A Journey Through Leadership in Hospice: From Student to Middle Manager and Beyond Dora Hall, LCSW, ACHP-SW Hospice of the Bluegrass Site Director, Frankfort

Objectives of Session At the end of the session, the participant will be able to… Discuss the growth of a leader over time. Identify the importance of a mentor Identify how motivation and experience help formulate leadership style Define leadership in a hospice setting.

Career Snapshot Bachelor of Social Work 1997 Practicum in the hospice setting and hospital setting Worked in a LTC setting from 1997 to 1999 Master of Social Work 1999 Practicum in the VA setting and the hospice bereavement Setting. Employed At Hospice of the Bluegrass since November 1999.

Growth of a Leader- Student MSW practicum student in the HOB bereavement program for six months Learned about the organization and the care for patients/families Enjoyed being around other Social Workers and observing their styles Met my first mentor, AVP of Counseling Services

Lessons Learned My passion for hospice grew while working with the bereavement department. I was able to see a snapshot of a hospice IDG working together to ensure quality end of life care in an urban setting. I realized the importance of seeking out assistance when a difficult situation occurred.

Growth of a Leader-Frontline Social Worker At the end of practicum, hired on as full time social worker in a rural service area Became a team player, honed social work skills, and was exposed to what Hospice care is all about. Gained 3 years of direct patient care experience Moved from novice to solid performer

Lessons Learned I consider this a period of learning from nurses, other social workers, chaplains, and nursing assistants how to provide end of life care to patients and families. I came to value the different team members and how to enhance the care I was providing to patients through anticipating needs, providing counseling and support, and solidifying my knowledge of hospice care.

Growth of a Leader- Nursing Home Coordinator Moved from a caseload to coordinating the nursing home program in the office No supervisory experience Grew in the areas of customer service and representing HOB to external customers Learned hospice criteria Enhanced public speaking skills and educating others about hospice care Worked on clinical supervision to obtain KY LCSW license for independent practice Carried a small bereavement caseload Spent time Site Director who provided suggestions in areas I needed to grow

Lessons Learned Learned LCD’s and Medicare Regulations Experienced both good and bad relationship building with external customers through different scenarios The Site Director allowed me to reflect on my successes and failures, while providing feedback on how I could solve issues differently. Started to develop critical thinking skills and self reflection

Growth of a Leader- Counseling Supervisor Moved into a supervisor role Completed NHPCO’s Management Development Program Level I Worked on completing LCSW supervision, carried a small bereavement caseload Worked under another Site Director who brought different learning opportunities

Lessons Learned I learned to be more direct as a supervisor and when communicating with the Site Director I learned to have two solutions to an issue when presenting problems Honed my interviewing and hiring skills I was able to rebuild the counseling department after a major turnover First experience with major agency change, while also experiencing a major life change

Growth of a Leader- Site Director After 2 years, moved into the Site Director position. Oversee/supervise 60 plus employees. Completed LCSW supervision/obtained license. Completed MDP Level II. Obtained ACHP-SW certificate Developed a functional leadership team Leading the office through multiple changes. Utilized the three mentioned mentors throughout

Lessons Learned When struggling with an issue, ASK FOR HELP from your supervisor and/or mentor Change in the hospice world is constant It is important to delegate and ensure that issues are handled in a fair manner Having more than one mentor to process issues with is important Be clear, consistent and confident when communicating issues and decisions to staff Knowing when to lead and when to follow

My Feelings: Mentor Actions Doubt Fear Concern Discontentment Impatience Anger Reassurance Education Encouragement to do more Guidance in which direction to go Suggestions in creating new processes

Importance of a Mentor Building a professional relationship with someone you can trust Learning new ways of thinking and doing Being able to seek advice Being able to share success and disappointments

Mentoring In the book Employee Development: Big Business Results on a Small Business Budget, Jim Guttman describes mentoring as a “wonderful opportunity …for employees to enrich lives of their co- workers by sharing information, skills, and abilities”.

Mentor-Mentee Relationship The needs of the Mentee should match the competency of the Mentor. There is a high potential of success Positive chemistry exists between the two individuals High level of trust Employee Development: Big Business Results on a Small Business Budget

Ideal Qualities of a Mentee Enthusiasm Clear vision of goals Initiative Wants to improve weak areas Open to constructive feedback Takes responsibility Proactive Listener Shows flexibility Employee Development: Big Business Results on a Small Business Budget

Ideal Qualities of a Mentor Trustworthy Optimistic Dependable Available Seasoned leader/contributor Influential Good listener Excellent interpersonal skills Employee Development: Big Business Results on a Small Business Budget

Motivation and Experience Increased knowledge and skills when solving issues Change is a constant, and moving a group through change is difficult Experiences bring lessons learned, and increases confidence when new challenges rise.

Next Step- Being a Mentor Several staff members reach out to me for guidance, and I approach each one based on their own needs I still reach out to my mentors when issues/concerns arise

Where to find Mentors Agency Peer Group (NASW, HPNA) Ministerial Association or Denominational group Toastmasters Civic Groups (Rotary, Sunshine Club) Medical Associations/groups NHPCO NCHPP

Leadership What is leadership?

Leadership Defined BusinessDictionary.com defines leadership with four key components: (1) Establishing a clear vision (2) Sharing that vision with others so that they will follow willingly (3) Providing the information, knowledge, and methods to realize that vision,

: (4) Coordinating and balancing the conflicting interests of members or stakeholders. A leader comes to the forefront in the case of crisis, and is able to think and act in creative ways in difficult situations

Question: How do you see this definition applied in the Hospice setting?

Qualities of a Leader In Robert Thomas’ book “Crucibles of Leadership”, he points out the following qualities and attributes of outstanding leaders:

Qualities of Outstanding Leaders Adaptive Capacity Engaging others through shared meaning Integrity

Attributes Resilience Creativity Open to new experiences Willingness to learn Acute observational skill Deep sense of purpose and focus Self-awareness and emotional intelligence

Attributes Skilled Communication Comfort with dissent Clear values and voice Balance among ambition, technique, and moral compass Able to work with value conflicts Knowledge of when to lead and how to follow

Tools to Grow in Hospice Leadership Keeping knowledge and skills of profession up to date Maintain/strengthen licensure, certificates Stay informed through NHPCO and professional associations (NASW, HPNA) Utilize NHPCO trainings Complete management training such as the NHPCO MDP program.

Additional Resources

Questions?