Rae Woods: From Advisory Board, we are bringing you a Radio Advisory. My name is Rachel Woods. You can call me Rae. We've been fighting against the COVID-19 crisis for nearly a year now, but there is another crisis that's been looming in the background and it's one within our workforce. In fact, I'm not sure that crisis is even the right word to describe what the healthcare workforce has gone through. And of course, the fight continues. So in this episode, I want to talk about enabling a resilient workforce and how to build a culture of resilience across your organization. To do that, we're going to start with two nursing experts, Katherine Virkstis and Anne Herleth. And then we'll come back with some takes on the leadership angle from our colleague Craig Pirner. Let's start with Anne and Katherine. Hey, Anne. Hey, Katherine. Anne Herleth: Hi, Rae. Katherine Virkstis: Hey, Rae. Rae Woods: We're going to be talking about resilience. How do you both feel like your personal resilience has been doing? Anne Herleth: Well for me, it definitely ebbs and flows. What I've found to be somewhat hard in the last couple months is the anxiousness I feel about getting vaccinated and getting back to reality. Rae Woods: Like you want to get vaccinated. You're eager to get vaccinated. Anne Herleth: Yes, can't wait. Last year, I just accepted my fate of being at home all the time. And now I'm ready. Ready to get back out there. Rae Woods: Katherine, what about you? How's your resilience doing? Katherine Virkstis: My resilience is okay. It's possible I may have become too comfortable being at home every day. Rae Woods: I hear that. The fact that I very rarely put on pants that zip is definitely indicative of that. Rae Woods: We're going to be talking about resilience today, but I have to admit, I feel like this term has just become another buzz word in our industry. So before we go any further, I want to do some level-setting. When we say resilience, what do we actually mean? Anne, let's start with you. Anne Herleth: So for me, resilience is what makes you able to continue to move forward, despite a lot of stress and tough things going on. And I often think of it like a muscle. The more we use it, the better we get at doing it. Of course, we can strain a muscle. So there's that piece. Rae Woods: Mm-hmm (affirmative). Katherine, how do you think about resilience? Katherine Virkstis: We've done research on resilience in the past, and we always thought about resilience as the ability to bounce back from stress. And I think what we've gotten smarter about more recently is, it's not always about recovery or bouncing back, but it's about showing up every day in the face of stress. Rae Woods: Mm-hmm (affirmative). And I think there's a lot of conversation in the industry about resilience, but there's also some other terms being thrown around, right? How do we keep the workforce engaged? How do we make sure our employees are satisfied? How are we avoiding burnout? What is the difference between resilience and some of these other features? Anne Herleth: The big one I hear is confusing it with burnout. Burnout is an end state. It's where you end up when you use your resilience too much, when you feel like you can't keep pushing forward. Rae Woods: Maybe when you've strained the muscle. Anne Herleth: Exactly. When you've strained that muscle. Rae Woods: So if that's burnout, what's the difference between resilience and engagement? Anne Herleth: Engagement is sort of the other end of the spectrum from burnout, right? It is feeling excited and in tune with what you're doing every day. And resilience can also help you get there, but it is not, again, engagement is an end state, not sort of how you're showing up day in and day out. Rae Woods: Katherine, how do you think about the difference between resilience and some of these other terms? Katherine Virkstis: With burnout, I think you hear about people who are burned out and they just can't do the job. Rae Woods: Right. Katherine Virkstis: Right. And it's not that they don't want to, it's that they can't anymore. Resilience is kind of like the skill or this kind of protective buffer that you have that prevents you from getting to that state. Right? So you might be stressed, you might be tired. You might be exhausted. But resilience is, as Anne said, that muscle that helps you stay productive to stay kind of in the mix when when things are really getting tough. Rae Woods: And I think it's difficult to talk about the different kind of efforts in all these areas, because they're often confused. I think about even before the pandemic, I can't think of a single clinical leader that would tell me they were not focused on engagement. They were not focused on resilience. And yet we saw burnout and stress on the rise. Help me square those two things. Katherine Virkstis: Yeah. So we had that same... We kind of scratched our heads, right? And said, "How is it possible that we have all of these organizations who are so focused on the wellness of their people, on engagement and wellness training and resilience training?" And the answer was when we went back to Maslow. Rae Woods: Mm-hmm (affirmative). Katherine Virkstis: And a lot of people know that that framework. It's Maslow's hierarchy, one in which we recognize that at the top of the framework is being your best self, self-actualization or optimization. And at the bottom of the framework are basic needs, the things you need to stay functional, the things I call air, food, and water. And what we realized is almost everybody is