My name is Rob Grabenkord. I'm a physician assistant. I've done critical care for around 40 years before I retired. Happy to share with you today some ideas on mentoring. And as I heard the lectures from this morning, I was struck how well they're going to blend into this short presentation. We're all going about it in different ways, but we're all talking about mentoring and the importance thereof. This doesn't want to advance here. Oh, there it goes. Okay, cool. Is that you or me? No? Okay. All right. Next slide. Nothing to disclose. Next slide, please. I'm used to saying that. I thought what we'd do is maybe look at a 60,000-foot view of mentoring, first of all. These ideas came from the inaugural address of Dr. Fred Ogbini when he assumed the presidency of the Society in 2007. What I really liked about his presentation is it talked about mentoring with these three categories. First of all, the early influences of mentoring. These would be not even your trainees or anyone, but basically recruitment, getting people interested in critical care or finding those that are kind of interested a little bit, but stoking that fire. Then, of course, the obvious one was most of our time today on the midterm influences thereof, the importance of being available to people who are trying to learn, of course, being active and learning at the bedside, teaching the importance of details and the importance of listening. We talked some about that, again, this morning, just the importance of communication, a huge part of which is listening. Then the lasting influences, imparting wisdom, wisdom being different than knowledge. It's more than teaching what a normal Ph. is or other decisions that need to be made, but it's looking at those forks in the road. Perhaps it's an unclear path, which way to go, but wisdom helps us navigate those forks. So I'm a history guy by avocation. I love history and learning about history. As I was thinking about mentoring, I came across this concept, and we're going to see here that before mentor was a title, it was actually the name of an individual. He lived around 800 B.C. This is from the Odyssey by Homer, roughly 800 B.C. He was a guardian of the city-state of Ithaca and was hired, probably is not the right word, but was asked by Odysseus, the ruler of Ithaca, to instruct and guide his son in his absence. So the king went off to war and mentor was there to help. Just a little bit of background. Next please. While we start, and our other speakers have started with definitions, mentoring is really a composite. It's not a single definition, which you can see here in this illustration. Success, direction, motivation, coaching, training, advice, and I spelled out some of these others here a little bit more. An advisor is different than a coach. An advisor gives problem-oriented, time-sensitive, focused on specific issues, often personal. These would be things like dancing the two-step of politics in the ICU, perhaps advising on what particular project should be accomplished, if it's a paper or some research, while the coach would be more instruction in, for instance, putting in a central line. It's task-specific and it comes with immediate evaluation. I think one of the greatest roles of mentoring, though, is the role model, and I think the most important part of these are dignity and integrity. Next. So if we look at, as we look at mentoring, it's improving the individual, developing the individual, training the individual, motivating, coaching, inspiring, but you can see that the heart of all this is the mentor. Next. So I like this illustration. I'm sorry it's a little blurry, but I found this. It looked like it came out of a business thing. It was Google Images, but I liked it because it has a number of interesting concepts. First of all, there's, in mentoring, let's put it this way, in contemporary mentoring, there should be bi-directional teaching and learning, and you have those two lines, parallel lines at the bottom, and I'm trying to remember who spoke on that this morning, but it is, it's not from high to low, it's shoulder to shoulder conveying information and teaching. And then I like this confidence time graph here in the center because of the way it illustrates the different phases of mentoring. We see where the green area, this is where your mentee is training, and slowly, you see this upward slope of the line, so he's slowly gaining some confidence, and then we meet that narrow little, you can just barely see it, that narrow little yellow band there where he or she is presented with difficulty or a challenge, which in turn can cause some anxiety or maybe even anger that needs to be worked through. But with the mentoring process, as you work through that red phase there, you'll soon come to the white area, which shows a rapid rise in the slope in both confidence and ability. Next. So this is from the Hillbilly Elegy from J.D. Vance, The Value of Finding a Mentor, excellent book if you haven't read it, about a kid that grew up in the coal mines and eventually went to Harvard to get his MBA and so on and so forth, but he says social capital is all around us, those that tap into it, use it, and prosper for, it connects us to the right people, and connecting to them, it makes sure that we have the right opportunities for growth, it imparts valuable information, because without these kinds of networks, you're going to be going solo, and that's never right, it can lead to feelings of isolation, and we talked about that a lot this morning. So the next thing is to identify the right mentor. This is from, I believe, Harvard Business Review, talks about successful mentors have these personal traits, just sort of fill in the blank, they place relationships before programmed mentorships, so mentorships are not something, just a way, it's a relationship. They focus on character rather than competency, I cringe a little bit at point two, because when Heather Meissen and I put together this NPPA training program, we focused on competency, we used Cobra Trice, some of you are familiar with that, built our curriculum on it, all about competency, but it's really about the total picture, not just learning. Display honest optimism, I put honest in parentheses there because in being optimistic, we don't want to have the Pollyanna approach of everything's fine, but we don't want to be honest in our optimism that there are problems, but we're going to work through it. And finally, they are more loyal to mentees than to the institution. So Condoleezza Rice has an interesting statement here, the trainee is out looking for the perfect mentor, and he or she is looking for, and I think this is sort of our inward design, looking for somebody that looks like us, right? Sort of thinks the same way, has the same interests, maybe went to the same schools, that kind of thing, but she brings out an interesting point here that if that's the kind of approach you're going to use, you're going to miss some important people. So she says search for role models that you can look up to, and people who take interest in you, but also look for people who don't look like you. I mean, here she says if I'd been waiting for a black female Soviet specialist mentor, I would still be waiting. Most of her mentors have been old white men, and they were the ones that knew the field