Dying with Dignity

The last week has been incredibly difficult as I had to say goodbye to my beloved friend and companion, my German Shepard, Lola. Like for many of us dog owners, Lola was more than a pet, she was a faithful companion and loyal friend. She could be found by my side every waking minute I was at home. 

Lola’s illness came on fairly suddenly.  I immediately sought the care and advice of one of the best vets in the region. I wanted to explore all possible treatment options for her. I was prepared to embrace any recommended treatment, no matter the cost. At the same time, I knew I wanted to the right thing by her. I wanted to make sure she was free of pain. I did not want to keep her alive just to make it easier on me. She deserved to die just as she had lived—with dignity and on her own terms.  And so, after long and thoughtful conversation with the vet, and considering all options, I knew the best thing for Lola was to let her go. It was difficult and sad, but peaceful. She did not suffer. 

Lola’s death fell near the anniversary of the passing of my “other” best friend, my father. A vibrant and healthy man, my father died in 2015 after battling cancer. At the end of his life, my family and I were fortunate enough to help make important end of life decisions for him. We were able to move him to a wonderful hospice facility, where he peacefully spent his last few days free of machines, comfortable and surrounded by family in a beautiful and calm setting. While it was an incredibly difficult time, I was comforted in the choice we were able to make regarding my father’s end-of-life care.

Lola’s death as well as my father’s, once again reminds me of the importance of being able to make the appropriate end of life decisions for our loved ones. Often, as health care professionals, we are focused on patient outcomes and restoring their health. As an industry, what we sometimes fail to realize is that the best outcome can sometimes be letting a person go. Each year, it is estimated that 30% of Medicare expenditures (over 50 billion dollars) are attributed to the 5% of patients that will die that year with one-third of those costs occurring in the last month of life.  Furthermore, most studies show that if the person is sick enough, this type of medical intervention does not have a positive impact. In fact, it can make those last few days and months of life worse.

So whether you are a health care professional or a family member, the reality is that we need to openly discuss end of life options before it is too late. And as health care professionals, we also need to devote resources to offering patients and their families the kind of services and space they need in those final difficult days. It was what I was able to provide my father and what I think all families deserve. 

The house is a lot quieter now without Lola. It will take me a while to get used to her not being right there next to me. But, I remain grateful of the time we had together, and I was honored that I was able to make the choice I did at the end of her life.

Walking in their Shoes

As I noted in a recent post, I spent several hours each month working on the front lines with team members across the hospital. Over the course of the last year, I have helped transport patients, worked with surgeons, residents and fellows, logged in 20,000 steps in one night delivering meals, accompanied nurses in the Cardio Thoracic ICU and Neuro ICUs on rounds and vitals, changed beds sheets with patient care techs, drawn blood with phlebotomists, and worked on medical surgical floors with nurses and therapists. In many ways, this is one of my favorite parts of the job—so much so, that I have been doing it for years. 

My intention in shadowing team members is not to spy on them, micromanage operations or garner unnecessary attention. I do this to be a more effective leader and team captain. Through this direct experience with my team members, I am able to understand my team better, grasp the challenges they face and see first-hand the amazing work they do. Additionally, it provides me the opportunity to garner vital feedback and gain invaluable insight into our operations.  

Working side by side my team members, I’m able to build a stronger connection with them. I gain an insight into who they are as people which improves communication. Witnessing their work up close, I can provide better feedback as I have a greater understanding for the complexities of their work, the challenges they face, and the sheer amount they have to accomplish. 

This time I spend with my team members also strengthens our ability to collaborate. Working together in this capacity, we develop a deeper understanding that we’re all in this together and have a greater appreciation for the unique talents we all bring to the table. 

While we might not all have the opportunity to work on the front lines with team members each month, they’re ways in which we as managers can gain a deeper insight into who our team members are as people and glean their perspectives on their work and the organization:

• Ask questions! Ask questions that enable you to understand their process-why they work the way they do. Spend time talking with them to learn what they value most about their work and what they would change if they could.
• Get to know them as people. Always spend the first five minutes talking with them on a subject outside of work. Relay a personal anecdote of your own to encourage them to share something about themselves. This will allow you to build a connection and a sense of trust.

The most effective leaders are ones that listen, act on what they learn and teach along the way. They are also ones who have empathy and an understanding of who their team members are outside of work. Spending time walking in your team members’ shoes will help you develop these skills.

Present and Accounted For

Over the last couple of months, I have met with nearly all of 8,200+ team members in groups of 200 to 300 to present, review and discuss our new organizational strategic plan. Over the course of these two hours sessions, my goal is to communicate to them the direction for the organization, explain their critical role in our evolution and engage with them—answering questions and gaining feedback and insight.

For me, this experience has been beneficial on many levels. It’s been so productive, in fact, that I will be holding one-hour sessions twice a year with my team moving forward. While the topics will vary, I will use this time to engage and connect with team members across the organization. 

One of the biggest takeaways from these sessions for me is the reminder to be present—to entirely focus on my team members when I am with them, to listen and be in the moment. Being present and engaging with others in a focused way allows me to not only create meaningful connections with my teammates and colleagues but helps me and my organization perform at a higher level. I genuinely believe that to lead successfully you must be present.

There are tremendous benefits to being present. Being focused and thus being present, demonstrates to team members that you are engaged, empathize and understand them. You show them that you are actively listening and hearing them. You build camaraderie and connection. Conversely, when you are not focused or present, team members get discouraged and lose motivation. They think if he does not care, why should I.

Being present improves your skills as a leader and manager as it enhances one’s ability to cope with stress, to stay level-headed and allows you to operate from a proactive position as opposed to a reactive one. Often, problems don’t need a definitive solution, they merely need clarity of thought and attention.

Practicing being present can take just that, practice. Here are a few tips to help you focus and thoughtfully engage with colleagues and team members:

• Take a moment to clear your head before each interaction. This will allow you to focus on the person in front of you and the issue at hand.
• Don’t multi-task and give your team member or colleague your full, undivided attention. If this is not possible, reschedule your conversation.
• Don’t interrupt or prematurely form opinions. You want to listen actively. 
• Recap or summarize what your colleague or team member is sharing. This forces you to listen for comprehension and allow you to ask probing questions to understand more thoroughly. 

At the end of the day, what drives us all to do and be our best is the connections we create with others. Being present, listening and focusing on others makes that possible.