Half-way

Again, I struggle with the notion that I should be as positive as possible here in Blogville. Sometimes, though, it's tough.

Last week was awful. And that's putting it positively! I made myself physically sick again with stress from work. I worked too many hours and whittled away too many nights on work; by the time Thursday night/Friday morning rolled in, it was just too much for my merely human body.

[Ugh.]

I went into work later on Friday morning, giving myself an extra hour of sleep, all the while wondering what I was doing to my body with the insanity.

It forces one to ask, "Is this really worth it?" To be honest, I'm still discerning whether it IS worth it.

I have to start celebrating my wins along the way. After I terminated that manager a week ago Friday, I made an SOS call to an external contact, asking him to take over immediate management of the department. I assembled two teams to prepare for the next site surveys from the state of Illinois. I had explosive HR issues to deal with in my largest physician practices. And the Epic go-live was rocky and I think my staff were *this* close to jumping out a ground-floor window!

Heck, I was ready to LEAD them out of that window. What bummed me out the most was that I could not spend any meaningful time with my managers. I couldn't be present to them and actually wrote a short apology to them for that. I hate when I can't be the director I set out to be each morning.

So things progressed and I survived it. However, the interim management of that one area is coming up with SO many improvement opportunities and he wants to use the urgency of the transition as a grenade to blow it all up. And I'm in so far over my head with the federal grant requirements that I'm not sure how we'll justify our $400k in funds. And the Epic go-live usually ushers in a valley of despair while staff, providers, and patients get used to everything.

All I can do is tell my staff that I understand their stress and that we're in this together. I can't do much for them when I'm doing my darndest just to survive, too!

But on the upshot, I had a new position approved for a physician practice manager, allowing me to delegate some of the compliance and regulatory items. The interim department management (that I contracted out) is strong and that program WAS compliant with state and federal regs. My life is shifting more from micro-management of people to the management of managers (to help THEM get their crap done).

And I feel confident for my big corporate presentation on Tuesday. I can't wait to rock that in the room full of the highest-level system execs.

Most importantly? I finished my four ethics papers detailing my Ethics certification and am now able to apply that coursework towards my Master's in Theology. My degree is officially half-way complete and I COULDN'T be happier that the "ethics papers" monkey is off my back!

Maybe I'm half-way through the other stress, too. It is unacceptable that work EVER make someone physically ill....so I'm spending the rest of today playing!!

We Think We're From Maine...

A couple weekends ago, Jack and I visited our awesome friends Vera and Mr. Vera. They're the perfect yin and yang of friends; Mr. Vera is also a hospital administrator and Vera is also a cook. Jack and Vera up the ante every meal, increasing the stakes and culinary difficulty of the chosen meal.

[The calorie counts also increase as the culinary bar is jacked up toward "gourmet excellence."]

Mr. Vera and I talk shop while the 'ladies' cook!

So this weekend was tremendous. The weather was perfect and the meteor shower was forecast for that evening. Since it felt so summery, we decided on a clambake.

These prawn:



Plus these lobster:



And these home-grown potatoes:



With pounds of Old Bay, became this:



And the home-grown tomatoes:



Became a caprese salad and completed our alfresco tablescape:



We always turn on the "Ella and Louis" Pandora station and drink good wine, toasting to a greater friendship. Except this time, sprawled out on our sea of blankets in the orchard, staring up at the meteor shower, my glass of cabernet from dinner fell over and spilled into the grass. The rest of the party thought it was hilarious that the wine dumped near my hair that I had hastily clumped in a bun on the top of my head. It became a wine-soaked bun and Jack wouldn't let me go to bed that night until I washed my hair- lest I stain the white pillow cases!!

Clambake 2012 with accompanying meteor shower was a stunning success (especially with the awesome iPhone app called "Sky Viewer"). And no pillow cases were harmed in the making of those memories!

Laughing

I really wanted to entitle this post "Exhaustion" but thought better of it when I considered the concerned family and friends that would probably reach out to me in my vortex of terror and stomach acid. When I'm tempted to get REALLY annoyed or ticked, I force myself to laugh. Oddly, it usually works to dispel some of the annoyance.