focused on engagement and wellness, which is really at the top of the pyramid, and kind of overlooking what was at the bottom, right? And what we found is there are cracks in the foundation of this pyramid, of Maslow's hierarchy. Rae Woods: That's super interesting. So if, in the traditional sense, you've got air, food, and water at the foundation, what is air, food, and water for a clinician? Katherine Virkstis: So we did these, and we actually looked far and wide, because there are lots of potential cracks in the foundation. Everything from, "Do I even have time to use the restroom because I'm so busy?" Rae Woods: Hear that. Katherine Virkstis: Right? There were four big ones and they were: Do I feel safe at work? Do I feel like I can deliver safe care? In other words, I feel like I have to make compromises in care delivery. Do I feel like I have time to recover from emotional stress? And then the fourth one was, I think super interesting and not as intuitive as the others, but it was the sense that people were feeling isolated in a crowd. Meaning, they're surrounded by people all day, but even still, they feel alone, because of the way care delivery has changed. Rae Woods: This is super interesting to me because the two of you and your team kind of determined these cracks in the foundation prior to the COVID-19 pandemic. Katherine Virkstis: Right. Rae Woods: But every single one of those challenges are challenges the clinical workforce is facing now, except this time it's turned up to a thousand. Katherine Virkstis: Right, exactly. Rae Woods: And I think that's actually a little bit surprising to people. I think folks might understand that there are safety risks being on the front lines of a deadly virus today, but what were safety risks before the pandemic? Anne Herleth: I mean, unfortunately there is a lot of point-of-care violence that happens within the health system, whether it's disruptive patients, disruptive families. And not to blame patients or families in high-stress and anxious situations, like when someone's health is not where they want it to be. People act out or people are on medications that interact and that can cause disruption and violence towards clinical staff. And so that was the big one. I think now we add the, "Do I have the PPE I need?" Rae Woods: Mm-hmm (affirmative). Anne Herleth: "Do I feel safe when I'm leaving work? Are there protocols in place for me to feel safe going home, and making sure that I'm not putting my family at risk?" So we really layered on a different kind of safety concern, but safety concerns have always been there. Rae Woods: And I think that kind of thinking is probably true across each of these cracks. If I think about a nurse feeling like they're compromising care delivery before, and now they're making a decision about who gets oxygen or not? That's a... No wonder they're unable to use their resilience, or no wonder they've fatigued that muscle, if that's what they're dealing with every day. Are there other examples that are kind of a big shift from pre- to in the middle of the pandemic? Anne Herleth: Well, I think the big one you see covered in the news and just talked about is the potential for PTSD in staff today, following the pandemic. There's always been a risk of emotional distress, stress, and even trauma for clinicians. I think we've just really amplified that when we talk about things like, "Do I have to pick what patient is going to get the ventilator? How many patients did I in fact see die in the last few months?" And that's really gone up. And so I think that trauma piece, we're going to see what happens there, but I suspect there will be a huge uptick in PTSD in the coming months and years. Rae Woods: I totally agree. And I want to underscore the challenge that Katherine brought up, which is this feeling of isolation- Anne Herleth: Mm-hmm (affirmative). Rae Woods: And feeling like people don't understand what you're going through. I think especially in a time where folks are still resistant to wear masks, are eager to get back to their life. That kind of feeling of being alone. I mean, gosh, that must be worse today than maybe it's ever been. Anne Herleth: Well, and at work they're isolated. You're putting your PPE on and going into a room- Rae Woods: That's right. Anne Herleth: And oftentimes that nurse or that physician is by themselves in that room for a long shift or for a long portion of the day. You can't eat lunch with your colleagues anymore. Rae Woods: Hmm. Anne Herleth: You can't just sit and chit-chat, because you have all of your gear on. So that social connection that you had at work has been diminished. And then you go home and maybe you're separated from your family out of precaution. You're definitely separated from your friends and everyone else. So the isolation that the whole world is feeling right now is a thousand times worse for the healthcare workforce. Rae Woods: And Katherine, you mentioned that even though these were the core cracks in the foundation, that you heard a lot of things in the research. I'm curious, were there any differences in some of these foundational needs when you look at different types of clinicians, maybe when you look at nurses versus physicians? Katherine Virkstis: Yeah. You would find some differences because their workflow is a little bit different, but in the end, the ones that really mattered are actually the same. We didn't see a huge difference between, say, a doctor or a nurse or another kind of caregiver. Rae Woods: So given all of this, how would you describe