Looking in from the Outside

Have you ever been in a life situation where you feel like everyone else has special access and you don’t? That you have to “be someone” in order to enter the world they live in? It is important to ask yourself if you created the distance with your communication style or behavior. Evaluate what you may have done to create the sense of distance. If you cannot find a reason based on your own behavior, then you need to look at other reasons.

Sometimes, as they age, people change. Their health, preferences, and priorities change. The meet someone, and everyone else becomes second rate. They get a new job, and that becomes the most important priority in their life. It doesn’t matter why, but rather how it feels. It causes pain and shame to perceive you are on the “outside.” It doesn’t have to be true-it just feels true.

What can you do about it? Remembering that you can only change YOUR behavior, you can realign your perspective, evaluate what you think you are missing and change your expectations. Sometimes you can reach out to those that seem to be excluding you, but they may not respond. What’s important is taking care of your own soul and headspace, which is all you control. It also helps to evaluate your own behavior. Are you leaving people outside of your world? Is someone hurting over your behavior?

 

Posted by Susan Odegaard Turner – MentorRN

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What Does Forgiveness Look Like?

I have been thinking a lot about forgiveness lately. How to do it? How to even start going in that direction? How to be near someone who has hurt you? Forgiveness has changed as I have aged. It takes more for me to forgive someone who has crushed my spirit. What if it is family you need to forgive? What about betrayal of the behaviors leading to needing to forgive?

Can you be your authentic self without forgiving someone who has hurt you? How do you know when you have actually arrived at forgiveness? Do you feel better? Haunted? Neutral? Angry? Sad? Accepting? Should you even feel different? Why does it matter?

There is much written about forgiveness and lots of discussion about it in the Bible and online. Google the word forgiveness and see what comes up…fascinating! Does failing to forgive someone give you more stress and discomfort or can you move on from the incident easily? Is it enough to end contact with the person who hurt you or can you continue to interact without any issues? Is forgiveness a religious behavior or one based on living authentically?

Do you have to have anything to do or say to the person to forgive them? Does forgiving them mean you share with them how they made you feel? Does the person that did the cruel, unkind behavior need to be part of the process at all? Can you avoid them forever more, and be done forgiving? Can you accept they did the best they can, and does that count as forgiveness?

I have many more questions than answers. Everything I read tells me I will feel better forgiving someone for hurting me. I believe forgiveness will help me deal with the mind-body emotions and physical symptoms that the hurting behaviors caused me. I do not want to associate, even remotely, with those who have hurt me that I need to forgive. Does that mean I am over it or just stuck? What do you think about forgiveness in your life?

 

Posted by Susan Odegaard Turner – MentorRN

Trauma, Tragedy and Triumph!

I have lived in Thousand Oaks for 40 years. I love it here, and was angry and sad when the Borderline shooting took place, and the Woolsey fire damaged homes and property. The trauma that families faced with the bar shooting was immense. I knew the sheriff who was killed, and my son knew two of the young victims from high school.

Entire families and neighbors experienced the grief from this shooting, and then were forced to deal with fires and evacuations barely 14 hours later. Talk about tragedy! Folks evacuated in the middle of the night, and spent days away from their homes and property, not knowing what happened to it.

As I attend funerals and fundraisers, I am struck by how much the community has pulled together. Hundreds of people lined up to buy T shirts; performance artists turned their concerts into fundraisers, and everyone I know has been affected somehow by the shooting or the fires or both.

It is important to remember how blessed we are here, but gratifying to see folks helping out each other. It gives me faith in humanity. Happy New Year!

 

Posted by Susan Odegaard Turner – MentorRN

6 Ways to Avoid Accepting a Bad Healthcare Job

By Angela Rose On Dec 5, 2018 for HEALTHeCareers.com

What makes any particular job a ‘bad’ one? Maybe the pay is too low. Perhaps the hours don’t work with your other commitments. It could be the commute is too long, or the opportunity for advancement is too little. A job might be bad because it has a poor culture, a work environment or mission that doesn’t mesh with your values. Whatever the reason, moving on could be your quickest route to happiness, especially if you’re an in-demand physician, physician assistant or nurse practitioner. But how do you make sure the next healthcare job you choose is better than the last?

