Latest / Nurse Leadership Dumpster Fire / Minimal Resources: A Nurse Leader's Guide to Avoiding Burnout
Transcript
- speaker-0: Welcome to the Nurse Leader Dumpster Fire Podcast. I am your co-host, Cindy Marit. speaker-1: I'm your co-host, Teresa Higby. We are both nurse leaders and we created this podcast to share our most challenging mistakes we have encountered in our nurse leadership journey. Hopefully sharing these mistakes and lessons will help you avoid these on your own journey. We welcome all aspiring current and seasoned nurse leaders to tune in as we hope to bring honest, tangible, and valuable lessons, tips, and tricks, regardless of where you are in your nurse leadership journey. speaker-0: We need to note that while Teresa and I are both employees of the VA, that this podcast is not a reflection of or endorsed by the VA. This podcast endeavor is separate from the VA affiliation. Our stories will be adapted to protect the anonymity of staff and colleagues that we've interacted with, but we will do the best to convey the gist of our story and the take-home lessons. We will of course also be protecting any potential patient identities to comply with HIPAA and privacy laws. Thanks for listening. Good morning, Teresa and audience. Good morning. speaker-1: We are recording this lovely Saturday morning and we have a topic we want to share with you. So kind of in the first episode was about the first 30 days as a new manager and then some other things. The next episode was about the next layer of things as a leader. In this one, I wanted to talk a little bit about this, about what do you do for the rest of forever? Five years in, maybe you're in leadership for 10 years. speaker-0: What do you think keeps you going at the end of the day? speaker-1: Mm-hmm. Honestly, some days I got to go to work. But in general, it is some of the projects. It is the desire to support my team in making positive change and supporting the bedside nurses and getting what they want. Something that, so I'm working in education right now and something that people misunderstand a lot. think we've identified recently as a healthcare overall that A lot of times education isn't the problem when we have failures. However, education is still the foundation when it comes to holding staff accountable. The first thing you have to prove is that they were trained properly. speaker-0: And that they understood it, that they actually learned the thing that you were teaching them. speaker-1: Correct. And that they were properly trained to the whole facility and know these things, right? Before you can even move on into anything else. So I'm trying to create systems that support that, but I kind of a little bit lost my train of thought, but I'm going to continue to talk anyway. So it might not make sense, but yeah, I just, what keeps me going is the fact that that, but the other thing is, is when I was talking to some of the staff that was taking a class that my team was offering, one of the things I mentioned to them is. Some managers don't prioritize education because they're like, I have staffing issues, I'm not going to do it. And I will say this right now. When I hear that, do struggle a little bit because Cindy and I were down 13 nurses. We had a 50 something percent turnover rate and we still were able to prioritize getting staff out for education. speaker-0: Like a lot, like a lot, like we had staff out eight hours a week almost because we're like, we have to get them trained. Like we had to do it because the handful of staff that were left that still knew how to do it, they were burning out. We don't like when this is like first aid 101. When you're you have to stop bleeding. can't just go, oh, go, keep going, keep going, keep going, keep going. know, just keep. speaker-1: They're gonna drown. You can't keep adding weight and tell them to keep swimming. speaker-0: Yeah. speaker-1: So anyways, I was talking to this nurse, she's been a nurse for a very long time and she was taking the class and I was just walking in the hall and I chatted with her and she was telling me how she was liking the class. And I was like, and I just asked her really quick, I was like, is one of the things that it kind of offloads you from your day-to-day routine and it's just nice to get a refresher and go through this, you have been a nurse a long time, but do you see the value? And she was like, ⁓ a hundred percent, I am feeling. So the other thing that people are not recognizing is that Having a day learning and just sitting there is sometimes nice for your staff to go back to the bedside and they give their all. It's still, they're getting paid to be there, but they're not just forced into the machine. You're filling their cup by doing that. speaker-0: For sure. I remember getting, because it was surprising to me that we focused on the education before we focused a lot on the culture. And I was surprised that the education actually was a huge contributor to improving the culture. And it was a big reason why people started wanting to come to work in the ICU. all of sudden everyone, like the culture in our hospital prior was don't work in the ICU. They're mean, it's scary, it's unsafe. And then that narrative completely switched when we introduced this education program. And all of a sudden staff wanted to come and be a part of that. And I remember we had three nurse residents who had come through our unit and we had allowed them to come through the class because they had more free time than everybody else did. So it was an easy thing to add. And all three of these, which are brand new nurses, they're brand new RNs, they all told me, we want to come to the ICU. because of this training, this is now the safest unit to work on because we feel prepared. Whereas other units where the