Dan:
Welcome to the show, Kathy and Bridget.

Kathy:
Thank you, Dan.

Bridget:
Thank you for having us.

Dan:
Yeah. This is going to be fun. I'm excited. Kathy and I go way back into Arizona days when Kathy was at Banner System and I was a nurse at Arizona State University learning and working there. And so it's fun to see it all come full circle, and now you get to be on the fun podcast. Kathy, what have you two been up to lately? I know consulting is starting to come back. Just where are you kind of impacting the healthcare system at the moment?

Kathy:
Yes. We are seeing the healthcare industry ramp up. All things COVID are moving now to all things post COVID cleanup. And so we're spending actually quite a bit of time working with leaders to develop their teams for really a new era, a new kind of leadership, as well as working with health systems to redesign the way they deliver care, taking in all the lessons we've learned from COVID. So yes, we're excited about all that.

Dan:
Talk to me more about this new form of leadership or this new era of leadership. What does that mean, and what are people asking for, or maybe where are there gaps at the moment?

Kathy:
Well, it's interesting because we wrote this book, Stupid Gone Viral: When Science and Reality Collide, and it's based on my research and high-reliability and complex adaptive systems, but we wanted to write it in a way that was interesting and practical and fun, and it came out right as COVID did. People think we wrote it for COVID, but as you know, our leadership models have been outdated for many, many years, and so COVID just emphasized that, put it on steroids for us.

Kathy:
The book is about healthy living, leading, and learning, and it's a model that starts with healthy me. We work with leaders on how do you get your head in a new space, and your actually body, mind, spirit into a healthy space so that you can lead from that. The leadership component is really how do you structure your organizations differently so that you create cultures of respect, learning, and ongoing knowledge where you're sharing with your teams. We talk a lot about that as well, but it's a different way to lead and it's non hierarchial and it requires some new skills.

Dan:
Yeah. I think that's an awesome overview, and for sure, the leadership of the future is non-hierarchical. I always think at least in complex systems, the network has more power than the hierarchy, and I don't think leaders think about that all the time, or they see it as a negative instead of leveraging the connections of the network to get things done. They still kind of do a top down thing, and I don't think that's going to work moving forward.

Kathy:
Yeah. I think the genie's out of the bottle, and our workforce, we needed them desperately during COVID to bring their best ideas, talents, skills to the table. People want to do that. They want meaningful work. They want to contribute. For those organizations that brought their team members in to do that, they are in a much better place than those who continued with the status quo, top down. They have a pretty disenfranchised workplace, and it's a lot easier to be top down and give orders, but it is not going to work at this time.

Dan:
What have you seen leaders have learned from the pandemic? They've been exposed to a lot of things, they've had to change quickly. Have they taken some lessons from that, that they're now incorporating into how they move forward?

Kathy:
We're asking those questions as we work with teams, and it's interesting because some leaders have learned a ton, and I love to hear their stories and they are so inspiring, and others are really literally trying to move back to where they were and they are struggling. But for those who have really, I would say are thriving at this point, they've learned some basic rules about the workforce, which is we need to bring the experts to the table to solve the problems. We need to anticipate the unexpected and proactively work on all those what ifs. We need to draw out the expertise and talents of the team, and create space for learning and small tests of change. So it's very different.

Kathy:
And then many organizations moved into team-based care and really learned... I mean, we've talked about that for our whole careers as nurses, and been in and out of teamwork depending on nursing availability and shortages. But this was really team-based care where everybody came to the table, contributed their component, and we all learned what the other person did. That's very different. We're used to working in those silos. So those are a few of the learnings, as well as negotiating for what you need in the moment, not waiting, not sitting back, but advocating for that mission of care.

Bridget:
I would just add to that, Dan and Kathy, that it's so important to recognize that many of those things are on what I would call full tilt right now. Some of them are working actively in that. They've had to, especially when it comes to negotiating and advocacy, they've really had to step up their game and learn new skills, cross collaborate in areas they probably never thought they'd have to. And so being open to all of that and learning new skills is so critical right now, and we're seeing a lot of that being mentioned.

