Nurse Interview – 46 years of servant leadership

I recently had the opportunity to interview an incredible nurse leader Kathleen Brender. In her latest role, she was in a dual leadership role as an Executive Director and Health and Wellness Coordinator for a memory care community. I had the privilege to work with Kathy and see her passion for caring for residents with some of toughest cases of dementia. Kathy trained her team to work with Frontal Temporal Lobe Dementia and the most challenging of behaviors. Her community ran 100%, and she was known as the one to go to when no one else could care for their loved one.

Kathleen has been a nurse for over forty-six years. In this time, she has done everything from surgical nursing, geriatrics, to management, in fact in speaking with her there are few areas she has not touched on at some point or another. Kathy decided on becoming a nurse at the age of 10. Her father was in a very a severe car accident resulting in massive head injury and ended up in a coma for months. When he eventually came out of the coma, the hospital staff did everything to relate to him and illicit a positive response. It wasn’t until they showed him a picture of Kathy that he lit up and responded. Kathy was taken to the hospital every morning after that and spent the day working with him one on one. From that day forward she knew exactly what she wanted to do with her life.

I am so excited Kathy agreed to allow me to interview her and learn from her lifetime of dedication to the nursing field.

Interview

Derek Di Camillo: Thank you, Kathy, for doing this interview with me. There is so much we can learn from you and I appreciate your time.

Derek Di Camillo: Was there anything you specifically did with the sole purpose of growing your career?

Kathleen Brender: I sought out the best in the industry and positioned myself to learn from them.

Derek Di Camillo: You had worked in so many fields when did you decide to move into nurse management?

Kathleen Brender: I was 24 when I took my first leadership role.

Derek Di Camillo: In a world where skilled is king what made you decide to move into management and leadership?

Kathleen Brender: I didn’t like what I saw in management. I thought maybe I could make a difference and change things. My heart was with the geriatric population.

Derek Di Camillo: What influenced your leadership style at such a young age?

Kathleen Brender: I watched what others did and learned what made them successful. I was always learning and seeking out the best education I could for myself.

Derek Di Camillo: At 24 I am sure you made some mistakes. What mistakes did you make that changed the way you lead?

Kathleen Brender: I was always very trusting, and unfortunately I put trust in someone I shouldn’t have. I learned the hard way that you can’t always do that.

Derek Di Camillo: I think in many cases it is the little things that add up, forming the foundation of leadership success. What do you feel contributed to your success as a nurse leader?

Kathleen Brender: I learned early on you have to learn to work with others. I also never asked anyone to do anything I wasn’t willing to do myself. Also, I focused my time and energy on doing a thorough interview and finding the right professionals to work with and learn from and listened to them. I learned to think before I responded and not react in anger.

Derek Di Camillo: How did you find the right professionals?

Kathleen Brender: I found people willing to work hard and learn. I showed them how important they are and showed them I was always there for them. I also found, if you show them support and make them feel valued they will always be at their best for you.

Derek Di Camillo: Is there anything you would do differently in your career?

Kathleen Brender: No, every failure was a learning experience, I learned from them and never made the same mistake twice. I have no regrets.

Derek Di Camillo: Often I see new nurse new leaders struggle with work-life balance. What advice would you give them?

Kathleen Brender: That is a tough one. You have to take care of yourself before you can help others. I found that you have to give a lot of yourself to your career, your staff, and your patients. Finding the balance can be tough. I think it comes down to the individual and is something different for each person.

Derek Di Camillo: What is one of the biggest challenges you faced in your career?

Kathleen Brender: Working for corporations. They come in and talk the talk but don’t always walk the walk. Often it feels like they are all about control. I think they often need to learn that If you take care of what is under your roof everything else will fall into place.

Derek Di Camillo: What was the most rewarding moment of your career?

Kathleen Brender: I have lots of these! I guess the best is seeing the smile on the staff and families face when they see, working together, we can make a difference in someone’s life. Also, with the love and kindness of an incredible team, providing a quality of life for whatever time the resident has left.

