The Power of One

Can one person make a difference?

I know this is rhetorical question but as I have watched the "Fiscal Cliff" discussions it has struck me just how one person can really play a pivotal role and also, how important the personal relationships are in that person making a difference. It also has made me start to think about how each of us could be that person who makes a difference in the lives of the children we serve, with our colleagues and people in our own community.

During the last 72 hours, one of the most powerful men in the country, Minority Leader Senate Mitch McConnell reached out to his former Senate colleague, now Vice President Joe Biden to ask him to step in and try to broker a deal. McConnell served with Biden and while they are of opposite parties and big differences in political ideologies, he trusted Biden and he knew they shared the same values. They valued the institution of the US Senate and what they were sent to Congress to DC to do. He knew that if we had gone over the "cliff" that the financial devastation and the public's disgust with Congress would never be restored. While the President and Speaker Boehner could not find words to communicate because they had no underlying relationship or trust, they couldn’t put together a deal.

The issue of trust is a tough one. It can not be "ordered" or mandated, it has to be earned. We ask our parents to "trust" that we have the right diagnosis and expertise to help their children but it is only after they see that their children improve that we begin to earn their trust. It is about how we deliver for our families and for each other that trust begins. It isn't about saying "I told you so" (although sometimes we want to say that) but it is acknowledging that what you said you would do you did or what you said would happen has happened.

Another example of the power of one is NYC Mayor Bloomberg. He is entering is last year as Mayor. People are starting to review his accomplishments during his tenure. He has had many accomplishments - streets are safer, public education is restructured, put calories on fast food menus, and maybe most surprising, obesity rates are down, attributable to his changes in transfat cooking. Bloomberg has made millions in business and brought that acumen to being Mayor. He knocked down all of the individual offices and set up a "bull pen" where everyone works together in one room with open cubicles. He forces people to interact and work together.

This week, one of long time patients from Mountainside LTC will be going home. It has been 12 years of her living with us - she has never lived at home. It has taken a village to keep her alive and get her all of the medical attention she needed to go home. It has been amazing to get to this point. Every person who has cared for her and negotiated with this family deserves credit for her being able to go home, but it was Maura Hines who has worked day in and day out at this point in the process, to convince her family she will thrive at home. Just like Vice President Biden needed to be the person at the person to broker the final deal, you some times need someone else to bring the ball over the line for the score.

Katie Marsala and Bobbi Jo Pansier have been working non stop since Hurricane Sandy to help and support their colleagues and friends. They have opened their homes, organized drives, done everything they could think of just so they could make sure people knew that they were not alone and as importantly that they are loved.

Think about the power of one; the power of trust. Never forget the importance of the little things we do are the building blocks that create trust over time. Perhaps you have a mentor; a special patient experience; a colleague that really has made a difference in your life or the lives of our patients.

I would appreciate if you wanted to share your stories about the power of one that you have seen or have impacted your life.

Through It All

This has been an awful eight days. I know for many, you still have no power and are just beginning to figure out how to rebuild your lives. I don’t want this blog to diminish any of the pain you are going through. I want to provide an opportunity for people to share what they have been part of or have seen given during these last eight days.

Having a bird's eye view in the command center, I saw more than I wanted to at times! I saw amazing acts of generosity - Bobbi Jo Pansier organizing work crews at the homes of two staff members to pull out their carpets and get their stuff out of their homes before the mold set in.

I saw people take coworker’s cars to go sit in gas lines so they would have gas to get home. I saw Phd trained professionals vacuumed floors and clean bathrooms because it needed to be done. I saw people bring in food from home for our inpatient staff, so they didn’t have to eat sandwiches one more day. I saw people who stayed 48 hours straight, sleeping at the hospital so kids would have care. In the devastation we had some fun. Every baby they gave me to feed, I put to sleep before they finished their bottles! I saw Pastor Baker walk in to Stevens Road and then a miracle - the power came back on! Beth Anne M. Dobosh showed up on Halloween with the best looking witch hat I have ever seen!

And in it all, I saw love. Love for our children. Love for each other and a desire to give and do more. Please share you stories about what you experienced and how you are feeling through it all.

Half Way There

We have now finished more than half of the employee meetings and we have had some really good dialogue around the topic of “us and them.” While the specifics are different depending on the site or the shifts, so many of the issues are rooted in a failure to communicate or to communicate with candor and directness. Let me share some examples.

- One of the respiratory therapists told me that she was so frustrated that every night she comes in and the oxygen tanks are empty. She was convinced that someone was doing it intentionally to start her shift off on the wrong foot. When asked if she had told anyone, the answer was no.

- When talking to the therapist about their frustrations, they have consistently messaged that they are being asked by the parents an update on the reauthorization is in progress. The therapist just know they sent it to PAS, but they have nothing to say week after week. PAS on the other hand is on the phone each and every day fighting with the insurance companies to get the reauths and if they are taking calls from 400 therapists looking for updates, then they can’t get the reauths.

- My manager has no idea how hard it is to reach productivity levels and I shouldn't be punished for no shows and cancellations.

