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Welcome to All About Nursing with your host, Dr. Joyce Batchelor. Executive nurse advisor, Dr. Batchelor, will present the significant role nurses play in providing healthcare in a multitude of healthcare settings.
Listen to some of today's key nurses who work and practice in academia settings and talk about the challenges they face in today's modern medical world. So please welcome the host of All About Nursing, Dr. Joyce Batchelor. Good evening.
I'm your host, Dr. Joyce Batchelor, on All About Nursing, and we're live on the BBM Global Network in TuneIn Radio. The focus for this evening's show is really going to be on how to create a healthy work environment. Nursing is a profession with many different kinds of roles and specialties in settings that nurses can choose to work in.
This is why leaders spend a great deal of time working with their teams to be sure they have the right kind of culture that attracts and retains the best and brightest nurses. This is especially important since there's a lot of competition for nurses in many different communities. In my prior system, C&O role, I always had a lot of passion related to this topic. I've always believed that the front lights staff have the answers when they are engaged and empowered to help create the changes that are needed.
I also have always believed that they'll have pride and ownership of the outcomes that they are accountable for if you have the right environment. And I'm really excited to introduce a colleague of mine this evening that shares similar beliefs, Dr. Bob Dent. And we'll be discussing the journey that Dr.
Dent went on related to improving the culture in his organization. Part of his journey has led him to actually be the co-author now on three different publications that will be able to hear a little bit more about this evening. But let me start by giving you a little bit of background about the accomplishments of Dr. Bob Dent.
So, Dr. Dent's currently serving as the Senior Vice President, Chief Operating and Chief Nursing Officer at Middle and Memorial Hospital in Midland, Texas. He maintains academic appointments with both Texas Tech, University Health Sciences Center, and University of Texas at the Permian Basin. Bob serves as the President of the American Organization of Nursing.
But Dr. Dent's career spans more than 30 years in healthcare and many different roles, such as nursing assistant, licensed vocational nurse, RN, assistant director of nursing, licensed nursing home administrator, chief nursing officer, and Dean of the Health Sciences Center at a community collared and chief operating officer. Dr. Dent served in a small rural to large urban hospitals over his career.
He's been the recipient of the modern healthcare class of 2006, up in Commerce and Healthcare Administration, the Texas Organization of Nurse Executives, 2013 Excellence in Leadership Award, the Texas Tech University Health Sciences Center, distinguished alumni award in 2014, and the Richard Hader Visionary Leader Award in 2016. Dr. Dent has academically progressed in nursing completing a vocational program and then going on for his associate degree in nursing in the South Plains Community College, a Bachelor's of Science and known many times by BSN, and a Master's of Business Administration with an emphasis in healthcare management from the University of Phoenix. And then his final part of going back to school includes his Doctor of Nursing Practice from Texas Tech University Health Sciences Center.
Dr. Dent is board certified as an advanced nurse executive, and is also certified in nursing practice, and is a fellow in the American College of Healthcare Executives and a fellow with the American Academy of Nursing. Over his career, he has lots of expertise, as you can tell, from what I've just read, and I've had the pleasure of actually being in the same class as Dr. Dent when we were in the inaugural class for Texas Tech's Doctor of Nursing Practice program.
So I've had the wonderful opportunity to really see and learn more about the kind of work that Bob's leading, and I know you're going to be really excited to hear in more detail what he has accomplished. So Bob, I've read a lot of what you have published, and I'd like to just start by asking you to share with our audience, did you have a specific problem that you needed to address at your organization when you began this work? We did. We, I started in mid-2007.
We began a journey to move into a build, a new tower to replace our outdated building, and we spent five years and a lot of money and time to build that, and we moved our, all of our patients from two parts of the organization, one campus, one across town, into the building, beautiful state of the art building. But we were not, we didn't get the results that we were wanting, building like we would get a natural bump in, patient satisfaction and other kinds of things, moving into everything that you would imagine in a building. But we did. So as we began that work, realizing that we had a, we just transplanted the bad culture into the new environment.
So we began working on that environment. So I know that your first book is titled Pickle Pledge, and I think that's a really unique name. And so I was just curious if you could share with us exactly what is the Pickle Pledge and who's involved in creating this? Sure.
