Chapter 8: An Evolution of Leadership Experience
Files
Description
Dr. Summers recalls that she had a “hunger for exploring management” and jumped at the opportunity when a position opened in Hematology at Fairfax Hospital. Dr. Summers explains why she was hired and also recalls that she had to teach herself management as there were no books available at the time. She describes the many functions she had to learn and how they became fascinating problems for her.
Dr. Summers observes that she has a pattern of taking on positions that demand confidence and competence and she meets them with confidence and sometimes less competence going in than is comfortable for her. Dr. Summers talks about her pattern of taking on positions that demand confidence and competence.
Dr. Summers gives examples and talks about learning lessons about management people. She then talks about her promotion to the Director of Nursing, which gave her responsibility for many inpatient units as well as for managing leaders. She then talks about her principles for leading managers and leaders to perform at their best.
Dr. Summers says that her habit of moving to leadership positions without having all the skills for the job is an “illness.” (She says she identifies with an article she read on “The Imposter Syndrome.”) She is constantly driven to perform at higher levels and notes that she made her moves when wanted to do something different. She is good at identifying new opportunities, not at maintaining an institution’s status quo.
Identifier
SummersB_01_20140123_C08
Publication Date
1-23-2014
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Barbara Summers, PhD, Oral History Interview, January 23, 2014
Topics Covered
The Interview Subject's Story - Professional PathProfessional Path The Leaders Leadership On Leadership The Professional at Work
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Barbara Summers, PhD:
Well, you know, I started to have a hunger for exploring management, and a position opened up as a manager for a Hematology Oncology Medical Unit at Fairfax Hospital, which is now Inova Fairfax Hospital in northern Virginia. So I figured, nothing ventured, nothing gained, and I interviewed, and I was selected for the job. Well, this was, believe me, one of those “Now that I’ve caught it, what am I going to do with it?” Because I had no formal preparation to be a manager. I knew a lot about working with people, I knew a lot about developing staff, but I knew zippo about budgeting. I had no idea how you do scheduling.
Tacey Ann Rosolowski, PhD:
What do you think they saw in you that made them overlook those lacks of experience?
Barbara Summers, PhD:
I think they saw someone who had clinical expertise in the care of the patient population, who had functioned successfully in an advanced practice leadership role and who had good communication skills and, you know, who could learn the other stuff. So this was great, I loved it, but, you know, I couldn’t be the clinical specialist anymore. I had to be the manager. So you have to deal with the whole deal of performance management and performance coaching and disciplinary action and developing a schedule. And, you know, there were no books to teach you how to do that, so I spent a lot of time on-the-job training with my own personal self in my office. How do you develop a schedule? I figured out how to do them. I got really good at scheduling. But not an easy thing to do when you’re trying to develop a schedule for a thirty-two-bed unit and you’ve got a mixture of nurses and nursing assistants and clerks, and you’ve got to have the right number all the time, and people want days off here and there. So it was a good challenge, but it was a challenge. And then I had the challenge of the financial management, too, and, you know, I was not challenged in math. I could do math. But I was challenged in understanding the finances of delivering care within a nursing unit and how to put all these pieces of data together into something meaningful.
Tacey Ann Rosolowski, PhD:
Can you tell me about that challenge? I mean, when you say the finances of delivering care, I’m not sure what’s included in that. So what were you learning at the time? What was the scope of what you were learning?
