‍Joni: 

Hi, this is Dr. Joni Watson. Welcome to The Handoff, the podcast for nurse leaders brought to you by Works. I'm thrilled to introduce our episode guest, Dr. Tara Kinard. 

Dr. Kinard brings a wealth of experience and expertise to the table. As Duke University Population Health Management Office’s Associate Chief Nursing Officer, her dedication to advancing patient care and nursing practice has made her a respected leader in the field. 

Beyond her administrative role, Tara is deeply committed to education and mentorship. As a Clinical Associate at the Duke University School of Nursing, she tirelessly fosters excellence and innovation within the nursing community. 

Today we'll have the privilege of delving into Tara's insights on the intersection of nursing, leadership and education, as well as the challenges and opportunities facing healthcare professionals in today's rapidly evolving landscape. 

Prior to Tara's current role, her career spanned diverse roles focused on addressing healthcare needs for vulnerable populations. In addition to our extensive experience in care management, Tara is passionate about patient-centered care, improving care transitions, and strengthening community partnerships.

Her dedication to addressing social drivers of health reflects her commitment to going beyond traditional healthcare boundaries outside of her professional life. Tara also provides support to aging parents, which fuels her ongoing motivation to improve care coordination and transitions across the continuum. 

Today we'll be talking with Tara about her passion for self-care, mind and body wellness, and how wellness impacts the ways in which we show up for our team members.

Welcome Dr. Tara Kinard. Tara, I am thrilled to spend time with you today. 

Tara: 

I'm so happy to be here, Joni. So happy to be, oh my goodness. 

Joni: 

Wonderful. Well, we're just going to jump right into it for the listeners today. So, part of your introduction, Tara mentions how wellness impacts the ways in which we show up for our team members. And I love the way that that's phrased. I mean, half of the battle is showing up, and then once we do show up, then we need to kind of show out a little bit for our people. Leadership. Self-care is vital and it's part of how we lead ourselves, but I think sometimes we view it as almost fluff. I mean, I have fallen into that trap in parts of my career. In what ways do you believe a leader's commitment to self-care influences their ability to show up for their team? And since I'm a fan of decision making, how does your personal wellness routine impact your decision making and leadership style? 

Tara: 

I love this question and funny you ask because I was just having this conversation with another leader very recently. We know that healthcare is complex, it's fast paced, ever changing, all the things, and then you layer on the complexity of personal life challenges that we and each of our team members have going on. And sometimes it can create the perfect storm. And as a leader, when we can show up for our team members when they need us to, and in the ways that are supportive for them, it really might make the difference of retaining a talented team member impacting a patient outcome or helping a team member grow and develop. And so showing up as a steady, emotionally intelligent and effective leader, it might be easy if we have a really small team, but what if you're leading for those of us leading teams of 15, 50 or 500, you have multiple team members who need some part of you.

How effective can you be if you aren't committed to your self-care? 

And then I think before I go any further, I should probably clarify what I mean by self-care and personal wellness. I think because you'd mentioned sometimes it can be like the fluff, right? Yeah. I think most leaders probably engaged in some sort of self-care and wellness activities. Like if you talk to folks, you probably can glean some of that. Things like going to the gym a few times a week, eating healthy, maybe some meditation dabbled in there. But the type of self-care that I'm referring to is that which has been incorporated into a consistent routine within our lives. It's one that we're able to dial up and dial down based on what's going on at a particular time, and it's going to vary for each of us. So my routine, for example, might be more intense than another because of what I need as an individual.

And on an airplane, they teach us that if the oxygen masks come down, put it on ourselves first so that we can help others. It's the same concept with leadership. As leaders, we must fill our own cups so that we go up for our team effectively and give them some of what's in our cup. And the only way to fill our own cups, because if we don't fill them, they're going to empty, is through our own individual consistent self-care and wellness practices. And so you also asked about decision-making and my personal wellness routine. It absolutely impacts my decision making and how I show up as a leader. And like most leaders, I'm used to dealing with multiple competing priorities and issues. So meditation and mindfulness, for example, have helped me learn to slow my brain down, be centered, and be able to think rationally with the front part of my brain so that prefrontal cortex rather than hanging out my feelings and the reactionary part in the back of my brain.

And then the other thing I would say is that it takes consistency and practice. I've had a lot of different leadership development in the form of training, education and experience. So for example, training like the community resilience model, mental health first aid, they train skills such as grounding and breathing, how to calm ourselves as well as others in crisis or escalated situations. It's one thing to learn those skills, but it's also another thing entirely to be able to actually access them and use them when we need them for sure. And so when my self-care and wellness are strong, I can more readily access and activate these tools, which can make a difference in any given situation.

