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STTI Nursing Leadership Connection Conference (19-20 Sep 2016) After Action Review

My own After Action Review (AAR) as there were no attendee evaluations:

What was supposed to happen (GOAL)? 1. Bring Awareness 2. Recruit Companions 3. Arouse Change

What was the plan to achieve this? 15-minute podium presentation, which includes in its slides links to the book’s web and Facebook pages, to include at the end of the presentation a slide that directs those interested to follow-up via those page links.

How did the plan change as it progressed? There was no change to the plan during its execution/delivery. Unfortunately, because of my inability to talk off the cuff I must read which keeps me from making changes on the fly. But without reading I risk missing essential points of the conversation.

What actually happened? I have no idea how it went or what actually happened, as it is hard for me to assess the audience’s reaction and this AAR is without anyone’s input but my own as none is available from those who attended the session. The audience had 20-30 people, I expected/hoped for more. However, the session was competing with three other sessions, all three of them in much bigger halls so those topics must have been more popular. The moderator’s introduction, which I wrote, stated I began as a nurse at age 16; I include that to show my interest in nursing was early and not a second career. However, I did not sense the audience was impressed. The introduction finishes, “Jose has worked for more than 20 employers…” Now that caught the audience’s attention as they let out a big, almost orchestrated and unanimous, “WOW!” at the end of that statement. During the presentation there was one moment the tablet I was reading from had a “seizure” and I lost my place. After the fact I have no one to ask if that was significant or not. One thing is for certain about the presentation I did have the audience’s attention and noticed a few reassuring nods and even smiles. Unfortunately, and it just might be my perception, what I saw most in the audience were facial expressions of shock, as if those persons were thinking, “What the hell am I hearing”. And a look which I took to equate those that persons were convinced that I was the anti-nurse (Christ) and running through their minds was something I have heard a number of times, “Where is the caring, compassion, empathy, sympathy, [and my favorite] why don’t you find another career?” I am sure those individuals, not knowing why I had worked for so many employers, had most definitely reached their own conclusions without a doubt as to why I had worked for so many. All that said, when I was done the presenter who followed me commented, “WOW! Jose, that is going to be a hard act to follow.” Which I took that as a compliment. Right? Interestingly, there were no questions for me during the questions and answer portion of the session. The presenter I shared the session with did get 4-5 questions but when the moderator asked specifically if there were “any questions for Jose” there was not a word. Not sure what that means. My guesses are two possibilities (1) the message was clear thus no questions needed (my wishful thinking) and (2) the audience was too shell-shocked at what I had delivered to ask any questions. After the moderator dismissed the audience, the moderator and the other presenter did comment they liked my presentation and appreciated the message. Additionally, two members from the audience came by to speak with me and both had very nice and encouraging words, both of them thanking me for being a voice, which is the intent of all this and very much appreciated when recognized.

Why were the differences between the intent and what happened? I set out to bring awareness to this silent national crisis and change. I did so knowing that one person can do neither and that I need to recruit companions. However, I jumped into this without any idea on how any of that gets done and how time consuming it has been. It does not help that my Knitted Brow is not the best spokesperson for this and neither is my “matter of fact” and inflammatory delivery. That said healthcare’s submissive nature does not help and that is not going to change. On top of that, and likely most significant, who wants to be unemployed. Because of those, especially the latter, I realize that I am asking a lot for anyone to cross to my side and help me push back.

What worked and why? Being called a voice tells me the message is the right one.

What didn’t work and why? Much more difficult to assess on my own. Is it the Knitted Brow or the “matter of fact” and/or inflammatory delivery that shocks the audience or keeps them from asking questions? Or is it healthcare’s submissive nature or the VERY REAL risk of being unemployed that I did not gain any companions, as the needle did not move? The day after numbers: -Facebook New Likes: 2 -LinkedIn Profile views: 1 -Website views: No change -Amazon: No activity (no book sold—not the goal but another metric) -Presentation download: 0 (like ZERO!) -Hearts and Minds changed: Hard to assess but looks like NONE! Despite those facts a self-AAR does not permit an appropriate evaluation of the differences between the intent and what happened, and why what worked or didn't work.

What could have gone better? The message is the right one. What I believe can be better is the spokesperson. Unfortunately, for now there is no one but me. More time allocated for the presentation would be beneficial as well, as it is hard to fit all the pertinent/convincing information in 15 minutes. That said 15 minutes should be more than enough to get someone to look in your direction if they are interested.

What advice would you give yourself if you were to go back to where you were at the start of the project? I am not the right spokesperson, I realize that, but right now there is no one else.

What are the two or three key lessons to share with others? (1) The heart is in the right place. (2) The message is the right one. (3) The spokesperson is not the best choice.

What next? On to Dublin, Ireland for a similar presentation, although the message there is specific to healthcare directed violence. More is needed under the belt as well to get the foot in the right doors. Reignite Senator John McCain’s (AZ) interest with regard to abolishing HCAHPS might be helpful as well.

What should be expected in a year from now? Hard to say, as the book has been out for almost 4 years and this was the third attempt to gain companions without gaining any.

Any personal lessons? I never thought this was going to be easy. But I never thought it was going to be so frustrating. Many of times I have considered putting down the guidon (flag) but remind myself this is not about me but about healthcare. If not me who? My bridges are already burned thus I have nothing to lose. I also find encouragement in Thomas A. Edison’s words, “Many of life’s failures are people who did not realize how close they were to success when they gave up.”

Conclusion: It is likely I am my own biggest critic and biggest hinderance as well. The criticism I can handle but finding another spokesperson is going to be quite the challenge. Despite those a lot of time and effort goes into these presentations for nothing to be accomplished. Next month, 25 Oct 2016, as mentioned, the book will have been out for four years and I realize my writing sucks but the intent, taking healthcare back, is still there in the book yet it has gone nowhere as well. I realize Florence Nightingale didn’t change nursing over night either. In NO manner am I comparing myself to Florence, oh no, but instead just reminding myself that change is never accepted so easily. Press on and reaching out to Senator McCain again might be helpful.

THANK YOU to those who attended the presentation!

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