‘Friending’ Rules of the Road

Since Facebook has become one of the fastest growing social networks in the world, many people are questioning exactly who they should befriend on this social networking site.
Facebook has become a wonderful way to reconnect with old friends, neighbors, classmates, relatives and former co-workers. But when it comes to connecting with people you work with, you might want to give friending a second thought.

According to a recent issue of HR Advisor, a survey conducted by OfficeTeam, a staffing service that places highly skilled administrative specialists, befriending people at work, especially your boss, can be very awkward. A phone survey with randomly selected executives from some of the nation’s largest employers, indicated that 48% were uncomfortable with being friended by someone they managed and 47% of them felt the same way about being friended by their bosses.

The feeling of discomfort extended beyond employees and bosses to include peers, vendors and clients.

What execs said about their comfort level in friending …

“The line between personal and professional has grown increasingly blurred as more people use social networking websites for business purposes,” said Robert Hosking, executive director of OfficeTeam. He said that managers, even if they aren’t going to connect with business contacts on social networking sites, need to be prepared to deal with requests for friending and such.

Hosking advises managers and employees to familiarize themselves with all the different options and controls social media sites offer. Use privacy settings and create different friend or contact lists to control how—and with whom—information is shared. “Individuals should classify their professional contacts into a ‘work’ list and limit what personal details this group can view,” said Hosking.

Here are some common Facebook situations professionals may encounter—and some recommendations for handling them:

• An Embarrassing photo of you surfaces on the site. Untag yourself and change your privacy settings so photos are viewable only by your close friends. Be aware of situations that could be potentially embarrassing when you are being photographed.

• Someone makes a friend request but you don’t want to connect with them. You may have to accept requests from co-workers to avoid slighting them, but add them to your “work” list and adjust the privacy settings so you can separate your work contacts from your personal contacts.

• You’re considering including your boss in your friends list. Think twice before reaching out to your boss. It could become very awkward for both of you.

• Joining a variety of groups. You should only join groups that really interest you. Keep the groups you join separate between your personal life and your professional life. Be very careful of comments you make on groups, especially your professional ones; people you come into contact with in the course of your job may be a members of the same groups.

• Fan Pages. Fan pages on Facebook are visible to anyone who can view your profile, avoid becoming a fan of any page you are uncomfortable sharing with anyone in your network.

• Online quizzes. Stop and think for before taking online quizzes and posting the results to your Facebook page. Do you really want your professional contacts to know which Disney character you most resemble?

• Political and religious views. Political and religious views can potentially create uncomfortable situations and slant the way people think of you. Therefore they should only be shared with your personal contacts and not your professional contacts.

Bottom line here-enjoy your networking on sites like Facebook, but be savvy about it.

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Recent Journey into Health Care: A Family’s Perspective

Some background…

Boomer Time!
Yes that is me - one of the 78 million born from 1946-1964. Along with our other traits, we are classified as the Sandwich Generation. Stuck in the middle to care for our children, parents and, if we are lucky enough, grandparents. I was blessed to assist in care decisions for a great grandmother, as well as grandparents.

A Nurse – so I know it all, right? Wrong!!
My grandmother thought I knew it all! It is so different to be on the patient and family side of the bed. We as health care professionals think we remember what it is like on the patient and family side of life in our practice. From my perspective, this is not so. Health care functions in silos. One area, the clinical side, is rarely concerned with the financial or payment side. I understand hospital settings very well. I have very little knowledge of the long- term care world.

Long-term Care - the unknown odyssey.
So much to know. So far behind.

The Daddy - He was and is just the best! To be honest, he is not even my biological dad. No one would ever know. He raised me from a baby barely walking and is still teaching me today. You see, he is 73-years old and has Alzheimer’s. Looking back, personality changes had already occurred 16 years ago when my son was born. He was emotionally disconnected. He has always looked healthy. And other than his degenerating brain, is healthy. He is not on one medication, and has perfect blood pressure!

In the beginning it was so frustrating for him. He noticed the changes… slow changes. He started to become overwhelmed in activities with multiple steps. Packing - pack, unpack, and pack. Money concerned him, but he was not sure why. He eventually forgot how to work the remote control for the television, how to dial the phone, how to cook. The man was a great cook. He tried to motivate his brain – crossword puzzles and a dictionary stayed on the kitchen table. Eventually, slowly, cognition declined. Even with my frequent visits, it become apparent he could not live independently. My family became more concerned and frequently fretted about next steps. We could not be sure he was eating. We knew he was not bathing regularly. More serious, he lived in an attached condo. He could forget and leave the stove on or a burner with a pan, causing a fire. We had great concerns he could harm himself or others, or someone would take advantage of his condition.

