Concluding Insights

Well, that went fast. I find myself wondering how it is possible that this is our last blog. Did I miss something? I feel like I have been so rhythmic at looking forward to our weekly presentations and projects, that I missed the weeks ticking by. This has been my first Masters Class, and I feel like the bar has been set high. I can say that I honestly learned in this class. Learned things about myself and for myself. I learned the things that you would normally learn as time goes on. These things all tie into my own plan for myself. I have had a personal mission statement for some time now. I think that it is true, and I believe that this class has helped to sharpen its words. I would like to share with you what my mission statement is.

 

My mission is to use my skills, both innate and learned, to aid in the advancement of others. I will care for, serve, and advocate for those with and without a voice. I will be known by my family, friends and acquaintances as a person of integrity, honesty, reliability and loyalty. I will always remember that even though I cannot change circumstances, I can change my response to them. I will never stop learning and will continually strive to maintain an open mind.

 

I strive to be a leader; a leader in the digital age who inspires, not manages. David Marquet (2014) was able to lead his team to be the best versions of themselves, by allowing them to metaphorically and physically take the wheel. Marques recognized that the weaknesses that he had were in fact some strengths of his team. He recognized that the sum of their skills collectively when used to their fullest was greater than the individual talents with a governor applied to them.

 

I mean, no one would ever dream of keeping this beauty down right? We recognize her potential, and when the time comes we take her out on the open road and let her show us her stuff. Marquet knew this of his people, and he created a team of winners waiting for their turn on the open road. I hope that I am able to inspire the same leader-growing confidence in the people on my team.

 

I love the idea of complexity science. I realize that in the future of healthcare, we need to keep in mind the balance of people and their value. I have learned that people of different personality types are all needed on our teams. The value and balance they bring are invaluable. If we have a team of all extroverts, we may not get much done except socialization. This does not serve our team or our goals.  Instead, when we add people to our team that are of different personalities and strengths, we are able to function in a way that unites us. Take the Rockettes for example. I bet when you think of the American staple of a dance troupe, you think of similarity. In fact they are not similar, they come in different heights, and ethnic backgrounds. A visual illusion is created by blending their strengths. By placing the tallest ladies in the middle and working their way out they create a visual that makes us feel like they are all the same exact height. We are also fooled into thinking that they are leaning on each other. It certainly looks like that right? In fact they are not. They position their arms in a way that checks their position, but doesn’t touch their neighbor. The truth is, that if they were leaning on their neighbor, no one would be able to be their best, they would all be hindered by the limitations of the person leaning on them. Instead, they use their own individual strengths to each pull off their best performance that makes the overall performance so much more magical. I realize how important this magic is, and it comes from diversity.

 

Emotional intelligence is a huge factor that I took away from this class. Though the recent past has taught me its importance, this class has helped solidify its place in my leadership skill set. It is kind of like the framework for a puzzle. There are so many pieces to put into place, but if we use our EQ like that outside edge of the puzzle, we know we will be adding to the big picture. Simon Sinek (2011) had so many words of wisdom in this area, but I think the thing that I feel is the most impactful were his words about not sending emails late at night or first thing in the morning. We need to take our time and decide if it’s worth the cost. I can’t help of thinking of Jim Jefferies (2015) a comedian who was making a point about gun control. He was speaking to the fact that as humans, we react then think. He points out that the constitution was written at a time when muskets were the gun of the day. He points out that if we still used muskets, we would not have as much gun violence as we do today. He says “You know what is good about muskets? It gives you a lot of time to calm down.” He then mimics pouring the gunpowder into the gun, then packing it down.  He says, by the time you are done getting the musket ready, you might think “ahh,… you’re not a bad guy.” While this is obviously a comedic routine, it gives real life examples. When we fire off our responses in anger, we shoot before we think. When we use a musket to fire, we can pack down our emotions and allow the logic of the situation to come to the top. I don't want my words to hurt anyone, and I know that my metaphoric musket will help me to think before I shoot.

