Leading by Listening

Jul 01, 2021

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I am human, and it is alright for me to care for my patients as my family. I am not weak; I am a caring nurse.

Desiree Hodges

As a nurse manager at Atrium Health Carolinas Medical Center in Charlotte, North Carolina, Desiree Hodges, MBA, BSN, RN, CCRN, NE-BC, has wide-ranging experiences in nursing. From her first post as a med surg nurse, to working as an IT nurse consultant and now serving in leadership, Hodges is well aware of nursing dynamics – especially within her health system’s teams. As more nurses retire and a new generation graduates from nursing school, Hodges knows that finding common ground to provide the best care for patients and their families is an important bridge to build.

You manage a multigenerational nursing team. What are some keys to success?

Listening. I have a large staff, and I am learning to listen differently in order to meet the needs of the team. I am learning lessons from each generation, and I can identify with all of them. You also have to meet people where they are and ask questions. It’s really important to learn what is meaningful to each of them and not judge them for it. Just because it is not what you did or what you would do doesn’t make it wrong.

Be open to the fact that you have to communicate differently. Yes, you will need to post on social media, send an email and have a staff meeting to get out the same information. If you become resistant to this, you will find yourself frustrated as a leader. It’s not catering; it’s communicating effectively.

Also, understand that life happens to us differently depending on our age. It’s easy to judge or make assumptions, so we must take the time to educate ourselves on different multigenerational preferences. We have to be aware of our own biases so we can become better leaders.

How do you create understanding with staff who may have generational differences and don’t see eye to eye?

I believe it’s important to find space in your department to display the contributions of the entire team. It sure is hard to judge someone who is contributing to the health of the work environment. I currently have AACN’s six Healthy Work Environment standards on display in my unit with sticky notes available for the team to write their contribution and place it in one of the categories with their name. This gives teammates a sense of accomplishment and pride. It also helps when teammates are not seeing eye to eye based on generational biases. I always tell them that I am not here to manage personalities, but I am here to remove roadblocks and support their growth.

It all comes down to properly educating the team, and I am working with our Unit Based Council, where we identify opportunities for improvement in nursing practice that can enhance patient care. It’s coming together slowly, and I am very proud of the team.

Why did you become a nurse?

My grandmother always told me that she wanted to be a registered nurse when I was growing up. That was not an option for her when she was growing up. She did domestic work and raised several families in our small town. I always knew that I wanted to help people, and I was fascinated with Band-Aids as a kid. I would put them on my dolls and myself. My grandmother was so excited when I told her that I was going to nursing school. Even though she is no longer with us, I know she is very proud.

Can you tell us about your nursing journey?

Many of my nursing roles fell in my lap as a reward for my hard work. It has been challenging as I have had to shift and pivot many times, but nursing is a passion of mine. It is who I am, not just what I do. I have encountered many wonderful mentors and leaders along the way who told me how to navigate nursing. I have learned that I can do almost anything I want to do in nursing as long as I am willing to work hard.

Have I made sacrifices? Yes. Has my family made sacrifices for me? Absolutely. I have learned that I will never be able to make everyone happy, but as long as I go home at the end of the day, knowing that I have done the best job I can for my team and my patients, I can sleep well.

How does your background and previous experience impact your work today?

As an African-American nurse in critical care, I have learned that I have a greater responsibility to nurses of color. It’s important for me to be a role model and to set the expectation that everyone can be a leader regardless of the color of their skin, their religious beliefs or sexual orientation.

I only went into critical care because one of the cardiac surgeons (who was Black) asked me about coming into the ICU. At the time, I was working as a nurse in the cardiac surgery stepdown unit. I told him there was no one else who looked like me in the ICU, and I didn’t think that I would be able to do it. Several times he asked me, “How do you think I felt in medical school and in my fellowship?” He reminded me that I was capable and good enough. He, along with one of my patients, taught me to never apologize or think that I am less than because of the color of my skin. I have carried that with me on this journey. Every encounter, positive or negative, every mentor, every encouraging word from my family, every failure, every mistake, every celebration and every “thank you” from another nurse has led me to where I am today. I may be exhausted, frustrated, and sometimes sad and disappointed, but I am hopeful for what is next for nursing. My hope is what keeps me going.

I have also been an active member of my local AACN chapter, and my experience has been amazing. It's where I learned the true meaning of networking and how to advance the nursing profession. To this day, I love meeting new people and mentoring new nurses who are struggling. Being a chapter member also gives you a safe space to try new things such as project management, event planning and helping with your leadership and communication skills.

What is one of the most meaningful moments you’ve had as a nurse?

As a critical care nurse in the CVICU, I had an extraordinary experience one night when I was the charge nurse. I was new to the charge role and the unit was extremely busy. We had several late open-heart cases coming out of the OR and an emergent case on the table. Everyone was busy and we were short staffed. I remember being a nervous wreck – l had a fairly new team that night, and I was the senior person and everybody’s resource. My chief of surgery came through the unit, pulled me to the side and said, “I need you to get this unit under control, and I will be back in 30 minutes to round.” At that moment, I realized what leadership meant – even though I had no desire at the time to be the leader. I called a huddle and we went through the logistics of the night. That same night I also accidentally shocked my surgeon with the internal paddles (no harm done to him), and I performed my first cardiac massage with his assistance. I will never forget that night; it’s when I graduated into nursing adulthood. This was about 18 years ago, but I remember it as if it were yesterday. You have to carry these moments with you when things get rough.

What would we be surprised to know about you?

Even though I love the thrill of the CVICU, at times I still wish I worked in the neonatal intensive care unit. I want to hold and care for little sick babies when parents can’t be there.

What is one thing more people should know about nursing?

As a nurse manager, I don’t think people realize how much time is spent finding resources. It is more than just finding staff and balancing the budget. It is figuring out ways for the nurses to be nurses to their patients. Over the years, nurses have become responsible for any problem that arises in the hospital – we transport our own patients, we empty our own trash and we often take our own inventory so we can order the supplies we need.

In addition, with the limited psychological resources available, nurses have had to become therapists and the handlers of complaints. Nursing is an all-encompassing job and role. Yes, it is what makes us so special, but we know that we cannot be everything to everyone and still safely care for our patients. I address this daily in every venue that I can to whoever will listen. It is my job as the nurse leader to protect our staff, our patients and, more importantly, protect our nursing profession.

What is the best patient experience you’ve ever had, and what did it teach you?

We had an entire family admitted with congenital heart disease – a mom, dad and two sons. Both parents passed away, and we ended up caring for the two sons. They remained in our facility for many months, and we celebrated birthdays, holidays and many special moments with them. As a healthcare team, we worked together for years to get them the treatments needed to live a full life for as long as they could. Watching how they loved and supported each other was so touching.

I remember when the last son passed away, we were at NTI in Houston and our chief called us to tell us as he knew how much we cared for this family. We all cried together, told stories and found strength in each other to return to work and do it all over again for our patients. This experience taught me that I am human, and it is alright for me to care for my patients as my family. I am not weak; I am a caring nurse.