Ask the CNO: Wake Forest School of Medicine Doctor of Nursing Practice Edition

(upbeat music) - Welcome to the first Best Nurse podcast, where each month we share information for and about atrium health nurses. - Hello, Carmen, my friend, how are you today? - Hey, Steph, how are you? Long time no see. - I know we went through a spell where we were together a whole lot. No, it's been like a week or so, and I miss you. - Only a week, only a week, only a week. We spent quite a bit of time in Atlanta this year at our ANCC Magnet Conference together. And so, yeah, I think it's been a week since we have come together. So, hello. - Well, I'm really excited for today's show 'cause it's something new we've never done before. - I know, I'm really excited about this. - I think everybody out there listening, you're really gonna enjoy what we have for you today. So, we partnered with the Wake Forest University School of Medicine Doctor of Nursing Practice Program and part of their curriculum includes leadership. And so, we solicited questions around leadership from the students in those programs, and then we have an expert from Advocate Health on today to help you answer those questions. That's pretty cool. - We love it, we love it. And so, that super power leader stuff we have on today is Dr. John Carlo Lau at Drostlose. - Yes, yeah. - Thank you, Dr. Carmen Shah. I'm Dr. Stephanie McDonald. - John Carlo, you've been a wonderful asset to our organization, so I'm just so excited to even just hear what you have to say today to really lean into some of these, I think, really good questions from our students. So, I hope you're ready, we got some good questions. (all laughing) - I'm looking forward to it, I'm hoping to do it justice. - Yeah, I wish I had these questions before I kind of got into leadership, so this is awesome. Well, we'll lean right on into it, John Carlo. And one of the ones that's really sticking out, I think it's very, very important is, we are in this ever-evolving healthcare world, everything is fast paced, lots of acquisitions, mergers, whatever the correct terms are, lots of changes, things going on around us, unknown, embracing the unknown. And so, as a leader, really an executive leader, and thinking about the evolution of nursing leadership and healthcare systems over the next decade, what do you feel like the role of a nurse leader is, and how can they continue to evolve in this new, I would say, era of healthcare? - Well, thank you for that question, Carmen. First off, I just want to do a quick introduction. As Dr. Shaw and McDonald have already mentioned, my name's John Carlo, I do work for Advocate Health, I am the chief nurse executive for our way forest market, or area now. And so, I have the pleasure of leading nine hospital CEOs in that area and our continuing health. But I also, not only that way forest type, but I also have other ties to the School of Medicine and Department of Academic Nursing, because I serve as associate professor for the department. And so, it's truly been an honor being able to straddle both sides, the opportunity to be able to straddle both sides of the practice, and a little bit on the academic side, and be of service to our wonderful organization. So, I'll go back to Carmen's question. So, say that one last part of that question again, Carmen, I want to make sure that I answer it honestly. - That's okay, and thank you for that intro as well. - Yeah, it's really how, you know, thinking about the healthcare landscape, the forever changing evolution of things that are going on around us in healthcare and it's fast paced, it's just different than it was five years ago, 10 years ago, you know, what do you see, or how do you see the role of the nurse leader evolving in that space? And that will really allow them to be, you know, successful, you know, and that's really based on your experience, and what you're saying. - Yeah, and so I often, and I have thought in programs, both academic programs, and just professional organizations, one of the things that I often say is, you don't really need a nurse to run a business. You need someone with an MBA to do that, or a business background, right? But the unique position that nurses bring to the table, who have business acumen, is the ability to straddle both the patient's safety, quality, practice, and the business mindset of it. It's easy to make business decisions, but the lens of the nurse leader, what we bring to the table is we translate what happens at the bedside, the work that is really important to actually help cure people, or help alleviate people's illnesses, the practice of nursing and patient care into the business decisions that we have to make in an organization. You know, at the end of the day, all businesses may need to make a profit, but I do believe that nursing plays a significant role in being able to make sure that we always have front and fore for most our mission in every single thing that we try to make in terms of decision. And for advocates, you know, for all, and we see that embedded in a lot