Blog Articles

November 2020

Although I’ve shared a fair amount about myself in my blog articles, this is more of a personal post than I typically do.  I was going back through my 2020 calendar the other day and reflecting on my time spent this year.  I counted the number of medical appointments that I took my mother to.  It totaled 81.  Yes, you read that right…eighty-one medically related appointments so far this year.  All for a variety of things.
​
I left my Chief Human Resources Officer job early last year.  I worked for a large hospital system, and I’ve often thought this year, as the U.S. has tried to handle a global pandemic, how would I have juggled my executive responsibilities and all of my mom’s needs had I stayed?  At the time that I left my job, I was barely hanging on as it was.  Having hit burnout myself, dealing with being the medical POA for my mother and all of her medical needs as she aged, I could no longer juggle the demands of my job along with the needs of my family. Her health issues were the proverbial straw that broke the camel’s back. I had thrown in the towel on my corporate life and shifted my attention on my family out of necessity.

And thank goodness I did.  She’s doing okay now, but her 4 ER visits, 3 hospitalizations, a stay in a rehab facility (to recover from post-surgical repair of a fracture from a bad fall) and a dementia diagnosis (the same week that her husband was put on hospice while he was in memory care) has been a lot to deal with this year.  She lived with us for several months early in the year when it became apparent she could no longer live alone. She is now safely being cared for in a new apartment in assisted living.  My stepdad passed away in September…his end of life came at the same time our County was on evacuation notice for wildfires.  It has been a lot to deal with.  But thankfully none of us have been touched by COVID-19 and we are all doing okay. 
​
I wonder though…if I’d been trying to juggle a demanding full-time executive position and support a workforce of healthcare staff, how would I have handled it?  I know the answer.  I couldn’t have done it.  I’m so grateful that I had the option to leave and take this time at home to focus on my family. I’m grateful my husband supported me in that decision. I’ve tried to launch my business this year which will allow me the flexibility to work part-time or full-time as my time allows and work is available, have the time I need to care for my family, and still get the professional satisfaction of contributing to my knowledge to help other companies create great workplaces.  It’s been difficult to do that amid a pandemic, but I’m so grateful to have the opportunity to try and that I’ve had some success despite the numerous challenges. 

Thinking about all of the obstacles I would have faced had I not decided to leave, brings me to this question:  What role do employers have in supporting employees who are juggling the demands of elder care?  It’s a lot to take on.  Sure, there is FMLA, but what is our obligation beyond that?  What do we need to do to address the psychosocial needs of our workforce who still have kids at home, caregiving responsibilities, and job responsibilities to attend to?  Those demands aren’t going away and as people live longer and our workforce gets older, the need to juggle all of it will only compound.  Employers will need to face this head-on in a supportive way.  I don’t have the answers to these questions, but having experienced the impact personally, I know I’d like to be part of the solution.

Back to the 81 medical appointments.  Despite the challenges that this year has brought, I’m grateful for those appointments and especially for those that have occurred since this summer when my mom moved from our home and into her assisted living apartment.  Since COVID-19 has put severe restrictions on visits for people in assisted living facilities, my ability to see her would be limited without the numerous medical appointments.

So, while I don’t love that she has so many of them for her sake, I am grateful that I get to put on my mask and go pick her up on an average of one to two times per week, take her to her appointment, be with her throughout that time and then take her back to her home.  It does give us time together in the car to visit and catch up in person.  It’s more than many people who have relatives in these types of facilities get with their loved ones these days.  And I’m also grateful to know she’s in a place where she’s getting wonderful, quality care and has loving caregivers.  Knowing she’s in good hands means everything to me.

During the drive to one of those 81 appointments recently, my mom shared with me she was sorting through some items in her home office and ran across an article that I’d written honoring her back in 2002.  It was called My Hero: Mom and was published in the Ladies Home Journal.  I had come in second place in an essay contest about Moms who were Heros.  I had written about the care my mom gave to my sister when she was battling brain cancer.  My mom commented on how much I had done to care for her this year and how she thought I deserved an award for it.  I don’t see it that way.  As hard as it is at times, I’m grateful to be able to do for her what she did for my sister.  My response to her was simply, “I learned from the best.”  

May 2021

So many people have lost loved ones during the pandemic.  I have lost two.  Whether you’ve lost a loved one from COVID or other causes, the uniqueness of a pandemic means we don’t have the opportunity to have the closure that we do during normal circumstances.  Celebration of life events, funerals, etc. are important rituals that allow us to honor the lives of our loved ones.  These events often occur before we return to work. 

​Without those, employees may be returning to work (virtually or otherwise) without having had that opportunity.  It becomes more difficult to move through the grief process without those important rituals.  In thinking about this, I realized many workplaces may be struggling with how to deal with grief as it spills over into the workplace even more now than it might in normal circumstances.  And, although difficult, I thought it was a timely topic to write about.

How do organizations support employees coping with the loss of a loved one?  If done well, it can provide enormous emotional support to the employee during one of the most difficult times in their life.  If done poorly, it can compound additional grief onto an already traumatic experience.  What kind of employer do you want to be?
​

​When I was in my early 30’s, my sister died from brain cancer.  She had battled it for 3 ½ years and I knew it was coming, but the loss was devastating, nonetheless.  She was a single mother to two young children.  Although my nieces still had their Dad, I was greatly worried about how they would cope emotionally through this loss. It was painful to watch my parents grieve the loss of their child. And I was grieving own loss of my best friend.  I had just started a new job and had only been with my employer for a few months, so I didn’t earn much vacation. I had already used up what I had and had even taken some unpaid time to visit my sister in CA during the last months of her life.  I had disclosed her illness and my need for time off during the interview process, so my employer was already accommodating my need for time off. 

The morning she died, my mom called my work because she couldn’t reach me on my cell phone.  My assistant was the one who had to give me the news.  My assistant, my colleagues, and my boss all surrounded me in my office and were there to support me while I cried.  I’ll never forget my boss’s words: “Take all the time off that you need. It will be paid.” I was floored. That single statement created so much loyalty for me to that company.  I didn’t end up needing to take much more time, but it was the sentiment and compassion behind her offer that mattered.  I sure didn’t want to take advantage of the situation and I probably worked even harder as a result.

Similarly, when my father fought the same battle with cancer and we had to go through the journey all over again, I couldn’t concentrate on much in those final weeks of his life or the weeks following.  I was with a different employer at this point. I tried to work from home and came into the office when I could, but my productivity was low. The compassion of my staff, my boss, and my teammates, is what got me through.  They supported me, helped cover the work, were flexible and understanding, left me cards, and sent me flowers.  It’s what carried me through that time of grief.  It created a sense of family at work and when others went through something similar, I returned the same compassion and support.  

​How your employer and the people you work with handle situations like these matters.  Not all people are comfortable in knowing how to handle these situations. Empathy and understanding go a long way.  I’ve been lucky that the people I was working with at the time knew what to do.  But for those who find themselves struggling when this happens, I hope this will help.
​
If you are an employer and are supporting someone returning to work who has lost a loved one, here are some things I would encourage you to do:

1. Express your sympathy for their loss.  Give them your condolences for their loss right away.  Upon their return, if your employee wants to share stories of their loved one, make sure you take the time to listen.  I recently listened to a podcast about an executive whose daughter was brutally murdered and what his re-entry to work was like.  He talked about how people didn’t know what to say to him upon his return and how much harder that made it.  But he also spoke about a colleague who was in his office and noticed the electronic picture frame of photos of his daughter.  She said to him, “When you are ready, I would love for you to tell me the story behind every one of those pictures of your daughter.”  He said it was exactly the right thing for her to say.  It was an acknowledgment of his loss, an invitation for him to talk in his timeframe, and a willingness to listen.

2. Be flexible with your employee on their return.  Most employers provide a few days of bereavement leave, but if the employee has experienced a traumatic loss, such as that of a child or an unexpected loss of a spouse, a few days will not be enough.  They may need to take additional time off or work a reduced work schedule (e.g., intermittent FMLA or even disability) for a period.  Be as accommodating as you can for as long as you can.

3. Be prepared to cover their work.  It’s important to have processes documented and teams cross-trained so that during times of unexpected absences, others can step in at a moment’s notice and cover for someone when they are out.  When the employee tells you they need to be out, assign their work to others to relieve their pressure.  Don’t expect them to find coverage for themselves.  They will be dealing with enough at home.

