Janet Holliday, DD, MSM, MSN: Empowering the Healthcare Workforce with Self-Leadership, Self-Gove...

Thank you for joining me for another episode of the Nursing Strategies for Success podcast with this week's guest, Janet Holliday. Janet is an experienced inspirational leader, coach, author, and speaker with over 30 years of nursing educator and leadership experience, where she has dedicated her career to collaborating with healthcare professionals and individuals who are ready to live a life they love and to be able to provide excellent care and services for themselves and others. To Janet, a treasure hunt is finding solutions to problems using unity and commitment. So let's welcome Janet to the show. Welcome to the Nursing Strategies for Success podcast, brought to you by The Nurse Speak, a show where we rally some of our nation's greatest nurse leaders educators, experts, and advocates to tackle some of our greatest challenges that the nursing profession faces. My name is Damion Jenkins, and I'm your host for this show. So sit back, relax, and get ready to learn that nurses can do anything. Okay, Janet, thank you so much for being on the Nursing Strategies for Success podcast. Why don't you take just a moment for the listeners and introduce yourself? Let them know a little bit about where you started in nursing and where you are today.

Well, hi, Damion, and thank you so much for having me as your guest. It means a lot to me. Now, I started nursing many, many moons ago is what I say. I started out as an LPN. And worked— did that 5 years and then transitioned over to RN after going back to school.

Okay. And when did you do your LPN to your RN? How long has it been now that you've been a nurse?

Oh my goodness, that's a, that's a lot of math. So I'm just going to say I've been a nurse for over 35 years.

Well, first of all, I have to say thank you so much for your many years of dedication. Um, just 6 months out of nursing school, I almost ran for the hills, so So the fact that you've put in 30-something years is a true testament to your dedication. So thank you for that. And so just, you know, tell, tell the listeners a little bit about the different areas that you worked in. You've covered a lot of ground in that many years as a nurse. So kind of run us through just briefly, what is the trajectory of your nursing career? How does that look?

Well, I started out, like I said, as an LPN, and that was in med-surg. Med-surg is where I grew up in nursing. And then after that, I left the hospital and did some community health, worked in public health, and also did a little bit of legal nurse consulting. That was fun.

Oh, wow.

And then I, um, we moved to Europe and I was there for a while after finishing RN school with 1 year of experience. So I worked on pediatrics and I also worked as a school nurse. Wow. During our 4 years in Germany. And then we came back to the States. I worked, I worked on a medical unit. And there were a certain amount of telemetry beds then. That was before— was a whole telemetry unit, if that tells you anything. Yeah. And then, um, and then I went and did some other things along the way. I did some— started, branched out into administration. I was an infection control nurse and the education coordinator for 2 hospitals. And then from that point, I found out— I found what I really enjoyed doing in nursing, and I, I worked closer with the leaders in nursing. So that made me want to branch out into nursing leadership. And then I worked ortho for a while, and, and then my most recent experience has been in senior care, working in long-term care, uh, rehab, and assisted living facilities.

Okay, awesome. And then how many years out of all of these decades of nursing have you kind of hung out in the leadership space?

I say in leadership administration, I say 20 years.

Okay, so yeah, so you knew pretty early into your career, you know, when we look back on things, 20 years you wanted to be in a leadership position. And, you know, you and I talked when we were in Hawaii at the Nurses Making Waves retreat, and I remember you saying very vividly that my trajectory in my career sounds a lot like yours. And that makes me really— that makes me really proud because I do want to follow in excellence footsteps, and I want to be able to use my skills to lead. Um, and in the current facility I'm in now, I'm able to, you know, really lend them all the skills and experience I've learned over the years, and we're going to make tremendous impact in such a large facility in our community, and it makes me very proud. So awesome. All right, well, the, the topic of this podcast is strategies for success in nursing, right? So You know, in order for us to identify the strategies, we first have to identify what's the problem, like what's the issue, right? Yes, challenge. So what is it for you, out of all of the years of experience that you have, what is the one thing that you really felt passionate about that you identified as a problem? What is that thing?

Well, you know, for many years I thought it was related more to quality improvement when I answered that question. But today, looking back, the one thing I would say is the importance of every nurse understanding what self-leadership is. Because if you're not leading yourself, you shouldn't be leading anyone else.

Can you say that again for the people in the back, please?

If you're not leading yourself, you should not be leading anyone else.

Absolutely.

The best leader is a self-awareness leader.

Yes.

In order to be a self-awareness leader, you have to know who you are from the inside out, not from the outside in.