of the things that we do, it's one thing to say it, but it's another thing to actually do it. And so for the future, I think nurses will, nurses and other, quite honestly, not just nursing, other clinical leaders, it's gonna be really important for everyone that has a clinical background to be engaged in the business of healthcare. And as, you know, external forces make policy decisions to be able to that affect the day-to-day work that we do, it's really important that people that have clinical background are in these chairs to be able to make sure that we do the right thing, not only for our patients, but for the people that are taking care of them. - That was good. You know, well, I think I'm playing a little internal game and let's see if we can stump you, but I don't think we can. I think you're gonna be able to get all these questions. - You can, so total disclosure for those that are listening, I did get these questions in advance, but if you know me, I don't really like doing any prep. So I didn't really prep for anything. So what you're gonna get is what you're gonna get. - Well, that was a great answer. I really appreciate. So I'm gonna pull that a little bit forward and ask another question, which is, as Carmen said, I mean, the world that we're working in is just evolving at an incredible pace with the innovations that are occurring right now in healthcare. It's just, it's exponentially speeding up, right? So as it continues to evolve like that, what do you believe will have the most significant impact in shaping the future of nursing? - Yeah, I love that question, Stephanie. There are a few things that I know to be true. One is the way we've delivered healthcare in the past 30 years is not gonna be the same five years from now. It cannot be. With the number of nurses exiting the profession, not because, you know, part of it is because, you know, it wasn't for them. We do have an impending exodus of our baby boomer nurses that we've started to experience really in the past two years, but they're just gonna really intensify here in the next three to five years. All of that, plus the changing landscape with our regulatory bodies and what's happening nationally, the way that we were able to accomplish outcomes is not gonna be the same in which we will be able to do that moving forward in terms of taking care of our patients and advancing our practice. And so I do think, you know, in terms of the future, a lot of the things that we're gonna need to be, that will make an impact in our care delivery models is how do we integrate technology? I think AI, and I count myself in this, I really need to brush up my knowledge and expertise on how artificial intelligence can help augment the work of the bedside nurse. And I say that because we will never be able to replace the work of clinicians at the bedside. You know, AI can only do so much in helping us discern the next right thing to do for our patients, but at the end of the day, patients go inside the four walls of our hospitals for nursing care. AI cannot replace that, that care that we provided at the bedside. Even when you look at the cross continuum and the ambulatory piece, AI cannot replace, you know, the counseling, the education, the care plan pathing that our outpatient ambulatory nurses do for all of our patients with complex diseases. But what AI can do is it can allow us to be able to practice at the top of scope of our license so that we are not worried about the minutiae of things. We're given prompts of what's the next best thing to do for our patients, but we use our intelligence, our experience and expertise to discern, 'cause there's gonna be multiple next best things for the patient. But it is up to the clinician at the bedside to determine what's the best next step in terms of taking care of our patients. So that's one piece of it. I think other care transformation delivery model, which I'm really super excited about our chief nurse executive at Advocate Health, Betty Jo Rocco, is very much a supporter of this, is we're really designing what is the hospital room with the future? Like how do we integrate technology into day-to-day care that we provide such as ambient listening, you know, in SITR, when we have patients that have a SITR, how do we use technology for giving us early warning systems for patients that may fall or for turning purposes? How do we make sure that we prevent pressure ulcers and use technology to help assist with that? So I think all of that will help, you know, bundle in and factor in in terms of the future of nursing care delivery models. But I'm excited to see what we have in store in the next five to 10 years. I just know that what we had is not gonna work for us moving forward. - Yeah, great, great answer. I kind of view like AI, for example, it's like a superpower. And so if harnessed correctly, it can really, really make us better. But you have to, you have to harness it correctly. And so that's what we gotta work on. So that's great. - And I do think that, sorry, is one thing that literacy is so important