Ripples

I'm completely, 100% convinced that there's a God. And He's good.

Have you ever had years of life experience, random quotes, plotlines from books, stories from friends, and testimonies from others' faith that all converge, from all directions, into one singular brilliant point of light?

And then it changes your entire life, its direction, and makes you forget the past, all in one instant?

Well, I have. And for as much as I detest discernment (only because I'm not very good at it!), I cannot ignore these moments.

My good friend and cousin, Yoshi, reminded me that the teacher is always quiet during the test. And the past few months have seemed the biggest test of my adult life, with insane schedules that won't stop, mounting responsibilities, and unsympathetic, uncaring people erecting obstacles whenever possible.

I was really starting to wonder if I was barking up the wrong tree. Me, in healthcare and hospital leadership? Maybe I misread the memo. Maybe God was instead directing me to something far less heady and stressful. Maybe I overestimated my abilities and this whole "swimmming against the current" thing wasn't just me trying to enact change...maybe the tension was supposed to stop me and I was just too stubborn to see it. Did I miss my true calling as a stay-at-home mom? Was I supposed to have stayed in SB, toiling away at jobs for which I didn't care? Did my life incorrectly veer off on an opposite track and God was just waiting for me to recognize my foible and go running back to the safe life I once knew?

There were about 24 hours of weird coincidences that I now know were not coincidences. It's humbling to look back and see I'm only a ripple in that pond. Someone else threw the big rock into the pond to create all the ripples- and it was God who hoisted that rock into the water.

On Thursday evening, I was supposed to have attended an employee recognition banquet. I had several employees being recognized for their years of service. But Thursday afternoon was brutal, after about 4 hours of calls and stress that are going to result in me missing three months' revenue in one of my departments, my brain was going to leak out my ear like last week's decaying Chinese leftovers. I called my friend, Mary, and asked if she wanted to grab a quick drink before heading to the banquet.

Mary was ripe from a church retreat and glowing from her experiences. I hadn't had a chance to ask her about her time away. Over a glass of wine, she shared her entire story and some key experiences that seemlessly connected with her work at the hospital. That touched me- the way she interpreted her faith experiences in light of her work. THAT's a connection I've been missing lately. Needless to say, when I looked at my watch, we were an hour late for the banquet and decided to have dinner together because the employee recognition obviously wasn't happening for us.

But that's where we needed to be that evening. We both knew it.

On Friday, 12 hours after that conversation, I had a couple experiences that changed my life. I had an opportunity to serve patients in new ways I hadn't tried, let alone thought of, in the past. It opened my eyes and I now know healthcare's where I'm supposed to be. I can't elaborate, but it was a moment of clarity I'd been fighting, and I would have completely missed it had it not been for the spontaneous conversation and dinner with Mary.

I felt light. Empowered. Happy. Peaceful. Emotions I haven't truly experienced at work lately, if ever. All the past confusion, fear, bitterness, anger, and uncertainty no longer existed. And it was though those emotions never existed in the first place! At the greatest level of peace in my professional career, I went home on Friday night, eager to see Jack, walk several miles, and kick back on the 70 degree evening with tiki torches blazing and Jimmy Buffet blaring from our patio.

As I settled into my Friday night vibe, my cell phone rang. Looking down, I saw that it was Ra, my friend from St. Gonzo's. She was on the brink of quitting her job, over an intense situation that unfolded this week. She lamented the exact same issues with which I had been struggling the last few months (years?). Into my newfound peacefulness by a whole five hours or so, I listened to Ra and then offered up Mary's story, and then my story. She immediately saw how she could add her story to our stories, building another chapter into the testimony.

I was a ripple in the pond...affected and then was asked to affect another person. It's so far beyond me. But I'm grateful to play a part in helping that wave of energy reach the other shores of the pond. We're all in this together and that's the true meaning of Church- getting each other where we need to go and spreading the right kind of energy and joy as we journey onward.

God is good. Do not be mistaken.

So at this point, I'm holding on, while the roller coaster whips around hair-pin turns with hair-raising speed. Instead of closing my eyes and wishing it'd all be over soon so I could start my real adventure, I'm going into it, eyes-wide-open, fully aware that this roller coaster is only going traverse stomach-dropping hills while increasing its speed.

But this is where I'm supposed to be. Someone please get my picture on the roller coaster cam as the coaster rushes by!

Acceptance

I cannot ever recall having had a decent sunburn in March.

And I absolutely love how the arrival of warm (hot!) spring weather coincided with the time change. It was as though summer literally arrived overnight and we went from furnace action to A/C in 24 hours.

But I'll take it. I think we all will!

This past week ushered in 400 miles of cross-system driving, as I had two out-of-town meetings on Monday and then on Thursday. It's inspiring to see things actually happen in these meetings; you get that recurrent sense that you're spinning in circles, just to break through it and realize the team's really made some success.

The other days consisted of light meeting schedules affording me the chance to stealthily escape from work in the late afternoon and happily work from favorite chaise lounger on the patio. It's the supreme deal of multi-tasking...getting something accomplished *while* sucking up some precious Vitamin D.

With temps still in the 80's, our friends Vera and Mr. Vera called us randomly yesterday and invited us over to play. Vera had corned beef and cabbage in the crock pot and homemade Irish soda bread in the oven. Bailing on our plans to work, read, catch up on homework, we joined our friends at their house on the farm.

Seriously. They live on 120+ acres. Wonderful, panoramic views!

We lazed around on their deck, sipping light, fruity wine and noshing on olives and cheese. Suddenly, Mr. Vera jumped up and went in the house, only to return with two shot guns and a carton of clay pigeons.

Wine + guns = two happy boys. You'd think they were 16!

