Keeping Our Kids Healthy

So I need your advice.

What should Children's Specialized do if we know that employees are intentionally putting our children at risk? Now that is definitely a loaded question and the first reaction is that we must do everything to protect our children. Ok, but what if the risk is that employees refuse to get flu shots free of charge? By not doing so - put our children at risk.

Okay - I can see the eye rolls as I write this. "Why doesn’t she just give this up already? We are already double the percentage for most hospital employees why can’t she just leave well enough alone?"

That was true in the past, but now most hospitals have achieved a 74% vaccination rate among their clinical staff. So we are not any better than the national average. There are now about 45 hospitals and heath systems that require mandatory influenza vaccination and a recent CDC survey of 1,500 health care workers indicated that 1 out of 10 employers required mandatory vaccination. The fact remains that unless we get a vaccination rate of over 90%, our patients will remain at risk from influenza.

We have surveyed our non vaccinated staff about why they refuse the flu vaccine. The most common answer is “I never get sick.” However, it is well known that health care workers may become sick from influenza but have such a mild case that they still come to work. That does not prevent them from transmitting the virus to their patients. For our children with chronic health conditions contracting influenza may cause significant complications and even result in their death. So we need to think about our patients health and get vaccinated to help protect our patients.

Not only do we need to get vaccinated against influenza but there is another disease out there that is making a major comeback. The answer may surprise you - Whooping cough (pertussis). Seven infants have died in California because adults had whooping cough, and transmitted to children. Adults who get pertussis don’t get whooping cough; they get the cough that never seems to go away and typically lasts about 6 to 8 weeks! But when babies and young children get pertussis they get whooping cough which can be deadly. The infants who died in California could not fight the infection because they were too young for the vaccine to be effective (pertussis vaccine (part of the “DPT”) is a series of three shots given at 2,4, and 6 months of age and a booster at 18 months). Infants don’t have immunity until they complete all three shots. The problem is compounded by parents who refuse to have their children vaccinated. Politicians have inserted themselves into this debate and said that we should allow parents to make their own decisions for their children - but what happens when their free choice impacts the rest of us? Adults who were vaccinated against whooping cough as children need to be revaccinated as adults and this can now be done when you get your tetanus shot But for those who opt out - the result may be deadly for our kids.

So what should we do? Right now we make influenza vaccination one of our corporate goals. We provided the shots free of charge and will virtually do them any time day or night. Our highest percentage of employees who get the shots are actually the administration employees who may never see children - such as all of our employees on Route 22. The employees who have the least vaccination, sadly our EIP employees who are most vulnerable because they are walking into people's homes each day. There is no environmental services staff there to make sure they are safe and things are clean.

We have talked about allowing staff to opt out but for clinical staff who are not vaccinated they would have to mask and gown before they were allowed contact with a child in the event of an influenza or pertussis outbreak. At RWJ they put a dot on their ID card to distinguish between those who have gotten their flu shots and those who haven't.

Your advice/comments would be welcome. How can we increase the number of CSH employees who receive their flu or whooping cough vaccine?

The truth is that with whooping cough starting, other diseases of the “past” may not be far behind. When the vaccination rate against polio dropped off in several countries in Africa, polio came back with a vengeance. As an organization we lived through that crisis once - it would be a sin to be faced with it again.

Words of Wisdom for Graduates

So, next Saturday morning at 9 am I will be standing before 600 graduates at Dover University giving a commencement speech. This is a two year school with the largest majority of students graduating in the health care profession of some kind. Some will go on to 4 year schools others will not. Many held full time jobs, have kids and a home while going to school full time.

I’d really like to offer these graduates some honest and useful advice. Who better to ask then our CSH family of employees? Many of you have sat through graduation ceremonies either as a recipient, parent or relative.

Is there anything you would recommend that I make sure I mention as I send these folks out into the world?

Thank You Fridays

In my last wrap up, I mentioned that we are designating summer Fridays as “Thank You Fridays” You can wear jeans every Friday through the summer, but in exchange, you need to thank someone you work with who you appreciate and who has helped you in some way. I LOVE this idea because there is nothing better than showing appreciation for each other. It doesn’t have to be the "you saved my life" thank you but the little things people do each day.

We will do it on the honor system, but my only request is you have to thank someone different each week. You may also post your thank yous here on my blog.

Can't wait to see the blogs or hear the stories! Thanks, James Marotta, for the great idea!

Here’s an example of a thank you I received from Geetha Bharathan - Geetha, sent me a small embroidered pouch. In the pouch it contained "worry dolls" the legend is that if you "give your worries" to these dolls each night, you will be able to start each day anew. She was concerned about how much I worried about each of you and our children and she wanted me to have some relief. I was so touched by her kindness and as a way of trying to relieve my stress.

Please share your words of gratitude below.

Laughter Is The Best Medicine

So it was one of those days where I just couldn't catch a break. The stress and worry of running 13 kids down this week on the inpatient unit and being behind on the outpatient volume has left my nerves frayed.

Have you ever noticed that when you are at wit’s end, there is something that happens that makes you laugh at yourself?

So in the middle of trying to figure out how we are going to tell of our Board of Trustees we are going to turn around a 500K loss for the year when the census is so far off and I know June will only make the hole bigger, Rose comes in and says "we have a problem". Never a good sign.