In each situation, how much easier would it be if we could just talk through these things? If there is a way to hard wire communication to make sure people have what they need to respond to our families and your colleagues – we need to find it. In the situation of the oxygen tanks and the reauthorization, an automated process, maybe a checklist or information being included on the mini, would help get the most current information to the therapist and the parents.

How many times do we get paralyzed, or angry, and let it impact morale because we assume that people do not understand what the other person is going through?

When I ask people if they have communicated often I will hear "no" or "I can't "or "I am afraid". So here is my short answer, if you are not giving that information to someone in a position where the rationale can be explained to you or we can improve what is going on, then we are destined to remain living with this frustration. I for one don't find that acceptable. Part of our culture of caring is to communicate directly with the person you have an issue. HR can help coach you on how to do this if you are not comfortable, but not dealing with the issues and putting your head in the sand, does not help anyone.

One of the vehicles you have to express how engaged you are as an employee is the survey that begins on November 5 - 15. While we ask you to complete the survey, it really is about your direct supervisor. There are open ended questions where you can comment about me or any other member of leadership, both positive and negative.

So I ask you again, please let me know if there are ways to facilitate these conversations to deal with the issues that prevent you from providing the best care or services possible.

Why Didn’t I Think of That!

Have you guys checked out Pinterest.com?  It’s a new social media site where people post pictures of their dream houses, travel destinations, recipes, or even helpful hints.  This had me thinking, why not do a little sharing here about tips and tricks that have made your life easier, stress reduction or just helping you remember something important – either at home or at work. 

When I was at Medical Day Care last week, Jennifer Bobadilla started singing itsy bitsy spider. When I asked her about it she told me she sings the song twice through while she washes her hands.  They used to use the birthday song, but the kids would get so excited thinking it was someone’s birthday!  When the survey team came in for long term care, they cited us for hand washing because we were washing our hands but not long enough outside of the water. Now, I find myself thinking of those two things every time I wash my hands.  Singing a little song in my head – easy to remember. 

Trish West Lowe, PT Toms River, had shared with me that she lost weight by increasing the speed of her running. She didn’t want to add more time to her workout but wanted to get more out of it. Trish instituted a process where she would run full out and then walk and then run full out again and practiced over and over again until she could run it the whole time. She cut time off her run and lost weight.  Win win!

It made me start to wonder whether or not there are helpful hints that you would share that could help others. They could be fun or serious, personal or at work - but in the end I know we’ll all be grateful for a few tips and tricks to make our lives easier. 

Please share!

Amy

Power of Positivity

My friends who are dedicated to yoga tell me that part of the importance of the meditation process is to be able to visualize yourself somewhere that brings you to a place to alleviate the pressures of the day. Today it is harder than ever to "turn off" those constant electronic and external stimulus or things going on in your own head.

A friend from church shared with me that her daughter was being bullied on Facebook by other girls. The things that we all know teenagers say, but when I was a kid, I went home and my parents could spend the time talking to me and helping me clear my head and reposition my thoughts. Now, the kids come home and get on line and all of the pressure of the day are there right where it was in school. Finding the way to turn off negative things in our life is a really important tool to give us perspective.

It is just as important to understand how your words here at work or online, can impact all who are around you, not just our kids or their folks, but also the people we work with each day.  In our Culture of Caring, we stress the importance of using a caring, compassionate tone at all times.  Because of this, we also have an official HR policy (HR-56) that explains in detail the use of social media on your own time off premises.  The policy details our expectations and the importance of understanding the written word posted online has the same negative effect, if not more, as it does if it is spoken within our buildings. 

Staying positive can have a profound effect on the people you interact with.  Judy Potter recently approached a little boy waiting for an outpatient appointment and he said to her, "Tomorrow I am going to hit a home run!"  Just out of the blue - Isn't it amazing how just one little sentence can set the tone for your attitude in how we live our day?

Judy's wondered what we could say to ourselves each day as an affirmative statement – here are a few of her suggestions, I think they’re great!

"Today I am going to comfort a parent”

“Today I am going to mentor a team mate”

“Today I am going to say something that makes someone feel appreciated.”

How might you answer that question?

Is there someone who has shared something with you that has changed your day or given you a new perspective?

“Today I am going to …"

Much More Than a Walk

As I drove to Johnson park on May 19, I thought about how blessed we are that we have people talented enough to figure out how to encourage 2,000 people to come out and support us and our kids. When I pulled in, I parked next to a car full of people with white t-shirts which said on the front 'miracles happen’ and the back ‘Team Ariana,’ for our own Ariana McQuire, CMNH Miracle Child. As I walked to the "gathering place", I was overwhelmed by the huge crowd of PSEG employee's. The chair of the team had made a personal commitment that she wanted this to be their best year ever and they won in 2 categories, largest corporate team and most money raised. They were so proud of themselves and their smiles could have lit up the park at night.

While I had met Coach Stringer before, I never had the chance to really talk to her. To share how important it is for us to be able to celebrate the success of our children and continue to raise funds that are so important for our continued success. She saw the commitment and excitement that people had to be there but more importantly, the love we have for each other and our children.