Wow, that makes so much sense, you know. And even, even going back to when I was just a new grad nurse and I was frustrated with all of the, the situation that was back then in 2010, which doesn't even seem that long ago, um, I thought to myself, wow, a lot of these highly skilled individuals have zero skill when it comes to self-governance, right? And I'm like, yes, what they're saying, how they're saying something, how they're acting, in which way, you know, they're, you know, just allowing profanities to come out of their mouth, or really aggressive or offensive body language. They're basically shrugging their shoulders and saying, I don't care. And I'm thinking, huh? So confused how, you know, individuals can go through all of this training. It's a tremendous amount of training to be a nurse, even if you're not quite at a nursing level, LPN or RN, even a nursing assistant. It's a lot of training and a lot of responsibility. And that self-awareness and self-leadership is so important. So yes, self-governance. I think it's all related. It's in its own kind of bubble. So give me some examples of the challenges that you saw when you were identifying that people just didn't have that skill set.

Well, I have to share that I worked— I was a Magnet coordinator in a large hospital, and that was my first experience in really understanding what leadership at the bedside should look like. Yeah. You know, the role models were there, the, the senior leadership was there, everything was aligned to improve, but it wasn't starting from ground zero, right? But what brought it to my attention was you could tell the people who were on board to change the culture, and you could tell those who were not on board, right? So the— when I sat at a meeting in listen to the senior leaders talk about, well, what are we going to do to change this? They drew a diagram, and the goal was to go from a little bit of communication to rich communication. And then we discussed how we're going to get from point A to point B. But for me personally, I had to go out amongst the nursing team, and I was the messenger basically to help execute the change. I learned so much about myself. Right. So I had, I had some, I had some growth growing up to do, basically, that growth spurt. I feel like I was a piece of bamboo almost, you know.

Bamboo grows real slow, and it was growing slow and bending very deeply in the wind.

Very deeply, yes. So I learned a lot about, uh, self-governance also during that time period and the importance of me as a nurse, being professional, not just in, in authentically being professional, being professional from the inside out. And I learned that it was really important that what my responsibilities are to my profession and to myself as a nurse— I'm responsible for my, my nursing practice. Yes. I'm responsible for my nursing competency. Yes, I'm responsible for the quality of care that I give someone else. Yes. Then when I decided to cross over into leadership, I understood better about the qualities of a competency that I needed as a leader, right? I had to make sure I— we had this— had the resources we need in place for my department or my, my area. And it was, you know, your human, your human resources, right? Do we have enough people here to give care?

Right.

And am I adding value to the people who are here?

Right.

Am I elevating them or am I pulling them down? And there were times when, you know, when I had a hiccup, and that's when you say as a leader you go back and you, you apologize for that, right? That was not my intent. And then there's, you know, material resources and electronic— there's a whole list that the, that the leadership team is responsible for.

Right.

But when the person at the bedside understands, or the nurse, I'm responsible for these things, that's what I take ownership. Yeah. Then we see better quality of care.

And that is so true. And I've seen it time and time again in some of the best-staffed facilities that I've worked in with the staffing ratios and not really having a big issue with absenteeism or tardiness. And I've also seen it in the facilities that have bare-bones staffing because they are in a crisis. And maybe they had a hiccup in leadership or a transition in ownership. And things change. And a bunch of people abandon ship even, right? And just after COVID, a lot of people left and didn't want to come back to the clinical space because of how traumatic that whole situation was. But it doesn't matter how many people are in the building. If they all govern themselves and have self-awareness and have that self-leadership like you're just discussing, um, every person that I speak to, they may say, hey, we're really tired of being short. But those individuals that have that self-leadership, they take the initiative to do their very best, and when they can't do their best, they let us know. So then it's our, it's our responsibility as leaders at that point to then help them pick up the pieces and fill in those gaps and not be punitive and say, well, you should have done better, you should have done more, you should have duplicated your body into 4 people so you could have gotten it done, right?

Because I'm going home, see you later, right?

And it's 4:30 and I'm going home and you have to be here until midnight. So yeah, so, you know, just the other night I I got an— I was doing competencies and I'm covering all shifts to make sure that I'm getting all the staff and giving them plenty of opportunity. And I get a message that we're down many nurses and there's only one house supervisor. One of the other house supervisors called out and it's like 11 o'clock and I'm like, there's no way I can go home in good conscience and leave the team hanging. So I jumped on the floors. I first went and met with the supervisor, then I went on the floors and I did as much work as I could until 4 o'clock in the morning when exhaustion just took me over and everyone's needs were met and everyone was satisfied with where they were in the process. And sometimes that's what happens, right? Whether we're in a leadership position or not.