4. Tell them what resources the company offers.  Make sure the employee knows what benefits they have available to them.  Have an HR person reach out to them directly if need be.  Was their loved one a dependent covered under their life insurance?  Does the employee have counseling services through health insurance or an EAP plan?  Don’t wait for the employee to ask about this and don’t expect them to go looking for the information on their own.  They may not have the energy to do so.  Provide the information proactively.

5. Check in with them periodically.  Do this just to see how they are doing and if they need anything.  Ask what you can do to support them.  They may say nothing but ask anyway and keep asking periodically.

6. Help their colleagues be ready to support them when they return.  Some people don’t know what to say when a colleague loses someone close to them.  The best thing to do is to help people talk about this and prepare for the person’s return.  Provide information if you can and have received permission to share.  Help people practice what to say if they are uncomfortable.  Depending upon your workplace culture, you may decide to do this 1:1 or in a team meeting.  At one of my prior workplaces, one of my direct reports had lost his spouse unexpectedly.  His staff and colleagues were struggling with how to best support him upon his return.  I had a representative from our EAP plan come to one of our staff meetings and talk about grief and how best to support him and each other during difficult times.  It was a huge help to the staff, and they were very appreciative of that resource.  They felt better prepared to support someone they cared deeply about upon his return. 

7. Remember grief takes time and isn’t linear.  When your employee returns, recognize that they will not likely be productive right away.  It may be hard for them to concentrate, make big decisions, and be productive in the initial weeks and even months.  When it appears they are “back to normal”, they may have setbacks as anniversaries or other things may create a trigger for grief.  Be forgiving and approach any discussions about performance gently and with understanding and empathy.  

​If you are someone who has lost a loved one and find yourself needing to return to the workplace, there are some things I would encourage you to consider:

1. Everyone’s grief process is unique.  Be careful not to judge yourself against anyone else’s grief journey.  Wherever you are in your process is where you need to be.  It’s important to honor that and you can and should expect others to honor it as well. 

2. Know your limits and set boundaries for others.  Most companies provide some amount of bereavement leave, but if your loss is significant such as that of a spouse or a child, it likely will not be enough.  If you can’t go back to work full-time, have a conversation with your employer (and possibly your doctor) about this and discuss your options.  If you are in a role that requires significant interaction with people, high levels of stress, or a leadership position you may or may not be ready to jump right back in.  Be honest with yourself and your employer about what you can and can’t do.  You may need to ease into it.  Pull in your HR rep to the discussion if needed.  Ongoing communication with your employer about your needs is critically important.

3. Reach out for support from a counselor or support group, if needed.  Check to see if your employer offers an Employee Assistance Plan or if your medical plan covers counseling services.  Most do.  Counseling after a significant loss can be a helpful resource in sorting through grief, particularly if there are any unresolved relationship issues with your loved ones.  Support groups can also be enormously helpful as they pull people together who are going through similar experiences.  Groups can be either grief-specific or loss-related, such as for parents who have lost a child or people who have lost someone from a particular type of cancer.  For a period, I attended a brain cancer support group through my local hospital system, and I found that to be an enormously helpful source of support. 

4. Don’t take things personally.  Many times, people who are trying to be helpful may say things in the interest of trying to be supportive, but they end up saying the wrong thing, things that are outright hurtful or they just don’t say anything at all.  Sometimes, these are people who have not experienced grief firsthand and cannot relate to your experience. Other times, they are just stumbling over what to say and they want to say something…anything and it just comes out wrong.  Just know that it’s not about you.  Be forgiving.  Understand their intention is good and move on.

5. Focus on healthy behaviors.  Keep yourself physically and mentally healthy.  Exercise.  Eat right.  Stay away from numbing your feelings with drugs or alcohol.  Spend time with people who bring you joy, even on the days when you may not feel joyful.  When you feel like laughing, then laugh.  It’s okay.  If you feel like crying, then cry.  It’s okay to let it out.  I’ve often described crying from grief to others as being like draining a wound.  Crying is cathartic and it helps the healing of the wound.  Then the wound heals like a scab.  Something happens and the scab gets knocked and bleeds a little bit.  That happens over and over and eventually, the scab heals, turning into a scar.  Some wounds are deeper than others.  Some take longer to heal than others.  Some scars are left bigger than others. But they all do eventually heal. 

6. Be good to yourself.  If your loss and grief are profound, there are days you may not want to even get out of bed.  Those are the days when you need to focus on the small wins and celebrate just getting up and getting dressed.  On other days, life will feel normal and much easier.  With time, the normal days will outweigh the bad days.  And remember grief is not linear.  You will feel like you are making progress and then you’ll have days of major setbacks.  Especially around holidays or milestone events, like birthdays or the anniversary of the day your loved one passed.  Each of these will get easier over time.

7. Do something to honor your loved one.  I think this is an important part of the healing process.  For some, it’s simply a celebration of life event where people gather and remember together, share photos, etc.  For others, this may need to be more, especially if the loss was unexpected, or the individual was young and hadn’t had a chance to live their full life.  When my sister passed, we supported her kids in both participating in a fundraising walk for the National Brain Tumor Foundation (NBTF) and we also installed a reading bench and planted flowers in her memory at her daughters’ elementary school.  I’ve participated in several NBTF fundraisers in her memory since then.  I know of others who have created scholarships in the name of children they have lost, people who have planted trees, and others who have installed memorial benches at loved ones’ favorite lookout points for the community to share.  There are so many wonderful ways to honor your loved one.  Find something positive and unique to them that you can feel good about and involve others in doing it. They want to help.

8. Share memories of your loved one.  Sometimes when people die, others become afraid to talk about them.  They become afraid that talking about the person is bringing up painful memories for the people closest to the loss.  Not talking about the person who has passed is what is the most painful.  After my sister died, I made a point (and still do) to talk about her and share memories so that her girls remember her.  Talking about your loved one is an important part of keeping their memory alive and helps with the healing process.  It may be hard to do this in the beginning without tears, which is often why people avoid doing it…it’s painful.  But after a while, you will be able to do it only with smiles. 

In addition to my thoughts, here’s another article from Harvard Business Review for more ideas on Returning to Work When You’re Grieving:  Returning to Work When You’re Grieving (hbr.org)

If you have a co-worker returning to work after facing a loss and you aren’t sure what to do, my biggest piece of advice is this - Don’t not say anything.  Silence is the worst, but choose your words carefully and be careful not to minimize their loss.  Here are a couple of articles that will help if you aren’t sure what to say: 
3 Things to Say to a Grieving Co-Worker When You're at a Loss for Words | Inc.com
Supporting a Grieving Employee - Workplace Options
 
We can’t separate our work lives from our personal lives.  We must teach our teams that empathy is a critical skill in the workplace.  Loss is a part of life.  We will all experience it at some point in time. All employers will be faced with helping those who do navigate the re-entry to work that follows.

Employers who do this well have programs in place that support employees going through the grief process.  Employers who haven’t considered this yet, need to do so before they are faced with handling such a situation.  If you don’t know where to start and have an Employee Assistance Program, I would suggest starting there.  They are a great resource for information on grief and how to help people going through the grief process. 

Leadership Empathy - A Critical Skill for Development

Why is empathy lacking in so many organizations? 
Is it seen as a weakness in leaders to be empathetic? 

I’ve often wondered when I’ve gotten hesitation and, sometimes, actual resistance as I’ve coached leaders throughout my career on the importance of expressing empathy in their leadership roles.  Some of the pushback has come from a misperception that it’s a “soft skill” that isn’t important.  In other cases, I think, it’s simply a situation of discomfort for the individual.  Perhaps it’s a sense that showing empathy with direct reports is akin to showing one’s vulnerability which is extremely uncomfortable for many leaders. 

What is empathy? 
At its core, it’s the ability to understand and share the feelings of another person.  It’s about feeling with someone, in a genuine, caring way.  To understand the difference between empathy and sympathy, let’s look to Brene Brown who has studied empathy for years.  Brene Brown is a well-known research professor and best-selling author who has spent her career studying courage, vulnerability, shame, and empathy.   