because I get discouraged sometimes at some of the rhetoric that I hear from some of quite honestly, some of our colleagues within healthcare and especially within nursing, demonizing AI and healthcare. The reality is there is not enough clinicians. - Yeah, right. - Whether you talk about nurses, paramedics, physicians, advanced practice providers, it doesn't matter what type of clinician, there will not be enough clinicians to be able to take care of the demands of the health system in the next 10 years. And so instead of digging our heels, how do we pivot and use the tools that are available for us so that everyone's practicing at the top of their license and their scope? - Love it. Yeah, absolutely. - Yeah, that's great. And I wanna go back before we keep going forward. You know, when you were a clinician at the bedside or you were early in your career as a nurse, what traits and actions did you observe from your leaders that you feel has influenced who you are as a leader today? - Yeah, I'll say for those of you that know my journey, I always say I never wanted to be a leader in the same way that I never wanted to be a nurse. I wanted to be a priest. And then I wanted to be a nurse practitioner. And then I pivot to being a CRNA. But all of that said, I would say that there's absolutely nothing else that I would rather do than be nursing, than be a nursing or than be a nurse leader. And if I had to do it all over again, I'd choose the same path. And so your question is what did I observe? I think I have been so tremendously blessed by being able to have the opportunity to be exposed with so many amazing nurse leaders across the country through my involvement in professional organizations. And at the same token, there's been many, there's been also examples of things that I've seen in other leaders that I'm like, "Okay, I need to remember how I feel right now." Because that is something that I never want anybody else to feel. And that behavior or action should never be something that I show to people. And so I'll talk about three lessons that I've learned from people that have been significant in my journey. The first and foremost, and God bless her, she unfortunately passed away last year. And her name's Linda Burns Bolton. And for those of you that know her or know of her, she was the chief nurse executive of Cedar Sinai, was the president of the Academy of Nursing and American Organization of Nursing Leadership, AO&E. When I met her through a conference in 2015 in Arizona, had the opportunity to connect with her and then end up working for her in Los Angeles. That's what moved me from San Francisco, UCSF to Cedar Sinai in 2015. One of her lessons that I still carry to this day that she always says is nothing about me without me. And that's from at the bedside to the boardroom. And what that really taught me is that the best decisions that we can make is when we involve those that are affected by the work in the decision-making process. And I'm not talking about a democratic process 'cause those are, that's not what you do in leadership. But there's many decisions that we make in leadership that I promise you that we can bring in the frontline nurses. Because no matter how great your idea is, if you are not doing the work, I promise you there's always a gap that you're not seeing. But when you bring the people that's affected by the work and that do the work day in and day out, they know what's wrong with the process because they're working on the workarounds. So then you work on that, you bring them together and you have a better solution moving forward. So that's one. Second was really related to one of my mentors, Dr. Sil Chopinier. He's a system C&E for Providence Health System. And it's really the way in which I lead or I try to lead. I'm not claiming that I perfected this. And he helped me understand that this was my leadership style and it really is leading with love. And for me, leading with love is not, people are like, "Oh, love, that's soft." It's actually not soft at all. It's about being present for the people that you are leading and that making sure that you're listening to listen and not listen to respond and that you dedicate your time with them because in your day, you're seeing a lot of people. But the person that's running from interview may have been waiting weeks to have an opportunity to have that 30-minute touch base with you. And to you, it's routine and to them, it's not. Part of that is the premise of I deserve to be at my best and my team deserves me to be at my best. And I wanna do that because it's the right thing to do for our patients and for the people that we're leading. And finally, around leading with love, it's not about, yes, it's about being present, it's being supportive, it's being their biggest cheerleader. But it's also about having the difficult conversation with individuals when things are not working out the way they need to. 