge and brought to him later for entries to be made under his tenure of office.

The hospital director in paragraph 10 blames the removal of the in charge of the drug rehabilitation center on running down the centre when it is no hidden secret that she was removed per the discretion of the DDNS I/C following persistent picking and persecution of the in charge by Dr Dordoye. This persecution started shortly after the in charge objected to Dr Dordoye’s demand to have the table tennis, an item which was donated to the facility by a philanthropist (one of the few source of recreation for patients on the ward) sent to his house for his children's use when these patients pay huge sums of money to enroll into the program. One will ask if a table tennis can be demanded by the HD to be sent to his house, then what other donated items has he sent to his house, your guess is as good as mine. He hastily tags the unit as being runned down over an incidence where some patients of the unit acquired a substance from another client when they went outside the rehablitation center to undertake an alcoholic anonymous (AA) meeting since the other client was attending the meetings on out patient basis. Honorable minister, Dr Dordoye failed to tell you that he is the reason why the only psychologist (the very person who mobilized resources and started the alcohol and drug rehabilitation center) we had at the facility vacated his post and this was the same psychologist attending to the service users at the unit. Dr Dordoye's leadership toward staff which resulted in the specialist vacation is the reason for the run down of the unit.

Now to bring matters into enlightenment. The HD speaks about reforms. One that is not reflecting in the lives of patients and staff of the facility, benchmarks for evaluating commitment to organizational mission and vision. The facility is worst of than when it was even running on little IGF. We invite you to take a trip to the facility to have a look at conditions in which patients and staff live in and you will be struck out of the illusions he wants to create.

Our hospital director on countless occasions takes to showmanship, intimidating, degrading and ridiculing nurses, most of who have diploma qualifications for not knowing an information he acquired in medical school and over about 20 years of work experience. Dr Dordoye fails to comprehend that, his role on the health team is not to make nurses, PA’s and others feel inferior but to provide them with the medical information necessary for patient care and we repeat “as his role”. There are instances when the HD had no knowledge about something when nurses knew, he requested to go and read. Where in this world are you allowed to undignify someone at work because he does not know what you know. His disregard grew to the extent of instructing a DDNS I/C to check vitals because he does not trust what has been done by nurses. Why won't he attempt micromanaging DDNS I/C. Same person will not organize workshops for staff, is unhappy when nurses go to school and does not like the idea if they request to take part in prescribers meeting.

How is spending about two hours on just 2 to 3 patients, increasing patients waiting time, engaging in fault finding instead of saving patients life, promote excellence? Is a patient likely to return to the facility under these circumstances?

How is he promoting excellence when he tells staff he the HD will always be the bird that defecates on other birds below it. Do human beings deserve to be treated with such disregard? We ask, why he alone is now playing the role of HD, administrator, DDNS, procurement officer and the likes.

What we have on our hand is a man in search of absolute power, a malignant bully who intimidates, embarrasses and attack the self esteem of others to hide his own inadequacies.

What the staff of Ankaful psychiatric hospital seek, is to maintain and enhance the already existing excellence and also to advocate and protect our patients from an environment which is no longer healthy and safe for their care because of the bad leadership style of Dr Dordoye.

His 4-page apology letter is a massage of the actual situation intended to garner public sympathy. He tried to justify his bad actions and his poor leadership style, a typical feature of workplace bullying. He also deliberately ignored the issues raised in the petition (that is: conflict of interest, misuse of scarce hospital resources, ignoring procurement processes, purchasing items at exorbitant prices and human rights abuse just to create a diversion. It's on this grounds that we reject his apology letter and ask that he is removed.

Thank you very much
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