He and my mother were married for 26 years and then divorced. Still bonded, my mother chose to move him to Tennessee where she lives, to care for him. Big commitment, right? My sister was also there to support as a caretaker.

He became part of my mother’s neighborhood. Walking was his thing. He would walk and walk and walk. He would stop and attempt conversations with the neighbors. The community came to know him, love him and look out for him.

Moving him to my mom’s was the easy step. Next came time for long- term care. This decision alone is stressful. When is the right time? The family members feel guilty and helpless. Ok, so that is one side - the family connection, feeling like you are abandoning a loved one. The other side is the unknown minutia of red tape, regulations, and facilities – in other words the real world of health care and the reason health care reform is so critical.

We hired an elder care attorney. While I know many cannot afford this, we could not either, but did. We chose to hire the attorney simply to guide us on the best decisions for my dad. It is amazing, however, the attention and response we received from health care representatives once they learned an attorney was representing my dad’s interests.

I consider our family responsible. We had records and documents and yet, still never seemed to have the right documents. What about those who do not? Maybe records and belongings have been lost in catastrophic events like Hurricane Katrina.

There were so many issues and decisions. What kind of facility is best? How do we pay and what is the financial impact to his long-term care that will be needed? He could live another 15 years. My dad is a vet. He was not in active duty, but was a paratrooper. Hence, he ended up with some chronic back issues. Of course there are no records to document this injury due to a fire at the VA records facility in St. Louis. My dad could not speak to this – no memory. One recommendation – keep every document!

This is not an unusual story. It is happening to thousands of families as you read this. During this experience with my dad, one thought repeatedly entered my mind. How do people that do not have family or significant others with their best interests at heart survive in our health care world? Everyone needs a personal advocate. Every patient is a person with a history, a story, and is a human being who deserves the very best treatment at the end of life. But not every patient is lucky enough to have that advocate. Certainly the guiding principle of assuring that advocacy should be an integral part of health care reform

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Sure, Transparency’s Good, But Only If You Can Trust It.

There’s a lot of current discussion about how important transparent leadership is in developing engaged, motivated workforces. So true! In fact, I’ve read research that shows that frequent, honest communication from the top of organizations can override the damage done by inept supervisors. Pretty amazing when you think about it, huh?

But just because a leader comes off like an open book and can serve up some tasty Kool-Aid doesn’t guarantee he can be trusted. I suggest that transparency is rather easy to accomplish, especially for gifted communicators. Trust, on the other hand, can only be earned through behavior that demonstrates honesty, fairness, unyielding commitment to doing the right thing, and irreproachable accountability.

Indeed, we’ve seen leaders whose eloquence changed the course of history. Adolph Hitler was one of them. So were Ken Lay and Jeffrey Skilling of Enron. Their public personas were powerful, engaging and seemingly transparent; only their greedy inner circles knew the juxtaposition between what they said and what they did. When their evilness was exposed, it left millions in shock and misery, and questioning how they could have trusted such despicable losers.

Let’s face it. We’ve heard elected officials blatantly lie to us. We’ve seen corporations run from their responsibility for human and environmental safety. And we’ve all been in personal or professional situations that made us think twice about who we can trust. Despite all that, for every miscarriage, we can probably cite a counterpoint.

Take the Tylenol tampering case in the 80s. Instead of dodging the issue, Tylenol’s maker, Johnson & Johnson, immediately stepped up to the plate with transparency and action. They backed their public service announcements with responsible solutions, starting with pulling every bottle of product from shelves across the nation. Then, they used the lessons from the tragedy to create tamper-proof packaging that’s become the industry’s standard. Now, nearly 30 years later, Tylenol is still one of the world’s most popular and trusted brands. I wonder if that would be true if J&J had treated the incident as just the isolated work of a lunatic?

Another very recent example involved a horrible error made by a surgeon on infant. The physician not only admitted his culpability, he is now working with the family to ensure ongoing care for the child, which he is funding out of his own pocket. Versus the normal outcome, a mega-lawsuit, the doctor’s remorse, personal accountability and actions were so appreciated by the baby’s parents that they felt they could not further punish him for his mistake.

