Monday, September 22, 2008

If Only It Were That Easy

It was nearly 0900 when HM3 came to me and asked me if I had seen HM2 that morning.

"Why do you ask?"

"Well, his jacket is here and the light is on, but no one's seen him today. We've called his cell phone and it just rings and rings."

Dread consumed me. Today was the anniversary of LT Willman's death and it had been on my mind for the past week. "Do we have anyone we could send to his house?"

"We could have earlier, but now we're down staff."

"Let me see what I can do." I called his cell phone and it rang just as HM3 said. I found the recall bill with his landline phone and called it, saying I was worried about him and could he call back as soon as possible. I told the Department Head our HM2 was not available and I was going to call Base Security.

"Why not send one of the HNs?" he asked.

"Because if it's something bad, I don't want to wreck the corpsman."

I called Security and asked the Dispatch if they could send a patrolman to do a courtesy call for us. I explained that we had left messages on the HM2's cell phone and landline and HM2 was normally at work before all of us. I also explained that HM2 suffered from PTSD and his spouse was deployed. "Let me talk to the Watch Commander," she said. I waited on hold.

HM3 popped into the doorway. "HM2 just called. His dog knocked his cell phone off the table and he overslept." Relief flooded my brain and my shoulders relaxed. When the dispatch operator returned, I explained we didn't need their services after all.

When HM2 got into work, I sat down with him and talked to him about suicide. "You don't have to worry about me," he responded.

"But I do," I said. I told him about LT Willman and how he was the last person who anyone would have believed would die at his own hand. I still have his request for the PICC line course in a folder in my desk. Such a silly thing to hold on to. I used to drive by his house in the weeks following his death, looking at the yellow police tape barricading the doors. I told the psychiatrist that I did this. Why? he asked. I'm not sure, I said. I guess I believe that one of these times when I drive past, the yellow tape will be gone, and he'll be in his yard, waving and telling me, "No worries, ma'am."

No worries, ma'am.

Link to suicide screening for primary care clinics: Screening

Saturday, September 20, 2008

Workers Leave Managers, Not Jobs

From a nursing leadership perspective, the middle manager and his or her emotional intelligence are critical elements in recruiting and retaining nurses. Slow Leadership, one of my favorite blogs, features writing from Peter Vajda:

Twenty Indicators of Failing at Leadership

My favorite leadership failure indicators from his list:
  • Leaders who begin their responses to others’ suggestions or ideas with “no”, “but” or “however.”

This one happens all the time. Currently, my department is pushing through a space utilization request. I've had staff at every level of the approval process tell me, "You know that this space is already spoken for, right?"

  • Leaders who rationalize counter-productive processes, procedures and nonsensical bureaucratic practices by saying: “That’s just the way it is.”

Oftentimes, it takes more energy to keep the status quo than to consider an alternative. I wanted to do a replication research project when I first got here and was rebuffed. "It'll take too long to get the project approved."

  • Leaders who become defensive every time someone questions, or is curious about, one of their thoughts, beliefs or decisions.

Fortunately, we've had a regime change and it appears the newly-instated leadership is open and accepting, which was not middle management's experience with the previous occupants of the C-suite.

  • Leaders who are scattered, unfocused and unbalanced—be it mentally, emotionally or physically.

If you don't make a decision, then you can't be accused of making a bad decision, right?

  • Leaders who are a source of weakness, confusion and passing the buck in a stressful and uncertain environment.

My director scheduled a call to a specialist in a project I was working on. He commandeered the conversation and asked questions I already knew the answers to and failed to ask the questions for which I needed information. He made both of us look foolish and ill-prepared and wasted this other person's time.

Fortunately, Vajda also offers antidotes to these leadership problems through self-reflection with directed questions. I would encourage you to read them for personal insight and work. I know I used to consider being an expert clinician the height of professionalism. I'm coming up on the two-year anniversary of LT Willman's death and another well-respected nurse attempted suicide this past month. Real leadership is hands-on and messy.

So, how do YOU feel about the idea that “soft skills” are so important to defining your career as a successful leader?

Thursday, September 11, 2008

Respect is a Two-Way Street

We recently had the opportunity to ask questions of our senior leadership. With nearly everyone in our command seated in a large auditorium, it is intimidating to stand, state your name and workplace, then coherently state your question.

Several people stood and asked their questions and were answered politely with every response staying on message. Evidently, this senior leader had extensive media training and, as my husband remarked, didn't get this high by being stupid or making stupid comments.

At least, until I stood and asked my question. This senior leader look over my shoulder at someone then stared directly at me. "I see your director looks like he's sucking on a lemon," he said. He added, "And it's not a sweet lemon." He said a few more words about this lemon and my director's facial expressions, then started comparing our workplace and mission to our mainland counterparts who are also somewhat geographically isolated.

While my intent was certainly not to embarrass this official nor to make life difficult for myself, it served only to indicate the level of intimidation that is present in this type of environment and it also served to illustrate that these cattle calls require attendees to ask only those questions that are bland and inoffensive.

How much simpler would it have been to respond, "You know, that is an interesting question. I don't know the answer, but I will definitely look into it. Thank you for asking." I would have considered him to be a gracious and thoughtful leader who honestly and sincerely valued my input.

In this exchange, I lost face with my director for embarrassing him and I damaged my own credibility with my peers. On the other hand, this senior leader lost substantially more in the ridiculous comparisons between Guam, 29 Palms, Oak Harbor, and Lemoore. If a patient is taken to anyone of those hospitals and requires more comprehensive treatment, the patient can always be medevac'd, just as a patient can be medevac'd from Guam. But it takes at least 4 hours to fly to Okinawa and 7 1/2 hours to Hawaii...providing the patient and the airplane are ready to go right that minute. From 29 Palms you could be in Los Angeles or San Diego in considerably less than 7 1/2 hours...and you don't have to worry about altitude either.