The, you know, the, the pickle pledge, you know, the way that I like in the pickle pledge is creating a common language amongst a group of people that really gets, moves away from some of that toxic behaviors. The pickle pledge in and of itself is that I will turn every complaint into either a blessing or a constructive suggestion. And by taking the pickle pledge, I'm no longer wasting my time and energy on blaming and complaining and those kinds of activities. And normalize, to liberate with others who may be blaming and complaining.
And so by establishing a common threshold, it's similar to what I always refer to Dr. Azlutian Leap at Don Burgh with the 1990s. And when they went on, on that campaign to save a hundred thousand lives and creating a common language around patient safety and quality ends up being, you know, one of the top things that is being discussed in boards across the country now. So in here, what we did in our organization is say that, you know, we recognize that maybe there's some toxic behaviors that are happening and we're going to create a common language that we're not going to tolerate that any longer.
And in some cases, we do have fun with that with the pickle challenge for charity and creating jars. We ask people that if they get, if they're caught in the act of engaging in toxic behaviors, maybe they contribute a quarter to the pickle jar and that goes to something that's fun for the department or the organization. We've done several of those kinds of things. There was one time that the local dean came in through my office.
She walked in, she was hunched over and she walks over to my jar that's on my desk and she puts in there a $20 bill. She slams it into my jar. She goes, Bob, we have to talk. Now here she was paying in advance and that was a great conversation around, you know, we have this, we understand that we're going to have some concerns and complaints and different things.
We can have that conversation. But, you know, really it's about creating a positive place where people will be able to work and be able to practice nursing and other professions. And then you ask the question, who created that or who involved in creating the play? That's Michael Wather, Joe Tai.
He's the creator of most of the work that we've been able to do together. And then we've partnered, as we've seen the successes at Midland Memorial and co-authoring the three books, but this has been a long-standing issue that Joe Tai has addressed over the course of his career. He's a healthcare executive himself and a guy around the country sharing this work. But we've done something remarkable in Midland and we've been able to share that together across the country.
Now, how did you get the physicians on board and individuals from other professions like the respiratory therapist, physical therapist and the rest of the team? That we did that together collectively in a leadership team pledge and they saw that the effects that was happening across the organization. So they began involved really quick. That sounds wonderful.
And this is all about nursing and I'm Dr. Joyce Bachelor. We're live on BBM Global Network and Tune in Radio. It's time to take a short break and we'll pick up where we left off.
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America is out of control. Today's capitalism and the approach to money is in fact the symptom of a more widespread pattern of excessive behavior. In his book, The Culture of Access, How America Lost Self-Control and Why We Need to Redefine Success. He's a psychologist Dr.
Jay Slosar, portrays in America where excess fuels live drive to succeed. Dr. Slosar examines the cultural factors that lead to excess ranging from obesity to fraud to pervasive budget deficits. His book examines the powerful economic and social factors and their impact on our psychological well-being.
Dr. Slosar explores the psychological impact of increasing narcissism, perfectionism, self-destruction and our identity confusion. He offers recommendations for helping generation me become generation we. Those who resist Slosar's message will want to avoid his discussion of regulation and his recent message that at this point, democracy must be more important than today's capitalism.
Get his book now online or by visiting thecultureofaccess.com. Welcome back, everyone. You are listening to all about nursing, live from the BBM Global Network and tuning radio. I'm Dr.
Joyce Bachelow, the host of this show. Prior to the break, Dr. Dunn has started to share a little bit about how he was able to get other disciplines in addition to the nurses really committed to the pickle pledge that he had shared prior to the commercial. Maybe Bob, you can continue to tell us how you got that kind of ownership by everybody.
When we started this work in Midland, you clearly could feel the change that began to happen in our culture. It wasn't long, but the medical staff actually said, we feel what's happening within the presentation, and we want to help champion this behavior in the hospital. We had one of our cheapest staff. He actually took time out of his private practice as a pediatrician and spent five days in training, so he could be a champion amongst the medical staff.
