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244: Natalie Zeleznikar

Breast cancer and sepsis survivor, Natalie Zeleznikar, shares leadership principles for executives in the face of trauma. With over 30 years as a LNHA, entrepreneur for assisted living models and CEO for various sized settings, Natalie is now the Executive Advisor at Procare HR – a PEO for HR and workforce solutions to senior living and disability providers.

Author of The Scars You Can’t See.

October is breast cancer awareness and sepsis awareness month.

Contact BTG to learn about sponsoring the Network.


Welcome to Bridge the Gap podcast, the senior living podcast with Josh and Lucas. A very good topic on today and very good timing. We want to welcome our special guest, Natalie Zeleznikar. She is a breast cancer advocate amongst other things, and she has an amazing story she’s going to share on our network today. Good morning and welcome to the show, Natalie.

Natalie Zeleznikar 

Hi. Good morning. Thanks for having me.

Lucas 01:03

Well, you know that this is Breast Cancer Awareness Month, or Cancer Awareness Month, at a higher level. And you have an amazing story and you’ve connected with the Bridge the Gap network here. Would you let our listeners know a little bit about your story and then also the things that you’re most passionate in this category?

Natalie Zeleznikar 01:24

You know, I’m, I’ve been a nursing home administrator for 30 years. I’ve been in the senior living space building assisted living and serving seniors. And so as a caregiver, we always say we care for others and not ourselves. And I thought, that’s just words. But I was six months late for my mammogram running the race as a CEO, and went in and they said, we need you to come back. And I said, “Okay, no big deal.” My mom had fibroid cys, It’s common in women. I’m not going to worry about it. Didn’t even tell my husband I was going in for a second one. Went back in and ended up on a biopsy table immediately. And they said, don’t be surprised if they call you and tell you you have cancer. So, you know, I thought that that wouldn’t be a big deal.

Natalie Zeleznikar 02:10 

And then you realize you’re just at work like any other day and you get a call and all of a sudden time stops and you just sit there. And I just remember where I was in a minute and I, and remember there were so many other moments in life where there are certain times, time does feel like it stops, everything’s going on around you, but you don’t even know what to do next. So that’s my experience was just I was a stage one breast cancer. And you know, in the breast, in the cancer lane, they score everything. So it’s scored zero to four. So when you’re scored a zero a one, I thought, I should feel lucky, I should feel blessed. I have it easy. There’s a lot of people that have it far worse than me. And so I wasn’t really mentally prepared that I’d be at any risk for a negative outcome because I was just a stage one.

Natalie Zeleznikar 03:03

So when everything went bad for me, I was caught on my heels and wondered what happened, you know? And so I had elected to have a double mastectomy. I had a fellow colleague that was a nursing home administrator that had the same cancer I had inducto invasive carcinoma breast cancer. And she had a lumpectomy and radiation. And then three months later it went to the other breast and ended up having the full double mastectomy. So I’m like, you know, I just wanna erase this risk. I’m trying to run 24 hour facilities. I’m on call 24 hours a day. I need to be available. I don’t want to have this drawn out. So I elected a double mastectomy, ended up having a severe infection happen in the first 30 days following my surgery that I learned was sepsis. And and nearly lost my life at 48. I just remember being in the emergency room. That was the same room my father-in-law was in one year earlier, and he died from sepsis, but he was in his eighties. And I’m sitting there praying to God going, “don’t take me now. I got a few things I wanna do.” And hearing the doctors say, “if you wouldn’t have brought her in, she would’ve been dead by the morning.” So that’s how it all started for me.

Lucas 04:25

That is a very compelling story. And one that I know so many people are going to be touched  by because they’ve experienced that in their own families or in even in their own lives. 

Natalie Zeleznikar 04:39

As a leader in healthcare. We talk about trust in communities all the time, you know, in nursing homes and assisted living. So what I’ve learned from my experience is how trusting I was. I grew up on a farm. I grew up working in healthcare, serving seniors. I’ve done it since I was 16. I’m now clearly not. I’ve done it for decades. And so when I ended up being facing a lot of surgeries and I was very trusting to, “we need to get you into surgery in this month. Okay, I have a provider. I had my children here. Everything went well, Let’s just go with that. I’ll stay locally and do that.” I didn’t research the doctors. I researched, because I operate under a principle of trust. I’m a professional. Everybody’s in their lane.