the state of the clinical workforce today? Katherine Virkstis: I would say the clinical workforce is tired today. They've been through a lot, but they actually have a very strong baseline of resilience. Rae Woods: Mm-hmm (affirmative). Katherine Virkstis: Most clinicians we've found, they're problem solvers. They're scrappy. They can bounce back in the face of stress. Anne Herleth: For the nursing workforce, who I feel like I focus on a lot, the word I've been using is they really have a lot of grit. They've been able to dig in and just keep coming back. And I think more than anything, I hope anyone listening to this can look at the workforce and understand what an incredibly resilient group that is, that they just keep coming to work. That, in and of itself, is resilience right there. Rae Woods: So let's get into what leaders, and I think particularly clinical leaders, should actually do about it. Where do you recommend folks start? Anne Herleth: So just to play on something Katherine said, which is, the workforce is tired and they need recovery. They need physical recovery and they need emotional recovery. So in the coming months, as we hopefully continue to see COVID cases decline, the workforce needs physical and emotional recovery. Rae Woods: Hmm. Anne Herleth: And then from there, I think we start talking longer term, how are you going after those cracks in the foundation? How are you ensuring safety? How are you ensuring staffing so that your workforce feels they can deliver safe care? So going directly after those foundational cracks so that staff can not use so much resilience, day in and day out, in the months and years to come. Rae Woods: I also get this feeling that the workforce, gosh, maybe they've just lost some trust in the system. Maybe even trust in their leadership. And it can be hard to ask people to keep showing up every day under the conditions we've described, without PPE, when you have to make compromises, when those cracks in the foundation are present. So if you are a leader that feels like you need to rebuild some of that trust, how do you do that? Katherine Virkstis: One of the things that I think is really important right now is being really honest with staff. Don't sugarcoat what's happening right now. Don't make false promises. I think the more you can be kind of a vulnerable leader and share that you might not have all the answers, right? The future is uncertain and none of us knows what's going to happen. I think the more you can be honest with staff, the more they'll trust you right now. Anne Herleth: Yeah. I would just emphasize everything Katherine said. And vulnerability can be such an important tool to use. Vulnerability, and truly transparency, around some of these hard decisions and what is coming down the pipe for your workforce. But it can be hard to do, particularly on the vulnerability piece. Rae Woods: Yeah. Anne Herleth: I think we just as humans, and many leaders, haven't really practiced that skill. So really being open and honest and showing your humility and your human side can go a long way. Rae Woods: Even beyond showing your human side, Anne, you mentioned recovery. I imagine leaders need to take a break, too. Anne Herleth: Yes. Rae Woods: But that almost feels... As a leader, that feels especially difficult to do. How do you recommend clinical leaders go about taking their own break? Anne Herleth: Well, one of the things we say often here is, "Put on your own oxygen mask first," to use an airplane analogy. I very much miss getting on airplanes. So anytime I can think about that, I do. But if you don't put on your own oxygen mask, if you don't take care of yourself, take that time off. Recover. You cannot truly help your staff. So I think many clinical leaders forget to take care of themselves first and that's step one. Rae Woods: Yeah. I also feel like one reason why folks don't give themselves a break is because they feel like they are responsible to show up for their team. But actually, I want to challenge that assumption, because if you take a step back, you are giving your team permission to do the same, right? You're modeling the behavior that you would want them to do. Rae Woods: Katherine, you mentioned earlier that one mistake that leaders might be making is that they're focusing on engagement instead of resilience. They're focused on the top of the pyramid instead of the foundation. Are there other, maybe well-intentioned mistakes that you see leaders making? Katherine Virkstis: Yeah. One that I see right now is, we're all so busy, right? And a lot of organizations are understaffed or trying to come up with the right complement of staff, and people are sprinting. Right? People are working long hours and stepping up and doing a lot. But the problem is, this pandemic is a marathon. It's not a sprint, right? It's not over yet. And we still have a ways to go. And the problem is, if you keep sprinting, you won't make it till the end. So we need to kind of reframe the way we think about this. How do we prepare ourselves for a marathon and not a sprint? Rae Woods: And I think that makes sense in theory, the idea that this is a marathon, not a sprint. But it is a lot harder to then make changes in practice. What do you actually recommend clinical leaders be doing? Katherine Virkstis: First and foremost, it's sounds really simple and common sense, but you need to refuel yourself. You need to connect back to the things that energize you. And one of those ways is to connect with your coworkers, with your colleagues, with other leaders