'Cause part of leading with love is allowing people to, having the courageous conversation of telling someone, maybe this is not the right path for you because you are not thriving. So my role as a leader is to find you another path that may help you thrive because this is not it. So I'll just stop there 'cause I don't wanna, I know we have a few more questions. I think those two have been pretty much my guiding light in terms of the things that I've observed and that I've learned from individuals. And I was fortunate enough that I've met those two individuals really early on in my leadership career. I've been able to help move that along and move that forward in terms of in the ways that I have led in the past few years. - I really like that concept of leading with love. And for me, it's love, trust, those things. It's kind of like you enter the relationship already having that and it's yours to lose, but that way I feel like you really start off on that open foot. So I really like that. - But I would add to that leading with love, which is awesome, requires a lot of time. So I would, I wanna ask how John Carlo, do you remain consistently leading with love in this fast-paced environment? Wherever you, to your point, people waited for weeks to meet with you, which is very common, but you also have had 20 other meetings before that meeting. So how do you remain consistent in that? - So Carmen, I tell you, it is an active effort and that's why I claim, I said at the very beginning, I've not perfected it. I'm trying to do it day in and day out. And quite honestly, what keeps me wanting to maintain that is I consistently remember the times when I felt that I've had a leader who hasn't led with love and how demotivated I was and how that affected my team and how that affected the people that they were leading and the patients that they were caring for. And quite honestly, you're right, it does take a lot of time because sometimes it's so much easier to say, Stephanie, do this, Carmen, do this. I don't really care what you're feeling right now or I don't really wanna walk you through the process, just do this. And it's so much easier to do that, but what I've found also is that in leadership, especially when you get to my type of role, no one really reports to me, no one, like literally no one reports to me. - You're leading through influence. - Exactly, there may be other people that report to me that help support the work that I do, but in terms of executives, no executive reports to me, but I'm still accountable for the outcome. And so the way that I'm able to move the boulder, to move the needle on a lot of things is absolutely you're right, Stephanie, is through relationships and leading through it with influence. And at the end of the day, if people feel that you are there for them and that you have their back, not blind. So there's two differences between blind loyalty versus having someone's back when it's the right thing to do. I think when people feel that way, they're more apt to go above and beyond the effort. - Yes. - Whereas if I would have done Stephanie do this, I am your chief nurse, you must do this. Stephanie will probably do it, but chances are Stephanie will do the bare minimum to if I say move the paper from this table to this table, Stephanie will do that, no problem, because by authority I made her do it. But if it was a different type of relationship, if Stephanie moved it from table A to table B, but table C was actually a better destination, then she's more apt to go above and beyond to move it to table C, even though it's further. - So let's take that advice, that those great words and apply it to somebody who's really a direct care clinician right now or they're a direct care clinician, but they aspire to be in leadership. What are some actionable steps for them to take now to really prepare them and get them ready for that leadership position and really supporting quality and safety? - Yeah, thank you for that Stephanie. I think the one thing that I'll share, the reason why I was so hesitant to move from the bedside to leadership and why I wanted to be an nurse practitioner and in a CRNA is because like many of us, part of my personal identity, so I grew up as an IC nurse, and part of my personal identity was my ability to be able to manage complex patients, and not to pat myself on the back, but manage it well. Right, so I knew-- - I think you can pat yourself on the back for that, that's good. - I knew who my patients were when I came in, it's because I looked left and right, wherever the crash cart was, that was my patient. And so, or wherever the risk commotion, that was my patient. And so, it was so hard for me to move away from that clinical expertise into a different realm and road. And so, my third person that I was gonna talk about, but I stopped was my third mentor, Katie Waxman. She is now the chair of the DNP program at UCSF Medical Center, but she was my DNP chair when I was going through the program at USF. And what she did was she kept asking me, "What do you wanna do when you grow up?" And she kept asking that to me because what that helped me realize is what I wanted to do was run my own heart