EP 76: Beyond Policies: How Genuine Leadership Transforms Workplace Culture

CB_76 – Stephanie Gedeon: Audio automatically transcribed by Sonix

CB_76 – Stephanie Gedeon: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Dr. Renee Thompson:
Plants thrive and grow in a peaceful, nourished environment, right? Well, it's the same with human beings. But what if that environment is not so peaceful? What if it's toxic? Welcome to Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. In this podcast, you'll get practical, evidence-based strategies to help you cultivate and sustain a healthy and respectful work culture by tackling an age-old problem in healthcare: bullying and incivility. I am your host, Dr. Renee Thompson.

Dr. Renee Thompson:
Hi everyone! Welcome back to another episode of the Coffee Break podcast. I'm really happy that you're here today, and I'm super excited to be having a coffee chat with Stephanie Gedeon, who is the assistant chief nursing officer at Augusta Health in Virginia. Stephanie, welcome to the show.

Stephanie Gedeon:
Thank you. So happy to be here.

Dr. Renee Thompson:
So before we press record, Stephanie and I were talking about the first time we met. And honestly, I've been a fan of Stephanie's. I love what she posts on LinkedIn, and I've had some other conversations with some really amazing leaders at Augusta Health, and she reminded me that it was actually, gosh, Stephanie, what, ten years ago, maybe or more hadn't been born? Yes. You know, if you want to be a good speaker, one of the ways that you start is to speak for other companies. So, I was teaching med search certification review courses for AMSN, and I went to as HCA at the time while I was HCA. And that's where you were and did this talk, and Crystal Farmer was my contact, and Stephanie, you were an educator there, and you reminded me that you actually, I needed somebody to write a renal case study, and that was you who wrote it. I was like, mind blow, total mind blow. So fast forward to today, Stephanie has been at Augusta Health for almost four years. During that time, she has led a lot of their efforts to achieve Pathway of Excellence designation. I'm really excited about that. And she's also done a lot under this umbrella of change, sustainability and really creating a safe, workplace violence-free workplace for her team members. And so I really wanted to talk to Stephanie about her leadership and how she's managed to actually, as a leader, create that sort of safe workplace. But first, something that I find really interesting, and I know a lot of you who are listening or watching today, will find interesting, too. I want to talk about the power of leadership and how you can cultivate a culture of accessibility at all levels of leadership to really promote that healthy work culture. And what do I mean by that? Your people want to have access to their leaders. But Stephanie, I really want your input on this because how do you do that now? Especially now when it seems like leaders are stretched so thin, especially senior leaders, you know, executive leaders, your people want you to be present. But oh my gosh, how do you do that? And how does that relate to a healthy work culture?

Stephanie Gedeon:
Oh, I'm so glad that you asked this question. One of the things that we're really proud of in our Pathway to Excellence designation is if you break down the question about accessibility of leaders, we scored above 90% for both categories for our Pathway to Excellence designation. And to be honest, it is so important to get out there and make it your business to know every single person that reports up through you and beyond. We talk a lot about incivility and bullying in your podcast, and if they don't know you and they don't have a true relationship with you, how are they ever going to report that type of culture and be a part of making that a difference? And so we do a lot of different things around that. Number one, you have to free up your leader's time. And last year, Crystal Farmer and I did speak at the magnet conference about this work that we did for Nurse Leader work Environment. And part of that is getting rid of those non-essential meetings. Not everything has to be meeting, right? And make their workplace fun. So we build in we have nurse leadership team meetings every month. And actually this group, this nurse leader work environment, which is comprised of all different levels of leadership. Take it over and they make it fun. Easter egg hunt. We try to do some team building amongst the leaders because the more unity that we see, the better that accessibility is. Because it's not just you being accessible for your team; it's the whole leadership team is accessible to you. And so we'll do things like that and really make sure that we're freeing, making that time for them and making it an expectation. So we want to free this time up. Many people went into leadership because they wanted to make a difference in people's lives. That's why we go into healthcare, because we want to do that well. We want to make that same difference with our people because our people then make those positive impacts with our patients. So we'll do silly rounding, right? You can't forget your night shift, okay? Please don't forget your night shift or your weekend only. And so we make it a point, you know, Saint Patrick's Day is about to come up, and I have a leprechaun costume, and I will go around and deliver pot of gold or whatever kind of treats that they want. So we do silly rounding that's planned. But I think don't underestimate the power of unplanned rounding. There's times where we have a surge happening, and our teams are working really, really hard. We've made a stance at a certain level. We just cancel all non-essential meetings, and we are all expected to be out on the floors with our teams. And so that might mean that that initiative might be pushed back a month, but that's the right thing to do.