or other staff or whoever they may be. We looked at the story that a lot of people will know about, called the Endurance. It was a book and a movie, and it was about the explorer named Ernest Shackleton from the 1800,. And he wanted to be the first to cross the Antarctic. Long story short, the ship got caught in an ice floe and it became very clear that they weren't going to cross. And immediately Shackleton's focus shifted to, how do I get every one of my team members out alive? Rae Woods: Wow. Katherine Virkstis: When it became clear that the ship was going to sink, they went back onto the ship to do a reconnaissance mission. And he said to each member of his team, "You can take no more than two pounds worth of your personal goods, or something that you want to bring back with you." With one exception. The ship's weatherman had a banjo. And the banjo was bulky, it was big, it weighed about 14 pounds, but he required that they bring it with them. It was the thing that brought them together every night. They sat around and they played the banjo and they sang, and it was the way they connected to each other. And later, after they had survived this mission, and by the way, every single one of his team members did survive. He was asked what was the key? And he had said it was the banjo. He called it the team's mental medicine. Rae Woods: Wow. So what's the equivalent of the banjo today? What is the 14-pound mental medicine that you are going to bring to your team every single day? Katherine Virkstis: Our initial thought was, it's storytelling, but we do lots of storytelling in healthcare. And we do a great job telling patient stories, but we're really terrible at sharing our own stories with each other. And that I think is the key. How do we create the space for time and connection to share our own personal stories with each other? What it's like to be on the front lines, to have to be with a patient taking their last breath, who's not allowed to be in the same room as his or her family member. Those are really tough shoes to walk in. And only the person who walks in those shoes really understands and can help you connect on that level. Rae Woods: So far, we've been talking about our advice for clinical leaders, right? Those who are going to be managing a team of nurses or physicians. But I'm wondering if you have advice for frontline clinicians. Anne, let me start with you. Anne Herleth: Well, I think first I would say that it is okay to feel tired, to feel burned out, to feel worn down. And that doesn't mean that you're not resilient. I think just recognizing that is so important. Rae Woods: That's such a good point, because when we use those other terms, like burnout, it feels like such a bad thing. It's like, I'm admitting defeat to say, "I'm not engaged. I'm burned out," rather than making it okay to be tired. Anne Herleth: Right. It is okay. You showed up, you continue to show up. We all owe you so much for that. And you should feel okay with where you are and the fact that you just kept showing up. Rae Woods: Katherine, what's your message to frontline clinicians? Katherine Virkstis: You know, I think we all often... I'm a clinician myself. We all often default to saying, "I'm fine." Right? We call it, we have a name for it. We call it the "I am fine culture." Rae Woods: Yeah. Katherine Virkstis: And sometimes it's about being stoic. But I think usually it's because you think you're fine when actually you're not, and you don't realize it. So one of the things we need to do for frontline staff is think about emotional support and not waiting for frontline staff to raise their hands, to opt in to emotional support. We actually need to bring it to them. You need someone to say, "Here, this is something that you're going to do, unless you tell me you want to opt out." Rae Woods: And by the way, that's another excellent behavior for leaders to model. To not say, "I'm fine. My weekend was fine." But instead to say, "I'm really tired. I'm really exhausted. I feel like I'm on the hamster wheel." Right? Whatever it is, to make it okay for your team. And you can only do that if you admit that to yourself. Anne Herleth: Right. That's vulnerability right there. Right? And like we said earlier, we struggle with that. So showing that vulnerability is so important, and not just tomorrow and next week, but forever, because some of the clinicians might actually be fine now and not be fine in six months, in a year, in 18 months, when something else happens that sort of triggers some of that trauma that they felt. Rae Woods: Let's talk about that. Because I think some folks might listen to this podcast and think this is odd, that we are talking about it now, right? Cases are starting to trend down. We've made it through the worst of the winter months, that you two know all too well was... I don't even know that sprint is the right word to describe what our workforce was doing across those colder months. Anne Herleth: Mm-hmm (affirmative). Rae Woods: But I'm not sure that the crisis with resilience is something that is going to end as the COVID crisis starts to wane. Do you agree? Anne Herleth: A hundred percent. We had a problem before COVID. COVID just amplified everything and it is going to continue. We are never going to quote, unquote "go back" to some state that we like to idealize before COVID. The other thing is that there is a long tail when it comes to recovery, and thinking about particularly emotional recovery. And so even though cases are going down, we are going to see the clinical