According to Brown, empathy fuels connection, whereas sympathy fuels disconnection.  Empathy is about feeling WITH people.  She references nursing scholar Theresa Wiseman's four attributes of empathy:

• To be able to see the world as others see it.

• To be nonjudgmental

• To understand another person’s feelings

• To communicate your understanding of that person’s feelings

Brown defines empathy as a skill, and so she stresses actively practicing giving and receiving empathy.
​For a great 3-minute tutorial on how Brown describes the differences between sympathy and empathy, watch this video:  https://www.youtube.com/watch?v=1Evwgu369Jw

As the video explains, empathy is getting down in the hole with someone when they are struggling.  Brown states in her book Dare to Lead, “If struggle is being down in a hole, empathy is not jumping into the hole with someone who is struggling and taking on their emotions, or owning their struggle as yours to fix.  If their issues become yours, now you have two people stuck in a hole.  Not helpful.  Boundaries are important here.  We have to know where we end and others begin if we really want to show up with empathy.”  It’s uncomfortable being vulnerable, but it gets easier with practice.  As I’ve often said, every good HR person keeps a box of Kleenex in their office.  That goes for every good leader too.  Get in the hole with people, but don’t stay there.  

Empathy and Emotional Intelligence
Developing empathy is part of developing emotional intelligence, or EQ.  In Daniel Goleman’s book, Working with Emotional Intelligence, he explains that “Emotional intelligence refers to the capacity for recognizing our own feelings and those of others, for motivating ourselves, and for managing emotions well in ourselves and in our relationships.”  Leaders who have a high EQ are generally found to be more successful in their careers and better at developing and sustaining relationships. Good relationships are a key component in influencing others and in effectively leading through change.  Low EQ leaders tend to struggle.  The good news is that EQ can be developed.
​

Empathy is part of the social competency aspect of emotional intelligence.  Goleman defines it further as follows:

• Understanding others:  Sensing others’ feelings and perspectives, and taking an active interest in their concerns

• Developing others:  Sensing other’s development needs and bolstering their abilities

• Service orientation:  Anticipating, recognizing, and meeting customers’ needs

• Leveraging diversity:  Cultivating opportunities through different kinds of people

• Political awareness:  Reading a group’s emotional currents and power relationships.

​You can watch Daniel Goleman’s explanation of Emotional Intelligence here:  
https://www.youtube.com/watch?v=Y7m9eNoB3NU&feature=youtu.be
​
Learning the art of listening with intention is a key component of developing empathy and EQ.  As Goleman states, leaders “who appear approachable or go out of their way to hear what people have to say, embody this competence.  And people who seem easy to talk to are those who get to hear more.  Listening well and deeply means going beyond what is said by asking questions, restating in one’s own words what you hear to be sure you understand.” 

Why does it matter?
Empathy is sometimes viewed as a weakness, but it’s the most important ingredient in sustaining long-term relationships with others.  Deeper, stronger relationships can help elicit cooperation and can withstand conflicts when they inevitably occur in the workplace. 

The inability to display empathy when it’s needed can send signals to an employee that you do not care about their well-being and can negatively impact their engagement and sense of loyalty to the company and you, as their leader. 

In the 2017 Forbes article Empathy is An Essential Leadership Skill - - And There’s Nothing Soft About It by Prudy Gourgeuchon, the author states that even the US Army indicates in their Army Field Manual on Leader Development that empathy is essential for competent leadership.  In fact, in that manual, empathy is listed as one of the characteristics that is valued by the US Army in their leaders. 

For some, empathy comes naturally.  For others, it’s a skill they need to work at, but it can be done.  As the Forbes article author points out, “If you’re naturally low on the empathy scale, at least know you have this deficiency and that there is a cost to it.  You can learn to check yourself and do what does not come naturally:  before you act, school yourself to think of the people who will be affected and what your action will mean to them.  And try to remember to not just recognize but care about that impact on others.  You can also make sure you have a trusted advisor who fills in the gap in your skillset.  That advisor must be empowered to stop you if you’re forgetting that there are other people in the world and that their feelings and agendas are not the same as yours – and that these matter.” 

A friend shared with me recently that she was fired from her position.  She didn’t see it coming.  Her boss hadn’t had conversations with her that her performance had been lacking, her prior performance evaluations were all good, but she did have the sense that something was amiss.  She was called to her boss’s office and told she was being let go.  She wasn’t given much of a reason, but, worst of all, the message was delivered with very little empathy.  The meeting was over in 10 minutes.  She was devastated. 

There was no expression of understanding as to the impact that this decision was having on her or her family, there was no explanation as to why and there was no real reason being given.  She’s toward the end of her career and she’d never been fired from a job before in her life.  According to her, the message was delivered in a quick, cold, and fairly heartless manner and she was left reeling.  Why couldn’t this message have been delivered differently?  There are key times in leadership when empathy is greatly needed.  An employment termination is one of them. 

When Does Empathy Really Matter?
Having leaders who can demonstrate empathy as a leadership skill is critical for many reasons, particularly in times of crisis or major change.  Empathy in leadership matters daily, but there are certain times when leaders need to step up, show up, and put the feelings of others ahead of their discomfort.  This takes courage and practice to do well if it doesn’t come naturally.   
​

• In times of severe crisis such as those we are experiencing as a society in our present day of COVID-19 and the Black Lives Matter movement, empathy REALLY matters.  It matters for leaders to understand where employees are emotionally.  Leaders themselves are trying to figure out how they feel about what is happening in our country right now, but it’s necessary to set aside their personal feelings and listen to how their employees are feeling about what is happening.  This can be particularly challenging when work may be happening remotely, but it becomes even more important to take the time to listen to employees’ concerns, ask open-ended questions, and gain their perspectives on the issues during these times. 

• Employees have lives and, consequently, on any given day, may have stressors outside of work – raising children, aging parents, ill family members, their illnesses, spousal job losses, divorces - trying to juggle these things and getting their work done can be incredibly challenging at times.  Make sure your employee knows that your door is open and you are available to them if they need something.  This does not mean that you are there to be their counselor, but they need to know they can share with you if something is going on in their lives that may be impacting their work. ​

• Empathy is not a substitute for lack of accountability. But as their leader, you may also be able to make some adjustments to their workload, deadlines, or work schedule that will allow them the flexibility they need to address issues that they have going on at home.  Or even just an extra, “How are you doing today?” will help them know that someone at work cares and can go a long way.

• When a leader must deliver a message to an employee about their termination or layoff it can be very tempting to deliver it in a short, curt message and move on to the next thing.  Just like in the example I shared earlier.  Often, this is a very nerve-wracking and uncomfortable experience for a leader, and they desire to just get it over with and get through the discomfort as quickly as possible.  This is one of those times as a leader that sitting with the discomfort and demonstrating empathy is important.  And turfing the action to another party to do, such as HR, is not appropriate.  While HR might attend and even participate in the discussion, the leader is the one in the relationship.   If you’ve seen the movie Up in the Air with George Clooney, you know what I mean by delivering such a message without empathy.  Sticking to a script or a timeframe doesn’t always work and can make a situation worse.  Appropriate displays of empathy and support are necessary during moments when employees are emotional or distraught.  It’s important to prep ahead of time for such meetings, but to be prepared for anything and to be willing to deviate from the plan based on the employee’s response to the message.  Knowing how to handle these situations gets easier with experience. 

• Workplace shootings have been on the rise over the years, and I have to wonder what is behind this.  I’m not suggesting this is a direct result of a lack of empathy, but how often do we hear in the news that the person was recently terminated from the employer?  I often wonder, was that termination handled with as much empathy as it could have been or was it handled in a cold unempathetic manner?  Perhaps in a way that triggered the person.  Mental health is a real issue in our society today.  As leaders, you have some responsibility in watching for signs that an employee may be in distress.  You know your employees best.  If you do have a concern about an employee who may be struggling, reach out to your HR person for guidance.  They can often partner with you and/or your Employee Assistance provider to come up with a plan to support your employee with the appropriate level of empathy. 

• Using empathy to create an open, inclusive workplace where employees feel that they can share what is on their mind that they will be listened to, and that their opinions matter is very important.  This drives high levels of employee engagement and is particularly important for creating an environment that feels safe and inclusive for employees who may be minorities or LGBTQ.  Demonstrating empathy and understanding as their leader when you have not walked in their shoes entails true listening and refraining from a natural inclination to be defensive.

