A LONG Weekend

This past weekend ushered in a lot of emotions and feelings I'm not quite sure how to process. This post is more for me than it is you.

It all started on Friday, with the terrific retreat I had with corporate leadership. It actually takes place on the convent grounds and it's so beautiful. I woke up to the first decent snowfall of the season and after a couple hours of white-knuckled travel, I actually started to relax (cue the stress let-down migraine!). Our group of 20 from around the system will come together for two days a total of ten times over the next two years. I was honored to even be considered for the program and stoked when, after the opening prayer service, they collected our blackberries and iphones. They wanted us to unplug and they meant it!

[I went into a quick, sweaty panic attack for I hadn't put my "out of office" notice up on Outlook.]

The whole point of the program is to get to know your peers in the group via classroom time together, communal eating, and fellowship. They're trying to make us stakeholders in the mission of Muppetville, so we continue the traditions in an era of declining religious vocations. I'm in so far over my head, as the youngest and lowest ranking in the group. There's one other younger woman in the group, who was on the Boca conference as well, and we're really bonding.

She rocks. She's one of those power women. And I will call her Ra. As in "she Ra."

The whole first day was used to break open the group and get people talking. Then we had a happy hour with a full bar followed by a stunning dinner with seabass and prime rib. The food was amazing and we intermingled with nuns and religious at meals (what was that vow of poverty? Does that not include prime rib?). Then I went where no woman has gone before...I played Euchre with the Mother Superior of the entire convent.

How freaking neat is that?!

But we lost. She was my partner and apparently her record is, like, 204-1. Make that 204-2! I hope this doesn't damage my chances of promotion within the system!

Seriously though, after Day 1, my head felt full and I felt so insecure. I don't have problems understanding philosophy and Thomistic roots of the Catholic liturgy, but I feel insecure because I have a mere fraction of the life experience of the others. I inwardly wondered what I could possibly have to offer the others in our group discussions. I decide that I wasn't going to self-select out and disengage, asking questions anyway. I think it's a matter of emotional intelligence; I'm still thinking about "me" when others are thinking "us."

Ra and I pow-wowwed for a couple hours Friday night and talked through our similar reactions to Day 1. I felt better after talking to her and we immediately agreed to put a standing meeting on our calendars where we could safely discuss our fears, questions, and victories.

I barely slept that night, keyed up from the day's activities and anticipating Zibby's wedding the next day. Day 2 of the retreat was better than day 1; we discussed metaphorical theology's interpretations of paternalistic models and paradigms and worked through philosophies of paradigm-shifts (that's fancy for "change management"). We discussed the history of monastic traditions and how healthcare evolved from those organizations. These utterly geeky subject matter excited me for my first theology class in my resumed-degree...Synoptic Gospels. I have a sneaking suspicion that this program and my classes are going to go hand-in-hand.

God has a sense of humor like that.

Anyway, I left the retreat and went straight over to my folks' house to dress for the wedding. Exhausted from the outstanding experiences and mind candy, I launched into adrenaline mode for the wedding. We arrived and I almost didn't recognize my brothers, Brady and Zibby. Both looked stunning. Both looked grown-up. And I felt old. Time marches on.

The wedding was pretty quick, albeit very nice, and Zibby married Libby. They're young, stupid, and penniless. But so were Jack and I when we got married, so I couldn't really cast stones at the young couple. My mom was a wreck and she squeezed my hand into numbness during the ceremony. Then Zibby asked Mom to dance during the mother/son dance and everyone in the family had red eyes as they swayed to "Unforgettable."

You know how some distinct experiences immediately over-write any preconceived memories you may attach to a song? That's how it was with "Unforgettable." It'll always be Zibby and Mom's song now.

As an afternoon wedding, it wrapped up early and my aunts and uncles hung around the hall, wondering when the party would start (like any good Pollack). A few of us shared stories and margaritas, trying to digest the fact that little Zibby is now a husband and father with his own family and home.

That night, Jack sacked out in my folks' recliner while Mom and I sat on the couch and listened to my dad and Brady rehash the wedding. Next thing I knew, I felt dad lightly covering mom and I up with a blanket and flipping off the light. I can't remember the last time she and I napped on each others' shoulders...probably when my grandma passed away some 12 years ago.

We knew we had to stay the night. It was Zibby's first official night out of the house. His empty room hit us all squarely in the gut. It was real. He was gone. And that was the first time I experienced empty nest syndrome...and I haven't lived in that house since I was 18! I couldn't even imagine the pain my folks felt with his absence. It felt natural to stay over and give them one more night with a full house.