workforce responding in different ways, over a long period of time. Rae Woods: And you used the word earlier, trauma, which I think is appropriate here. Anne Herleth: Mm-hmm (affirmative). Rae Woods: And trauma is not something that ever has an end, right? Anne Herleth: Right. Rae Woods: Right, it is something that you will keep having to battle, gosh, for far into the future. Anne Herleth: Right? And so the emotional support, the long-term support for trauma, but for other symptoms of depression, anxiety, substance abuse, all of the things that we will see, needs to be part of what health systems provide forever for their workforce. Anne Herleth: Well, Anne, Katherine, I want to thank you so much for coming on Radio Advisory. You know what's coming, it's the question that I ask every guest on every episode. When it comes to workforce resilience, what's the one thing you want our listeners to be focused on right now? Katherine, let's start with you. Katherine Virkstis: I would say, don't underestimate the impact that all of this will have on your staff, not just today, but into the future. And in the same breath, I would say, don't underestimate the impact that you can have as a leader on your staff, by showing that you're listening, by having their back, by showing them that they can trust you. Anne Herleth: Anne, what about you? Anne Herleth: I'm going to cheat a little and say two things. And one is, on your hard days, on the days where it just feels like you can't show up, remembering that just showing up is enough right now. Rae Woods: Hmm. Anne Herleth: And the second is to sort of double down on what Katherine was saying, which is that vulnerability is an incredibly powerful tool for frontline staff, for leaders to use. And so embracing your humanness and that vulnerable side can do wonders for yourself, but also for the people around you. Rae Woods: I could not have said it better myself. Thanks, Katherine. Thanks, Anne. Anne Herleth: Thanks, Rae. Katherine Virkstis: Thanks, Rae. Rae Woods: We'll be back with more on resilience with leadership expert Craig Pirner. Rae Woods: Hey Craig, thanks for joining us. You are obviously somebody who spends every single day looking at leadership and the role that leaders play. When it comes to resilience, is there something that jumped out that Katherine or Anne shared, that's not just important for the clinical leader, but for all leaders in healthcare? Craig Pirner: Well, it was a really valuable take from both of them, so hard to pick just one thing, Rae. But I do think this idea of focusing on cracks in the foundation is really important. A sober evaluation of where the workforce is, and in particular where their trust is. Rae Woods: Hmm. Craig Pirner: A lot of high-minded talk about resilience is not going to fly when our workforce doesn't feel safe, or if they don't have any time to engage in really foundational emotional recovery, or if their operating environment is totally broken. Rae Woods: If leaders are going to focus on cracks in the foundation, do you have any recommendations about how they go about that? Any kind of lessons learned from your own work with leaders? Craig Pirner: Absolutely. I'd say a couple of things. The first is, recognize that in any organization, there's going to be real variability. Some organizations have done things during the pandemic that are foundation-enhancing and trust-enhancing, while others have had to take some steps that undermined those things. And that variability may even apply within an institution, to segments of the workforce, or even particular units. Craig Pirner: So I would really recommend that manager-level leaders, and not just executives, are involved in this sober evaluation of where things stand. And then I would be really cautious about equating cracks in the foundation and getting them addressed to going back to basics. This idea of, "We're going to suspend all activities and initiatives and tell our people, 'Focus only on patient care.'" The intention there is good, but I've seen organizations, in doing that, strip away all of these vital points at which the workforce was actually connecting with each other and recovering. If we weren't pleased with what the basics were before, we should be cautious about going back to them. Rae Woods: That's right. I am cognizant of the fact that we are asking leaders and managers to do a lot right now. And I have to believe that there are some simple things that leaders can do to practice resilience themselves, alongside enabling resilience with their teams. Any advice there? Craig Pirner: Yeah. Lots of advice. Let me share maybe three ideas. The first is, emotional regulation. We've talked about that before, Rae, but it's the idea of, when I am feeling something, I should name that emotion as specifically as I can, because that puts my rational brain back in charge of my response. Craig Pirner: The second is to seek social connection. All of the resilience research shows that those who have strong social bonds experience both less stress overall and less severe stress. Rae Woods: That's right. And that's one of the things that Katherine and Anne were talking about when it comes to sharing stories and creating the banjo moment. How do we create that among our staff now? Craig Pirner: Yeah. The banjo moment. And it's about really making a plan for, how will I deepen social connections at work? And individual leaders can think about that, through techniques like the banjo thing or techniques as simple as, "Where am I going to sit in this meeting