I've been pounding the keyboard for the last couple hours, trying to dig out of Email Hades, while Jack's put on an acoustic guitar concert. "One," "I'm Yours," and "Hotel California" never sounded better- he finished HIS big go-live today and is celebrating his new found freedom from the confines of his office.

It's all about attitude, right? So instead of focusing on the litany of CRAP that happened today, I instead choose to focus on the funnies. I offer you this picture that my Diabetes Center manager randomly posted all over the Center on the same day we had our big go-live and a new doctor starting:



He added a little Post-it with "3" on it, suggesting that our last velociraptor attack was on Friday.

I was chatting with our IT support staff in the break room and one of them looked quizzically over my shoulder and asked, "Is that a dinosaur?" Thinking it was some announcement about Franciscan leadership or the annual HIPAA education, I shrugged it off. Walking through the practice, I saw three more dinosaur signs. Arriving back at my office (in a busy hallway of Administration, I might add), I saw another dino sign. I couldn't help it, I laughed until I cried.

I love how my great managers know when I'm really struggling and they somehow buoy me with laughter. Like the time another manager squeezed pixy stix under my office door and still another manager "pranked" me with a fake emergency that ended up being a surprise party. While it's risky, I like being vulnerable with these people; I think it's okay that they see the real me and see that I struggle with stuff, too.

It's the same with "the awesome people," the core group of directors at work who get each others' backs. As soon as I sent out the termination notices on Friday evening, I immediately had six directors call me and offer to do whatever they could to help. THAT is friendship.

That's why I am taking time out of the longest work day in recent history to record some of the gratitude I feel in a very dark, bleak, scary, and overwhelming situation. It's so overwhelming that my CNO gave me carte blanche to clear my schedule for the rest of the week so I can, well, not die. I only have 29 meetings this week, a road trip, and a presentation in front of all the system CEO's, COO's, CNO's and VPMA's next Tuesday at Muppet Corporate. It's been a dream of mine to present to that group and it's finally happening- but I'm too stressed to even worry about the presentation yet. Figure I can do that the night before!

It's all about optimism, right? I'm trying to keep a positive attitude about this whole situation with the manager I fired on Friday. He wrote a letter to a Board member, assassinating my character and leadership style. Every where I look, I find another deficiency in his work. I feel bad; this shouldn't have happened...but last time I checked, grown men didn't need babysitters.

I also chose to IGNORE the frustration and crap of Friday by working on ethics papers for 12 solid hours over the weekend. I had to write three ethics papers and I FINISHED decent drafts of them all. Another hour or two and I'm done. Halfway through this master's degree! That was enough to really lift my spirits; those papers were the biggest monkey on my back. My pastoral theology class is over and I'm now onto a Church history class studying the Ecumenical Councils and their effect on the formation of the Catholic credo. I'm technically a seminarian now and I have the option of buying a shirt that says something to the effect of "I study theology and I'm cool."

Theology IS cool...but so is forcing yourself to laugh when it matters most.

Tugboats and Wine

I felt the need to write tonight. I’ve been writing in various forums over the last several weeks, but not so much on the blog here.

Today sucked. In a weird, makes-you-look-at-things-harder sort of way and in that unique way where something great rises from the ashes. I feel like the little tugboat we spotted off the coast of Cozumel while on the cruise ship a while back.

That doesn’t mean I like it.

For one, budget workbooks for the 2013 fiscal year close at midnight tonight. Enter numerous managers and directors, huddled in their offices, streaming the Pandora Adele channel while they try to cut another 10% in staffing and overall expenses. Each person I called this evening, I could hear little snippets of some after-hours radio. It seems appropriate that budget time ushers in some Stones and White Snake.

What the heck? Why not?

So amidst the budgets, I have a massive Epic (our electronic medical record) go-live on Monday. I have superb managers in those areas and luckily thought ahead to order a hot breakfast for the staff, physicians, and IT support gurus. I also have a brand new doctor starting in that same area on Monday (a terrible coincidence- luckily she takes food bribes!). I am just hoping they don’t quit, kill me, or throw food at me, making me hide behind my office door! That go-live and its processes created some 1,428,304 emails. I’m ready to take “reply all” off the toolbar options.

