Listen to Moments Move Us Season 2 Episode 9: Leading with Vulnerability with Sylvain Trepanier
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New Podcast Episode: Leading with Vulnerability with Sylvain Trepanier
What You’ll Learn:
For Dwight W. McBee, Executive Vice President of Clinical Health Equity and Chief Experience Officer at Thomas Jefferson University Hospitals, his purpose has always been clear, even through challenging moments. His sister suffered from sickle cell anemia, and supporting her while they were growing up sparked his desire to help people reconnect with their “why.”
Healthcare has always been a challenging field, but the past few years have been especially taxing. In a time when many feel discouraged, we need to reignite passion and sense of purpose. It’s up to leaders to inspire their teams so this can come to life.
In this episode, Dwight shares a moment when he wasn’t looking to be seen, but a leader saw him anyway. He went from a night nurse in a cardiac unit to the Executive Vice President of Clinical Health Equity, and Chief Experience Officer at Thomas Jefferson University Hospitals, with the help of a mentor who took the time to invest in and push him. Today, Dwight is responsible for implementing patient satisfaction goals, and now finding and retaining quality healthcare workers in an increasingly non-traditional workplace. Listen in to learn more about how you can do the same.
THEMES: Belonging, Mentorship, Diversity, Connecting to Purpose, Health Equity, Innovation
“Right now, I have the privilege of leading experience at Jefferson. I think just like anyone else, you never thought you’d be doing what you’re doing. I really didn’t come into this role and this kind of industry with a lot of intentionality. It has happened along the way.
I’m from South Jersey originally, just outside of Atlantic City. Growing up, I was always the person that kind of hung out and stayed behind with my younger sister, [who] suffered from sickle cell anemia. Like any family that has a loved one with a chronic illness, I was the one that always had a tendency to care and to just be there and be a support for my sister growing up along the way. My sister eventually passed away in 1999, but that sort of led me into healthcare and led me into nursing.”
“There’s one leader in particular, [Charise], she was the only African American leader in our organization at the time. I was just like, ‘Wow, I have to meet her. I have to talk to her. I have to see how she got to where she was.’ And meeting people like Charise sort of opened my eyes to this bigger world that’s out there in leading in healthcare. It just so happened that there’s lots of little things along the way that we can talk about, but for me, I think it’s meeting the right people.”
“Being a young, Black male, nursing wasn’t like, top of mind. It just wasn’t commonplace. And in fact, in nursing school, there were no other Black men in my nursing program. Obviously things have changed dramatically since then, but at the time, I was an outlier.
But spending that time with my sister, getting that level of comfort, being there for someone in those moments of need, it was second nature. Some of these experiences we have growing up do mold us and do shape us for the future that we have now. When I got into nursing and I would come across a sickle cell patient, knowing that my sister passed away from it, it was always something that just amped up my care level. It’s definitely the things that we experienced growing up and those things that led us into our careers and for us in healthcare, the things that are strong purpose and our why, they don’t go away, and it leads us into those greater roles that we take on. Definitely was the case for me.”
“There’s times in my life that I wanted to be seen, and then there’s times in my life where I didn’t care to be seen at all. I just wanted to keep my head down and do what I was there to do. I met my mentor Charise when I was in those moments where I just didn’t care. I was working at the bedside. I was actually working for an organization that had an internal agency, so we deployed to the areas of need. And at this particular shift, it was night shift, and it was in an ED overflow area. And I must have had seven or eight patients by the end of the night by myself. And I was so used to just working with my head down and working in that agency mindset, I didn’t think anything of it.
Charise was the administrator on call and was at home and wondering, ‘Who is working in that ED overflow unit? I know we don’t have enough people. I’m going to go in the morning and find out and see just how much of a mess there is.’ When she came in and she saw everything working, she was like, ‘Who are you? Where did you come from? I must know more.’ And so that’s how we met.
