Hello everyone and welcome to another episode of the Procrastinators podcast. The show on the internet about a bunch of people who make stuff talking about stuff. I'm the best guy ever, and today we're joined by Digibro. I'm alive. Very true. I'm alive for you. I'm alive for me. We're all alive. That's true. Which after our podcast yesterday, that's a good sign. I can't believe it. That's very true. That's very true. Though this will be a week and one day when this goes up. But no matter. Okay. Let's get right to it. All right people. Okay. Incest. We're talking about incest. That's what it is. So let me get some dictionary definitions off of the Urban Dictionary of course. Okay. There's two dictionary definitions that are good for this. Okay. First one. Having sex with members of one's own family. Fine. And the second one is, it's very direct. The way the British royal family keeps itself determined. I like that a lot. One of the few times the Urban Dictionary was actually funny. Yeah. They did it good this time.  Let's just launch into it. Literally fam. Oh yeah. That's true. Very well said. Okay. Where do we start with this?  You know what? Let's just do a whole goddamn episode about incest so I can just get it all out there. So I bagged and pleaded and got this to happen. And I was also demanded to be on this by Momke. So Momke since you wanted to, since this is your podcast and you tend to get short changed on the dialogue in these, why don't you give us the big intro? Oh boy. Well I do have a big incest related story about my personal life that I've been waiting to tell if we want to just start off with that or if we want to wait for later. Let's do it. Now. Let's do it now. Okay. It's all the way back to my freshman year of high school. The story of how incest changed my life forever in a either positive or negative way that'll be up to the viewer to decide. First of all. Excellent. The question for you folks at home. Let's go around the horn.  Do you think it's okay? And I was under the impression that it is okay after reading Harry Potter. Do you think it's okay to date your best friend's siblings? That's a tough one. Yes. It's a sticky situation. Is it possible to do it right? Yes. It is possible. It can be done. I mean I think it's definitely okay but if your best friend has a problem with it then it's going to cause friction in your relationship. Yeah. Well like. Yeah. There's a lot of siblings who won't care.   Well that was one of those situations I was in. I was a freshman. My girlfriend was a year younger and we met because my best friend who I guess will call Harper, because I have a Harper Lee book right in front of me. So my best friend Harper. Year older. Is it to kill a mockingbird by chance? No. It's to Ghost at a Watchman. She wrote only two. Because I stole a copy of Ghost at a Watchman from the store I was working at because I was like oh there's a bunch of controversy. I wonder if this is even worth it. And then I never even opened it. I just have it sitting on my shelf. Is that the sequel to to Kill a Mockingbird? Turns out it's the prequel actually. Yeah. Well. She's an Atticus Finch. A little bit racist. A little bit racist. It's not actually a prequel.  And then scrapped it and used the same characters to write a better book. Because in this one scout is like an adult.  But enough about that. There's no Atticus Scout incest unless you go to a certain part of Tumblr which I have definitely been to. So I'm dating my best friend's younger sister. Two years younger than him. I'm just picturing Scout now. You're dating Scout. I'm dating Scouts. Very tomboyish. Yes. And her older brother Bo. Bo is you know not appreciating this. Are you picturing like your imagination of Scout from reading the book or like the movie version of Scout? My imagination.  Yeah. Okay. Okay. So you know me and the girl we're dating and like I'm 15 and she's 14. So she doesn't really want to do any of you know the sexy stuff like we can kiss. We can hold hands. We can hang out.  She don't want to show me those titties. She don't want to let me go cave exploring if you know what I mean. So imagine my surprise towards the end of the relationship. I find out that this girl has cheated on me. Not only with my best friend but with her own brother. Whoa. Whoa. Dang. So that's two major betrayals.  They didn't sleep together.  They didn't sleep together. Oh okay okay. So that's two major hurdles for you to get over. What did they do if not sleep together? Well that's the thing.  Yeah I don't want to. I don't want to do that.   I can only assume where this is going because I know where my mind is going is that you jacked off to this image for ever ever since this is all you've thought about it.  I think this podcast right here is probably the most positive that four people have been about incest publicly ever in history. It's quite possible. Even the guy who has no incest fetishes is like yeah man stay out of people's bedrooms like granted Tom is also the guy who wrote the what's it called Tom. How do you want to describe it before I describe it? How do you want to salvage the description of your your your pony fanfic? Oh about no underaged or sex. There's no way to salvage it. Is this not the tricksy one? Is this something else? No the one he wrote about Scootaloo having sex with a like 30 year old guy. That sounds great. It was a full novel. It was received to Y to claim which disgusted me to this day. I had no idea. What? You wrote a full-length pony novel? He wrote a full-length pony fanfiction. 2013 novel. It's horrible.  How did you not know that? I don't know I guess maybe I just got confused and whenever like it came up I just kept thinking it was like the tricksy comic for some reason and I always thought I always thought you were saying like you never written a book but here you go here's your breakout hit dude. That doesn't count as a book. Is the old man a human or a pony?  But the older guy is also like borderline XB for Tom himself. What was that guy's cutie mark? Everyone said that. It wasn't even the point. Maybe just because it's written from his perspective so it sounds like he was groaning curious for sure. Yeah, that's true. That's what I thought it was good. Well, yeah, I don't know what was your even your question. What does it have to do with what we were talking about? I was just pointing out that you that while you are not an incest fetishist I cannot pretend as though you're like the normie here. No, clearly, no. Everybody go read that fanfare. I don't know what it's called. Post a link in the description, Ben. I know you're gonna listen through when you edit this. Of course. Ben can dig it up. Hey, if we have well if we're not, you know, super into incest we can just do 30 minutes of questions. Yeah, I was just thinking maybe let's just switch over to that. I can potentially say more about incest. If you got it if you got a thing you want to say yeah go for it. I don't know how deep I want to get into it but because like because yeah you guys talk about it as like a fetish I never thought of incest as a fetish like it was more just a tag like it's not something I sought out I like it especially like again like a older brother younger sister stuff but more because like I mostly encountered it so much because I like lollies in general so I would come across a lot of that you know it wasn't so much that I was seeking it out and so like I I wouldn't have said I had like a fetish for it until recently and that's because it turns out that while your girlfriend looks exactly like she'd be your sister that is well that too and and she's like way into that idea. You know my little sister's name is Grace and Ben's first girlfriend was a girl named Grace.  Ben's got no problem with that. I agree I agree with that statement I don't think I could do it that'd be really weird. If I met a girl named Patchy it would just make me harder.


Hey, good afternoon, everybody. Tom Stewart here. I'm with Liz Trotter. This is Smart Business Moves. Matt Ricketts is joining us today. And Aja is. Yes, Aja Holliday is our special guest today. Hey, Aja, how are you? Good, how are you? Awesome. Thought maybe you changed your mind. Yeah, I ran away last minute. I forgot to shut my door. Well, we've had stranger things happen. I know you're not going to leave and leave those dogs in the room though. That's not happening. No. How many dogs you got there? What's going on in the world? I've got three dogs with me. I have three dogs now. Is that SOP? They're there every day? Pretty much. Yeah. I usually bring a combination. I'll bring like one and leave two at home. But today I brought all three of them because they're all very many today. Okay. So, Tom, you're going to love this. She was on vacation last week and she only took one of her dogs on vacation with her. And because of that, she felt guilty. So she made that dog stay home and made the, and let the other dogs come to work with her. Yep. Do you think the dogs like related to that and appreciated the consideration? I don't know if the critical thinking skills are high enough for that, but I do think they felt a little abandoned by me. It made you feel better. Yeah, I feel better. I feel so much better about it now. She wasn't taking the chance that they were going to hold a grudge. No. No, absolutely not. No. They're still very needy though. I love that. Any news going on out there? This is Tom. You usually know the news, Tom. You were Matt. Matt, you know anything cool going on right now? This is the news right now that Tom's got up. I got a letter about that even I qualify for. Yeah, I did too. I'm excited. The child tax credit monies are going out this week are starting to go out this week. And if you got a child under six and if your household income is less than 150,000, then you'll be getting a check for $300 for the next six months every month. Wow. You're going to be between the ages of let's say six and 17. You'll be getting $250. Well, what? Don't you feel like just getting ripped off? Nothing in here for dogs. You got this for dogs and you've got three of them. You'd be making bank. I mean, I'm just saying, I feel like I made out like a bandit because I didn't have kids during COVID and home schooling and all of that stuff. So I was like, yeah, praise no children right now. No kidding. No kidding. Yeah. And I said for the end of the year, it's going to be a total of the 3,600 to 3,000. So they'll be getting that either $300 or $250 for the next 12 months. Nice. Yeah. This one is this one is kind of, you know, another one that kind of a head scratcher at this point, but it was originally put in place almost a year ago that they wrote this. So this was not this last one. Was this the one that was written last year, Tom, or this one coming to place? This was done earlier this year, I believe. So this one was the one that happened in January. Okay. I wasn't sure if that one, if it was the one that was prior to this, it just took a while to kick in. So all is running well. Got an ERC check. I'm sure most of us are starting to see some benefits from that. I'm making some big investments on my Spanish language side of my business and hiring a Spanish language recruiter and, you know, really