Portal de Periódicos da CAPES

Kathy Douglas, RN, MHA

2014; Elsevier BV; Volume: 12; Issue: 4 Linguagem: Inglês

10.1016/j.mnl.2014.05.006

1541-4620

Nancy M. Valentine,

Human Resource and Talent Management

Every Nurse Leader cover brings us face to face with a nurse leader who we want to get to know better, and a colleague from whom we have the opportunity to learn a new perspective. Kathy Douglas, RN, MHA, has had a different career trajectory than many nurse leaders working in hospitals and healthcare systems, so providing us with her insights into alternative leadership pathways is an important viewpoint for others to appreciate. Kathy is an entrepreneur, nurse executive, and film maker. Let's start at the beginning of how this all unfolded. Every Nurse Leader cover brings us face to face with a nurse leader who we want to get to know better, and a colleague from whom we have the opportunity to learn a new perspective. Kathy Douglas, RN, MHA, has had a different career trajectory than many nurse leaders working in hospitals and healthcare systems, so providing us with her insights into alternative leadership pathways is an important viewpoint for others to appreciate. Kathy is an entrepreneur, nurse executive, and film maker. Let's start at the beginning of how this all unfolded. NMV: We often wonder about each other —how did we get into the field of nursing and how did we get launched? What attracted you to nursing, and what were your early experiences in getting started in the field? KD: My mother died when I was 10 after a long struggle with illness and that experience made a deep impression on me that I am sure had some influence in drawing me to nursing; it most certainly established in me a strong desire to help people who are struggling or suffering. When I was 18, I got a job as a housekeeper at a hospital in California, and while cleaning patient rooms, I observed patient—nurse situations, and something inside of me said I just had to be a part of that. I had a thirst for understanding and was drawn to the work. I had no specific guidance or understanding of the nursing profession, so as a first step, I went to the local junior college and become a CNA [certified nursing assistant]. On my first job, I was fortunate to have a charge nurse, Brenda Williams, who was very inspiring. She had just returned from Viet Nam, and I was in awe of her calmness and professionalism, especially in very difficult situations. Noticing the rapport I established with patients, she took me under her wing and encouraged me to become an LVN [licensed vocational nurse], which I did. She felt I belonged at the bedside, and at that time, RNs [registered nurses] were often team leading and spent a lot of time at the desk, so she thought the LVN role would be right for me. But after some experience, I recognized the limitations and returned to school to become an RN. NMV: Much of our foundation as professionals is influenced by our early mentors and role models. What was your experience, and how did this shape who you are today? KD: Interestingly, if I had listened to one of my early nursing instructors, I would not be a nurse today. I was told I would not make a good nurse because I did not respect authority. For example, I questioned why I needed to give up my chair when a physician entered the nursing station or why we needed to wear caps in the ICU [intensive care unit] when they kept getting caught in lines. I was not actively defiant, but I did and continue to have a veracious curiosity and question things that don't make sense to me. I have always been one to ask “why” a lot, and that can be misunderstood.. I offer this example to point out how difficult it can be to have a different point of view. In this case, she wanted me to think the way she thought and acted, and I did not want to. Sometimes our best teachers are those who model for us ways we don't want to embrace. I learned from such encounters that individual thinking and narrow views can impede progress. As leaders, we need to be mindful about this, not throwing up similar barriers to our young leaders, but rather be open to listening to their views, new ideas, and encourage their curiosity and creativity. Just as some early experiences showed me what I did not want to be, what does inspire me is to be constantly alert to improving my listening skills, absorbing information and learning from colleagues, patients, families, and even strangers who do great acts of courage. I learn from them every day. For example, I recently visited Glide Memorial Church in San Francisco and observed firsthand the courageous work the nurses are doing on behalf of impoverished people. And I also recognize and want to honor the courage of the homeless people themselves who are making their way through their own challenging situations; it is both humbling and inspiring. NMV: In addition to professional role models, who in your family would you identify as influencers? KD: Well, certainly my mother who was so brave in her battle with cancer. My maternal grandmother, who we spent a lot of time with after my mother died, was very pivotal to my development as she was not your usual stay-at-home grandmother. She was a dynamic, sophisticated businesswoman long before it was fashionable. As an international buyer of lingerie for a major department store, she would be flying off to New York or Paris. I saw her as an exciting figure I wanted to emulate. My brother has also been a huge inspiration to me. He was born with a physical disability. I have watched throughout his life how he has never let that stop him from accomplishing great things. Also my father taught us sailing, and I think those experiences developed strong observation skills and an appreciation for how small changes can have a big impact on outcomes. Racing with my father and brothers, I would see how little adjustments to the sail would make the boat go faster. This carried over to nursing as we are trained observers to see how even small changes can be critical to getting better outcomes, providing comfort, or saving a life. NMV: As you progressed in your