Bittersweet day for us at CCHMC as @billpatcourtney gives the Schubert lecture for #CincyKidsPGR @CincyKidsCME as she begins retirement soon.
Sharing profound memories of Dr. Schubert as the epitome of a trusted leader.
She's one of the greats.
❤️💜💙💚💛🧡 Sharing lessons from Dr. Thomas Delong and reflecting on lessons during COVID.
Most importantly-
Be crystal clear about how others experience you.
Be crystal clear about how others experience themselves when they are with you.

I've been thinking about compassion and pediatricians.

There's an idea that pediatricians are "softer" than internal medicine docs because we take care of kids. And kids are cute! Funny! Sticky! 1/ Once when I was a resident, a scrub tech told me I was going to treat runny noses all day while HE worked in the OR doing SURGERY.

I had already matched to a hem/onc fellowship.

But the perception was there. My job was soft. His was hard.
2/

Day 2 @theNASEM workshop
The highlight from day 1: LaToya, a CNA, gave a moving, honest, courageous account of being a direct care worker. “The ice cream truck should not be a luxury.”
- hours & pay are bad, the work is hard & they love & care their patients & their dignity @theNASEM First up- @EspinozaNotes from @PHInational
The intense focus on direct care workers, paying people a living wage, improving working conditions so that we can also improve patient care during this event has given me so much hope

Good morning from the Keck Center @theNASEM where I am so pleased to be part of their workshop this morning to support and sustain the workforce to care for people with serious illness! #hapc #pedpc #wellness #wellbeing #suffering The first panel shared experiences from the front lines so vulnerably and beautifully. @MaguirePeggy @PhilRodgersMD @RachelMayAdams

Thinking about how the same gesture can be received as incredibly compassionate or just- not- depending on the actor.
Ex- after 4 was in the ED, I took cookies to say thank you. The nurse cried. "No one does this."
But if an org leader did the same, likely different response. 1/ I appreciate that the meaning and receipt of the gesture depends a lot on the power and intention of the person making it.
An org leader can change difficult working conditions and chooses instead to bring cookies, that's incompetent compassion for workers.
2/

Next up: Fr218A- Agitation and feeding intolerance in children with medical complexity with @StocktonBev and Dr. Katherine Maddox! Front row is Dr. Julie Hauer. The OG of this topic who wrote the book. If you don’t have it and you do #pedpc here is a link:
bookshop.org/p/books/caring…

Next up: FR201a- An epic step forward- a universal #pedpc navigator in the EHR with @conradw4, Alice Bass & Kat Thomas #hapc23 Actual cartoon of Conrad and Alice at work creating a #pedpc workflow in Epic. #hapc23

“If we could make the EHR better it would make me feel so much more well.” - @conradw4

Dr. Martin Bogetz, a bereaved father, sharing the legacy of his daughter Alyssa:
- an MSW who cared deeply about wellbeing
- the first non-physician associate program director in Peds at Stanford, who focused on supporting trainees
- sister of @jbogetz, #pedpc wonder ❤️ #hapc23 The inaugural Alyssa Bogetz lecture: Dr. Susan Block talking about the state of integration of #hapc and #mentalhealth
Alyssa died of AN. The educational fund was started in her honor @AAHPM w the appreciation that our field needs to grow to support people like her. #hapc23

Next up! TH110B- A seat at the table: professional competencies define roles and value of psychologists in #pedpc!
@PedsPCTF members @RachelKentor and Amanda Thompson & Sarah McCarthy! #hapc23 Competencies help standardize roles and practice requirements for #psychologists in #pedpc and highlight the important and unique contributions they bring to the interdisciplinary team. #hapc23

Next up: TH109B- Together is better: a combined #hapc and #psychiatry substance use disorder clinic for patients with advanced #cancer
@AmericanCancer take note of this model
#hapc23 @lauramakaroff thinking of special populations and your work!

