Latest / Nurse Leadership Dumpster Fire / Growth and Connection a Vulnerable conversation

Transcript

Growth and Connection a Vulnerable conversation · Nurse Leadership Dumpster Fire

• speaker-0: Hey Cindy. Good evening. Hi. I ⁓ am excited to talk to you. I know we both have had a lot going on. ⁓ I personally have had a few things happen that I have realized I need some areas of growth that have created some unrest for me. And so we both kind of took some notes on what we were experiencing and I thought we could talk about it today. speaker-1: Okay, that sounds great. speaker-0: Some things that I recognized for me was I had another person put in their notice that I knew was maybe struggling a little bit, but I didn't think they were gonna leave. Like I thought that was something we could maybe work through and like whatever. But they decided they were burnt out and that they needed a different role. And so I was like, ⁓ talking to my upline and I said, you know. Where is the data for me to f determine my turnover rates? And so we kinda talked about it and we looked at my turnover rates and they're a lot higher than I would like. They're above fifty percent. They're sixty four percent for the last year, which does not look great. ⁓ and it doesn't feel very speaker-1: Yeah, I do. speaker-0: And I have an area that is likely going to have higher turnover rate. It's kind of a stepping stone type of a area. What they do r requires someone with a a driven personality, meaning they're probably going to be looking for other growth opportunities. and and whatnot. So I had to accept that, but it was still wasn't easy. ⁓ I asked my boss, I'd really like to know if there's things that I should be doing better as a leader that I can either prevent this or if there's things that I can do, like is there something I'm missing? So I asked my boss to do an exit interview with my staff. speaker-1: You had her interview the leaving staff instead of you doing that. speaker-0: Correct. Okay. Interesting because I feel the reason I said that, my thought was if they haven't told me about their concerns yet, are they going to now? Maybe not. So my hope was that in a neutral a little bit more of a neutral environment that maybe they would share. And I did the same thing for someone of of her staff that was leaving to a higher level position. speaker-1: That's a nice like give and take that as you say that I'm like, ⁓ should we all be doing that? Like having a neutral party reach out to talk to the person instead of 'cause we generally just have the manager do those and you're right. If they didn't feel safe to say it before, are they gonna feel safe to say it now? speaker-0: Yeah, even if they're leaving, some people will, but not every person is the same. And some people are really careful about burning bridges 'cause you never know. speaker-1: Yeah, totally. speaker-0: Like professionally you're you gotta be consider that. So then the other thing that I asked her to do and that we kind of talked about was looking at our market analysis and are my team getting paid what they should be getting paid when a floor nurse maybe has ⁓ differential and can make more money that way. My staff their their compensation is more of a a sustained schedule, but they have to work harder than a floor nurse in the sense, yeah, project management, preparation and planning, organization, ⁓ chasing staff. Like they have to do that harder stuff though, the in the sense of like now you're trying to get your peers to ed do education and they also still work in staffing. speaker-1: Right. speaker-0: So they're not 100% away from staffing. And then in the exit interview, my boss didn't share all the things, but she did do a brief summary of some of what she said because part of it was we were said it could be confidential. but if they were okay that she would share some with me. So I did get some of the feedback and some of it was actually good. And so that was helpful. And some of it was like, I want you to keep doing this, I want you to keep doing this. What I discovered is this. person may not be super honest to your face anyways after I found I discovered that she thought the questions were stupid and I reviewed the questions and I was like, these are really valid questions. Did you feel safe and collaborative? Like obviously worded better, but like I don't know. So maybe that still wasn't perfect, but it was still an improvement and it still gave us information. So that was one of the things that I've done. And I know that you've also been having some experiences. I will say that something I experienced with this and something we kind of have mentioned before is it did give me a little bit of imposter syndrome. And I know that that's something that has come up for you too. speaker-1: Yes. Yeah. ⁓ before we go on to impossible did your boss give you anything that you could work on? Like did she give you any feedback that was useful? speaker-0: No. speaker-1: No. Okay. I think like a lot of the stuff said like this is a unit that is often a stepping stone and people just don't stay on units like that all the time. And so that's okay. ⁓ so maybe it's just not really about you then, which is fine. That's good news. Yep. Yeah. I was covering a whole other department for like two and a half months and I had to do some really ugly HR cases. Had to like speaker-0: Mm mm. Not