Joni: 

That's great wisdom. I love that concept of being consistent, but also being able to dial up and down your self-care based on what's happening. Because goodness knows there have been seasons of my career and life where I've had to dial that way up and take care of myself in different ways than other seasons of life. So thanks for giving that foundation and background because it definitely helps solidify that these are skills, that there is evidence behind it. It is not fluff, it's scientific. You have really spent your career, Tara, taking care of truly vulnerable populations. And if you'd be willing for a moment, I know this is a lot to ask, but if you could pull back the curtains a little bit and maybe let us see a vulnerable side of you for a moment. I know it's a lot to ask because even though it's just you and I right now, there are people listening. Can you share a personal story where prioritizing your self-care significantly improved your ability to lead?

Tara:

Absolutely.

Joni:

Thank you.

Tara:

So I experienced a personal trauma a few years back that really forced me to take at how I was taking care of me. I have generally taken pretty good care of myself for as long as I can remember, but this traumatic experience really knocked me off kilter. I found myself zoning out of conversations, feeling more anxious and even tearful at times and struggling how to show up. Feeling confident and centered definitely impacted my decision-making ability, I felt paralyzed. I felt like I did not have control over how I showed up as a leader, and it wasn't fair to the people around me. And I don't mind talking about this time in my life because I've learned a lot from it. And I want people to know that as I sit here and I talk about self-care and how it can impact how we show up as leaders, I really do know what it's like to experience hard things, be on time and resources, and then figure out how to actually get my groove back.

And as part of this process, I learned to give myself permission, giving myself permission to carve out time for self-care and to incorporate it in my life as a daily practice. And this was not an easy thing to do. I knew I had to get motivated. And so while I was recovering from the traumatic experience, some days this looked like putting one foot in front of the other and just simply following the action plan that I put together with some professional help of course, and trusting that if I followed the plan eventually I would feel better that things would get better. And so for me, exercise has been an important part of my life over the last couple of decades. But I was really determined to address barriers that I had to make it a more consistent part of my routine. And so over time, I invested in home exercise equipment and I really made a commitment to it.

And so my routine, which has now been this way for the last couple of years, has been I get up early to ensure I can get my workouts in. I treat my exercise as a basic need, water and food. I'm up at 4:30 in the morning, which is well before others in my home are up. So it's quiet and I hop on my indoor bike. I'm an avid Peloton fan. So over time, I've been able to be fortunate enough to invest in the bike and then eventually the tread and the row along with some weights. And additionally, we now have a 100 pound golden retriever. And so I'm also out walking him. Most mornings we do two and a half to three and a half miles. I've also strengthened my network of close friends and carved out time for connection time each week, even if it's just brief.

And so over time, and it really didn't take too long, maybe a few months, it's not something that happens overnight. But I noticed a change, and not only was I physically stronger, my clothes fit differently, better, I felt centered again, I was able to hold space for others who showed up in my office needing a listening ear or someone to talk through tough situations with. I was able to find the right words to say in difficult conversations. And my decision-making improved as did my confidence. I felt more in control over how I showed up as a leader, and I really liked the shift. And so I started trying new things. It kind of becomes a little addicting once you get the hang of it. 

I started adding in a monthly massage and I got a subscription to Audible so I could listen to books while I was walking just to kind of fit it all in. And then I started to learn more about wellness and self-care and the impact on our bodies and mind you mentioned there, there's science behind this. There's a lot of literature out there that supports it. And I only wish I would've known this earlier in my life. And so fast forward to now, I'm totally in my self-care groove. And not only do I prioritize it, but I know when to dial it up. So does my family and the people around me. I need more of it and dialing up for me. So what that means is I might add an evening, I might add an extra meditation, or I might just do something simple like lay on a bed for 10 minutes with a face mask on, but I feel better and I show up better as a leader, a better parent, a better friend, and a better me. And I'm always setting personal and professional goals for myself. And self-care and wellness is not a one and done kind of thing. I'm always trying to figure out how to incorporate new things to elevate my self-care and wellness. I prioritize it like I do my job, my family. Self-care feeds resilience and our abilities to show up as a strong leader.