acuity is lower, but the education isn't supportive enough. And so they felt more scared to work on a unit that didn't have a robust education program than they did to work in the highest acuity unit in the hospital because we had an education platform. ⁓ That was very eye-opening for me. speaker-1: I just think that we need to reconsider ways we can fill up our staff's cups and also put the onus on them to help us also. And actually, when we did start doing those things, our staff naturally started to protect us. speaker-0: did. I do remember staff coming in and saying, are you okay? Like, is there anything I can do to help you? Like, I see all this work you're doing. And when we did all that, because we were very vocal about it and very transparent about what was happening, they all saw the work we were putting in. And so yeah, I had a lot of staff come in and say, is there anything I can do to help you? And that meant a lot to me. So anyway. That was a good point, the education and just in general, like finding ways to elevate our staff and give them growth opportunities. speaker-1: Yes. speaker-0: And same for us, you know, like I think we also need to be allowed to have growth opportunities in leadership. I'm going to a conference in a month and I've never been to a national conference in person. This is the first time and my, I'm lucky my organization is, they're not paying for my whole trip, but they're paying for my tuition, which is it's like $1,700. So it's, it's a fair amount of money. speaker-1: Yeah. I asked if my facility would help me and they were like, no. Every education thing I've asked for lately has been no. And I already know and was told that our budget was approved for education and I built it in for my whole team. And one of the things I wanted to do was a drive four hours away to take a class that would benefit my team. And I was told no. I was like, but I already, you already told me I was approved and this is offered by our facility. speaker-0: Yeah. Yeah. And I think like what your experience right now to me sounds like reactive leadership. Yeah. If that's happening, that might be happening above you right now is that, you know, like, and I do this on my personal budget, right? Like, I'll be like, I've got money coming in, I've got my budget. And then maybe I go over spend at Costco unintentionally. And I was like, I was going to spend $100 and I spent $400 because I was at Costco and that happens. speaker-1: You're human. speaker-0: And all of a sudden I'm like, nobody can spend any money. Like everybody, we're eating frozen freezer, like we're eating beans and rice for two weeks because we have money left. And so like, I have that reactivity. I think that people in higher level leadership that are managing budgets can also have that reaction. And that's been the state of the healthcare world lately, like the administration right now. is very, very heavy on efficiency and accountability and like so much so that it can take away from the things that really provide growth and enrichment. You know, we lost in our local VA, we lost some really great educational contracts that we used to get really cool education from. ⁓ speaker-1: We just. speaker-0: We used to have, when I worked at the VA with Teresa, we had classes like Crucial Conversations that were really great opportunities to send staff. If you had a staff person who struggled with their interpersonal communication skills, you could send them to a class like that. And it really did help them do some inner work that you can't necessarily teach as the supervisor. You can guide them through, they have workshops where they literally have to have an internal dialogue. communicating, understand how that communication is being heard on the other side. speaker-1: You know, those types of classes, especially crucial conversations, also support their intrapersonal relationships. that crucial conversations is something you have to do consistently in your own personal relationships with your spouse, your partner, your children, your family. this is, these are skills that are very valuable. speaker-0: Universal across your whole life. But those are the kinds of programs that got cut. know, it's like, ⁓ this is fluff. And that's what it was all categorized as. These are fluffy things. These aren't critical to patient care. So they're nice to have, they're not necessary. the so it's a pendulum, right? And think going back the other way again, like, will change administration will change the goals will change again. Yes. and trying to, you know, navigate that. which all of this is remind is bringing me back to one singular conclusion, which, you know, I asked you like, what keeps you going? And I think what keeps me going is that I have to remember that I have to take the bad with the good. speaker-1: Yes. speaker-0: which I had to do as a staff nurse too. There was days that I got my ass handed to me and there was days that I was just bored doing, you know, maintenance education and maybe I was surfing on the web and I was just like watching the clock. And I had to do that as a staffers and I also have to do that as a nurse leader. speaker-1: Yes, it's true. And some days as a nurse leader, your brain doesn't work and you're there and you're trying so hard to make your job, to do your job because you don't want to end a day where you feel like, cool, I was useless. What am I here for? But sometimes your brain just is done and that's okay. And those are the days I try to just do like my online education or, you know, I'm like, ⁓ I can, I can read through this one thing and offer feedback here or whatever. speaker-0: I do think there's something to be said about that interpersonal inner dialogue though, like, cause what you're talking about and saying some days my