changing. speaker-1: build build the cases, like work on the evidence file, and then I had to make proposals that were pretty pretty heavy for, you know, the employee. And ⁓ and it was really difficult for me which surprised me because you know, I'm not this isn't my first rodeo. I've if not I've done these things before. I've I've had to discipline staff. I've had to do I've had to remove staff. ⁓ but this one really like Settled into my soul. And I was really like struggling to figure out why it was bothering me so much. Legitimately, I was like, I don't disagree with any of the things we're doing. I I feel confident that that we're doing the right pathway here. But I felt like I was holding on to it more than I should have been. And there was a little bit of imposter syndrome, like. By this time in my career, I should be able to just do this and not take it personally and move on. But speaker-0: Can I say something about that though? I'm really glad that you don't. I know that it's hard on you. Yeah. But it makes you so much more human and considerate because even if you know it's the right thing, you still know that it's gonna be hard for that person. And that's not easy to do. speaker-1: Yeah. So what I ended up doing is I was like I think I told you and I told my husband that I felt like I was feeling a little burned out. And I was like, I need to do something. And so I told my husband and I was like, Let's go camping. I think maybe I need some time in the woods. It just really took like a whole day in the woods. I we didn't even do anything, like we didn't go hiking. I just like hung out in the tent, took some naps, sat by the river and just like Thought, like let my brain just think. And I realized that the people that I've been doing this with are not holding themselves accountable. And so I was holding them accountable for them. And I felt like I was taking that on as like my responsibility. Instead of being like, you made this decision, you did the behavior, you should be accountable for this. I was like, ⁓ you don't want to be accountable? Okay, I'll just do it for you. Let me just hold all that shit for you. ⁓ which then I realized was kind of a trauma response for me, like of growing up in sort of an unstable home and having a parent that was slightly emotional immature and trying to hold that for them. And like I was repeating that and I was like, ⁓ my God, what are you doing? Like put that shit down. That's a bag of bricks you don't need to hold. It's not your responsibility. So yes, I appreciate what you're saying about empathy. And yes, I do have empathy for this for the employee and what this means for them because this some of these decisions dramatically impact their lives. And I don't take that lightly. But I also realize that I was probably inappropriately holding on to some emotion that didn't belong to me. speaker-0: Yeah. speaker-1: So have you ever had that happen to you? Do you have you ever like recognized that in yourself before? speaker-0: I I have seen it, but not to the level that you're experiencing it or have experienced it recently. Mine is usually I only notice it in smaller scenarios. ⁓ I probably do it, if I'm being honest. If I were in your situation I probably would because that you did have several back to back situations that were just kind of heavy, if we're being honest. They were heavy. speaker-1: And all of them, like all of them were projecting out. Like all of them were like, it's not my fault. It's all these other people around me. It's all these other things. Like none of them were like, I made a mistake. And so I think that I was like, okay, well, if you're not gonna hold yourself accountable, then I will have to hold that for you. And then I like I internalized that. It was not good for me. speaker-0: Yeah, definitely. I think that that's pretty cool. So when I was talking about my experience with the ⁓ turnover rates and all that, when I like, ⁓ we're doing this podcast and we're doing all this stuff, like I shouldn't be having this. I should have everything dialed in and I should be perfect. And that's where it also that imposter syndrome was showing up for me. It's like we ex we have these expectations for ourselves that are not realistic when in reality these are things that all managers face at some point. Like just because we have a period of time of unrest. Like for example, COVID in the past we've talked about how COVID burnt out our previous managers and and whatnot. And it absolutely did. It was make decisions, do this, do this, change pathways, do this, do this. And and then We got a flood of patients for a while, but we didn't sustain a flood of patients like every other place did. And so it was constant pivot, constant movement that I think would burn anyone out. And they'd already been doing it for several years. speaker-1: Nobody knew nobody knew what it was or like how it was going to affect us, what the long term effects were. So it was so much uncertainty. I think as humans we're really good at actually managing the stress, but we're not very good at managing the anxiety on the what ifs. And ⁓ and I think that was a lot of COVID. But what you're talking about with the imposter, like, ⁓ I've been a manager, I've been a leader for so many years. I should have my shit together. I feel like I really embodied this as a staff nurse that you're gonna have good days and you're