What really worked was after she recognized that I really cared about what we were doing there, she spent the time to get to know me, spent the time to set up time to mentor me, time to understand where my knowledge gaps were and expose me. And when there was an opportunity to lead a unit, she tapped my shoulder. I didn’t know a thing about leading. I didn’t know how to open up emails. I really didn’t know anything, but it was the confidence that she had in me knowing that what she had already experienced, that she felt confidence in endorsing me for that role.
It’s really great when you have those moments where you’re not looking to be seen, but somebody sees you anyway. And for her, I think personally, she was looking to invest in someone that was coming up behind her. I’ve cherished that in my heart, and I look intentionally to do that throughout my career.”
“Growing up in South Jersey, we weren’t the most well-off family, so just growing up, appreciating what we had. I had a career, I have a job. My mom is from Jamaica, and so we had a lifestyle where we took good care of what we had, and we appreciated what we had. I carried that mindset into the work. Grateful that I’m able to work today, and able to help this organization. And I think there’s a moment where you just go, ‘Okay, I wonder how this is going to turn out, or I wonder what I can learn from this.’ And thinking throughout the career that I’ve had, there’s absolutely moment after moment where you’re faced with that same sort of fork in the road.
When you have that kind of mindset, doors do open because you’re open to the possibilities. You’re not caught in that whole mindset of, ‘What else is going to go wrong here?’ And I think it wires you in a certain way where opportunities come your way. And I don’t know if I was really intentional about that throughout the rest of my journey, but it was just operating from that place of thankfulness, gratefulness. And I think it comes from the bottom up.”
“I’ll tell you a quick moment that mattered for me in that I was in nursing school, and again, Black male nurse. In nursing, sometimes you just cluster to your friends, and I didn’t have that little cluster of friends. And I was doing new things and trying to figure things out along the way. I was really nervous, and I was taking care of this one patient who had an NG tube (the tube that goes into your stomach from your nose), and I had never seen one before. I walked into the room super nervous, brand new nurse, and I see liquid coming out, and I didn’t know how to even safely engage with him. And he said he saw me. So, this is a moment where I needed to be seen. And he saw me, he saw the nervousness, and he said, ‘Hey, it’s okay. Here’s the shutoff valve. This is what the nurse before you did,’ and like, caught me—because he had been living with this issue for a long time. And he actually taught me so much more than I would’ve ever learned anywhere else. I think those were the kinds of moments that planted seeds for me to now see the value of engaging people in a meaningful way to help us to connect back to what’s really important about the work.
On a day-to-day basis now, I seek opportunities to get our patients and our families to talk to our workforce about what it’s like to receive care. It’s hard to say, ‘I don’t know if I can really do one extra thing,’ when you have a patient saying, ‘This is the only thing that matters to me right now, that you sit down and you just explain what you just said in a different way.’ It’s hard to argue meeting somebody’s needs when you know that if you just do this, everything else throughout the day I can put up with. But this one thing’s really bothering me.
[How do we get people reengaged to the work? is] a great question to ask, especially now, because we need inspiration more than ever. We have inspiration all around us. It’s just, are we willing to do the work of really engaging people in a meaningful way so that we can connect people back to the why of the work?”
“In Covid, we separated our patients from their loved ones, the one tribe member that they had with them. And what did we see in the outcomes? All the outcomes got worse. Quality outcomes got worse. Experienced outcomes got worse. Falls went up. Injuries occurred. We learned a very valuable lesson through that. And I think the first thing we need to think about is, ‘How do we create more opportunities for our loved ones, support people to engage in a meaningful way, not just the patients, but what’s happening the entire patient journey? How do we make it easy for family members to chime in along the way?’ There are great tools, technologies out there, but how can we do that in an amazingly cool and engaging way for patient, family, cousin, loved one, at whatever appropriate levels, that our patients feel comfortable sharing? That’s really the fundamental need.”
“I think we’re on a journey in society. And [the] more we talk about inclusive practice, diversity, equity, the more we are aware of our own natural tendencies, the more we get after that stuff. It’s honest, we all have biases. We all have natural places we gravitate to. Our organization and many others have made a commitment to make sure we’re aware of those tendencies. And then leave us with the decision on how we want to move forward but show people the value of inclusivity. Perfect example: We recognize that in healthcare we take care of a lot of disabled patients, but we don’t have many disabled within our workforce with visible disabilities. To some extent we have those invisible disabilities, and many of us have them, but with physical disabilities, we just don’t have a high percentage of a workforce like that.