Stephanie Jones was on the phone. EZ pass was threatening to fine us $500 because one of our CSH vehicles was not accurately registered. Carl Gelormine and my name are on the account and they would only speak to one of us. Great. Carl is on his sick bed and so it was left to me. We had to get the secret code from Carl and the vehicle information from Kevin Sullivan.

I was finally able to sit down to make the call last night. I push the buttons and get to a live person. She asks me a series of questions - account number, security code, address on the account and the license plate number.

Then she says "Ok. I can help you. What type of vehicle is it?"

I stop dead knowing I don't have the right information - so all I can come up with is, "It is a blue truck with a Children's Specialized sign on the side." Like she really cares about the color and signage!

"Is it a Ford a Chevy? Two doors or four doors?" she asks.

Again, I’m dumbfounded and can’t muster anything else to say but, “It is blue."

We both crack up and she says she’ll list it as “unknown.” We both start laughing so hard we can't stop.

So at the end of a rough day, without a lot of answers, a little humor never hurts.

Got a funny story to share?

Unexpected Gifts

Thursday of last week was a particularly difficult day. It was what I call a "three-fer". I had committed to too much on my schedule, I wasn't as prepared as I wanted to be and it was a 200 mile day driving myself all over the state. So you know what happens, I don't sleep the night before, fretting that I am not ready for all of it, having those repeating comments in my head which alternate between why didn't I prepare more? And you are a loser for not being at the top of your game. Neither thoughts are helpful in getting the sleep I need for what will end up being a 15 hour work day.

So, I get through my first meeting. Gave my presentation and hit it out of the park. Late to the next conference call and had to leave early. I didn't really fulfill my duty as I should have on the call but was able to skate.

Jumped in the car, late, to drive 51 miles and needed to arrive in 57 minutes. You are getting the picture right? Get to location for the speech that I was still changing the slides during the previous conference call. Speech is to 100 really smart people, on the future of health care in NJ.

And it happens.

I get my cadence. I never played team sports because I was the nerd, but I imagine that is what the sensation is like - when you just know there is nothing that is going to slow you down. It was a home run.

At the end of the speech, a woman was waiting to see me. She said " I heard you give a speech in 2004 with similar themes, including about knowing how to define the end of life,” the woman said. "Within 6 months of you giving that speech, my 88 year old mother entered the hospital and the doctors started talking about opening her chest for cardiac surgery and that she would be able to survive on a vent I heard your voice. You said – ‘you need to love them enough to celebrate their lives instead of fighting their deaths.’ She died peacefully the next day and I wouldn't have done that if I hadn’t heard you speak."

There is a reason we are sent on certain days to do certain things - even when we don't know it at the time. My guess is that this has happened to you before - a gift that comes when you need it the most and expect it the least.

Do you have any similar stories?

Beating the Blues

Ok - so I need your suggestions.

There are times in all of our lives, work and personal, where the weight of it all, meaning the things we need to manage, just seem overwhelming. In health care, it has been especially difficult because we know our reimbursement is going to remain flat or even go down, when every other cost we have is going up - including wanting to increase salaries.

There is so much to be excited about - the great work we do, the friends and family we have, that we live in a great state where you can be in the mountains or at the beach in an hour or less but I have to be honest, there are days I just want to pull the covers over my head and make it all go away.

I have told you before that I go running to clear my head, but sometimes that isn't enough. Unfortunately I usually end up in DSW buying some really high heel that is going to make my feet bleed, but look really pretty on. That is the price we pay for fashion and a little retail therapy. My rock of course are my parents, who are never seem to tired of giving me that hug and that reassurance that this too shall pass. In the end, I know they’re right, but hearing it from them always seems to make it better.

So what do you do when you are trying to shake it all off and refocus on the good?

Any tricks can you share?

The Art of Negotiation

Next month I will be doing a panel discussion at the Governor's Council on Women and the topic is the art of negotiation. I started my career as a social worker and negotiation is at the core of what we often do with and for the people that we serve. Trying to negotiate services, trying to negotiate with clients to identify their needs and create plans that they will actually follow to improve their lives. Most people think about negotiations like a lawyer around one specific issue. I would argue that we all should think about negotiations in terms of our daily life - work and personal.

Some of you may have heard me say, in a tongue and cheek way, that I think life is all about the accumulation of points. There are some days that you are doing good deeds or favors for others and you are ringing up "good will points” - not that you need something right now, but you know there will be a time when you need something and you can pull on those points, or favors, to be able to get you through a tough time. See, most of us do really well in times of crisis. We can rally and step up and show our best. Sometimes we don't always do well on the day to day.

This week a long time employee was telling me she finds herself on the receiving end of what can only be described as verbal abuse from her colleagues about how they have had enough of "her" demands and they aren't going to do it anymore. When I push to identify who these people are so we can give coaching about our values and culture of caring, she says she isn't comfortable because she has to work with them every day and doesn't want to be seen as "ratting" them out.

This conversation made me so sad at so many levels. Sad that she did not feel like she could tell her colleague to stop yelling. Sad that her colleague was so frustrated that her only tool to manage the stress was to yell. Sad that even after all the discussions about creating a non punitive workplace where we hold each other accountable, we still are uncomfortable doing it, And last but not least, most sad that the child who needed our care was being delayed by our internal issues.

So I will continue to "negotiate" with each of you about creating an environment that allows you to hold each other accountable for the behaviors that we all signed up to uphold when we joined Children's and we will live to fight another day.

Our kids need us.

We must.