gonna have bad days and you have to learn how to take the good with the bad. ⁓ and I think that's true in leadership as well, except that the good ⁓ periods of time in the bad tend to be longer than just a day. And if a nursing position, it's like you had a bad shift or you might had a had a couple bad shifts. But it's not usually weeks long. And when you're in leadership, the problems that you're dealing with take longer to deal with. And so I think when you have something really challenging going on, you're short staffed or you have a bad disciplinary case you're dealing with, they take weeks to deal with. And so you have weeks that are hard and you have weeks that are fine and weeks that are good and you feel successful. And so like to me, the resilience as a leader is recognizing that you still have the ups and the downs, but they're just longer periods of time than they used to be as a s as a frontline staff. speaker-0: Yeah. I agree. That's actually something when I was a frontline staff, when I got to about ten years of nursing, that was when I recognized reflecting back the periods of time as a nurse I had experienced phases of burnout that I think are actually somewhat normal because their growth periods not necessarily burnout, but they are a little bit. ⁓ because your very first year, you're You're really gung ho. You're really excited and you know you want to learn. You're excited you got your job. You're you're finally working. You're eager. And in a few ways you usually get humbled. You learn a few things that are the hard way. You learn some things just naturally. You you have some wins and speaker-1: New bad things happen to like get the the fear of God in you, so to speak. You know, like I think Yeah you don't really become a nurse until you've seen some really awful things happen, unfortunately, and then you're like, ⁓ that's why we have these practices, so that we don't kill people. Like I didn't realize that was actually important. speaker-0: Yeah. It's it's kinda true. It's it is kinda true, unfortunately. But ⁓ yeah, I was I recognize that I had periods like after one year and then three to five years you have another layer of like you have been doing it for a while, why did I choose this? What was I thinking? This is so hard, is this really gonna be my career for the rest of my life? I had a little bit of that. And then at ten years I was pretty comfortable. as a nurse at that point. I was like, listen, I've seen a lot of things. I've been not just a nurse this long, but I also was a CNA before and I've I did a nurse extern program, which is like following a nurse for an entire year before I became a nurse. So like there's these layers of experience that I have by then. You can lead people more. You have more experience. You can speak to things. You can be like, ⁓ I have seen that before. ⁓ I've done that. And then it's kind of like a win. But then you're like, do I really want to do this? For another twenty, thirty years, forty years. How many years do I have left? You know, you start like counting in your head like Yeah. So then there's that little phase there too. And then and it's not all bad. I have loved being a nurse. I do love being a nurse, but I think those ebbs and flows, just like a nurse, happen as a nurse leader. What do you think? Do you think it has a similar like timeline process that like kind of how I just kind of laid out like speaker-1: The whole theory of novice to expert that I had to read in nursing school that was like called novice to expert. And I do think that that's reflective in leadership. Because you're starting over as we've talked about before, being a nurse, being a good nurse, not necessarily translate to leadership. It's a whole new skill set. And so I do think like your first one to two years you still are a novice. And then you're kind of like, okay, now you're competent and you like know how to do a job. But yeah, like every three to four years, I think that you get another layer of depth. And like I think I'm having that right now. Like I think I'm in a growth phase. In fact, my boss actually messaged me yesterday. It was really sweet. So I said so I've been covering this other department and one of the managers of the department I've been covering messaged my boss and said that they really appreciated everything I've done and thought I was doing a great job. And then she had responded back and was like, ⁓ yeah, I saw this in Cindy from day one. And I see growth in her every day. And I'm like, well, yeah, I think I've had a lot of things thrown at me in the last three months that have put that like extra pressure on me to make me have to like peel away some more layers to say like who's that real leader underneath. ⁓ that's been interesting. And part of that I think is like rec like figuring out how do I maintain a resilience through some of these challenging times when the workload's heavy. And it it to be clear, it wasn't really the hours of workload. It was like the emotional speaker-0: Yeah. The of what you have to do as a nurse leader sometimes. And that can span across several scenarios and situations. ⁓ the novice to expert theory was popularized by Patricia Benner in her ⁓ book novice to expert. It was actually kind of based off of a different model, ⁓ called the Dreyfist model of skill acquisition. speaker-1: She'll not burn ⁓ so as you were going through your