I guess the toughest part of today was the crucifying we receiving during a state and federal survey for our emergency preparedness. We have been preparing for months (or so I thought) and the manager overseeing this area completely and utterly avoided the ball. It’s not that he dropped the ball, he never picked it up. He fed us lines about how ready we are and how the binders and opening presentation were all set.

He made the hospital leadership looked like asses. I got called out on “denying” him resources when all I’ve tried to do is help him. I wasn’t sure whether I should be livid or disgusted at the performance and reflection on the hospital.

The surveyors, embarrassed at our lack of organization, actually paused the survey and then cut it short. We’ve never had that happen in the history of St. Fozzie’s, where a survey is suspended because we’re not prepared to BE SURVEYED.

[You try explaining that to your CEO when he steps out of a CEO meeting at Corporate to ask you about the survey’s failure. That was fun. ]

Luckily, my leadership team was behind me and we knew what we had to do. After flitting between budget meetings, I pieced together the documentation needed to term this manager. I talked to my boss who unquestioningly supported me and kept checking in on me throughout the afternoon. It was my first time terming a manager and I am very grateful for the TUMS that my friend Vera supplied! After meeting with my VP of HR and COO (remember EVOO?) We did the term with a grace and panache I’ve never seen in a termination before. I had one of those out-of-body experiences. I then had to suspend another one of the managers who had an equal part in the survey’s failure. It’s serious. When we look bad to the state, we look double-bad to the feds.

Who wants the feds pissed off at you?

But in an unexpected way, this event made our team closer. My boss supported me like I’ve never seen or felt before. My VP of HR and COO mobilized my decision-making. My CEO told me he has absolute faith in my ability to rectify this pigsty of a survey. My friend and colleague Mary took extensive notes during the exit interview and is supporting my leadership of this endeavor. Plus, she hugged me when I wanted to puke. And I took over a completely new area of the hospital in the process and must start from Ground Zero in my understanding of its operations. We’re going to emerge stronger from this experience and as God as my witness, when those surveyors come back in November, they will tell us it’s a 180-degree improvement from today’s wreck of a survey.

One more step.

I just hope I get to sleep this weekend. I am on call now until Wednesday morning at 7am! Wish a girl luck, please, and send me some wine.

Phelps

I just love me a good Olympic race. I jump up from the couch and cheer on my favored athlete to victory. For a few moments, I shoulder their competition, their frustration, their joy.

[Then Jack calmly reminds me I'm in the presence of other human beings and can I please keep it down?]

I heart the Olympics. Every two years, whether in summer or winter, we get to watch athletes who have sacrificed EVERYTHING to reach the pinnacle of their physical fitness for their chosen sport. I cannot imagine the sacrifice; although, that Visa commercial (broadcast 296 times) talks about how so-and-so hasn't ordered dessert in two years and hasn't watched television since 2001.

Okay, point taken. But why are you making the television-watching masses feel guilty since you haven't watched tv in years?

(insert "LOL" here).

However, it's so inspiring to me to watch the Olympics. I involuntarily tear up when someone like Missy Franklin wins the gold in swimming. I cringe when the medal favorites blow it in the gymnastic all-around. I celebrate when Kerry and Misty May roll over their opponents as though they're playing middle school teams.

Yes, I even cheer for Michael Phelps, who, to the untrained eye, looks a little cocky. Dude, we know you are worth millions and have broken all records for the number of medals accumulated by a single athlete. But you withdrew from the integrity bank because of your 'last dance with Mary Jane.'

I'm just sayin'!

He's a tremendous athlete. And a savant in swimming. We won't see another Phelps in our lifetimes. But he motivates me. Word is, he swims every single day of the year. On Christmas morning, when I'm snuggled up in my jammies and robe, sipping some flavorful coffee, he's swimming laps in some gym across the country.

It makes me realize that I really can make time to go to the gym during a busy week. If these people can train hours a day, I can squeeze in a half hour workout. No excuses!