• Leading any kind of organizational change can be challenging.  During times of great change, communicating empathetically is critical, but many leaders don’t know how to do that.  Taking into consideration employees’ perspectives about the change, and how people are feeling about it, and tailoring communication to address concerns transparently greatly increases the likelihood that change will be accepted.  Being willing to adjust timelines, when possible, based on input from the workforce will also build leadership trust and credibility and help ensure employees feel valued.  If you can gain support for your change and ensure organizational readiness by really listening to the workforce in a genuine and empathetic way and incorporating their input, the likelihood of success for the change is high. 

Extending empathy improves collaboration with others.  When people feel empathy from you, they are more likely to be willing to collaborate in the workplace because they feel a genuine effort to understand.  When people feel truly seen and heard and they know you have their back, they become fiercely loyal not only to the organization but to the individual leader as well. 

What Leaders Can Do to Demonstrate Empathy
Let’s face it, sometimes being in a leadership role can be lonely.  It’s important to develop genuine relationships with the people you work with to combat that loneliness and that requires a need for empathy.  This applies to relationships that you have at all levels of the organization – with those who report to you, with your peers, and even with your boss.
So, where do you start with demonstrating empathy in the workplace?  Here are just a few ideas:

• Get to know the people you work with and who work for you as people – not just as the employees who work at the same organization as you do, but as full human beings.

• Ask them how their projects are going.  Learn about their lives outside of work. Spend more time listening and less time talking.  What do they like and dislike?  Do they have families?  What are their spouses’ and kids’ names?  How do they spend their off time?  What are the things that they value?  These conversations take time and it’s sometimes hard to find that time for “small talk.”  One tip for that:  arrive ten minutes early for a group meeting to have time for these kinds of conversations before others arrive.

• When your employee or a colleague is facing a difficult situation, whether it be at work or home, listen with an open mind.  Put yourself in their shoes and try to see things from their perspective.  Demonstrate understanding by affirming their experience.  Offer assistance.

• If someone is going through a challenging time or has had a death in the family, send a card to let them know you are thinking about them or expressing your sympathy, as appropriate. 

• Show your vulnerability.  Share things about your personal life with others. 

• Know your employee’s strengths and weaknesses and help them focus on where they can excel.

• Be genuine.  Demonstrate compassion.  Don’t be afraid of tears.  Get comfortable with being uncomfortable and have a box of tissues handy.

When it comes to your direct reports, it’s about balancing the head and the heart. Leaning too far either way is a problem. Resist crossing the line into becoming their counselor and know when a referral to EAP is appropriate.  Talk with your HR partner if you are unsure.  Remember, showing empathy during tough situations with your staff helps earn their trust. 

Developing Empathy
Empathy is a critical leadership skill.  It needs to be included in leadership development, perhaps as part of a core curriculum on Emotional Intelligence.  This is especially important as a new generation of leaders is being developed.  Reliance on technology to communicate limits the ability to express empathy and may be creating a whole generation that has greater difficulty expressing themselves in a way that demonstrates empathy.  As this generation enters the workforce and becomes leaders, this may create a new set of challenges in the workplace.  It will be incumbent on employers to ensure that teaching empathy as a core leadership competency is part of the leadership development curriculum.  Empathy can be learned and it’s critical in the workplace. 

In Brene Brown’s book Dare to Lead, she emphasizes the following five empathy skills to develop:

• Empathy Skill #1:  To see the world as others see it or perspective taking – learning to honor people’s perspectives as truth even when they’re different from ours. 

• Empathy Skill #2:  To be nonjudgmental

• Empathy Skill #3:  To understand another person’s feelings

• Empathy Skill #4:  To communicate your understanding of that person’s feelings – this requires us to be in touch with our feelings and be able to recognize and name our emotions.

• Empathy Skill #5:  Mindfulness – this is really about being present and paying attention.  Easier said than done, especially when we lead busy lives.

Do you want to build your skills in empathy as a leader?  As a place to start, I recommend two books:

- Working with Emotional Intelligence by Daniel Goleman

- Dare to Lead by Brene Brown

Something we can all do daily is to practice listening…really, fully listening.  The art of that is a key component of empathy and it’s something most of us can get better at in both our personal and professional lives. 

Deeply listening to what another person is saying – and listening for the message behind the message – and mirroring back what you heard, can go a long way in making someone feel heard and validated as a person.  And that can strengthen a relationship and build great trust between a leader and those with whom they have the privilege of leading. 

August 2020

“I can be changed by what happens to me, but I refuse to be reduced by it.”  Maya Angelou

Life is hard sometimes.  No matter how you reframe it, repackage it or what lens you look at it through, most of us go through hard times once in a while.  Some more than others.  Some are blessed with going through life where they have been sheltered from hardship and struggle, but eventually, it will come. 

Right now, a pandemic is sweeping across the globe and hitting our nation particularly hard, impacting individuals and businesses greater than most anything has in most of our lifetimes.  Some have lost jobs as a result.  Others have lost loved ones.  But human beings are incredibly resilient.  We have choices in how we respond to the hardships we are dealt.  

For many, these situations bring out the best in people, and moving into acts of service to others is how they cope.  Countless stories on the news have been shared on how resilient people have overcome these difficult times.  For artists and musicians, new beauty is often born out of times of great struggle, pain, or grief and becomes inspirational to others.  If you haven’t heard Alicia Keys’ tribute song and video “Good Job” which was released in April of this year, watch this:  https://www.youtube.com/watch?v=dSUZIFBJHwQ . 

Essential workers in our country have demonstrated resilience this year like no other group has.

Resilience and Gratitude
The basic definition of resilience is “the capacity to overcome quickly from difficulties.”  Some see it as being tough.  But it’s more than that.  You see graphics of flowers growing through cracks in concrete being a visual representation of resilience.  It’s about going through something difficult in life and not only managing to get through it but observing the experience in such a way that you allow it to change you.  It’s about growing from it and beyond it. 

Growth happens in such a way that you learn something that you can apply to a future situation when you experience it again.  If it’s profound, it can alter your life in such a way that you end up taking a different path or your view of the world may completely change.  In some ways, the more difficult the experience, if you allow it to be, the more meaningful the change can be.  Because of this, resilient people end up becoming stronger people as a result and better able to cope with additional difficulties.  Oftentimes, resilient people become the most grateful for their difficult circumstances.

One of the most resilient people I know is my cousin, Kat.  When I need to find inspiration for resilience, that’s who I look to.  Kat was diagnosed with early-onset Parkinson’s disease when she was 48.  Her diagnosis came the same year her mom died.  She was also busy juggling a career as a midwife and the director of a busy hospital-based midwifery practice. 

Fast forward more than five years later and Kat has retired from her career, she has embraced her disease and doesn’t allow it to define her.  Instead, she’s living life to the fullest and inspiring others along the way.  She boxes regularly, travels, is an incredible watercolor artist, hosts events at her home, and serves as an amazing source of support to her family and friends. 

She is actively involved in volunteer work with the Davis Phinney Foundation, she was a speaker at the World Parkinson’s Congress in Kyoto, Japan last year and she’s in the process of writing a book!  She’s taken lemons and is making lemonade and serving it to others who need it.  I’ve been so inspired by how she has handled this (and other challenges that life has thrown her way). 

Kat has always had a positive, yet realistic attitude about life’s challenges and I think that is one of the keys to resilience.  I know it’s helped when she’s shared that perspective with me.  Almost twenty years ago my sister passed away from a brain tumor.  It was a very difficult time for our family and I distinctly recall a conversation with Kat where she and I were laughing through tears.  Isn’t that the best feeling?

We agreed we didn’t like that saying, “What doesn’t kill you makes you stronger.”  We agreed we hated it.  So, we changed it to: “What doesn’t kill us, gives us more gray hairs.”  We both can attest to having plenty of that!  And being plenty proud of our resilience.  While we would not wish our experiences on anyone, I know we have both developed gratitude for the love of family and how our experiences have come to shape our lives. 