Our chief medical officer has done the same. We've had opportunities over the course of the last three to four years in which we've had to address poor behaviors by some of our medical staff and obviously some of our other interprofessional colleagues. In each of those cases, you're sending them back to a culture of ownership training and understanding this is our culture. We can either stay in practice here or we'd be honored, except your resignation.
In each of those cases, for the most part, they've been able to step up and change some of the behaviors. Unfortunately, we've had to lose some of our leaders in the hospital to not living up to the culture of the organization, but it was rebasing, if you will, from that perspective. I would imagine, though, that by taking that kind of accountability and removing people that really showed that you were extremely committed to what you all were saying was going to be the new culture. I would applaud your efforts on that because a lot of times that's what staff are looking for is whether or not you're going to really follow through.
That's great. Did you also have your patience and the families somehow involved in this? They've been in the process of rewriting some of our information that we give to the patients on a mission and the family. We have a daily leadership fellow that starts at 8.16 a.m.
every morning and we begin by reciting the pickle pledge and the promise from the A's of the self-empowerment pledge. Sometimes we've had patient families, community members that have joined in on that daily. It's right in the main lobby of the hospital. It's open, transparent communication.
They've been involved all along. They understand what's happening. Puzzles are happening throughout the organization. It's an opportunity to stop thinking about everything else that is happening, stand together against passive behaviors and then to talk about things that are working well and opportunities that we have for improvement within that particular unit or the organization.
They've been involved in it. If they ask, our people are very well versed in the pickle pledge and our culture of ownership. That's wonderful. There's been a lot of discussions around the fact that there's five areas of concern that staff seem to be expressing when there's been some listening chores that some leaders have done and those related to staffing where they feel like they don't have enough or the concerns over at the number of new nurses.
A lot of, as you know, regulatory requirements and then there's been a lot more pressure from patients and families and then the horizontal bullying, which I just still have such a hard time believing we're still having to deal with that but we are. Then I think with the pace of change, sometimes they're feeling like senior executives, chief nursing officers are not listening. I know in the book that you published called Building a Culture of Ownership in Healthcare, you described the healthcare crisis within. What do you mean by this?
Can you share a little bit more about that? Sure. Building a culture of ownership is a pretty comprehensive book. It's an overarching book that gets to the pickle pledge, the self-compartment pledge that we talked about and we'll talk about a little bit more about the 12 core action values.
But the healthcare crisis within, you know, we have, there's so much, as you mentioned, in the five things that were identified by the staff that are happening that's maybe not within our control. There's a lot of things that are within our control and the healthcare crisis within that toxic behaviors, the bullying, disrespect, instability, other kinds of things in which you know, it creates a workplace, practice environment where people may have trouble either staying. What we do it to ourselves in a lot of cases, and that's all clearly we found in Mid London as I traveled across the country and talk about this particular topic in and of itself, I hear story after story. It's not even just within a unit or in a hospital, but even happens from hospital to hospital.
I mentioned in our last segment that I've got three brothers that are all nurses as well. One of them is a flight nurse and he would tell the story that whenever he transfers a patient from a small rural facility to a larger facility, sometimes in that department, the physician or medical staff nurses would say, why did they transfer this patient here? Couldn't they have taken that from, you know, taking care of them where they were. And he would say, you know, that's kind of funny that you say that from here, because when I transfer your patients to the tertiary facility in Dallas, they say the same thing about you.
I think we have time, but we really, we've got to treat each other with a little more respect and help where it needs to treat each other with stability. There's so much more that we can do if we could do that across. There's four million nurses. We do recognize there's going to be a nursing shortage in the future.
How much more better would it be in our hospitals and our units and across the healthcare if we could rid our environment of this toxic behavior? You know, maybe you could share a little bit about what you've seen in terms of effects on the people when there's a lot of emotional toxic behaviors happening in an organization. Sure. You know, that's toxic.
You know, I mentioned over times of actions, whether it's throwing something yelling the over actions of toxic emotional negativity, 10, if you will, and then the covert sabotage, refusing assignments or the role I wrote with those kinds of things. But those kinds of behaviors, I mean, it's documented that it has a significant impact, including anxiety, depression, post-traumatic stress disorder, hypertension, you name it, all those things that have an effect on our body. It's said that if a nurse or somebody is a victim of horizontal violence, that toxic emotional negativity, we even witness that. They're more likely to believe the department.