Joni:

Tara, so many nuggets of wisdom in there for leaders. I mean, you mentioned giving yourself permission to take care of yourself. I mean, for me, that's been a big one, honestly, because either as a nurse or as a leader or as a mom, as a wife, some of the other identities that I have of myself, I'm always taking care of other people. And so giving myself permission is a big one. And then you mentioned leaning into getting help from professionals and other people who love you and care about you. And I mean, that is so big. It's so huge to be able to listen to the people who love you because you're right, our family, our friends, they know when we're like, whoa, whoa, whoa. Something's going on here. We got to take care of you. I love that you mentioned Peloton. So Peloton, if you're listening, Tara does not have any conflicts of interest here, but she is a raving fan of yours.

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And I must say, Tara, I was astounded. I too work out on Peloton equipment and you are much more consistent than I am. So I love how you spend consistency on that work and you thread it throughout your life because it is a priority. So great role modeling. And then you mentioned connection time each week with people, which I think the evidence continues to show through things like the Harvard Adult Development study that's been ongoing for 70 plus years, that really our connections and our relationships are so important to our resiliency and our overall health. So that's beautiful. 

Tara, I'm curious because you are certainly in the thick of population health, which has just exploded I guess over the last 20 years. And so you're in the midst of the headwinds and the tailwinds that are pushing and pulling in healthcare. What positive trends have you seen in healthcare that support or are supported by a focus on self-care and wellness among healthcare professionals and maybe patients too, if you've seen that in care management?

Tara:

Yeah, there's three things that come to mind. So first, and maybe I'll start with employees. So most or many organizations do support healthcare professionals with services such as personal assistance services. As a benefit, I'm also seeing wider networks and coverage for behavioral health professionals as well. Some insurance companies are providing a benefit of acupuncture or other kinds of non-traditional ways to treat and treat behavioral health and wellness employee benefits as well. I think most employers include some sort of form of paid time off, which hopefully is encouraged. And most organizations take it, discounted gym membership rates, access to a dietician, wellness supports. They'll even offer self-assessments, like the health risk assessments, just so folks have awareness and can kind of tap into available resources. And then I think the other thing I would add is that leaders I think are being encouraged more and more around what their team members really get to know their team members as individuals, and then incorporate team building and wellness exercises into their team meetings.

And so for example, at Duke, we incorporate wellbeing questions into our individual conversations that our leaders have with our team members and as team members, as we're considering goals for the year, we encourage folks to have a wellbeing smart goal, for example. So those are some ways, and I think from a patient perspective, well, I'll say our care managers and I do see this occurring more widely. I think it's just the setting varies, but skills like motivational interviewing, I think I mentioned the community resilience training, just to be able to help meet our patients where they are. And then addressing, I think the elevation or it's more attention on social needs and how they really impact a person's health and social needs, incorporate concepts of wellbeing, physical activity, safety, diet, exercise, all of those things.

Joni: 

Yeah, that's great. Tara. I feel like I have had to learn this lesson over and over and over in my career and sometimes in some really painful ways, very similarly to the scenario that you've mentioned. And part of it has been the thought of, well, I can do that when I get there to the next part of my career. I'll have time then, but right now I need to hustle or something. What would you say to emerging leaders who are probably working quite a few different jobs and roles as an emerging leader, whether they're in nursing or have side gigs or something like that. What would you say to emerging leaders to prioritize their wellness amidst the high demands of leadership? Knowing that as young leaders, we often feel compelled to say yes to a lot of things early in our careers to kind of get where we want to be.

Tara:

Oh, three things. I like the three things. So first and foremost, I love this. Prioritize your wellness. And that includes setting healthy boundaries. “No” is a complete sentence. Wellness does not have to be expensive. It doesn't have to be complicated. Just as you would carve out time to support your team members or be in the fray of the hustle and bustle, you must carve out time for yourself. So that'd be the first thing. Prioritize your wellness. Second, many of us think we don't have time in our busy day to carve in that time to do something for our wellness. I hear this a lot. I used to think this. I'd always put it off. However, I would reframe this and restate it as thinking of self-care and wellness as essential to being a strong leader. And especially if you are an emerging leader and you have aspirations to climb the ladder and achieve a certain role or position, being center and showing up, making sound decisions, those things will help you achieve that.

And if you are somebody, an emerging leader and you don't really have that aspiration, then it will make you a better leader for it. So I see it as a win-win. And just as you might prioritize, like a tiered huddle, for example, within a health system, how are you prioritizing your wellness so you can show up in that tiered huddle ready to lead. 

