Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / How Phoenix Children’s is Shaping the New Generation of Nursing Culture

Transcript

How Phoenix Children’s is Shaping the New Generation of Nursing Culture · Becker’s Healthcare -- Pediatric Leadership Podcast

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  This is Chris Sosa with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Rhonda Thompson,
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  chief Nursing Officer and senior Vice President of Patient Care Services for
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  Phoenix Children's Hospital. Rhonda, thank you for joining us today.
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  Thank you for having me, Chris. I appreciate it.
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  Excellent.
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  Could you please introduce yourself and tell us a bit about your background?
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  Certainly, yes. Uh, this, I'm Rhonda Thompson. I, uh,
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  joined Phoenix Children's in the summer of 2021,
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  and I proudly serve as their chief nursing officer and senior vice president of
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  patient care services. And basically, in a nutshell,
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  that means that I'm responsible for developing and advocating, uh,
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  the organization's more than 1400 nurses, um,
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  but growing every day with the number of nurses based on our growth, um,
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  and collaborating with our physician leaders, um,
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  and everyone across the organization to drive continuous improvement in clinical
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  services and patient outcomes. Um, I'm excited to be here with you today.
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  Ronald.
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  What would you say are your top priorities in redefining nurse culture at
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  Phoenix Children's?
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  Um, well, you know, I think it's, it's really what I've learned, um,
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  especially after the pandemic and, you know,
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  some of the nursing students and new nurses not having as many,
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  uh, clinical opportunities in an organization.
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  And what I've learned from that experience is helping them develop their softer
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  skills in nursing. And what I mean by that is, you know,
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  how do I cope with what I'm gonna see, what I'm going to hear,
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  how I'm gonna feel? Um, you know,
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  we have not only did did the pandemic influence newer nurses and newly licensed
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  nurses, but social media obviously has an influence as well. And I, you know,
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  I kind of coined this term at, when I was talking to a nurse about, you know,
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  swiping is not an option in nursing. Um, you know, we,
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  we've developed this kind of unique, um,
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  skill of swiping past something on social media if it's not something that we
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  want to, to read or see or hear. And we don't have that option in nursing.
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  And so what does it take for, um,
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  folks to be able to walk into any room, um,
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  and care for the patient and families they might see, um, and, and, you know,
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  deal with, and, you know, what, what does that mean for them, um,
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  and their coping skills? So, you know, that's probably certainly a priority,
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  you know, understanding, um, you know, externally what they,
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  what they've experienced, whether they were in school during the pandemic, um,
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  or shortly afterwards, uh, and what they may need to be successful is important.
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  So we do spend a lot of time with our newly licensed nurses and their preceptors
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  and our educators understanding where they are, um, you know, for themselves,
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  where they are and what,
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  what they might need to help support them in becoming a successful nurse.
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  And then like every other CNO across the country, you know, recruiting,
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  um, onboarding, um, retaining, uh, our,
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  our skilled and our intellectual capital is important.
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  Um, but what does that mean? It looks a lot different than it does now. Um,
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  you know, especially when I think about the, the time that I spent at the,
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  at the bedside and what was important to me. So, you know,
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  I think it's evolving. The, the, the, one of the priorities is how do we evolve,
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  um, with the, the newer nurses? What are,
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  what are their needs? And those are things like, you know, they,
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  they are not accustomed necessarily to, to working 12 hour shifts. Um, and,
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  you know, I started nursing, it was eight hours,
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  and I remember the transition to 12, and I thought it was the end of the world.
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  Um, but now, you know, 12 hours is, is not exactly an ideal shift for everyone.
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  So we're looking at, you know, whether we can do four hours, six hours,
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  eight hours, any kind of combination of shifts. Um,
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  and that does mean a lot more part-time or PRN staff,
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  but what it means is that they're engaged and they're, you know,
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  fulfilled with their work schedule, uh, which means that our patients, um, are,
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  are better cared for. So, you know,
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  I think those are probably some of my top priorities.
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  Besides offering nurses flexibility.
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  What do you find is key to retaining nurses?