Natalie Zeleznikar 05:24

They’ll do what they can do. They know the knowledge. And what I spent time looking at is the plastic surgery side, bacause I didn’t know as much about that because I’ve never accessed that in my life. So I  thought, “well, that makes sense. I’ll look at that.” So what I didn’t realize is there are, there are ways for us to get information. What I didn’t do is reach out to my, my family and friends on Facebook and say, “hey, who’s had this, who’s been through this situation?” There’s Reddit groups, there’s a million platforms through podcasts and things. None of that crossed my mind to ask, what have you experienced? What would you do differently? Never did. I just went into a lane of, “okay, schedule surgery in 30 days. I didn’t research the doctor. Look at how many mastectomies have they done?

Natalie Zeleznikar 06:28:

What are the outcomes? What are other women’s outcomes? What has happened?” I just looked at, okay, well this seems to make sense. I’m a low risk. I’m a stage one. Why wouldn’t I wanna stay in my hometown so my family can, it’ll make it easier for me to run the business, take care of the seniors, be back home. So that’s what I did. And what I learned is that, it’s like anything else, like leadership and any other capacity you need to be looking at, when somebody does something, a lot of procedures, they’re probably going to be better at it. And none of that entered my mind because I’m just was a hundred percent trusting in that. And now I learned that we really have to be an advocate for ourselves and take that understanding that physicians are great and have a skill, but they’re not God. And so bad things can happen with good people just like it can in leadership. And so you need to, to be comfortable because you can put 10 doctors in a room and they can have 10 different platforms of a pathway. And you have to be comfortable with what, what seems to line up most with what you’re going to be able to live with the rest of your life. And so that element I didn’t really grasp in the early phases as much as I do now.

Josh 07:26

There’s so much I want to talk about Natalie. But one of the things while we’re on this specific topic of I couldn’t help but think you know, you were a very healthy individual as far as you knew, very fast pace of life, running a business, a family I’m sure like many of us in a similar situation, probably many of our listeners right now, the last thing they’re thinking of is, what if I got a similar diagnosis today? I feel fine. There’s nothing going on. I don’t have any underlying symptoms. But outside of that, what can you tell someone that’s in your situation, that’s in the hustle and bustle of life, that while we don’t want to live in fear of all the what ifs, there’s some things that we can do maybe in our homes and in our businesses to be prepared when the curve balls of life comes your way. Was there any takeaways that you could give to our listeners that, that might unfortunately find themselves in a in a situation like that?

Natalie Zeleznikar 08:38

I think as a leader, what I always believed in is creating teams and collaborative teams where you don’t have silo thinking and you’re, you’re having cross training it away. When you have a labor shortage across the country like you have, and we all have so many hats we’re wearing, we have to ask ourself, “where’s the best use of my time as a CEO, as the RN, as the LPN, as the aid? How do we cross train in an effective way? So if I need to go out for two months for a, a hip replacement, a stroke, anything that happens in our life, for me it was cancer. It could be somebody loses a child. It could be a million traumas that happen in life. How do we keep running 24 hour operations successfully and how, what lanes do we need to be in, and what lanes can we either delegate it to other people or outsource and, collaborate with other people in a non-competitive way? 

Natalie Zeleznikar 09:33

But just saying, “this is the best way that protects the business so we can care for seniors, and this is the best way that protects us as humans to care for each other,” because we’re in a caregiving role every day of our life. And the stress, I think all of us as leaders, healthcare workers, we know that we’re on call 24 hours a day. I’ve been on call 24 hours a day for 30 years. So I’m ready for the missing resident in the middle of the night. Or somebody didn’t show up for a shift or whatever it is. And so that’s in the back of your head. And so understanding how to, even though I never felt stressed. There’s no way my body didn’t absorb some stress over the last 30 years. And so I’m now more aware of, I have to unplug at some moments because we’re available 24 hours a day to our campuses, to each other.