Derek DiCamillo: Are there any tools or recourses you found helpful?

Kathleen Brender: One of the best things I ever did was take my team through a reality training. They learned how it felt to be one of the residents. I found this training made all the difference in the world in the way they cared for the residents.

Derek Di Camillo: Thank you. Is there anything you would like to share with the readers?

Kathleen Brender: Be true to yourself, never compromise on your beliefs, support those you work with, always have an open mind, listen, and never stop learning, and you will succeed.

A special thank you to Kathy for not only taking the time to do this interview with me but, more importantly, devoting her life to the nursing industry and taking care of our aging population. You are appreciated for your contributions and passionate care you provided.

 

Technology The 7 Characteristics of a Nurse Leader Part 7

When hiring nurses for leadership positions one of the most overlooked criteria is how well a nurse uses technology. The industry is changing, and old school paper and pen nurses are going to be left in the dust if they do not learn some necessary technological skills to compete in the job market of today. It is no longer enough to know how to draw blood, take blood pressures and document in the chart. We now must know how to use electronic charting, patient monitoring systems, sophisticated call systems and more.

In 2015 over 4 in 5 of all non-federal acute care hospitals had adopted a Basic EHR with clinician notes, whereas, 80 percent of small hospitals with less than 100 beds, rural hospitals, and critical access hospitals had adopted a Basic EHR with clinician notes. Nearly all non-federal acute care hospitals have possession of an EHR certified by HHS.

Health IT Dashboard

I remember hiring a nurse with years of experience. She knew her stuff. However, when it came to technology she carried a flip phone, didn’t know how to text, and barely knew how to call someone on it. She never liked technology and never cared to learn.

This lack of technological fortitude first became an issue when she was given a company phone with email on it. She did not know how to work the phone in the slightest. I would end up calling, texting, and emailing to reach her and find out days later the phone was going off but she could not figure out how to unlock it! It was frustrating to the core. Over the course of her time with us, this regularly held her back. She missed emails consistently and rarely respond, even her assessments which were great on paper, were barely existent in the system.

While myriad forces are changing the face of contemporary healthcare, one could argue that nothing will change the way nursing is practiced more than current advances in technology. Indeed, technology is changing the world at warp speed and nowhere is this more evident than in healthcare settings.

From Nursing World

Now I will admit she is on the extreme side of the spectrum. Most nurses are not that technologically challenged. However, many lean towards technological ignorance.

Nursing Technology can be broken down into two categories. One being that of patient support technology. This group consists of monitoring tools and the ever increasing tools used to gather assessment data and documentation. The other category is that of necessary workplace technology. That copier you want to take outside and go office space on falls into this category.

Office Space Technology Nursing
http://gph.is/2dtrtpL

Nurse leadership requires a certain proficiency of both. While patient support technology typically comes with orientation and training, often it is left to us to learn the other.

Top 3 Programs to master to be an efficient nurse leader

  1. Outlook
Microsoft Office, Technology, Nursing, Outlook
Copyright: dennizn / 123RF Stock Photo

Outlook is the most used email platform in the world. While sending, an email is simple there is so much more to learn from this tool. A weird thing is an instrument that is so powerful we spend no time training people on how to use it.

It clicked for me one day when I was in my office and had just gotten yelled at by a patient by epic proportions.  I was supposed to see her that day and forgot. I thought there must be a better way to organize myself. So, I did what everyone does this day of age; I Youtubed it. This led me to hours of Outlook calendar videos on sending invites, organizing sorting, and setting up recurring appointments. To this day, I use my calendar extensively. It has even turned into my to do list!