And in some cases, they even consider leaving the nursing profession altogether. Yeah. And I know that one of the behaviors that sometimes you could see is that they'll call and say, who's working tomorrow? Oh, I think I'm going to be sick.
So we can talk a little bit more about this. But we're coming to you live from the VPN Global Network in tuning radio for all about nursing. I'm Dr. Joyce Bachelor.
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This is all about nursing and I'm Dr. Joyce Batchelor, the host of the show. Prior to the break, Dr. Dent was talking about the negative impact that people will have feel as a result of working in an environment where they are seeing toxic behaviors or feel like they are being bullied or disrespected.
Maybe you can continue a bit more about what you have been seeing and share an example or two. Sure. One of the things outside of the effect that it has on nursing and our interprofessional colleagues, one of their affected by that, Christine for us, you wrote the book Mastering Civility. I read an article that she published last year in November and in there she was talking about even in a different industry in restaurants.
There they, the MAM profile, owned the 26-27 restaurants in the New York area. It's one thing to have knowledge and skill but you also need to have a great attitude too. Sometimes he would have to fire or terminate his most seasoned chefs because they treated somebody badly. His thought there is that his customers could taste the insubility that was being demonstrated there.
I think too, if you can see that within an organization, a patient satisfaction and outcome, then our patients can probably often feel the insubility if it's present within the organization. That's one way to test the, you know, just a litmus test, if you will, within your department is what kind of outcomes are you achieving? That's great. So I would like to move to another piece of what was in your book that was related to the three essential elements of a culture of ownership and the three that you had described in the book are emotionally positive, self-empowered and fully engaged.
So can you tell us a little bit more about what those different concepts mean? I can't. I use frameworks a lot in my leadership practice, evidence-based frameworks for leadership and this is a perfect framework in my mind. One, we've got to be emotionally positive in that work.
A lot of that is related to the pickle pledge. If you were to look at it in the book, it relates back to there and that we're going to risk our environment to topic negativity. Maybe we can be a little more grateful for the opportunity that we have to be a practicing nurse and having to be able to work with patients and then self-empowered. You know, there's a self-empowerment pledge.
There's seven promises. You know, I think it's really about life and leadership. Monday's promise is about responsibility, that you're going to take the complete responsibility for your life, happiness, success and those kinds of things and Tuesdays accountability. As we began that to pickle pledge and self-empowerment pledge, we saw things like change within our hospital and within our community as we went through that work.
It really empowered our people. I can't empower somebody. Maybe I can help shape or inspire a shared vision, if you will. But if you allow or enable people to really be empowered to work, that those first two are very important.
And then the final part of that one is being fully engaged. That can be fully engaged in your department, across the hospital. You mentioned earlier about professional governance and even interprofessional governance. If you're fully engaged in that work and having been emotionally positive and self-empowered, that's going to create a lot of positive outcomes.
And fully engaged, too, I, from my perspective, and whenever I talk to the folks across the country, that's even within the nursing professions. Since we're talking about all about nursing. I think it's an important part of our responsibility to join and belong to a professional organization, such as AONE. We've talked about AONE before, but that is the voice of nursing leadership and there's 70-something other nursing professions, but being a member of that and being fully engaged in the work.
It's not just a clock in, clock out, we're nurses 24-7 and we have a responsibility to be fully engaged. And so those three, there's multiple chapters associated with each of them and it's very positive. How did you really shape and get your leaders to really follow you and help to make sure that all the staff and we're going to really be held accountable for making this change? Because it's not an easy change, it would be my guess, from what you described so far.
Oh, you're right. It's not easy. And I think the sustainability of any sort of change is probably one of the most important parts of any change that you're going to go through. I think first, people have to be able to recognize that we have a problem.
And in this case, it may be a problem with culture. And we did. And so to be able to highlight it and get people to where they're shaking their heads and then to say, if we recognize that we have a problem, then where do we really want to go? And that's creating that shared vision of where we want to go.
