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What healthcare leaders need to know now

Managing Stress: Four Key Strategies for Leaders

By | July 7 th,  2021 | executive leadership, leadership traits | Add A Comment



Our lives are undoubtedly busier and more stressful, the result of tremendous uncertainty in our world today. Leaders generate a high degree of emotional and physical stress that leaves them exhausted. However, for leaders to be most effective, they must not only be able to recognize and manage their own stress but be compassionate to the stress of their team as well.

The importance of managing one’s own stress reactions is often overlooked in our fast-paced world, but it must be a priority if you want to excel as an effective leader. Here are five key strategies for leaders that can help manage this stress:


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Our article from
Wharton Healthcare Quarterly explores how empathy is perhaps the most powerful tool a leader has during these dynamic times. Download a copy here.


Identify Stressor Reactions


Stress is often triggered by emotional responses. The limbic brain, which interprets crisis from an angry insult, for example, responds similarly to how ancient people reacted to fear of being chased by a predator.


This response often reveals hidden personality traits that can negatively impact interpersonal communication. Identifying the source of stress and recognizing when these triggers are present is key to managing one's own response.


When faced with stress, the brain's most basic survival needs can get triggered. First we assess the threat and then, if necessary, react with appropriate physical response: Flight, Fight, or Freeze. While these reactions were necessary for survival in more primitive times, they are not conducive to creating a modern work environment that aims to promote teamwork and foster camaraderie.


Being adept at recognizing these reactions and how they present in our modern day-to-day interactions allows leaders to increase their emotional intelligence and effectiveness as a leader.

  • Flight response is characterized by the need to avoid confrontation and often leaves an individual feeling drained, depleted, disinterested in work or other activities. A person displaying this type of reaction will withdraw from their interactions with others as a means of self-protection. This withdrawal can lead to isolation which may be manifested through substance abuse, lack of energy for work tasks, or reduced productivity levels.

  • Fight response is demonstrated through aggression and anger that typically leads to aggressive communication styles such as sarcasm, passive aggressiveness or overt hostility directed at superiors or team members.

  • Freeze response is characterized by a lack of response to stimuli and may be seen in cases where an individual feels overwhelmed. The freeze response is often accompanied by feelings of fear or helplessness.

Left unchecked, the flight, fight, and freeze responses can have significant negative consequences on the individual’s wellbeing and have a negative impact on team culture. It is imperative for leaders to check in with team members to connect and communicate on a regular basis, but during challenging or chaotic times on a more frequent cadence.


Create time and space to recharge


During check-in meetings, leaders should start by acknowledging their own stress levels and then open the discussion to others. They should also provide opportunities for team members to interact with each other on non-work-related topics, which creates deeper interpersonal connections and lowers job anxiety. Additionally, leaders should encourage themselves and their teams to take the time and space to recharge and avoid fatigue.


Building community among team members will lead to resilience. When people are honest and transparent with one another, it creates a vulnerability which builds relationships that offer closeness throughout the recovery process.


Cultivate Psychological Safety


It is important that leaders create an environment that values candor, vulnerability and authenticity in relationships. As you meet with others or work with your team, approachability should be something to consider. It is equally important for leaders to evaluate their own behaviors and moods while inviting trusted advisors into the process as well.


Leaders must be willing to take on tough conversations with a level of empathy, recognizing that it is not easy for others. Creating an environment where people feel safe will help them remain engaged in conflict-promoting discussions that lead to more creative problem solving and accelerates team performance.


Leaders should also create time and space for themselves to recharge and find ways to deal with their own stress the best they can. Pursue active stress relieving activities such as exercise, yoga or meditation and create on-the-job strategies to decrease work pressures.


Demonstrate Empathy


A leader needs to have the courage to acknowledge emotions rather than avoid them. One of the most powerful tools a leader can deploy is to simply listen and validate the experiences of others. “Name it to tame it,” is a phrase coined by author and psychiatrist Dr. Daniel Siegel that best describes why empathy is so impactful.