Barbara Summers, PhD:
Well, okay. So I would get my monthly financial report, and on the report I would see here was the total revenue for the care provided on your unit by your nursing team, and here were your total expenses: personnel expenses, supply expenses, drug expenses, blah, blah, blah, blah, blah. And, you know, the goal was always to have the revenue exceed the expenses, and there were these ratios on the flipside of the report that I knew had some meaning, but I wasn’t quite sure what to make out of them, so I just had to study it. And one of my first aha moments, because I had always heard people talking about FTEs, FTEs, FTEs, full-time equivalents, and I’m like, “Oh, my god, I don’t know what they’re talking about.” And then one day in my office with my own calculator, I had the aha. One FTE is 2,080 hours of work. That is a full-time person. If a nurse works eight hours per shift and five shifts per week, 2,080 is a full-time employee. I mean, that was just like the most basic building block, but it was a huge aha moment. Then after that, things just started to fall into place. So I then understood, okay, if I’m looking at what is my expense-per-patient day, how do I break that down into personnel expense-per-patient day and non-personnel expense-per-patient day? If my personnel expense-per-patient day is exceeding budget, then what contributed to that? Did I have too much overtime? Did I have too much paid time off? So, I mean, then it became fascinating and I loved it. So it was one of those challenges that I had repeatedly in my career where I would go from a position where I felt very competent and very confident, and then I would uproot myself from that position in that organization and go to a new place where I didn’t know people, I wasn’t confident. I might have had competence but I wasn’t confident about that either. And I had to rely upon what would become over time a set of knowledge, skill, and ability that could be used to be successful. So that was a lot of fun. I very much enjoyed that, and I was in that position for a number of years, learning lessons about managing people, you know, learning that as hard as I would try in working with employees or physicians, that there are some people who are just so unhappy in their personal lives, there’s nothing you can do to make it better at work. You know, they’re just there. You can’t fix it. Learning how to be fair and at the same time hold people accountable to a standard of performance; learning how to develop my ability not to have my face tell everything that I’m thinking. I have a very expressive face, and often I wouldn’t have to say a word because people would know exactly what I was thinking, based on my expressions on my face. Learning that there are very few things that come to you as an urgent pressing need that you have to decide on right this moment. Most things can sit for a day or two or three, and give yourself time to think about it, because decisions made in haste are often regretted. So, learning to trust my gut, that going against your gut almost always ends up being not a good thing. So just had a lot of learning about working with people, working with nurses, working with patients, working with families, working with physicians. And then I had an opportunity for a promotion to a director level, and I applied for that and I received that promotion. So I was then responsible for a large number of inpatient units, and that was all fine and good, but then I was also responsible for Hemodialysis. I knew nothing about that. I was responsible for Psychiatry; knew nothing about that. And I was now in a position where I was responsible for managing leaders, not for managing their staff, so you have to learn how to lead differently. And that was a great experience, a really, really good experience.
Tacey Ann Rosolowski, PhD:
What are some of those differences? How is leading leaders different than leading staff?
Barbara Summers, PhD:
I think the biggest challenge is in recognizing that while oftentimes it might be easier, in your mind, and faster to do it yourself, that if you jump that line and go from yourself directly to the staff and don’t hold the manager for that staff accountable for achieving change, then you are really aiding and abetting in their not being successful, and that the more you do that, the less able are you going to be to hold them accountable, because you’re at every turn encouraging their codependence. Because why should they be accountable? Because they know you’re going to fix it. And then also recognizing that you have to lead people where they are to where you want them to be. You can’t lead them where you want them to be. You know, you want them to be high-performing, self-motivated, accountable leaders. Well, that’s good, but not everybody comes that way, and so you have to figure out where are they and then help them to develop the skills to get to the place they need to be. So that was interesting.
Tacey Ann Rosolowski, PhD:
I’m curious about this pattern of going from a position where you feel really competent and confident and then throwing yourself into something else. What’s the motivation behind doing that?
Barbara Summers, PhD:
I think it’s an illness. (laughter) I don’t know. I’ve done it repeatedly, though, in my career, and it is not intentional, believe me. I mean, I don’t sit and think, “Oh, good, I’m going to move myself to incompetence,” because it’s a horrible feeling when you get there. And I actually remember the promotion I got to be the director, there was serendipitously an article in a journal about the imposter syndrome, and I read that and I thought, “That’s me.” And, you know, the imposter syndrome basically says that you find yourself in a situation or a position where you’re like a duck and your webbed feet are paddling as fast as you can under the water, but on the top you’re trying to appear as cool, calm, and collected as you can be, but you’re living in complete fear that one day people are going to figure out you don’t know what you’re doing. Now, so that completely described me, but it goes on to say that really it’s a normal and a natural feeling and that it actually drives to better performance. But I sent that article to the woman who had been my boss, whose position I took, and I remember she sent me back a note, handwritten note, because in those days we had no email, and she said, “You’re no imposter. You’re the real thing.” And I saved that note for years and years and years. I don’t know why I did it. I have no idea why I did it. I think it was because I would get antsy. I’d be in a job for three years, and then I’d start getting antsy, and I’d want to do something else. So I was always very good at starting things up, identifying new opportunities, launching them. Not so good at maintenance. And interestingly, though, when I was promoted to be the director, I had come to a place where I had decided, “Well, I like this job now, being a manager. I think I’m just going to do this for the rest of my career.” And I was good with that. And then this opportunity presented itself, and off I went.
Tacey Ann Rosolowski, PhD:
Mm-hmm. A new challenge, new mountain to climb.
Barbara Summers, PhD:
Yes, a new mountain to climb.
Tacey Ann Rosolowski, PhD:
Yeah, a higher peak.
Recommended Citation
Summers, Barbara PhD and Rosolowski, Tacey A. PhD, "Chapter 8: An Evolution of Leadership Experience" (2014). Interview Chapters. 1245.
https://openworks.mdanderson.org/mchv_interviewchapters/1245
Conditions Governing Access
Open