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  You know, there's no magic pill, otherwise, I'd probably be a millionaire,
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  Chris, if I had the answer to all to, to that question. I think it's providing,
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  um, you know, a safe culture. I, I, I think, again, as,
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  as you know, communities have changed. Um, it wellness is important,
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  and so them feeling safe, them feeling like they have a voice, um, you know,
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  so I often, um, you know,
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  I'm on the floors talking with the nursing staff to make sure they feel like
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  they have a voice. We have a very robust shared governance structure,
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  so the nurses have an opportunity to be a part of our shared governance. Um,
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  so those are, those are important retention. Um, and then, you know,
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  just listening, I think that's key. Uh, you know,
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  I talk a little bit about going up to the units and, and rounding with them,
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  but it's, it's listening in every different capacity, whether that's on, um,
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  you know, a virtual meeting or I've, I've been asked to host different, um,
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  open forums for different staff. So, you know,
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  I think it's listening and being honest with, I don't have all the,
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  all the solutions, but I want to hear, um, how they're feeling,
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  what they're thinking, and,
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  and potentially hear some of their innovative ways to, um,
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  to create a, a better culture so that we retain great staff.
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  You mentioned the pandemic. Given the wave of rsv,
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  RSV and other illnesses we've seen over the past winter, uh,
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  how do you think the nursing staff has been affected by that as well?
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  Yeah, I mean, I think the pandemic in general, what we saw,
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  and this really relates to retention, is like everyone else, um, you know,
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  the pandemic forced many of us to just reprioritize our lives. You know,
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  we were, we potentially were isolated from family and friends. Um, and,
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  you know, once those things started lifting the, the isolation requirements,
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  people started asking themselves, you know, do, is this where I really wanna be?
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  Is this what I want to be doing? Um, so I think it's, you know,
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  I I think people reprioritized the same thing with, you know,
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  rsv and we're seeing, you know, as, as we have a younger generation of, uh,
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  of caregivers and providers within the organization,
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  many of them having young children, you know, the,
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  the fear of carrying something home with them. And so, you know,
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  ensuring that they feel safe in this environment, they have the PPE they need,
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  um, but also, you know, just being, um, empathetic to where they are. And,
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  you know, I think we've had, uh,
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  my leadership team and I have had a lot of conversation about what do they need?
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  And, you know, I, my motto has been, how do we open more doors?
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  And sometimes that means they need a break and, you know,
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  they need a personal leave. And, and we see that a lot with,
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  especially newer moms. Um, you know, they,
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  it's one thing to take care of someone else's sick child, but, you know,
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  potentially taking care of your own is, is a different story. So I think,
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  you know, in a nutshell, it's just reprioritizing what, what matters, uh,
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  to folks right now in, in the moment. Um, and,
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  and us being just understanding and allowing some flexibility with that.
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  I think you've touched a little bit on this already,
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  but given all the feedback that you've been taking in and all the introspection
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  and all the other data you've been accumulating,
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  how do you anticipate your role is going to change in the next 18 months?
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  Um, well, I think not just with the, the growth of Phoenix Children's. I mean,
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  in the next 18 months, we'll have opened, um, at least two,
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  if not three new facilities. Um, so, you know, my role is expanding,
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  um, which, which makes it even more important than I'm listening and,
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  and out with, uh, the staff in each of these facilities. Um, you know,
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  maybe a little bit of imposs impossibility there, but, um,
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  I'm gonna be optimistic that, that I can,
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  and I think the other thing that's really,
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  we all have to be cognitive of is technology is changing in healthcare.
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  And so, you know, my role looks much different, um,
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  today than it did even five years ago with the use of technology and how,
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  um, you know, I help support staff in,
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  in the use of technology within their day-to-day work. Um, so I think,
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  you know, those are the two areas. Um, and then I think from a,
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  from a staff perspective, what's gonna happen is, again, going back to,
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  you know, how do we get, um,
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  creative with recruitment and retention and onboarding. Um, we've,
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  we've looked at several different models. We've, um,
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  reinvented our nurse residency program. Um,
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  we've expanded it from a year to 18 months.