At a wedding I attended, the minister started the service with a statement about his own life. He said, “My wife and I have been married for 30 years. We’ve lasted this long because she expects certain behavior from me and I oblige.” I believe that’s the essence of trust…responsible, considerate actions that speak much louder than words.

Long and short, I’m all for transparency. I want honest communications - good, bad or indifferent. But throw in consistent behavior that I can respect and trust me, I’m yours.

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Workforce Planning in an Economic Downturn

The August unemployment and jobs report has been released and the numbers were not good for the acute health care setting (or the workforce in general). Hospitals shed 700 jobs in August. Overall the health care industry added 27,900 positions in August and 180,400 new jobs over the course of 2009. These overall numbers include all job gains including physicians’ offices, dialysis centers, blood and organ banks, ambulatory care, etc.

Cumulative data for hospitals shows that from January 1 to September 1 of this year, hospitals added 17,100 positions as compared to 94,100 over the same period in 2008 and 66,800 for that same period in 2007.

We know anecdotally that hospitals are being cautious about adding positions due to the overall economy this year and we also know there have been significant hospital layoffs in some geographic areas. The ranks of uninsured have proliferated, leading to more uncompensated care. The overall financial situation for much of the hospital industry has worsened due to a number of factors. New building has decreased. Donations and endowments are down.

Additionally, many members of the health care workforce have had to rethink retirement due to the economy and are working longer than they anticipated. Those who were part time or per diem may have had to extend their hours to compensate for spouses who have either been laid off or are under employed. These factors have resulted in precious few job openings in general.

Adding to all the above is the huge unknown of health care reform and the uncertainty of how that will look and how the coming reform will impact hospitals, technology, usage, staffing, etc. Add to this the threat of an H1N1 epidemic this fall and you are looking into the great unknown.

Given all of these factors, what is a cogent argument for the health care recruiter or HR executive doing the work to develop a workforce plan during these tough economic times?

One reason is the possibility that the lull in recruitment may have afforded you the opportunity to think a bit more strategically and to plan for future needs more proactively than in the more hectic past.

Just a cursory look at the health care workforce demographic projections is enough to make the most sanguine person nervous. To say nothing of the U.S. population projections. No one is unaware of the aging RN population or of this same phenomenon in other health care professional groups. And we are all bracing for the impact of the aging Boomer population on health care usage.

Workforce planning can seem like a daunting task if you look at the overall big picture, but taking baby steps can both get you started and also demonstrate that it really is not as difficult as you may have thought.

Why not take some time right now to look at where you currently stand in terms of your workforce-even if you only gather information on ages by department and type of position (including managers), and average age at retirement? Capturing just these current numbers and plotting five and ten years down the road will usually be a real eye opener, particularly when you look at some of those small departments with just a handful of employees. If your current HRIS system cannot provide this information, now would be an excellent time to see if you can change that so that you can easily retrieve this information and get a birds eye view of those demographics.

Looking at your own organization, what are projected changes that might impact hiring needs? Are you adding or contracting services, changing or augmenting technology, changing staffing patterns? Are you regularly having dialogue with practice managers about these changes and forecasting future needs for your high volume areas and hard to fill positions?

Look externally a bit and investigate migration in and out of your area, focusing on age and ethnic groups. What does your current population look like? Do your caregivers reflect the community they serve? What is the business climate in your area? What are your local colleges and universities doing in terms of enrollments and graduations in health care professions programs? Are there new programs or are the current programs contracting or being dropped? What will the impact of all of these factors be on the supply of health care professionals for your facility or system?

These baby steps will give you a real competitive advantage in the months and years ahead. And will lead to your being able to develop a true workforce plan.
Beginning work on this vital initiative now will stand you in good stead when the crunch comes. And it is coming…

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Labor Day Reflections

I am writing this entry on the Friday before Labor Day, immediately after the Department of Labor announced the August unemployment rate was 9.7%, the highest in 26 years. The latest numbers account for 216,000 jobs eliminated in August and represent an uptick from an unemployment rate of 9.4% in July.

However, economists had predicted an even higher job loss, leading some to suggest that the slower pace of job losses signals that the recession is beginning to ease. Still, most experts feel it will be many months before we return to pre-recession unemployment numbers.

