The story that emerges from the interviews in Chapter 5 is one of major change accompanied by the development of a demoralized group of hospital employees. This chapter provides the second set of independent interpretations by the three consultants.
There is no point in mincing words: Things have gotten worse, much worse, perhaps worse than feared. All units lost positions; some units lost many. Between firings, resignations, and budget cuts, some managers do not even know how many people they have authority over. Top management resists requests to fill vacant positions, and middle managers and their staff work overtime in increasingly futile efforts to do their jobs. Not only that, just as all this was happening, top managers fired the consultants who recommended all these changes and brought in a second group with a well-circulated reputation for savagely cutting organizations. Without a moment’s hesitation, the people interviewed routinely say they and their staffs feel frustrated, angry, anxious, and depressed.
It doesn’t take any special psychoanalytic sensibility to see or understand these reactions. However, what deserves special attention is just how deeply these people are wounded. It bears repeating that a