failure clinic and make an impact in the system and the people that we were working. I really didn't wanna see patients. And what she helped me realize was that I can only do that by going through healthcare systems leadership, the pathway in healthcare systems leadership. And I say that because we have amazing clinical leaders, nurse practitioners, CNSs, CRNAs that are in executive roles. And our chief nurse executive is an example of that. But to expect that you are at a clinical expert and then transition to expertise in leadership is a folly. And we do that often in leadership. The people that we promote are the clinical experts. I am a product of that. I got promoted, I got asked to be in leadership because I was a clinical expert in my field. We fail to realize that leadership is an expertise on its own and your clinical experience doesn't always necessarily translate to leadership. Along with an answer is the first thing is to realize that if you have a desire to be in a leadership position, it's to know and understand that leadership in its own is a different expertise within nursing. And so when you approach it with that way, you approach it with an open mind and thinking that you won't transition from being the biggest man on campus in clinical side to the biggest man on campus in leadership. And I say that because I got my DNP when I was in 2016, I was a nurse manager. And I knew that I wasn't gonna be a CNO immediately after I got my DNP. It's because I needed to build my foundation and expertise in leadership before I got to an executive role. And so for those that are in the DNP program that is starting their leadership journey, be open to possibilities of exploring, a nurse manager, a supervisor role to be able to know and understand operations. 'Cause at the end of the day, if you're gonna be an operations leader, you need to know operations and to have an understanding around it. And so that's one piece of it. The second is, be open to opportunities even though it may be lower than your aspiration. You may want to be an executive, but you're not gonna be an executive right off the program. So start with a manager or director of some sort. - Thanks for saying that too. Also, sometimes you need to step laterally or step backwards just to achieve that. Thanks for bringing that up. That's really important and people are sometimes hesitant to do it, but sometimes it's, you know, the important is learning in a different environment or something like that that makes it worth it. So thanks for bringing that up and sorry to interrupt, but just wanted to highlight that. And number two is seek a mentor. You're not gonna be able to accomplish what you want to be able to accomplish by doing it alone. I didn't get, and I don't think I've gotten to, I've accomplished a little bit in my career, but there's a lot more and more accomplished than I have. But with the little that I've been able to accomplish, I didn't do it because I was doing it as an island, as a sole person. I think I may have said this earlier, I have been able to stand on the shoulders of many amazing people around me, mentors and leaders. And most of us who've had experience in leadership are very open in mentoring and guiding people. And so be teachable and be coachable because if you are those two things I promise you, people will invest time, effort and energy in you. But if you go into a situation trying to do it all yourself and thinking that you can do it, people are turned off by that, leaders are turned off by that and they will avoid you like a plague because you're dangerous. 'Cause there is such a thing as you don't know what you don't know. No matter where you are in the level of leadership. And so then finally, I think, continue to seek opportunities to engage in professional organizations and special projects. Not only within your organization, but outside of the organization. I told you about my journey. When I started with AO&L, at the time it was the American Organization and there's executive, I was a charge nurse. That's how that organization and with the Association of California Nurse Leaders, which is the state affiliate of AO&L, that's how those two organizations have been able to connect many mentors across the state and nationally so that I can continue to grow and develop. - That's excellent. And most states have, if not all, have a state affiliation for the national versions of the professional organizations. So it should be readily accessible to anyone. You just have to maybe do a little bit of searching to find what works for you. - Absolutely. - For those that are listening, whether they're in school pursuing their DNP or maybe they have graduated with their DNP and even thinking about going into executive leadership, one of the things that I see is that, we talk about burnout at the clinician side, the bedside, we talk about that. We don't talk a lot about the burnout at the executive leadership level. And I think as people pursue that, pursue those types of roles, it's important to understand the burnout