Dr. Renee Thompson:
Especially in that moment when your team needs you.

Stephanie Gedeon:
Yes. Adjusting our work schedules. You know, if it's a nighttime thing, what can I take off of your plate so that you can be here for your team tonight? So, making it really more of a group effort and not just expecting that manager to always be the one to, A, go into staffing or to come in in the middle of the night, I'll go down to the emergency room and admit patients. It's all levels of leadership. And so I think having that type of connections, and I have scheduled time on my calendar where I just go and just hang out in a unit, and that's my protected time to spend with my teams. And it's not just my leaders, it's really I want the EBS worker. It's my business. It's my business for them to know who I am so they can come to me.

Dr. Renee Thompson:
Holy cow. All right, let's unpack here. I'm kind of like the kid in a candy store right now. All right, I first want to talk about. You. Said you got to free up your leader's time. This is something that. It's so funny. I listen to other people's podcasts every single morning while I'm getting ready. And I was listening to one this morning about spring cleaning your life, work, life, and the first thing that they talked about or no, it was the second thing that they talked about. First thing was create a do-not-do list. Like, I'm not going to do these things anymore. But then they said, take a look and triage your calendar. Do I have to attend this meeting? And sometimes it's asking the question to the meeting organizer, hey, how important is it that I'm at this meeting? And when I think about this, in healthcare, we have these standing meetings. And sometimes I swear it's because we've been having the same meeting for the last 20 years. It's just the way we do things. So, are these meetings essential? Do they all have to be an hour? Come on. If you give it an hour, it'll take an hour. But if you give it 45 minutes, that gives you another 15 minutes of free time. But anyway, it's taking a look at freeing up the leader's time. And I think about organizations that have leadership layers. So, in a department, there's a manager or assistant nurse manager or supervisor. You know, there's the layers and they all have to go to the same meeting. Can one of them go, and they take turns and then bring back what they learned. So, like how can you be creative in giving some space back to leaders? And again, I'm thinking of you and your assistant chief nursing officer role. That's you, too. Like, how do you manage your calendar to say how essential is this meeting? How essential is it that I'm at this meeting? Can I come for the first 15 minutes and then leave? So, how have you done that intentionally? What have you seen as a result? Because I know what some people do. If they don't have to go to the meeting, they'll spend that time checking email. Guilty, that's me. I'll check email. I forget that email is not my job. Okay. But yeah, how have you done that intentionally?

Stephanie Gedeon:
So actually I'll give you a good example. So, most places have a committee that focuses on falls, and second committee that focuses on hospital-acquired pressure injuries, and a third meeting that is a work group that is focused on workplace injuries. Well, we took those three and made them into one. That's our mobility committee. Because really, if you focus on mobility, and impacts all of those things. So I think sometimes focusing more on what are those things that you can combine together and really have the same initiatives to do better. Good, do that. And guess what? Not every nurse manager needs to be in that. You need one representative who makes sure that they go back, and they make sure that their team members know, hey, this is what we talked about in the mobility meeting, and this is how you need to impact it. One spokesperson and so that was one way I got three things off of my calendar into one. Yeah. So, really thinking about those types of strategies, we're getting ready to implement a new electronic medical record. And with that, we've been all challenged to think about our calendar. So this is a great time for this. So we're actually compiling and our nurse executive team all the meetings that we are invited to where are the duplicates. And we use teams here and have made a teams channel with a notebook, and each tab has a different meeting, and that will be the location where we will put, like, I'll attend the pharmacy and therapeutics, for example. Put the minutes in there. Here's the high points, and send it out to my team. So, it's one repository for everyone to go and look at one source of truth. Hey, I'm your representative. It's something that I need someone to do, something that's my responsibility to go and talk to that leader. So I think dividing and conquering but making sure that we're still having a cohesive group that everybody knows what's going on you know.

