KEY POINTS:
When Fiona Ritsma became a radiographer in 1978, she had no idea that almost 30 years later she'd be chief executive of the Blood Service, working on plans to encourage young New Zealanders to donate urgently needed blood.
But then, just a few years before that, she had no idea she would become a radiographer.
She admits her career path has not been planned in fine detail. "I'm not one of those career women who's always looking for the next step," she says.
But she is someone with an eye for an opportunity, and a willingness to try something new. That, and what she calls persistence, but others might call dogged determination, has landed her in the best role in the [health] sector.
The series of unplanned moves leading to that happy state began in Napier when, as a schoolgirl who loved sport, Ritsma studied science to prepare for her chosen career as a physical education teacher.
In 7th Form she frequently helped the PE teacher, and was astonished to find that not everyone loved sport, indeed many students were reluctant.
At the same time, her grandfather developed laryngeal cancer.
In Christchurch visiting him while he was undergoing treatment, she became interested in the jobs of those providing that treatment.
"It was the teamwork thing. It was the doctors, it was the nurses, it was the anaesthetists, the radiographers a whole team approach.
"It just seemed like a really neat way of working," she says.
"It was using the sciences, our whole family was really appreciative of what everyone was doing it looked interesting."
So, a job cajoling reluctant teenagers into activity or a job working with people and families who really appreciated what you were doing?
Ritsma saw the opportunity and went for it.
Fast forward, she qualified, did the obligatory OE and returned home. In what seems remarkable now, she couldn't get a job as a radiographer. But there was an appointments clerk vacancy at Christchurch Hospitals radiology department.
It was close to the area she wanted to work in and meant when a grade radiographers position became vacant, she was on the spot.
And the story of how she got that job demonstrates her remarkable persistence.
Ritsma was appointed but not for long. In those days if you applied for a job and you didn't get it you could appeal to the hospital board to have your case reconsidered.
"That happened and the hospital board, without even laying eyes on me overturned my appointment and appointed a colleague.
"She resigned, so they readvertised. I applied again and got appointed again, and someone else appealed. And the hospital board overturned that appointment as well.
"So I ended up taking it to the appeals board in Wellington. I had to pay for a lawyer and take those people up to Wellington, and in those days you never got reimbursed."
The appeals board said Ritsma should get the job, and so, finally, she did. It cost her a lot of money and time. Others might have thrown the whole thing in, but not Ritsma. "I really wanted that job," she says.
Ritsma liked her first taste of supervising others. Five years later she took another step up to Auckland Hospital to become charge radiographer, supervising about 32 people.
When she arrived, she had more than a bit to deal with.
"They'd had quite a bit of change there and it was a pretty disjointed team.
"They didn't work as a team and there were a lot of factions.
"Within about two years in that role I think we had a really cohesive, good-working team."
How did she achieve that? "Open communication, letting people know what was happening, involving them in the decisions and setting the direction for the department.
"I think that is leadership and that's what I've enjoyed. I just do it."
Talking to Ritsma about what it takes to be a good manager, one word keeps coming up: Teamwork.
"Teamwork is fundamental to the way I work, and what I love about the health sector," she says.
"Because the whole thing as a manager is you're only as good as the people you manage.
"Your role is to create that environment for them to do really well and work as a team."
Her step into management came during the health reforms of the 1990s. "They had divided departments up and had managers, and looking at the teams there, I thought, I could do that. I guess with the encouragement of some of my colleagues I put my hand up and was appointed."
As manager of the oncology service she was now responsible not just for radiotherapy, which she knew about, but also chemotherapy, which she didn't. The way she handled that reinforces her strong belief in teamwork.
"The tack I took there was actually spending more time in the new service I didn't know, trusting myself and my team to look after the radiotherapy side so that people had confidence in my ability to manage and support them."
"Stepping outside your comfort zone always involves anxiety. There's always fear," says Ritsma.
"You're human. You worry but you also need to portray that persona that you can do it."
Ritsmas strategy for doing that is simple: Self talk. She just tells herself she can do it, and does.
Early in 2001, soon after she became Auckland District Health Boards general manager of clinical speciality services, that self-belief came in handy during what Ritsma calls "a bleak period in my career".
"Thirteen disparate laboratories were brought into one centralised facility LabPlus. Management focused so much on the move that systems, documentation and engagement with staff were neglected," Ritsma says.
"We had the auditors come in to assess the laboratory and two of the sections actually failed their accreditation."
Reports of the time tell of a fractured organisation in which staff mistrusted management, systems failed to deliver, problem-solving was not encouraged and key positions remained vacant.
"We had to do a huge amount of work to get the accreditation back and rebuild the team. It was pretty devastating. There was a lot of anti-management feeling at that time.
"I based myself in LabPlus for a period of time, just to be with the people and understand."
With the quality manager she worked on a plan to get the accreditation back, something that took four to five months. "It felt like a long time".
But even from that, she took lessons about what it means to be a good manager.
"You can never drop your eye off quality. I guess that's what precipitated the whole thing.
"And disenfranchised staff can make life really difficult for management. If you actually keep working with your team then, together, you'll achieve what you need to achieve."
Now, Ritsma is working outside the hospital system, even if closely connected to it. As she reflects on how she got here, she remembers one mentor's advice.
"He said, if you get an offer to do things in an area outside what you are doing, pick them up, broaden your horizons, expose yourself to other people.
"It will make you a better all-round manager. I think that's good advice."
Fiona Ritsma CV
2006: Chief Executive, New Zealand Blood Service
2000-2006: General Manager, Clinical Specialty Services, Auckland District Health Board
1997-2000: Service Manager, Acute & Allied Health, Auckland District Health Board
1994-1997: Business Manager, Oncology, Haematology & Palliative Care, Auckland Healthcare
1990-1994: Manager, Oncology Service, Auckland Hospital
1988-1990: Charge Radiographer, Oncology Department, Auckland Hospital
1983-1988: Grade Radiographer, Clinical Oncology Department, Christchurch Hospital