doubling down on that, that path that I had really working for me in the past. So that's, that's an investment that I'm making. And I think it's worthwhile. Anybody else got anything like that that they're doing with the money? Not me. Nothing yet. Also, my, my company has told us, Matt, that we could be looking at up to six months. The IRS is taking up to six months, two quarters to process that ERC. So. Yeah. I mean, I got one check already and there's quite a little bit left to go. So I'm, I'm looking forward to those, you know, to what we can do to reinvest that and really grow in the rest of the year. As far as I had conversation with Tom, we're back to 95% of pre COVID revenue, but this kind of really ties into the topic today is I have 75% of the staff doing 95% of the revenue. Right. We have, I have, I had 704 recurring service sets, which is a made central term, but that would be like a scheduled cleaning for a customer. So some customers have multiple service sets or whatever. But I had roughly 700 customers. Let's just use a number that everybody's familiar with. And I, I only have 580 today. And again, 95% of pre-code revenue and we're not doing any one time work. So what we've done is we've increased the frequency of our customers that we have. We did a few things to do that. And then we've, we've raised our rates and are getting more work. More per every job. I think that's kind of what we should all be. Azure, are you seeing something like that? Yeah. Actually extremely similar. Cause we were, we were about 750 clients around COVID. Laura had to be bigger than me by the way. She was. No, I'm kidding. What? Just a little bit. We shrunk probably a hundred clients the year previous. So we've been about 850 in 2018 and drop down to 750. And then, yeah, COVID, I mean, we lost 120, 130. We were, yeah, we, we hovered around the 600 for a little bit. And then we leveled out about 640 until February this year. And now we just hit 700 again this week. So we definitely exploded in the last couple of months. Yeah. Not doing one time single jobs at all. And raised our rates. Booking like absolute crazy right now. I think we have 20 new clients on the board already this month. So. Awesome. Yeah. That is, that is exciting. We used, I used a kind of a points, a points method. I know you kind of do too. Yeah. The point, like the points thing is like off the charts. If anyone's not familiar with points, you kind of count, like I count like a monthly as a quarter of a point. You know, some people count them as 1.2 points. Yeah. So, so I kind of do it a little differently, but we're up 10 points, which would be like 40 points with the old system where it's like, and you guys, sounds like you guys are up like, what, like 40 points this month. Yeah. We're almost, I think at the end of today, we'll probably Wow. So that point, that point structure is just a way to kind of equalize what every customer is worth.  So it just kind of equalizes that. So that is a, that is a banner month. What's your best month ever? Do you know? 80. 80. 80 points up. So. Yeah. And well, yeah, we're also putting out another price increase, a really, really large price increase this month because we're still having issues with staffing. So we're having a hard time keeping up with it. And we have a lot of people that are underpriced and kind of want to reallocate some of that. So we might, we might still end up breaking even. Yeah. We had, we had a little bit of a level off as we did a price increase last month. You might see that. That's kind of interesting. So Tom, what do we, we're here to talk about scheduling efficiency and things like that. Scheduling product, you know, production planning, production management. I mean, you guys are kind of talking about it here. I mean, you haven't said it directly or literally, but what you're describing here is scenario where you guys are making more gross profit, more net profit and cleaning fewer homes to do it and actually doing it with fewer cleaning professionals. So, you know, that's really kind of a magic thing, isn't it? It's not how many homes you clean is how much money you make. You guys are describing that. And hopefully how much profit you make, it would be even better, right? Yeah. I mean, the thing is that's, that's really the thing. I mean, we're really up until we hired about like 11 people in the last few weeks. We were, we were hovering around 38% direct, you know, revenue to, to payroll. And right now we're at like 40.7. We actually, I don't like to go above 40, but it is what it is. Like the last couple of weeks, we've been above 40 with all these new hires, but I'm okay with that because I know that in a few weeks we'll be pushing that number down as all these people kind of get back up and running. But that's the crazy thing, Liz, is that we're generating more revenue per employee, which obviously means more profitability. Like we're getting 300 plus per employee at this point per day, really. And it would be closer to 320 if I didn't have all these new hires on the board. So what about you? Do you know what you're, what you're producing per employee at this point or just a rough guess? Definitely across the board. Thankfully, it makes it really easy. So I'm just going to pop over and look at that real quick. Good job, Aja. Good job. It makes it really easy. So while you're looking it up real quick, I just want to say hey to a bunch of people over here that we haven't said anything to. Liz, I'm curious where you're located. 95 over there. And hey, Phyllis, Katerina, Diane. Somebody, Phyllis is saying Laquisha holiday. Does that have anything to do with you? Does that mean anything? She's quite tagging a friend to watch in today. Just since Aja last name is holiday, I thought, well, maybe she's a related something. Not that I know of. Not that you know of. Not. Well, good to know. Good to see everybody over there. Oh, Grass Valley. Grass Valley. I remember that. Yeah. Is that what they smoke there? How does that work? That's Colorado. That's where I'm at. Oh, OK. I don't get about Washington, y'all. Colorado was first, though. Maybe it was Washington. It was the same year. Yeah. Same time. But I think Colorado was just more excited about it. They advertised it more. I think that's, yeah. Yeah. So I think we're looking at between that 250 to 330 range on average per technician per day. OK. Some that do like 350, 375 a day that are absolutely insane. But I would say, well, that 300 mark is pretty average. I'm really a big fan of kind of looking at like the productivity of my employees, you know, in micro, like each individual. But I'm going to shout out to her. Lacey, she's probably not watching, but I have an incredible team member called Lacey, the name Lacey.  So if you give her a three hour job, she does it in two. And what I love about that is that made central or whatever production software that you use, if you pay your employees that way, as long as the quality scores are good, it really encourages your best people. Lacey's been with me for seven years. And I mean, she really does an amazing job and the customer scores are incredible. And she basically only needs to work 20 hours a week to get a full time check. I mean, it's, you know, it's a good deal. So there's one thing I don't like about that. So Matt, you're in St. Louis and, you know, you're on here periodically.  But y'all, why is that person the outlier? I really want it to be so that we have 95% of our employees are Lacey's and only 5% are these other people that are not. You have to have a baseline, Liz. Lacey brings up everyone, but you're always going to have outliers and people that are going to be the outliers. I've got three or four people. I could shout out to Savannah or to a few other people that are just really incredible. But what I like that model of pay for performance that I know that you guys use. I know that Tom, I know a lot of us are moving towards job taking hour or commission. It really does help with the production plan because you can generate more revenue per day. So, yeah, so if somebody Katrina is asking about explaining how she's made some adjustments and got rid of low paying customers and she's making more profit and cleaning fewer homes. Good for you, Katarina. Good for you. I'm thinking that you're on smart business moves fairly frequently. And I don't think that that's a shock for the people that are on smart business moves are all feeling a lot more confident about making some of these changes and getting rid of some of these jobs that we're not making money, that we're actually costing you money. You can't afford it anymore. Yeah. One of the things kind of one of my mentors early on, so I doubt Kathy Gage is still watching smart business moves. She's retired. She's moved on. Yeah. Everyone said, I just talked to her. Okay. So one of the things Kathy told me early on was every single job you need to go ahead and run an audit on it and make sure that you didn't go over your allowed hours. And she did this religiously. Now I was pretty sloppy about it early on because I didn't have a good way to do it. Now I just hit a report button and I pull that data. But no matter what you're doing, you shouldn't be waiting to find out a year from now whether your jobs are off.  And that's going to really be a big move that you could put in place today that will drive down your cost of good sold. Didn't Kathy make her cleaning professionals at the end of the day with a calculator, paper, and pencil? Do the calculation themselves? Yes. And then they had to write an explanation so if they were off on the percentage they had to write an explanation on the job of what happened. She held them accountable to a level that I've never seen anybody do. I tried to do it. I just couldn't stick with the process because it was... I mean I just didn't want to be there every day to be totally honest. But Kathy was a very hands-on owner and that process was really critical to how she sold her business and was able to sell it at a good profit because she was able to demonstrate every single job made money. I mean she didn't mess around. She was a financial person. Yeah. We talked about this on Monday with Chris Willett and he has been doing this every single day and getting tons of benefit from it. Not just financially but he was saying how much benefit he's getting with the engagement of the people in his office and everybody's just in a better spot. I know you have Marina. I see you all the time. It's little micro wins. If you can solve a problem instead of waiting to fix something big it's just a little micro win that you can have every day. Hey, I saw a job that was off. I talked to my clean tech. It was off because of this. Another thing scheduling-wise that I did recently within my business was there's zones that we schedule everything into. And a zone is like a zip code or multiple zip codes. I had some zones that were too big and so the geographic area could have been five miles from end to end. I basically broke all of my zones up into two miles basically two square miles so that when I'm scheduling even just visually moving blocks around if I know that a color code if I schedule everything within a single color code there's