Dr. Renee Thompson:
It reminds me as you're sharing this: when I was a unit manager, I was asked to be a part of our diabetes committee. I have a lot of expertise in diabetes, and one of our clinical nurse specialists, she said, I want to get a diabetes group together, a nurse from every department, and would you help me? So we did. Here was something that we realized immediately. We are expecting that one nurse from each department to come to a meeting and then take whatever they learned back to their colleagues to disseminate that information, but we never taught them how to do that. We never provided any structure for that. And there's something that. So yeah, go to the meeting. Here's the minutes. That's not helpful. I'm sorry. Nobody's going to read all of those minutes. It's well, I say nobody. It's rare to say that anyone's going to read the minutes, but I learned something from, and I've mentioned his name on the podcast before. His name is Jim Kwik. It's all about brain and learning and how you best learn. And then there's someone else that wrote a book called The Second Brain. Tiago. I think his last name is, well, the best way to learn something and share it with others is take like you go to the mobility meeting, and what you do is it's not minutes as you take a step back and you think, what did I learn? What were some key takeaways? And you distill it down into bite-sized pieces of what you learned, what you took away, and then you teach that to someone else, like you do a little summary, and then you share that with someone else. And that's the key. And making sure this doesn't turn into a, oh yeah, you don't have to go to these meetings, but now you're not informed because we gave you 27-page minutes, and nobody's going to read that.

Stephanie Gedeon:
Yeah.

Dr. Renee Thompson:
So it's making it easy for people to feel that they were kind of at the meeting without really being at the meeting. Does that make sense?

Stephanie Gedeon:
Absolutely.

Dr. Renee Thompson:
Yeah, I love it. And I'll put a link to Jim Kwik's website in the show notes. I get his newsletter a couple of times a week, and I'm always learning how to learn better. I'm learning how to learn. It's kind of cool. Okay, I want to go back to something that you said about making the workplace fun. You know, Stephanie, healthcare is serious business.

Stephanie Gedeon:
Yeah.

Dr. Renee Thompson:
And some people, they get a little like, I can imagine that you're in some leprechaun suit, and there may be people rolling their eyes at you. Look at her. We got serious issues here, and she's here in a leprechaun outfit, so I don't know. Obviously, I think you should instill as much fun as you can into everything that we do, especially if it's serious business. But tell me a little bit more about some of the things that you've done to instill some fun and any pushback that you've gotten and how you've dealt with it.

Stephanie Gedeon:
Great question. So, like I said, we try to do silly rounding, and we celebrate everything. Your patient satisfaction went up. Doesn't mean it's at goal, but it went up. That's hard work. Let's celebrate it. How do you guys want to celebrate? It's always food. Okay. Just everybody loves food. And so food or here. They loved t-shirts, right? So they made a certain milestone. Hey, let's decorate it. Let's you guys design a t-shirt. Let's get you the team t-shirts. Really trying to do that. Nurses week, it is seven days for us, and it is hectic. Like I know many other organizations, the feeling we want people to feel is I'm appreciated. But I also do great work and I also give back. As a nurse, I am a part of healthcare, but I'm not the only part of healthcare and really trying to instill that with giving back during Nurses Week, but really making it fun. I have absolutely had people who didn't know me kind of give a little bit of pushback. I have a candy box outfit I wear for Valentine's Day, and I'm not the only one that dresses up, and there's many of us. I'll talk about the holiday tours that they do here, which is really, really a cool thing that they do here. But I did have one person, and they weren't a nursing. Interesting, that said to me, it must be nice to just walk around and give out candy all day, right? And I just smiled, and I said, it is fun to do that. It makes for a longer day because I still have my job to do. But I do love getting out there and connecting and giving somebody something, some joy that maybe they wouldn't have had before. So it just, it still hit it head-on without making them feel deflated. Really sharing, this is the why. This is the why that we do it, and it's important.