clinical work, what were other key decisions early on? KD: As I got more experience, I took a different path., I was drawn to the business side of healthcare and therefore got bachelor and master's degrees in health administration. I wanted to know more than just the nursing perspective—maybe it was the entrepreneurial spirit in me that eventually led me to Stanford business school to understand business leadership. All this education was over a 15 year period, largely due to being a young mother of 2 beautiful children. I often reflect on my start in healthcare as a housekeeper and am grateful for all the different roles I have experienced. They have given me perspective and appreciation for what everyone does on the team. I see the potential in everyone, no matter their role, and how they can contribute. NMV: What was that decisive moment when you started to combine informatics with your work, and how did you find the signposts to pursue the path to taking leadership roles as an early pioneer in nursing IT? KD: I was working as a manager in the ICU and got involved with implementing a new lab system. What I saw in that first experience was frustrating since the computerized system was actually making the job of the nurses harder, not easier, and the last thing the nurses in the ICU needed was more to do. From that experience, I decided that I had to help make this better. This was in the late 1980s, still the early days of the Mac, and I was an early adopter with natural affinity for computer skills. In fact, my husband and I started a desktop publishing business because the Mac was so simple to master and use in creative ways. The striking contrast between the user friendly computing experience with the Mac and the systems in the hospital told me we could do better in healthcare. In the same time frame, my brother, a PhD in quantum electronics, introduced me to a software engineer who was working with 3 physicians developing one of the early electronic patient records. Shortly after we met, I was invited into that tight circle of EMR pioneers. The company, Oceania, brought the first graphical user interface EMR to market in early 1990s on the NEXT computer platform. Joining Oceania allowed me to bring the nurses' perspective to software design—so it would match the needs of the nurse. I got the opportunity to discover a new way of working with technology. This was before Windows, and it was exciting to be on the ground floor taking ideas and translating them to a new reality. We changed the world of how clinicians would use technology and grew the company from 7 to over 200 people before the company was acquired around 1999. That experience created a passion in me for working with progressive, innovative teams. I have since been involved in several startup companies and love working on the next new thing. NMV: Tell us about your experiences as a filmmaker. KD: I actually made my first film at Oceania, where I directed a movie about the company, its' founders, and the story of our evolution. After that experience, I only dabbled in film making until 2009, when I was inspired by a desire to share with nurses, some of the wisdom I enjoyed through my community in Sedona, Arizona, about the importance of self-care. I created the film The Song Within Sedona. The week after that film was screened at the Sedona Film Festival, I was diagnosed for the second time with cancer. Filmmaking went on hold during treatment. But I thought a lot about nursing during that time and when I began to get my energy back, I knew I wanted to make a film that helped people understand nursing and one that I hoped would help bring some recognition to the extraordinary work of nurses, the film NURSES If Florence Could See Us Now was the result. An overview of the goals and purpose as well as how the film was originated and produced is described in an earlier issue of Nurse Leader [“Reflections on NURSES, If Florence Could See Us Now.” 2012; vol. 10, issue 5, pages 57–61]. I am pleased that both of my films are distributed by First Run Features, one of the largest independent film distributors in the country. I am often asked how a nurse becomes a filmmaker, and my answer is simply “the nursing process,” which when embodied, allows us to tackle anything—even if we start out knowing little about how to do something. This has been true in business, filmmaking, and life. If I want to do something, I don't see barriers, I see possibilities and embark on a systematic process of discovery, trying things, constantly evaluating and making course corrections. NMV: Your personal journey indeed has been a courageous one. Do you see a connection between having to survive challenges associated with illness and following unchartered paths with how this has shaped you as a leader? KD: I believe every nurse is courageous. This work is hard. We see and experience some of the most difficult things life can offer up. The question is what do we do with these experiences, how do we process them so they don't become a burden that hardens us but rather become part of the rich patterns of the fabric of our lives. When we face difficult situations, like illness or loss, it brings a personal experiential dimension to our knowledge and that presents the opportunity to deepen our understanding and compassion. NMV: Since you have been successful in leadership roles, describe your specific orientation to leadership in general and perhaps describe your own brand as a leader? KD: To me, leadership is little about title or role. It is really about the personal journey of self-discovery and the willingness to constantly work on one's self in order to deepen one's ability to listen and to take things in so one can form new ideas. It's about big thinking, receptivity to new ideas, and then having the interest, skills, and stamina to translate these into a new reality. And it is about inspiring others to do the same. To me, leadership is not a destination you arrive at, but a place you are always evolving towards. NMV: What is your advice to current and aspiring nurse leaders that you believe will make a difference? KD: •Be mindful. It is critical for each one of us to be confident in the face of change and be open to listen and see the opportunities; to not be limited to thinking only in our current mental models, potentially missing ideas or innovations that could make huge impacts. For example, we have to ask ourselves critical questions such as, are we missing an opportunity to advance our profession by not changing educational curriculums, not trying and testing out new approaches, new roles, not letting go of old models that may no longer serve us? If we are not mindful of how we are functioning in day-to-day leadership practice, we can transmit these limitations to others, which can hold so much back and limit the possibilities of outstanding change and progress.