Leadership and Resilience
For those in leadership positions, how we help those that we lead be resilient can make a big difference in whether our employees continue to be engaged and, consequently, our workplaces thrive.  It starts with being resilient ourselves and role modeling resiliency for our staff.   Massive organizational change and disruption in workplaces are common challenges most leaders are facing right now.  It also means we won’t have all of the answers.  We are working in a state of constant change and new information, so getting comfortable with ambiguity is critically important.  It’s okay to not have all of the answers.  Good leaders are using critical thinking, figuring things out along the way and that’s what matters.

Coaching staff on that same thing and on how to build their resiliency is an important area for leadership focus in today’s environment.  Often staff are afraid to fail.  I once read that FAIL = First Attempt In Learning.  I often have to remind myself of that because failure isn’t fun.  Becoming resilient can often happen as a result of failure if growth and learning occur.  We experience something hard and we grow from it.  Make the work environment safe for your employees to try.  Creating a learning environment is also creating a resilient and innovative organization – one where trial and error are encouraged, and both employees and the organization can thrive as a result.

“Only those who dare to fail greatly can ever achieve greatly.”
― Robert F. Kennedy

​Employee Engagement and Resilience
The best way to help build a resilient workplace is to focus on building an engaged workforce.  This can be more challenging to do if your workforce has suddenly become virtual as it presents additional challenges for a leader to connect with the employees, but it becomes even more important to do so.  According to the Gallup organization, weekly check-ins to establish expectations, continually coach, and create accountability are key to building employee engagement and a more resilient culture.

It’s even more important for organizations to be investing in their leaders and their development at this time.  Great managers provide meaningful feedback to staff which reshapes the way people think and behave in their roles.  Having weekly touchpoint meetings can help people reduce worry, stress, and loneliness and keep employees informed about what is going on with the organization. 

It also is an opportunity for the manager to check in and see how the employee is doing.  This is particularly important if the employee is working virtually from home and may be feeling isolated.  These are times when that all-important leadership skill of empathy should be tapped into.  Now is the time for kindness, and compassion, making the time to engage in dialogue and lots of listening.

Making sure employees’ basic engagement needs are being met is critical at this time:  Do they know what is expected of them at work?  Do they have what they need to get their work done?  Do they feel cared about?  Are they feeling appreciated and recognized?  Do they feel like they have the opportunity to do their best work?

If managers focus on these items with employees on weekly check-in calls, do it in a genuine and meaningful way, and share frequently what information they have about changes that are going on within an organization, even with a workforce that has been forced to suddenly go virtual, this will go a long way to maintaining engagement and resiliency during this challenging time.

Characteristics of Resilient People
Type R: Transformative Resilience for Thriving in a Turbulent World by Ama Marston and Stephanie Marston was first published in 2018 and introduced the concept of something called Type R and transformative resilience (TR).  In the book, they state, “Individuals who embrace TR are more adept at springing forward because they are emotionally complex.  They don’t deceive themselves with positivity; rather, these individuals look for something redeeming amid difficult situations.  They shift their focus to a positive outlook more rapidly and they respond to adversity by drawing on a broader range of emotions.”
​ 
So, do you have the characteristics of a Type R person?  These are the six that are outlined in the book:

1. Adaptability – This is a skill that many have been called upon to practice recently.  We’ve been tasked to be adaptable to virtual workplaces, distance learning, zoom meetings, shopping online, and creating fun staycations for our families, for example.  Leaders who may have been reluctant to allow telecommuting for their staff have been forced to allow this now.  In some organizations, they’ve realized it’s working well enough they may never go back to the way it was before.  Restaurants had to adapt to take out only for many months and in the early days of the pandemic, some even started offering grocery items to their customers as a way to help supplement their lost income and also help meet a community need. 

2. Healthy relationships to control - It’s an instinct to want to control a situation and some of us can let go of this better than others when the situation calls for release.  Resilient people recognize when taking control of the situation is warranted and when letting go of control is in their own best interest.  The book states, “Believing that we control the outcomes of our lives and our successes isn’t only empowering but also a starting point for creating Transformative Resilience.  Yet, focusing too intensely on an internal locus of control and our ability to control has significant downsides.”  It’s important to know when letting go is needed.

3. Continual learning – This doesn’t have to be formal education.  My dad was a lifelong learner, but beyond his formal education in his trade as an electrician, he had little college education.  However, he was self-educated in a variety of subjects.  He loved educational shows on TV such as National Geographic, cooking shows, home repair shows, and more.  There are many ways to educate yourself these days:  YouTube, reading books, online webinars, and learning about cultures by traveling and exploring other places in the world, are among just a few of the ideas.  Type R people have a thirst for continual learning and are self-motivated to find ways to do it.  

4. Sense of purpose – This may be as simple as raising a healthy family or running a business that one is passionate about.  It could also be as broadly impactful as Greta Thunberg’s work, the Swedish activist who has won awards for her work in traveling the world speaking to global leaders about the environmental crisis. Both are equally meaningful to the individual and no less important.  Use your values as a guide to what gives you meaning and a sense of purpose.

5. Leveraging support – Having social and professional networks is key during times of stress.  Although it may be tempting to go inward, resilient people know the importance of reaching out.  Asking for help is key.  Don’t assume you are alone. You aren’t.  This is where having a coach, mentor, or simply a network of peers to reach out to is key.  It’s hard to do when you are busy, but it’s important to make time for it. I have a group of friends that has been getting together regularly for close to 20 years.  We refer to our group as the “poker group” because sometimes we play poker when we gather, but mostly we talk and share our lives, perspectives, feedback, and troubles. We share a meal and serve as sounding boards for one another.  We laugh and have fun. We’ve been with each other through divorces, marriages, illnesses, job and career changes, having and raising children, and more.  But in the end, we are always supportive.  I know I can count on these ladies to be there when I need them.  Professionally, I also have a small group of mentors who have been part of my career for ten and some, for twenty or more years.  I know I can count on them for advice and support when I need it.  It means the world to me to be able to reach out and know those people are there and to also be able to serve in that role for others who call on me to be that support to them. 

6. Active engagement – This is about taking action once we’ve assessed the situation in response to it.  Type R people don’t do the typical fight/flight response.  They have a reasoned response to the situation.  For example, if you’ve lost your job, what’s your plan to find a new one?  If you’re diagnosed with cancer, what are the treatment options?  If you’ve been presented with a challenging problem at work, what are your options for resolution?  But in those circumstances, resilient people don’t curl up on a ball and stay in bed waiting for the situation to pass.  They choose to act reasonably.  They resist a victim mentality, and they take their power back by taking action.

Having a Type R mindset is important to thrive in today’s world.  Ama Marston talks more about it in the following video: https://youtu.be/wk-gb8EqODw  

The book outlines the following specific actions that individuals and leaders can take to develop transformative resilience:
Individuals

• Question your default mindset.

• Practice emotional hygiene.

• Connect to the context.

• Examine your relationship to control.

• Clarify what matters.

• Ask different questions.

• Concentrate on learning.

• Create a failure CV.

 
Leaders

• Walk a mile in another’s shoes.

• Model Transformative Resilience.

• Reward colleagues for Type R behavior.

• Understand the root causes.

• Take a stand.

• Call upon Type R vision.

• Empower employees in your organization.

• Set aside time and resources for continual learning.

For more details on each of these actions as well as actions organizations can take as well as parents and families can take, I encourage you to read the book.

I think of all of these, my favorite is the idea of creating a failure CV.  What a concept!  Again, it goes back to the concept of celebrating failure and recognizing that failure is simply a first attempt at learning.  If we remember to take time to reflect upon our failures and learn from them, we can grow as a result.  Getting through hard times and embracing the lessons in it, growing from that, and finding the silver lining in the experience is how resiliency develops.

Conclusion
Everyone has a story. Everybody has their share of hardships and that’s why we all need a little grace.  And for those who have managed to sail through life without any, the first time they hit one, watch out – they won’t be very equipped to cope with it.  So, they are going to need a little grace too.  Especially now, during this time of the pandemic, quarantines, social distancing, and racial and political tensions, in our workplaces and our neighborhoods…let’s practice kindness and remember…we are strong…we are resilient, and we will grow from these times.  

And if you didn’t take a pause the first time through and watch the “Good Job” video, here it is again.  I’m pretty sure it’ll help give some perspective on the resiliency of the people in our country and the gratitude that we have for many of them this year. 