You can't manage your team unless you are managing yourself first. The key to success is understanding and recognizing the emotional toll that stress takes on us as well as being aware of our own physiological responses in stressful situations. Be attentive to the needs of your team by creating an environment that values candor where employees feel safe enough to share their thoughts openly without fear of repercussions or judgment. In a culture where people feel like they have voice and worth, it's easier for them to be resilient when faced with challenges because they know their opinions matter. Stress reactions will still happen but these steps can help minimize them so you can maintain composure while leading others through tough change.

Servant Leadership: Valuing Relationships over Process

By | May 21 st,  2020 | Leadership Development, executive leadership, authentic leadership, Servant Leadership, Healthcare Leaders | Add A Comment

As we find ourselves working and leading our teams through the COVID-19 crisis, a meaningful quote by leadership expert John Maxwell resonates with us:


“They don’t care how much you know until they know how much you care.”


To us, this quote speaks about “servant leadership.” Servant leadership is the belief that the most effective leaders strive to serve others, including colleagues, direct reports, and employees, rather than accrue power, knowledge, money, or control. Servant leadership disregards title, authority, and hierarchy and, instead, embraces that which serves others so they may become their most effective, valued, and engaged.


The increased stress that everyone experiences in varying degrees stirs up natural and powerful self-protective instincts. In a way, the toilet paper panic buying frenzy of a few weeks ago is a remnant of that primal urge. It makes sense.


But while it is natural to be self-protective, it is just as evident that we are all sharing the experience of this global pandemic. Especially now, servant leaders must set aside their self-serving efforts and serve others.


Knowing the importance of servant leadership and adopting a leadership approach that seeks to help others over ourselves is vital for this time. Allow us to offer three ways that you can demonstrate this style of leadership to engage and serve others.

  • Awareness: Now is an opportune time to be aware of what others are experiencing both professionally and personally. Respect the situations, feelings, strengths, and challenges of those around you. At the same time you must also be aware of the same things about yourself in order to sustain and remain an effective leader.
  • Listening: We all are struggling and need to be heard and understood. Servant leaders listen to understand by allowing more space in the conversation for others, which turns into a wonderful gift. Not only must you hear what is being said, you must notice what’s not being said, including non-verbal cues that play a role in how someone’s message is being conveyed.
  • Empathy: It is important now more than ever to be patient and empathetic toward colleagues who may be experiencing their own considerable stress and fear in their own unique way. Empathy means making room for your colleagues to be themselves. Demonstrating a level of patience for stretched, distracted, and irritated colleagues is vital. Empathize more, judge less.

Take a look around and you’ll recognize how everyone, independent of status or title, is stepping in to serve others, humbly checking that they are all right emotionally and psychologically to engage in the work at hand. Knowing that we are all in this together, imagine what might happen in our personal and professional relationships if we paid less regard to status for a short time and become a servant leader.


We will defeat this virus together. Remember, “They don’t care how much you know until they know how much you care.”


Pam Cipriano: In value-based care, nurses are ready to lead

By | July 14 th,  2015 | care coordination, finance, Pam Cipriano, chief nursing officer, nurses, Blog, nursing, value-based care, American Nurses Association, executive leadership, quality, Top 25 Women in Healthcare | 3 Comments


One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2015.


As the healthcare industry begins to shift to value-based care, Pam Cipriano is utterly convinced that nurses are prepared to lead that transformation in many ways.


“I believe nurses are continuing to be the key providers in this transition of care,” says Cipriano, president of the American Nurses Association, which represents the interests of 3.4 million registered nurses. “Nurses have been the owners of care coordination for decades – they have this skill as a core competency. They tend to be the most holistic members of the team regardless of settings.”


Care coordination, says Cipriano, is a linchpin for quality, and the industry is taking notice of the pivotal role nurses can bring to the entire equation.
“That may come under many different names: care coordinator, case manager, outcomes manager,” she notes. “The major insurance companies have already seen the enormous value of having nurses in these roles.”