 

All musket talk aside, I know that resolving conflict is more about understanding and better communication than being right. One of the principles that Susan Clark and CrisMarie Campbell (2015) spoke of, and really stuck with me, was using the force of the energy from the conflict to dive deeper into what the real issue is. It helps us ask the questions that we may not have asked. I know that conflict is inevitable and probable, but I also know that I have more tools in my tool box now to use. I know that it is my goal to help both sides get to “yes”. I know that I can and will encourage positivity. Because after all, success is hard work. Success is even harder when our front line has a person who is negative. A coach once told me that wearing weights of negativity around does not make us stronger over time…it in fact makes us much weaker and less effective. Dana Casperson (2015) says that conflict can give us the energy to talk about what matters. This is helpful in both flushing out what the actual conflict is, but helping to change that negativity into positivity.

 

Yesterday, I had the best compliment that I could ask for. I have established that my “why” is to make people smile so that they can relax and be ready for change or education or whatever is needed at the time. While at an all day event with my organization yesterday, I went up and introduced myself to one of the newer managers from one of the other clinics. I shook her hand, welcomed her and told her that I was excited to see her at that event, as I hadn’t had the opportunity of meeting her yet (we work at different buildings). She then gave me a huge smile and said “Oh, I remember seeing you at our Ambulatory Spotlight Meeting in January. You had so much energy and excitement about what your staff had accomplished in the last year. You made me smile, and think ‘How could you NOT want to grow and change with her as your leader?’” Yes! (Insert happy dance here) I have gotten my “why” across to at least one person, and maybe more. While I realize that I cannot win over everyone all the time. I do know that I have impacted someone…and that is a good start. It actually made me think of Fred Lee’s presentation (2011). I was the person remembered for how good I made someone feel. As a Leader, we don’t get many Kudos, we give them. It was nice to have had one given to me.

 

I know change is hard, but it is necessary. I am truly lucky to work for an organization that KNOWS where we are headed and are on the right path. In fact, our EVP/COO said yesterday “We are living in a digital age, and we know healthcare is changing. We are on track to be on the right side of that change. I am so grateful that we have leaders like you all who are leading your staff to make that change at the front line…” she went on to speak of how we are such a large diverse group that is spread across a lot of locations. I wanted to raise my hand and say “That is a complex adaptive system you just described!” instead, I giggled to myself and felt pride that I had learned the “How” of our organizations journey. It was all coming together for me now. Looking back I realize that when I started in this Lean model line clinic, I was told that our “True North” was our patients. I, of course, felt like this should have been a no-brainer, but these last few weeks, I realized something: Our “True North” is really our “Why”. We love serving children and their families in all ways possible. Our “How” is by transforming ourselves from a linear organization into a digital age, complex adaptive system. Our “What” is the Lean system for performance management. Sinek (2010). This speaks to what Pat Ebright (2010) talks about when she speaks of where healthcare needs to go, and what needs to happen for it to get there.

 

To quote an old Chinese Proverb: “Feed a man a fish and they eat for a day; teach a man to fish and you feed him for a lifetime.” This quote has come to mind several times during the course of this class. I realize that I am that type of leader. Transformational leadership, it turns out, is my style. I admit to sometimes doing more things myself than I need, but usually that is because I know my staff is too busy to take on even one more thing. Having said that, I am also likely to give back to them a problem that is theirs. 

 

Just recently, we started having more providers on Mondays and Tuesdays than any other days. This poses a problem with scheduling. To be more specific, granting people’s requests to have time off. Some people just like to have off Mondays, others might have a trip planned all day, etc. I saw that this is becoming unfair and asked my staff to give me input on how to proceed with their schedules. I gave them two options and asked them for input and asked them to come up with other suggestions as well. 

 

They were kind of confused at first, but then one nurse said “Well, this is our time off, we need to find the fairest way to go forward” I was asked a few clarification questions and had to add the ever popular “This of course is as staffing allows…meaning if something weird comes up, I might have to change things up a bit for that occasion.” They all, of course, lamented over that last bit, but still understand that we have patients to see. They knew that those patients are why we get to come to work. There were a few holdouts who were trying to find the best possible scenario for their own situation.