And in here with the culture of ownership work and working with Joe and all of the work that he has done, this fit in very well with our organization and what we're doing. So getting people engaged in that work from the beginning. After that, we created a leadership team pledge in which it creates a common set of standards, if you will, that we're going to embrace this culture of ownership and then we're going to treat each other with respect and civility, all the things that we know we should do. But here we are setting the standard that anything will other than this is not tolerated.
That's great. I would imagine that your process for finding new leaders when you're going to make a hiring decision really has also begun to engage all of this. Is that accurate? That, oh, yes, it's very accurate.
You know, you've got to hire for culture and attitude. Going back to team steps, even team steps, knowledge, skill and attitude. I mentioned Christine for us and the rest of the tier. But team steps and the knowledge, skill and attitude, attitude is probably the most important part of that.
In the book, building a culture of ownership, it's about the invisible architecture of culture values and the attitude which is the interior design of that. But having somebody that is going to work for your organization, you've got to hire them that's going to fit within that culture and do well. I mean, you can't just hire a body to hire a body. You're going to have a lot of negative effects on the organization.
Have you found that your ability to find the right kind of leaders applying has actually improved because people hear about the kind of organization you have? Oh, yes. Whether we find that new leaders in West Texas, you know, our landscape is pump jacks and oil barracks and it's pretty dry. And so, yeah, finding people that are going to be fitting with our values.
But what we find is that people stay longer, our internal race and everything else are much lower. That's wonderful. This is all about nursing and Dr. Joyce Bachelor.
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Joyce Batchley, the host of the show. Prior to the break, we were discussing the journey that Dr. Dent has been on with his organization and helping to really achieve a very healthy work environment and the positive impacts that it's been having on a lot of the various outcomes and certainly being able to track and retain a lot of talent, which has been wonderful for him. So Bob, I'd like to move us to talking about your latest book, The Heart of a Nurse Leader, where you have really described values-based leadership.
And I'm just really curious, how did you identify these values? These values that were identified in brief, if you will, in the building of culture, of ownership and healthcare. Joe Tai and his research for a long time created 12 core action values. There are two sets of six, if you will.
The first six core action values have developed the inner strength of character that is needed to be a strong leader. And any of the second six core action values are the catalyst for action-inspired contribution to the profession, if you will, taking that effective action. And so as we went through and discussed these to create the Heart of a Nurse Leader, really understanding from my perspective, incorporating Joe's values, coach, if you will, the 12 core action values, it was important to be able to recognize that, yes, we do have these core values. Maybe they're not all your own personal values.
You may have others think about lifelong learning family and those kinds of things. But I think in essence, the 12 core action values are representative of the values that we all can espouse to and lead by. And so in the book, we describe those 12 core action values and even give some action items if you will for nurses. It's called action for something to consider.
Now, there's outside the 12 core action values, each of those values actually have four corner stones to them. And so in essence, there are 60 different portions of this book that really can drive a nurse leader to reflect on themselves and what they can potentially do to improve their leadership practice. And then how do they get feedback on how they're being perceived by other? Have you incorporated that into like a 360 review of their leadership from staff and others giving feedback?
In some cases, we do. It's not a great idea. We've incorporated some of the AAOE competencies for nurse manager and nurse leaders. Within the development of their evaluation, they do get evaluated on their attitude and embracing the culture of ownership and health care and embracing culture of ownership.
But to get to the actual 12 core action values in the corner zones, to be that specific, we haven't. We have addressed the failure of leading by example and engaging in toxic behaviors as a leader. Dismissing toxic behaviors are not addressing them quick enough. So we do address it from that perspective, but that would be a good idea to think about.
So I'm just curious, do you have a personal favorite amongst the 12 core action values? Oh, I have multiple favorites. You know, I think if you look at the first six and that's developing our own interaction, the integral values, a couple that come to mind authenticity. I think we have to be authentic in our leadership.
We have to be who you are. You can't really as a leader, if you can be comfortable understanding who you are as that leader and develop at your strengths, not focusing on your weaknesses, but developing your strengths and being completely aware and mindful that's core action value three and then core action value four, courage. Whenever you're thinking about change and change management, even in this culture, to be relentless in your nursing leadership, it's going to take courage. I have the opportunity to interview Linda Quinn Everett during the AAOE annual meeting.
