Thursday, November 22, 2007


Today represents not only a national holiday but a turning point in my life. I am officially 40 years old today. I am still thinking about where my life has been, and how quickly the time has gone by. Wow..I really understand what my residents speak of when they talk about how quickly their lives were spent.. On that note; I have taken much of their saged wisdom to heart and am living my life with a purpose and intent instead of simply living. (thank you to my two female elder mentors!) I am so ever thankful for the elders who have crossed into my path on this journey of living.

With that said today represents so very many things to people. Many spend it with family, many spend it at home watching football and resting. Others get out and do things like run a 5K in the snow, (Detroit today has 6 inches of snow on the ground, and it is freezing drizzle/snowing still. Not exactly great running weather!) There are also people who get out and do for others today; working at homeless shelters, handing out meals to shut ins and those in need.

The people I am most thankful for are the employees and care providers who right now across America, are working to take care of our frail, forgotten, and neediest of Americans. Yes they are getting paid to do this..However, on any Holiday they are there working to assure that these individuals are cared for and remembered. In my facility like all across America, a big Thanksgiving meal is being prepared for noon. The dietary staff in any given facility is prepping for that meal as we speak.

I am sure in most buildings, the staff and residents spend this day enjoying the day together. Holidays in a nursing home are chaotic for staff; yet rewarding. Families come into visit in large numbers; many have not been in all year and they will have questions and concerns about how their loved one is. The staff will take the time to respond to every one. Many elders will have a sad day; as their families fail to visit or worse; they have no one to visit and observing the many visitors it reminds them of their all alone in the world status. Again, the staff will recognize this; and offer comfort and empathy; in return the elder will smile, say thank you or give a great hug and both may shed some tears in silent understanding of the emotional connection that occurs.

It is this spontaneous nurturing and giving that occurs that I am so ever thankful for. Outsiders - those who have no inkling of what really happens in care facilities; do not know of the symbiotic relationship that exists between elder and staff. It is a giving/receiving/giving cycle that occurs when true care exists.

As I have focused my life; it is this very element of care that I strive to teach, role model and educate others on. We can create beautiful structures; we can give outstanding clinical care; but without the humanness of giving selflessly; we fail as care givers. It is perhaps the most difficult element to teach, and grasp; it is not visual, nor tangible; it must be felt. Yet, once understood and recognized, it becomes an intrinsic part of the heart and soul of every great caregiver. It is this giving that outsiders "feel" when they come into homes that practice this.

Happy Thanksgiving to each of you. May you recognize the gifts you have given, and those that you receive. Continue to share and allow others to share with you. Be thankful for the simple things..they matter the most in the end..

Wednesday, November 21, 2007

Life Lessons Can Not Be Risk Managed...

I received a great article yesterday from a colleague regarding children's authors in England being "censored" for writing about risky behaviors. According to this article, authors are being told to re-write scenarios in their books that may encourage children to engage in behaviors that could lead to harm. The scenarios? Simple things that we did as climbing trees... Yes you read that correctly, according to this article these types of books could lead to children engaging in behaviors that could lead to harm..

I guess this puzzles me. As a child, we did all sorts of stupid things that could have lead to our impending doom; yet by the grace of God we survived with minimal damage; and great stories for our children. None of the incidents were premeditated or directed by something we read. In fact they were usually spontaneous actions brought about from three creative female imaginations deciding that some activity would be fun. The three female minds were myself and accomplices of at least two of my three sisters. One would come up with an idea, and the others would follow or add additional embellishment to the original thought. For example the time we had a significant snow fall; and the drifts were so high that we could climb to the top of the wood piled against our garage and then slide down the roof of the garage, over the wood pile and get significant distance into the yard...Needless to say the neighbor ruined our fun by calling attention to our mother that we were on the roof...Lesson learned? Mom indicated we could break our neck from falling off the roof, or worse at least a limb; and that the neighbor was in on her anxiety.

So why do we feel the need to "protect" our children from all risks? There are inherent lessons to be learned from taking on risk. Stifling a creative story will not stifle risk. Giving parents false hope that by eliminating any "idea stimulator" will decrease the risk to their children is wrong. We are human beings; and like any animal we learn from attempting behaviors; and our minds work so that ideas and decisions can be made spontaneously.

As a parent I always hoped that I had done my best to teach my child how to way decisions and make responsible choices. Yet, he has had some significant learning from taking on risks and then dealing with the consequences. I believe he will be a better adult and person because of it. As a parent it hurts to see them suffer from their consequences. It is natural to want to protect and eliminate; but the learning is lost in overzealous protection. Ironically, the lesson takes longer to then learn.

Why was this story sent to someone who works with elders? Because, it is the same thought process that care providers deal with every single day. We are to manage/control risk for our elders; and in some cases their rights be damned. The regulations are conflicting in this case. Yes you have rights; but I also am required to protect you from all harm. Even that harm which you could cause to yourself from (gasp!) being human and having an inquisitive determined mind. For example, walking. If we (your care provider) feel you are not safe to ambulate by yourself, we must do everything possible from allowing you to ambulate unassisted. Imagine sitting in your room; and seeing your roommate drop her Kleenex box on the floor. Your mind and spontaneous thoughts tell you to "get up and hand it to her". Wrong! your thoughts are no longer allowed to govern your own behavior... Welcome to a new life lesson....

