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I pause every time I f… to that question because its blended. It’s a combination of being a servant leader and being a democratic leader and being strategic. And its blended for me because how diverse … a lot of my question for me would relate to this position as a director for nursing services (DNS), as well as the senior nurse executive for all the nurses that are associated with Fort Belvoir. So, when one has that type of diverse cohort of individual that I represent, I found that one leadership style does not work. I lean towards to be a servant leader than the others just because I see my role as moving barriers for my nurse executive as well as CNOICs, the head nurses and other administrators like OICs. The only way I can do that is if I can devoid myself of self and look at the organization and its needs. That in itself causes another challenge because I can’t be two nurses centric, I am one of 10 board members here and we all have a vote when things are concerned, where Fort Belvoir community hospital is concerned. So, although I love to be nursing centric, I am in part, but I also have to look at the board picture of where we fit in and how we remain relevant and consider other customers that we serve, other directorates. So, yes, its blended, but I do lean towards servant leadership.
Yes, I am. It’s become a little bit more popular and lot of folk are talking about transformational leadership. And really for me it’s a set of its ability to inspire. And as a transformation leader, I consider myself as a transformational leader because I combine the servant, democratic and the strategic, I ensure that I maintain the attributes to inspire those that I lead. It takes a lot of forethought; it takes some vision and it takes communication to be transformation. One of the worse things a leader can say is “this is how it’s always been done” because things always change. One can’t be transformation if one is set in their ways, so yes, a big of transformational leader is to motivate and I put a lot of energy into doing that. One also needs to be considerate of one those who you are trying to inspire and motivate, I think that’s also a big part of transformation leadership as well.
That’s a loaded question. I have to learn to be vulnerable. When I humanize myself it translates into my genuine direction and so I will admit, when I make mistakes, I have to be empathetic, I try to understand where that particular person is coming from and I also try to realize that what my approach to person A is not the same approach to person B because everyone is different and they get motivate different from different things. It’s a deliberate process actually.
Alright…. When emotional intelligence I was not here. At that time, I was the director for a Practical Nurse course, (LPN school) in Georgia. I did a lot of presentation on Emotional Intelligence. I’m happy that it’s still in the conversation because Emotional Intelligence to me is being aware of your own self. So, they are fallacies out there that recognize them. One might have anx pertaining to a particular, you might be anxious about recognizing that you are anxious. Something might have happened that could influence your interaction, recognize that there could be that influence. All that surrounds your emotional intelligence. It really being mindful,… now more persons are talking that being mindful is being emotionally intelligent, not sure why, so the conversation has slightly shifted but it’s the same thing…be deliberate be mindful. Self-regulate. You know you need to go to bed early, you know you have to adhere to performance tirade, eat right, eat right and exercise right…. All of them are being a part of emotionally intelligent.
We have been having battling in our organization to get all our patients tested for COVID. Science really doesn’t back testing because, testing is not that specific yet. Its really the truth of the matter. And none of our testing apparatus are calibrated or certified to test asymptomatic patients, those are just the facts right now. However, there is a lot value in testing and retesting. We had a patient last week who came from Malcolm grow, this patient who tested positive two months prior to that visit, who went ot the ER, went to the OR and subsequently came your ICU and until then no one thought of testing and when tested he came positive. For me that was the last straw, so I came in, it just so happened that this goes to a lesson that I learn, this was a huge leadership lesson for me. I was here one evening on call with maternal child health nurses and four other med-surg nurses and the nursing supervisor slipped a note because I was still on the call and the note said that the patient tested positive. Now I know exactly what, she did not have to go any further because we were advocating that the patient getting tested when they were in the ED, and they were like “No, he was just here for xyz, so urology team thought he probably has some antibodies and I was slightly revved up, so this going to answer your question. I come in the next morning and sometimes, so every morning at 7 o clock I host a nursing meeting and its all of the sections chief, surgery, ED, Infection, pharmacy and also patient safety so it’s how Belvoir starts its days and its actually how the DNS works. So surgery as you imagine was very upset 6that this happened and the possible exposure to all the OR team and of course the E#D was upset and the back story is that I have been advocating that all patient get tested for the longest and I went to the board of directors, we have the Board of directors meeting everyday AT 1000, So I went to the BOD and felt frustrated and shared very forcefully my thoughts of how irresponsible we have been for not testing all of our patient regardless of their story and I went to bed tat night with the directors face expression in my heard as well as the chief of Staff because they were shocked because I’m usually little bit more guarded and poised but they rev up started the night before and continued in my morning report and I let them have it. IT was then that they decided that they were going to start testing all the patients, so I got what I wanted from nursing standpoint but that was not me usually. Son long explanation to your question. The leadership lesson to me was I had to be aware of my own frustrations and in delivering something that or change that I’m asking for, my own emotion shouldn’t overly control the way I delivery it but that day I did.