I mean, and it helps to take that side.

Yeah, many times at the bedside I wasn't the leader. I was— and what we— what I say people to never say about themselves— I was just a nurse, right? Just a bedside, right?

There's a nice poem called Just a Nurse. I need I'm just saying that to you. It's a really good point.

Yeah, I think I read it before.

Okay.

But I always tell people, you know, don't use the just stop. But when I was at the bedside and I didn't have a supervisory title, I remember many times having to take one for the team, right? I didn't have relief, so I had to stay over. Or I saw my colleagues drowning and I ran over to help them when I was caught up and I had a minute to breathe. So, you know, all of this is part of what you're getting to is that self-leadership, right?

That's true.

Um, so I'm, I'm, I'm guessing at this point you just saw a tremendous lack of that in the general sense of things. Um, it's not anything new, and we know this branches off into many other issues if we wanted to kind of fine-tune different issues. And it covers things like bullying, right? It covers things like workplace incivility, um, lateral violence, right? A lot of these types of things we deal with as nurses, um, because individuals lack those skills to self-govern, to self-lead, to be proficient and be very proud of their scope and always practice to the highest of their scope, which has always been one of my concerns with the profession as a whole is because I feel like we spend a lot of time focusing on these behaviors rather than some of the more advanced things that we need to do, like restructuring our payment model, you know, or decreasing comorbidities, or maybe moving into the 21st century and streamlining all of our technologies in our organizations, which I feel are much more pressing concerns but we spend a lot of time and energy on helping others find the way to self-lead, right?

Right.

So, Janet, right, you must have— you must have the magic formula, right? You must have at least a few strategies to help us get to that point, to help on an individual basis or even on an organizational basis. So share with the listeners, what are some things that you've seen or that you're doing to help individuals find that self-leadership so that we can improve our teams and outcomes?

Well, actually, I love that question. I, on Thursday next week, I have a virtual training and it's on the power of self-leadership.

Awesome.

But just to give you a snapshot of that, I'm going to discuss with, with the attendees, of the attendees, how to, how to really understand your values first. Because the values are— values are our foundation. And a lot of times we get, um, have anxiety, we're overwhelmed, we have a lot of things going on, but we don't focus on the— in our internal self, right? Where our social, our social and emotional intelligence is under fire. We don't, we don't look at that piece because they're trying to put out fires and run around, right? So that's one part that would help someone, just, just make a, a list of what you value, what's important to you in your life, what will you stand, what do you stand for. And then if your list is really long, just if you can get it down to 3 things, that'd be great. Because, you know, there's a lot of things that I value, but I want to focus on those 3 key things— that's important to me. So when I'm around other nurses, other coworkers, other leaders, I want to know, what do you value in your life? To see how it all aligns. And then I'm going to focus on mindset. I'm going to discuss some things with them about how to really look at 3 shifts that will change your mindset.

Right. Well, that sounds— really helpful, right, on an individual basis. And you said you're going to be hosting, um, this on this coming Thursday?

Yes, it is going to be on, uh, it's virtually on Zoom. I have it on Eventbrite. Okay, people can register, um, register that way.

Make sure I have that link and I could put it in the notes of this episode. Um, in fact, this episode is going to go live tomorrow. So it will be Friday by the time listeners are hearing this recording. Today's Thursday, so you'll go live on Friday the 17th. So just send me that link over and I'll make sure it's in the show notes so anyone interested can sign up for that. And then on an organizational level, how are you helping leaders in those spaces help to transform this culture? Because, you know, that is a big problem we have. Some really amazing clinicians who dedicated years and years of service, but they're just burnt. Their attitudes are poor. They don't want to do any additional effort to change, um, or to work on the situation. Or maybe we're relying on a lot of outside staff, like from agencies, and they have zero interest in, um, joining the team or, or kind of redesigning their attitudes or the way they carry themselves. What kind of tools do you have for us?

And that's a very good question because every— I believe there's a core to all of this, but everyone is different in how they approach it. And just from experience, just to get around the table and really just get it all out. What— identifying what, what are— what's our stumbling block? What's this? What's this? What's the— how big is our gap here? And then once that's all there on the table, so to speak, then we can look at the next step. And that next step is looking at what model do we need to use to really bring— to close the gap, bring the bridge together, and understand that it's not going to happen overnight.

Right.