there as well. And you can burn out really quickly. So from your experience and thinking about your journey and where you are today, what are some of those, I would say, core guiding principles that will help create boundaries so that you don't get to that burnout point because it's very easy to get there? - Yeah, and I am still learning and trying to figure out where, so first off, and I may be controversial in this, but I don't believe in work-life balance, I believe in work-life harmony. I think our CEO for Advocate talks about it in terms of work-life integration, similar concepts. And so for me, work-life harmony is the ability to move across your spheres, between your personal life, your professional life, slash work and your extracurricular activities, and then your family. And so what I believe is that, you invest time, effort and energy, and you're shifting throughout those spheres consistently because one day or one week, it may be your family sphere that needs a lot more attention. But if you're able to shift around those spheres and consistently and give what you can give to those spheres at that time, I think you'll be able to do that. The reason why I don't believe in work-life balance is because it implies 50/50. And so I get maybe six hours, seven hours of sleep a day. It's not by desire, it's just by design. That's just how my body is wired. And so by definition, I've failed in work-life balance already. 'Cause work-life balance is 12 years, 12 hours of weight, 12 hours of sleep. And so that's why I don't necessarily prescribe to that. And so shifting your mindset is the first, right? 'Cause then when you're thinking about, oh my God, I'm spending 12 hours at work today. And then that starts your spiral of woe is me, I'm overwork, so on and so forth. But are you really like really spending 12 hours a day in your work every single day, you know, all the time? The answer to that is more often than not, the answer is no. Right? In a work-life balance mindset, you're always looking for that, I'm spending too much time here, so I need to move that. I need to stop. Whereas in a work-life harmony perspective, yeah, maybe spending 12 hours at work today, maybe 16. But on Friday, I'm gonna be working for four hours. And so most of us in our four or six hours, most of us in an exempt role, which is a lot of leadership, you know, there's flexibility in your work hours because it's all about the outcomes you deliver to the organization. You know, the exemption is gonna be your frontline nurse managers. I do think that they have one of the hardest jobs in the health system, because you have shift workers that demand your time 24/7. That is all about working on infrastructures and support systems so that the decision is not centralized on you. So that's my second thing on burnout, is most oftentimes than not, there's a reason why you hire people, trust them. They will nine times out of 10, they will always make the right decision. You don't need to be integrated in every single decision processing your team. You need to know what's going on, but you shouldn't be the final say on everything. So what that does is it allows your people to grow and be comfortable. And also it allows them to know that you trust their expertise and what they bring to the table. And so what that will do is they're more apt to bring small things to you as an awareness. And they will always 9.9 times out of 10, you know, have your back when something big is coming down the pipeline. And then we tell you, hey, I messed up, or this is an issue that's gonna come up to you heads up. And so that's, those are two things that I've been able to have work life harmony. And number three, you just have to plan for some you time. It looks different for everyone. Some people like to pray, some people like to meditate. You know, I crossfit every day, or most every day, you know, about five, at least five times a week, I go to a crossfit class and that's my form of meditation. It's literally the one hour of the day that I can't think of anything else other than what I'm doing in front of me. 'Cause otherwise I'm gonna injure myself. - Yeah. - And then I said last thing, but the final thing is know your boundaries. And so I, I, and this has frustrated some of my bosses in past lives and that's okay. You know, we'll both get over it. And so what I don't do is I don't respond to an email after 7 p.m. Monday through Thursday. And then starting on Friday at 7 p.m. through Monday, I also don't respond or send to emails, or send emails. You know, there's exceptions. If there's obviously, you know, if things are burning down and there's an emergency, I'm not gonna be like, "Oh, it's 7 p.m. "I'm not gonna send anything." But very few times you will see me send, you will see an email come from my inbox on the weekends or after 7 p.m. It's because I wanna be respectful of people's time. And the reason why I say that is because as a young manager, I used to have a CNO who emailed me at all hours of the day and told me that I didn't need to respond. And