How ironic to be celebrating the American worker at such a difficult time for most of those very workers.

According to the Department of Labor, The first Labor Day was celebrated on Tuesday, September 5, 1882 in New York City as a result of plans developed by the Central Labor Union. In 1894 Congress created the national holiday of Labor Day. It was suggested that there should be parades to highlight ‘the strength and esprit de corps of the trade and labor organizations’, and a ‘festival for the recreation and amusement of the workers and their families’.

Of course, over the years the holiday has evolved into a long weekend marked by picnics, family gatherings, and golfing. Labor Day signals the end of summer and the beginning of the school year. We rarely consider the true meaning of the holiday.

It is fitting that on this Labor Day of 2009 and the week that follows, we pause to reflect on the great American workforce, which though perhaps bloody and wounded, still represents the best ideals of our forefathers and those who envisioned this holiday.

This workforce has endured a year of downsizing, layoffs, furloughs and other decreases in hours worked or salary earned. Workers have seen co-workers laid off, have been forced to work harder and smarter because their numbers have been thinned, and have worried about the security of their own jobs.

Companies they had thought safe have gone out of business, leaving more workers unemployed. The nightly news is replete with stories about food banks running out of food, unemployment insurance running out and those seeking jobs giving up the quest. Job fairs attract thousands and workers settle for either part time positions or positions they are wildly overqualified for. There is not a single American who has been unaffected by this recession and its attendant job losses, either directly or indirectly.

We can only hope, going forward, that the long decline is nearly over, that in the next few months jobs will be created, furloughs will cease to exist and that by Labor Day 2010, we can truly celebrate the American workforce, confident the worst of times is over.

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Communication in the 21st Century

The popularity of Twitter, Facebook and instant messaging has begun to have a troublesome effect on communications, based on my purely unscientific observations.

In the past few years, we have been reading about how the Millennial Generation has trouble problem solving and employing critical thinking, because since childhood they have used computer programs with pull down menus to guide them. Seems when that is your frame of reference, you have difficulty finding the answers to life’s little predicaments. No pull down menu, what to do?

Recently I have noticed the effect of the abbreviated form of communication used with Twitter, Facebook and instant messaging on communication in general. Have you noticed how emails have been becoming briefer and that apparently those sending emails are not consulting spell check? Punctuation? What is that? Grammar? Not important.

I must confess, I find myself not even capitalizing the first letter in a sentence when I am IMing, to say nothing of using any type of punctuation at the end of my IM messages. And I am not by any stretch of the imagination, anything but a member of the Veteran Generation.

When one is encouraged to be as brief as possible (in the case of Twitter, messages cannot exceed 140 characters and messages in Facebook are pretty much in that ballpark, possibly because most folks tend to use both sites), forming a longer sentence becomes daunting.

Young people prefer texting over a real conversation and that medium has a lexicon all its own. Abbreviations, symbols, numbers-it is like aliens have taken over the English language. I pride myself on never having texted in my life (although why, I have no idea). Probably my one last protest over the constant change technology has wrought. When you have the choice of emailing on a Blackberry or similar device or texting, I just can’t fathom why you would opt for texting.

We have one young friend who insists on texting rather than calling us on her cell phone, despite the fact that we don’t even have a texting out option on our cell phones and that was a conscious decision. I guess this young woman cannot conceive of a human being who is not similarly infatuated with texting and wouldn’t prefer it over picking up the instrument one is using to send the text and actually calling the person with whom one wishes to communicate.

After she has texted us, I always call her cell phone and she is invariably surprised to hear from me. Does she not realize it is a cell PHONE she is using? Back in the dark ages, people actually used them to talk to each other.

Think of what this abbreviated method of communication would have meant to the great authors. Hemingway would probably have loved it. Tolstoy, Cervantes and Shakespeare, not so much. War and Peace would probably have been a modest one hundred pages if written today.

Are we only a year or so away from mini-books, composed of 2000 characters? Is social media creating its own Haiku? Are we miniaturizing our language and our thoughts and concepts?

I fear there is only one step left…and that is communicating with symbols such as nautical flags.

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A Historic Overview of Health Care Reform in the United States

There are few Americans on the fence about the current health care debate. To say there is a partisan divide is to overstate the obvious. In the conversations out there, some bemoan the politics, others are passionate in their defense of non-profit cooperatives or a public option, and still others read threatening intentions into the drive to reform health care.