going to be no more than two miles between any job. That just quickly visually helps me quite a bit. I think that's like that was a huge break for me for scheduling was our map code system. I actually like brought up a compass, a color coded compass to color code everything so that the colors are also relational to each other so that even if somebody is brand new in the office they can pop in, see the colors and be like those are both variations of pink. Exactly. They must be close to each other and do that and then I've also been thinking about breaking down our map zones a little bit more. We don't have a huge service area which is good but there's enough traffic around here that even if they're in the same map code right now it can still take 20 minutes to get from one to the other when really it should be we should be shrinking that down a lot for sure. Yeah, I want to just just so we can talk about colors you could share it or I can share it I haven't pulled up but I have a master's degree I haven't pulled up but I have a master's schedule pulled up with what we're talking about as far as screen colors and things like that this is kind of old fashioned guys if you're not using software you can just do this on a whiteboard and just have some magnets and create some schedule density by coloring your zones so this is kind of subtle here but these are two different shades of yellow these are two different zones and like what I was just talking about is is that zones that are adjacent to each other is where you know you can schedule like these are two different shades of pink here and you know reds and pinks can kind of go together for us but the darker it is the better I mean it's just internal visualizing colors and then when I see something like this I'm like we got to move this monthly this shouldn't be here I know that there's probably some reason my staff did this but maybe one thing that could be happening here is my employees can start from their homes so maybe this employee lives close to this house and then we can just work our way in and it's kind of funny because you mentioned Kathy Gage I've heard it said that she was the one that actually invented or created this idea putting the even and odd weeks together the way you're showing it there and Aja was the one that through building these like mind blowing spreadsheets actually took it to another level I want to swing back around and let Aja talk about that a little bit but I've got a couple of comments here I want to recognize that Denise in the house and she hasn't been with us in a while or at least I haven't seen her so it's awesome to have you here I've got some hats over here I should just put one on for no particular reason That's enough to 4th of July right? 7.14, 7.4 And Wayne and Gus are mentioning that we monitor time cleaning daily as well as request cleaners to help with the logistics in terms of drive time we adjust accordingly and Wayne has to, Wayne covers a huge service area so Wayne thanks for being here today I had a conversation with him he's covering like 40 square I cover 11 square miles maybe more than that but he's going 40 miles away from his central office that's all we just started doing something that is kind of helpful we haven't been doing it for very long so Wayne you might be doing something like this too we created a Slack channel for each team and so each team checks in each day with their drive time so if they're because we're having so much building row construction etc so we've got to be able to map you know maps isn't working right now because of all the row construction so the teams are putting in into Slack anything, any drive time that's over 5 minutes or 5 minutes more than was budgeted for them and we have seen a good reduction just doing that too what do you think you could do could you pass that on to the customers in any significant way or does that just sort of break down I think so we just need to tighten things up make sure that any teams that if we have a team of two going out two jobs where we have this then we got to break them up and get them into solos we got to be working that getting pushback Don is kind of raising a point here you can modify your driving schedule but if you start mixing up which texts are going to which customers that can be a problem just one question what's more important we've done it a couple of times where we've reached out to the clients we need to rework their schedules you know if you want to keep this person we just might need to move you to another day and rework within the team and we've done that we used to do that really regularly and now we've been able to keep up on it more since it's within made central it makes it a lot easier to like catch it before somebody's able to get attached to somebody but as far as this initial reworking it was very intense but it was like we would make the ideal schedule and be like alright we know you like this person but we need you to move to Thursdays because that's when they're in your area and we had zero pushback from that being able to just at least group up the other bike day within that technician I'm about to need to do that again but just make your growth it's about time that I think we need to move some things around within the teams again we were talking about that with Chris too he does that every six months he optimizes his schedule religiously every six months finds out anybody that accidentally got popped under the wrong day or has just over time moved skipped a clean and said oh no that's okay start rotating me from this other day you guys all know that that can happen and now you're in the wrong area on the wrong week right so that can happen he's really good at doing that every six months I'm always impressed he's like oh I've got to optimize the schedule again do you look at your schedule sometimes Liz or Tommy as you just be like how did this Monday only have 5,000 we've got 8,000 on every other day we really messed up yeah I had a good conversation with my sales guy probably out of a month ago was like I need you to be looking at the totals at the top of the master schedule because Thursday has more than every other day of the week and we are dying on Thursdays right now so Thursday is closed off pay attention to the top keep it level please yeah that's a big part of revenue planning I know that I've got one Monday of my four week rotation that is like this I was going to pull up an report we don't have to look at it but it turns out about 7500 plan with just recurring revenue and oh it looks like they sorted it out it's actually fixed I pushed hard on this I don't have this going on anymore so we had this one Monday that was like $2,000 lower than all the other days and I was like we got to either move some other customers to this day or do something because it's just too hard to sell a Monday $2,000 in one time nobody wants to come in to work on a Monday that you know two back-to-back deep cleanser I don't really worry too much about Mondays because I can pretty much get someone to take that day off if I have a light Monday I really, really, really don't want to be driving all over the place I would rather have fewer jobs on a day that are tight than have more money on the day and I got a lot of drive time because that's just going to end up costing me money and it's frustrating and many people are frustrated too because I don't drive heck and gone so I'd rather take the day off Any other hacks you guys are using right now like just like quick tips that everybody can use to put into place like some scheduling efficiency I know you're really good at you know spreadsheets and moving things I mean right now I haven't had to do a whole lot and I mean again thanks to main central for integrating all of that because it makes it so much easier I usually go once a week and I set the next week and I really look for any new clients that may not be in the best spot so people that haven't met their recurring team yet that I'm able to just move over on the same day same time or whatever but be able to just optimize it that way I do that weekly just to catch any new clients before they get attached Well and you guys recently switched over to solos I mean you only got fully solo gosh it's only been a few months now I mean I guess we've fully switched middle of December so it's been about 6 months that we've been fully solo again and that has made it so much easier I honestly cannot believe how much easier it is to schedule efficiently with solos that has been insane Well when you're only trying to get 2 jobs versus 4 to 6 like really hard to get it's really hard to get above 75% efficiency with teams I consistently see 80 to 90% efficiency with solos Have you looked at that percentage and like the efficiency of just of their day? I mean it's consistently at the 88 range and then I have some that have really tight schedules that are in the 95 range like where they're just like the only time is 1 minute of drive in their 30 minute lunch Right, plus when you're doing solos and you schedule them really efficiently because they're starting and finishing at customer jobs you might only be paying them 2 or 3 miles for the day Additionally even though we don't pay the drive to work I also changed all of our team colors to match the map code that they live in so that was probably the track that I could have found because now they're even closer to where they live they are only meeting up with other people if we end up having to send help or they have duplicate jobs or anything like that they are able to they're seeing all the same people because they all live in the same area too We do the same thing so you kind of look at the schedule efficiency map tool or something like that and just kind of make sure that like they're starting where they're the team to our map colors so everybody that lives in that same map code has their team color on the side is that color of the map code that they live in and it actually like not on purpose it created a pod system for us too which I've been wanting to do for years it accidentally created a pod system based off of where everybody lives Can you share a screen of the pod? It's a pod that I've visualized in this Not okay Okay, I can't wait to hear about the pod system Liz Liz was saying something about all turnovers must be 24 hours so you have adjustments and you can fit people in what did you mean about that Liz, all turnovers must be 24 hours like give 24 hours notice or what does that mean there? Fill us in a little bit I do like to need saying three jobs a day for solos we get a lot of solos doing three jobs as well I only require two and three is like if they want to make extra money that's kind of how we make the job more appealing is that you only have to do two a day if you're done by two you're done by two but if you can pull another job for us that's great Chris was saying on Monday that his average efficiency currently is 95% and his objective over the next few months is to get it to 100 and he's thinking on that he's like do I really want 100 can you have 100 I mean you have to have the jobs within a minute of each other so they have to be close together there's two jobs close together and they are going under