Delegation: developing the habit.

Often, individuals take personal delegation skills for granted and assume the presence of expertise with the practice of delegation, which may not be the case. Those assumptions can be found at both ends of the process, with the manager and the employee. Every time a manager places an employee in a job and gives him or her a job description or a set of instructions, the manager has delegated. The manager has placed someone in a position to perform operations for which ultimately the manager is responsible. Delegation is both a process and a condition. The process is the act of assigning work to an employee; the condition of delegating a job is a thorough and mutual understanding between the supervisor and the employee of specific results and methods by which these results can be achieved. The condition goes far beyond the simple process of assigning a job. The point at which many managers fail in delegating is in neglecting to move past the process and take the required steps to establish a true condition of delegation. Failure to delegate is the leading cause of managers retarding their professional growth. In the case of a workaholic--someone who fails to learn the value of delegation--the job soon becomes too much, and the effectiveness of the department may suffer. By reducing the burden of technical duties and busy work, managers will find that it is possible to be more effective and actually spend more time managing. A number of the reasons why managers fail to delegate are complex and subconscious, such as insecurity, fear of competition and even fear of not being recognized for accomplishments achieved. Other reasons for failing to delegate are habit and shortages of staff members or time. Delegation is an investment in time. The eventual gain from such an investment, which may temporarily cause the department to fall further behind during a training period, outweighs the costs. The manager is the final authority in such duties as approval, recommendations and implementations. Remember that to delegate authority does not mean to delegate ultimate responsibility. Only the manager should bear the burden of responsibilities that directly affect his or her career. One of the most common mistakes in the process of delegating is to turn an employee loose on a job with inadequate instruction. Too often this is caused by lack of time. Strictly speaking, when managers assign tasks to employees, they are delegating the authority to perform the task. However, all responsibility for the completion of the task remains with the manager. In most instances, responsibility for the failure of a delegated project lies with the manager, not the employee. While some failure is to be expected, it can be minimized by proper evaluation of the situation and proper communication. Delegation is a calculated risk. The manager should be willing to take a risk to see if an employee does have the skills and ability to perform the specific task. How else will the manager ever know? Developing a strong habit of delegation will lead to development of an effective and efficient staff and department. Delegation will serve not only the organization well, but also managers throughout their careers.

Boerhaave syndrome.

Boerhaave syndrome is a serious and rapidly fatal spontaneous esophageal rupture that mimics myocardial infarction or upper gastrointestinal conditions. Initially misdiagnosed about 50% of the time, Boerhaave syndrome has a mortality rate of more than 90% without prompt diagnosis and treatment. This article presents a case of nearly fatal Boerhaave syndrome in an otherwise healthy young adult and discusses the historical, statistical, pathophysiological, diagnostic and therapeutic aspects of the disease.