It also inspires me to strive for excellence. Second place means nothing to most of the athletes. It's "go Gold or go home." I watched several athletes cry on the medal stand, having come within .001 of a gold medal.

We all want to win the gold, right?

So I challenge us to this question...what is your gold medal race? What race will you enter in the next year where silver will not satisfy you. You want gold. You need gold.

What are you going to do to become the gold medalist?

GREAT

This is my favorite quote for the YEAR. Maybe this decade. Isn't it funny how you get exactly what you need when you need it most?

I usually approach motivation in terms of perseverance, endurance, a little "just keep swimming" through the crap people throw your way. I tend to think of experience as something I get when I don't get what I really want.*

I recently returned from a lung-clogging conference in Chicago at the Four Seasons (no, not from the 110 degree heat index and smog combo, but because I've somehow come down with a bad case of bronchitis that progressed to walking pneumonia. Seriously? Who the HECK gets pneumonia in July when you're NOT 92 years old and in a nursing home? Sigh). This was one of those 'executive summits' where you find yourself brushing elbows with hospital presidents and system execs. Hey, at least they knew who I was- but that didn't stop me from feeling like the kid at the dinner table when they waved me over to join them at lunch on Tuesday. One half of the table discussed the neophyte accountable care organization and physician alignment. My half? Your favorite vacation memories and how much everyone hated the asparagus soup they served us.

Some conferences serve to reinforce what you know. They strengthen your resolve to advance patient safety and process improvement. Other conferences stretch every brain cell in your head and address high-level strategic planning techniques designed by nerdy PhD's so that you're left wondering how you can possible boil it down enough to do something with the knowledge at home.

I felt the temptation to feel beat down. Defeated. Young. Green. Outta my league.

[I really hope part of that temptation was from my July bronchial nightmare!]

However, I'd like to think those hospital presidents feel insecure sometimes, too.

[Right?]

Last month, my mentor told me to start thinking of myself as a top executive. If I don't project that image, they won't think of me as that either. However, several points are coming together, challenging me to NOT seek upward mobility as an end in itself. My Franciscan Leadership course, my pastoral theology class, and my friend "Joe" all said the same thing- that true, true leadership is not about upward mobility. It's about downward mobility- to serve your employees. To let them know you and your vulnerabilities. To let them forgive you when you make mistakes. And to reflect upon these experiences to discern God's hidden voice in all the mind-clutter of daily life.

True leaders abandon power and authority and focus on service. Power and authority are meaningless without a spirit of service behind them.

It's a HARD pill to swallow and a personal battle I have almost every day.

But when I attend events like this Summit in Chicago, I am unfortunately reminded of who I don't want to be. I don't want to be that seasoned exec, whom, when the young Dorrie strikes up a quick conversation, I dramatically check my watch. I don't want to be the exec who is sure to tell me about the national award he's receiving for operational excellence. I don't want to be that exec who name-drops to increase his own perceptions of his own importance.

Your ego doesn't impress me, buddy.

I'm not throwing stones here. Mistakes happen. But these actions seem to betray that sense of humility true leaders are called to embody. That's the tough part- I cannot plead ignorance and sometimes, it stinks!

However, I appreciate these conference experiences, the story-sharing with colleagues, and opportunities to eat our way across the city (Gibsons, Check! Jilly's, Check! Signature Lounge, Check!). All of these lessons add up to influence me for the better and for that, I'm grateful.



*That strike of brilliance wasn't me, I read that quote a while back and cannot recall the author. Ethics first!

I Have a Bartender's License Now

Everyone kept telling me I needed some hobbies.

I have hobbies! C'mon! Going to grad school again? Memorizing Top 40 hits during my commute to work? Flossing? Paying bills? Drinking wine? Watching Jack cook? Those all count as hobbies, right?

Ehm, no.

So Jack has recently re-taken up the guitar. He's good and is mastering a lot of our "beach hymns" by people like IZ and Jack Johnson. And he rocks "Hotel California," my favorite acoustic song. That counts as a hobby, but he also added cycling.

Luckily, when Jack decided to buy a bike and start riding, he took my measurements and bought me one, too. AND he bought me rollerblades to replace my neglected, dead rollerblades. He reasoned, "you like this. And you need a hobby."