 

Ultimately, they all agreed on what they thought was the most fair way. They even said, “We may need to just do more trading or communication to each other when we need a day off.” I was very pleased, I had given them a problem, and they solved it. They, as well, were thinking into the future about how to take care of those one-off times when they might need extra help. This is what Transformative Leadership means to me. I know the needs of my staff are important, but always doing things for them will not serve their needs or our patients’. I know the road to transformation is long, but I have brought a few new tools along with me and plan on camping out in order to see it through.

 

Thank you so much for encouraging us to see the leaders in ourselves. I have enjoyed this class more than I would have ever expected.

References

T. (2015, July 13). Conflict is a place of possibility. Retrieved January 19, 2018, from https://www.youtube.com/watch?time_continue=115&v=WfQeH3092Sc

T. (2015, July 13). Conflict – Use It, Don’t Defuse It | CrisMarie Campbell & Susan Clarke | TEDxWhitefish. Retrieved January 18, 2018, from https://www.youtube.com/watch?v=o97fVGTjE4w

M. (2016, June 07). Retrieved February 14, 2018, from https://www.youtube.com/watch?time_continue=7&v=NzBqJNh8z2U

T. (2011, April 06). TEDxMaastricht - Fred Lee - "Patient Satisfaction or Patient Experience ?" . Retrieved February 06, 2018, from https://www.youtube.com/watch?v=tylvc9dY400

M. (2010, February 02). Complex Adaptive System Theory. Retrieved February 14, 2018, from https://www.youtube.com/watch?time_continue=14&v=VNFFEJqz9YA

TEDTalks: Simon Sinek--How Great Leaders Inspire Action [Video file]. (2010, May). Retrieved January 7, 2018, from blob:https://embed.ted.com/ecfb94a1-b469-455a-abf2-658e2663e4c4

T. (2011, April 06). First why and then trust. Retrieved February 15, 2018, from https://www.youtube.com/watch?v=4VdO7LuoBzM

What is Leadership? (2014, May 17). Retrieved January 7, 2018, from https://youtu.be/pYKH2uSax8U

Healthy Organizations

This week we were asked to complete a couple of self-surveys. To be honest, I didn’t feel like either were true to who I am on these subjects. However, I am more closely associated to the Thomas-Kilmann style that I resulted into. The Anger assessment showed me split between a spewer and a leaker. I felt like neither of these really fit, I am not explosive, nor am I passive aggressive. I am somewhere in the middle. I think this test has missed the boat with me. That is alright though. I get that some people do fit into those categories. In the Thomas-Kilmann quiz, I was shown to be compromising, which fits better, though I admit to being a problem solver as well. I am always looking to find common ground, it helps to get to “yes”. However, I have a rule that if I am going to complain about something I dislike or find unfair, I offer a solution. I don’t think it has to be THE solution, but a solution jumping-off point. I want to show that I know I am in disagreement, but am open to finding a new way. I am not a griper just to gripe. I think this is one of the reasons that I am not a fan of having the split anger score. It makes me feel like this…

Healthcare relationships are so important. We don’t actually know who or what we are dealing with. Non-compliance can be a result of being obstinate, ignorant (in the literal sense), or circumstance. Dave Moen (2009) spoke from the heart on this subject about seeing the person, hearing what they are saying, and not alienating them from their own care. When he saw the woman, whom he knew was being abused, he recognized her shame. He knew that he needed to ask her about what she needed rather than lecture her (that didn’t turn out well for him the first time). That woman was able to feel comfortable and she was helped. If she didn’t feel comfortable, she would have shut down, and may have left. I have seen this in my practice in many versions. The one that stands out in my mind and heart, is one that has shaped my beliefs.