And what she really wanted to reflect on in that interview that I did with her there, was all about courage and what it takes as a nurse leader to develop that courage. And then if you flip that and go to the action items, which I'm, I think I'm all about action. But core action value number nine, which is about focus. I think sometimes we take this shotgun approach to addressing all kinds of things and we don't always get to focus.
I'm often times reminding myself, just to focus on the vital few things that's going to make a big difference. And so I found a journal entry from April 2005, 13 years ago, and in there, and that journal entry because I keep a journal all the time, I, I wrote in there that I'm having a hard time finding balance in my, in my personal professional life. And I need to focus on more of this or that. And so here it is 13 years later and I'm still acting on trying to maintain focus because there's just so much opportunity within, within healthcare.
And then clearly 10, 11 and 12 that that is booty-asmon. And the second cornerstone of that is energy. If we have nurse leaders can't bring that into the table, it's hard for people to be able to step up and do and recognize that, you know, what we're doing as a nursing profession is inspiring and we really want to do that. Not again, as a chief nursing officer in succession planning, if I can't be enthusiastic about my role and responsibility, who wants to succeed me in this role?
So I have to bring it. And I, you know, from my perspective, it's all about serving leadership and being helpful and mentoring other people, passing that back a line or passing along, given that gift of, of mentoring. I've had great mentors in my life and I want to get back to the profession and so having those simple conversations with people across the country in my role as president of AOE has been, it's been remarkable. It's been fascinating to see what good things are happening and what we can do to continue to serve nurses across the country.
I was working with an organization where none of the managers were interested in becoming directors and none of the staff wanted to become managers and I asked them to reflect on the impression that they give to the staff when they come to work because you could just tell that they were not coming in energetic, they were not coming in leading to inspire, they were showing that they were tired and they were aggravated. And yes, you will have bad days when you're in a leadership role, but the impact you can have is tremendous. So having the right kind of environment where you feel like you can, in fact, ask questions, challenges, status quo is important, but the image that you are projecting is certainly being seen and impacting much greater than you may be aware of and I really agree with you about energy and being really important because people really do watch us and they want to see whether or not you think this is a good thing or not. So thank you so much.
Well, this is all about nursing and I'm your host, Dr. Joyce Bachelor, we're live on the BPM Global Network and it's time to take a short break. For over 50 years, Evelyn Stupula has been a loving advocate for people with disabilities throughout the state of Pennsylvania, president and founder of Big Heart Bridges, her organization actively campaigns for legislation and support of civil liberties that meet the needs of disabled individuals with housing, transportation and employment. Mr.
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Welcome back everyone. You're listening to all about nursing, live from the BBM Global Network and tuning radio. I'm Dr. Joyce Batchelor, the host of the show.
Before the break, Dr. Dent was sharing a little bit about the 12 core action values and some of his favorites, one of which he was describing as really being around courage and energy and you can certainly tell by the work that he's led in the conversation so far this evening that he certainly is inspiring many and having a lot of energy with this kind of change that we need to be doing in our profession. And I know that Bob has mentioned a couple of times that he is, in fact, the president of American Organization of Nursing Secutives, which is a really important role. And I want to recognize and really have our listeners see about how Bob has taken the work not only that he's done at his local level, but that he's now beginning to influence this on a national level.
And the American Organization of Nursing meets with the National League of Nursing, the American College of Nursing and the American Nursing Association. They have a meeting called the Tri-Counsel for Nursing. And recently the Tri-Counsel created a nursing civility proclamation. Can you share what this means and your role in helping to set this direction?
Sure. As President of the LECC last year, I had the opportunity again with the Tri-Counsel and you mentioned the Tri-Counsel there and really shaping a group, a strong group of people that can help influence what's happening across the nation. But as we went into 2017, you can imagine the climate in the country after the presidential election and the violence that was happening across the country. There's a lot of incivility.
And what's happening on campuses, you mentioned the American Association of Colleges of Nursing and National League for Nursing. So they were addressing that and asking questions, too, about how we address this incivility that's happening across the nation on our campuses. And then, Senator Briano and Marla Weston and others with the American Nurses Association myself, we began thinking about even from an acute care facility in nursing profession. It's really creating this unrest.