Thank you, Alicia Keys:  https://www.youtube.com/watch?v=dSUZIFBJHwQ

Why Feeling Like I Was Failing Was One of the Best Things to Ever Happen to Me

January 1, 2020

One year ago, this month I left my corporate job.  With the exception of a 9-month period of time in my 30s when I was laid off when the company I worked for closed, 2019 was the first year since I was 15 years old that I hadn’t been steadily employed. 

I turned 50 this past year.  As that birthday was approaching, I was utterly exhausted and, for the better part of a year, went home at the end of every work day feeling like I was failing.  It was time to reassess my priorities.  And I’m so glad I did.  This past year has given me a new perspective and a new sense of happiness that I don’t think I could have gained any other way.

What led up to the decision to leave my job was that I was losing myself.  Somewhere along the way I had burned out.  And with that, I lost my passion for my work.  I had been struggling with the overwhelming workload for quite some time.  And I was failing to achieve the things that gave me satisfaction in my work.

​That was coupled with the need to reduce even more staff, the challenges of finding good people to fill the critical vacancies we did have, the need to make some major system redesign changes, and the continued increasing expectations that came with being an executive in a high performing health care organization - the pressures just continued to increase. 

​I found myself skipping my son’s sports games for work commitments, staying later and later at work, missing family gatherings, and bringing my laptop home to do work at night and on weekends all to try to meet deadlines and keep up with the demands.  I wasn’t sleeping well and started skipping my gym time to stay later at the office.  It started to take its toll on my health.

My boss was always supportive when I wanted to take time off, but the expectations of getting the work done were still there.  I felt like I was in a constant state of crisis management – if it wasn’t one person’s crisis that I was responding to, it was another’s. Vacations inevitably always became working vacations, often disrupted by one thing or another. I was chained to my cell phone constantly and it seemed never-ending. 

I didn’t feel I could delegate more because my staff was already so overloaded that they didn’t have any capacity either – at least that was my perception.  We had enough turnover on the team and HR positions are very hard to fill - losing more would just add to the problem.  It was a vicious cycle.  It seemed like we could never get ahead and I couldn’t get approval to add the FTEs we needed.

Empathy is one of my strengths, but this also became a double-edged sword in my work.  My team had dealt with some extraordinary personal challenges – parent and spouse illnesses/deaths and I had a close colleague whose son had committed suicide.  While supporting these folks during these times was a privilege, it also took a real personal toll on me.  All of those challenges, coupled with my own parents’ declining health just became too much.

I recognized that continuing in the current state wasn’t fair to me, my family, my team, or the organization.  My attempts to improve the situation weren’t working – at least not fast enough.  The organization needed a leader who could come in with a fresh perspective, a renewed energy, and get out of the hole I thought we were in.  And I needed some relief from the stress.  It was time to throw in the towel and take a break.

It was far from easy for me to come to that conclusion.  My husband and I talked about it for the better part of six months.  Once I finally decided to leave, it felt a lot like jumping off a cliff into the unknown.  It was scary…really scary.  And very emotional.  Leaving my work family, where I had established so many strong relationships and had put in so many hours of dedicated hard work for almost thirteen years was very hard.  I felt like I was abandoning my team.  But I knew I had to do it for myself and my family.

Now that I’ve had a year to reflect, I’ve gained more perspective on the situation and I’ve learned some important things about myself, about what will make me happy and more successful in the future.  Some of what I’ve learned is:

• The inability to say no and the desire to please can be to one’s own detriment.  You can work to put better boundaries on time, but often that leads to bigger backlogs and getting further behind.  No one likes that feeling so the time creep happens again to catch up.  Developing strategies to ensure you stick to your guns on personal boundaries might not solve the problem of workload backlogs, but it could make the problem visible sooner and allow for problem-solving.  

• A desire to have things done a certain way and some perfectionist tendencies can contribute to a constant feeling of being overwhelmed and an inability to just let go of things at times.  Wanting a quality outcome is a good thing, but when that desire leads you to go overboard with the need to have things a certain way it can be to your detriment.

• An inability to ask for help and say this isn’t working can be a contributor to the problem of feeling overwhelmed.  It’s hard to admit when you’re in over your head, especially when you pride yourself on being so capable.  But at times we all need to rely on each other as collaborative problem solvers and not get stuck out on an island all by ourselves.  Pulling in thought partners early on in a problem and being open to others’ ideas of ways to problem solve might have helped.

• Sometimes we can be really great at following through on professional commitments, but not very good at those personal commitments, such as commitment to gym time.  Making self-care (such as exercising and eating right) a priority, can help ensure better quality sleep and better stress management, all of which can contribute to more effectively dealing with pressure.

• When you are stuck in the weeds of crisis management, it’s really hard to see the big picture and problem-solve for the long term, but that’s a requirement if you’re going to find sustainable solutions.

I’ve realized that the level of productivity that I managed to sustain all those years and how that translated to the expectations of others was very unrealistic.  What I consider now to be a “productive” day is more in line with that of a reasonable person.  I couldn’t see that when I was running as fast as I could on the hamster wheel.  And that wasn’t fair to my staff as it translated to expectations of them.

So, what have I done with my time off this year? 

• Most importantly, I have invested time in my relationships with the people closest to me – my son, my husband, my friends, and my family.  It’s been amazing to see how my sixteen-year-old has blossomed so much this year having me home and more involved in his life.

• I have focused on being really present in my day.  That includes observing things around me, really listening and engaging in conversations, and appreciating nature and the little moments in life that I used to take for granted.

• I’ve been intentional about focusing on my health, getting back to the gym, cooking, and eating healthier.  I’ve helped care for my mom as she’s recovering from her health challenges.

• I’ve cleaned out closets and organized my home office.  There’s something very satisfying about getting rid of things you no longer need and simplifying the space around you.

• For several months, I spent many hours using adult coloring books.  It took me months to calm my mind enough to focus on reading a book.  I discovered that coloring is equivalent to meditation, and I attribute this to my ability to sit quietly and read a book again.  And I’ve learned to paint with watercolors.

• Reading!  I had a backlog of books that I’d accumulated over the years that I wanted to read and never had time to.  Now I read…a lot. 

• I’ve continued my education, taking both personal and professional development courses.

• I’ve traveled much more than I anticipated I would this year.  I’ve been to the Oregon coast, Canada, Switzerland, Italy, New York, and North Carolina!

Having this time has also helped to guide me to the next step in my professional career.  When you are constantly feeling like you can’t be successful at work it doesn’t do much for the self-esteem.  But this past year has helped me regain my confidence and as I’ve reflected, I have come to recognize all of the knowledge and professional experience I have gained over the amazing career that I’ve had. 

I’ve had the privilege of working for some pretty great organizations and with some great leaders who have taught me a lot.  I’ve been through a merger, an affiliation, a de-affiliation, a dissolution of an organization, and countless large organizational change initiatives…all of those involving major impacts to people and all done in a way that kept respect for people at the forefront.  I played a key leadership role throughout those initiatives and, as such, I have tremendous knowledge I can offer potential clients who may be facing similar challenges or who simply want to make improvements in their workplaces. 

I now have a sense of personal peace and professional purpose that I haven’t had in a long time. This summer as I was taking a walk around town, I noticed the color of the sky seemed bluer and the grass seemed greener.  The colors of the flowers were noticeably different to me…brighter.  It’s like I’ve become awake for the first time in who knows how long. 
 
I’ve had people tell me that I look ten years younger. I can only imagine what the effects of chronic stress have done to my body.  I just know that ultimately, that feeling of failure, while terrible at the moment, led me to a much more beautiful place in the long run once I stopped fighting it and embraced it.  

I’m so happy about that and excited to see what the next phase of my professional life brings with this new-found perspective.  Jumping into the unknown, while difficult at the moment, can be worth it in the long run. That’s one thing I’m sure of.

Burnout in Healthcare Leadership

February 2020

You can’t open a business magazine or scroll through LinkedIn these days without running across an article about burnout.  It’s a topic on a lot of people’s minds.  A quick Google search of the word “burnout” brought up over 104 million results in 0.53 seconds.  Wow!  Narrowing that down to “burnout in healthcare leadership” dropped it to slightly less than 3 million.
 