Phrases like ‘death panels’, ‘socialism’ and ‘public option’ have had divisive effects on enlightened public discussion. Town meetings erupt into shouting, and politicians either face riled up constituents, rail back at them, or hide. None of these approaches are effective, and civilized discourse is lost in the chaos.

Very few (even pundits and politicians!) are well informed about the options on the table, but none are shy about stating their beliefs. Their points of view largely rely on what source they use to obtain news and/or their political persuasion. You cannot pick up a newspaper, read a blog or listen to a news broadcast that does not have something to say about this topic. A tremendous amount of misinformation is being broadcast, and the heated hyperbole in these conversations is tremendous.

No one disagrees that there are millions of Americans without access to coverage, or that the United States spends far more on health care than other nations. Most Americans are good-hearted, generous people who would wish their fellow men the ability to have access to affordable medical care. In fact, we are the only first world nation that does not ensure this basic right for citizens.

Given those points, why is health coverage such a polarizing topic? For decades, private and political groups from all persuasions in the United States have attempted reform, and few have succeeded. Cost is largely cited as the breaking point. Here is a brief overview of efforts.

The first efforts began in 1910 when the American Association for Labor Legislation and T. Roosevelt’s Bull Moose Party made separate, compelling cases for a compulsory national health plan. Their efforts were quashed by U.S. entry into WWI and opposition from special interest groups, including the American Medical Association, who decried these efforts as socialism.

The decade of the 20s saw no attempt at reform efforts, although General Motors established health insurance coverage for their 180,000 employees during this decade.

After the Great Depression in the 1930s, Americans desired increased security for the elderly and unemployed, and again pushed for health care reform. The Social Security act was passed as a result, but without health insurance provisions.

In the 40s, employers on a large scale began offering health insurance as an employee benefit, and Presidents F.D. Roosevelt and Truman proposed health reform bills that were voted down. Truman’s proposed government-provided system to cover all Americans was vilified by the AMA and denounced as a Communist plot.

In the 50s, the first dialysis machines were created, and the first organ transplant done. There were not enough machines or organs to treat every needy patient, so care was truly rationed for the first time. Medical/ethics panels were set up to review criteria to determine which patients would most benefit from treatment and which chosen would have the most successful outcomes. The polio vaccine was created, and the cost of hospital care doubled.

In the 1960s it was clear that the poor and elderly citizens who could not obtain insurance through an employer needed some type of assistance to afford hospitalization, and Medicare and Medicaid legislation were passed into law by the Johnson administration.

In the 70s, both President Nixon and Sen. Edward Kennedy proposed separate bills for compulsory national health coverage, but both were defeated and Nixon’s was left behind in the Watergate scandal. HMOs came into play. These caused public outcry because of ‘gate keeper’ strategies that patients viewed as obstructive.

Corporate for-profit entities came into health care in the 1980s, and Diagnostic Related Groups (DRGs) were introduced by the Reagan administration as a way to cut costs by creating a system that paid a pre-determined amount per diagnosis. Private insurance quickly jumped on the DRG bandwagon as a way to control costs.

In the 90s, another proposed federal health plan was defeated in Congress, and health care costs rose at double the rate of inflation. HMOs were reformed to diminish the intrusive role of gate keepers, although to this day, most insurance plans require some form of pre authorization for hospitalization and most procedures.

In 2003, during G.W. Bush’s administration, the Medicare Prescription Drug, Improvement, and Modernization Act was passed. Unfortunately, there were no provisions in the act to pay for the additional services, and the cost is estimated to exceed $500 billion. In enacting legislation without a way to pay for it, there is no sure bet that it will move forward.

The current administration has a real challenge. People are warier than ever given the high unemployment and the spiraling deficit. Politicos of every stripe are presenting their viewpoints, and the lobbyists and special interest groups on all sides add to the confusion.

As a nation with increasing disparities in health care access across racial and economic lines, and catastrophic illness the leading cause of U.S. bankruptcy, it is imperative to rationally look at the issues and establish priorities.

Reform or the lack of it will have a significant impact on everyone and, specifically, health care employers and insurers. What are you doing to find out more and let your voice be heard?

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What Are Your Customers Saying About You?