Dan:
Yeah. I saw a quote recently that kind of highlights some of that too, which is it was surprising how fast red tape got out of the way in a crisis, and how many things you could get done without all the approvals and meetings and whatnot. I was talking to somebody about that, and they're like, "Wouldn't it be wonderful if that could just stick? If we didn't have to go through 15 layers of whatever politics to get this one simple thing done, because we all know it's the right thing and we have no other choice, but to do it." I think that's one thing I'm hopeful for, that we kind of break down some of these structures that hold us in towards the stagnation side of things and actually can make decisions faster.

Kathy:
For sure. Some of that is we don't trust each other. I think one of the learnings out of the pandemic is we have to learn to trust each other in the crisis and in our everyday work, and learn how to collaborate better together, and create structures that support that. That's what I'm hoping comes out of this. We put a lot of interim structures in place. We now need to rethink the old structures of the organization and how we can create forums where people come together quickly, identify the issue, come up with a potential solution, test it quickly, small tests of change, and then roll it out more broadly. That requires trust among the disciplines as well as from the top leadership to people at the point of service. That's why creating those cultures where people are able to learn and take some risks and have the feedback available to them are so very important now.

Dan:
What are some of those tactics that you have that a leader could use let's say tomorrow when they show up to work to start to build that trust with their teammates?

Bridget:
It's so important to think about how you can avoid some of those pitfalls, right, strategies to overcome pitfalls. Look at social and cultural norms that support this hierarchical thinking and behaviors, and kind of unpack that. Engaging your at-risk employees. It's about relationships, creating relationships, getting to know your team both personally and professionally, I call that rethinking your thinking. Make relationship connections. I mean, those are so important. But it's also about living with intention. Making sure that you can find purpose in what you're doing.

Bridget:
It's so important to find that self care as well as a leader, and to make sure that your team isn't burned out. You're not going off course. You're trying to find ways to infuse the mundane work with deeper, soul-stirring ideals, such as the honor, truth is really within you. So bring that to the surface. Let your team see that. The team needs to see your authentic leadership. That's so important. That realness is really what is helpful to them.

Bridget:
I think one of the most important things for a leader today is really to be able to connect the vision to the team's contribution to the cause, whatever that is. You don't have to achieve greatness all at once, but for leaders it's really important to start small and go beyond the thank you. It gets back to that show your authenticity, your connection to realness with your team. I mean that just uplifts your team as a whole. Getting rid of that perfection mindset, I think that's really important. As leaders and as team members, we all want to be perfect. We're striving to be perfect, and that's not always possible. So you have to create those safe spaces, as Kathy was mentioning before, in order to fail. And as a leader, that is so important for you to be able to do that for your team.

Dan:
Yeah. For sure. I think the theme underlying what you just mentioned is that transparency of information. I think a lot of times leaders think they need to keep things close to the vest, or we couldn't possibly tell our frontline about X, Y, Z, finance decision, critical things impacting the business, because that would just create chaos. But I think at the same time, that lack of transparency also leads to poor decision making, because now people who are solving problems that you may not even know about don't have the right information to do it. And then that creates mistrust as well and rumors and all that spin that you all know about. I think it really comes down to how well can you communicate the right information transparently to people so that they can make those right decisions.

Kathy:
Yeah. I think one of the skills with that is being able to talk about those conflicting goals out loud to your teams and struggle through them with them. I mean the perfect example is efficiency versus quality. We do need to achieve both, and we're going to have to work on both at the same time, and they come into conflict with each other. Let's talk about that one, it occurs. Let's have real conversations about that instead of denying that that actually occurs, because that's what gets people cynical and burned out.

Kathy:
By the way, those conversations as leaders we think we're withholding from our team, they already know. They already know what's going on and they usually fill in the blanks with worst case scenarios. So that transparency becomes very important, and to be able to have those conversations and hold those polarities as you work with your team without blaming is really an important skillset. Stick with the facts. This is tough, but these are our two priorities here and we need to figure this out together.

Dan:
That's a great tip. Another concept that you talk about in the book is grit and grace. I wonder if both of you could explore that with me and give me a little bit more detail on what that means and how a leader can take that to work and implement it

Kathy:
Yeah. I'd be happy to talk about that. Grit and grace are two sides of the leadership coin and they are both essential. Often, we see leaders who are able to work in one realm and not the other, and so grit and grace is about learning to do both and integrate that work. Grit is about staying focused on the tasks at hands, keeping your eye on the goal, the outcome that you're achieving, and removing the barriers for people along the way to get there.