on both jobs that would be productivity but it's a mix of both I get it a big part of having homes a technician can do in a day how they're work loaded what are the allowed hours for those homes we're doing a lot more solos now than we did prior to COVID we have some solos that will do five units a day and they're smaller their apartments but if you can schedule five apartments all in the same building you can get a lot of work done and you all have a minimum anyway so that kind of solves that that kind of solves that that's probably a pretty profitable day truly we got some tax that can do over $2,000 a week really nice Tom's going to bring it up we're right here I'm sorry I'm just not paying attention that looks pretty so all these people live in our pink zone and they drive to our pinks and purples mostly so the top header color is where they live zoom in so everyone can see the header color so you've really dialed this in even more this is a great hack for those of you guys that don't know exactly what's going on you're not familiar with main turtle I'm going to tell you a little bit and explain this a little bit more granularly is that a real word something like that it sounds like it should be so what she's doing here is because people can see color so quickly you can see exactly if things are matching up if they're going together when you see color schemes that match and go together it feels more right so what she's done is this awesome hack the team itself has the color of the area that they live in which is also the jobs that they clean in so if they clean an area of pink a pink area their team color is also pink so that sounds like a really small thing but your team color is the same as your area color but everything is more in alignment and even for them they feel like oh this is closer these are my people it's a very powerful little thing that she's doing now that's super smart I can't believe you have to hear this in MMA I think you're totally in a way that you're cutting their commute down the amount of time that they're away from their family you're just being incredibly thoughtful on how you're scheduling I know we did something similar but yours looks better than mine we actually did the same thing with our teams but yours is so what's the word I'm looking for it's like when you're wearing matching clothes it's aesthetically pleasing coordinated we're in sort of time warp yeah what happened mine does that all the time Aja I love that's happening to someone else Donna yes on the whiteboard did you do it on the whiteboard with marker or did you use post-its so this system that Aja was just showing that's what Kathy Gage had created a long time ago these little poster boards up on her walls one for every single team and she would move post-it notes around just on these paper boards yeah but if there was a door that opened up and blew them all over she was in trouble but that wasn't her it wasn't her only system she was using service CEO desktop back in the day but she had this as like a tool to help her visualize what she was doing I met Donna Garman today actually she had a demo she like she she kind of geeked out on this a little bit because she remembered the old day when she was using markers and we were talking we were talking about that about the old days because I had mine with magnets because I saw Kathy's and I was like man if a windy day happened so I had to put mine I bought magnets and then had colors and stuff like that so many good ideas we've talked about Kathy three times we have to send her this video and Kathy came from Kathy because she was such a shareer and then she went to everything and learned from other people so it may not even have been her ideas always 100% but she would execute on them better than most anyone else she would take an idea and she would execute on it so that's the biggest thing I can take away from any of this today is maybe find one or two little things of what we talked about and hammer them home and execute on something today and really the smart idea is to pick one so you don't need to do all of them you don't even want to do all of them because by the time you got all 20 things done you probably needed to switch over anyway some of those didn't even need to be done anymore it's going to be most impactful for your business and just do that just hammer that little puppy down until it's perfect I thought you were going to say something else Liz nope not today I would tell you that going to solos was one thing that I really thought was very impactful for my business that was a scary move I was doing it kind of slow and then one day my wife walks in the office and she's just like what is the hold up just do it so she starts moving stuff on the board and by the end of the day I had like 12 solos and I was like I guess I just needed to ask Angel to come in the office because I've tried to let her step back and do family stuff but she is very impactful when she comes in and does things so my wife is my business partner in my business and you know we've had a lot of family stuff and where she's kind of stepped back a little bit but every once in a while I just kind of bring her in as a consultant to kind of get a her view of things and then a little push I just tell her not to hurt anybody's feelings too much because she'll come in like a whirlwind and then be like well leave it all to do I'm like as long as it's a good idea that's fine but don't just like leave us with all these ideas that we can't execute on or everything that's wrong this isn't good you guys got to fix this fix that you know and as a little side benefit for those of us I mean we've been doing teams for years and we're still kind of a hybrid model but we've got a lot more solos than we used to and we're starting to get rid of some automobiles and you know we're getting quotes on cars that are several years old that the amount of money that they're offering because there's just no cars to be bought anymore is pretty much what we paid for the car when we bought it now it's crazy wow are you guys having that good of luck you guys have new cars Aja over there not so much I don't think the I don't think the sparks are they don't hold their value so well but we are I mean we're doing okay I think the problem is just trying to for us it's been just having the time to do it it's oddly time consuming to sell a car much less sell 10 cars I've gotten really good at bill of sales and title transfers and I've got it all back up over here for the next ones and it's just it is very intensive I need you know this because I have to do all that myself but that is you know the story of my life but you know maybe the sparks you had Chevy sparks is that what it was I still think it probably made it easier to unload I had Corollas and Prius C's we sold like 10 of them during Covid I have to maybe 9 I don't remember it's a lot of cars and it was a lot of paperwork and a lot of sell cars but every one of them we made substantially more than I would have the year before like maybe two or three thousand dollars more that's a good one yeah so Tom's talking about Corollas so I have a Corolla that we were leasing directly from Toyota and the dealership was like we'll pay you 14,000 for that car and the option for me to buy it was like 10 so I can only imagine what they're trying to sell that used Corolla that only sold for 22,000 new they're having to mark it up so it's probably a tough time to buy a car but you know if you got to buy a car you got to buy a car and then so yeah if you have to unload a car right now you've got some excess vehicles that might be something to think about I still have one or two that I'm thinking about selling yeah we've got three that I'm still like I'm not ready to get rid of them yet I don't know but they're there Aja Rochelle wants to know if you ever thought about selling them to your employees who don't have great cars that's so funny because that just like flew through my head about 15 seconds ago as well that I have one employee whose car just recently blew up and she is borrowing one and was talking about trying to get another car and I was like why don't we just sell them and it's already wrapped that's awesome yeah and we actually maybe someone added discount but she has to keep the wrap yeah she can get a discount to keep the wrap but yeah that was I actually love that idea and I was like why haven't we why didn't I think of that like a rent to own the process even kind of thing just uh you're in my brain Rochelle you were literally in my brain like if you watched the video you probably would have seen me like drift off for a second while I was like huh it happens all the time to me Aja don't worry about it kicked my video while you guys were talking I'm like trying to fix all this thing what do you got there in front of there Matt what's that what is that on the side of your screen uh that's like I'm in a closet I'm in a that's my shoe rack so funny I really purpose my closet I'm building an office in my basement but that's not going to be done until the end of the summer so so for now the shoe rack is it yeah I'm like yeah totally take my camera in there I just have dogs in the around so well I'm pixelated so hey we've all got our worries over here well we've all got problems so what what else are you doing Aja that you're not sharing with the world until you get live on smart business moves and then share I don't know I'm not really sure I feel like what other scheduling changes have I done recently I don't um I mean doing it weekly was probably a big one oh okay wait I have one so one thing that you should you could you could talk about right now is when you are switching over to solos like everybody always talks about yeah switching to solos is the best thing ever I want to tell you how many days that Aja was in group in like meltdown mode about solos so it's not as easy as we might make it sound so yeah not at all so maybe talk about it was so impactful oh yeah it's what you had to keep moving forward but there are times where it was like oh my goodness and it was like I feel like you know if I hadn't been in the mindset of like I know this is the right decision I know this is going to be like 100% for the better I would have given up 100% it was going through the process of pulling apart the teams especially since we had lost so many people during COVID as far as employees that we only had like one really solid person on a lot of our teams that those clients were attached to so that was really hard that I did I wasn't able just to split them between the two people I had to really like pick and choose who got to stay with that person a lot of that really depended on the drive time where that person lived having to get people to say they were okay having long drives so like on my master's schedule I still have several solo technicians that have horrible drives because they wanted to keep those clients so I'm like alright we're just going to take a productivity kind of hit for that but pulling apart the teams took a really long time kind of creating ghost teams moving people over it was very very tough for about four weeks how would you define a ghost team? I didn't have anybody assigned to it