Over and over again I saw children who had been with us as inpatients, now home with their families, continuing to thrive and accomplish things that I couldn't have imagined when they arrived on ventilators and so frail. To watch them run around and be defiant of their parents made me laugh out loud at how "success" is seen differently based upon where you sit!

Then I saw many of you. Coming with your spouses, your children and even, your dogs! Joanne Hunt won for the most money raised by an individual and it helped put Team Mountainside over the top. But team New Brunswick had the largest number of members, taking that honor!

You gave of yourselves again, as you do each and every day.

So I offer this with my deepest thanks. I would love for those of you who were at this walk, or past walks, to share what was notable to you.

For me, it is the chance to have a little less formality and to see each other with a "humanness" that sometimes gets lost in our day to day work.

Sharing Your Voice

Last week I was in Washington for the public policy council of the Children's Hospital Association. We heard from national experts giving their thoughts about what was going to happen with the Supreme Court on their ruling of the Healthcare Law, and the outlook of the Presidential campaign. While the experts offered many different views, what struck me was one common theme.

All agreed that regardless of who is elected President, or who controls the Congress, the federal deficit will be addressed in 2013. Cuts will be made in all federal programs and they will be severe. No if’s, and’s, or but’s about it - severe cost cutting will happen. This means that Medicaid, the program so many of our children rely on will be cut. The question is not if it will be cut - but by how much.

Staff from Congress came to speak to us. They reminded us that when Medicaid was created, it was intended to support the healthcare needs of the poor - not what it has evolved into, it is now the program covering the massive long term care expenses for the elderly. (In NJ most of the $6 billion spent in Medicaid is spent on the elderly in nursing homes.) They said we must be able to have an honest, thoughtful conversation about how to restructure the program or else the program will be cut irrationally, and arbitrarily.

My gut wrenched. It is time to sit down and be an adult. Not just an advocate who says, “you can’t cut me; go look somewhere else,” but instead asking for real solutions.

It took me immediately back to what we have been talking about over the last 2 years. I have told you that we are not going to get paid anymore in reimbursements. The president of the American Hospital Association said last week when he spoke at a private meeting of NJ Hospital CEO's, "What you get paid today, is the most you will ever be paid. You have to do more with less, and if you don’t figure it out, someone else will."

This wasn’t news to me, and shouldn’t be to you because it’s something I’ve been discussing over and over again. But just like a recent conversation I had with a staffer who shared their concerns, “How do we have the courage to put ideas and real changes on the table that might hurt for a short time, but protect our entire program for years to come?”

I thought about examples of changes we made personally or professionally and wondered if we had the benefit of hindsight, we might have personally done things differently. There is no argument that whether you call what we have been through since the crash of the stock market in 2008 a recession or a depression, we know that 1 in 10 people are unemployed and the numbers of those underemployed are 1 in 19. People are hurting. Some have lost their homes, or are working two jobs. Some of you have shared the challenges your spouses and family members have faced and are still facing. Your children have moved home or you are helping support other loved ones who have fallen on hard times.

At some level, we knew that the "good times" couldn't last forever - right? Our houses were worth twice what we paid for them, by doing no additional improvements; we were getting salary increases every year, even though we were losing money and we were consuming. Consuming products and stuff (iPad’s, computers, houses …who would ever pay more than $50 for a purse in 2000?). We were buying bigger houses and as a people, Americans were running up huge debt. And then it happened. The bottom fell out. What would you have done differently if you knew then what you know now?

And that is how I am looking at the conversation last week in Washington. The experts tell us “it” is coming. Congressional staffers, off the record have said, you have to give us something to restructure the programs you depend on or you are going to end up having people who don’t understand what you do as well as you do, restructuring the program for you. I am now talking to my colleagues about putting tough questions out there and trying to give them the hard medicine but at least we can prepare for how to live with it.

That is what the 100 day work outs are about and why we continue to ask you for your ideas on restructuring our business and becoming more efficient. We have to change. We will not get paid any more for the services we deliver, and in some cases we will get HALF of what we get today. We can be mad that we are in this financial time or we can use this time before the cuts happen, to figure it out and be ready.

If you don’t engage in this process and give ideas to your supervisors and directors, then the cuts will come and we may not make the "best" decisions, or the ones you think we should but I am asking you now - get engaged.

Even if it is in other departments - often it is hard to see how to change when you are in the middle of it. Right, that is why we go to personal trainers or counselors, we need people to help us think through and work through. We hired consultants who helped us get started on the 100 day work out process, but now it is on us. What should we do? How can we make changes? We had this discussion during the employee meetings but most of the conversation was about doing more, spending more money, which is ok but it does not get us ready for what is certainly coming.

So I ask you - what is that our senior leadership is not doing that we can do better to get you engaged in this process, of putting real ideas on the table for significant change? Because it is coming, and changes have to be made. If you want to be part of what the change looks like, now is the time.

You have a voice in this. Make it heard.