Back to the hobby talk, eh?

So anyway, we've become weekend warriors on the cycling front- he organizes "boy dates" during which the group rides 20-30 miles and stops a brewery halfway through the ride to "refuel." I get sick of the treadmill and agree to try to keep up with him on these epic rides.

Well, they're really not epic, but for this wannabe-cyclist, they're pretty rough. Last weekend, we rode about 30 miles. This weekend, we did 36.

My calves are huge and threatening to burst out of my pantsuits.

[Charming image, no? I'm, like, the Hulk. A non-green, female, non-cyclist Hulk-ess.]

But it's been fun. Every weekend's been fun because we always ride somewhere.

Yesterday, we served at our annual parish festival. It's actually a requirement as parishioners, that you serve in some food tent, game, ticket sales booth, or carnival ride.

Us? We were bartenders. Would you expect anything different from us?

SO Jack got carpal tunnel from pouring about 300 cups of beer and I did the stylish-trying-to-be-cute-bartender and had lots of the guys seeking me out and flirting. I was getting this! I could get everyone the right beer and pour a mean margarita! Yes, plan D! If the hospital administrator gig doesn't pan out, DQ isn't hiring, and my dog-walking business fails, I will become a bartender! I'm GOOD at this and customers are SEEKING me out!

Then my colleague and fellow parishioner came up to say hi. Then she said, "did you realize your fly's down?"

#(*&$@^&^!

Serves me right, I guess, for thinking I was just that popular of a bartender!

We had a great night at the festival, but after being soaked with beer and ruining my favorite pair of fancy sandals, Jack and I left to celebrate our anniversary.

Our anniversary! 11 years of marriage. We celebrated with a big, fancy dinner a few weeks ago because we knew we had to serve at the parish fest. The first year of marriage is celebrated by paper, the second year as cotton. The eleventh year? Bartending at a parish fest, I guess!

For the record, the 11th year is steel and we're investing in the best knives we can find. With Jack as Head Chef, his chief complaint about our kitchen is our dull knives. I cannot have a chef disgruntled by poor knives.

Otherwise, work's been going well. Summertime always ushers in a slower pace, solely because half the world takes vacation and progress stalls every time I receive an "out of office" reply on urgent emails. I've been feeling like the administrator again lately, working through patient complaints, patient safety issues requiring immediate intervention, and collaborating on system-level projects that will, some day, make a serious difference for our patients. It's an equal mix of short-term and long-term projects that keep me hoppin'.

And when I'm not hoppin', I'm cyclin' now!

Opportunities

Growth

I’m trying to sum up what’s happened in my world since the last post (almost two months ago!). The one word is “growth.”

[Luckily, it’s not just my pant size!]

I missed blogging. While it’s quasi stressful at the time (one more thing to DO), it helps me reflect upon my life and the lessons I’ve learned personally and managerially. So you’re stuck with me until I self-impose another fast from blogging!

Back to growth…

Work and career discernment lately has taken a big toll on my emotion and mental wellbeing. I was up for another executive position at a sister hospital (requiring a relocation to another city). Then I was immediately rejected for the position- because that hospital tried to “recruit” me from my current hospital. They actually got in trouble for tapping me on the shoulder. I’m still digesting the whole situation- usually when THEY call YOU, you’re in. But all it really did was increase my stock value at St. Fozzie’s and at the same time, make me feel caged in and as though I was a marionette puppet whose strings were moved by another power.

Feeling both lost and powerless over my own career, I caught Elvis for a spontaneous, hour-and-a-half discussion. I left his office relieved to hear they DO have plans for me and part of those plans is to keep me a “generalist” in administration so I can avoid being pigeonholed. They also want me to try a bunch of different things so I become a well-rounded leader. It all makes sense now, but I could have used that explanation 4-5 months ago!

So I grew- in my trust, in my faith, in my confidence, and in my frustration that my calling is to continue being that voice of change. I’m supposed to become the change I want to see in healthcare.

I’m going to have to keep swimming upstream.

[Insert "growth" here.]

[Perhaps I should change the title of this blog to “Just Keep Swimming, Dammit” ???]