I learned just yesterday, actually, we hired somebody with a visible disability, and I just thought how powerful that was for us to understand what that employee’s journey is like. What it’s like to engage in work events, and engage in work practice, and what it’s like to engage in our workspaces having those limitations. Those are the kinds of ways that we can get after it organizationally: training about our biases, putting our money where our mouth is, and bringing people in to help us and the communities we serve.”
“We know that many of our patients have a form of medical PTSD. They’ve had bad experiences. I have a member of PFAC and he often shares that he’s had such bad experiences in just getting to the facility with a wheelchair that he chooses his medical care wisely. He chooses it carefully. He researches the facility. He sends people ahead of time to see what the path would be, so he doesn’t have to go through that. All of these are because of prior experiences, and some of those prior experiences aren’t even with us. Some of them are in some other place somewhere, and they’re transferring all of those traumatic experiences to the current experience.
I do think some form of trauma-informed care, where we recognize those lived traumas and we understand and appreciate the lens within which people see the world, that’s definitely part of this access. And part of the tactic is, how do we convey trust and compliance and competence in handling your health affairs? How can we leverage information ahead of time so that we can ease the burden of access and the whole concept of health résumés or health passports—packaging information in a way that’s meaningful to you and your clinical team can take it and know about your light sensitivity, noise sensitivities? What within the built environment do we need to be aware of before you come so that we can make your care experience less stressful, and we can reduce suffering? Because that’s really what this is all about. We tend to just use a one-size-fits-all approach with healthcare. It’s an old model that’s dying away. I think patient expectations are absolutely changing, and we need to change, and we’re probably ten years behind the change.
The things we should be thinking about: How can we create flexible environments? How can we use furniture that changes configuration? How can we give agency to our patients to control light, to control sound? These are the things that we’re obviously working on and exploring, because we know that we can’t anticipate all needs for all people, and we can’t use a one-size-fits-all. It really is a shift in control, so that our patients can take more agency over their environment.”
“I was talking to a patient who received a really bad diagnosis in his care journey. This is somebody who’s competent, can make all of his decisions, he was able to do everything he needs to do, but the moment he heard the word ‘cancer,’ he became intellectually disabled. (These are his words.) And so, he’d lost the ability to effectively navigate his own care in that moment. And we on the healthcare side should really be thoughtful. Not only about sort of the support people might need if they show up with nobody or they have a support person, how do we work with them differently? What are the situations within healthcare that we know, predictably, you’re going to need some support? And how can we adapt resources to those moments? That’s really getting to the heart of person-centered care, is anticipating needs in that way.”
“There’s so many moments that go right, but we started a program here around recognition. We just want to get jump started with our culture. We just want to start recognizing people. And there’s one moment that really stood out and it was actually a pretty sad moment. It was a young person who had a pretty devastating diagnosis, and he was turning 20 the next day. We were charging up the teams around, ‘We have to make a difference. We have to just use anything [that] we have to really go out of our way to make people feel special.’ And this team found out that it was this young man’s birthday, and they went out of their way. They all got t-shirts with his name on them. They got the big cake. They did the huge party. For that moment, he had totally forgotten about all of his problems. It actually turns out that this young man’s family works for another health system, and they were like, ‘Oh my God, thank you so much. I can’t believe that you did that for one of ours.’ That’s just so encouraging that we’re in this one big healthcare tribe together. And so, we celebrated that through this recognition program. We celebrated the whole team this week, but it’s sometimes you realize some point, people do listen. Despite all of the hard things we’ve had to do over the past three years, people inherently want to do the right thing and they’re just looking for those moments to do it. And I think we as leaders just need to give that little nudge. Here, figure out a way to recognize people, figure out a way to do something special. And it’s great to see when they take you up on that.”