yet but I was just like kind of pulling the houses over there to visualize it but I was still scheduling as teams so I called them ghost teams essentially where they weren't colored yet they had all my color coding going on I didn't have colors yet so they were ghosts that's what I started calling them in my head but yeah that was really stressful and a lot of that was talking with the teams about it the pushback of change that was probably even more difficult than the scheduling aspect of it but you did say just today that you by doing this you were also switching over to made central obviously but you were able to get rid of an entire person in your office a scheduling person I mean how much easier it is in the office by being remote solos and having made central is mind boggling I mean we're 300 clients bigger than we were when I came into the office so we're almost double the size the amount of work is a fraction of what it was when I started in the office how many people run a company your size how many back office support people are there three I have three as well and the only reason I'm considering another person is a bilingual recruiter just because no one in my office speaks any Spanish so I'm like I'm going to pull the trigger on that because I feel like that's the way that we're going to open up the channel we have a swing person too that's a quality assurance person so she's running out in the field most of the day doing quality checks and whatnot but she's not a person a revenue producer also hey look at what Rachelle says can you see her comment Aja over on the right not that one Tom the one up about help yeah so this is a thing this is a real thing you would agree with Rachelle like 100% right so absolutely when you're switching over from teams to solos this is something that can happen a lot I know it's happened to a lot of people that have switched over yeah I mean when we first switched everybody was speedy they were fast they were like all about it and then you know started to get help particularly for like initial cleans like those first time ends they're like oh my gosh I need all the assistance right now I need all the help in the world and they're like oh it's not easy to get help at three o'clock in the afternoon I'm just going to do this every day and we went through a couple of months of dreadful issues going around help and then at the beginning of last month we we changed the process that they have to request help and somebody else has to volunteer we don't delegate help anymore at all we stay out of it you're welcome thank you if a team if a technician gets help does it diminish their pay no because we're straight hourly okay if you have an incentive pay plan like revenue share or job ticket hour a lot of times people don't want help because they're giving up money at that point we had oh goodness so this was and that was probably one of the big turning points for us at the end of May one of our girls we only have one person on commission because she is fast so fast and has amazing quality so she's our only person on commission and she'll do gosh like 12 hours by herself a day and do amazing work like it's absolutely insane but she needs to go help somebody and the girl she doesn't work here anymore for this reason but also because of the helping thing too made a comment along the lines of well we can just you know go slower so we get paid more and the commission girl came back to me telling she's like I was the one person she shouldn't have said that to and I was like yeah you're right because you just made $150 on that job because you finished it in three hours when it was supposed to take six and she she only worked there for you know the person that made that comment I was like oh my gosh this is the mindset that people are getting to around help and now it's it's gone like the new system has helped so much and we're sending maybe help to two three people a day today I was like nobody and instead of you know six seven eight people a day yeah so great great point Richelle thank you for bringing that up really really big thing to worry about Robin wants to know Aja do you have like a maximum amount of hours you would assign to a house yeah we do we do four hours and 15 minutes is our max so once it hits four and a half hour point we send two people okay so you would never send somebody to say a five hour house to say that's your house and that's all you're doing today not typically not unless that technician has told us that they want to do that house alone is there what's the reason for that that they would want to no what's the reason that you would limit the amount of you know house that exceeded four two folds so one was the technicians it was very much in their head that it was too much it's too big it's too much you can't do it and we couldn't seem to get past that hump the other part probably was even more because I think I probably could have worked through the mind block was clients that want somebody in their house that long all day right that was probably the that was the biggest part was clients people that are two and a half hour three hour house that are pushing back on having one person in their house for three hours so that is probably the biggest pushback we've gotten about Solos is clients wrapping up somebody that they're that long we created a tag for customers that like want teams and so we still run three three maybe four teams a day so I have a teams tag but I tell them I tell those customers that that's fine but that our trainees are on teams and you'll you'll have some of our best trainers but you're gonna have you're gonna see a lot of new faces because that's where all we only have one and it's because you know one of the girls just can't drive and she was with us beforehand and she's not does that have a vehicle she like legally can't drive so she's partnered up with somebody but they're really designated but we have the same thing and we only do it typically for the first house of the day that they'll meet up for that one house and they separate and do their own house individually at the end of the day but that way they're still able to get the two same people we're able to keep it consistent in the morning and it's like having a team but they're still Solos and they still have their own job to get to after that house let me know you think of this $25 extra if they have to have first cleaning of the day must have not just prefer it but if they say they must have it do you guys do anything like that? I love that I love it now I don't love it a year ago I've been doing this for several years and you know there's a setting in Made Central I know we've been talking about Made Central a lot today but there's a setting in Made Central where you can go and set preferred time or must have times the customer during a sale tells us they must have a time and we want to try and say yes to them the only time that we can guarantee them is between 8.30 and 9.30 every day and we can get you on that spot but you know there's a chance you might get it if you just prefer it and if you're flexible you might just get it for free but if you must have it we charge you $25 extra because those clients that must have anything can really screw up your schedule and your profitability and your ability to schedule efficiently so that's kind of how we address that I've been doing that for years and really haven't had a lot of pushback on it because you might get it anyway because we're half of our cleanings we tell them half of our cleanings are first jobs anyway we're not quite half so I think what I wanted to do is similar to that but on the opposite side is push up our hourly rate again again again and do a discount for flexible people yeah I think that's smart too it's pretty much the same thing but being able to like really hone in that like what we want is for you to be flexible with us psychologically that's probably the better solution to be honest like you're getting a reward for it instead of a punishment for it yeah psychologically that's a better solution I just don't know the answer of how to do that with software yet but I think that's coming I think that solutions like that are coming someday and we're building them in Made Central and we're trying I love calls with Tom because he's always he's got those notes going when I get to talk and I love it you know we do have some things on the drawing board that address this I mean eventually we're going to be pricing jobs the way airlines price tickets and if you want to guarantee something if you want a particular time it's not a matter of no you can't have it's just a matter of how much you want to pay for it yeah I love that the variable price market that the airlines have done that's been around for like 20 or 30 years with their software so like Saber is the software it's funny because several of the airlines use the same ticketing system because it can do this variable pricing thing and it's crazy all the variables that go into a ticket about like you know how full the schedule is that day or you know any combination of things and you know I use the example of you don't go to you don't go to the best salon in town and ask the best person cutting hair to give you the same price as the Lady at Great Clips that just got out of hairdressing school it's just not how it works and yet that's how we've kind of done it in our industry at the same rate for the best people we have as if there's no difference because there and there is there's such a variety of skill level and difference even among our technicians that we don't recognize that very well and I think that that's going to be something that we're going to have to think about in the future and building more efficient schedules and profitable schedules but yeah Robert wants to know if you charge the same surcharge for a set time in the morning or afternoon I can't guarantee an afternoon time with any predictability so I don't do that in the afternoon I don't know if anyone else does either but the only thing I can predict that's going to predictably happen in my business every single day is first thing if I gave them an afternoon start the day now if I gave them an afternoon afternoon time there's a chance we'd have to have a team sitting in a car I'd have to charge a much bigger surcharge even $25 to guarantee that maybe $50 or even more because if a team has to wait an hour between houses you know two hours that's just not something I want to try and manage I think Ben does this at Rain City Mades in Seattle he's able to guarantee his afternoon slots he's the only person I know that's been able to reliably do that and make money make money consistently the important part not upset a lot of customers right Ben if you're watching come on and tell us about this yeah you get him on here to talk about that he won't share no it's a trade secret that's not something he shares really well with a very select group of people got it he's not coming on here and sharing with people that are in Seattle that's not happening so Liz you're out of luck I know you're not in Seattle directly but there's a lot of people watching that are you're in the same state he might not let you, you're in the same state he's