Sunday, November 11, 2007

Social Responsibility...

Does a company, or it's leaders have a moral/ethical responsiblity to educate, develop or offer personal growth for their employees?

This was the topic of discussion last week in my organizational leadership class. The further discussion centered on where are the leaders of the future going to come from, and are we facing a critical shortage of great leadership in America? One answer that resonated with me from a class peer was the perspective of social responsibiity of corporations and business to create and grow their own next generation of leaders.

As we shared our own personal journey's into leadership roles; it was evident that some companies are getting this idea better then others. I have thought about this topic all week as I face a "change" in my own leadership role and take on a new challenge. I have thought about how we/I as a leader, view development of future leaders.

I also have researched and looked for information regarding developing good leadership programs for future administrators and nursing managers. What I find is very good resources; with limited applications throughout our industry. A sad testament to what we view as important.

Yet, we espouse conversations about quality, we talk about driving down costs, increasing productivity while maintaining high staff satisfaction rates. None of this can be accomplished without some very basic leadership skill and development.

It is as if we "assume" that persons in leadership roles have a skill basket filled with the necessary ingredients to create the recipe for success. The reality, is that most leaders in health care are in these positions perhaps based on some in born ability or talent and personal drive. They may/may not have actually recieved good hands on training and knowledge of the nuances of leadership it takes to reach the level of excellence we are seeking.

I again am fortunate to work for someone who recognizes this as an area of growth to be developed on an individual basis. Yet as I start to think of our industry on a global realm; I realize how truly lucrative it could be for me/my building and my company if we develop a phenomonal talent pool of future leaders. It is something our competition has not even begun to address or focus time and resources on.

Growing our own leaders comes at a cost. In fact, the cost may be losing some of those that you develop. I sit in my office at work today; cleaning out my desk. On my desk is the list of the upcoming nursing graduates that we will sponsor an event for. I have two of my own employees on this list. Both are part of our tuition reimbursment program. Both will make phenomenal nurses and have bothpersonal drive for quality and a passion for customer service. As a leader to have had a hand in developing these two young women and watching their personal growth is a reward unmatched. Yet, the dilemma is where are we going to place them? I have no nursing positions in my building. Discussion with sister facilities will have to take place to find a place for them to continue their journey. Perhaps they will even leave our company.

So is it worth growing future leaders if you have no place for them once ready? My answer to this question is a resounding yes. I feel as a care provider it is my social obligation to create excellence for all care givers. If this means over development of potential leaders then so be it. Imagine the possibilities if all companies felt this responsibility. We would not be facing a leadership drought, and health care would be so much better for it...

Sunday, November 4, 2007

Hello and Goodbye...

Ok, so i can talk about embracing change, and my need for constant flux in my life..But when it hits you out of the blue are we ever really ready for it? For those of you newly reading; welcome to my blog. For my current readers, a little update. I am leaving my nest, the comfort of home and the known that I have retreated back to from time/time in my life. I have been offerred, and accepted a position in another building, located 100 miles from my home.

I did not expect this quite so quickly, I have come to learn to be careful what you wish for; in my life it seems to be if I speak it, write it, or even think about change, it happens.. With that said I am thrilled by the opportunity, sad for what I am leaving unfinished, and remorseful about leaving my elders.

For my new building, staff and elders we are about to embark on a new path. I am so very excited to be working with a great team. Your reputation for great care and outstanding compliance precedes you all. You should be very proud of what you have accomplished, and I am honored to be able to work with you as we take this building to a level of remarkability that will be a model of care, customer service and what aging should and will look like in the future. Given your expert abilities at care, we are going to transition well to the next level. As your leader on this journey I am committed to giving my heart and soul to working with you as we create the new vision of care.

For my current staff, friends, peers and elders; I am sad that our journey this time around was only a year. But what a journey, and look at what you have accomplished! The communication levels, the team work, the focus on customer satisfaction and community involvment are all off the chart successes you should be very proud of! You are all responsible for taking a facility and making it part of the community. A place that everyone recognizes for not only great care, but greatness period. When people in our area talk about our building, they talk about the environment, culture and feeling that you have all worked very hard to create for the elders whom you serve. I hope you realize how very special each of you are; and that every individual has played a role in this achievement. I am honored to have played a small role in your success, and cannot wait to see what you accomplish next. I am forever grateful for the opportunities, support and lessons I have learned working with you over the past 14 years.

As I told someone last week, no I will not be back, unless it is to live in about 35 years... and yes I would be proud to allow you to care for not only me, but any of my family. That in itself should speak volumes to the level of trust and respect that you have earned.

What a crazy week this has been...I return from a great training where ironically the focus was on the implications of change. Only to come back to a phone call first thing on Monday with a change being offered. The implications of this change? Huge for all involved.. I have spent the last 48 hours thinking about it all..planning for the future, getting a little organized and adjusting my mind to the past memories; and future possibiities..

Hello to the unknown future, and Good Bye to the comfort and known of my past... All at the eve of my 40th birthday...I apparently enjoy the drama of it all..