1. Ask about the previous job holder.

“I always tell nurse practitioners to ask why the practice is hiring,” says Renee Dahring, MSN, CNP and founder of NP Career Coach. “In other words, why did the person who held the job previously leave? You may find out it’s a new position. In that case, do you want to be in a newly created NP job? The employer may have misconceptions about what an NP can or cannot do.”

David Wolfe, founder and CEO of NP Now, an NP and PA recruiting firm, agrees. “It’s important for NPs and PAs to ask why the last employee left,” he says. “Why is the group losing people? Sometimes groups overutilize NPs, requiring them to see lots of patients and work overtime without pay. Ask candid questions so that you can identify any red flags.”

2. Request clear expectations.

“You have to be assertive when asking about role specifics,” says Susan Odegaard Turner, founder and CEO of consulting firm Turner Healthcare Associates, Inc. “Ask for a job description and talk about the tasks you’ll be expected to do. Understanding those specifics will drive a lot of your success after you are hired.”

Wolfe agrees that job seekers should make sure they have clear expectations of the position. “Asking questions like ‘What are the productivity benchmarks I need to hit in order to be successful?’ can help,” he says. “That way, you’ll know what the hiring manager expects and whether you can really provide it. If they won’t give you a straight answer about their expectations, that can be a red flag.”

Dahring also encourages healthcare professionals to ask about the specific characteristics needed to be successful within the organization. “That will help you get at the culture,” she explains. “Oftentimes a bad job isn’t due to an issue with clinical skills but with fitting in with the culture of the organization.”

3. Shadow a current provider.

For the clearest picture of an organization’s day-to-day work environment, spend some time shadowing another NP, PA or physician employee.

“An employer can hide dysfunction during an interview or while walking you through the clinic,” notes Dahring. “If you’re feeling at all uncomfortable about the opportunity, ask for a shadow day with a current clinician. Nobody can hide dysfunction for half a day.”

Wolfe agrees. “A good employer will let you interview and shadow the NPs and physicians who work for them,” he says. “If they won’t, it’s usually a bad sign.”

4. Understand how you’ll be compensated.

While you don’t need to bring compensation up in your initial interview, you’ll definitely want detailed information on how you’ll be paid before you accept an employment agreement.

“Are you going to be paid hourly or salary?” asks Wolfe. “How many hours are the current providers actually working? A lot of groups will say they’re offering a 40-hour position on salary but actually expect you to stay until 7 pm every day to do charting. That’s why it’s important to ask the hiring manager and NPs when they actually come in and leave every day.”

5. Research the organization’s history and reputation.

Odegaard Turner suggests an Internet search to find out if the organization was recently sold or downsized as well as to look for any news pertaining to its relationship with unions. “Is it a positive or negative relationship?” she asks. “Kaiser Permanente, for example, has a very positive relationship with the labor unions they deal with. They’re going to provide a different environment than an organization that is fighting for or against unionization.”

“You should also look at Glassdoor and other employee review websites to see what other providers are saying about the company online,” adds Wolfe.

Dahring suggests considering patient reviews as well. “If patients aren’t happy, that could indicate a problem,” she says.

And while you’re at it, Odegaard Turner advises personally evaluating the customer service side of the organization. “You can do that as easily as standing in the emergency room lobby on a Friday night or calling the front desk to see how you’re treated,” she explains. “You can learn a lot about a facility by the way they treat their customers.”

6. Read the fine print.

If you’re eager to get back to work, it can be tempting take the first position you’re offered. However, experts urge a careful review of the contract first.

“Don’t accept a job if they won’t give you an offer in writing or a formal contract,” says Dahring. “That can be a warning sign that things aren’t managed well. Lots of promises may be made, but verbal promises are as good as the paper they are written on.”

If you don’t want to impact your future prospects should the position not work out for you, “look out for a non-compete clause in the employee agreement,” Wolfe adds. “Non-compete clauses aren’t that common, but they’ve been in about a third of the NP employment agreements I’ve seen.”