pretty good at talking with me I'm far enough away we're not at a risk there's some of that I personally believe this is such an execution game I'll tell anyone what I do I just don't think 99% of people will execute at the level that I'm willing to execute at most of the people that are watching this are probably good at execution and maybe you think you aren't but you're better than a lot of people that are still one man shows, you're growing a business you're executing most people people hitting up all the time about entrepreneurial stuff on Facebook you're like hey what should I do what kind of business should I start I'm like what are you good at that's such a broad question everybody wants to do this stuff at some point you just got to go and do something so that's why I'm not afraid to share because I know 99% of people aren't going to go execute even if it's a business down the road I want to talk about foundations real quick because one year at Foundations we had one of Derek's direct competitors not even what 15 minutes down the road remember that I do and people were like how of course I want her here I want her to be successful the more successful she is the more successful I am high tide raises all votes and she's only going to do the stuff that she wants to do and she's going to tweak it anyway she's not going to do my thing my way and turned out to be right another side of that same coin is I want more and more people to be successful in my market so that they're charging the same prices as me so they're not being like God better life made is so expensive I have two really good close competitors that I actually have lunch with pretty regularly and just I'll tell them anything that I'm doing because I want them to be successful I'm like you guys really need to get on the same software as me you want them to be professional high quality and you want them to be charging high rates charge more money we are at the top of the hour so we're just about done for the week as always you are awesome you know you're on our short list of favorite people in the industry thank you for sharing today yeah thank you we're having Chris Koenig on Monday is that right Les? Koenig yeah Chris Koenig I was calling Koenig and it was for years I got it wrong for years Chris I'm so sorry yeah Chris is awesome we're going to love having her but I do have to say also real quick before we go any of you that struggle managing your operations managers or your general managers that's what Aja does hit me up for MMA group and let me tell you how we can help you with that so yes we are going to have Chris next week is she on Monday? Tom? that's what it says the 19th alright cool I thought she was on Wednesday the schedule doesn't lie does it? yes it does sometimes it does so we'll be here Monday Easter and you guys have a good rest of your week we'll see you then thanks Matt bye bye


you recite so if you please could could write what country you do come from you can see there's many european countries and also africa south africa and india and also australian receiving great thank you still more answers coming in okay i will end this poll and then we have another one just to say um here we ask you what uh what is your main occupation or role and as you can see there's many clinical midwives and also midwifery students and different kinds of occupations as well thank you just in this poll and then the last poll we will do just here to start would be this one where we are asking you from where you're joining from during this conference thank you thank you very much and i will end the poll and then i will hand over the microphone to you so again okay so welcome to session 12 my name is sarah bansak and i'll be your facilitator for this presentation and the next one and with me we also have a net who we've just met so um virtual international day of the midwife 2015 would like to welcome the fabulous sally presaro um sally started her career with a degree in communications media and popular culture and drama before studying midwifery with a masters in leadership for health and social care she's been involved in health care and charitable services since 2004 and she's interested in the well-being of health care professionals post-traumatic stress disorder mental health and well-being and has spoken at uk health care conferences about her experience and ideas for the improvement of health care services and sally is currently enjoying further phd study in this area welcome sally right thank you very much for that introduction i hope everybody can hear me they should be able to i see the green light is flashing um so that's a good thing um thank you very much for inviting me today uh it's very exciting to be here and especially on a day where they may be a royal baby born that we are all discussing midwifery and other babies being born but what i'm obviously put predominantly interested in is when babies are born and when things happen in midwifery and what happens to the midwife um what happens to the clinical staff when we do the job that's needed um okay i'm trying to put the microphone closer to my face because you're saying i'm quiet is that better much better great okay okay oh no too close right okay final adjustment good yep okay great then i shall continue if you are all sitting comfortably so my name sally pizarro i had that introduction there i'm a phd researcher at the center for technology enabled health research and that's at coventry university and i'm passionate about the mental health and well-being for health care professionals specifically midwifery um i'll explain a bit more about my project and how it works and how you guys can hopefully become a part of it to help me um what i'm trying to do is develop and evaluate an online intervention so an online platform um which is designed specifically to help midwives uh and midwifery professionals um who are experiencing psychological distress i'm just at the beginning of this project at the moment but i'm telling people about it because obviously i'm going to need lots of people on board to tell me what this thing should look like how it could help and what what else should be included um so i've got my supervisors ready dr wendy kline dr andy turner emi falton are all helping me design this and and get make it evidence-based and then i've also got dr claire jarada and elizabeth bailey now claire jarada i don't know if any of you know who she is but she is um immediate past chair of the uk um college of gps um so she's very high up in in the gp world and she's actually um design things um like the practitioner health program which helps doctors in distress and gps in distress some with substance abuse disorders or just mental health issues in general and there didn't seem to be anything um equivalent for nurses or midwives now my background is midwifery um and i definitely saw a gap for this so that is the reason i saw this opportunity to explore this area and um my blog is is there and if you'd like to follow all the research and all of the stuff i do in this area for interest you please follow that or follow me on twitter and hopefully you can join me in this journey so why is this project important well a safe high quality and cost effective health care is it intimately linked to good staff health and well-being now we all know that don't we really um whether there's enough emphasis placed on that is another matter um and traumatic work environments in maternity services may be associated with stress vicarious trauma and anxiety so we know that um maternity wards can be very busy can be short staffed and very emotional in terms of the roller coaster we go through um and how how kind of we we cope with that on a daily basis and currently there is a paucity of support for midwives who could be at an increased risk of psychological distress due to the fact that they are independent practitioners wherever they work um in a high area of litigation maternity services generally um accrue the highest litigation cost rates for whatever reason that might be so that stress is constantly there for us so what are we hearing from staff at the moment now this is other people's research i've drawn from rather than my own um but you know people are saying i suffer from a condition called being human now um i think midwives can sometimes you put on a pedestal as in they're perfect nothing ever goes wrong um for them and you know they they don't necessarily need the same help that patients do but they are human and there's reports that say some of some people are saying they're close to having a breakdown in mental health and just carrying on um or looking to leave the profession and a lot of people are saying i didn't come into the health service to be mediocre and fail that's not why anyone joins the health service it's not why anybody becomes a midwife you do that because you want to make a difference and do a good job it doesn't always work out the way you planned and then this important quote here blaming scolding and punishment really have no place in the treatment of any illness so when midwives are struggling i think it's really important that we don't have punitive systems in place that stop other people coming forward and get help so the current UK facts this is just in the UK poor mental health um is equitable to a quarter of staff sickness absence now that's quite high and it looks as though something should be really done to remedy that and 38% of NHS staff have reported um having suffered at work related stress and all been very unwell um as a result of work related stress so we know it's affecting them um and so inevitably they are going to need support for that um unfortunately only 57% of NHS trusts have a policy in place to support that support mental well-being of staff so we've got the problem but perhaps not the support there and 68% of staff report attending work at least once when they didn't feel well enough to do so now as we know that staff well-being and health relates directly to patient care if people are coming in when they shouldn't be um then that is going to affect our care our level of care and our quality of care unfortunately so the midwife as the second victim this is the concept of of this term in particular and dr albert woo coined this phrase and i've been looking a lot of about his work as i'm learning more about the subject uh and basically obviously that the patient is the first victim whatever they're going through however their um needs are at that particular moment um they are a victim of um something physically happening to them but where the health professional is involved and in an anticipated unanticipated adverse event they can come to become traumatized themselves when that happens they could then become the second victim of whatever trauma it was in the first place and there's lots of um reading you can be done around this and i've left all these links and references on so that people are coming back at a later date can just uh have a look at those in detail so what's the impact for the second victim well they often become professionally insecure um they don't have as much confidence which we know we need in practice to advocate for women challenge poor practice