Session TH103A Leading for Wellbeing with @KristinMDCT. Let's go! #hapc23 @AAHPM Point 1: Wellbeing of leaders predicts wellbeing of staff. There are indices that are specific to leaders. #hapc23

Kicking off #QMC2022- @arifkamalmd with Top 10 Pearls in #hapc #quality! #pedpc Speaking of @PalliativeQual - do you do palliative care?
Do you follow the Palliative Care Quality Collaborative? No time like the present! Twitter is still here!

"Listening is only powerful and effective if it is authentic. And authenticity means you are listening because you are curious and you care- not just because you are supposed to."
@jennilinebarger (quoting "Difficult Conversations" & "Humble Inquiry" books)
#hapc #pedpc ❤️this chart from "Humble Inquiry"
It's about listening to understand- not to tell.
Not to prepare the next thing you will say.
We are trained that knowing the "right answer" = good doctor. There's much more to it than that.
@jennilinebarger #CincyKidsPGR #pedpc

The Stress First Aid model (Credit- Patricia Watson, PhD) adapted by @theSCCH for use in healthcare describes 4 phases of stress: green, yellow, orange and red. It's so useful because even if you don't know the details- I think NO ONE has been green for over 2 years. 1/ This is especially true in healthcare.
We can't pretend COVID is over.
Patient autonomy is being taken away.
The best of us, on our best days, are probably still pretty yellow.
2/

Memorial Day is to remember those who died for our country.
But today, I think of a friend who continues to risk his life in our military. His 3 kids and his wife. The work he's doing.
1/ Our friend flies big planes.
He evacuated thousands from Kabul. He flew into the madness and got people out.
I took his wife out to lunch while he was there. Sat with her. Worried with her. Felt it.
2/

In #pedpc we think of Pam Hinds work- parents ask themselves, what would a good parent do?
I think this is the crux of what many of us have struggled with throughout the pandemic.
How we weight risk/benefit often comes down to our personal definition of a good parent. Last week, my children's school dropped the mask mandate for the 3-6 classes. My husband expected it. I didn't.
We have managed to avoid our children getting COVID for 2 years.
That doesn't make us "better" parents than others.
We have been lucky. And tried hard.

Something interesting is happening as we work our way back into in-person meetings. I’m realizing how conveniently stunted emotions have been in virtual meetings for the past 2 years. How did I miss this? A🧵 (1/) There are so many nonverbal cues that pass us by in virtual meetings. I find dialogue that is both meaningful AND difficult to be almost impossible. But I hadn’t noticed until recently. I thought things were fine. (2/)

Whew this hits home- @JoShapiro3 talks about how we are "asked to metaphorically debrief on a toxic system" on an individual level.
This is why #organizationalcompassion in #healthcare is necessary! Ooh there it is! "The best results are organizationally driven...there are factors that are organizational driven that are harming our wellbeing. Often organizations don't know what those factors are."

There are no local appointments to vaccinate my 5 year old.
Feelings:
Failure as a mother for not sitting waiting when the appointments came online.
Failure as a pediatrician for my kid not being one of the first.
Frustration.
We have waited so long.
1/ Wondering- how did all these other parents pull it off so quickly?
Twitter filled with pics of littles getting vaccinated.
Even my nephew in Seattle got his shot yesterday!
2/

"Academia rewards those who can make hardship invisible, who can be productive amid and despite crisis...Academic parenting, sandwich generationing, left no space for processing."
@klharrisonPhD ❤️💜💙
Making Space for Grief in Academia ja.ma/3ksigRZ via @JAMA_current "In retrospect, what I needed was systematic supports and anticipatory guidance... I needed funding for a year so that I could wait to write grants."
She is describing what I consider to be elements of #organizationalcompassion

Each time my husband deployed, I had a plan for what I would do if he died.
I assumed someone in military dress would find me. At work? At home? Could be anywhere.
I would know when I saw them why they were there.
1/ In Texas, I had a plan of who I would tell them to call to be with me. These people were different at work versus home.

When I moved to Ohio, I didn't know anyone. So that person became our #hapc #fellowship coordinator.
2/