Kathy:
Grace is the other side of the coin, which is working with people in such a way that they want to contribute, that they see the meaning that they bring and the talent that they bring to achieve the goal. So grace unearths that talent and gets it to the table. It's fun to watch those leaders who are able to go back and forth with that and bring their teams along in a way where they're really engaged and know they have something to contribute. In the day of knowledge workers, which is what we have, we need their best thinking. That is the only way that we're going to be able to thrive in our organizations is by displaying both those significant attributes of leadership.

Bridget:
Yeah. Grit and grace is about relationships, as Kathy mentions. It's particularly in that realm of providing, coordinating, implementing and communicating and evaluating care. You all know that very well. The respect you show for others, as well as your ability to get that job done is so critical to your success, your reputation and your brand. We should never forget how important that personal brand is, and that's where grit and grace is so important.

Dan:
That's a great overview, and super helpful. All of this, the transparency, the grit and grace, the things you're seeing, I'm super curious how you enter an organization and get them to buy into the fact that they may not be high-performing, that there's a lot of cracks in their structure and system and processes, and then you're kind of there to continue to tell them that stuff, and then kind of flip it around. I'm curious how those engagements go and how you approach those type of conversations.

Kathy:
Well, they're fun. We do a lot of work with the senior leaders of the organization. We have assessment tools that we use in interviews to get at their underlying beliefs and values, their real underlying beliefs and values, because that's what's going to inform the culture in a very significant way, but we do the same thing at the manager level and an assessment of that group. When you are able to show the disconnect between what senior leaders think and where managers are, particularly at the values and expectation level, you can quickly get people's attention.

Kathy:
I've been a senior leader for a long time in an organization, and as you all know, the higher you get in the organization, the more filtered the information is coming to you, and people don't want to deliver bad news. So it's really showing the delta between the two and then creating strategies to bring the two together. I want to emphasize, we talk about culture as 50 shades of culture, because people talk about culture, but never define it. We get down to defining it for an organization so they can get their arms around it, because until you do that, you can't really change it. And you change it by creating new structures that change the way people behave, behavior as far as decision making, problem solving, communication, etc. It's behaviors, structures coming together in a new way to create a different environment.

Bridget:
The assessment part is so important because it provides the data. When you have data, you can have a much more open and honest discussion. The facts are there. So as long as individuals are open, I guess we could say leading with eyes wide open, or willing to accept that brutal truth, if you will, then the conversations can really be robust and helpful, but the data is where it all starts, and I think that always adds a lot of value because it's not just Kathy and I coming in with our opinions on leadership, or an organization believing that they already know what they have. The data really helps put sunshine on that and then helps us move forward.

Dan:
I love that approach, because when I was in my PhD work, there is a whole theory about how conflict and misunderstanding of conversations leads to innovation. I feel like what you just described is really highlighting those misunderstandings and using it to catalyze the conversations to move the organization forward. I just love that approach. Is that kind of sum up how it's going?

Kathy:
Yeah. It pretty much does. I mean, it's not necessarily conflict. Sometimes it's simply working from two different roadmaps and not even being aware of that, which obviously creates conflict, but sometimes it's very subtle nuanced differences that make a very significant difference on how you approach an issue or a problem with your teams. So it can be anywhere from major conflict to just small misunderstandings or different maps.

Dan:
Yeah. It's that initial condition of understanding that the decisions are made off of can have drastically different outcomes depending on how people interpret the information.

Bridget:
It's also really teaching them how to communicate. Quite often, we speak past each other. We really don't speak to each other. Management and others will say, well, we did tell you, and the other side is not open to listening. So creating that listening environment, those listening skills that are really important to continuing a conversation and solving a problem is so important. So we really help teams do that as well.

Dan:
That's awesome. That's such great insight for leaders to think about. I think for those listeners that are nurse leaders, healthcare leaders, you really have to kind of reflect on what you're saying and how it's being interpreted and kind of listened to, and be able to change that quickly in a moment if it's being misunderstood, or even just clarifying it in the moment so that you can make sure that information is getting across the way you intended.