In my mom's words, a full house is a full heart.

And so we stayed.

The morning came quickly and Jack and I departed for our own home. The weekend left me unsettled and uniquely overwhelmed....yet, oddly at peace. It was as though one chapter is ending and another beginning.

And I'm going to be okay!

Quote Journal: Turning the Table

"If you want people to stay the same, tell them what they want to hear. If you want people to change, tell them what they need to know." -Fulton Sheen



I like this quote. As a leader, you want to be liked. But being liked and being effective are two different things. I would prefer to err on the side of being firm and challenging someone rather than sugar-coating a piece of news so it did not pierce the poor soul’s thin skin. Gee, even the way I stated that sounded harsh! I am a believer in full-disclosure and use that technique during employee evaluations. And I think it helps people understand what they need to do to truly improve.

I’ve been saving many leadership quotes lately, for use with my staff. When I accepted my current position, I sort of skipped a level of management. I was given several departments that all had their own managers. I was asked to manage the managers. So I’ve been trying to motivate my managers from within. I once read that true leadership is where you get people to do things because THEY want to do them.

So my next plan in developing my managers is to highlight their strengths.

I’m running in this counter-cultural (at least to me) angle about highlighting strengths. Where I’m from, you humbly accept your strengths (and don’t you dare boast about them), but you highlight your weaknesses so you can improve upon them. You do everything you can to strengthen your weaknesses so they become less of a liability to you.

Then one of my fellow leaders at St. Fozzie’s turned me on to a book called StrengthsFinder 2.0. The premise of StrengthsFinder is to highlight your strengths so you can excel in your strong areas and work with others’ strong traits. It’s a whole paradigm shift for me…I know exactly what my weaknesses and frailties are. But I had no true understanding of my strengths.

I took the StrengthFinder assessment (about 170 questions) and emerged with my Top 5: Achiever, Discipline, Focus, Competition, and Relator. The relating piece surprised me, but the other four did not. Except that I had been viewing my need to achieve, my insane OCD focus, and my competitive streak as liabilities and flaws in my character. I kept trying to weed out these facets of myself, thinking they were unchristian or presumptuous. I kept trying to overcome my incessant need to race in traffic, win at Scrabble, and accomplish many new projects at work and FORCE myself to chill out and not care so deeply about what I achieve. Obviously, it wasn’t working and only served to re-enforce that deep insecurity that arises when you try to change something that is unchangeable and fail. Repeatedly.

Just like my impatience. I will admit that I’m one of THE most impatient people you will ever meet. I can’t help it; it’s a core facet of my personhood. And to be honest, it drives me to obtain results and increase accountability to others…so it works in its own odd way. But I about drove myself batty, trying to change these unchangeable facets of my personhood and I didn’t exactly have the utmost patience while I continually failed to change.

My point is that, by accepting and celebrating our strengths, we can utilize our God-given uniqueness and celebrate the strengths we have. I hate to sound so after-school-special, but I actually learned how to better accept myself and the strengths I offer this world. I highly recommend the book if you want to learn a thing or two about yourself.

Traffic = Stroke

I was invited to an all-day conference on the north side of Chicago, on how to run a stroke center and how to create an integrated stroke system of care.

That's code for, "Please pass the wine!" Just kidding. I'm too tired to drink. Pass the lemonade!

Since the conference was basically in my back yard (so to speak), I decided to drive up this morning. I knew traffic would be hairy with the Eisenhower and Congress Parkway under construction and the trip might take me an hour. Two and a half hours later, I was trying not to scream at the sheer volume of cars, forever swearing to never travel that stretch of road ever again on a Wednesday morning. I drove less than 5 mph for an hour and ten minutes. I think I wore down my brakes in one commute.

So I was late in arriving to the conference. Such is life. It was awesome, I met some wonderful contacts from neighboring health systems in the Chicago area, and actually learned several things about current and projected stroke regs, the importance of integrated stroke care, and how to pin down an ROI for things like an $800k neurosurgeon's salary. Plus, they had really good snacks and the center of each group's work table was filled with slinkys, toy cars, rubik's cubes, and other fidgety, ADD-relieving items.

I learned a great deal about strategic planning and plan to return to subsequent conferences. I was scheduled to meet EVOO in the city to talk career opportunities and so I quickly departed the conference venue and hit the road. Traffic was as bad (or as my jangled nerves will tell you, worse) than this morning. In fact, I got bored sitting there, going 5 mph again, and I started taking pictures of the goofballs around me in traffic.

Okay, and one shameless skyline shot. I can't help it. It's my favorite skyline in the world.