Me: But we got what we wanted?
Leader: Yes, we did.
Me: But do you think if your approach was different you would have not gotten it?
Leader: I don’t know, Im not sure
Me; What do you think?
Leader: Because it was so out of character for me to react so really really really took it seriously, so maybe if I was gentler, we wouldn’t have gotten that then, but I think we eventually wouldn’t have gotten all our patient tested. Yeah so, maybe there is place for some of that passion.
Yes. Relating to this position, again I , as you know we diagnosed the first positive patient in Virginia and might have been the third in the DMV area (DC, Maryland and Virginia) so we have been at this early and that patient was traveling and probably got exposed to COVID in the airport or the plane. This is on the 5th of March, by the 7th of March we had another patient, and several other patients were tested positive but they weren’t sick to be admitted, so we send them home to be quarantined, at the same time the NCR (National Capital Region), as you are aware we are a part of the cohort, Walter Reed, Andrews, Annapolis and few other.. and the NCR wanted to have a NCR approach, a market approach in dealing with COVID patients which require a lot of movement, at least in my lane, a lot of reports needed to be generated almost immediately, because they wanted to make an assessment on what our capabilities were – us and Walter Reed, and I made the decision then, this is in direct answer to your question, I made decision that I didn’t get by in for and I did it then deliberately because I didn’t think we had time then, an example converting 7 North floor to be the designated COVID floor, I got no buy in for that, I made that decision and I think I don’t need by in for that but in retrospect might have been a mistake, it was ight decision but it ruffled a lot of feathers amongst my nurse leaders, they felt they didn’t have a say, so even though to this day I know we made the right decision but I would have slowed down slightly and would have discussed with my nurse leaders and the democratic part of my leadership wasn’t realized earlier on in COVID contingency measures and I did some damage because there were people who had except what I thought needed to happen and lot of them didn’t have buy in, I got the feedback later on that I was dismissive in some of the instances. So yes, if I had to relive that I would change my approach slightly.
Me: So, you choosing the 7th floor as a COIVD floor was not the mistake that you made but you not discussing with the nurse leaders was?
Leader: Exactly and it was the processing I which I went about doing it. There was strong strong strong nursing advocacy from my nursing leader that 6th floor be the COVID floor, what I have not shared with you is that those leaders went ahead and converted 6th floor North as the COVID floor outside of my blessing and I made them tear it down and move it upstairs and transfer the patients because I wanted the 7th floor to be totally isolated and that was my vision but because I had to tear it down it did some damage.
Me: What kind of backlash were getting from the nursing leaders? What was their reason as to not want to take that route?
Leader: They thought that we should have started taking more COVID positive patients in 6 Center because that in enclosed, then move to 6 north and let 7th floor continue with their med-surg patients but because the NCR required us to provide 73 beds and they only way I could provide them with 73 beds was to kick out the residential unit which was 7 south and use the 7th floor and move down but they didn’t see it that was because they felt the 7th floor mission is too important and the nurses on the 6th floor were, there was some disparities in terms of nursing capabilities, my nurses on 7 were better skilled, all of that played into their factor and I wanted to cohort everything on the 7th floor and they had a staged approach.
What we were discussing now is what comes to my mind, this is paramount. Dealing with COVID, dealing with reconfiguring the hospital and getting pushback from some of the communities you are displacing is challenging. Having to work with other directorates where COVID was concerned was also challenging.