Kathy:
Yeah. That's really important, because when you're a senior leader, you are a power figure, whether you think you are or not. And so people read into that all kinds of other messages. And so, like you said, Dan, checking in and asking people what they just heard, or what they think the moving forward work is, is so important. And too often as a leader, I thought it was pretty articulate and I was just surprised. So the checking in is so important with your teams.

Bridget:
I think it's also, as a leader, you have to remove those barriers or those boundaries that staff believe is there. Quite often, I've heard going into organizations, I know Kathy and I've heard this quite often is, I can't say that in front of that person. No, that would be the end of my career. You can be diplomatic. You can air your differences in a way that gets you to the solution that's really needed instead of being so fearful and intimidated. So leaders really have a responsibility to break down that barrier and help improve that dialogue.

Dan:
I see that so much in nursing too. I mean, if you go on Instagram, Facebook, even LinkedIn, there's this like, oh, well management is doing this to me, or those nurses are doing something. There's such a divide in nursing specifically, it seems like, that is just not a healthy way to even think about an organization or a team, let alone kind of function. And so how do we kind of fix that divide, or what are some tactics we can do both from a nurse at the frontline standpoint and from a nurse leader standpoint to kind of stop that line in the sand?

Kathy:
I'll tell you a starting point that we really try to practice and teach is we call it kindness before rightness. That is common courtesy, showing empathy, respect in your interactions is so important with your team. If you can't start there, they may not hear you. They're going to hear other sorts of messages. Too often, as leaders, we jump in with, here's what you need to do. Here's the right thing. You didn't do that right, and people shut down. So practicing kindness before rightness is really an important skill to have with your team and to have it be real. Think about if you were getting that feedback yourself or hearing that information from your one-up, how difficult would that be?

Kathy:
So that's just one tactic, but there are multiple ways, by creating forums and asking questions, and then sitting back and listening. You've got to have the dialogue, and too often we are so productivity oriented we don't carve out the space for people to come together and talk authentically, work through tough problems, and be willing to say, yeah, that's tough. I don't have a solution to that. We're going to have to keep working on this one. I think too often as leaders, we think we have to have the answer. What we should be doing in this day and age is creating the forums for the teams to figure it out, have the experts in the room, those with the experience in the room, and be willing to listen, which is not always easy.

Bridget:
Yeah. I think it gets back into your earlier comment where you mentioned there are so many meetings going on in organizations, there's just so many. How about creating, as Kathy just mentioned, the right forum that's really adding value to your team. Remove some of those meetings that really do not need to be on individual schedules. Rethink how you're visiting your day. Those forums can be pretty powerful.

Kathy:
Yeah. Let me say something about those meetings, Dan.

Dan:
Please do, because I'm not a fan of meetings. I just actually gave a presentation the other day to AACN, and I was like, "Imagine if you had zero emails a day and you cleared your meeting calendar every quarter, and just put ones on that added value." It blew the deans minds. I'd love to hear your thoughts on this.

Kathy:
Yeah. I think that was what people were hoping when they started working remotely too, was like, hoo, hoo, no more meetings, but didn't end up that way. But one of the things that we do when we go into an organization is we literally catalog all of their meetings that they have, or their teams that get together. And then we go through this exercise of creating a charter for each team that clearly calls out what is the work? What is the timeline? What is the talent you need on the team and why? What are your deliverables and when? It is just an extremely interesting exercise, because when you start working with these teams, and literally, we hear, well, we've been meeting since 2009. Wow, that's just quite amazing. What have you accomplished? Often, we'll hear, nothing really.

Kathy:
Or we'll ask the question of what is this team about? And we'll hear, we don't really know. Or why are you on this team? What is it you are here to contribute? We often hear, I have no clue. And so by the time we get through this exercise, we're actually able to eliminate dozens of meetings that are just a complete waste of time. They're a social gathering. They make people feel good, perhaps, but they are completely nonproductive. This gets back to grit. All right?

Kathy:
And then for those that are left, to structure them in a way where they're going to get results. And that also means they're reporting out to a senior team member or a team on a once a year or twice a year basis, knowing that's coming up and you're looking at their goals. There's ways to structure it so that there's accountability and true action going on that leads to results.