Anyway, after traffic started moving (yawn), I met EVOO downtown for dinner. It was the first time I drove in the city without a map or directions. Better yet, it was the first time I was on the recruiting end of the table, telling him what I'm looking for in a permanent administrative position. It's nice to be wanted, needed, and wooed.

When I started this job, I had three goals: 1) To survive. 2) To learn a lot and make a difference at St. Fozzie's. 3) To do so well that people fight over me when my assignment is finished.

So far, all three have panned out. And I had no idea how difficult it would be to make a decision if people DID fight over me! I got what I wished for and it's not that easy. In fact, I'm more confused than ever! I set up an appointment with Jim Henson next week and will hopefully receive some clarity on my paths here.

But for right now, for this moment, I'll (say it with me) just keep swimming. Or, y'know, we can blow up that lightbulb fish for trying to eat us and then maybe make him drive the Chicago expressways as punishment!

Symbolism

I drove to St. Rowlf's for Leadership training this morning and black storm clouds gathered in my rear view mirror. It was a nice symbolism because I felt reassured that the storms are behind me. You know, metaphorically. I felt uplifted, thinking that the really tough "stuff" of this past year is truly behind me.

The Leadership training was great. The morning sessions were a bit slow, but they picked up momentum when we started talking about generational gaps and how to manage across the age differences. The afternoon session started with us all coming back from lunch to a room full of game boards...4x6 foot game boards, glass beads, and a several stacks of cards. It was a game! The boards represented hospitals and they had four units...ER, Surgery, ICU, and Tele (step-down). The glass beads represented patients and I was in charge of the ICU. You'd spin and wheel or draw cards to tell you how many patients presented to your ER or how many of your Tele staff called off sick or how you have an oxygen leak in the ICU and must take three beds out of service. We had to accommodate all the patients and go on ambulance bypass if our ER was too full.

The point was to think outside the lines, go beyond the "rules," and figure out how to adjust to events beyond our control. There was a nurse manager in my group and we both knew the adequate staffing ratios. So we sort of cheated and stretched our staff further than the "rules" allowed. But that's the scoop of real hospital life....when the unpredictable events happen, you have to flex your staff to accommodate that.

Our team worked well together but our assigned "administrator" took his job too seriously and barked at all the managers to push those patients through! Keep the productivity up! Keep the costs down! Keep the quality up! While the administrator can see the big picture of the whole house, he didn't understand the specifics of each department.

Em, yes. Duly noted! Lesson learned.

After the conclusion of the game, we received our profit and loss statements...our hospital lost $120,000 in one night because of incorrect staffing penalties. We weren't sure how to digest this, but we all knew the staffing ratios were well within safety parameters! It was a mental victory!

So after leadership training, I drove back to my Chicagoland pad. On the way, I noticed that the sky was divided in two. The west side was sunny with wispy clouds. The east side was stormy with gray clouds swirling. As I drove into the western sun, I realized that, while I am still in the midst of the storms and driving rain, the sunshine is filtering through and raising my spirits.

Thank You's

My OCD perfectionism is kicking into high gear today.

St. Fozzie's is a "Studer" hospital. If you don't know what "Studerization" is, then I suggest you jump up from your chair, turn around twice, flick yourself in the ear, and shout, "Anarchy!"

Or you could just google Quint Studer. Did you really flick yourself?!

He's the Mickey Mouse of Hospitals, seeking to make each hospital akin to a stay at Disney World. Yes, I know dozens of people who will go to Disney World to have their appendix removed or their hip replaced. I hear Disney provides excellent end-of-life care.

The management philosophy is to recognize everyone in the organization, create a culture of accountability, and to provide utmost customer service to the patients. Part of this philosophy includes regular thank you notes that leaders are required to send others within the organization. These notes are to be written weekly and Guest Relations people actually log the notes you send.

So Mickey can track you down and beat you if you forget.

It's a great practice and my day's always brighter when people send ME thank you notes. But it's a stressful practice to write them to others. First, I feel the need to tailor them to exactly the person's role in my professional career. Then I must make each letter unique and wonderfully written. It has to be the best letter that person's ever received. High standards? Naaah.

This letter-writing process is quite tedious and I tend to procrastinate...putting it off until late Thursday or early Friday. Then I'm sitting in my office, brainstorming people to thank. Or I have people I KNOW i want to thank, but I can't find the words yet. Vicious!

As I conclude this post, I am going to write my requisite thank you's for this week. Wait, don't I need to empty the trash? I hear my phone ringing! Boy, I should really beat my high score on Farkle!