sort of valley in your journey just recently, ⁓ is there anything that you found helped pull you out of it? speaker-0: couple things I recognized. One thing that I recognize is one toxic trait that I noticed that I'm a little ashamed of, but I need to address it. So one of them is when people leave my department, the trauma response to I kind of initially have this desire to villainize them a little bit. ⁓ And I have to reel that back in and realize they're not bad. You're not bad. Nobody's bad. Nobody's mad at you. Nob nothing's wrong. It's just part speaker-1: Personal attack on Theresa. Right. speaker-0: Correct. Correct. So that that's a little like vulnerable too for everybody listening. Sorry, but also it's just true. and I know it. I I don't always mean to. I had to like kind of reflect on that. Okay, okay, they're they are not bad because they want to leave, and you're not bad because they have this is called life, and people just do this. Yeah. So there was that. speaker-1: their own trajectory and journey and like we intersect at times and we, you know, parallel for a while and sometimes we go a different way and that's just speaker-0: It's totally natural. I put a lot of effort into people and I really do want to see them succeed and I really do want to see them grow. So and and that doesn't just because they changed rules doesn't mean they didn't, right? So kind of some of that self reflection of that. I noticed I was doing it a little bit today and then I had to reel it back in, the villainization. But ⁓ speaker-1: Can you do that without somebody playing it out to you? Can you be like, Yeah, that's a that's a really interesting skill set. Like how do you do that? How do you yi it seems like you're able to see your own blind spot sometimes? speaker-0: Sometimes I can. Sometimes I cannot. We were talking about ⁓ education today, obviously, because we're a bunch team of educators, and how one of our educators that was in the IC that we worked with was an excellent educator. Incredible. Can break concepts down into tiny pieces that make sense and make you go from zero to a hundred without feeling like you even moved. Mm-hmm. And it's it's very natural and easy and And we are reading our book club book and one of the terms that came up when someone starts being negative is called skunking. I then I was like, Well, you know, some of the nicest people are murderers. One of the people looks at me and goes, You're skunking And I was like Yeah. Yes. I can see my own blind spots sometimes. Sometimes I cannot. Sometimes I don't want to call them out because I feel a little bit dumb when I realize them. ⁓ I think we all do. I don't think they're comfortable. speaker-1: Mm-hmm. speaker-0: I would say I feel like I'm still in it a little bit. But I've hired a great new addition. I'm really excited about this girl because one of our weak spots has been dementia education and Jerry Sykes support. My favorite. And this girl is has a degree in psychology and gerontology before she ever even became a nurse. So that's like her other degree and her other passion. Before she became a nurse, she was actually a coordinator at a facility and like worked with these types of patients. So she knows how to manage this stuff. ⁓ and so I'm really excited about that. I'm excited to see where things go and see how she helps the facility ⁓ improve care for these elderly veterans that are gonna continue to come through our our healthcare system and in drugs speaker-1: We're in like a national crisis right now. And I've been talking to other people who've been like in more national conversations and nobody has this figured out right now. And so I think like we're in a healthcare crisis. And ⁓ so that's really cool. I think I think everyone's like trying to like put this like, okay, what are we gonna do about this problem? It's clearly coming. It's like I feel like ten years ago they were like the baby boomers are gonna retire someday and there's not gonna be any nurses. But we didn't predict that the baby boomers were all gonna get dementia and be really hard to manage. speaker-0: Yeah, especially all of it it's true. And Alzheimer's and so many different things that we're experiencing and witnessing. It it's it's hard. One of the other things that helped me get out of it was a little bit we did a team activity today and I think that was really good for all of us just to reconnect as a team and to regroup and to kind of revisit that. We've been working on a couple of things. I have always had a mission and a vision. ⁓ but one of my goals this year is to maybe readdress that and make sure it's a mission and a vision that we're all in alignment with, in addition to creating a a sim lab mantra so that when v guests come to our sim lab, they understand what we expect, which is psychological safety. You're here to make mistakes so you don't make them in real life and that type of stuff. So we're we're working on a poster and a saying, but I wanted the team to kinda come up with what they wanted so I had one of them kind of start it and then they passed it off to the next person. They're playing with in like Canva and creating different designs. And then next week we're gonna get together and they're gonna fine tune it. speaker-1: Speaking of, we have another episode that was about how to align your vision with your teen's vision. So you should listen to that 