um we can have changes in professional attitudes so um you no longer become kind of compassionate about the certain things you used to or you you know you become angry or burnt out um in in that sense it can affect you um and then there's post-traumatic stress and post-traumatic stress disorder now these are really high up on the spectrum and they really do need to be properly diagnosed by a psychiatrist or mental health professional which i am not um but everyone thinks post-traumatic stress disorder is is just something that that kind of goes goes around whatever you know as a word we throw about but actually people can can suffer from just post-traumatic stress the stress by an event doesn't always go into a full blown disorder um because there's certain criteria that would need to be met for that diagnosis so we're looking at general stress symptoms anger they can have substance abuse disorders developed to cope with whatever's happening um and that can be a a symptom of the general distress um compassion fatigue they literally burn out of things to give even even though they want to care and that's in their nature they haven't got anything left in reserve to do that so they become perhaps have they they have the sleep patterns um altered so they get tired and and anxious um that can have an effect on their family life as well as depression and all these things can impair their conduct a lot of people forget the behavioral symptoms of mental ill health health and just think it's all internal but actually they could become um angry they can do things they wouldn't normally do um and there's those things that are really difficult to look out for and they have increased risk of both personal and professional adverse outcomes so they could lose their job they could be put on um a period of leave um and obviously the worst of these um impacts is death by suicide which is rare but it's on the rise and recently there was some data about some gps that unfortunately took their lives while they were being investigated um and no such data really exists for midwives so hopefully that's something I can address in my future future past down this course so what might be the cause of these um horrible horrible um inflections on on midwives well adverse patient incidents obviously we've got never events critical incidents and we all know our our obstetric emergencies that can occur anytime anywhere and they can go well they can go bad they can be managed well they can live with you in terms of the memory of it for a long time um medical error when people nobody goes to work to make a medical error they go to work to be good practitioners but this happens and when medical error happens it brings about a whole lot of emotions such as guilt shame lack of confidence again and they actually um need a lot of help and support to get through that um whistleblowing is a big area of concern where people are often victimized or isolated if they whistle blow it's a very kind of isolating brave thing to do and there are obviously problems in needing support to do that effectively workplace suspensions you know they're not supposed to be punitive when you are suspended you are supposed to be taken safely away whilst while some kind of investigation comes out or is investigated but actually you feel punished and punitive you know you feel punitive action against you because you can't speak to anyone you're on your own and you don't know what's happening and you're not kept in the loop people don't understand or necessarily prioritize your own emotional needs at that time and that's the same with regulatory investigations um the the research says that menaces and midwives are terrified of the nmc at times and don't want to self refer and they're so scared of being reported um for for misconduct or ill health that they they will often find that traumatic in itself if they do have to engage there obviously workplace bullying has come out within the francis report and midstaff's and the curcup report um has been a huge issue and that could be as a result of other people being stressed in the workplace and taking it out on others or you know the the narrative there are endless really we could talk about that as a whole other whole other um presentation and sometimes our patients are aggressive towards us and expect and demand more and more uh and if we can't deliver that or if we can't control that or or give them the care that we want that becomes a real traumatic experience for us and the negative and traumatic organizational cultures as well in terms of do you have empowerment at work do you feel that you can be promoted and be respected in your workplace um doing my advice feel they're being paid enough and valued enough well we know that they are still fighting that cause as we speak um so it's interesting to see how that could help that boost their confidence are they suffering in silence now i'm sorry there's so many words on this slide i know that's very bad but i just can't have all these things here so people could at least come back at a later date and have a proper read but basically lots lots and lots of midwives lots and lots of healthcare professionals are in distress and relatively few seek help they will often suffer their whole careers um with secrets and facts that they hide in terms of feelings of shame guilt distress um and it's ingrained in us that a person should shouldn't suffer is the patient so the healthcare professional will always do whatever they can to make the patients not suffer um patient comes first that's all the way through midwifery training the patient comes first and when you have that um it means that sometimes you can forget about your own needs and you don't want to admit that that you're not coping or you're not doing very well or you're suffering because you know you could lose your job you could be suspended um the punitive systems that say you know if you've had too much time off sick it becomes a disciplinary issue um and also people judging you know whether you are capable enough to do your job if you are suffering in these conditions um and and that's something most people would like to avoid um and because you are a health professional you know exactly how to mask um a a sort of mental health problem because you've seen it in everybody else and now you know the signs you would look out for you could hide from your colleagues and you might isolate yourself because you're feeling bad so again people can't see that you're in in in distress and struggling on your own so barriers to seeking help the words are very very small I apologize here um but we see the pressure from inside don't show um and until breaking point comes really so there's a lot of evidence to say that midwives will hold it in hold it in hold it in and it will come out in some kind of big outburst at some point whether that be anger or breakdown or um those kind of things and there's lack of service provisions for places for midwives to go to seek help especially if they feel that they can't go anonymously and their employer may find out or um if they're having severe problems with substance abuse disorder that they know they might be referred to a regulatory body so the stigma is there and they often can't recognize their own mental health problem it's difficult if you are ill to recognize that you are ill um and there's limited finances to provoke to provide counseling or whatever it is people may need poor accessibility and burnt out staff may have a distorted view of themselves so um if they feel that they aren't worth helping they aren't worth um looking after then they may just go deeper into depression and not address their own needs and issues which is really really sad um as I'm sure we all love our colleagues we want them to go through that so hopefully this phd project can help the title is the development and evaluation of an online intervention designed to support midwifery professionals experiencing psychological distress so every few seconds someone in the UK will search the terms depression stress and anxiety into Google now that tells us that people are looking for information on this online um that might be because they're suffering themselves and they're turning to an online platform to do that they may want confidential support um rather than go to their managers or go to someone else they may want to just completely go under the radar and speak about it openly there um the intervention I'm hoping to build can be tailor made to suit the needs of the healthcare professional away from patient centered services you know if you're suffering with a health professional you may not want to go to the same surgery that you work in because you may see your patient and you're in distress and and need to keep that professional boundary separate and then hopefully this um online platform can offer peer support midwife to midwife so um that that can be quite therapeutic for people we can also potentially add um evidence based therapies story sharing um talking and CBT therapies online are quite effective as well um and if we can use the online intervention to distribute support for those experiences psychological distress we can also hopefully promote help seeking behaviors in disclosure through an anonymity and amnesty so a place of amnesty as well where you cannot be judged I'm hoping we'll give people the confidence to seek the help outside that they do need whether that's a GP or drug and alcohol services so my project plan is basically at the moment I am doing literature viewing I'm telling people my plan to see if they think it's a good idea um please tell me lots and lots of feedback I need to know if this if this is something that you guys would find um important um I'm reading other literature which tends to be unfortunately a lot of it's done in the States um rather than a UK midwife so clearly I've got loads of work to do probably my lifetime won't be enough to to do what needs to be done um but looking into the literature it's so clear um that they are in distress the numbers aren't clear at the moment but they're there and something needs to be done we obviously have the Schwartz round I don't know if any of you guys in the UK know about Schwartz rounds um they're a kind of debriefing talking service where people get together in a hospital and talk about the emotional side of their work but as you can understand everybody may want to talk openly to their colleagues um at that point in time and so alternative an alternative platform online could be the best place for those people who don't feel able to talk openly so after I'm doing all my literature reviewing and telling you you lovely people about this I'm writing papers hopefully to get it out there as well I need to work out is this feasible what do midwives need um to do this and identify who who needs this and I think it's most midwives and midwifery professionals to be honest there's obviously ethical considerations to be explored if we're to do this um and we have a ethical responsibility to tell um to tell the NMC if somebody's not unfit to practice how can we do that um when they actually need to speak openly um about their problems so again the um ability to be anonymous