Organizing a Conversational Cloud

Part of my executive training involves watching, learning, and then executing my own brand of organizational thinking. I think I've practiced a fair bit of these thinking skills in grad school, but it's completely different to outline a textbook. In the boardroom, I find that everyone likes their voice to be heard. Everyone has an opinion. It's very much like an large Italian family's dinner, where people are yelling over each other and unless you cut someone off, you won't get to talk.

I also notice that, in the boardroom, folks are often more interested in what they're going to say next, then what you have to say. People wait for others to finish, just so they can say their piece. It's a verbal vomit of epic, technicolor proportions.

On Thursday, St. Fozzie's conducted an all-day strategy meeting. Even though we had a distinct agenda for the day, the morning session was more reminiscent of a large Italian family's dinner. Nothing was accomplished and all we did was talk around 28 topics, in no particular order or structure. It was awful, unproductive, and exhausting.

During the lunch break, I asked Elvis if there was any structure to the morning. He shrugged and admitted he couldn't follow it, either. Well, that's good! If the CEO's also lost, then I can cut myself some slack. :) However, I still had to document the morning, as it was my responsibility to create an action plan out of the verbal vomit, which meant I had to adhere the material to some sort of structure.

The afternoon session was much better, as the EVOO boss stepped up and enforced the agenda. That part was easy to organize, but I still struggled with how to best capture the morning's conversation and formulate it into steps. Later, I hunched over my desk and made some sense out of everything. This is one area in which I still need practice...how do I harness these verbose and assertive personalities? How do I keep people on track, to best address the items in the agenda? And how do I get through these long meetings without requiring vast amounts of sugar? I actually excused myself at break to visit the hospital's gift shop and pick up a bag of candy corn!

Meeting Isabelle

*LONG POST ALERT*

I spent the day in OB today and would like to blog about my day as a way of processing the info. I went up there around 7:30 this morning, right after shift change. I decided to shadow Monica and Rachel, two RN's in Labor and Delivery. They were great and they thrust me right into the action.

Three patients were already in labor at that time. One was 23, one 25, and one 14. Yes, 14 YEARS old. She just graduated eighth grade and her boyfriend, the baby's daddy, was still IN eighth grade. They both looked young for their ages. She was scared and alone and I spent a little over an hour at the bedside, trying to distract her from the pain. She wasn't far enough along to do the epidural, so she lost herself in the Disney Channel. My eighth grade patient was watching, "That's So Raven."

All three labors progressed similarly and Anesthesiology came up to administer the epidurals for all three. I had the awesome luck of having met Dr. Doctor at last week's golf outing, so he invited me to get an up-close and personal view of the epidural. Honestly, I was fine until I realized that the epidural is a tiny tube going into the patients' spines. I always thought it was a big, long injection. Like, a shot. Not a continuous thing! I steadied myself against the wall and was fine until the doctor pulled the tube out just a bit and there was a bit of spinal matter in the tube. Seeing that spinal matter upset me and I had to step out of the room.

I was okay while watching the other two epidurals; I knew when I look away and avoid the spinal situation!

So things calmed down until lunchtime. We heard the ambulance arriving and it was a hemorrhaging woman, 27 weeks along. It was...gruesome. They took her right into the OR as Monica and Rachel started the blood transfusion and the docs ran ahead to scrub in for surgery. They asked me if I was coming and I answered with a wavering, "sure, why not?" I scrubbed in, full regalia, and was a fly on the wall in the OR.

I watched as they cut an emergency Caeserian, separated a layer of fat and muscles, cut the through the uterus, and pulled out a 1.3 pound baby. As soon as the baby was out, they did a hysterectomy or the mother may have well bled to death. Watching surgery ended up being like watching a trainwreck...I couldn't NOT watch. Sure there was blood and internal tissue waiting to go to Pathology, but I was weirdly okay. I eventually turned my attention to the Neonatal doc, as he stabilized, intubated, and ventilated the baby. Mom survived the surgery and baby was transferred to one of the medical centers downtown after a short tenure in the NICU. However, it was organized chaos and to my untrained eye, it resembled madness in there!

After that little adventure, all three of the "regular" births progressed accordingly. It amazed me to watch those births...One mom gave birth at 4:08 pm and by 4:25, the room was cleaned up, instruments and lights stowed, baby's vitals recorded, and mom was left to snuggle with the newborn. They're so...efficient! My eighth-grader gave birth a little before 6pm, a healthy daughter (with an even healthier set of lungs!) whom she named Isabelle.