brain doesn't work. You have to recognize that that's happening to you and then know how to proceed forward. Many people don't recognize when that's happening. mean, like I have, I get these weird migraines sometimes and it's like, it'll be going on for like three hours and I'll be like, I think I have a headache. And I'm like, why did I think I've had a headache all day and I didn't realize it. But like I was feeling kind of queasy. I was feeling kind of like moody. My eyes were sensitive. It wasn't like an electrical shock down my brain. Right. Very subtle. And then all of sudden I was like, ⁓ my God, I'm having a migraine right now. Like I have all these symptoms. just, didn't, my brain didn't register that it was happening. And so for us as leaders, there is definitely worth It's definitely worth spending the time to understand how your brain works, what motivates you, what demotivates you. I one manager who was the manager of two units, which was a lot. was, and they're two very different units. So it was unsustainable. We knew that. And I worked for the last two years trying to figure out how to get it separated. And it's happened and I've hired a new manager. So I have now one manager of one unit and this other manager. has been able to let go of one of the units she's managing. She's a very high achieving leader. Like she's one of the people that I think wants coaching from me, but usually she already knows what to do. I don't have to tell her how to do her job. And we were talking the other day about the future and I told her, I said, I am concerned. said, I know you feel relieved right now because your workload just got dramatically better. And that's awesome. But I am concerned about what happens in six months when you don't have enough to do and you get bored and you have to find a way to fill your cup when that happens. So I was like, you may not even realize it's happening. I was like, so take this from one person who sees myself in this other person. Like I see myself, I definitely recognize a lot of the similar traits. And I said, If you get to the point where you're like, God, I don't really enjoy work right now. I feel kind of depressed. said, we need to talk about that. As soon as that happens, if you feel depressed, if you feel demotivated, I want you to come to me and talk about it because I almost will guarantee that this is going to happen to you. And we need to be prepared for when that moment happens so that you don't just feel like, oh, I just need to leave this job now because I'm unsatisfied. speaker-1: Yeah, I was talking to one of my employees this week because one has identified that he eventually does want to move up into leadership and become a nurse manager. And so I've been doing some stuff with him. Like, for example, I'm going to be gone some of the month of August. So I offered some of those dates when I'm going to be gone to cover me. He obviously can't do the admin stuff, but there's some things he can do. He can help communicate with the team and manage the team the way I do and like lead the team meetings or whatever. Right. And so I said something to him about it. And I said, ⁓ But I was like, hey, I'm going to offer you these opportunities to cover me. And then this other person, I was talking to him and I was like, you know, I'm offering these because this person wants to do this because he usually covers me. And I was like, and that one goes, well, I don't really know what I want with my future yet. And I was like, well, that's okay. You have a lot of other life things going on right now. He's in the middle of buying a house. And, you know, I was like, you don't always have to know every aspect of your life. I was like, right now also he has been in this job for less than a year. And I'm like, you're still learning this job. Like, you know, I was like, I don't expect that for me. This person has been in their role for almost going on. This is going to be his third year. And so I think it's, this is appropriate. So just also coaching them that just because you don't know yet doesn't mean there's anything wrong. speaker-0: ⁓ for sure. And we didn't have this conversation. Like she's been in the role maybe a year and a half now. ⁓ And so like she's still learning and growing, but I think she's getting to that point. And now with like the workload shift, which the workload was leaning towards burnout for that overburdening. And now we're gonna relieve that pressure. So that should dramatically shift that piece. But then I am worried about like what happens in the after-effect. And I think she is somebody who will probably move up in leadership again. And so we also talked about what you're saying, looking for opportunities for, what do we call them? Stretch assignments? Working, you know, even if it's not in my position, particularly, like I would do the same thing for her. Like I would have her, I could delegate some of my tasks. You know, I'm the chair of a few committees. I could delegate her stuff like that to her. I could have her lead some of the work groups that I'm running. And there are certain things I can't delegate to her for obvious reasons, but even if there was like a manager detail for a unit, maybe in like outpatient, like somewhere completely different from where she and all of those experiences will help you grow as a leader. I think that my experience of going from being a critical care, you know, inpatient driven nurse for the majority of my career, and then switching into. more long-term care, geriatrics, dementia has been hugely beneficial to my learning experience, has completely changed the way that I view the organization. I've had to completely change the way I communicate. I've had to completely change the way I show up. And had I not put myself into an ⁓ environment