I’m going to say morale is non-traditional. Having to address morale in the face of COVID pandemic coupled with the restriction it came with it, all of the COVID trappings cupled with social on rest I recognize that my little board of directors, not the command BOD but my nursing leaders, the section chief for Behavioral Health wo attends my morning meeting along with Section Chief Arnold and Major Gibson, ED, commander Be Williams, DSS the section chief for perioperative nursing, I recognize that there was some anxiety and I felt some people feeling overwhelmed so I started to change the tone and ask reflective questions and I wouldn’t give them any prewarning and I would say “Tell me what happened yesterday that you were grateful for?” “Did someone impact you positively, any patients or family members?’ Just to redirect them to why we were here, and it was deliberate process for me, and I started to see some calm down. The other thing I did is that I started inviting the chaplains. Either the beginning of the meeting or the end, I like the chaplains to be last. And I charged Chaplin to share encouraging words, not necessary in a biblical sense but just in general. Im not saying they shouldn’t talk about god because I’m a pastors kid and not from a religious sense but from a calm and reassuring space and that’s what he has done and continues to do and it has made a world of difference.
Me: In hindsight would you have done anything differently or do you have any other solutions?
I’m going to shift from Fort Belvoir and I’m going back to when I was Inspector General. One of the Command IG, so we have changed the leadership, and my boss and we both worked for the Surgeon General came is a micro manager, she didn’t understand the process and we were trying to orient her to what we do and our methodology for our inspections and our methodology for our assistance and investigations and all the functions that the IG do. When we shared the notes of our methodology she would question everyone one of them and wanted to know what regulations back each particular approach and it was frustrating and I dealt with for few months and finally, so we were in San Antonio, and the boss flew down once a month from here in Falls Church from Defense Head Quarters and I said “Ma’am I’m recognize some friction and what I don’t want is for every time we learn and I’m speaking on behalf of my team now that you are coming down or we have a tight ….. with you and our heart rates goes up coz that’s happening right now so something is not working well now so let’s talk through what is that you are not getting that you think you should? Are we not providing? Why are you seemingly so distressful of my team? So, I have all these whys. She is from DHA and we were Medcomm. She said, “I spend last three years in teaching”. She ran the vaccines, she is the physicians, she ran all the Department of Defense vaccines program and she said “everything that I ask you to back up, all the questions that I have been drilling down and something this organization needs to get sed to coz that DHA methodology” so she was trying to change our culture. We have to justify all of actions and a change was coming that we didn’t realize and she knew and she was trying to redirect us and it was really boil down to us putting our cards down and sharing our frustration and offering her an opportunity to share her approach and we came to an common understanding.
Me: So, the situation got better later?
Leader: Yes, the situation got better.
Me: So, was she sent to change the culture?
Leader: She might have been. We were a lot more careful where we went and how often and where the cost didn’t factor before she forced us to, so we did not make frequent trips to Hawaii and to the pacific coast as we use to.
Talk about it. Don’t shy away from it. I never thought that I would have to address race but I have. There were people that were paralyzed by what was depicted in the news. I myself shared my personal experience. It’s really having a conversation being opened to various viewpoints. I have Caucasian professionals tell me that it was blown out of proportion and there is not such things as racism and there is only bias and prejudice and they tried to convince me. So in fielding those conversation because each person on each side of spectrum need to talk about their respective perspective and as a leader, even though I have negative experience in the one end of the spectrum where prejudice and biased are concerned, I still needed to be open here to other and I couldn’t be judgmental so yes, its really being a faciliatory in conversation and not hold people or judge someone who you invited to the conservation based on their view. It is challenging.
Me: Have you personally experienced racism?
Leader: Oh absolutely. I have a colleague who retired last summer. Retired, purchased a house in this rich community in Orlando, we were visiting. I knew I had a PT test coming so I usually run in the morning and I was running in the neighborhood and I noticed light and two cop cars surrounded me, and two cops asked me what I was doing in the neighborhood. So, I shared that I’m visiting Dr. Jackson and his house is two houses down on this same street. And I enquire why I was stopped, and they replied that someone called saying a black person is running through the neighborhood and looked suspicious and they said that the person looked like they were running away. So yeah. Our son is a physician in San Antonio, and this happened three years ago. The campus police at University of Texas, San Antonio Medical Center stopped him in the parking garage and asked, “What are you doing in this garage?”, “I’m a resident here in this medical center”, “Really?” “Yes”, “OK, prove it”. So, he had to get his residency ID card and they examined it, so yes, we have experienced racism. My wife and I have a 32 yealr old boy who married his high school sweetheart, she is a registered nurse, they both live in Nashville Tennessee and he started his first job as a brain injury physician at Vanderbilt Medical Center in Nashville. He is physical medicine Rehabilitation doctor. He did a fellowship in traumatic brain injury. And when he started at job, they were very happy that he chooses that hospital and they were proud to take him because he was the only one who had fellowship and Board-certified traumatic brain injury doctor in the state of Tennessee. Imagine how proud we were when they did that? However, while we were basking in that pride, he and his department got a mail inviting him to leave the state of Tennessee because he was welcomed. So, have not only I had experience with racism but my son also has experience with racism. Of course, my son knows that Tennessee is Tennessee and there are some people who will not accept that a black person is leading a new department.