So today, I spent 12 hours in OB, watched four births, and met Isabelle.

Aptly Titled

I *feel* like I need to "just keep swimming" lately. What is with this rain? Did God not get the memo that it's summer and it's supposed to be 80 and sunny? My mood tanks when it rains (or is incessantly cloudy). It takes at least three times the effort to be "on" and probably four times the caffeine. Even though my offices don't have windows, I can just sense that it's crappy outside.

Yesterday was one of those "multiple Mt. Dew" days. I had a four-hour meeting in the morning, one in which I thought I could sit back and observe. Turns out, it was a form of leadership training and we had intense stuff like group discussions, role play, and even skits. You can't just sit back and observe that stuff. So I jumped in and had some fun with it.

Eight minutes after having returned from that meeting, Sister Lourdes popped in my office and invited me to IRB (Institutional Review Board) at the other hospital campus. I attended the meeting because it has an ethical element to it. Several docs presented drug trials and we (okay, they) had to decide whether the trials were ethically-conducive to human experimentation. Pretty interesting and they had STELLAR chocolate cake for dessert.

What really struck me about today (and exhausted me), was the comprehensive tour of the Cancer Institute while at the other campus. My family has been touched by cancer many times and, as many of you know, my own experience took me down the cancer road. The Cancer Institute is astounding; the technology really is state-of-the-art. Yet, as I looked at the radiation suites, the cozy and comfy chemo chairs, and the scanners and diagnostic equipment, my mind rushed back to 2006.

I didn't actually have cancer. That's what they told me when I woke up from surgery. "Benign" was the magic word. But I still went through all the motions and was prepared for the chemo, radiation, and subsequent life changes. My life ended up going in yet another direction, but I still cannot deny those experiences. I was the sickly post-surgical patient in the cushy chair. I was the patient who confided in her oncologist because my regular doctor didn't understand what I was going through. I was the patient who was scared to death of those big, loud machines. I've walked a mile in those shoes and understand patients' fears.

Walking through the Cancer Institute, I was reminded of my own harrowing experiences. A few times, the memories threatened to overwhelm me. I braced myself and instead focused on the artwork hanging on the wall. But at the same time, I realized just how darn lucky I am to be alive and how appreciative I am for this experience at St. Fozzie's. I really do feel as though I'm called to the healthcare field, if only because I've been in the patients' shoes myself. You really don't know until you've been there.

D.I.H.L.

One of the biggest lessons I’ve learned this week is that most of the medical field (including hospital administration) thrives on acronyms. CHF, EBOS, EMR, etc. Well, here’s my contribution to the list: DIHL. I like to pronounce this one as “deal” and it stands for “Deer in Head Lights.”

As I sat in my first system-wide executive meeting at corporate on Thursday, I realized that I have a particular facial expression when I’m a DIHL. My eyebrows are slightly raised, my eyes are rounded, and I get these little lines in my forehead. Taking a quick restroom break before the meeting, I saw evidence of my DIHL expression in the mirror. Instead of wiping that smile off my face (a common expression my mom used when I was being a smart-aleck), I tried to wipe that deer off my face.

I wasn’t even that scared by the meeting itself. The subject matter was easy to grasp and since I’m still in school mode, I was able to follow the subject matter. My DIHL kept emerging when I compared myself to others and tried to hold myself to their level (mind you, the room was full of senior execs and very important strategic folks who serve the whole system). I got discouraged with myself when I couldn’t quickly think of a question or comment that would “wow” the bunch. OF COURSE I am not yet in that place; I realized I needed to give myself a break. It was Day Four in my residency and I had spent 90% of my hours in meetings at the hospital. I was spent. I was exhausted. I was so tired I could have laid down on freezing-cold concrete and immediately passed out into deep sleep. That also helped me realize that I need to watch the exhaustion and when I start feeling insecure and unconfident, the necessary prescription is SLEEP.

Nurse Starbucks emailed me about the body’s stress cycle: of increased heart rate, blood pressure, and cortisol levels. As your body gets overwhelmed in stress, it breaks. I need to be careful that I do not run myself down to physical and emotional (and spiritual and psychological and mental!) exhaustion. This awesome and totally terrifying experience is teaching me the actual subject matter of administration, but also how to think like an executive and balance this insane schedule without breaking down.

My Visa Bill

Graduate degree in Healthcare Administration...$18,940

48 credit hours' worth of books I cannot sell back...$2,173

3.5 years' worth of Diet Mt. Dew...$378

Advil for stress-induced headaches...$49

Having my (Summa) MHA completed....PRICELESS!