so when I'm seeing their email at 11 30 p.m. and it's seen, and I, when it's your boss's boss, you lose the ability to distinguish what's urgent or emergent. And so what often I find myself is, you know, I'm researching, I'm responding, and then it's 2 30 in the morning and then I'm wired. And then as a unit manager, you know, you have to be at huddle. So then you're like, "Oh gosh, maybe I'll take a nap "for an hour and a half, 'cause then I'll need to be up "to be at the unit by 6 30 or 7 o'clock in the morning." So I didn't have work-life harmony. So that's why I'm so mindful of sending emails on all hours of the day. Because at the end of the day, no one's gonna die because you didn't send that email at 7 p.m. If it's really that urgent, they're gonna call you or they're gonna text you. - Yep. - I think that's really important too, because I sort of recently came to the realization through some things I had learned and read that boundaries are really for you. They're not for other people. So other people are gonna cross them. And if you let them, your boundary doesn't exist. It's up to you to maintain that boundary, which was sort of a mind shift for me, because I thought, you know, I was kind of leaving it up to other people to respect my boundary, got it the other way around. So. (laughs) - And what I do is, 'cause especially when I'm traveling, you know, I may get into the hotel at 6.30 p.m., but I've missed the whole day of working. What I may do is, 'cause I don't also wanna be stressed out with like, you know, impending workload, but what I'll do is I'll schedule send it for 4.30 in the morning. So that when somebody wakes up, it's one of the first few things in their email. - Yeah. - But they're not seeing it at 11 p.m. when they're trying to wind down. 'Cause we all say, don't check your email before you go, we all do. I mean, most of us do. - Yeah. - We're getting close to the end of time, Carmen. I do wanna ask if you could just share a few of your favorite leadership books or podcasts or blogs, or like, where do you go to stay fresh on your leadership information? - Yeah, so I have three leadership books that I often give to new leaders that come within my team. The first one is, I hope I remember this, it's Your Ship, it's by Captain Michael Avershoff. It's been out for a while now, actually. And I love, and it's a story about how he turned the last ranking Navy ship in the Navy to the highest ranking Navy ship in the Navy. And it's all about culture building and doing the right thing for your people. He didn't call it leading with love, but a lot of the principles of leading with love is within that book. And it's because like, simple as sending a birthday card to someone when they're their birthday, or when a shipman accomplished something, they send an email or a letter to their loved ones, letting them know what they've accomplished. And so there's that sense of pride and sense of ownership. And it really is turning the, well, I'm just here for a nine to five to, this is my life while I'm here, and I'm gonna have that culture of ownership. So that's the first one, I love it. I think it's still relevant. I reread it every once in a while. The last time I read it was a year ago, and it still has so many pertinent things in it. The second one that I love is Cy Wakeman and her book, "Reality-Based Leadership." The reason why I love her, and she can be controversial, her approach is gonna be controversial. - She can be, but she's really good. She's really direct with her advice. - She's really good. And the reason why I love her is because we all get stuck on the stories we tell ourselves. It's human, everybody does. It's human nature in the same way that everyone's uncivil because we're human beings. The challenge is, the difference is, what is our degree and severity in which we get stuck in the stories we tell ourselves? And reality-based leadership is all about driving to, what do we know to be true? What are the facts of the situation? And let's de-dramatize what's happening and then act on the information at hand and do the work that we need to do. So then I countered that with Brene Brown. - She's my, yeah, that's my girl right there. (laughing) - So Brene Brown's leading authentically, showing up as yourself and being a truly listener. And one of her key things is that I love to keep reminding myself is, I'm gonna misquote this, is clearest kind times clear or something like that. And in my honesty, sometimes we sugarcoat things and we're not honest with people thinking that we're trying to preserve a relationship. What that's really doing is degrading the trust between people. And so all of that in compass, I think helps build the foundation and helps guide me in terms of how I'm gonna lead with love. - Oh, such great books, thanks. - I love it, love it. Well, John Colo, this has been such an extraordinary, I think conversation and just, you know, you highlighting your journey and I think dropping nuggets for those that, you know, aspire to become executive leader or a leader, nurse