In every quality-improvement initiative, it is nurses who play a crucial role in determining if that patient experience will succeed or fail, adds Cipriano, who has served on boards and committees for a variety of respected industry organizations, including the Joint Commission and the National Quality Forum.


“When providers say, ‘We’re going to prevent readmissions, we’re going to prevent hospital-acquired conditions, or we’re going to make sure that people with chronic conditions don’t come back to the emergency room for their care and that they’re taking their medications’ – it’s nurses who are driving all of these activities.”


Cipriano herself has been driving the agenda for the ANA since her election in 2014. Yet she took a non-traditional path to nursing, beginning in a med tech program at a state college in rural Pennsylvania. Dissatisfied, she began looking for a parallel course of study to which she could apply her chemistry and biology courses and ended up at the Hospital of the University of Pennsylvania School of Nursing. She became heavily involved in the National Student Nurses Association and her career took off. She eventually earned a Ph.D. and has served in a variety of leadership and teaching roles for the University of Virginia, including chief clinical officer and chief nursing officer.


Her first year leading the ANA was a whirlwind, including a very visible role as the nation dealt with a number of cases of Ebola.


“What was most important was not only protecting the nurses, but also making sure we played a role in reducing the fear and anxiety of the public,” she says. “There was so much bad information that was being propagated and people were unable to focus on the science in the height of emotion.”


The ANA worked with the AMA, AHA, CDC, HRSA and many nursing associations to provide information and a reasoned response to the situation. Cipriano even did a media tour with Rich Umbdenstock, retiring CEO of the AHA, guesting on numerous morning radio shows across the country to assuage the public’s concerns.


That’s the kind of leadership that many nurses demonstrate, Cipriano shrugs. But she is not sure they receive adequate credit for their executive acumen.


“First and foremost, I believe there is a myth that nurses don’t understand finance, and so I believe there is a bias against placing nurses in positions that would oversee an organization’s financial position and budgets,” she says. “Yet if you think about a typical hospital, over half of the personnel and usually more than half of the budget is under the leadership of the chief nursing officer.”


That’s a lot of responsibility. And so Cipriano admits one of her pet peeves is when chief nursing officers or executives don’t report to the chief executive officer of the organization.


“It is absolutely critical that the chief nursing officer not only report to the highest level executive but also has access to and regular interactions with the governing body of the organization,” she says. “We now have pretty solid data linking outcomes of care and patient satisfaction and engagement scores with direct relationships to not only the nurses but also other employees directly involved in care. So why would you relegate that CNO to a role that is viewed as less important?”


Cipriano says many nurses don’t seek out a CNO role not only because they prefer to manage at the point of care but also because of the politics that can derail a career at that level.


“If you talk to nurse executives across the country, there are many who have left their jobs or been removed from their jobs because they didn’t get along with the CEO or they didn’t go along with the CEO,” she says. “And so, being in a CNO job is really tough work advocating for person-centered care and those who provide that care.”


If you get the impression that Cipriano is a fierce advocate for nurses, you’re right. As she continues her term as ANA president through 2016, she’s also helping nurses adjust to possible shifts in the setting of patient care as it moves from primarily hospitals to all sorts of venues, including the home, along the continuum of care. She’s also testified at briefings on Capitol Hill championing the installation of lifting equipment because nurses and so many others are injured trying to lift patients.


“Nurses are fifth in line among occupations for the most musculoskeletal injuries, ahead of many manufacturing jobs. It’s scary,” she says. “The turnover cost for a nurse can be huge --- it can be over $100,000 for an organization.”


Ultimately, she says, she wants to see nurses recognized by consumers and policy makers as intelligent, highly skilled and resourceful healthcare leaders.
“I want nurses at every level to be recognized as individuals who bring a lot of underrepresented knowledge to the conversation.”


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