After dinner, a storm started rolling in, way off in the distance. The guys, content to jam on their guitars, serenaded the shattered clay pigeon pieces in the field. Vera and I, however, went out into the middle of the orchard to watch the storms build. The unobstructed views took my breath away.

So *this* is why people live in the country!

It really made me think about my perceptions of events. It's tempting to think about the negative implications of the coming storm...it's scary, uncertain, and with its horizontal lightning, probably dangerous. We could get hurt if we stand too close. Are the risks, danger, and uncertainty worth it?

But afterward? The rains made all the fields and lawns green. Even though it's still technically winter, good times are here. We're exactly where we're supposed to be, doing exactly what we're supposed to be doing.

Value

Some things never change. Instead of working on my theology paper with discipline and focus, I keep finding myself staring off into space and procrastinating.

[Wow! I really need to dust the blinds.]

[Must Google where Manning is going after he leaves Indy.]

[Man! That trash can needs to be emptied *right* now!]

[Should I flip all the clocks up an hour now, just to save myself some time later?]

[Hmmm. I'm hungry. What can I cook that won't mess up the kitchen too much?]


Don't you love it when I tell you what's going on in my head?

[#@$&%, she's crazy!]

All procrastination aside, this week was freakishly productive. It all started with our executive Lean training on Wednesday. Somehow, by the grace of God, all 19 execs from our region sat in the boardroom for eight hours of training from Purdue University. They absorbed the subject matter, asked difficult and engaging questions, and actually ran around the boardroom in "Lego hospital" simulations designed to help them realize the impact of Lean.

I was VERY nervous about having organized all of this. I considered it my one shot to get Lean on the map.

And it simply could not have gone better (by no doing of mine; it was Purdue's genius that made it happen).

While we were all brain dead after an all-day training, something magical happened....in several meetings Thursday and Friday, key execs asked the question, "Does this add value?" Does what we're doing add value to what we're ultimately here to do--serve the patients? Are we meeting in circular committees that far out-stayed their welcome? Are we doing things just because we always have?

I about cried with relief when, during a strategic planning meeting, one of the VP's repeatedly asked that question, "does this add value for our patients?" What better way to focus a diverse group of minds into one context?

So guess what I'm doing? I'm creating banners asking this question and I'm hanging them in every conference room and boardroom to continually remind us of why we're doing what we're doing.

[So far, my keys and security badge still work!]

End of an Era...Beginning of Forever

I used to laugh when watching Friends and Rachel had to move out of Monica's apartment when Monica and Chandler decided to (illicitly!) live together before marriage. Whatever. The funny part is that it was "an end of an era."

I have to confess that I sensed a tremendous sense of loss today. Harry Potter is over and it's the end of an era. Jack and I went to see Harry Potter (which we thought opened last weekend, guess we're not as big of fans as I thought!). Anyway, HP #7 #2 was great and Harry saved humankind (surprise!). I watched a story on the Biography channel about the making of the Harry Potter films and know that 98% of the films were shot with green and blue screens behind the actors and mostly, the actors were the only 'real' thing in the films. Anyway, today we went to see the final installment in a film series that has accompanied us the last ten years.

We bought the newest Potter novels several times at midnight; for the Goblet of Fire book, we waited in line two hours. We saw HP #4 on opening day in Dublin while vacationing in Ireland and cheered with the Irish team in the Quidditch World Cup. Everyone in that theatre in Dublin cheered on that Irish team! Talk about camaraderie!

We saw every Potter film in the theatre except #1, when we watched that flat on our backs. Seriously. Jack and I both had a terrible flu thing in 2002. I was burning up with a 103 fever and Jack was coughing up a storm...Jack was in better shape to do a quick Meijer run for OJ, Ginger Ale, and Harry Potter and the Sorcerer's Stone. We watched the movie twice in a row; one, because it was good and two, we couldn't really move to do anything else. Oddly enough, it was memorable.

Hence, our love for Harry Potter was born.

In our first collegiate apartment (nothing says 'collegiate apartment' like a crappy 17" television and Irish flag nailed to the wall), we gobbled sour gummy worms and took turns trying to beat the PS2 Harry Potter game, cursing over lost wands and incorrect spells.

We eventually matured so we could read the books and watch the movies without cursing. But on some level, we still grew up with Harry Potter. The phenomenon started when we were newly married, penniless, and dependent upon store sales to make available chicken wings, potato skins, more gummy worms, and cheap strawberry daiquiri mix to fuel our Potter parties.

Wow. Potter parties? No, we really didn't do that. Sounds cool, though, eh? Jack, Jack's brother, and The Edge often joined us for impromptu Euchre games. Our penniless state lent itself to many Saturday nights in our tiny, collegiate apartment. As Harry was young and vulnerable and clueless in the early films, so were we.

Harry matured in the films to follow. He eventually defeated huge snakes, dementors, goblets and contests, witches, Snape, and, finally, Voldemort (how much power does that franchise have over me that I feel I should say "He Who Must Not Be Named" instead of "Voldemort?"). As corny as it sounds, Jack and I matured as Harry matured in his wizard role. We gained confidence as the years ticked by, marked with experiences and stories from our life together. You soon get to stop acting and start living...because you understand your roles and how marriage should go.

I can tell you this because we spent last night together, reminiscing about our marriage. Our 10 year anniversary is in a couple weeks and we mentally traversed the battleground of early marriage to the easy friendship accompanying year 10! We talked about our youth, the proms and youth group events we attended in high school, our courtship, our wacky engagement, our wedding, our first two married years that were very trying on us both, our first house, and our scary years of 2006-07. Then we rehashed the year-month-and-eight-days we spent apart in 2009-10, our move out of SB, to now, the crazy-yet-awesome life we share. Every experience makes you who you are today and without those crazy and sometimes scary experiences, we wouldn't and couldn't be who we are today.