Dan:
Yeah. And even just rethinking the ones that you feel like you have to do. I was speaking with a nurse leader the other day around shared governance, and he's like, "Yeah. We have shared governance meetings, but I don't really know what happens there or what gets done, but we're doing them." And even those kind of core, you think you have to do it for whatever reason, magnet or culture or whatever you're trying to do, you kind of have to reassess those critical meetings and reevaluate their value and how they're structured as well, or even delete them in some cases. Just checking the box isn't getting you anywhere.

Kathy:
Shared governance, keyword is shared. Often, you'll see, no, I don't go to that. I'm not invited. But they can become extremely bureaucratic. The whole purpose behind it is to get people who do the work involved in making decisions about the work. And so I agree with you, there are many shared governance structures that are bureaucratic nightmares and need to be rethought.

Bridget:
Well, I would say also this, we coined it, the meeting fatigue, but it truly sucks the energy and life out of an organization. You really want their best and their most creative thoughts. And to constantly be thrown into meetings and in that kind of environment, I mean, just look around the room and all you have to do is see a glaze look on most people's faces who are there, or they're looking at their phones or looking at their computer, they're finding another way to be engaged outside of that room. There's a lot of telltale signs. People just need to lead with eyes wide open yet again.

Dan:
Yeah. One of the tactics I've been recommending too, and it's a little bit drastic maybe, but let's say every quarter, just delete every single meeting off your calendar and see which ones come back. We were even talking about that at Trusted the other day. We were like, well, Google calendar actually allows you on the corporate account to delete everyone's calendar. You can literally just wipe everyone's meetings off the books and start over. At some point, we considered it because people were so packed with back-to-back one-on-one meetings that weren't adding value, or too long, didn't have objectives, and it was getting in the way of us actually getting work done and also being strategic about work, because we were just kind of jumping from meeting to meeting. I think there's a bunch of tactics people should consider, even just deleting an entire three-month block of meetings and see what comes back.

Kathy:
Yeah. Or spacing them out. I mean, so often you have meetings spaced in a way that people can't get any work done in between, so they come back to the next meeting and you have the same meeting.

Dan:
Yup. That's right. That's so true. The kind of last topic I want to hit on and it's something that's important to us at Trust, we just did another survey that we'll be releasing some results soon on, but can you talk about the physical and mental health aspect of leading, and how that directly contributes to your performance as a leader?

Kathy:
Yes. It's so important, Dan, which is why our model starts with healthy living, because if you're not coming from a good place, a place of emotional strength, spiritual strength, physical strength, you're not going to be able to lead in healthy ways. It's interesting to me that we are all in healthcare and we so don't buy into that. I mean, think about how the body works and the advice that we give to others. So it starts with putting your own oxygen on first, and when we don't do that, we are not good for anyone.

Kathy:
We do talk about what's getting in the way of that, of taking care of yourself first, and we hit on some of them earlier, but one of the primary ones, especially for women, I would say, but men as well is living without intention, without purpose. We have so many choices in today's world and so many nuanced choices that come at us and we don't say no. We say yes to everything coming in and keep piling it on instead of knowing what is it that gives me strength, meaning, purpose, what feels right to me, and learning to say yes to those sorts of things, and learning how to say no to the rest.

Kathy:
We actually have an exercise, write down six different ways to graciously say, no, thank you, and memorize them and be ready to pull those out of your toolkit when you need to. That's just one tactic, and I would say pitfall for staying healthy ourselves.

Dan:
I think from the complexity standpoint, which I know, Kathy, you're deep into and Bridget as well is it's all about energy, right, in an organization. And so if you can't bring positive leadership energy, and it doesn't have to be positive in the Pollyanna, you're always happy, jumpy kind of person. But if you can't have that kind of quality energy when you're interacting with people, then it rubs off and the organization kind of gets infected with that, and then it can spiral. I think that's something leaders I don't think always think about. But if you look at some of the top most famous leaders in the moment, Elon Musk, Bezos, some of the billion trillionaires, their day starts with working out, with meditation, with focused time on themselves.