There are lots of work issues right now- fighting consolidations and outsourcing, implementing mergers and igniting cultural change, programmatic developments, and process improvements. My work-BFF, Mary, took over the Quality department and since she’s schooled in Lean, we’ve been working together a lot lately to improve our delivery of care to our patients. THAT is fun and quite rewarding.

Sometimes professional growth is fun, too.

On a personal note, I am halfway through my summer Theology class, which is a pastoral theology class. It’s “fluffy” as far as theology classes go, but it’s hitting me to my core. I always considered pastoral theology a joke; now I see how it fits into the mature theologian’s world view.

For instance, my old pal Bewley visited this past weekend with her 16 month-old son. Who is attached. At the hip. To the point where when Bewley leaves the room for even 10 seconds, he breaks out in an inconsolable bloody murder scream. This was *really* fun after the first couple hours. As soon as she was out of eyesight, even to grab a Kleenex in the bathroom, he’d quickly well up with alligator tears and run screaming into the night.

The old Dorrie would have gritted her teeth and invented some business emergency by which to escape (Kidding! Well, sort of). The new, pastoral theology-schooled Dorrie, chose to {gulp!} embrace the difficult situation and practice some Franciscan hospitality. Without muttering TOO MUCH under my breath!

See? I’m growing. Painfully but certainly.

Finally, Jack and I have taken to cycling for a nice summertime hobby. It's a great diversion from the usual stress, but is also serving to develop me some "dude legs" as my calves are huge from all the pedaling. We're up to 25-30 miles a weekend (not an easy feat in Chicagoan wind- it is ALWAYS windy here) and having a great time at it. Plus, our usual route takes us by one of the region's best breweries, so we afford ourselves the chance to stop, all sweaty, for a cold brewski.

That's what summer's all about so far: growth (and beer!).

Road Ahead?

"I finally figured out the only reason to be alive is to enjoy it."

— Rita Mae Brown

This quote touches the core of where I'm at right now. Work's going to be tough, it's exactly where and what I should be doing, and there's still so very much to learn. Every day, I discover more of what I didn't know I didn't know. And it's fun, even if I do go to bed exhausted each and every night. I know I gave it my all and there's tremendous peace in that feeling.

One of our elderly patients "adopted" me over the last couple of weeks and in these periodic, in-between-meeting visits, she's taught me so much about life. At 96, she has a lot of life experience to share. One of the biggest blessings has been the perspective she's shared with me- I'm about 1/3 her age and take on these huge worries and stressors and concerns. And for what?

I want to make my life exciting enough so that I have juicy, unique stories to tell someone when it's ME laying in that hospital bed. I want to keep enacting change, going against the grain whenever possible, and doing crazy, spontaneous things like driving to US Cellular Field and buying cheap White Sox bleacher seats on a random Wednesday evening. In short, I want to go to bed exhausted at the end of each day. That's how I know I'm giving life my all.

It's that time of year when my foot automatically disengages from the gas pedal, as if controlled by another power, to force me into a little coasting at work to allow the engines some rest and refueling. As part of that refueling, I am going to decrease my work hours a bit, resume my running schedule, fight crime, continue with my wonderful theology coursework, stir up some trouble, visit new friends, learn guitar, and give blogging a rest. I love reading about my own adventures a year, two, or three later. It helps me to see my own progress and success in huge struggles along the way.

However, I have less and less from my work world that I can share here. Between the negotiation of massive contracts, more operational moves, construction projects, and movement toward accountable care in the health system, I do not feel comfortable publishing some of the intimate details. I've had to start a separate journal in which I work through these difficult work situations and record them for reflection later.

I'm not sure if this is the end of Just Keep Swimming. If it is, thank you for reading my stories and laughing/crying/cringing along with me! I may still visit this forum for inspirational stories, work-related events that taught me a non-work-related mission, or other funnies, but I'm really not sure. I have no idea what the road ahead looks like or what adventures it will entail.

Until then, go live your life in a way so that it's juicy, adventureous, and spontaneous enough so you can easily entertain people who sit at your hospital bedside when you're old and gray!