In 2019, the World Health Organization classified burnout as an “occupational phenomenon.” Specifically, they said, “burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

• feelings of energy depletion or exhaustion;

• increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and

• reduced professional efficacy.”

 There has been a lot of attention given to physician burnout in recent years and rightly so.  The suicide rate among physicians is alarming and burnout is often pointed to as a contributing factor.  Health systems are making efforts to address burnout by pursuing initiatives that focus on physician wellness and engagement, reducing “pajama” time, and addressing the bureaucratic challenges that electronic medical records have placed on physicians by doing such things as adding scribes.  All of these are important to help combat the burnout that our physician partners are experiencing and they should continue.

However, burnout in the healthcare industry isn’t exclusively experienced by physicians.  It’s happening in many positions – nursing and others.  According to a 2017 white paper published by the Institute for Healthcare Improvement titled IHI Framework for Improving Joy in Work, “If burnout in health care were described in clinical or public health terms, it might well be called an epidemic.” 

What most health systems are neglecting to address is the burnout that the rest of their employees are experiencing.   I see it in the most extreme and with the least attention given in the area of leadership.  Burned-out leaders responsible for units that are operational 24/7, such as nursing leaders, are being hit particularly hard, but even leadership over areas such as Information Systems and Human Resources are reporting burnout. 

In a 2017 study by Witt Kieffer called The Impact of Burnout on Healthcare Executives, 79% of study participants indicated that burnout was negatively impacting their organization and 79% of participants didn’t feel that their organization was doing enough to reduce or prevent executive burnout.  The report indicates that “respondents at all levels report experiencing feelings of burnout during the previous six months with directors, CIOs and CFOs reporting the highest rates.”  100% of directors participating in the study indicated experiencing some level of burnout.  That is staggering.

The study also indicated, “An alarming 71% of survey respondents indicate they are concerned that burnout will affect their careers in healthcare management.”  Most disturbingly, “three-quarters of healthcare executives know a colleague who left the industry altogether due to career burnout.”

This is a crisis in the healthcare industry that we must start talking about more openly and addressing.  If we don't, the talent shortages that already exist in an industry that is already experiencing pressures is only going to get worse.  Talent is leaving the industry at a time when we need their expertise.  

 What is it like to experience burnout?
​It’s similar to the proverbial frog being boiled in a pot of water.  I can speak from experience on this because it happened to me.  I’ve spent most of my career in the healthcare industry and it’s always been demanding and rewarding.  I’ve always been energized by the mission of the organizations I’ve worked for.  Although I’ve never been in direct patient care roles, I’ve always felt a great privilege to lead a support department and knowing the important role that my team played.  As I moved into an executive position, my responsibilities became broader and I took those responsibilities very seriously.  For me, and I know for all of my colleagues, it was always about doing what was best for our patients and our community.

Burnout snuck up on me.  I was a good team player, a hard worker, and willing to take on more responsibility when it was needed.  I didn’t know burnout was happening to me until it was too late.  For me, it happened throughout a couple of years.  Unfortunately, it took finally leaving my corporate job altogether to recover.  I just couldn’t see any other way out by that point.  I had tried addressing the problem with extended time off, using a health coach, putting limits on my work time, and blocking my calendar, but none of those interventions were working. 

For me, the long-term chronic stress and workload that exceeded my capacity had gone on too long and came from systemic issues that needed to be addressed to make an impact.  The things I tried to address on my own were mere band-aids to a bigger organizational problem and I couldn't get traction on the primary contributing factors.  I also needed to take some serious time to step back and reflect on how my approaches to work under stress might also be contributing to my problem. 

Ironically just a few days after my decision to leave the organization was made public, we had a national speaker (Dr. Bryan Sexton from Duke University Health System) give a talk to our organizational leadership on burnout in healthcare workers.  As I was sitting there listening to him speak, there were two things he said that really resonated with me:

• Telling someone who is burned out to learn a new skill like meditation is like telling someone who is drowning to learn how to swim. I wanted to jump up and shout “Yes!”  I had been working with a health coach for a year to learn how to meditate and it just wouldn’t stick. Nothing was working and now it made sense as to why.  By the time I had already hit the burnout stage, it was too late.  The key is learning new skills to help you combat burnout before burnout happens. 

• Telling someone who is burned out to stop and look at the sunset is like telling someone who is being chased by a tiger to stop and appreciate life.  They just can’t do it.  They feel like they are running for their life.  After all, they are being chased by a tiger!  This helped me understand why I felt defensive all of the time and why my attitude about everything seemed so negative. I didn’t want to be that way. I didn’t like the person I’d become.  This helped me understand it.  It was so enlightening, and, in a way, I felt such a sense of relief.

In the weeks leading up to my last day, I had the opportunity to have a lot of individual conversations with colleagues about my experience, and, in turn, several shared with me their sense of understanding, their support, and, their experiences.  I learned that some of them were struggling too. I wished we’d been able to talk more openly about our mutual struggles instead of quietly charging forward like everything was fine.  Burnout can feel very isolating and lonely because when you are struggling and you think everyone else is fine, you feel like it must be you that’s the problem.

When I quietly shared with a colleague that some days when I was on my commute home (the only part of my day that I truly had to myself), I was so exhausted that a fleeting thought went through my head that if I had a car accident maybe I’d end up in the hospital and at least I could get some real rest that way.  I clarified with her that I was not thinking about hurting myself.  She said she completely understood and shared with me that sometimes she had a fleeting thought of getting pregnant just so she could go on maternity leave. 

We both recognized how warped and twisted our thinking had become.  But it also demonstrates how desperate you can start to get when burnout makes you feel trapped and in need of a real break – something far beyond what a typical vacation can provide.  You feel like you need to keep up the façade that everything is okay…and keep going at the same crazy pace that the healthcare industry demands of leaders.  What is wrong with this picture?  A lot.  And it needs to change.

The Complex Health Care Environment
According to a white paper produced by Change Management Solutions, Inc. titled, Why Employees Burn Out:  The Burnout During Organizational Change Model (B-DOC), “Burnout is NOT simply an individual’s maladaptive response to stress.  Work environments strongly influence an employee’s attitudes, behaviors, levels of motivation, and feelings of stress.  Many organizations unwittingly build cultures and work environments that create burnout.”

The high pressure, high demand, and complex culture of healthcare make it ripe for burnout.  Add to it that the type of people often attracted to work in the healthcare industry are often those personality types that are service-oriented and highly empathetic people.  Coincidentally, those are the same type of people who are more prone to compassion fatigue and burnout. 

The healthcare industry is filled with hardworking, committed, and caring leaders.  It’s also filled with extraordinary work demands, a constant sense of urgency to get things done, and limited capacity in which to achieve them.  These things together can be problematic.  The motivation to continuously go, go, go is always in the best interest of the patient, but often it’s at the risk of self-sacrifice.  The culture of healthcare, with the increasing pressures to reduce costs due to declining reimbursements, new government regulations, and the need to become more efficient, all while continuing to provide exceptional quality and service to patients can be unrelenting for leaders. 

And in case you missed it, we’re all getting older.  People are living longer, patients that are accessing health care are sicker and there are more of them…which creates its own set of challenges.  For some communities, as the population is aging and the demand for services and technology continues to grow, the facilities are aging as well.  All of this comes at a cost.  Hospitals must make a positive bottom line to reinvest in their aging infrastructure so they can care for the community in the future.
 
Leaders rarely get to put their worries away at the end of the day and go home.  Their work often comes home with them and that contributes to their burnout.  Rarely does it feel like there’s time for a break…or to even take a breath.  And there’s certainly no time to stop and reflect.  There’s always a mountain of work ahead to tackle and complex problems to solve.  In the beginning, this is exciting and energizing, but over time the chronic stress that this creates can take its toll.

Eight Things That Will Help Prevent Leadership Burnout
So, what is the solution?  There is a lot that needs to change about our complex health system.  More than I can address with this article.  But there are a handful of things that I think can help start to address the burnout problem that leaders are struggling with.
 
I see it as a problem that has to be tackled from two angles.  Those who are experiencing it need to learn to do things differently and the environment that is placing unrelenting demands on leaders needs to change. 