So while Harry's been though his own crud, with Voldemort and all that, Jack and I have made it ten years together. Because we got married young, many thought we wouldn't make it. Sure, we've been through our own crud. But at the risky of sounding dramatic, Jack is truly my soulmate. When I have a great day, I want to tell him about it. When we have a fight and disagree, I find I want to talk to him about it. He only encourages me in my career ladder-climbing; he's my sounding-board about my employee issues at work and the professional challenges I face. When I don't know what to do, he has a suggestion that usually befits some part of me I've neglected too long. I have to give him kudos- when I'm on the brink of falling apart, he'll hide my blackberry or ask me "what do you need from me?" And I know he'll do whatever he can for me.

That's love. Selfless love.

He can often outdo me in the selfless love category...

I hate to compare Jack to Harry Potter, but it's somewhat appropriate. Harry offered up himself for the good of humankind and Jack offers me whatever he can for the good of Dorrie. It's humbling to me. Usually the expression goes, "behind every strong man, there's a strong woman." Except in this case, "behind every strong woman, there's a stronger man."

Happy (early) anniversary, Jack!

Blizzard of Teamwork

"The sun is shining, the weather is sweet. Makes you want to move...your dancin' feet." -Bob Marley

Now that I've slept for 13 hours, I have my sense of humor back!

I did end up camping out at the hospital Tuesday night, throughout the blizzard. I worked a full ten hours with my "normal" job, then jumped into Incident Command. We had been doing regular conference calls throughout the day, to begin preparing for the storm. Yet, when it started getting bad outside around 2 p.m., few folks could actually believe the storm that was forecasted since Saturday, had materialized.

I was asked to be the Liaison and Safety Officer for the event. That basically means I was responsible for all the communication and organization of the event (I geek out about that stuff). As a hospital management team, we've been having Incident Command drills for the past few years...but this was the real thing.

So I figured out who was going to stay, from all of hospital management. Some people quickly disappeared and we never heard from them again. Some gave cheesy excuses. Some had to stay home because their spouses were snowplow operators or police or had kids at home. We ended up with about 25 individuals, across both of our campuses, who truly stepped up and kept the hospitals running through the storm. The storm really separated the wheat from the chaff and I know who all the go-to team players are now. (Well, you mostly knew who they were, but now you REALLY know!).

I do admit, I was jealous and a bit bitter at my colleagues who didn't even bother to check in. I knew they were at home, in front of their fireplaces, drinking hot cocoa. But in a time like this, you have to put all of that aside. Jack buoyed my spirits and I tried to pass along that enthusiasm. Whether we like it or not, it's our time to shine.

Our team, composed of about 14 people, was stationed at one campus (the central command post) with another group of 11 at the other campus across town. The night started quietly enough, with everyone in high spirits. We watched The Weather Channel in our command post (in one of our conference rooms...I will never view that conference room the same way ever again!) and teleconferenced with the other campus every two hours to discuss staffing, safety, electricity, and other resources. The command structure worked beautifully.

Then I was asked by the Incident Commander, to take over the helm of things throughout the night hours. So it was me and the Director of Security who ran the command post from 11 p.m. through 4 a.m. The most exciting things that happened were that the other campus lost partial power and their roof started leaking. The other, more scary thing happening was that we could not get staff in. So we were running very short on ER and ICU nurses; those in house were given beds, food, and clean scrubs and we worked them to the bone. We had people for 36 hours and while it wasn't ideal by any means, everyone came together when we needed them the most.

At the 4:00 a.m. conference call between campuses, someone said, "Man, this feels like Groundhog's Day, the movie." We all looked at each other and laughed because it WAS Groundhog's Day. And that darn rat probably did see his shadow. Oh wait, we don't even know that the Chicago groundhog predicted because they canceled the event at Brookfield Zoo!

Anyway, I finally went to my office to sleep at about 4:30 a.m. and slept until 8. It was the best sleep I ever got. I'll never view my office the same, either!

Rousing myself, I then joined one of our doctors who stayed in-house, to round on the units. People were in surprisingly good spirits and Doc really rallied the troops. We snapped pictures of every group of people, from the hospital operators to the weary EMS workers to the cafeteria workers who kept us all fed to the bleary-eyed nurses leaving to catch a few hours' sleep in an unused unit. It was touching.

By late morning on Wednesday, the storm was winding down. More and more staff were able to come in and relieve the exhausted crews on every unit and department. We had a few 4x4's that hospital Security officers were using to go pick up ICU and ER nurses from home. While the crazy part of the storm was over, patients were starting to flood the ER's because they could now get to the hospital.

Seeing that things were under control, I send out a couple last communication blasts, reassigned some beds for staff, and packed up to go home. I offered to stay another night, but our Command structure worked so well that things were quickly returning to normalcy. A few folks wanted to stay, so I left. Some wonderful saint dug my car out for me so I could zip right out of there.

Luckily, the drive home wasn't too harrowing. There were few cars on the road and I drove in the middle of two lanes. Arriving home, Jack took my bags, handed me my pj's and robe, and sent me off to a long, hot shower. After my shower, I quickly checked my blackberry one last time and saw that the Command post was closing and all officers were headed home. I was so happy. We made it!

And that is how a team is born. All day, people have been emailing each other, thanking them for the great work in keeping the hospitals functioning.

Me? I've been at home, on the couch, enjoying hot cocoa! Back to the grind tomorrow!