I had a family who brought their 4 week old daughter in to our hospital, because she had been sick and had a fever for several days. We all know that a newborn with a fever is no bueno. By the time the family brought their baby in, the baby was full-on septic. I was the nurse taking care of this baby when she began to deteriorate further. I called a rapid response, and the baby ended up being transferred to the PICU. I will never forget watching the providers tell this family that the baby was very sick and might not survive. The mother was sobbing, doubled over in her sorrow and guilt the dad was stunned, holding his wife and staring into space. You see, this family had waited to bring their baby in on purpose; they were in the US illegally. Because of their fear of being deported, they held back on the treatment of their newborn. The baby did not make it. I will never forget this story. Not ever. We often shake our heads and say things like “Why would you wait to bring in your baby?” or “Well, you can’t fix stupid”. The fact is, we needed to look at that family and say, “we want to help your baby, please tell us how long she has had a fever.” We need to see their humanity and not mistake their fear for ignorance or stupidity. We needed to give them grace.

Patient experiences are as unique as the patient. I often think of my dad when I think of unique patients. Fred Lee (2006) spoke of how we can put our patients at ease. My dad kind of forced his nurses/Dr’s to put him at ease. Even after several rounds of unsuccessful Chemo, when he filled out his patient forms, under “Questions for the Dr” dad would pick a theme “Why do we drive on a parkway and park on a driveway?”. These things are what made those tough conversations easier. It put him at ease when they laughed and joked about whatever his topic of the week was, he loved to make people smile and laugh. It allowed those providers to give that special customer experience. I agree that we need to do better at putting to rest the fears of our patients. Some patients are easier to engage than others, but that is a challenge that we all face with each interaction we have.

Speaking of crucial conversations…and millennials. Those two topics are kind of blended in my mind currently. I feel like I have had more conversations on the importance of communication lately with millennials. Communication is the key, to…well… it all. Without effective communication we don’t know where the other is coming from, or where we want to go. I had a young woman interview for a job opening last week. She was planning on starting nursing school in the fall and informed me “Well…they say I can only work until I start nursing school, then I have to quit”. This is a topic that I find very amusing. Let me give you a glimpse of my perspective. I went through an accelerated nursing program, while being a single mom, and working full time. Boom…mic drop.

I feel like more people these days want to do their own thing, on their own terms. So why would being told that they HAVE to do something mean they would/should start doing it now? If they WANTED to work and do school, they would. I also find that they have a thought processes that they deserve to be hired without experience, because….well, they just do. More times than I can count, I have heard nursing students lament to me over “not getting interviews because ‘they only hire from within’”. My response is usually “well go get in”. When they say “we can’t work and go to school” I give them my history. They usually look at me blankly and say “why did you do that?”. I always respond “I wanted to work here, I knew people here, and I never had to work nights, because I was already here”.  It usually takes some time to sink in.

Back to my interview last week. I had the opportunity to have a conversation with this young nurse-to-be. She looked at me and said “So, you think work ethic is more important than school?” I told her “I think work ethic is more than a good GPA, it shows your level of commitment, not your level of regurgitation.” As she left, I realized that I had just described emotional competence as a value over strictly IQ. I also realized as I was going over presentations that this is why it is important to de-toxify my team when the emotional competence level is low. It all blends together. This is our chaos model. 

-Joleene

References

T. (2012, August 09). The future of patient-centered care: Dave Moen at TEDxUMN. Retrieved February 06, 2018, from https://www.youtube.com/watch?v=hUsyuloD198

T. (2011, April 06). TEDxMaastricht - Fred Lee - "Patient Satisfaction or Patient Experience ?" . Retrieved February 06, 2018, from https://www.youtube.com/watch?v=tylvc9dY400

Emotionally-Competent Leadership

Sweet lawd Brene Brown is my spirit animal! I may have plenty of differences with her, but listening to her I heard a kindred spirit. I was surprised to find that I did see vulnerability as defined by Brown (2011) as a willingness to do things from the heart on a leap of faith. That is who I am. I am the friend that says, I love you, and even if you need to blame me for your confusion in life right now…that’s fine. I will still be here. I know that to be vulnerable is not always smart or easy, but it is right…for me. I love that she then goes on to discuss how horribly she reacted to her first Ted Talk. It was clear that she was still on her journey. Though the sheer fact she was discussing her reaction showed her vulnerability and courage.