  1. PowerPoint
Microsoft Office Powerpoint technology nursing
Copyright: vadymvdrobot / 123RF Stock Photo

By learning to create engaging power point presentations you can engage your staff, pitch your ideas, and grow your ability to educate and lead your employees. One piece I of advice I give people here is, though power point is simple to use there is a wrong way to do it. A bad power point presentation can just as quickly lose your audience as bad content. I have seen great ideas and thoughts poorly executed in presentations. So do you research on what makes an excellent power point presentation.

Check out
Damon Nofar’s power point slide on slide share for an excellent visualization of 8 Tips for an Awesome Powerpoint Presentation

  1. Excel
Microsoft Office Excel Art Technology Nursing
IMAGE: FLICKR, AMIT-AGARWAL

Trust me to excel doesn’t excite most people. It is a bunch of boxes with numbers or letters on them. However, the impact of this tool is enormous. While Outlook is my most used program, Excel is easily my second. Learning the basic functionality and formatting in Excel is easy, and will save you hours of time.

I was working with another nurse on an analytics project, and we were working on an excel file. There was one difference, I could apply a few filters and highlight a few areas and find the information I needed quickly and easily. I found out the nurse I was working with was hours in and still trying to locate the information she needed. I showed her how to get the information with a few tools, and her look she gave me was appreciation and maybe a little resentment.

These may seem like basic systems, but they are important. When going through resume’s one of the areas I look for is basic knowledge of how to use Microsoft Office. Not only does this tell me that they are efficient in work and communication but also that they can learn EMAR systems and have a foundation of knowledge to build on.

Find the Previous Articles, part 1 -6 at The Nurses Lounge

If you found this article enjoyable and informative, please consider liking and sharing.

Also, please comment below with any additional ideas or thoughts on healthcare’s future in technology.

 

 

 

The 7 Characteristics of a Nurse Leader Part 6 – Sales

 

Now before you hit the back button or click on that x that is calling your name in the corner of the page, hear me out. Learning sales skills can be one of the best investments in time and energy you can spend. In the last post, we discussed communication and the need to communicate effectively in our day to day roles as a nurse. Taking that next step is where selling comes into play.

Many nurses cringe at the idea of sales and nursing. Many others think it only applies to sales reps of the big evil pharmaceutical companies. After all, we went into nursing to help people, not sell them something, right? I am going to propose that learning to sell will not only lead to better career growth in any nursing profession but also better patient outcomes and satisfaction.

As a new grad, I can remember doing wound care on a patient. This was the third time the patient had been in, and the wound just wasn’t healing the way we were hoping. The patient was given all education in the world, but for some reason, it just didn’t stick. The patient didn’t understand or maybe care why it was so important to follow through in between visits. I spoke to the patient a few times and remember saying something like, “I really think it’s important that you do this” or “you have to do this when you are home, or it won’t get better” I even printed off some educational material and presented it including a nasty looking wound and trying to scare her into follow through. Nothing worked, the patient just didn’t care.

Then I got the opportunity to do a ride along with another nurse. She sat down with the patient and at first didn’t even ask about the wound. Instead, she commented on the house, the pictures, the memorabilia, and eventually the patient lit up! She went on and on about her son and how he is getting married and about his new wife. The nurse talked to her about this at length. She took to time to connect when the timing was right put a game plan in place for her to be able to attend her son’s wedding. In this game plan, you guessed it, the patient’s commitment to follow through on her wound care.

The patient did fantastic after that. You see the nurse didn’t just educate her on why it’s important to follow the doctors’ orders or why she should care; she sold her on the idea of following through with her treatment. In effect, she connected and built trust then gave her the desire to follow through.

“Every Sale has five basic obstacles: no need, no money, no hurry, no desire, no trust.” – Zig Ziglar

I remember how impactful this was on me at the time. I considered myself an empathic person and someone able to connect with others. But after speaking with the nurse, she showed me that sometimes you must put your sales hat on but instead of selling perfume or meds or devices your selling desire and inspiration.

