Leadership can be a mixed bag, a tough pill to swallow, a double-edged sword. There are numerous idioms at play that can describe the relationship between a manager and their underlings, as often the relationship is complex and complicated. That is not the case here, where Sonia Mathews is the definition of servant leadership, and beloved and respected by all. Sonia utilizes her leadership position to help others and elevate those around her. She has recognized the needs of the unit and sought to fill them, she has worked tirelessly to create a cohesive unit culture, and she has worked to build a unit based on mutual respect and trust. Sonia is ready, willing, and eager to jump in and give a helping hand when she sees an opportunity. Often, she sees a need and fills it before the need has even been verbalized.

A couple of months ago, PFW (Pavilion for Women) NICU had two babies going for procedures assigned to one nurse, and the rest of the unit was swamped and staffed at the bare minimum – cardiac deliveries and many other things going on, only one neo responder floating, assignments condensed, and all floaters pulled into assignments. During the morning huddle with Newborn Center leadership, it was mentioned that PFW would have a remarkably busy day and had no wiggle room. No one on the call offered any solution or help; there was radio silence. Immediately after that call, Sonia found that bedside nurse with the two remarkably busy, sick babies, and offered to sit for her for breaks, to help with any tasks and give meds, and to make sure she felt supported. Through this help, the nurse was able to premedicate her patients going down for cardiac procedures, appropriately chart, take her necessary breaks, and care for her two patients safely. This honestly meant the difference between lunch and no lunch that day for this nurse, allowing her to do her job safely, and allowed our unit to continue to function, as what precious little resources we had were able to be diverted to other busy and extremely sick assignments.

As a manager, Sonia works an adjusted schedule, and will sometimes work a partial day, coming in late or leaving early and not necessarily working a full 7-7 shift. No matter what time she arrives or leaves, she always makes sure to check in with the unit charge nurse when she arrives and before she leaves. She doesn’t swing by and say, “doing okay?” while quickly walking away in the other direction; she will sit down and ask how the day is going, ask about specific patients and families, and really check in with the unit. She identifies hot spots, finds out about which nurses have which tricky assignments, and makes it a priority to go and see them. This not only allows her to stay on top of the unit but also creates a level of trust with the bedside staff that she is tuned in to what they’re experiencing and what they need.

On our unit, knowing what is going on involves being aware of what is going on in Labor & Delivery. She recently attended a cardiac delivery of twins to be the transcriber for our neo response nurses. The neo response team did not ask her to come; Sonia took it upon herself to show up and wear a “bunny suit” for the OR delivery and offer help and support. Once infants were stabilized, she returned to the unit to fill in for the neo response assignment in the unit until they were able to return. Sonia’s servant leadership is readily apparent through her proactive approach to the unit and by helping keep everything running as smoothly as possible.

Our unit, like the nursing world at large, experienced a tumultuous 2020 and 2021. To say it felt like the sky was falling to our bedside staff was an understatement. Over the course of a six-month period, we had turnover at 4 different levels of leadership over our unit. Our unit morale and turnover rate (FY21= 19%) were terrible; Then Sonia came and helped change it all. Our current turnover rate for FY22 = 10%. It can be difficult to describe a unit’s culture, and thus to describe a culture change. It is one of those things that must be experienced to really understand – you must work alongside the bedside nurses, coding a patient, charting on a new admit, getting report from nightshift – to understand and get a feel for the pulse of the unit. Because of these intangible qualities, a unit’s culture can easily go unnoticed until it turns toxic. When the culture is good, it blends seamlessly and feels effortless. Changing course is no small task. Sonia has sought to change the course of the unit culture and is putting in the work, investing in her staff, and showing that she cares. Every single day that she is here, she is present. She rounds on the staff – not just nursing, but every individual from nursing to environmental services (housekeeping). She will sit, if time allows, and asks them about their lives, their families, their goals. She asks about the assignments and the patients as well, but often her focus is on the staff themselves. She will sometimes round with a snack cart and offer a treat – a candy bar, or a bag of popcorn, or a coffee pod, nothing too extravagant, but if one takes the time to notice, they will realize the treats have been chosen with care. Are you gluten-free? Do you keep kosher? Need dairy-free options? Sonia has made sure to stock the cart with options for everyone. She made sure to take everyone’s dietary needs into account and has made it a priority to include all. It is such a kind and simple gesture, but so touching and meaningful.

Sonia has also sought to celebrate our staff in new and exciting ways. Our receptionist has been with the unit and TCH for 30 years. Earlier this year, Sonia orchestrated a surprise anniversary breakfast party for her to celebrate her years of service to TCH. She got doughnuts, flowers, a sash, and a tiara for her to wear for the day and got everyone in on it. She was shocked – she was in tears and beyond touched by the outpouring of love and support. Sonia also similarly had an anniversary party when one of our longtime nurses hit her 30-year anniversary at TCH. She knew that this nurse had a few dietary requirements, and specifically found another RN to find out exactly what she was and was not able to eat. This ensured Sonia could make sure the event for this nurse had food she would be able to eat! She told this nurse (and the rest of the staff) there was a staff meeting that morning and appeared to start off with the usual slideshow with staff updates, but the second slide was a picture of this nurse that said, “Happy Work Anniversary!” Before Sonia, these were recognized by higher management with a pin, and with a TCH staff luncheon, but not celebrated on a more personal unit-based level.

Sonia also worked to create a new tradition for the unit. She implemented “Pink Wednesdays,” after a staff member noticed she was wearing a pink scrub top and pink shoes one Wednesday and commented “On Wednesdays we wear pink” (a movie quote from Mean Girls, in true Millennial fashion). Everyone wears their best examples of pink for that shift and Sonia will post the pictures on the unit retention page. Not wearing a pink shirt? Sonia will let you borrow a pink necklace, hold a pink water bottle, give you a pink sticker or candy wrapper that is pink – anything to include you and get you to smile and have your picture taken. This has given the staff something to look forward to, even when the days are long, and it sometimes feels like we will forever be short-staffed. Looking forward to Pink Wednesdays and the opportunity to laugh, smile, be silly and bond over something so inconsequential as what color we all wear has truly had a positive impact on our staff morale and cohesion.

Sonia is welcoming, approachable, and genuine. She has worked diligently to “right the ship.” She understands that the necessary changes to create an environment of respect and trust take time, effort, and planning. She is investing in her staff and investing in the relationships between her staff. She lifts spirits and she touches hearts. Every unit needs a Sonia. You need someone who cares so deeply about the work, and about the people who do the work, day in and day out. Sonia is the heart of our unit, and we are so lucky to have her.