And being willing to have that commitment to put the energy into it and the finances for it to happen, because we're talking at a leadership level. We're not talking about the best, at least with the bedside, we're talking about those people who are the decision makers, who are deciding what would the new model of care look like? Because I really believe that the future of healthcare is a different model than what we've seen in the past.

Sure. Absolutely.

The whole world around us is changing. As a leader in nursing, it was rocky and hard for me to get in, to break into that, that part of nursing. But what helped me the most was when I stepped outside of healthcare to get my leadership experience and knowledge, right? Then I put that with my nursing experience and knowledge, and, and it was like, oh my goodness, this is the missing link. This is, this is what we need to do in healthcare. I find myself saying that still all the time. How can we approach things in a different way? I have a beautiful program called— I didn't develop it, but I had an opportunity to learn about the Working Genius and what that means, right? And just that and other things that we can do to help people self-identify. But we, we take people through programs to help them self-identify, but then we take them through a program to help them self- resolve it, right? What is the resolution to this? Because no matter what, if every— if, if we all look inside ourselves and know that the answer is there, we just need to pull it out. And sometimes we need someone to help us pull that out, right? And then, and, and redesign and remodel. But at the same time, one thing I learned from the Magnet experience, Magnet experience, is making sure you have— making sure you have a well representation of at the table. Yeah, making sure the nurse— a nurse from each area, not just the nurses in the management level or supervisory level or leadership level, but the nurses that are leading at the bedside, because they have the answer.

Absolutely.

They know, they know the problems.

Absolutely. And when they don't feel that management are taking the time to hear those problems or to show up with solutions to those, right? Then they just wind up not saying anything at all, and it winds up turning into a toxic work environment because no one is disclosing the buffoonery that's happening in the facility until a sentinel event occurs, or we have a tremendous staffing crisis, or, you know, people quit, or people protest, or whatever the case may be. We have negative reviews from visitors and family, you know, and maybe even a negative community reputation because everyone talks, right? And agency nurses are like, don't go work at that place, it's terrible. And this— it's a lot of things that can be done to mitigate these negative outcomes. And I definitely have adopted everything that you've said, um, learned through a variety of connections like yourself and learning from you in Hawai'i, and then also just from sheer experience, you know, being there time and time again and seeing what works. And you're right, currently giving people the opportunity to sit at the table and just let it all out and tell us what are the things they're fed up with, what are they willing to, you know, work with us on, and what are the non-negotiables so that way we can make sure that we start moving forward and you know, set realistic expectations. Like, it can't happen overnight, right? We all want to wave our magic wand and boom, fix the situation.

A magic wand.

All of our jobs perfect at that point.

But unfortunately, we don't live in a perfect world. This world we live in, so it's not going to be perfect, and there's no such animal. All right. And if we try something new, what, 90-something percent it's not going to be correct when you roll it out, but it's being big enough to look at it and say, "Huh, let's do something different. What do y'all think?" Because the nurse at the bedside, if you tell them a situation, they're either going to say to you, "Okay," but in their heart of hearts, they know that's not going to work.

Correct.

But they're not going to tell you that information voluntarily.

Correct.

So it's, it's again, it goes back to the values in the heart of the person, right?

I'm giving everyone an opportunity. Yes, their strengths as well, I think is super important. Um, some people are forced into roles that they don't align with and that's not a good fit for them, but they take it on because they fear their, their job or they fear their income. Um, but then we know the quality of work goes down, the relationships go down, they become resentful, and eventually they either burn out completely and leave, or they just are the worst to work with because they're so miserable, right? So, you know, another thing too, you know, always try to make sure that we're putting people in the right positions and, and giving them an opportunity to where if we do see that they're struggling to, to, like you said, self-identify with their values and their strengths and then really support them in moving into the space that's going to be best for the entire team. So, yes, awesome. So, Janet, if people want to connect with you and learn more about the products and services that you offer, how can they find you?

There's several ways, but I'll give you two. Sure. One is I have is through my email address, and it's janetburnsholiday@gmail.com.

Okay.

And I have a couple of websites, but there's one that's just— it's going to link to the other one. That's going to be the janetburnsholiday with two L's dot com.

Okay.

And that will, will be an introduction to what I do. And you can also on my website schedule— feel free to schedule a meeting with me.

Sure.

You can ask questions. We can, we can just kind of have a good discussion about your thoughts, your ideas. And if you have a leadership growth need, how do you, how do you see that unfolding?

Got it. Awesome. So it sounds like you do some high-level consulting for leaders in a variety of settings and organizations. It's not just specifically to healthcare, right? You can help leaders, right?