Brown (2012) spoke of shame vs. guilt and how they come from very different places. Shame is saying that “I am bad” and guilt is acknowledging that “I am a good person who has done something bad”.  Wow, this is one I need to discuss with my kids. I KNOW that I am not a bad person, but I also KNOW that I can do bad things. This is something that we have learned all our lives, “Hate the sin, not the sinner”. It is easy to apply it to others, but hard to do that to ourselves.

While going through the readings this week I noted a theme:

1. Trust your gut

2. Keep your eye on the prize

3. Know your strengths and weaknesses

4. Admit when you are wrong, use it as a guide, then recycle it

5. Wear your heart (personality) on your sleeve.

All of these are great, and for the most part I resonated with them. I know I will never be a perfect leader. I will always strive to be though, even when it means making myself uncomfortable, and sad. This too, shall pass.

Susan…I have a confession. I never actually read Emotional Intelligence by Daniel Goleman. We were supposed to have during our final semester of our BSN program. I skimmed, and wrote my paper. I thought I was too good then for needing help in that area. Karma has a funny way of showing me how wrong I was. You know the first thing I did when I had a time in my life that I needed to stop and redirect myself? Yep, got that book out and read it. I needed that information, but I don’t think I was at a time in my life to “hear” it. I could have read the words, but I would not have applied them then to my life. Watching the videos from Goleman gave me great insight. It reinforced that the overarching motto and goal for interaction is right. You can’t change your circumstance, only your response to it. In other words. STOP, take a breath, collect yourself then think/speak again. This same information was also given in various form by Simon Sinek (2011) when he says to not send emails late at night or early in the morning. When we distance ourselves, we might not feel as passionately.

The story Goleman (2007) tells about the Stanford daycare children is so vivid. We all want that juicy marshmallow, but the patience to wait in order to get a second one…that takes skill. I use EQ when I interview people, I am that manager who asks the situational questions. I want to know your response, but I also want to see how you respond. Do you just spew out an answer that may not be the smartest one (I am AMAZED at what people tell me in their job interviews) or do you pause, and share the answer that tells the story that paints you in the best light? Don’t get me wrong, I am calling your manager to get a referral, but I do believe that this is a huge insight into people.

You know, I haven’t actually worked for a highly competent EQ leader. I have however had teachers who had that. I LOVE them, I can tell you specific things from their classes because they resonated with me. They touched a part of me that wanted to not just do my personal best, but that teacher’s personal best. I knew where I stood with them, and I knew I could be honest with them. It is a mix of tough love, vulnerability, and compassion that makes them great. I think this speaks to our book in chapter 10 on how Leadership occurs in the space between individuals working together” (p406). I think that that space within is a more powerful pull than we think. 

I am really excited to read and watch all of these presentations, I feel like I could write a book based on the information that I have learned. I can’t wait to see what next week has to offer.

References

T. (2011, January 03). The power of vulnerability. Retrieved February 01, 2018, from https://www.youtube.com/watch?v=iCvmsMzlF7o

T. (2012, March 16). Listening to shame. Retrieved February 01, 2018, from https://www.youtube.com/watch?v=psN1DORYYV0

A. (2007, November 12). Social intelligence. Retrieved February 01, 2018, from https://www.youtube.com/watch?v=-hoo_dIOP8k

C. (2011, April 11). Simon Sinek: Why to Wait Before Making an Emotional Decision. Retrieved February 01, 2018, from https://www.youtube.com/watch?v=tIIJIqLmptg

Porter-OGrady, T., & Malloch, K. (2018). Quantum leadership: creating sustainable value in health care. Burlington, MA: Jones & Bartlett Learning.

18 Behaviors of Emotionally Intelligent People. (n.d.). Retrieved February 01, 2018, from http://time.com/3838524/emotional-intelligence-signs/

Cole, S. (2014, December 19). Why Emotional Intelligence Is More Important To Hiring Than You Think. Retrieved February 01, 2018, from https://www.fastcompany.com/3029306/why-you-should-make-emotional-intelligence-the-cornerstone-of-your-hiring-strategy

10 Things Successful People Never Do Again. (2017, November 29). Retrieved February 01, 2018, from https://www.success.com/article/10-things-successful-people-never-do-again