and have amnesty is a very ethical dilemma that I'll need to look at in more depth so then my next step really is to do um a Delphi study now a Delphi study is where I get a a panel of experts and you guys are all experts because you know what you need and you know what you want um and I get a panel of experts and I get consensus on on things that should or shouldn't be included in this intervention so should it have online mindfulness should it have CBT online should it be anonymous should it be um peer support based and people telling their stories openly and anonymously and you guys can definitely help me with that if you'd like to become involved in that study then after I know from my Delphi study what people would want to see in this online intervention I can start to build it so that would be my kind of after that you know after this summer really I can start thinking about building and developing something and then obviously we pilot test it we ask midwives or who want to use it does it work can it help you um and those kind of things in a qualitative way really in a research sense so we can publish papers about it improve to people this is needed ongoing um and if this tool proves to be effective in supporting how can we take it forward with the with the NMC take it on as an important way to take care of itself with the NHS take it on um NHS employers we um need to basically have it funded so if this works it will be it will be lobbying really to say can we have the funding please to keep this moving forward because my phd is only three years long so I'm looking for people to get behind this so if it works we can keep it funded um by somebody going forward and then you know eventually if it works we can open it up potentially to nurses doctors and other professional groups so thank you everybody for listening to that and if you do want to make this happen I will be recruiting midwives academics yes student midwives I've just seen someone asking about student midwives um so I'll be recruiting all of those kinds of people to help me uh sort of synthesize what should be in this platform what you guys would need to make it useful to you um and again on my blog page I will be announcing when I'll be recruiting for that and I think it will be this summer and later on when it's all built I hopefully I can keep in touch with you via my blog via my twitter and get people together to test the intervention to see if it works properly or whether it needs um you know tweaking here or there um so that's how I want you to get involved that's how I want you to share my research and get excited about this because I'm sure it has a place for midwives in distress and we need midwives to be healthy so that our patients can be healthy you know that's the whole title of my blog healthy staff means healthy patients and that's what we're trying to get is it only in the UK I've just seen it will be initially um because I first have to make sure it works there's no point in spreading it across the world if it's rubbish I need to make sure this is evidence based and it works if it works then I can spread it out further in the UK and then if it works in the UK other countries may well um say do you know what this could work for us can we try that doing this in Australia doing this in New Zealand and midwives and midwives all around the world and I'm sure they share the same issues in the same psychological distress in some form or another so yes there is the possibility that it could go everywhere but this is a small pilot study to say does this or doesn't it work and if it works I'm hoping there are no limits to where it can go so um I'm sorry to talk about lots of difficult issues and suicide and distress and those kind of things and I understand that some of you guys may be struggling or in some kind of psychological distress in the workplace so I do actually have a link for support any support people may need may need from having this webinar discussion with me um so please access that if you feel you've been affected at all and I'm just saying about my presentation limitations I said before most of the studies unfortunately are based on American clinicians American doctors American midwives or nurse midwives as they're called there and I'm finding it hard to get the same kind of literature and research that I need in the UK but as I said I'd like to build on that and like to keep in touch with all of you so that any studies in this area or in the future I can bring you with me and use your expertise in making things happen for the better okay so thank you very much for listening I think that's about it and I'd love feedback and questions if possible so you've helped me to learn about how this can help you and what else it might need um right now as I'm building it and as I'm thinking about what what it should contain um it would be great to hear some of that I'm just reading through what you're writing very important wish it was running now do you know what I wish it was running now too Linda I actually spoke to NHS England and they were very keen to have this up and running as soon as you know soon if you could guess it but it does take time to research things and make sure they're evidence-based effects of a midwife's own birth experience as well yeah I imagine that if this was built lots of people would be wanting to talk about many different issues about their workplace their own birth experiences and those kind of things uh you can count on me to work in Iran as well this could be really useful for midwives working in conflict zones my experience of working with midwives in Afghanistan shows the trauma really impacts on midwifery practice that's very true but we also have to think about access if you're somewhere where there's no wi-fi no internet how you know if you can't use your mobile at work to get into the app if you you haven't got a computer at home there are going to be barriers to this unfortunately and yes there are a lot of hurting midwives Emma you love to be involved okay link with me on twitter link with me on my blog and I will make sure that you can have the opportunity to to become a part of the study have you considered how to maintain confidentiality and privacy for patients when midwives share things such as adverse outcomes of birth I have considered that um I think it's going to need that anonymity um clause uh in it very very strongly um I also think it's going to need a large amount of midwives to dilute the data obviously if I get a group of midwives from one labour ward talking about something they're all going to know exactly who they're talking about exactly about which patient and that's not really going to work and sometimes it is better to speak to a midwife you know hundreds of miles away to get a different perspective on what you've been through um so that that's going to be key in doing that and obviously not sharing hospital trust names patient names all of those things that are in the nmc code of conduct anyway um and the social media code of conduct that would need to be um a part of of that sort of the rules of the rules of use I hope that answers that question but yes ethically there's lots to think about that will be my next step I think there are many survivor midwives yes there are survivors not rather victims but survivors keep going through trauma and midwifery is common however as we midwives often expect to step up a lip yes I've witnessed this so many times and I'm glad this is now being considered for a research and I hope for the support of midwives yeah I know we have that a stiff upper lip culture perhaps that's British perhaps that's just midwives I don't know but definitely I think midwives are put up on a pedestal of being sort of angels of mercy never do anything wrong they are midwives oh my goodness you know you you looked at in such awe um and it seems such a privileged job it's almost you know how can I possibly complain I've got the wonderful job of being a midwife and sometimes people cannot you know often feel like they can't complain they can't whinge they can't whine and they can't sort of say how they are stressed with it because you've got this wonderful job of being a midwife and so you don't say anything you carry on because the patient comes first and sometimes we need to put ourselves first to care for ourselves so that we can make healthy patients got more questions coming in I think and more people joining in I think this presentation is going to be obviously recorded and I'll put it up on my blog and I heard it was going on YouTube I don't know if that's true or not but if so that's awesome because we can refer back to this conversation and hopefully extend the conversation onto social media or on the blog where we can you know if you guys have got any more ideas you want to contact me I'm very happy to sort of get your expert opinion on this true I'm I'm just reading all of that I don't necessarily have any more coming in or whether you're whether you guys are done bored with me talking this kind of ties with self-care that was discussed this morning yes self-care for me the wife is so important but do we do we give that um enough credit do we realize that's important when from student midwifery training we're told that the patient comes first at all costs I think that's it I think everybody's finished talking there's 45 of you now who have enjoyed this so I hope you found this interesting and I hope I've inspired you to get on board with something like this because me hearing you say how important it is makes me feel like yes I really am doing something worthwhile so thank you very much for being a part of this and I hope to see you in the stratosphere soon yes actually Maxine very good point midwives who are hurting and then hurt those around them cruel to women and to colleagues etc that's the sort of by by product of compassion fatigue they cannot give anymore and it turns out actually is poor conduct sometimes you know speaking harshly to people losing that compassion which hurts everybody and it's just because they're hurting themselves and they need help rather than punishment I think actually that's where the punitive doesn't come in someone who's behaving like that doesn't need to be necessarily disciplined they need to be helped is my personal view okay yes but bullying on other staff as well why are people bullying is it because they're nasty people I don't think so I think it's because sometimes they just feel so insecure and pressured themselves that if they remedy their own self you know self well-being and safe psychology that it could be turned around okay that's great oh everyone's typing now okay feel free to share it and show show it with your your colleagues and friends because the more feedback I can get the better and it would definitely direct the the path of my research going forward wonderful thank you Sally that was you welcome thank you that was a really good presentation and I'm and I think you really hit a nerve with it as well um by the looks of the chat box it's a much needed project so um we really appreciate your time and I think your passion for the subject is evident so thank you so much it's been lovely thank you for having me okay I