and will I meet someone new?" Craig Pirner: And then I would also really advise every single leader to decide on something, outside of work, that is going to help define you, and then engage in that thing consistently. That could be time with family and kids, it could be reading, it could be exercise. But it's really important to understand, "Who am I as a person outside of my professional identity?" Craig Pirner: Now at a cautionary note, all of that said, let's be cautious about those things being simple. The ideas are straightforward, but turning any of those things into a habit, particularly when some of them might be counter to the "I'm fine culture" that Katherine and Anne spoke about, is often anything but simple. Rae Woods: That's right. Craig Pirner: It takes real determination and courage. Rae Woods: And you use the word habit, which I appreciate. Maybe I would go a step further and use the word culture. We don't want any kind of resilience work to just be programmatic, to be something that we start now, in a crisis, and then, as you said, go back to the way things were. Craig Pirner: Mm-hmm (affirmative). Rae Woods: So if you are a leader that's trying to establish the habit or the culture of resilience, how do you actually do that? Craig Pirner: That takes a lot. If I'm thinking about building resilience into culture, I would, one, ensure that we're not only talking about personal resilience. Personal resilience is really important, but it's really only part of a larger conversation about burnout. And when you look at the organizations that have made great progress, pre- and during pandemic, about burnout, they are talking about and tackling, not only cultivation of resilience, but inefficiencies of practice that can make it feel like a grind to go to work, for even the person who is personally resilient. Craig Pirner: And then I think you have to consider the elements of culture. Culture is a multi-legged stool. One of them is infrastructure. Do we have policies and systems in our workplace that enable and embed resilience? Now, there's talent management. Does the way that we set expectations for talent, evaluate talent, reward talent, enable resilience, or even undermine it? And then leadership commitment. And this is the thing, of course, that I spend the most time working on organizations with. Do my leaders model what we say we're striving for? Rae Woods: Yeah. I really like this take because I'm afraid that the danger with talking about personal resilience is that, if personal resilience is the answer, personal resilience is also the problem, right? Craig Pirner: Mm-hmm (affirmative). Rae Woods: It is on you. It is your, dare I say, fault that you're not able to show up for work. But what you're talking about, with culture and all of these legs of the stool, is building a system around your people that allows them, and ultimately you, to practice resilience every day. Craig Pirner: That's right. And ensuring that I'm not encountering consistently things in the workplace that either require me to have so much resilience that I have no capacity to recover, or that I'm encountering things that just break down that resilience every day. Rae Woods: So when it comes to building that culture, building that system of resilience, is there one thing that you want leaders in healthcare to focus on right now? Craig Pirner: One thing is hard, of course. But I would say, in your development of leaders, address that leading is about head and heart. So much of cultivating a culture of resilience is about the heart side of leadership. Our leaders showing up in a way that is detrimental, neutral, or accretive to a culture of resilience, and too many development programs are only about head and tactics, and not about heart and a deeper examination of what's really at work here. Rae Woods: Yeah. I love that. That reminds me of some of the comments Anne was saying, about being vulnerable, and modeling the right kind of behavior, and being aware of the shadow, I think, that you leave with your team. Craig Pirner: We care about vulnerability because it's an enabling force. We want to be vulnerable as leaders because vulnerability enables the stuff of resilience- Rae Woods: Yeah. Craig Pirner: Feeling worthy, feeling connected. As a counterintuitive example, in a culture like a lot of healthcare cultures, where war stories are often the currency, it can be a very vulnerable act to in fact, share a positive emotion, like "I actually found time in my weekend for tranquility." Rae Woods: Hmm. Craig Pirner: That can be counter-cultural, and thus a very vulnerable thing to do that gets to this idea that it's actually okay to have some downtime. Rae Woods: Yeah. Yeah. And again, adds to that culture of resilience, making it that habit. Craig Pirner: Mm-hmm (affirmative). Rae Woods: Well, Craig, thanks so much for giving us your thoughts, your hot takes. Craig Pirner: I am always happy to join the pod. Thanks for having me. It was great to be with you. Rae Woods: We'll talk soon. Rae Woods: Honestly, when I think about what the workforce has been through this year, I just want to say, "Thank you. Thank you for continuing to show up and to use your resilience every single day." Rae Woods: And by the way, I'm not the only one who should be thanking the workforce. If you are a healthcare leader, listening to this episode, recognize the role that you play in supporting your team, in supporting yourself, and in supporting your organization. So if you're looking for more, remember, we're here to help.