He says you should also make sure bonuses are mapped out in the contract. “How are the RVU [relative value unit] bonuses calculated?” he asks. “It’s important to understand how many patients you need to see in order to get productivity bonuses, and you should have that outlined in the employment agreement.”

 

Posted by Susan Odegaard Turner – MentorRN

Trusting Your Team

I recently had a chance to take a river cruise on the Rhine in Europe. Although low water levels impacted the tour as planned, the teamwork that was demonstrated is some of the best I have ever seen. There were multiple types of staff on the cruise, and the service was impeccable.

By far, the most impressive teamwork I saw was that of the crew who sail and pilot the river boat. This boat is 600 feet long and houses 120 passengers plus 50 crewmembers. To sail from Amsterdam to Basel, Switzerland, the boat needed to pass through numerous river locks. Locks allow a boat to go upriver, as water comes into the lock to raise the boat to a higher water level.

Traversing locks is a specialized, dangerous and difficult process. It takes all sailing crew on deck and available to assist. The captain of the boat relies on his crew members’ feedback to adjust the position of the ship. There is only 5-6 inches of wiggle room on the side of the boat entering the lock, so it is a very precise procedure.

As the captain stands next to the steering mechanism for the ship, there are crew members present in the front and rear of the ship. The person in the front tells the captain which way to turn the shift and how to utilize the thrusters that move the boat forward to enter the lock. The captain gets constant feedback by radio from the crew in the back and front of the ship, and adjusts the dials, joy sticks and dynamics accordingly, but he cannot see the ship move, except from his place in the middle of the boat.

The captain must trust his guides to tell him the changes to the ship course and direction. He doesn’t question or argue about their directions. He acts on them and make the requested adjustments. They see where the ship is going from the front and rear, but he cannot.

This process is the ultimate test of trust. This crew did this procedure 15-20 times during this 7 day cruise. It was an incredibly well coordinated ballet of behaviors by several crew members at the same time. No one argued, questioned or did their own thing. When was the last time you and your team worked like this crew?

Posted by Susan Odegaard Turner – MentorRN

Leadership and the Human Condition

There are numerous definitions for the “human condition”, both religious, philosophical and otherwise. It is people being who they are, with all their lumps, bumps and ugly stuff. One of the biggest challenges of leadership in any setting is accepting people as they are; exactly as they are, in their present human condition, no matter how snarky and frustrating.

As leaders, most of us strive to provide direction, meaning and hope to those we oversee. Helping people improve means taking where they are in their human condition. This is not always easy to accept or identify. Some folks are grateful, seek out input and accept mentoring and coaching gracefully and graciously. Many others are difficult, defensive, angry and resistant. You cannot lead someone that you do not understand or accept.

Consider your role as supervisor, manager, director, or C suite person. Do you accept folks the way they currently are; especially if they are difficult? Or, instead, do you lead who you want them to be? That never works. I have struggled in my leadership role to deal with folks that are difficult people. That means I have not accepted them in their current human condition. How are you doing with acceptance?

Posted by Susan Odegaard Turner – MentorRN

Chaos and your True North

There is a photo on Facebook today in my feed that shows a sunflower growing through a tiny crack between bricks. There is absolutely nothing, except pulling it out or spraying weed killer that will stop that flower from flourishing in that unlikely space. Are you like that flower or do you feel like your direction is wavering with all the chaos we are experiencing in our lives and country?

I have a friend who is a religious leader in the Catholic Church. As a non-Catholic, I rely on him to help me understand the chaos around the latest accusations and revelations of clergy abuse. I mentioned how hard it must be to keep your perspective during all this craziness. His response was something I will always envy and respect. I’m paraphrasing, but the gist was that “no one could cause him doubts or consternation with his faith and spiritual practice because he was steadfast in his beliefs.” In spite of all the allegations, poor choices, lack of transparency and cover-ups, his direction and “true north” remained the same.

I’m not sure many of us can say the same. Some of us don’t have a true north. We don’t really know or recognize what we believe in; no matter what. My true north has changed as I have aged. Relationships have ended and new ones begun because of my true north values. Do you know what you believe during chaos? Do you have a true north to look to for reassurance and direction?

 

Posted by Susan Odegaard Turner – MentorRN