leader period, I think they can certainly take a lot of good things from this conversation. So thank you for, you know, you being authentic and telling us your story and kind of those things that helped you be successful and even some of your own faults. So we appreciate that. I wanna also forgot to say in the beginning that congratulations to you. Recently was inducted into the, as a fellow, I believe with the American Academy of Nursing, is that correct? - Yeah, so I have the joy, honor and privilege of being inducted in DC two weeks ago now, I think, as a fellow of the Academy of Nursing. And I'll tell you, no one, I don't think anyone ever sets out, like at the beginning of your nursing career, to be like, I wanna be inducted as a fellow. It's really a culmination of the work that you've done. And I just feel so honored and privileged to be able to be inducted in the Academy at this point in my life, in my career. It was, you know, it definitely was a bucket list wish list, like before I retire, kind of thing. (laughing) But I had amazing mentors and my two sponsors was Mayor Beth Kingston and Michael Blake. They really helped me, you know, realize that now was the time to do it. And they never, here's having what a good mentor does, they never let you quit even though you want to, because the application, so for, if you ever get an opportunity to apply for the Academy, the application takes months to complete. - Yeah. - It's not a really long application, but it's such an introspective process of trying to highlight what is it that you've done that you want to be able to highlight that affected nursing globally and within the nation. And that application timeline was at the same time that I was transitioning into my new role at Wake. So I kept saying, you know what, I don't think today, this year is the time, next year, let's do next year. And they're both like, no, we're going to do it right now, we're going to dedicate the time. So yeah, I was just super fortunate to do it. - Well, congratulations on that. And, you know, you're right, a lot of people try to get that right before they retire. So congratulations to you getting a little ahead of that. - Well, thank you. I hope I don't retire soon. - No, unless I hit the jackpot maybe. - That's true. If I hit the lotto, I won't tell anyone, but you'll just see like $15 running around the bathroom. (laughing) - Well, we always end our podcast with, because really, you know, the first best nurses really founded upon our original atrium health mission and vision, but it still aligns with our new purpose and commitments that we have today. So we always offer to our guests a little bit about, you know, how do they see themselves leaning into that mission and vision? And so our commitments this year, just to remind you here with advocate health is lifting everyone up, leading the way, thinking boldly together and embracing the unknown. And so as a leader with advocate, as a nurse leader, as an executive leader, which one do you find yourself either aspiring to live out your best in or you feel you got it, you've mastered it. - Yeah, yeah, definitely not master. (laughing) But, you know, I am trying my best to really lean into embracing the unknown. And I say that because you just look at our current healthcare environment, political environment, national environment, healthcare environment, there's just so much uncertainty and changes that's happening. And so much transformation within healthcare that is happening and that still needs to happen. You know, change, we always say change is inevitable, but I do think, you know, I've only been, you know, a nurse going into my 19th year of nursing, but in the past three to five years, the pace of change has just accelerated dramatically compared to how I felt changes were happening earlier on in my career. And so I think that's why I'm striving my best to be better at it with embracing the unknown and really trying to do the best that I can with the information that we have to make sure that our patients are taken care of. We follow our mission for all. And at the same time, we take care of the people taking care of those patients. - That's so good. Yeah, I think embracing the unknown can be a challenge, but definitely a skill we all need to lean into. So, John Carla, thank you so much for your time today. This was a fantastic conversation. - Well, thank you for having me. It's my honor and pleasure. - Thank you. - And a special thanks to the Wake Forest University School of Medicine, Doctor of Nursing Practice, program leaders who reached out to us and to the students who gave us these really thoughtful questions for us to try to stump you with today. - Yeah, thank you. - I hope everybody really enjoyed this exercise. And I'm looking forward to, you know, maybe having some more topics like this where we can really dig into some really meaningful insights. So, appreciate your time. - Yes. - Thank you. - Thank you, John Carla. - All right, thanks everybody for tuning in and we hopefully will catch you next time.