Q: A team member with us for five years is leaving on good terms and has accumulated 36 hours of unused paid time off. Historically, we haven’t paid out unused PTO when someone resigns. However, I’m considering paying her for 15 to 20 hours as a goodwill gesture. Would the payout pose any issues since we haven’t done it for other former employees?
A: Check your state’s employment laws. In places like California and Illinois, accrued but unused PTO is considered a form of earned wages and must be disbursed upon separation. However, companies in states such as Florida have no legal obligation to pay out PTO unless the action is specifically stated in the employee handbook or employment agreement or has become standard practice. If your written policy states that an employee forfeits unused PTO upon termination, and you historically apply that rule uniformly, then you are not legally required to pay it.
Choosing to pay a portion of PTO to one individual, even as a goodwill gesture, can create unintended consequences. The payout might set a precedent, opening the door to other employees claiming inconsistent or unfair treatment, especially if you denied them a similar benefit. If you intend to part with a valued team member on positive terms and acknowledge her years of service, you have options that wouldn’t risk undermining your company’s policy.
One option is to allow her to use a portion of her accrued PTO before she leaves. Another is to award a one-time discretionary bonus as a thank you. You would need to frame it as a separate, nonprecedent-setting gesture unrelated to PTO or any other accrued benefit. Either approach allows you to express appreciation while preserving your policy’s integrity and protecting the business from potential claims of favoritism or inconsistency.
Q: A team member has developed a habit of responding to requests or responsibilities outside of his immediate duties by saying, “That’s not my job.” For example, when asked to assist with cleaning a treatment area after a busy shift or help a coworker with patient prep, the employee refuses, insisting those tasks are “for someone else to handle.” His responses have begun to frustrate other team members, who feel their workload is uneven and that collaboration is lacking. At what point should his behavior be considered a performance or attitude issue requiring formal intervention?
A: The repeated response “That’s not my job” reflects deeper cultural problems within your practice. Such behavior often develops in workplaces where collaboration, accountability and shared purpose have weakened. It may stem from unclear expectations, inconsistent leadership, poor communication, or a perception that extra effort goes unrecognized or unrewarded. Over time, employees begin to focus narrowly on their assigned duties.
When employees stop helping one another, resentment grows among team members who feel unsupported, and productivity suffers. It can also hurt patient care and client service.
Addressing the issue requires looking beyond one person’s behavior and assessing the workplace culture that allows it to persist. A culture audit is an objective way to identify the underlying factors contributing to disengagement, resistance and poor collaboration. The process typically includes confidential staff interviews and surveys to gauge morale, communication patterns and perceptions of fairness. You also need to observe daily workflows and leadership interactions and review policies and recognition practices. The goal is to uncover gaps between stated values and the day-to-day reality.
A culture audit can deliver a comprehensive report that outlines strengths, problem areas and actionable recommendations. These may include the need for:
- Leadership coaching to improve communication and the modeling of collaborative behaviors.
- Clearer role definitions that still emphasize flexibility.
- Recognition systems that reward teamwork.
- Structured accountability processes that ensure consistency.
A culture audit can help hospital leaders shift from reacting to individual behaviors to proactively shaping a healthier, more engaged workplace.
Q: During a tense check-in, a client raised his voice at a receptionist, called her names and demanded immediate service. When the employee tried to explain the client queue, he commented on her appearance and said he would “wait outside to make sure you do your job.” She finished the interaction but was shaken and asked to leave work early. What is the best way to handle client misconduct in real time, and what are our options if the behavior continues?
A: Employers must take reasonable steps to prevent and correct harassment from any source, including clients and vendors.
Prioritize safety by removing the employee from the situation, engaging a manager to conclude the interaction, and calling law enforcement if the perpetrator threatens, stalks or refuses to leave. Calmly tell the client that services will continue only when the communication is respectful. If the conduct persists, pause or end nonemergency care. When a patient has urgent needs, separate the client from the staff member, bring in leadership and complete only what is medically necessary.
Afterward, offer support resources to the employee, and ensure that the team member can leave safely. Also, document who was involved, what occurred, any witnesses, the precise language used and any available video recording.
The next steps might include:
- A written warning to the client.
- A client behavior agreement for future visits.
- Restrictions such as curbside service only or management-only contact.
- A trespass notice in severe cases.
To prevent a recurrence and ensure consistency, train the staff on de-escalation language, handoffs to supervisors and safe exit strategies. Post a client conduct code in public areas and on your website, and state your right to refuse service when conduct is abusive.
Consider incorporating the following policy into your employee handbook: “Client conduct must remain respectful at all times, and abusive, harassing, discriminatory or threatening behavior toward team members will result in pausing or refusing service. For nonemergency care, the practice may reschedule or terminate the client relationship if the conduct continues. For emergency care, the practice will stabilize the patient and, if needed, end the visit. The practice may issue warnings, behavior agreements, service restrictions or trespass notices to protect staff and clients.”
Practice leaders can also use concise language in real time, such as “I want to help you and your pet. We will continue once we can speak respectfully. If the yelling or name-calling continues, we will end the visit today and follow up by phone about next steps.”
If the behavior persists, close the encounter with a clear statement. For example: “We are ending this visit now because of the behavior we discussed. We will send a summary by email with information on transferring patient records. Please leave the premises. If you do not, we will involve law enforcement.”
Finally, consider ending the relationship when the behavior is repeated, severe, threatens safety or includes discriminatory slurs, stalking or harassment. Send a termination letter that cites conduct standards rather than personal traits.
WHEN CLIENTS MISBEHAVE
Aventis Learning Group identified five types of difficult customers: demanding, bullying or aggressive; complainer; confused or indecisive; impatient; and know-it-all. For tips on how to deal with each type, visit bit.ly/475bJVG.