Me: So how is he handling it?
Leader: So, he is ignoring it for the most part and just moving forward. So he got two letters and none of have identified themselves and it could have been a jealous colleague or anyone. Since we don’t know he decided to move on. As a parent you experience enormous pride one minute and the next its pepper with fear. I think its just professional jealously.
Me: I’m sorry you have to go through that.
I’m glad you ask that. I expect the difference of opinion. When I don’t get the difference of opinion then I’m concerned, when I know that I don’t have all the answers, im not the subject matter expert for every node of the nursing clinical operations, and I also know that as a leader I’m stubborn, I try to be deliberate and I sometimes can dig heals in, and I make a conservative effort to look for and solicit differences of opinion because I think that allows me to make more distinct decisions. If I have a section chief or a nurse manager who agrees with, I’m actually concerned because I really want to be challenged. I need all of those nodes for me to make the right decisions.
An example of that would be I actually came to Fort Belvoir Community Hospital 20 months ago. I came not having to work in a joint facility before and when I got I knew that we were joint with Navy, Army and sprinkle of Air Force, I never had to interview for any kind of clinical job, so all Army personnel comes through me and I was the go to person. Now I brought Lieutenant Colonel Sheila Webb from San Antonio, TX to join the team and my intent was to install her as the Chief of Perioperative services, however her order she came from the army specified that she was coming to Belvoir for that. But since Fort Belvoir is a joint facility after she got there, Captain Purdue who I was supporting at that time shared with me that I couldn’t arbitrarily install her as section chief for perioperative nursing and that she should be subjected to an interview process and that’s how Navy does it, and since Captain Purdue was Director was Nursing Services at that time I have to adhere to the Navy process of interviewing. So here it is that I have brought a senior nurse from the command and she has orders to be the section for perioperative nursing, but she may not get the job because now she has to compete for it. That was very very challenging for me and I conceded and now I understand that it has to be that way. It a process necessary because most services get more qualified nurses coming in because they all are qualified there has to be a process to vet who is the best qualified for the job. If it’s a sole service, like just the Army I could do whatever I want but since it’s a joint I have to exercise fairness and conduct the interview process and that was challenging for me, I have made that as a part of my own practice now.
Me: How did Col. Webb feel?
Leader: Col. Webb was very upset. I had to recues myself of this interview because I knew Col. Webb. The committee interview three candidates and ended up choosing her.
Actually yes. As a leader one has to be willing to admit their shortfalls. I had to do a lot of introspection and I constantly see where my blind spots might be. Sometimes I realize in my role as Director of Nursing is that everything that involves nurses regardless of directorates involves me. For instance, they are asking for additional help in the COVID clinic and Covid clinic is embedded in the department of medicine and because they are asking for additional help I can’t turn a blind eye because if a nurse in any aspect or any part of the hospital even though it might not fall under DNS I take ownership. Another pertaining where my leadership stands is I have to be mindful that I’m never blindly loyal. I have to ensure that I not only have the obligation to represent my nurses and protect my nurses, I have a bigger obligation to be a vibrant part of Board of Directors and when I make decisions that hurts nursing interests it benefits the better good for the organization and that’s the decision that I have to go with. So, I can’t be blindly loyal. I have to overcommunicate. I have to repeat it, it’s not said and done, I have to clear and concise, and the last thing I want to say is I realize that I set the toll. If I come in and I bring some of my issues and my disposition is less than pleasant that affects my leaders, their day so I have to be mindful that although I have things outside the Fort Belvoir community hospital I can’t bring any of that to work because I set the toll.
Me: Have you worked at any other hospitals before coming to Fort Belvoir?
Leader: Yes. I have served for 31 years and this is my ninth hospital and I grew up as a ICU nurse.
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