In Conversation with Dr. Linda Burnes Bolton


In Conversation with Dr. Linda Burnes Bolton

The Cedars-Sinai CNO shares ideas and insights with Working Nurse Editor Catherine Rhodes

By Working Nurse
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If you only know “Dr. LBB” (as her staff calls her) by her big reputation, you might be as surprised as I was to learn how diminutive this titan of nursing appears in person. “I thought you’d be ten feet tall,” I blurted out.

She smiled at my silly comment as she rose from her desk to shake my hand. Her firm grip and the impish sparkle in her eye quickly belied my first impression. Linda Burnes Bolton, RN, DrPH, FAAN, may appear tiny, but she has enough energy to power several ZIP codes.

Our hour-long conversation encompassed many topics, from the comparative value of the DNP and the Ph.D. to nurse-managed mobile clinics (which she characterizes as “VNA on steroids”) and the impact of the ACA (which she notes has not yet reduced over-utilization of emergency departments).

However, I found myself returning to a more basic question. With her many responsibilities at Cedars, her important work on national boards and committees, and a speaking schedule that is booked years in advance, how does she do it all? Here’s what she said.
True North

Burnes Bolton says her guiding principles are what she calls “True North” and “lead self.” She defines “True North” as that thing we value most deeply. We know it in our bones, but to follow it through the clutter of our everyday lives, each of us must “lead [our]self” to find the way.

“Lead self” is as much a time management system as a philosophy. Burnes Bolton notes that we are each in control of our destiny and we are all equal in being allotted 24 hours in each day. How well we use that time is determined by how effectively we “lead self.”

To do that, she says, we must create filters to keep the extraneous and the frivolous from eating up our day. We must also be very clear about our values because our time is a zero-sum game. If every hour is already occupied, taking on a new task means taking time away from something else. “Every time you say yes to something,” she explains, “you need to ask yourself, ‘What am I willing to let go of in order to do this?’”

I noted the parallel between this philosophy and that of Sheryl Sandberg, the Facebook COO of Lean In fame, who has a sign on her desk reading, “Ruthlessly Prioritize.” Burnes Bolton smiled and nodded, remarking that we must always question whether what we’re doing is moving us forward or just keeping us busy.

What if you can’t identify your True North? This is where self-reflection enters the picture. In that case, you must budget time in your day for thinking and meditating on your values so that you may be guided to your True North.

Her advice for our readers? She says nurses must clearly identify the outcomes they want to achieve and then ask themselves, “What skills do I need to acquire? Who can help me? Do I need to expand my network in order to get the help I need?”

Burnes Bolton lives this philosophy every day. To keep up with her demanding schedule, she sleeps just five hours a night and her alarm goes off at 3:45 a.m. After breakfast and 40 minutes of Jazzercise, she arrives at the hospital ready to work by 6:30 a.m. At the end of each 14-hour day, she returns home to meditate for 30 minutes, to “let it all settle.”

Challenges for Healthcare

Before Laura Coverson from public relations tapped on the door to bring our conversation to a close, I asked Burnes Bolton for her thoughts on the biggest challenges facing healthcare today. She identified three main problems:

1. There are not enough primary care services. In this challenge, she sees an opportunity for nurses — and in particular nurse practitioners — to play an important role in “population health management.” (Indeed, this need is helping to drive the current wave of increased NP autonomy in states like West Virginia.)

2. The public needs to be better educated on self-care so they can manage their own health. Burnes Bolton believes much of this education should take place where the community meets, such as in churches and other houses of worship.

3. We need to eliminate unnecessary health services. She offers as an example the overprescription of antibiotics and painkillers that has led to an epidemic of addiction and the rise of antibiotic-resistant pathogens. As a healthcare community, she says we must become more comfortable with “watchful waiting” before rushing into surgery or other courses of treatment that may be both wasteful and unproductive.

Finally, I asked her what she would like to see more of in the healthcare world. “Disruptive innovation,” she replied with a voice as wise as Yoda’s. “We must be open to letting go of old ways in order to replace them with something better. Sometimes, paradoxically, this means having new trust in old ideas.”   

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