“to many people, the word selling implies manipulating, pressuring, cajoling–all the used-car-salesman stereotypes.But if you think of selling as explaining the logic and benefits of a decision, then everyone–business owner or not–needs sales skills: to convince others that an idea makes sense, to show bosses or investors how a project or business will generate a return, to help employees understand the benefits of a new process, etc.” – Jeff Haden Inc.com in his article Without This Skill, You Won’t Succeed

Starting out as a new grad nurse is tough. You have this 1-page document to summarize your life and convince someone to hire you. However, it doesn’t stop there. In your career, you will always be selling. Selling your skills, your techniques, opinions, and ideas.

Now some of you might be saying to yourself right now “but won’t my skills and work ethic speak for themselves?”. I know many nurses who are fantastic in their job who have been in the same job for 15 years without growth. Now don’t get me wrong a portion of them really don’t want to go anywhere or do anything else. But, for others, they just never learned to sell themselves and get that promotion they have always wanted.

“Everyone lives by selling something” – Robert Louis Stevenson

Nursing Sales 101

Zig Ziglar is world renowned as the master of sales. A great resource is his Selling 101: What Every Successful Sales Professional Needs to Know. This book by design is messaging those full-time salespersons making a career of it. But there is some fantastic information. Mr. Ziglar talks about selling by design not by chance. How can we adapt these to the nursing profession?

4 Steps in Selling Patient Care

Step 1 What’s the need?
Sales identify the need
Copyright: ivaleksa / 123RF Stock Photo

This first step in the sales process is identifying what the need is or in Nursing terms the assessment phase. In the example above we determined that the patient wasn’t following through with the provider orders. We can diagnose this as Ineffective Health Maintenance. By digging in, we discovered that the patient didn’t feel she needed to comply with the doctor’s orders. However, we found out she had a need and better yet a desire to go to her sons’ wedding.

Step 2 Help patient to see the need!
Sales helping customer realize there need
Copyright: bonninstudio / 123RF Stock Photo

The next step after identifying a need is communicating it in a way to help the patient clarify the need to themselves. “It sounds like going to your son’s wedding is really important to you!”. (In nursing terms this is active listening.)

Step 3
Sales solutions
Copyright: ismagilov / 123RF Stock Photo

In Step three you provide a solution to the patients need. Again, going back to the above example “I know how important going to your son’s wedding is. It sounds like we have time if we really focus on getting this wound healed.”

Step 4
Closing the Sales
Copyright: iqoncept / 123RF Stock Photo

The last step is the commitment. “Here is a calendar I made for you. Why don’t you cross off each day that you complete your wound care? How does this work for you?”

As a nurse, my hope is that you will see the importance of sales in the nursing profession. By learning basic techniques, we can get the job we want, get the patient assignments we deserve and become advocates for the patient and nursing profession. We can not only a caring and empathetic voice but an influential voice as well.

 

 

 

The 7 Characteristics of a Nurse Leader Part 5 – Communication

Communication

We are 5 posts in on our path to identifying what makes great clinical leaders. This post we will discuss the role of communication. A clinical manager must also be an excellent communicator in both written, verbal, and non-verbal communication.  We will build on our previous posts and utilize these characteristics to enhance our communication skills. This single skill can contribute to greater job satisfaction, as well as personal growth.

Kathleen A. Vertino wrote in her article in The Online Journal of Issues in Nursing.

 “Although much has been written on workplace safety, lateral violence, and bullying to address issues that we face as professionals in the workplace, little has addressed how effective interpersonal communication can contribute to a healthy lifestyle in both the personal and professional life of the individual nurse.”

I think this is profoundly true! Learning to effectively communicate (and yes this is a learned skill) will have not only a huge impact on your professional life and job growth but also your personal relationships.  We learned some of this in nursing school when we took our interpersonal communications classes or through our acronyms such as SBAR. However, we should never stop learning and practice this skill.