And what can we do? We are the nursing profession, the professional practice of nursing. So Dr. Rune Alexander, she's the lead of diversity and inclusivity at the University of North Carolina, she and I, she was the president of Atlanta at the time.
So she and I were charged with creating a nursing civility proclamation. And looking at the data, the research and others, we did create that and really it gets to some of the things that we've been able to identify and the political pledge and the culture and others. And there's a lot of documentation, not just in that. I mentioned Christine Porett in the Master of Incibility.
But there's a lot of other work that's been done around that coal, coal Edmonton has done the stopbullyingtoolkit.org as part of his academy work and others. So there's a lot of people that's working on that. So here, we ended up creating the nursing civility proclamation by the end of the year and tapped into what each of the four organizations were doing to address that. And for example, A1E had worked with the emergency nurses association on toolkits around workplace violence and others.
So there's a lot of that work. You can find it on the tricounsel for nursing.org website that's tricounselfornursing, all one word.org. And it's the nursing civility proclamation published in 2017. And it really talks about what these toxic behaviors are, what effect it has on the individual, what effect it has on our patients and the people across the country.
And then it ends with a charge that, you know, that be it resolved, the tricounsel for nursing hereby proclaim that nursing civility should be practiced throughout the United States and establish healthy work environments that embrace this invaluable diversity, inclusivity, and equity. And so we try-counsel, we call upon all nurses to recognize nursing civility and take steps to systematically reduce that in ourselves, our professional practice, the workplace environments that we do that we practice, and even within our communities. If you think about four million nurses who can take on this charge and the effect they have in their circle of influence, we have the power to really effect change in our environment nationally, if not globally. I know that this is definitely an area that's getting a lot of national attention as the burnout rate and the kinds of concerns that you're expressing are being felt not only by nurses, but by the medical staff and other professionals.
And there's a work being done as a result of effect too that what we're seeing is an increased number of suicides within the medical profession. And I think that we sometimes underestimate the impact that the violence in the communities is having on the caregivers that are in the organizations receiving the victims of this kind of violence that's really taxing on the healthcare professionals. So I think you're really doing some amazing work because it's definitely an issue that's got to get raised up and discussed more because it's really having very detrimental effects in a lot of different ways. So I applaud that you're doing that.
I would like to just ask you a little bit about what you had included in your book that was related to your leadership philosophy. And I really enjoy your leadership philosophy and have shared this in other forms that I teach, but how did you develop it and why do you believe that it's important for leaders to have a philosophy that they share and role model? You know, I think each of us, you know, your experiences as a chief nursing officer and you were a chief nursing executive of a large system, your experiences are going to be different than mine, which is going to be different from somebody else's. And I, you know, through my 30 years of nursing and nursing leadership, my adventures that I've had, the types of experiences that I've had that I don't want to repeat in some cases where I found good practices that got great results that I want to continue to repeat.
So I reflected on that and I keep a journal, I write those experiences down how I felt. You know, you talk about suicide rates within a medical profession and a nursing profession, you know, that's so sad. I can't imagine having set up as a nurse leader to create an environment where people are having that sort of an effect. And so what can I do to really affect that change?
But having a leadership philosophy, you can, and it may change over time as you have additional or other experiences, but writing it down what you stand for, what you don't stand for, what you tolerate or what you want to tolerate in that regard. And if you can do that and you share that with your leadership team, with your nursing staff and others, it creates a sense of understanding. It's part of communication, relationship building, that's the number one core competency and the nurse executive competencies listed on the AOI website. I think that is the most important competency to have.
And having a leadership philosophy where people can really understand who you are and how you lead is very important. Well, this is all about nursing and I'm your host, Dr. Joyce Bachelor. We are live on the BBN Global Network and tuning radio.
We'll continue this conversation when we come back. Attorney Renee Marie Smith is changing the way we sell real estate. She wrote a series of books called My Short Sale Guru Guides for All Real Estate Practitioners. Whether you're a homeowner wanting to understand the process, an agent who has been handling short sales for years, or an industry analyst wanting to know how short sales impact your business.