best. When the potential mentee is looking for a mentor, look, take a broad approach. So beginning the journey as a mentee, it's important as a mentee to have a plan. So we want to look at reflecting on what you want to gain from this relationship, do your homework, take Condoleezza Rice's advice, and spend some time identifying the right person with the greatest expertise. Then once that's done, organize your goals, present them to the mentor, create a structure for time together. A lot of this is interpersonal, so it's very important to convey appreciation. These people are spending their own time doing this kind of thing. Be respectful, communications, texting, emailing, get it back to them shortly. And then seek out multi-professional opportunities for mentorship. The mentor should also consider, before entering this kind of a relationship, about what kind of individual he or she is interested in. So make some careful considerations when choosing a mentee. Establish a mentorship team. I think many of you are split between several hospitals, and it's always good to have a backup. In the case of the mentee, you're not there, perhaps those rare times you're on vacation, you need some sort of backup situation. So make other people, although they won't be as involved, but make them part of your mentorship team. Run a tight ship, be organized, you're yes, be yes, you're no, be no. Head off potential risks and address them. That was one of the things that was a stress to me by my bosses when we set up the residency program for MPs and PAs. Get the problems off soon, quickly, don't let them develop and fester. Don't commit mentorship malpractice, be honest. If it's the mentee's idea, give he or she credit for what they're doing, don't take it for yourself. Prepare for transition by leaving ideas behind. The ideas that you leave with your mentees are the building blocks of their future. So make sure these blocks are solid and let your words be honest, fair, and well-intentioned and we've talked some about that this morning, but absolutely critical. Now there's some general expectations for both parties. As I said in that previous slide early on, it's bi-directional interaction for mentor to mentee and it's horizontal, not vertical. There's a mutual respect of each other's time and your efforts and qualifications. Relational clarity, by that I mean no smoke and mirrors. It's all very clear of what is expected and what kind of things to be anticipated. As much as possible, have the same chemistry. My last boss and I were by personality about as different as one could imagine, but we did great things together because we had similar chemistry. We had the same idea of where things needed to go at Emory and we worked together and it was a great working relationship. Try to understand each other's interests and values. Again, it kind of gets back to the generational thing Sergio talked about. Creating an enduring relationship, hopefully. This will be a lifetime friendship. Coming to SCCM is always a treat for me because I look back and I see the PAs, NPs, doctors that I've worked with on committees here or we've had phone calls and we've straightened out problems together. It's awesome. And then as that graph, the graph that I showed you earlier, expects some interpersonal fluctuations. Evaluation is important. Again, no smoke and mirrors, open with full disclosure. As much as possible, make it an analytical assessment which should avoid judgmental comments and I think Sergio talked about that as well. And then as much as possible, provide active real-time feedback. Absolutely critical to provide your trainee with feedback so that things do not fester and continue to fall apart. And finally, be consistent in your evaluation. Well, training can be exhausting, but there are benefits for the mentee. Easier entry into the department or group. We had some interesting discussions on bringing APPs to the bedside in various ICUs. These mentorship relationships, I think, are key in bringing these people in with varying degrees of experience in critical care. Expanded ways of thinking and problem solving. It's great, many minds working together to solve problems. Again, network entry and exposing your mentee to other people, create other relationships. Hopefully it will create greater career satisfaction and will help the mentee maybe, perhaps, if the situation works, hang around afterwards to become part of your faculty or staff. And finally, a quicker rise in productivity level, simply because there's confidence there. Next. There's benefits to the mentor as well. Exposure to new ideas, certainly as a mentor, it will keep you on your toes, and it will help you better understand the generations that are coming behind you. There is a sense of personal accomplishment, and I have experienced that through the society. And it's quite, when it's all said and done, the fact that you put in X number of central lines with very few complications kind of fades to the background. It's the relationships that you remember. It gives you a great deal of fulfillment of having given back to the society. You create new networks for yourself. You can collaborate on goals and interests, and then last, there would be criteria possibly for promotion. The institution also can benefit from mentoring, again, solving problems early, get them there on the ground level, can be a pipeline for future colleagues coming through, greater workplace engagement and retention. I think I've heard several times this morning about feeling isolated, and isolation leads to the exit door a lot. So if we can engage our people more, we can retain them more. And it leads to a more satisfied faculty and staff, hopefully greater productivity, and a feeling of family within the institution. So I'd like to close. I told you I was a history guy, so one more slide on history. All of this sounds great. Some of you are maybe asking the question, you know, I've got all these things to do. Do I really have time for mentoring? Well, here's an illustration from Abraham Link that mentoring is not necessarily a 15 or 30-minute PowerPoint. Let's just take a survey here. You've all heard of Lincoln's Gettysburg Address. Does anybody know how long it lasted, how long did it take him to deliver the Gettysburg Address? Five minutes? Five minutes? Yeah. Right at or less than two minutes. Yeah. Okay. What did the hard copy look like? I mean, you can look at the picture, but it was written on a rumpled piece of paper. Tradition has it that he stored all his paperwork in his stovepipe hat. But the point we're trying to make here is that sometimes a little, oh, let me ask you one other thing. There was a speaker that came before Lincoln. Does anybody know his name? What? No? What? Go to the head of the class, doctor. Yeah, Everett. Edward Everett. Does anybody know how long Everett spoke? One or two hours? Two hours. So, the point I'm trying to make here is with the exception of one person here, and myself because I Googled it, nobody's ever heard of this guy, but we've all heard of Abraham Lincoln and we've all heard of the Gettysburg Address. The point we make here is a little is enough to make a lasting impression. Thank you.

physician assistant

mentoring

critical care experience

successful mentors

professional growth

Abraham Lincoln