Illusion of Control

It's been one heck of a week...between the late evenings and the two physician dinners I had this week, I cannot wait to camp out in my bed on a snowy day tomorrow and watch movies. To me, there are few things more relaxing than snuggling up in my nest of feathers (we have a down comforter and a feather bed) and watching movies. I finished several big responsibilities this week, including a massive audit of the annual mandatory education completion rates by my entire staff and the last 13 of the annual evaluations. Talk about a monkey off my back!

So on Monday night (after running around like a nut all day), I drove up to OakBrook to woo a new primary care physician. It was a good dinner, but I must rave about Maggiano's an upper-class Italian chain of restaurants. I usually hate chain restaurants, but I had a salmon dish that was just awe-inspiring. Check that place out if you get the opportunity. Tonight, I accompanied the Wound Clinic and physician staff to Coopershawk. I've raved about Coopershawk before...go there, too, if you ever get the chance!

I had several HR and irate physician issues this week (long story) so among all the stress, I somehow completed a fair amount of work on one of my Muppet Corporate committees, Patient Flow. Locally, at St. Fozzie's, this touches on patient throughput through the hospital. It provides us a lot of opportunities for process improvement. I also spoke at the Leader Forum, the monthly meeting at which all hospital management is present. While most people dread public speaking, I am finding that I thrive on it. It gives me a high. Isn't that weird?

For the first time since I've started in this position, I feel as though I have the illusion of control. I finally fully understand what occurs in my own departments and in the services we offer. I am working with the managers to construct business plans so we can enhance and evolve their services to align with the strategic plan. I finally feel, despite the long hours, that I'm settling in.

So cue the conversation I had with Nurse Jackie yesterday, that they are considering changing my job description. I have no idea what this means or where I'm going...just that, when I finally feel like things are settling down (work wise!), I'll get to mix it up again and start over!

A quick house update...it appears that we are still on track for a December 11 move. This is good news. It feels like forever since we bought that house and Jack and I are just ready to move already! Bring it on! I'm anxious to put up that Christmas tree and get settled in my new home!

(Wipes Sweat off of Brow)

Well, I'm happy to report that my first class-teaching experience went very well. The participants responded well to the conversation points, asked good questions, and we bounced through the group discussions like sprites on a candy fix. It was fruitful, enlightening, and daresay, fun!

And, true to my trademark, I brought candy. Lots of it. Mini Snickers bars did the trick this time. Ever since I had that dental work done, I cannot really handle the Swedish Fish and Gummy Worms. Such is life, eh?

But the three-hour class was great and my evals all came back positive. To top it all off, I was asked to repeat the same class at St. Gonzo's and St. Piggy's!

All that aside, I've still been flirting with burn out lately. I worked almost all day Saturday, preparing for class, but also digging out from my perennial piles cluttering both my offices (I didn't dig out very far). I spent Sunday playing with Jack and watching the ChiSox game from the respite of my heavily air-conditioned home. Too soon, it was 7pm on Sunday night, the magic witching hour when I drop my "Weekend Dorrie" hat and quickly staple my "Work Dorrie" cap to my skull for the week.

The fires started last night, with a very sick patient in the ICU who needed continuous dialysis (a single patient contract that needed to be executed by yours truly), an irate physician over the Craziness Project, and what could blow up into a lawsuit for an accused negligence case (which, after having been reviewed by two physicians, doesn't look like much of anything...but try telling that to a ticked-off patient). So while I was teaching the class, my pager was going off like an alarm clock that just wouldn't die!

I called the Risk department; we're not being sued. But I still have probably two hours' worth of phone calls to make tomorrow morning. And if the dialysis patient survives the night, there will be a stat ethics review on the case. Never a dull moment in administrator land!

And did I mention that the Director of Food Service brought me a whole CASE of Diet Red Bull? You can come visit me in the heart cath lab on Thursday!

Restless Spirit

I'm happy to report that the doctor party yesterday afternoon was a resounding success. I was nervously tapping my foot at 12:02, enduring those teenage fears that no one is going to come to your party and you'll be left with cuisine (and margaritas) for 55 people. However, the steady stream of medical residents, fellows, attendings, and hospital administration started at 12:06 and didn't let up until the room was full and excited conversation fill the air.

Whew! It was great and while I spent a lot of time with the cardiologists, having everyone in the same room was wonderful. In fact, they requested a monthly "happy hour" at rotating hot spots downtown and would I mind orchestrating something like that?

Party planner? Why not. I can file that under "other duties as assigned" in my job description!

Despite the frenetic pace of the last week, I'm awash with reflective mojo today. I just worked for two hours on my beautiful deck, enjoying the 80-degree, breezy summer day. It doesn't get much better than this in Chicagoland. It makes me a bit sad that summer is coming to an end, but there's an exciting world of football, chili, sweatshirts, and falling leaves approaching soon!

See, told you I was feeling reflective!

After my initial viewing of "Eat, Pray, Love" last night (thank you for accompanying me, Jack) and having read 75% of the book "The Lost Girls," I'm trying to pin down my own sense of wandering.

I've written about "Eat, Pray, Love" before and while I don't necessarily agree with the author's reason for leaving, I totally understand the need to get away to figure out who you are. I understand how easy it is to succumb to life pressures, mortgages, 70 hour work weeks (*cough, cough*), and other responsibilities that we created for ourselves. Seriously, if we didn't have the new cars and the white-picket fence, would we really be working our fingers to the bone in the endless quest for financial security? Isn't it true that, once you boost yourself up to the next level of financial prosperity, your spending just increases at least by that amount? I'm just sayin'!