Renee uses her vast real estate experience to take a comprehensive look at the recent market phenomena while relaying it in an easy to understand format. Through her company, Smith Title Services, Renee has counseled thousands of short sale participants and processed in excess of a thousand short sales. Her knowledge is transformational for real estate professionals and laymen alike. And her live presentations provide people the opportunity to ask specific questions about their issues.
Buy her books and schedule her to speak at your next event. Visit www.smithtitleservices.com or call 305-705-3428 or email her at Renee at smithtitleservices.com. Isn't it time to sell your property today? Learn the My Short Sale Guru way.
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To order your Wiggy Wags, visit wickiwags.com or to find out where to buy Wiggy Wags in your town, visit mindwiggywags.com and start enjoying having man's best friend around. I'm your host Dr. Joyce Bachelor on All About Nursing and we're live on the Bee Bum Global Network and Tune in Radio. Prior to the break, Dr.
Dent was sharing a little bit about his philosophy and how he developed it in terms of what he believes are most important things for himself and others when they're in a leadership role. And it was great to hear that you talked about relationships being one of the most important things. And I had a boss a long time ago that said it's all about relationships and I've always believed that was probably the best advice I've ever gotten. It's really been wonderful to hear all of the work you've been doing Bob at your place and also not only impacting the work environment in Midland but throughout the country with the kinds of things that you're leading, particularly the work with the tri-counsel and then three books which I think is no small feat.
And so I was just curious because I think with people here publishing a book there's like a dear and a head like kind of look on. I can't do that. That's insane. You know, I would never know how to get started.
So are there lessons learned or wisdom that you can share with other colleagues on how to become an author? Sure. You know, that was always one of my, one of the things I wanted to accomplish. If you think about the things that you want to accomplish in life, to be able to share my experiences, I've got other things in mind that I want to write.
But I'll still a phrase that Joe tied my professional friend, Colleen Coloster, the three books that he shared that really helped me launch in working with this and that is creating a memory of the future. And so I had the opportunity, Joe has plenty of opportunities, somebody said, you know, I want to write a book and I'll hand them a $5 bill or Joe would hand them a $5 bill. So, you know, I want to buy the first publication that you do and even create a book jacket for that individual so they can see what that book jacket might be. But part of it is just starting to write.
I think, you know, if you keep a journal, write the things that you're most passionate about, find a partner. There's different ways to do it. Two of our books, the Pickle Pledge and the part of it is we are self-published. The Building on Culture, Ownership and Health Care, that came after a presentation that Joe and I did at AOE so years ago.
There was a editor for Sigma Theta Todd in the audience and she came up afterwards and she goes, what you got here is really remarkable. We want you to write a book about it. And so they contracted us to write that book. And so they did.
So you can go through a publisher like Sigma Theta Todd. There's other publishing companies or you can anymore now and do a lot of that work through self-publishing. But really it's creating that memory of the future and begin writing and just really think about Joe and I in this regard, each of our books. Sometimes we just walk around the park over and over again and just thought about what all would go into a book.
And sometimes we sit and we just write and then we just sit there and write all the little things down on page after page after page that would end up being parts of chapters or whatever and we'd expand on those concepts as we begin to write. I learned a lot from Joe. He's published many other books in that regard. And so to be able to partner with him on these three books and we're already talking even on my trip, my drive here to Fredericksburg, where I'll be presenting tomorrow.
We were already talking about the next three books that we'll be doing together. So it's great work. It sounds like you've done a great job also finding someone that can help mentor you through. And what I always say is take the fear out of publishing, which is wonderful.
And I think that there's probably more people out there than we think that would be very willing to do what Joe has done with you. And so I was just curious, how did you find Joe to begin with? We brought a key note to a nursing leadership retreat back early on in 2011 or 2012. And so that was my first interaction with him.
And we developed a kick-up relationship and developed that over the last several years. Well, that's wonderful. I really appreciate you being on our show this evening, Bob, and sharing the journey that you've been on. And congratulations on three publications.
It's just been wonderful. This is all about nursing. And I'm your host, Dr. Joyce Batchler.
We're live on the Beeping Global Network and TuneIn Radio. Bye for now. You've been listening to All About Nursing with your host, Dr. Joyce Batchler.
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