The third thing, as leaders, we have many competing priorities. However, hopefully we also have lives outside of our jobs. Prioritizing our wellness helps us show up strong, not only for our colleagues and our patients, but also for our families and friends. 

Joni: 

That's beautiful, Tara. It really is because it's a real struggle. It's a real struggle as an emerging leader, and I am sure somebody said very similar things to me early on in my career, and here I am 21 years later and wishing, “oh gosh, if I had just kind of listened and soaked up some of that wisdom, then.” I guess we all kind of have that. If I knew then what I know now sort of scenario. But this is really one of those things where you are right, the priority. It really does make you a better leader. It does. So thank you for sharing that. 

So Tara, this has been an incredible time. There are a couple of questions that I love to ask every single guest, and I know that you are an avid reader. You mentioned your Audible subscription and your reading habits are awe inspiring, which says a lot because I read a ton. And so you're right there with me. I know I can always get great recommendations from you. I am always curious about what other leaders are reading or doing, watching to sharpen their skills. What are you reading or learning about these days? Any recommendations?

Tara:

I love that you're asking me this question because I follow you on LinkedIn and I pay close attention to your book recommendations. You've introduced me to some fabulous books and authors, so I just need to say that my current read is Adam Grant's, not surprisingly, newest book Hidden Potential. So good. I'm still in the early chapters of it, but I know I'm going to love it. The part that I'm currently in really talks about the research and science behind character development and how it can impact all areas of our life, including whether or not we're able to realize and reach our full potential. I am a huge Adam Grant fan and would recommend all of his books. And so then the books I read immediately prior to Hidden Potential are The Life You Want by Arthur C. Brooks and Oprah Winfrey Loved it. And Atomic Habits by James Clear

Joni: 

Classic. So good.

Tara:

It's fabulous. Then of course, I usually have a fun read in addition to my learning read. So I've been working my way through the Bridgerton series, and currently I'm reading When He Was Wicked. So for those of you familiar with the Bridgerton series, it's focused on Francesco, who's number six of the eight  Bridgerton siblings. 

Joni:

Oh my. That is so great. I have not read that series, so that's fabulous. I might dive into it. It's always nice. Fiction does a contributes well to our creativity, for sure. I love it. And so, Tara, I love spending time with you. Thank you for your contributions today. Ultimately, what would you like to hand off to nurse leaders at all levels and in every setting today?

Tara:

We feel better and are better when we show up in ways that are congruent with our values and who we are as an individual and a leader as our best selves. I empower anyone listening to this podcast to reflect on your current self-care and wellness regimen. It can be a simple exercise. Just write down what you do to nurture your physical and mental wellbeing in any given day, week, and month. So things like exercise, do you get enough sleep? What is your nutrition? What are you reading or listening to? Because what you put in your ears and through your eyes is just as important. And how are you spending your free time? Do you enjoy bubble bath meditation, a massage or a walk? And how frequently are you doing these things? And then after you've done this, do a self-reflection of your leadership. How often are you showing up as the leader you want to be? How is your team functioning? What are your even better ifs? So what could you have done better or differently? How are you experiencing your even better if moments? And then look at your self-care and wellness regimen alongside your leadership. I probably don't need to go any further than this because you'll be able to quickly identify areas. 

And I'd recommend starting with something small. One thing, adding a 20 minute walk or a 10 minute meditation each day. Go to bed 30 minutes or an hour earlier, and then build on that. Just remember that the mind and body are connected. So even simple things can have really big impacts. And as leaders, we are constantly learning, growing, and pushing ourselves outside of our comfort zones. Rather, we're pushing ourselves into our discomfort zones. 

Leadership is a journey, and in order to do it well and show up for the people we lead, and for many of us, this also impacts the patients we serve in their loved ones. And wellness is a critical part of the equation.

Joni:

Oh, goodness. Caring for ourselves in ways that are congruent with our values. So good, Tara. So good. Where can people follow or connect with you to find more of your work after the handoff?

Tara:

Well, LinkedIn is the best place to find me these days. I do have a good friend who's also a healthcare leader. We've dabbled with the idea of actually developing our own podcast, but that's a long way off. So for now, LinkedIn, it is. 

Joni: 

That's awesome, Tara. Excellent. Everyone, be sure to find Dr. Tara Kinard on LinkedIn to continue conversations. 

Tara, I love the way that you lead and take care of people. Truly. It is beautiful. I feel honored to share this space with you. Thank you for handing off such great leadership guidance with us today,

Tara:

And I'm honored to be here. Thank you so much, Joni. It's an honor to be with you today.

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