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  Now that doesn't mean orientation is expanded,
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  but what it means is the ongoing support for those new,
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  new nurse residents will, will go on for 18 months. Um,
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  and that goes back to the softer skills I was talking about in coping. You know,
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  this gives them an opportunity to continue to meet with their cohort of,
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  of new nurses and talk about what's impacting them on a day-to-day basis.
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  Um, you know, we're, we're, we're also looking at, um,
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  our preceptor program and how that might be impacting new hires. Uh,
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  again, we, we have seen through, um,
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  the turnover that we're asking younger and younger and less experienced nurses
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  to precept. And so my concern is we're all, I mean, that's where we are.
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  That's the reality of our world, but how do we support them through that?
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  So we're looking at the preceptor program and will implement a new preceptor,
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  um, orientation structure that will be part of the nurse resident.
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  So in their first six months,
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  they're gonna learn some kind of fundamentals of becoming a preceptor, um,
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  and basic things, giving feedback, you know, um, how to mentor, uh,
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  a new student, et cetera. But, you know, it's really, again,
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  kind of going back to where they are and, and where we are,
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  and we've gotta figure out how to get to them or at least, um,
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  a compromise so that we can help support them.
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  You mentioned so many things that seem to be definitely working for Phoenix
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  Children's. How do you think other health systems can implement these,
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  and how much communication have you had with people in your position?
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  Well, I'm part of a phenomenal group, um,
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  through the Children's Hospital Association and the CNO forums. Um,
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  we just actually met last week, um, and there were 25 of us,
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  uh, in a room at, at tables,
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  and these are the exact things that we're all talking about. Um,
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  and then I got an email, uh, just the end of last week,
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  so even before the conference was over,
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  asking for some details around the preceptor program and how we're,
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  um, you know, how we're building that into our nurse residency.
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  So we have a lot of discussion. Um, you know, we have a LISTSERV through chha.
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  Um, so I'm constantly in contact with other CNOs about best practices,
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  what's working for them. Um, you know,
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  I think that the unique thing about Phoenix Children's is, you know,
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  there's not a lot of other children's hospitals that are growing at the pace we
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  are. Um, so that, you know, has its whole, a whole other bucket of,
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  of challenges around, you know, um,
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  employing enough nursing staff and support staff to,
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  to build two new facilities. Um, but it's just, you know,
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  it's a great networking opportunity and we really do learn from each other. Uh,
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  you know, I think our, our clinical nurse attending program, um,
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  has been really well received by other CNOs, uh,
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  and I've had many folks reaching out about that program, so, well, you know,
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  I think there's a great support system, thank goodness. Within,
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  within the CNO group as well.
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  Uh,
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  you spoke about technology and other changes that are certainly going to
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  be, uh, part of your evolution. Uh,
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  what other issue do you think deserves to be talked about more in your field?
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  Um, you know, for sure. Yeah, I, I mean,
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  I can't say enough about technology and, and how we're using that. Um, I think,
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  you know, advocacy and community health, um, and, and this is one thing,
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  you know, I can tell you from 30 years ago, uh, graduating nursing school, I,
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  I had no idea what it meant to be a true advocate for a patient. I, you know,
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  I knew what it meant to care for a patient and family, um,
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  but I didn't really understand the role of advo advocacy.
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  And I think that's gonna be, um, really important. Um,
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  especially now with, you know, um,
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  many things around healthcare being politicized.
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  It's gonna be important for nurses and all providers, um,
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  especially, you know, nurses and physicians to be able to,
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  to advocate and,
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  and speak to our government relations folks around what the needs are of
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  patients, um, because it's not just happening in these four walls. And I, I, I,
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  I talk about that all the time, that the care we provide, um, you know,
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  certainly is important within these four walls,
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  but it's even more important that we're providing, um, the right resources,
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  education, and care for our families outside the four walls so that, you know,
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  they, when they get home, they don't have a nurse. Um,
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  and so we need to be able to, to help them care for themselves.
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  And a lot of things around advocacy and legislator legislation, um,
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  you know, either help support that or may not help support that.
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  So it's important that, uh, we all have a voice in that.
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  Yes,
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  and certainly advocating for patience is the first priority that you have and
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  any health system would have. Rhonda,
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  thank you so much for your time today and your expertise.
• 13:32
  Well, thank you, Chris. I appreciate you having me.