Leaders can help themselves by:

1. Developing Self Awareness – Burnout is more about our perception of our effectiveness than our actual effectiveness so accuracy in our perception is important.  It’s important to have reliable, trusted colleagues to provide feedback, help develop self-awareness, and maintain perspective.  Find a coach or mentor to help you.  

For those of you who are introverted or highly sensitive, it’s particularly important to build space into your day to have time to process your thoughts and decompress.  Learn to value this about yourself and do not allow others to intrude on this time.  If you must, leave your office to take a walk so that you cannot be interrupted. 

Recognize your limitations and know when to seek support and help from others.  Learn when to let go – for your self-preservation.  For some, it’s easy to fall into the trap of being constantly busy and in some cases, this can lead one down a path into victim mentality.  Be aware of this trap and recognize when it is starting to occur.  Competing with other leaders of who is the busiest is helping nobody.  It can be harmful to an organization’s culture.  Leaders need to become problem solvers to the solution and not victims of a busy culture.

2.   Practicing Gratitude & Positivity – Practicing gratitude and positivity will help you see things in a more positive light and there are many ways to do this, personally and within an organization:  

• As a leader, you can role model this for staff by adding a section to every meeting agenda to spend time on staff recognition. 

• Practice positive rounding where the sole purpose is to look for things to celebrate.

• Participate in random acts of kindness – and focus on other leaders who often get far too little recognition because those in leadership positions are often so focused on ensuring staff are recognized. 

Not only will all of these things make the recipients feel good, but they make you feel good! 
Dr. Bryan Sexton suggests the simple act of jotting down three good things that happened to you at the end of each day (https://bmjopen.bmj.com/content/7/5/e015826).  This daily reinforcement of gratitude helps build an attitude of positivity that can help combat burnout.  

These are seemingly little things, but they can help rewire the brain’s thinking to be more positive over time and create an important protective mechanism when one is feeling overwhelmed.  They help create resiliency.

3.  Practicing Self-Care – Those in the helping industries are at particularly high risk for burnout because of the amount of compassion that the job often requires.  This makes the need for self-care particularly important.  Create a self-care plan that is unique and meaningful to you and that supports positive mental health and boosts personal resiliency.  Make sure it includes some or all of the following:

• Spend time in nature. 

• Exercise. 

• Get sufficient sleep. 

• Practice meditation and mindfulness. 

• Eat foods that are nourishing to your body. 

• Spend time with people cultivating relationships that are deep and meaningful. 

• Invest time in a hobby that brings you joy. 

Being a role model for others in practicing self-care and demonstrating a healthy work-life balance where caring for you is a necessity, not an afterthought.

Organizations can protect leaders from burnout by:

1.   Openly talking about it.  The feelings of burnout can be isolating.  If it’s openly talked about in a way that’s not viewed as shameful or weak, but more as a check-in to make sure everyone is doing okay, and if any adjustments need to be made, the conversation can be viewed more positively.  An organization must create a culture of psychological safety for meaningful dialogue to occur.  

Creating a culture of high standards and expectations can be good for an organization (e.g. stretch goals), but it’s important for executive leadership to assess and openly talk about when the expectations may be too high and if they’re contributing toward burnout within a leadership team.  You don’t want to establish a culture where leaders create such a high bar that people burn themselves out trying to achieve the goals.  In the long run, turnover goes up and that is not good for the organization.  It’s costly.  Morale and productivity can then be negatively impacted, which has longer-term implications.

2.   Ensuring reasonable workloads – Those who are the highest performers and the most highly engaged are often at the highest risk for burnout.  Our most capable leaders are the ones we tend to turn to with new and bigger projects because they are so capable.  And because they are so engaged, they willingly take on the challenge.  Consequently, their workloads get bigger and bigger.  But this also contributes to burnout.   

CEOs and Boards of Trustees need to look at strategies and targets and determine if they are reasonable for the organization. They should also be assessing:

• How far can leaders be reasonably stretched? 

• Is there enough organizational capacity to accomplish the work?

• Do leaders have enough staff to support their work? 

• Nursing leaders notoriously have huge spans of control.  What is the right ratio of leaders and direct reports to be effective? 

• Do leaders have the appropriate technology to support them and help make their work processes efficient?

Organizations need to ensure that they are distributing workload demands appropriately and providing leaders with the tools and resources they need to be successful. 

A July 2019 Harvard Business Review Article titled 6 Causes of Burnout, and How to Avoid Them lists workload as the first of six causes.  The article states, “When you have a workload that matches your capacity, you can effectively get your work done, have opportunities for rest and recovery, and find time for professional growth and development.  When you chronically feel overloaded, these opportunities to restore balance don’t exist.”  It’s the organization’s responsibility to help keep this in check.

3.   Protecting calendar time – This is particularly challenging in hospital environments when leaders need to meet with physicians and they run 24/7 operational units.  Supporting flexibility can help.  If a leader needs to come in very early or stay late for a meeting, encourage them to adjust to the other end of their day to account for that. 

Don’t allow people to be boastful about working all night and discourage leaders from sending late-night emails or working during vacations.  You want leaders to be getting real respite when they aren’t at work.  They are role modeling behavior for staff to help ensure they are setting the organizational standard.  This starts at the top.  Respect people’s home lives and keep interruptions to true emergencies. 

Encourage calendar “white space.” An organizationally mandated calendar block time for “planning” or “well-being” and a guideline to avoid scheduling meetings over the lunch hour can help with this.  The key is ensuring it’s adhered to.

4.   Allowing space and celebration between high-demand projects – High-driving cultures tend to roll right into the next big thing without slowing down even to acknowledge the completion of the last project.  While this might mean a lot gets accomplished, it can be a contributor toward burnout. 

In an improvement culture, we are trained to look for the “reds” – those things that need our attention.  But it’s important to balance that with celebrating the “greens”- those areas where we are meeting the goals.  It’s necessary to allow time and space between big projects for those who carried the bulk of the workload to have some breathing space and for the team to celebrate the achievements. 

One way to allow respite time for your leaders between high-demand projects is to ensure leadership is shared or alternated fairly among leadership team members so that there is not a disproportionate burden on certain team members to carry the workload.  If the same team members are carrying more of the load than others over and over again, this can increase the chances of burnout. 

5.   Creating a culture that allows autonomy and empowerment – This requires trusting leaders to do what they believe is the right thing and having faith that they will.  Put mechanisms in place to allow leaders to have input into the organizational strategies that will impact their daily work.  They are the ones that are required to carry out the strategies so ask them what they think and incorporate what they have to say. 

Allow leaders to lead and avoid micromanaging their work.  If you have a leader with performance issues, address that head-on, ensuring you have accountability systems in place, but don’t address performance issues through micromanagement.  Develop your high-performing leaders by giving them opportunities to learn and grow.  Empowering them with stretch assignments as they are ready is another good way to combat burnout. 

The Cost of Burnout
According to A 2020 Global Culture Report by OC Tanner, employees are more burned out than ever.  “Employee burnout costs companies more than $190 billion in healthcare spending.”  OC Tanner also indicates that there is an 87% decrease in the probability that an employee will stay with the organization if they are moderately to severely burned out.  And turnover is very costly.

An article published by the Society for Human Resources Management called Blocking Burnout in Your Organization states the following: “Employees who say they very often or always experience burnout at work are:

• 63% more likely to take a sick day.

• 23% more likely to visit the emergency room.

• Half as likely to discuss how to approach performance goals with their manager.

• 13% less confident in their performance.

• 2.6 times as likely to leave their current employer.

The cost of burnout to an organization is seen in increased turnover and lower productivity.”  And when this is translated to leadership, it’s even more costly due to the impact that the loss of a highly engaged leader has on the progression of strategy within an organization. 

My Hope for the Future
My great hope is that others don’t find themselves in the situation that I found myself in – that proverbial frog in a pot of boiling water.  And that health systems start to address the issue of leadership burnout more openly by finding systematic ways to combat it from a prevention standpoint before more leaders choose the path that I did and leave altogether. 

When you couple this with the large challenge that the healthcare industry already has in filling many leadership positions due to the hard-to-fill nature of the jobs, this is an issue that the industry must address.   Failure to do so means the talent gap is going to get worse and fewer and fewer young talent will be willing to step into these leadership roles in the future.  The industry has to act now.