So while we create these never-ending responsibililites for ourselves, I completely understand how, sometimes, you just have to get away. That is the crux of both stories. "The Lost Girls" is a wonderful, candid travelogue of three late 20-somethings who travel the world for one year. They're also escaping their Manhattan lifestyles, hoping to find a sense of belonging, meaning, and peace in a materialistically-saturated NYC existence. Aren't we all searching for a sense of belonging, meaning, and peace? This strikes me as a universal quest, undertaken by any thoughtful person.

As I'm inundated with this concept...of leaving your life to travel the world and figure out who the heck you are as a person, I reflect on my own life. As appealing as it would be to backpack South America again and visit quaint villages in Asia, I realized that I've already had a similar experience. Sometimes I forget that I already did the backpackers' gig. Granted, I didn't visit outreaching villages on the coast of Vietnam, but I garnered a fair bit of experience while in Europe for a year and South America for two weeks. Every time Jack and I get a chance, we're on a plane somewhere. I frequently get bitten by the travel bug and jump at any chance to experience something new. So while I'm tempted to drop my life and travel, I realize I've already had this opportunity. Seriously, how many people have attended mass at the Vatican on Easter Sunday, spotted a tarantula (and a colorful parrot) in the wild while hiking the Iguazu Falls, or witnessed the generosity of a nameless bakery owner who bestowed warm, fresh-baked, FREE brownies and pretzels to me in Sweden when I about froze to death after watching fishermen haul their catches ashore? And that's not even counting the fact that I've been able to traverse nearly every green pasture, traditional pub, seaside village, and towering cliff in Ireland. I'm so lucky!

Okay, fine, so I won't do the backpacking gig again. But can't I just up and leave my current life, take a new job in a big city, venture out by myself to make new friends, and leave all my fears behind? Oh yeah, I did that, too, with my whole 1 year, 1 month, and 8 day separation from Jack. I was able to do all of that and more and I feel so much stronger because of it.

So now, I'm wondering what I should do to break out of the norm and continue my search for belonging, meaning, and peace. I feel like I've already done the "escape route" option. Is it time to do volunteer work? Get more involved in our church community? What's next?

[To be continued...hopefully!]

Can I Sleep Yet?

I have to report that my teeth are still sore and infinitely more sensitive to hot and cold than before all that dental work. I also learned that I'm going to have to sell my firstborn child to pay for the work!

It's been one of those weeks where everyone is wishing each other "TGIF" and "When is this day going to end?" greetings. It seems as though it's been tough for everyone.

Me? I've been on pain meds most of the week. :)

In all seriousness, things are great. I'm receiving a lot of positive affirmation from my colleagues, EVOO, and Nurse Jackie regarding my work. I'm "breakin' some glass" and restructuring departments and my newest project is to help develop an Orthopedics program. Orthopedics is the one DRG still making money and due to the influx of Baby Boomers coming down the pike, needing knees and hips replaced, so they can enjoy their retirement in style, Ortho is the way to go. Every hospital in America has an Ortho program (or they should!). We have a half-way Ortho program that fizzled since 2006 and I'm doing my darndest to jump start its resurgence.

On Wednesday, I attended my usual barrage of meetings and at the very end of the day, I received a phone call from St. Kermit's, to speak to a group of scientists/researchers about publishing their work. I went to one publication workshop at a conference and have published two articles….that hardly makes me a pro. I guess it's the medical school methodology…watch one, do one, then teach one. So on August 30, I'm teaching a 3-hour "class" on how to publish your work.

I spent Thursday at St. Piggy's, filling my head with Lean methodologies. During the morning, I attended a meeting at a Suzuki/Toyota plant (yes, they share) and learned the background to the Toyota culture and method of process improvement. Plus, I learned about 6 new Japanese words (to impress my friends at parties!). It's not just the Lean tools that are important, but the Lean thinking. The tools just help you think through the process. In short, I'm infatuated with continuous improvement and I'll be teaching a course in January to all hospital management. I'm also making house calls, if you ever want to learn more about the Toyota culture and improvement philosophies, I'll bring my Mr. Potato Head to your home and teach you Japanese! I spent the rest of the day with the quality improvement gurus at St. Piggy's and we sat around the table, Socrates style, engaging in an intellectual orgy, trying to figure out how to best attack hospital re-admission conditions that soon, we will not be paid for.

Yes, I really just said "intellectual orgy." Doesn't that portray the point well? I think it does.

Well, all x-rated metaphors aside, today was a decent day. Nurse Jackie was out at St. Rowlf's today and I had to lead all the morning meetings. THEN we got to play in the water in the Leadership car wash, where everyone in hospital management took turns washing employees' cars. It was actually pretty fun, except for when I got in the middle of a water duel between Elvis and one of the nurse managers!

I've got to call it a night. My brother, Brady, is visiting us in the Chi this weekend and I need to go show him a good time in the city!

Paint the Place Pink

Nurse Jackie and I have become nearly inseparable the last few weeks. I've transitioned into my role and am beginning to feel comfortable being over the outpatient areas (well, I have the illusion of control!). However, that job title is about 20% of my job, as I'm still very focused on a lot of other stuff. That big operational project I've been talking about? Well, I still cannot talk about it, but I'm going to henceforth refer to is as "The Craziness Project."

The Craziness Project is eating up everyone's time, as we're spending hours and hours talking to physicians. We need them to buy in to the idea and provide feedback. EVOO and Nurse Jackie bring me into meetings to help organize their thoughts, plans, and next steps. The learning curve has been steep, but I am actually starting to feel like I contribute to the team (again, maybe I have the illusion of contribution?)

Anyway, at the end of last week, all the "guys" (consisting of Elvis, EVOO, Cookie Monster, and all the male VP's) were out at corporate meetings or on vacation. It was literally just Nurse Jackie and me. Nurse Jackie kept reminding me that we're in charge and that the girls are running the hospitals.