“It’s starting small and having the right people lead you along.”
“My hat goes off to every single bedside nurse, clinician, PCA. It’s been a really tough couple of years.”
“I’m a huge supporter and advocate [for sickle cell anemia]. When we have sickle cell patients, I’m all over their case to make sure they’re getting the care that they need. Knowing that sickle cell patients are very misunderstood, a lot of them come in with chronic pain. They have increasing tolerance to certain pain medications, and so they’re easily labeled as drug seekers, and I’m there to dispel that myth very quickly. And unfortunately, I have to do that often because it’s just a bad combination of things that come together. And unless we’re really hyper-focused on the full picture of our patients, we can fall into that trap.”
“I think it’s the right question to ask right now in terms of, ‘How do we get people reengaged to the work?’ And I think it goes back to the why—and it’s an old cliché, but it really is one of the most powerful things we can do. And I think the quickest way we can get to the ‘why’ is find a way to talk to our patients, find a way to get our families to really engage with our workforce in a meaningful way.”
“I definitely think that our patients wield a very special power in a sense that we in healthcare are just coming to grips with. I think this is a very old idea to engage with patients and families in a meaningful way, but it means so much more now than ever.”
“In leadership, we have a responsibility over the work environment.”
“There’s this great book by Don Reem called Thrive by Design, and it’s all about how we are neurologically wired to have a need for belonging and a need for your tribe. This whole movement around joining the workplace was really about, ‘How can we take in the environment that we have and the tools and the skills that we have at our disposal, and how can we create fun? How can we gamify the work environment? How can we just do this differently? Who says we have to do it the traditional way?’ And great things came out of that. Obviously, the idea of play—having staff meetings that start with a game and with a game, things like that. Simple things. But I think that’s another way we can think about inspiring people in a time where inspiration is needed.”
“I think we’re all on that journey in healthcare. We all need to do a better job. I would be first to admit that none of us have really arrived in that space. But there are some core sort of principles that we should be embracing—and I know Jefferson is, and many others are, and it’s the idea of trust.”
“The more we can do today to dream about those [changes] and prepare in a meaningful way, I think that those are the right things for us to be focused on.”
“Healthcare is dynamic. You’re dealing with a lot of emotion, a lot of change as Covid and MPOX and everything else, sort of whatever else is waiting for us, and how do we then maintain that workforce?”
“What worked yesterday will not work today in terms of meeting patients’ expectations.”
“It’s really great when you have those moments where you’re not looking to be seen, but somebody sees you anyway.”
“Despite all of the hard things we’ve had to do over the past three years, people inherently want to do the right thing, and they’re just looking for those moments to do it. And I think we, as leaders, just need to give that little nudge.”
“We as leaders have a responsibility over the atmosphere. I think our workforce has the best ideas, but they have no opportunity to unleash them. I think where we can create space for our great idea makers, our idea generators, to try new things. I think we have to be more willing to deviate from the status quo, the traditional, and we should be thinking about intentionally disrupting the status quo to get to that higher level of performance and that better atmosphere that we all know we need. And I don’t think it’s always up to the leader. I think we as leaders need to create space and trust our workforce to come up with some really great ways to enhance the atmosphere.”
“I’m just really excited about where we are in healthcare. We’re emerging from this last three years. Everything has changed. Everything is like a new normal now. We’re in a design moment. [I’m] just excited about leaders and experience and our partners, because we can work together creatively to redefine the healthcare experience. We’re forced into it. We’ve got all these other competing forces. We have literally no choice, so let’s lean into this and say, ‘Wow, what good can come of it?’ So, I’m really charged up, excited, about leading and experience and finding great partners along the way to help us lead through and think through our challenges and look at them and say, ‘What good can come of it?’ Because I do think in five to ten years, the healthcare we have today, it’s just going to look so radically different. We’re not even going to remember what this version was.”
“We need inspiration more than ever. We have inspiration all around us—it’s just, are we willing to do the work of really engaging people in a meaningful way so that we can connect people back to the why of the work?”
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