'cause I you should listen to that video. speaker-0: Yeah, and that's gonna be on YouTube. So if you're listening on Spotify or P ⁓ Apple, you need to jump over to YouTube. We have a bunch of short videos that are kind of more helpful. So go check it out. ⁓ speaker-1: I before we end, I wanted to talk a little bit about some of the things that I have been doing that I think were very useful for me, come out of my headspace. ⁓ so first of all, I think was recognizing what was going on was a big one for me. But I ⁓ our whole health team had had all these books as like freebies you could take. And so one of them that I took was called the Daily Gratitude Journal. And I have been doing that religiously every day, and it's been like my one thing. That I'm like crafty. All the negative things, it's like my one moment that I get to sit down and like think about something positive. So even though it's it feels like it's very short, ⁓ I'm trying to set the stage for a better tomorrow. ⁓ and then like you talking about things that are really valuable to you and like linking your vision. So one of the things for me that is really uplifting that I recognize this year is mentoring. And so I have, even though I feel overwhelmed and dizzy with other employees, that brings me a ton of joy. And I forgot I don't even know what's going on with different myself. So I also sort of made myself come into work, go to the units, and just talk to people again. I f I feel like I had not put enough emphasis on that and I realized I need to go connect with people. Because I think when all I see is bad things, it starts to make me think that that's everyone. And that's not true. That's not what's happening. It's not reality. So I had to like go seek out positive things so that I could remember that this is just a blip that's all consuming to me right now, but it's not actually the reality of what the rest of the world is doing. I love that. And that was like speaker-0: The way you handled that was was so good. ⁓ I think the common theme for both of us was something that seems to pop up in every single thing we do and it's connection. Funny. speaker-1: Yes. Yes. Relationship connection. To me, like if you don't know where to start and you're in leadership, it's just go talk to an employee and start to build a connection. That's like really when you like break it down to like the Lego sized piece of information, it's like go talk to an employee and like find a connection with them. speaker-0: Right. Not all of our brains are created exactly the same and we can remember all of those things. So one of the tips I had given them that I had heard and learned if I can't remember stuff is putting notes in your phone with their contact information if you have it, or even creating a contact if you don't with the notes about them so that you can refer. It is a way to kind of help. And then they feel more valued that you took the time to remember, even if you don't remember exactly, you took the time to take the notes, which also matters. speaker-1: Yeah, that's true. You're like being your own ⁓ corporate exec ⁓ assistant by like taking your own notes. Like that's what the assistant is supposed to do is be like, ⁓ this person likes this and this and this and this is their family's name so that you sound like you remember and you care. But you have to do it for yourself. It is hard to remember all those details. I know I just I was talking to one of my employees today who I know is going out of town next week and I was like, ⁓ what are you doing again? And I was like, I know you told me this, but like right now I can't recall what you said and I felt kind of dumb. But she was very crazy. speaker-0: I think being honest about that, you know you talked about it. I can't remember the exact details. What was that again? Please share it with me because I'm excited for you. speaker-1: Yeah, remind me because I wanna 'cause I wanna be thinking about that. I wanna be thinking about this great thing you're doing next week. Well, I'm not doing that. I'll be at work. But speaker-0: It's okay. Could be worse. I we have good jobs and we we do enjoy our jobs for the most part and I think that there's just hard times sometimes and I think that's okay. And I thank you so much. speaker-1: can figure out how is what's makes leadership sustainable is figuring out how to navigate the hard days. Because there the the hard days is when you really question, is this what I can do I want to do this for the next ten years? Can I do this for the next ten years? Is it sustainable for me? Is it good for me? And if so, what does that look like? And so I think I want to feel successful for a long time. it's really important to me to figure that out. So I love that we get to talk about that. speaker-0: And I love that we're creating this podcast and working on it and building our community so that people have a place to know that they're not alone. I hope. I hope that that's what we're creating. And hopefully we continue to create that for other people. speaker-1: Mm-hmm. Yes. So All right. Well, thanks for listening, audience. We appreciate you. And check us out. We can have you come on the podcast sometime and talk to us about your challenges and what's working well for you. speaker-0: We've had some of our stuff has been from other suggestions. So definitely do it. Have a good night. speaker-1: And I