This has happened before, where she and I are the only administrators in the house. During those times, she'll text me and say "It's time to paint the place pink!"

The Ladder

The tables have turned and I suddenly became the mentor.

I spend so much of my time, soaking up others' experiences and advice. When I was asked to let a grad student from the U of Illinois shadow me, I was a bit taken aback. What do I possibly have to teach her?

She looked to me as the seasoned executive (yeah, I about snorted my coffee when I heard that) and had a lot of questions about what she should take in school and how one breaks into administration. Everyone's out for a job these days…but one of the huge lessons I've learned is that women need to pull each other up. That was my complaint of the few scant female execs I met before Nurse Jackie. They were too worried about retaining their own positions that they never made time to mentor other women. They didn't want to lose their jobs. They just didn't make it a priority. Nurse Jackie is the first female exec to pull me up, to teach me the ropes, and to baptize me with administrative lava. You can only learn so much by studying and talking about it. Eventually, you have to jump in and JUST DO IT.

EVOO challenged me to become like Nurse Jackie. He encouraged me to "pass it on" and to mentor as many young women as I can. While I've just started climbing the ladder (and the top of the ladder disappears into the clouds while I’m about 3 feet off the ground), these women are still standing on the ground, not sure which ladder to start climbing. They're not sure if the rungs are greased or if women are even allowed on the first rung.

So I gratefully accepted the student who wanted to shadow me. I toured her around the hospital, introducing her to all the nurse managers, RN's, techs, and even a few of the housekeeping staff. By doing that, it raised my own confidence that I can now (comfortably) go to any nursing unit and know most of the folks by name. I can walk into the ER and ignore the feelings of faintness I feel when I see a gunshot victim who took a bullet to his chest. I can go up into surgery and know which areas require scrub and which do not. The student had the Deer in Headlights expression but I'm starting to see that it's my job to help other women wipe the Deer off of their faces!

C'est Finis!

The stroke program is up and running and it's DONE. As the French would say, C'est finis!

THAT's another monkey off my back!

Treehugger

I'm treading water, treading, treading, just keep treading.

{gurgle, gurgle}

Please throw me a life preserver, I'm sinkin' here!

Just as a warning, tonight's post is full of onomatopoeia's. BAM!

I'm actually sitting on my deck right now, soaking up the humid 89 degrees on this lovely Monday evening. I love hot weather! After I excused myself from a doctor dinner tonight, I came home at 7 and promptly set up shop on the deck, figuring I'd be productive and accomplish two analyses I was asked to present tomorrow morning.

Nope. So far I've done everything but get started on work.

Tangent! POW!

I decided that I love the expression "wrapping my head around it." I literally picture a brain stretching to accommodate a new object or two arms trying to reach around a tree trunk. Well, I'm still trying to wrap my head around a project I was asked to lead last week (Nurse Starbucks and Therese, sorry for the repeat story here). It's hairy, scary, crazy and I'm still working this out in my head. ZOINKS!

Muppetville's CMO tapped me again and this time, I wasn't able to defend myself! There was a big corporate meeting last week, in which the system execs discussed the upcoming roll out of Epic. Technically, I'm no longer invited to these meetings but have been told I can attend if they pertain to my areas or if something is of burning curiosity to me. Fine. I skipped so I could work on some strategic planning and meet with two core teams involved with our upcoming strategy retreat. Next thing I know, I get an email from the CMO (copying all the ceo's and coo's), thanking me for my help in leading the Epic care continuum project. Huh? How'd I get nominated for that?!

I instantly fought the temptation to either throw up or hide under my desk. I had to close my door, put my head down, and breathe deeply. How in the...? What in the...? HUH? Will someone please tell me what's going on?!??

I reread the email and saw that Elvis nominated me to represent the Chicago hospitals on this Epic team. There are four people total (one from each area of the system) and we are going up to EpicLand to design the clinical workflow and patient care coordination around Epic. Then we come back to the corporate execs' meeting and present our findings (current state versus future state analyses). These people are all Lean Six Sigma black belts with 10-20 years experience. Me? I'm a green belt with one and a half projects under my belt. On the upshot, they're all introverts and I have no problem presenting things to executives. I just know I'm in over my head and while I'm thrilled to be given this opportunity, it's daunting. YOWZA!

{pause as she climbs out from under the desk}

Our former surgery software just plopped itself in the middle of our clinical workflow and disrupted everything, so this process redesign is a good thing. I'm just trying to convince myself that I'll have enough time to devote to it without flipping out too badly. I know I'll flip out, I just hope it's not a terminal case! I'm not ready to go to the looney bin yet. Wait...do they have COOKIES there?

In other news, I've been acting like an administrator today (yes, this is newsworthy). I got a call from the ER when they were stuffed to capacity and had a rowdy (rude) patient making a ruckus in the waiting room. One of my managers called me to ask if she could change out a respirator mask if the ones on supply contract were not working for the department. Then I presented to 40 ER physicians about stroke and answered their questions (you can totally tell if someone is "old school" or "new school" by the types of questions they ask). I met another 15 or so employees in one of my departments this afternoon. And finally, I launched into an unsolicited litany about our legal review process and proposed that we fix it and all Nurse Jackie did was laugh and nod her head frantically. GREAT. Guess who just created another project for herself!?

All in all, I'm hanging in there. After all, I only feel like throwing up 23 times a day now! Wahoo!

Confidence in Punting

Even though I sort-of-semi-officially announced that I accepted a position at St. Fozzie's, things have not slowed down one bit. In fact, I feel busier than ever. But that yucky feeling at the pit of my stomach, where I internally-shuddered at the fear of the unknown, disappeared. While I knew everything would eventually work out fine, I still (if briefly) wondered what would happen if I gave all this time and effort and it was all for nothing.