Dr. Renee Thompson:
I have to unpack this a little bit, because I'm sure other people who are listening right now have also been hit with something snarky like that. Oh, must be nice. We're down working our butts off, and you're in a candy. And I look at it, there are two good ways to respond, and one common way that is not a good way to respond, the way you should not respond. And I don't want to should anyone, okay? Because it's natural. It's kind of normal to do this, but we defend ourselves. We get into, oh, well, you know, you don't understand. I have all these other things to do, but I am. And you put yourself on a pedestal, but I am sacrificing. I do not defend yourself. So there's two ways that really work well, and you did one of them. You agreed with them. It is nice. Yeah. It makes for a long day because I still got my work to do. But it is nice, it's fun and this is something I look forward to. Okay. So thank you. You do that. So anytime you can agree with someone agree with them it disarms them. The other approach is you could just use their verbatim comments right back to them. You just said it must be nice spending my days delivering candy. Interesting. And then just walk away like, don't take the bait.

Stephanie Gedeon:
Yeah.

Dr. Renee Thompson:
The bottom line is don't take the bait. But I like your approach best.

Stephanie Gedeon:
It is. Thank you.

Dr. Renee Thompson:
Yeah, it makes for a long day. Oh my gosh. You just gave me a little happy place right now. You know, I have been in organizations where people put stars on other people's lockers. Like, oh, what are we in kindergarten? We have to have stars on our lockers. I always say, you know what the haters are going to hate. I guarantee you want to put a star on their locker. They would have been the first ones complaining. How come I didn't get a star on my locker? Yeah, but more people want to see the leprechaun costume in the candy. More people want to see that. I think, as humans, we're designed to add humor and fun as a way to decompress the seriousness of life, and I love that you're doing that. Tell me with the Easter egg hunt is mentioned.

Stephanie Gedeon:
Oh, yeah. So, each department last year around Easter time, hid eggs all over the place. We put little treats inside of them and some of them had like a card in there that said you won a gift card, so everybody was looking for those.

Dr. Renee Thompson:
Oh yes, those things.

Stephanie Gedeon:
But it really, you know, hey, we can take a minute throughout the course of our day and try to find these. So, each leader kind of did their own thing. But for our nurse leaders, we did various games. So, I know you've heard of Chubby Bunny. We did that that game with them. We're very competitive. So you take, we actually took like the Peeps, and you see how many peeps you can put in your mouth and still say chubby bunny, and people can see. There's no point to that except that we're competitive, right? But we're laughing and having fun together. We had a game called Scrambled Eggs, and in Scrambled Eggs, we had all of these Easter eggs, the plastic ones, but they were connected to the wrong colors, and they had to pair up, and each one had to wear an oven mitt, and disconnect the ones and put them together with ones that matched to see how many they could do in teams, right? so that was a little bit of a team building slash. Let's just have fun and be competitive. And we had like little prizes with that. But again, it's like, yes, we can do business 10 out of 12 months. In 2 months, we can have fun. It's, I think, really helped our work environment and to see each other as people that enjoy the same things.

Dr. Renee Thompson:
Well, and when you look at just the science behind all of this, is that when you laugh, you release all those feel-good chemicals, okay? And we look at stress burnout. It's because we're all hanging out with this incredibly high level of cortisol, like we're always waiting for the saber-toothed tiger to turn the corner and try to eat us. So it's constant high cortisol. And that is truly the root of all evil is, you know, this constant cortisol. Well, studies show that when you laugh, it reduces cortisol. And guess what? It's free. Laughing is free. … before, and I do this in some of my keynotes where I talk about laughter, yoga, and, you know, laughter yoga. There are really no yoga poses, but you just, you know, force yourself to laugh. And when I was first asked to do this, I was like, what the heck is this? Like laughter. Yeah, I was going to speak that day, and they wanted me to do a laughter yoga session. I'm like, we're in a stadium, stadium-style seats. I don't see any yoga mats. I'm in a dress. I'm thinking, how am I going to do downward dog? Okay, all these people. And that's when I learned there were no true yoga poses. It's just laughter. And it's based on the premise that when you laugh, it doesn't even matter if you're laughing for real or laughing for fake. You still receive the benefits of all those feel-good chemicals, and you reduce cortisol. And I'll tell you what, an hour of that I felt good, I wasn't stressed, I was calm. And so we know this works. And so some of you who are listening right now, again, you may be not someone who likes to have fun and play games, but your people do. And I love that you're intentional about this, and I am absolutely going to share the whole Easter egg thing and maybe the chubby bunny. Maybe we can do that at a retreat. Yes, we could do so. Yeah, my team members are listening. We're doing Chubby Bunny next time you guys come in. All right. In the time that we have, I do want to shift a little bit and talk about your journey to pathways to excellence and workplace violence. Can you just maybe give our listeners or the people who are watching just a few key strategies that are helping you to really create a safe work environment for your people under that umbrella of pathways?

