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I was honored to have been asked by Vickie to write the "A Closing Word" for this year-end issue. Many of us have been closer to the fire as Vickie has battled the year's challenges, somehow managing to stay the course and keep the publication on track-I am sure I represent everyone when I say "you are no less than an inspiration for all of us, Vickie, thank you."


The health care industry is, by far, the most challenging one could hope to survive in professionally; considering all the issues available to write about, it really came down to the simplicity of staying present. I do not care how good you are at what you do, one of the questions in everyone's mind as we move forward with health care reform and continue to meet the regulatory requirements of multiple agencies is how we can continue to provide safe, quality health care and maintain our sanity as individuals, both personally and professionally, as both are equally important.


Technology and the ability to communicate with one another wherever we may be (including vacations, unfortunately) are setting the pace for deliverables at a rate that our mental and physical bodies cannot keep pace with. Much of what I do in my role requires exceptional mediation skills. That skill is challenged daily, as there is always someone (patient, family, staff, or others) who brings a different component to an issue requiring modification in my approach. Given the human element of what we do, this is no surprise, and there are as many ways to construct solutions as there are people on the earth, making solution, a moving target. Interactions require "time," that occasion where we are challenged to actually interface with another individual and exchange information that may or may not make a difference, and what does "spending time" do to our schedule? Did you hear that whoosh passing by? That was your schedule-out of the window! All right, by now you are asking, where is she going with this?


Most likely, you are in a role because you are very good at what you do. We have responsibilities that require expertise and the ability to execute that expertise. So how is that going for you? Many people in the health care business who I respect as leaders are muttering about a resurgence of the imposter syndrome. Most of us have experienced this at some point in our careers, but as seasoned professionals and with current trends and rapid pace, imposter syndrome has been reappearing for many prompting questions like "I use to get to solution sooner"; "I use to have faster buy in"; and "there seems to be an element to all this I cannot identify-is it time for me to get out of health care?; they hired me to do a job, why cannot they just let me do it?" Any of these sound familiar?


Risk management is about protecting the organization against loss. I cannot do that if I feel like I am losing part of my day, every day. It is a cumulative concern that compounds itself and then? There you are, you have missed the deadline, lost your notes, miscalculated someone's intention, or worse, generated hours of work on a project only to discover that the players are not on the same page. The byline to my e-mail for years now has been "clarity endorses excellence, ask the question." So I asked my team-that team being me, myself, and I-without picking up the daily pace to the point where lists cannot begin to capture what is really going on in my daily calendar, how can I, as a leader, work smarter instead of harder.


Laws of attraction dictate, and although we all would like to think that luck is on our side, the reality is, luck is the residue of design. So to start the New Year with a design that brings you additional clarity, below are some suggestions for you to consider to help increase your output without feeling overwhelmed by input:


1. System plans change-maintain your flexibility and focus; it will sustain you in these challenging times.


2. At a leadership level, there is project work and there is work that moves on a continuum. Recognize the difference, and plan accordingly.


3. Get rid of the things you do not need-at home and in the office. You will be amazed at the space and clarity of thought this simple action brings. When you do this, you make room for positive change, an expansion of mind and capability. Try it, go on, just try it.


4. Master the art of a good conversation. This can save you hours of frustration and bring you considerable clarity. If you do not feel you are good with "the conversation," get yourself into a program that cuts to the chase and focuses on skills that are effective-be prepared, however, to make the effort it takes to identify where your opportunities are. I recommend Crucial Conversations as a tool for development. It is direct, is to the point, and has audio compact discs for those who drive-a bonus. Practice in your personal and professional life patterns proficiency-count on this!


5. Delegate, delegate, delegate. That means putting trust in someone else besides yourself. You can do this! Sure you might give up a little control; however, you provide the opportunity for others to expand their skills and provide yourself the gift of time for other matters that may require more of your expertise and attention. Building quality partnerships is key for overall success in any department; every role is important, and responsibility breeds capability. Thinking anything less than this limits the potential of the leader and the team and, therefore, your organization.


6. Leadership development is essential-participate at every opportunity, work to be a good leader, and work equally as hard at taking quality time away from the office to rejuvenate yourself by staying involved with the elements of life that inspire you. Remember being inspired? Capture that in your daily living.


7. Realize everyone else is managing similar issues. Every role, every person has his/her own challenges. Assist where you can-be grateful at every juncture.



Wishing you continued success in 2012, and a little more "clarity."


Lynda Benak, MSN, RN


Forensic Nurse Specialist Manager


Clinical Risk, Interpreting


and Patient Relations Services


PeaceHealth Southwest Medical Center


Vancouver, Washington


The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article.


Ms Benak is a reviewer of manuscripts for Dimensions of Critical Care Nursing.


The editor gratefully appreciates Ms Benak, and the test of the Dimensions of Critical Care Nursing team is to do even more work as I handle some health issues. Thank you, Lynda, for a wonderful "A Closing Word."