Right.

Not just healthcare, but your specialty is healthcare. So we all need help there. We all know.

Yes.

Every—

take care of home first—

and physician. We all know we need lots of help there. Um, and I see a book in the background. Uh, let's talk a little bit about your book. What you got there?

Okay, this book is my first solo book. Is— I don't think it's—

so you won't be able to see, but it's a picture of Janet at the top, and the bottom is in red. And what's the title of the book?

Wrapping Paper: Leadership Gifts to Share with Novice and Aspiring Leaders.

It is.

So that's one. And then, and then I have to share this other one with you.

Oh, you got another one back there? I didn't even see that one.

This is one that was a book collaboration that was— was 22 nurses wrote this book, and it's called Letters to a Future Nurse. We each wrote a chapter, and what's exciting is that Dr. Jean Watson wrote the foreword, and you know, she's a theorist. It's really, really great.

And Leah—

I have to give Leah Parker kudos for this— she's the one that put this all together. And thanks to her, her know-how, her dedication, within 4 weeks this book was an international bestseller.

Wow. And I'm sure it's impacted so many people.

Yes. I have had tears.

I think I want a copy for my bookshelf in the, um, educators' classroom is where I said.

Oh, that's a good idea.

Yeah, because I'm the director of education, and so whenever we have any of these issues, you know, like, you know, this— the manager might come to me and say, hey, I have this, this staff member who is just being non-compliant or attitudinal or dismissive or disrespectful. Or they keep making the same mistakes and I don't know what to do. Of course, I, I just always come from a place of I give them the benefit of the doubt. Maybe they just never were told or shown the right way. Maybe they just weren't held to a high standard before. Maybe they didn't have anyone to roll out or demonstrate those behaviors, those skills, or, you know, the process of documenting whatever the mistake or behavior may be. And then I come from a place of, I bet you just didn't have these tools, so let me give you these tools and have you return demonstrate, and we'll, we'll sign that you understand and we've done this. And then moving forward, then if— then, then the person has a choice at that point. They could either demonstrate and continue those skills and behaviors, or they could choose to not. And then at that point, you know, very clearly as leaders, it's a It's an intentional decision to be non-compliant. And at that point, we can move forward with determining if they're no longer a fit for that role. Right? So I like that.

I like that.

I never come from a point of punitive or assumptive reaction. You know, so many times I'll see supervisors just go up and start yelling, why didn't you do this? You should know. Do they really know? Right? Can you be—

that model just doesn't work, right?

Can you be certain that they actually were trained on that? I know for a fact there's plenty of things in my training that I didn't get privy to that other people did. Um, so if someone came up to me and just started telling me, you've been a nurse for 13 years, you should know better, I might get highly offended and not want to work there anymore. And this is what's happening. Right, this is one of the many, many things, right?

No, you made me think of something. We talk about self-leadership, there's also self-accountability.

Correct, absolutely, self-accountability. And so that's where we come from. I come from a place of no assumptions. I'm not going to make any assumptions about you, and I will educate and role model and mentor and support. And then if you continue to still do opposite of what you've been taught or demonstrated, then at that point, again, we have to make decisions. Some people just don't want to do the work, and we have to figure out who those people are and put them in different roles, like let them go or put them in a different role altogether.

Yes, that's true.

All right, Janet, so thank you so much for sharing with all of us this self-leadership talk, self-governance, self-accountability Right, being aware of your own values. All of these are such powerful tools to not only create leaders at a high executive level, but to lead yourself on a day-to-day basis, right? Because if we don't have those skills, and if we're not in touch with ourselves to be able to facilitate our own reality, right, then we will be in chaos. We will always be stressed out. We will be resentful. We will focus on the negative. And there's too many wonderful things in this world to be focused on.

Oh, many, so many.

Awesome. So thank you so much for being on the Nursing Strategies for Success podcast. I can't wait to hang out with you again, um, and take care. We'll talk soon.

Thank you, Damion, so much.

My pleasure.

Thank you. Take care.

And that concludes episode 4 of season 3 of the Nursing Strategies for Success Podcast with this week's guest, Janet Holliday. As always, we hope that everything that we shared in today's episode will help to inspire you and enable you with the tools that you need to lead the charge and find the nursing career that you deserve. All of the ways that you can get in touch with Janet will be in the show of this episode. And as always, if you have any questions about anything we covered, feel free to reach out to me at thenursespeak.com/contact. I would love to have a conversation with you. So until next episode, take care, be well, and remember that nurses can do anything.