Mystery shopping began in the 1940s as a way to measure employee integrity. The most common venues where mystery shopping is used are chain and retail stores, movie theaters, fast-food chains and high-end restaurants, apartments, health clubs, resorts, banking and financial institutions, and more recently, medical facilities and health care organizations.

Mystery shoppers are paid to enjoy great meals (and in some cases not so great meals), view free movies, play a few free games at their local bowling alley, enjoy a free workout a local gym and even have a relaxing overnight stay at a Five-Star resort.

Mystery shopping has also been developed as a strategy to rate recruitment departments and evaluate company websites, ease of online application, response back to candidates and the overall recruitment process.

One of a health care organization’s most precious assets in a competitive environment is its reputation for customer service, which directly impacts its customer (and employer) brand. We all know satisfied customers are repeat customers. And too often, information gathered from patient satisfaction surveys does not yield enough good data to drive needed change and improvements.

Now, more than ever, health care organizations are engaging customer service mystery shoppers to help them step past the competition to understand the customer experience and perceptions about their organization. Customer service mystery shoppers can dig (in real-time) beyond the patient satisfaction surveys to reveal issues health care organizations wish to address.

By engaging customer experience mystery shoppers, health care organizations gain valuable insight about their staff’s interaction with patients and visitors. These ‘shoppers’ are better able to identify areas of improvement regarding the care and treatment of patients because they have been trained to look for gaps in the customer experience. Customer experience mystery shops also reveal and report environmental impact factors that may require correction. Reports include recommendations for improvement, which may include staff training, scheduling adjustments for both staff and patient flow, and a variety of environmental strategies.

Let’s face it…perception is reality and the patient’s/visitor’s perception is all that really matters. Health care organizations that use customer experience mystery shoppers say the reports have led to a significant number of improvements in the patient care experience. Everything from better signage to better staff communication and courtesy (and everything in between).

If your goal is to capture the customer experience in key department/areas through observation of staff with patients and visitors, environmental assessments, telephone calls to key areas and follow-up calls to patients, a customer experience mystery shop can help improve your customer service and enhance your reputation in the community as a premier provider. Our own experience in customer experience mystery shopping bears that out.

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Staying on an Even Keel

by Kate Christmas

Tumultuous Times
With the prolonged economic downturn and the continued threat of unemployment looming, I find a tremendous amount of emotional struggling going on. It is a challenge to keep equilibrium and positive energy in the current climate. The relentless focus of the news media on the most recent bad news certainly doesn’t help.

Recently I spoke to three good friends who are in career turmoil. Their companies are unstable, their job futures are unsure and they are not finding viable job prospects out there. Another just moved his family across country for an opportunity, because he could find nothing in the southeast. All have had decades-long careers in health care.

One recruiter I spoke to mentioned they will start their third round of layoffs in just over a year. Morale at her institution is dismal. Two small business owners I know have had to trade expansion plans for workforce cutbacks in an effort to keep their businesses afloat during this crisis. One is a family business that has been in operation for 52 years.

Business slowdowns, cutbacks and shortfalls due to the fall of the stock market and banking crisis are evident everywhere you look. Last year, the unemployment rate in North Carolina, (where I live) was under 3%. In June 2009, it was 11.2% - nearly quadruple - in one year.

Several friends who had planned to retire this year will not be doing so because of plummeting home values and catastrophic losses to their IRAs. Three RNs I know are simply holding on, aging, ailing and unable to leave the workforce because they need the health insurance.

Still others, who continue to work very hard, are finding less return for their efforts. Some who were at the top of their game are frustrated and guilt ridden because those efforts are not producing these days.

This is reality at the moment. The recession dominates the mood and creates fear and instability.

Finding Balance
Numerous studies have proven the impact of relentless, negative stress on the body and mind. And the results are not healthy.

So the question is – how does one find balance, and discover positive energy during such challenging times? The answer is, it must be searched for. You can help to improve your own outlook by seeking opportunities to relax and find joy in life.

To the point — in the midst of all this worry, when was the last time you took a break? Got away from the day-to-day grind to celebrate the little things in every day – a sunrise, a walk, a day at the beach or the lake, a simple picnic in the park?

We could all take a page from the younger generations in the workforce. Unlike Veterans and Baby Boomers, their personal identities are not completely wrapped up in their careers. They actively seek time off to do civic work, and to spend time with their families and friends.