Natalie Zeleznikar 10:22

We want to be, and yet we also need to understand how to take care of our space, our mental space. You know, I need to get in the kayak and just be where there’s nothing except a loon or listening to water and whatever that is. For me, it’s baking cookies. And I go back to tradition and things I did with my grandma and my mother, but for everybody it’s different. And I think we, we don’t, we are so geared in caring for other people. We give selflessly and that’s a great quality. But we also need to keep our body, We don’t see the barometer of stress inside our body. I didn’t have chest pain or anxiety or anything. I’m a, love the energy of people. And I think when you’re that way, you sometimes can get, you don’t even know you maybe need to pause a moment.

Josh 11:16

So I’m curious to when all this happened, you’re diagnosed you have surgery you become ill, you’re down for a while. You obviously weren’t ready for that. Do you think like how, how difficult was it for you to focus on healing yourself when you’re laying there thinking about all the things and the loose ends that you don’t know if anybody’s going to pick up those loose ends or not? I mean, what was that like?

Natalie Zeleznikar 11:50

Well, I  always say I’m grateful I went through this in a non covid period because I was able, I am I have two sons and a wonderful husband of 30 years. And and I grew up with brothers, but at the end of the day, I needed to be around women. I needed my mother and I wouldn’t have been able to have my mother in the world we’ve been in the last two years because visitation was limited across the country. And I needed that because she would come home from, she lives in Florida and I’m in Minnesota and her and my dad just drive back instantly and she’d come in the hospital and she knows me and she knows my personality and she’d, she’d grab my phone because I’d get a housekeeper to please take my charger and weave it through the back of my hospital bed because I’ve got to figure out how I can get the bank to get a credit line of 300,000 so I can cover payroll.

Natalie Zeleznikar 12:42

Because I don’t know how long I’m going to be out. And what if the census drops? And what if the revenue drops, I’ve got to get a plan. My mom just grabbed the phone and said, “you’re done.” You’re not doing this anymore. Your brain when you’re a CEO and you’re in a leadership capacity is never off even when you’re near death. And so the only time I was off is when I was in surgery and, and in anesthesia. I couldn’t make a decision, and I would always tease them, just make sure I wake up, because I got stuff I gotta do. And I try to use humor in ways because it was where I was at and dealing with your own, when you’ve cared for people 85 to a hundred your whole life, I thought everybody gets to a hundred.


That was the shocking thing to me. I just assumed, you know, we laugh about, “Oh, you’re gonna have another birthday.” I’m like, “no, that’s, that’s real. Don’t laugh about it. Be happy to celebrate your birthday.”I thought we, I just never thought I wouldn’t live to 90. My grandparents have, everybody around me has, I’ve cared for people. So to think that you could lose your life at 48 just was…no breast cancer in my family, no cancer in my family. But I also realized things happen to people every day. And so I wasn’t, I tried to stay positive and I think the hardest thing as a leader and a healthcare worker was to actually be the person to tell somebody you’re sick. Because I’ve been taking care of people who are at the end of their life or people who are dealing with grief of saying goodbye to people.


But I didn’t want anybody worrying about me. And the reality is people want to care for you. And it’s hard to take that care because you’ve been the leader. And leaders need to be cared for too. So it was a humbling experience to walk down the hall in a hospital with an IV bag and, everything hooked onto me and look in the rooms and think, oh my gosh, all these people with white hair look way better than me. And I’ve been taking care, it is like, “look, you’re going to beat me in a race down the hall. I can hardly get out of bed right now.” I had people taking care of me that worked for me over the last 30 years and, and you know, I’d look in their eyes and I clearly knew who they were.


And there’s HIPAA so nobody can say who they are. I’m like, “yeah, it’s me. I’m the, I’m the lady you worked for. It’s okay. I’m just the patient right now.” But what I did realize is that, in senior living, we’re surveyed and we have compliance and everything and I was kind of surprised and caught off guard that, bad things can happen in a hospital. But I felt like, where’s all the same tracking like we do in assisted living in nursing homes.  We track infections and why does nobody know how many sepsis infections there, there are post for all the surgeries that happen, What are the statistics? And it’s a different model in the hospital of what they track. I was surprised by that because I thought, well why does my life not matter if I die at 48 and nobody’s going to know why.