Yep, that yucky feeling is definitely gone. The powers-that-be at St. Fozzie's not only created my dream job for me, but matched my asking price.

I know, I know, I'm extremely, extremely blessed!

Anyway, things are progressing well and I've already gotten into two huge operational projects and may end up leading one of them (so exciting!). I'm not sure I'm ready to manage 7 clinical departments, but I figure I'll grow into that responsibility.

I've experienced a lot of growth lately. I attended one of the super-intense Muppet corporate meetings on Thursday and was...fine! I remember my first experiences at those meetings, just feeling utterly lost, overwhelmed, vulnerable, and like a fish out of water. More accurately, I felt like it was "Bring Your Daughter to Work Day." Those meetings provided me a mental and emotional work-out and it always took two night's sleep to fully recover.

Perhaps the mental and emotional training has worked because I'm happy to report that those feelings have passed. Even though there were 31 people in attendance (yes, I counted), there were only 4 women in the room. While I greatly enjoy not having any lines in the ladies room, it's a sweet victory to get over myself and start participating in these meetings. Not only did I meet two of the newer COO's in the system, but I was able to ask a question in the large forum and have the corporate VP of Strategy back up my argument. Don't get me wrong, I still get a bit nervous before the meeting starts. But once everything begins, I have no problem talking to the CEO's, COO's, CFO's and introducing myself to people I don't know.

Like I said, it's a growth experience. This sort of thing takes a lot of practice!

In a concluding, off-the-cuff conversation with Baker, the CEO of St. Swedish Chef Hospital, I asked for some advice. He's a newer administrator and I asked him what he wished he knew when he was just starting out in administration.

He said, "Learn how to punt. And when you have to punt, be confident about it."

Because the NFL Draft was that night, I asked him if he was secretly coaching Tim Tebow or one of the other stand-out QB's. He reiterated the fact that administrators must make a lot of decisions and act on many situations...when you don't know what to do, you punt. Then you feign confidence!

This struck me as sage advice and I keep thinking about how this might pertain to me, as I'm inheriting a world of healthcare reform with Baby Boomer population marching toward Medicare. Hmm. Might have to punt...confidently.

For now, though, I'll just worry about my new operations position and keep on growin'.

Drum Roll Please...

I accepted a job today in Chicagoland, at St. Fozzie's, as Director of Clinical Operations!

(More to come on this; I am going to go shriek for joy from the rooftops!)

New Cereal Idea

I just had a brilliant idea. Why do cereal manufacturers maintain such a dichotomy in cereal choices? When you're a kid and don't care about nutritional content, cereals such as Cocoa Pebbles, Trix, Cookie Crisp, and Lucky Charms completely count as a good breakfast. [Side note: my mom only let me have "sugary" cereals every other week. I had to have "healthy" stuff like Cinnamon Toast Crunch or Life on odd weeks.]

Anyway, I would love to sponsor a contest where such "responsible" cereal manufacturers, such as Kashi, Quaker, and whomever makes Fiber One battle to create a healthy Lucky Charms. I need a Lucky Charms with high nutritional value and decent fiber content! Can they please cross Total with Lucky Charms? Total Charms? Totally Lucky?!

Yes, that's what we'll call it: Totally Lucky.

Which is exactly the attitude I've chosen to have these last two days. I've been so stressed out and completely swamped that my body is threatening to break down. Not sick-wise (well, maybe that, too), but the muscles in my body are a wreck. I have knots the size of tennis balls. Maybe this provides a business case for the in-house masseuse position I'm creating in my Chicagoland pad?

Just kidding, Jack!

Anyway, I decided I'm Totally Lucky. I was asked to attend a corporate Muppet Lean/Six Sigma meeting at St. Piggy's. St. Piggy's is a scant 2.5 hours away and required 5 hours on the road. I spent all of Thursday afternoon working in Business Development (the finance and revenue numbers that must be compiled and organized before hospital-wide decisions are made...after five hours of this, my eyes were bleeding and I wanted to fall on a letter opener so I could escape that office). So Friday morning, I was one tired pup and I was so sad I had to travel the Interstates for 5 hours.

On the way to St. Piggy's, I watched the sun rise over the snow-covered flatlands and had a sudden change of heart. Maybe it was the Vitamin D I absorbed from the sun, maybe it was the realization that, a year or so ago, I couldn't even fathom receiving invites to corporate meetings. Thinking about how far I've come, I felt lighter....more in-control....and happier.

The meeting was phenomenal. We actually had to play a Pictionary game accented with Charades (to make a couple of communication-related concepts real) and we all received Mr. Potato Head dolls after a simulation on the importance of correct and tight processes. I actually had fun and I asked a lot of questions. This was the first corporate meeting where I didn't feel braindead and raw after the meeting's conclusion!

Either the subject matter was much easier to grasp, I wasn't so worried about the other execs' perceptions of me, or I'm just getting used to these forums. I'm not sure what's going on, but I loved it. I had enough energy left on the ride home to make an hour-long call to Business Development. Then my brain was mush! Still, though, I'm totally lucky.

I Fought the Law

I feel quite accomplished today and equally exhausted. I made it through another round of Code Stroke, Physician Recruitment, and Lean Six Sigma in Surgery Throughput meetings (all of which I'm leading, by the way...does that explain my exhaustion? Probably so. I found out yesterday that I'm now responsible for three Six Sigma projects at St. Fozzie's...so I'm teaching the biweekly three-hour classes and serving as a consultant of sorts while also learning all this stuff myself. Makes for an interesting experience). Then I had a physician dinner tonight with the OB/Gyne department, which I actually blew off...even Dorrie has her breaking points and one more late night out would've been the perpetual nail in the coffin.