Stephanie Gedeon:
Absolutely. As you know, pathway, one of their standards is safety. It's all about safety. It's, and it's workplace safety around peer to peer. But it's also about patients and families. This, over the last 18 months, we have really focused a lot around that second category. We had a team member in our ICU that said, hey, I really think we need to look at this tool, and it's called the DASA. It's the dynamic appraisal of situational aggression, and it's designed and evidence based and behavioral health population well used across the nation, and we took her advice. We looked at it, and we have implemented it in our inpatient areas. And so really what this has done is, has helped us try to prevent workplace violence events. We might not have realized because we didn't pick up on the signs. And so our nursing staff are screening them twice a day. I have asked them several times, hey, don't you guys just want to do this once a day, once on the mission and then at PRN and transfer? And they're like, no, it doesn't take any time. So they want to continue to have that added documentation because they see such value in it. It does signal for myself, other people, including security, all other leaders who lead these departments to know who is on our radar, that we need to make sure that our team members are safe and we have tools in place for them to say, okay, this person screened, hi, I need to make sure that these measures are in place. If those measures are not sufficient, any one of them at any time of the day or night can ask, hey, I need a safety care conference because I don't feel like all of these measures are sufficient, and we need to think about something different. And even at 2:00 in the morning, we will pull up a safety care conference virtually and go through the case and allocate resources if they need security presence 24/7, that's what they get. We just make it happen. We're not perfect at it yet, but we are continuing to really work on this journey. We have outpatient clinics, and a home health hospice, and what's called care home medical that delivers DME equipment. And those are our next areas that we're going to implement this tool with key strategies that will work in their environments. So I would say if that was the biggest thing that we've done over the last year, that has been impactful and it came from a nurse.

Dr. Renee Thompson:
So, can you say the name of that assessment again? And then I'm going to want to make sure we put this in the show notes, too, because I know I wrote DA. That was it.

Stephanie Gedeon:
D A S A.

Dr. Renee Thompson:
D A S A.

Stephanie Gedeon:
DASA, it stands for dynamic appraisal of situational aggression.

Dr. Renee Thompson:
Wow.

Stephanie Gedeon:
It's seven questions.

Dr. Renee Thompson:
Seven? That's it?

Stephanie Gedeon:
That's it.

Dr. Renee Thompson:
Not 27.

Stephanie Gedeon:
Yes.

Dr. Renee Thompson:
I always say you have to make it simple. Because if you don't make it simple, nobody's going to use it, even though it's a great tool. I was honored to be a moderator at a virtual event that AONL did on workplace violence, and we talked a lot about what other organizations are doing under that umbrella of workplace violence and how they're trying to keep their people safe. I've not heard of DASA. And so that's interesting that that wasn't even brought up, but they recently just published a white paper based on that event, and so I'll also put that in the show notes. Stephanie, you're just reminding all of us that there's a lot of great work being done in organizations all over the country to keep our team members safe. And so I want to thank you for the work that you've done. As we start wrapping up, somebody listening and, you know, we've talked about a lot of different things protecting time for your leaders to be accessible to their people. We've talked about infusing font, and now we've talked a little bit about workplace violence, being a little proactive, and identifying those patients who might be on their way to becoming violent. If somebody's listening and they really want to start on their path to a healthy work culture, I don't know. Is there a tip or something that you could share that would help them to get started?