Josh 15:41

This is an important month to talk about cancer awareness, breast cancer awareness, as well as sepsis. And I think that’s something I personally haven’t heard as much about. And your diagnosis that got you in the hospital and got you to surgery was not really what almost killed you, is that correct? 

Natalie Zeleznikar 16:04

It wasn’t. What I learned is it’s so important to know your own health. What’s your normal blood pressure? What’s your normal body temperature? What’s your health look like? Because had I known that, low blood pressure is a sign for a signal for sepsis, it can be many times. And so I had been in the hospital, when you’re in a cancer mode, you’re seeing an oncologist and you’re seeing all these different professionals and, and you move from one doctor to another. And my blood pressure was 80 over 60, which is very low. And mine is normally a hundred over 60. Well, a low blood pressure is a signal. Knowing what I know right now, I would’ve asked to have my blood drawn and what is my white blood count looking like? Because there’s a range for a white blood count and it’s typically 5,000 to 11,000, somewhere in there.

Natalie Zeleznikar 16:53

Mine was 12,000 when I ended up in the hospital. Very clearly had an infection. The problem for me was I’d never had a mastectomy before. So I had severe bruising on the non-cancer side. It was black, I thought it was bruising. It made sense to me that maybe you’d bruise more on one side. I didn’t know. What I learned is it was really, the tissue was dying because there was no blood supply. So it was really necrosis, which is the tissues dot dead and it wasn’t bruising and it was really tunneling of wound into my ribs. And so by the time I ended up having the fever, you know, I went from 97 degree temperature and in 15 minutes I was over 102 in just 15 minutes and crashed that fast. But the wound was growing the whole time.


I thought it was bruising, it was black tissue and it was dying. So in the first 30 months when anybody has a surgery, the first 30 days are the most critical. I know that now. And I would’ve been looking for signs of infection. And the sepsis alliance does a great job of looking at, do you have a temperature? Do you have any signs of infection? Are you feeling cloudy in your head with mental, and do you have excruciating pain? I had all of it. I had chest pain that was on the side of the mastectomy, but I thought it was from the breast cancer and the surgery, I thought it was surgical pain. And so when I called in, you know, it was like, well, you probably did too much. You’re going back to work tomorrow. And so I just, you know, I didn’t have any other signs.


So it was sepsis the whole time. And by the time I got to the hospital, I was in a heart attack. Ycan have a pulmonary embolism, which I had that too. I had a blood clot. The train just kept going and going. And so it is very common and yet we don’t talk about it. So I think it’s being aware of it for all of our health, it can happen after a dental procedure. Kids that have, root canals or or wisdom teeth out, you can get infection. And so knowing sepsis is really critical for every age.



Well, it’s certainly important topics that you’ve touched on. And Natalie, I believe you’ve written a book about this, right? That shares your story. 

Natlie Zeleznikar

Have here it is, The Scars You Can’t See. 


See Lucas. I know our listeners are going to want to get that and I’m sure that’s gonna be available in our show notes.

Natalie Zeleznikar

Yeah. And it’s I think it’s just really important for people we don’t, like, for me, I get educated when it’s relevant to what I’m going through in life. And so you don’t think about cancer, you know what’s going on in education when you have kids that are young, you know what’s going on in senior living when you’re looking for a place for your mom or your grandma, but you don’t think about sepsis or cancer until you have it. And so what I want people to know is just what can you do if it happens so it doesn’t happen to you? And be aware to make choices


That’s so important. I mean, this is one of those stories, Natalie, I imagine that you had people in your life that said, “you should write a book,” and then you actually did. So this is going to be very helpful to our listeners. Thanks for getting your story onto our network and sharing your story so candidly with, with our audience so that they can learn and be aware to. Thank you so much.

Natalie Zeleznikar 

Well, thank you. And I just encourage all the healthcare providers to take care of themselves because you’re the heart of caring. The buildings are a building and they’re great, but without us, we can’t give care. So we have to take care of ourselves too. So thank you for having me.


Well said Natalie, thank you so much. And to all of our listeners, if you want more information about this, you can check out the show notes or you can go to btg, connect with us there and connect with us on social. Hit us up on LinkedIn and thanks for listening to another great episode of Bridge the Gap.


244: Natalie Zeleznikar