A Dispatch from the Front Lines of COVID-19

The United States is nearing one million confirmed cases of COVID-19 at the moment this is being written. COVID-19 has already taken the lives of 700 people in Washington State alone, 385 of those being in King County. 

Michelle Curry is Chief Nurse Officer at Overlake Hospital, a stone’s throw from our offices in Bellevue, Washington. In late February, Michelle received notice of a local COVID-19 patient and immediately knew Overlake Hospital needed to prepare for a possible pandemic. Their leadership team met and a command center was put in place. Traditionally, a 24/7 command center is exceptionally rare and Overlake Hospital was about to embark on a new operation that would forever change the hospital’s operation in an emergency situation.

Michelle is a good friend of Effectiveness Institute and is familiar with our Behavior Style framework. We couldn’t resist the opportunity to talk with her about leadership at her organization and how Behavior Styles have played a part in their success. I “social distance” sat down with Michelle and asked her about this experience.

[Read “A Letter from Effectiveness Institute’s President”]

Cindi Johnston: What have you learned about leadership during COVID-19?

Michelle Curry: I’m getting good at difficult conversations. As a person in charge, my biggest win is that I’m good at difficult conversations. And they’re not pleasant all of the time but if you give people valid data, whether they like it or they don’t like it, they get on board. As long as you are honest and transparent, and have data behind what you’re saying. . . they’ll get behind you.

Do you have an example of one of these “difficult conversations”? 

Letting my staff know what personal protective equipment (PPE) they can utilize each day, and how we will all make the numbers work. Everyone doesn’t get what they are requesting because we need to make the hard decisions on who gets what.

Communicating the limits on our resources became a daily part of our command center and updating the numbers throughout the day. We started with a chalkboard in the command center where each positive test, patient on a ventilator, number of PPE etc. were listed and calculated. One of the positive outcomes of this experience is we have evolved and improved on the operation of the command center and we updated to an electronic board that updates our calculations in real time throughout the day.

[Read “Navigating Conflict Is Your Responsibility, Not Theirs”]

How have the different Behavior Styles approached the crisis?

As a Controller, it’s easy to put yourself out there and make direct, difficult decisions. This type of behavior is usually more challenging for someone who is stronger at building harmony, like the Stabilizer. They excel at many other things for us and are so important in our day-to-day care. It takes the whole team and people with strengths in all four styles. Our Analyzers are critical in compiling and giving a count and managing our data that we review each day before any decisions can be made. Our strong Persuaders, such as our COO, Tom DeBord, are keeping us connected with the community and the media to share our needs and our story. He’s promoting what’s happening on social media and giving people accolades because it’s so important to acknowledge the community.

What are your strengths as a Controller during the beginning stages of this? What are the challenges?

We have many areas in the hospital that have been significantly reduced. The average person doesn’t realize that all elective procedures have been postponed or canceled. We have a fairly significant percentage of the workforce that is out of work. My challenge is to keep people employed, yet use their skill set to help the others that are drowning, like in critical care. 

The patients in critical care need 8-10 nurses to work on proning a patient. They don’t have the resources for that, so me, as a Controller, I have to ask myself: “Okay, who has the skill set?” I have to go through each department to discern who can do what. I realized that surgical services had such a super-extended skill set on PPE. They don and doff between every surgery. They get all gowned, and they go in, and then they take it all off. They do it precisely. That’s what I needed to teach my critical care unit (CCU) nurses and the floor nurses. CCU nurses knew how to do this already but the PPE experts are there to ensure that they don’t make any mistakes and to assist with the cumbersome equipment. They’re assisting because of the dramatic increase in COVID-19 patients. 

We didn’t have the skill sets organized properly. So we moved the volunteer nurses from surgical services to be PPE experts. They wear signage. They’re dressed. All of the nurses going to critical care are dressed appropriately. And that was a golden win for me because I think I would have burned out every single CCU nurse without the assistance. It’s just overwhelming work. 

I also moved a couple of in-patient surgery nurses to be nurse extenders so they actually help the nurses in critical care to extend their abilities. Usually, nursing in the CCU is one-on-one or two-on-one. These nurses, in their wildest dreams never would have gone there but, as a leader, I had to say, “I need you.” Now we did not mandate it. So it’s on a volunteer basis, but a number of them have stepped up. They’re really performing well. 

[Read “A View of COVID-19 and WFH from a Controller”]

What do you hope your team learns from this experience?

I hope that at the end of this the nurses who pitched in and helped in other areas realize that their work isn’t any harder than their nursing colleagues. Different nursing areas like to argue why their work is the hardest. And it’s not true. I hope they remember that because it takes all of us. If our nurses know how each puzzle piece fits together, we’re going to be so great as a holistic healthcare organization. I hope they know collectively that each piece matters. Each misstep ruins it dramatically for everybody. It pushed us to a new level. I hope it stays. 

It reminds me of 9/11. We were all together on this for a few months and then life happens and the memory fades. I think it will stick for a little while and it will be enough for me to build upon it. There are just so many exceptional people standing up.

What type of support have you received from the wider community during COVID-19?

The community for Overlake has been phenomenal. I can’t even tell you the thousands and thousands of donations. They range from PPE, such as masks or goggles. We have Microsoft 3d-printing and making us full-face shields. We have several surgeons whose husbands work elsewhere. They’re coming up and bringing us boxes of homemade face shields that work better than some of the professional ones. The amount of face masks donated by your stores is inspiring. We receive donations every day. Even just small bags. You can’t even imagine the food donations. We’re getting 50-250 meals a day delivered to us from other restaurants. Our staff doesn’t have much time, so without these meals, it would be difficult to eat. 

[Read “When You’re Behavior Style Needs Aren’t Being Met”]

What do you think will be the biggest societal changes we’ll see once we have COVID-19 under control? 

I think that how people interact in large groups will be the biggest change; however, my greatest concern is economic. I believe small businesses will be hit the hardest, people will lose their livelihoods and primary sources of income. We will head into a recession and the jobless rate will be high for a very long time. 

There will be more than economical impacts. It will have a deep effect on the emotional state for many. I expect to see behavioral health issues escalate like we haven’t seen in recent history. I am putting energy into prepping my teams for this. Fortunately, Overlake has served our community for behavioral health for over 50 years, and we will be here when our community needs us most.