•Be humble. Leaders should not forget their humility. Don't lose touch with who you are and how you got to where you are. Understand your power and scope of influence, and use it wisely. I had the honor of touring a new children's hospital with nurse CEO, Rhonda Anderson. When we crossed paths with staff, patients, or family members, I was struck by how she knew so many of them by name, and when she stopped to speak with them, they got her full, undivided attention—so inspiring!•Stay in touch. Staff notice us. They watch all we do—so do the right thing. On the opposite end of the spectrum from the above example, I heard a story of a CNO who, doing a favor for a friend, went to a nursing unit to check on their family member who had been hospitalized. When the nurses on the unit saw the CNO arrive, they thought they were in trouble, because they had never seen her on their unit before. It is easy for leaders to get lost in all their meetings and decisions, and lose touch with what and who they are leading.•Be “respectively disruptive” in your environment. Some leaders aim to stabilize and stay the course, but I suggest we aspire to change the world and work with others so we all can think bigger—that in itself will grow other people. Step out of the box, be the future you imagine!•Move fast to get out of your comfort zone. We need to constantly refine and reinvent who we are and what we do, otherwise we become stagnant. I believe we are at a tipping point from a system and professional perspective—and the opportunities for nursing are gigantic if we indeed move quickly enough in our thinking, our willingness to let go of the past, and to take action to reinvent and create the future. Hometown:Oakland, California.Current Job:CEO of The Sedona Group, co-founder of Wise Women Circles.Education:ADN, Butte College, MHA, University of San Francisco, Executive Program, Stanford University.First Job in Nursing:Nursing assistant, Desert Hospital, Palm Springs, California.Being in nursing leadership gives me the opportunity to:Inspire innovation and change and to grow as a human being.Most people do not know that I:Won a “Women at the Helm” sailboat race in San Francisco Bay. We were a double-handed team; I was driving with my younger brother as crew.My best advice to aspiring leaders:Always be open to new possibilities.One thing I want to learn:To dance Sevillanas, a festive folk dance of the Seville region of Spain.One word that summarizes me:Grateful. Hometown: Oakland, California. Current Job: CEO of The Sedona Group, co-founder of Wise Women Circles. Education: ADN, Butte College, MHA, University of San Francisco, Executive Program, Stanford University. First Job in Nursing: Nursing assistant, Desert Hospital, Palm Springs, California. Being in nursing leadership gives me the opportunity to: Inspire innovation and change and to grow as a human being. Most people do not know that I: Won a “Women at the Helm” sailboat race in San Francisco Bay. We were a double-handed team; I was driving with my younger brother as crew. My best advice to aspiring leaders: Always be open to new possibilities. One thing I want to learn: To dance Sevillanas, a festive folk dance of the Seville region of Spain. One word that summarizes me: Grateful. NMV: Any parting thoughts and reflections to share? KD: I think, as a profession, we need to strengthen the unification of our vision and our voice both within nursing and across our sphere of influence. We have so much potential, and I think we are our own worst enemy. We need to create a future that puts our collective progress above individual aspirations. We need to be nicer to each other. It is hurting our profession when we make choices that divide, that alienate, that separate and drive talented, creative, and caring people away. This is true from the bedside to the board room. As leaders, we need to embrace and celebrate each other's success, not hold people back or throw up barriers. We can be more open to other perspectives and embrace contributions from nontraditional pathways. As a 2-time cancer survivor, this helps me to remember that life is short—so if we all really tuned into that fact, let me ask—would it change our priorities, would we go after our dreams? Or would we compromise in frustrating situations and put our dreams on hold? I have worked to look at the world through the eyes of gratitude rather than the eyes of judgment. I am not always good at this, but when I am there, it is a beautiful place to be. I know that the cancer can come back at any time, and that reality inspires me in so many ways. I now invest in things that really matter, that can make a difference. I also think that my life experience has led me to believe that being “different” can be good. Instead of being shunned for not being compliant—it is a quality that can be celebrated and nurtured. Where is the next generation of spirited nurses? Who will be the entrepreneurs of the future? How can we nurture their passion? My wish for nurses in the future: Don't hold back, be all that we can be. My hope for my colleagues in leadership roles is not to hold others back but to be the ones who make their success possible. ErratumNurse LeaderVol. 12Issue 5PreviewThe managing editor apologizes for excluding the names of the photographers for the May/June and the July/August issues: Full-Text PDF