Dan:
I think in healthcare, that's not taught in leadership class. That's not the top thing. It's like, how do you make a schedule, and how do you do this thing? I think we need to focus more on how do you take care of yourself and build your capacity to lead, and then the task can come later.

Kathy:
We talk a lot about understanding your own human tendencies and habits of thought, and have exercises to help people get to those because that's truly understanding yourself and what makes you do the things that you do. If you don't understand that about yourself, then you can't lead in healthy ways. Those are things that we all need to be working on. We all have areas that get in the way of our leadership, and so becoming more aware of them is really important, those tendencies for perfection and demanding that of others, micromanagement, that super leader syndrome, I will do it, I don't trust others, or some it's just, I'm a victim. You see that a lot with nurses. They come in with sort of a victim mentality, which can lead to blame or territorialism.

Kathy:
We work on those tendencies and how do we begin to move out of them. I mean, it's a journey. This doesn't happen overnight, but it requires a different way of interacting and leading.

Bridget:
We're so conditioned to always think with our head. Do you know what, sometimes it's okay to think with our heart because that's really where that magic of your leadership has strength, and it's okay to be bold and not sit back and accept that status quo, or all that chaos that's going on around you. I mean, sometimes it can just be overwhelming. So use that knowledge and sense of curiosity to really question what's happening, and push those boundaries a little bit so you can achieve a real balance or growth, because it's really within you. Quite often, we hear this phrase, but we really embrace it. It's really embrace your own warrior spirit. That is so important and that really helps with that whole healthy mindset.

Dan:
Yeah. I like to say my warrior spirit is MacGyver.

Bridget:
Very good.

Dan:
That's my spirit animal. Love the animation. But yeah, I mean, I think you do, you have to tap into it. I think from nurses specifically, and many healthcare leaders is, what drove you to the specialty that you chose? I mean, there's a certain type of person that likes the ER versus ICU. As you move up through leadership, that same sort of tendency of you like a lot of different stuff, but you don't dive deep into it, maybe for an ER nurse speaking personally, that may be how you do leadership as well. And so just recognizing those things and owning it and seeing how it impacts things, I think those are great. All of the tools you talked about today are amazing. I hope people will check out the book, Stupid Gone Viral. But where else can people find you both if they want to ask more questions, find out, or even engage in your services?

Kathy:
Check out our website, which is www.l3fusion.com. We have lots of resources and services listed there. We have lots of YouTube videos, blogs, and other information that could be helpful to you.

Bridget:
You can also reach out to us personally at kathy.scott@l3fusion.com and bridget.sarikas@l3fusion.com. We really like hearing from individuals, and we started dialogue on LinkedIn. We're really hoping to really bring people into this L3 Fusion community, and certainly the website is the portal for that, and it does have a lot of good information. So check us out there. That would be great.

Dan:
That's awesome. Check out the book on Amazon. And so we're going to wrap up with the final question, Kathy, and then I'll ask Bridget next. Kathy, what would you like to hand off to our listeners?

Kathy:
I'd like to hand off that it's okay to struggle with a different way of leading, to learn to do something differently. Think about you've been an expert in an outdated model and invested a lot in that model, and how important it is to learn new ways and become a novice again. So be willing to do it and put yourself out there and get support along the way. There's other resources. Don't go it alone, but do it.

Dan:
Love it. How about you, Bridget?

Bridget:
What's important really is creating an inspiring statement to guide your team. I think that that is so important to help individuals start out their day, really get them motivated. We kind of have one that we want to share with you. It's no matter how tough you think you need to be, no matter the things you experience, it's you that people appreciate, it's you that we cheer for. So remember, the heart you put into every interaction is what makes you different, and together, that makes you fierce, and that's so important. With those kinds of guides to help your teams get through the day, you'd be surprised at how uplifting that can be, how motivating that can be to them. So as just leaders, take that moment to get creative and find those special moments or guides, if you will, to help your teams.

Dan:
Yeah. What a wonderful way to wrap up the show. Thank you for that insight. Kathy and Bridget, wonderful to chat with you today. Go check out the book and the website, and you can learn a ton. Leaders, remember, it's about you. And so you got to take care of yourself to move forward. So thank you, Kathy and Bridget.

Kathy:
Thanks a lot.

Bridget:
Thaks so much, Dan.