One friend I know has a mountain retreat she goes to on weekends. The beauty of the natural surroundings reminds her that there is more to the world than work. Another meets with a group of talented women, and every two weeks, they complete a beautiful quilt for one of their members. Another is an avid tennis player, competing in matches every week. Playing and singing music is my own salvation. A night of singing harmony with friends lifts me like nothing else can.

A west coast friend is active in her local homeless shelter. She says nothing snaps her back to how good her reality is than spending a few hours with those less fortunate.

What about those long-standing summer escapes – a good book or a summer blockbuster? Taking a few hours away from the chaos can set you free, open other vistas, and put things in perspective.

I recently had a long discussion about how one friend’s priorities have changed as a result of this recession. She is working, but her spouse was laid off and has been unable to find other employment for six months. Her youngest child is heading to college this fall, but will have to take on student loans because of the change in family fortunes. Her two older children, who have already graduated and are in the workplace, have pledged to help their younger sister with college expenses. My friend and her spouse are sad about this, but realize their family has become more open in their conversation and closer as a result. She feels she has gotten to know her children in a way she might never had, if circumstances had not taken this downturn.

So, to be cliché – look for the silver lining! Keep working hard, but do not forget the importance of balancing the stress and worry with healthy pursuits that lift your spirits. After all, what goes down must (at some point) come up!

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Is There Life After Reductions in Force?

I wanted to take a few minutes to reflect on the economic times and the fallout the economy has caused on workers. I doubt that there is one of us who does not know someone who has lost his job and in some cases we may know several who have lost their positions. The American culture defines itself by what we do, so for many to lose a job is a very devastating event on many different levels.

A wide range of emotions will be experienced- from shock, disbelief and “why me?” to anger and outrage- very similar to those stages described by Elizabeth Kubler-Ross’s in her work on the death and dying continuum.

Losing a job is a profound loss, especially if it comes very suddenly and without warning. Even if you were unhappy with your position, you had a sense of control over what you wanted to do. When that control or the choice to walk away from a job is taken away and you are told you no longer have a position, your very being feels a profound loss of control and dignity. There is no opportunity for closure or to say goodbye, to wrap up loose ends. Along with those feelings comes a heavy dose of self-doubt. “Maybe if I had spoken up more or volunteered more or if I hadn’t said that in the last meeting this wouldn’t have happened to me.”

Anyone in the position of having to let someone go will often say something like, “This is not personal, but a business decision.” However, because of the pride we feel in what we do and the importance our culture places on this, while we can rationally understand it, we have difficulty emotionally. Self-doubt will be a large factor that must be overcome. Going through the entire cycle and having support while doing so will help with the self doubt and self blame, but you must be aware that it will still exist.

I urge all of you who may be experiencing this or know others who are, to work through the cycle until you reach closure. It will come, but it does take time. Reach out to others who have had the same experience. Open yourself to new opportunities; you can never go back to what has been but need to look at what will come. This may be the perfect opportunity to look at something else that has always interested you or something you have done for fun or as a hobby. When I experienced this personally, I transitioned from the acute care setting to home care and it opened an entirely new career for me. I also worked for an attorney doing medical review, working with expert witnesses and actually going to depositions and court hearings with the attorney. I would have never even considered either one of those positions had I not been “displaced.”

For the survivors of reductions or restructuring, there is a sense of fear that “this may happen to me.” For others there is a sense of guilt about still having a position when your peer does not. When you see colleagues leaving your facility or your local recruiter chapter it is important to reach out to them.

Many people feel uncomfortable doing this, partly because they don’t know what to say and partly because of that survivor’s guilt complex.

Look beyond how you are feeling and try to put yourself in the other person’s shoes. It brings a tremendous amount of comfort to have someone pick up the phone or, in today’s day and age, email or Twitter just to say, “Hello. I am here for you. “

Having had this happen to me, I know I will never forget the day I was “displaced’” and how that felt. I will also never forget the people who called and reached out to me. People whom I was never especially close to reached out, which really touched me, and I have never forgotten that. On the other side were people whom I was very close to who didn’t call. I made the conscious decision to call them because I valued those relationships and they were very relieved that I did. They fell into the “survivor guilt” category and just could not bring themselves at the time to call.

One last tidbit: keep your sense of humor-that is something no one can ever take away from you.

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