that was different from what I knew, I would never have had that opportunity to grow and stretch in that regard. speaker-1: Yeah. So when it comes to the rest of forever, I am being a nurse for however many years you decide and a nurse leader for however many years you decide. I think it sounds like it's complex, just like everything you're going to have your ups and downs. And I think, ⁓ like Cindy said earlier, she, said it perfectly. You got to take the good with the bad and. and look for opportunities to grow and also take that time to rest. Take that 42%, which sounds outrageous to both of us because we are not 42 % resters. I would say I'm a solid 25 % rester. speaker-0: same. speaker-1: But that's speaker-0: Even if I don't have stuff going on at work, I tend to create my own projects elsewhere. I'm like, let's remodel the kitchen now. That sounds really easy. speaker-1: 100%. One of my friends texted me today. I'm just going to throw a little personal thing in there real quick. But one of my friends texted me today. We were in a group chat and someone goes, ⁓ my God, Teresa, why are you so prepared? And it was funny because I'm not always prepared first of all. And second of all, and because I really do have a lot on my plate right now. I, I'm just going to throw out some more stuff. I have my full-time job. I have a second job. I have this side gig. I'm remodeling my entire house. I have, I'm learning how to make sourdough. I'm taking a Spanish class and let's see what else. And I have a family member that we just put on hospice. So there's only a few things that are going on and it's one of my very good friends birthday weekend. So we're like planning all these things. So I have to be prepared in order. ⁓ and my daughter just moved into her very first apartment. Just a couple. So she needs help. Everybody needs help. Right. And so if I'm going to show up for people, I gotta be a little prepared. Otherwise I'm going to fail. But. I did take time to rest. Yeah. ⁓ but I do get, ⁓ frustrated at times when people are like expecting a lot of me or are getting frustrated with me because I am not exactly on their timeline. When I'm like, your timeline is yours. Mine is mine. I'm trying. I have things going on. So, but anyways, overall, I think. speaker-0: in schedule. speaker-1: being a nurse leader is I do find it joyful. I find being a nurse joyful. I find being a nurse leader joyful. Even with the ups and downs, sometimes I feel like a fraud as well. I don't always feel like my team has it together. I also, I don't feel like my upline really truly values the person that I am and the way I view leadership. And that doesn't always feel great either. And that makes me feel like a fraud because you would think that if I'm sitting here talking like I know stuff, that people above me would be like, she's great. They don't. They don't always agree with my opinions. speaker-0: Well, and I felt that was one of the reasons I went to a different city because I felt similarly, you know, and I don't like looking back, I think they did appreciate me, but I don't know that they were able to show it to me in the way that I wanted it to be shown to me. Yeah. So sometimes the option is find a new place to work. Sometimes that's not an option though, in your situation, like you have obligations and ties to where you are right now that don't allow you to just up and move to a new location. And you if you don't want to leave the overall system you're in, like, so yeah, there, you have to be creative about it and find ways to fill your cup. Like this is always an ongoing fluid art form. And you know, there's leading up, you might be looking towards like, ⁓ like helping your leadership understand how to better support you. speaker-1: Yes. speaker-0: or even other people who are at your level of leadership as a whole. And you might be working on your secession planning and your delegation skills and helping by also giving opportunities to the unofficial leaders that you're managing. And then really, yeah, being able to roll with the punches, which does, think as leaders that make it past two years, I think we do get pretty good at that. Most leaders, I think quit within two years. So don't learn how to do that. speaker-1: It's interesting too, because they say it takes you two years to learn these types of higher level jobs. It's not a one year type thing. speaker-0: And I want to also clarify that I did, I haven't fact checked that that's my own personal opinion and observation is just, I've seen a lot of leaders go into leadership, feel really gung ho, get hit with a bunch of challenges, like sort of try to manage it. Don't get the support that they need. Don't do enough of their own growth. And then they burn out and then they quit. And that usually happens within the first two years of the experiences that I've seen. So I'm not saying this as like a fact or this is not research based. So please don't. speaker-1: I do that too sometimes. I'm proud of you for calling yourself out. I sometimes say things like a fact, it's more of like my experience or my opinion. I feel like it was an important episode to have. ⁓ We definitely want to know what are your plans to manage your career for the rest of forever. speaker-0: Yep. All right. Thanks for the great discussion, Teresa. speaker-1: Thank you so much for tuning in and listening to us and joining our Nurse Leadership Dumpster Fire podcast. If you have any ideas on topics or want to connect with us, you can reach us on Instagram at nurseleader underscore dumpster fire underscore podcast or via email at teressa at aria-nurse-circle.com or cindy at aria-nurse-circle.com. speaker-0: If what we've been talking about resonates with you, please like and subscribe to support our channel. Thanks and bye.