The New England Journal of Medicine conducted an experiment published in 2014 to determine the effectiveness of communication during a change of shift. Titled Changes in Medical Errors after Implementation of a Handoff Program this study evaluated medical errors and the effects of a good handoff. It consisted of both written and verbal components of handoff and resulted in a 23% reduction in medical errors and a 30% reduction of preventable adverse events.

Effective communication is crucial for any organization, but at a health care facility, a communication breakdown can literally cost someone his life. – Chron.com

As a nurse leader, you are not just responsible for giving a report but also communicating with staff. I remember a great nurse I worked with. This was the type of nurse you could give any assignment, and you left for the day confident it would be completed. However, I also spent more time mediating arguments with this nurse than any other. He had excellent communication skills with myself, the patients, and the families, however, when it came to co-workers or care staff he was always rubbing people the wrong way. I got complaint after complaint about him being rude or unprofessional in his communication.

I decided to spend some time observing his interactions and found though I truly do not think it was intentional, people were right. He was abrupt and cut people off because he didn’t have time to listen and spoke over people. What he lacked was humility in his communication.

Below we will discuss ways to increase communication skills and improve our ability to be great nurse leaders.

3 Steps to improving your communication skills

  1. Listening and humility

    Listening and humility

There are numerous types of listening. For example:

Combative Listening is when we listen for our turn to talk usually to push our agenda or objective. We care little about what the other person is saying and more about what we must say.

Passive listening is where we genuinely care about what the other person say’s with no goal or objective in the conversation.

Active Listening is where we find the most benefit as a nurse. The key to active listening is being humble by putting aside what you must say for a minute and listen to others. Probably the most given advice for men entering the dating scene is to learn to listen. Stop listening for your cue to talk and listen to what the other person says. This applies well to leadership. In any conversation, by using active listening skills, we can better understand the concerns of the other party and address their needs. In the example above the nurse was missing this ability. He was using combative listening and not taking the time to be an active listener. Learning this skill will not only get to better patient satisfaction but also improve personal relationships.

  1. Adapt

    Adapt

I often think of communication as more of an art than a science, needing constant adjustments and tweaks in our overall skill and often within individual conversations. Learning to read your audience and adjust your communication will have significant impacts on your skills. For example, while communicating a patient status to an MD, we will use SBAR. This is a very technical and straight forward communication. However, if we tried to apply SBAR to all our communications without adapting it would come across as lack of empathy and go over many patient and family’s heads.

A trick I find to communicate with patients and families clearly is to write out an SBAR but replace all technical terms with layman’s terms and put more emphasis on active listening and pulling from my SBAR tool rather than just regurgitating information. I often start out with questions and find what is the biggest question or concern, then pull information to clarify and answer.

  1. Systems

    Systems

In the experiment above we saw the impact of how a system of delivering handoff can significantly decrease errors. Communication is always happening if we want it to or not.

Communication can be largely affected (93%) by body language and tone of voice, leaving only 7% of the intent based on actual words. – HCPR

By putting systems in place and communicating on purpose, we can set the stage for a positive interaction. As a new nurse leader, I found myself confronted by questions and interactions often. In fact, I spent a majority of my time answering family and patient questions and concerns. Now we had a system in place for care conferences where we would spend time with each family and discuss care plans, but this was not done consistently and often not at all. By implementing this process and taking the time to set the stage for this meeting, I found people were more likely to wait for this formal meeting with questions and often we were able to answer questions more thoroughly and to their satisfaction.

As a nurse leader, this is compounded by adding staff to the mix. However, the same principle applies. Often I will put into my calendar key conversations I need to have. That way I can plan them out ahead of time and give my undivided attention.

Now I often go overboard here, but anyone who knows me knows I love systems. I have a system in place to communicate emergencies, call off’s, changes in patient condition, pharmacy concerns, etc. You name it, and there is a formal system in place to communicate it. I found this is the best way to ensure consistency and understanding on all parties.

Learn to communicate on purpose, if you don’t then you don’t know what your communicating.