Tomorrow's an all-day meeting at St. Animals and Friday's an all-day meeting at St. Piggy's. I was supposed to go to SB for a meeting at Muppet Corporate on Thursday, but I bailed becuase I have one last committee at which I must present the stroke order sets. It's another week where I'm rackin' up the mileage on the ol' Toyota. I need a heated massage chair in my car.

I have a song stuck in my head, the one one from the '60's that says, "I fought the law and the law won." Except that I wrote the law. I can't remember if I told you before, so I'll tell you again (teehee). When St. Fozzie's put me in charge of the stroke program's creation in October, I quickly contacted the Illinois Department of Public Health (IDPH) to see what the regulatory language was. One of the policy analysts wrote me back and said they hadn't drafted the language yet and did I have anything I'd like to see included?

I dropped what I was doing and scrawled out a list of 40+ facets I would like to see addressed. They were generic, as it was up to Illinois to figure out the specifics. I sent off my list and the policy analyst replied, thanking me for my time and input.

I forgot about that exchange until about one hour after my stroke presentation last Wednesday. My Blackberry buzzed to life and I saw that policy analyst's name pop up in my inbox. I quickly opened the message and found that Illinois did, indeed, draft the language in rough format. The policy analyst requested that I edit the rules and help formalize the regulatory language.

Since I spent all weekend painting, I didn't get to the law-writing until Monday afternoon. And I didn't write as much as I poked holes in their logic, cited inconsistencies, and pointed out areas that needed additional clarification. These people at the IDPH need an introductory course in logic and reasoning!

Now, I know this is a strange fluke, that I'm not truly qualified to be helping write state laws. But since I asked for info and submitted my suggestions in October, I must have stuck in the analysts' minds. Whatever the case, isn't that a cool resume-builder?! How many times do people get to help write laws?

I Think I Can, I Think I Can...

I have a very strange feeling of peace that's recently settled over me. Sometime Tuesday, I must have turned the corner again. I wasn't nervous for my presentation, I wasn't nervous for the always-harrowing drive downtown, and I just knew things would work out. Either my mind has completely shut down and is trying to protect me from the stress of this job…or maybe…just maybe, I'm adjusting. My shoulders feel lighter, my outlook seems brighter, and I just don't feel the same impending doom I've been experiencing since New Years. It was a very stressful six weeks, among the most stressful of my entire professional career and perhaps I've subconsciously realized that I made it.

I've made it out of the slimy pit, out of the mud and mire.

And good catch, that's from Psalm 40. I don't know all the Psalms to be able to quote them like that. But Psalm 40 is also a U2 song! If anyone out there in the blogosphere has been praying for me, THANK YOU. The peace I feel right now is palpable and it enables me to faithfully face anything coming toward me in my future.

I see a light at the end of the tunnel. The light is getting brighter. I feel like I just might survive this year. I just hope the "light" isn't a steaming locomotive headed through the tunnel, barreling towards me!

Acceptance!

After months of attending the monthly, highest-level physician practice administrators' meetings at Beakergroup, Dr. Sails finally recognized me as a participant in this meeting. Dr. Sails, a former president of the group and well-respected physician in the institution, is one of the "old school" guys who tends to respect men and relegate women to the home. He's foreign and I suspect there are some cultural ruminations there. In the meetings I've attended, I've been the only woman in the boardroom.

Each and every time.

Anyway, I saw Dr. Sails in the hallway in the CardioVascular building today and as he passed me, he said, "So, you're coming to the meeting tonight, right? I'll see you there?!"

I *did* attend that meeting. In fact, I canceled plans I had with my fellow Fellow friends in downtown Chicago tonight, so I could attend this meeting. Again, I was the only woman in that boardroom tonight, but I owned it!

Little victories, people. Little victories!

SBAR

Another lesson in variation...

"SBAR" is a hand-off tool that Muppet Corporate is suggesting that nursing units use when handing off their patients. It stands for Situation, Background, Assessment, and Recommendation and it's a proven methodology for consistent and safer communication. When I was asked to lead the SBAR implementation project at St. Fozzie's, I figured, how hard can this be? Just get everyone to use the same methodologies for hand-off's? No problem!

We had our first brainstorm the other day. We filled up 6 sheets of newsprint. My hand cramped from scribbling everyone's thoughts and words. This is what I learned from that first brainstorm:

1. There are actually TEN different kinds of hand-off's. Everything counts from ER to Unit, Unit to Unit, Shift to Shift, Unit to OR, etc. Caregiver-to-caregiver.

2. There is a whole separate form (and hand-off process) for charge nurse hand-off's. Charge nurse-to-charge nurse.

3. And physician communication, when nurses must call the physicians.

So yes, the project suddenly morphed into a brainstorm from hell. Actually, what I experienced was a migraine of a brainstorm!

It was good, though, because we talked through the process. As it turns out, each unit uses its own SBAR form. None of them actually follow the SBAR format, but they have pieces of it. So I formed one task force to develop the caregiver-to-caregiver SBAR tool that will be used on all units. This task force will seek the input of front-line staff; projects like this are far more successful if you obtain their buy-in. It will work, because we'll give them the "S," "B," and "R" and let them modify the "A" to fit their individual units' needs. It'll be standardization that fits all units. Hurray!

Then we agreed to tackle the physician hand-off tool. Luckily, we can borrow a template from a neighboring hospital and adopt it to St. Fozzie's. I can make these changes and will be rolling this out to the appropriate committees next week.

The charge nurse-to-charge nurse piece was not touched. That's for next week.

Okay. Now. When is that Overachievers' Anonymous meeting?! We can do Mensa puzzles next!