Stephanie Gedeon:
I think the best way, my biggest tip that I would say is, find a framework that works for you. A pathway to excellence, that's what helped us. I mean, it really making sure that we have all of the things in place that matter to the front lines. That's what worked really for us. But the IHI has a great tool called, it has to do with joy. I'm escaping.

Dr. Renee Thompson:
I know exactly what you're talking about. I'll add that to the show notes, too.

Stephanie Gedeon:
Yeah, and I think that that is also a really great tool Magnet, ACN, Renee, you probably have a framework. If you don't…

Dr. Renee Thompson:
… have a framework?

Dr. Renee Thompson:
We do have it. You're talking, and I'm thinking we built this framework and it just happened organically. And I was thinking, I need to do more promoting this framework because it is a framework for a healthy work culture. All right. Put that on my list.

Stephanie Gedeon:
Yeah.

Dr. Renee Thompson:
Our website, we use it with all of our consulting, but we don't always articulate it in that way. But yeah, thank you for that.

Stephanie Gedeon:
I think if you, you know, give yourself a roadmap. But I think you have to do it with heart because if you don't genuinely care about your teams, it's not going to feel genuine, and you're not going to get the outcomes that you want. So you have to say, this is what why did you go into healthcare and to begin with. Yeah. Remember that purpose. Remember that passion and drive that framework with all your might with 100% of that, and it will shine through. And people want to feel cared about.

Dr. Renee Thompson:
Yes, they do, and I love this because I love a good framework. I am one of those people that, if I have to start working on something, I want a framework to kind of guide me. And I've been meeting with the same. I have a business coach. I've been with him now for about two and a half years. Anytime I'm struggling with something, I'll say, I'm going to talk to David about this because I know he'll give me a framework for it. I should actually catalog all the frameworks, like I have a delegation framework, I have a how to hand something off to someone else framework. I've got all these frameworks. Frameworks I think are an excellent starting place. And pathways has an excellent framework. So does AMCC. So does, like, so do we. And I'll actually put our framework in the show notes. But none of that matters if you don't start with the heart. You can have the most beautifully articulated framework and strategic plan. But if you don't truly, and this sounds really awful to say out loud, but if you don't care about your people, none of those frameworks are going to work. None of them are going to stick. And actually, if you don't really care about people, healthcare is probably not the best place for you to be. So I just, I cannot thank you enough, Stephanie, for sharing your journey, what you're doing at Augusta Health. And I also, I have to put in a little plug. I wasn't planning on doing this, but I have to. There's somebody on your team, Erica Grant, who has just been a great colleague of mine, and I consider her a friend. I spoke at a conference. I think it was. I don't know if it was the VNA or UVA. They were back to back, and they have very similar initials. But she gave me a little gift, and here it is. If you're watching this, it's called. But if not, I will describe it. It's a little crocheted potato and it says positive potato. I may be a tiny potato, but I believe in you. Go do your thing. Let me just tell you this thing. This little potato. I keep it on my desk, and I look at it. The moments that I'm really struggling. Like everybody needs a positive potato in their life, and this is somebody on your team, and I just. I can't thank her enough. My whole team knows I have my little girls, like, get the potato, get the potato if they know I'm having a rough time. So you have really good people at Augusta. Really good. So thank you for being here. I appreciate the time that you spent with us. I also want to thank all of our listeners. And if you're watching this, thank you for carving out time out of your day. And, Stephanie, if people want to connect with you, what would be the best way to do that?

Stephanie Gedeon:
My LinkedIn profile is probably the best way. The easiest way.

Dr. Renee Thompson:
Yeah. We'll have Stephanie's LinkedIn profile in the show notes, along with all the other resources that I mentioned during this call today. And again, thank you all for being here. If you really like this podcast, please, please, please, can you post a review, or a review campaign right now? If you could rate the podcast and then share it with others who might need to hear this today. Again, thanks everyone for being here. Take care. We'll see you next time.

Dr. Renee Thompson:
Thank you for listening to Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. If you found this podcast helpful, we invite you to click the subscribe button and tune in every week. For more information about our show and how we work with healthcare organizations to cultivate and sustain a healthy work culture free from bullying and incivility, visit us at HealthyWorkforceInstitute.com. Until our next cup of coffee, be kind, take care, and stay connected.

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