Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Theresa McDonnell, Senior VP & Chief Nurse Executive at Duke University Health System

Transcript

Dr. Theresa McDonnell, Senior VP & Chief Nurse Executive at Duke University Health System · Becker’s Healthcare - Clinical Leadership Podcast

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  This is Laura Dierda with the Becker's Healthcare
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  podcast. I'm thrilled today to be joined by
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  doctor Terry McDonnell, senior vice president and chief
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  nurse executive at Duke University Health System. Doctor
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  McDonnell, it's a pleasure to have you on
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  the podcast today.
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  It's a pleasure to be here with you,
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  Laura.
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  Now I'm looking forward to our discussion because
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  I know we're gonna dig a little bit
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  deeper into some of the interesting things you're
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  doing at Duke, regarding workforce, talent development, nurse
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  education, and more. But before we dive in
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  there, can you tell us a little bit
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  more about yourself and your background?
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  Sure.
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  I am an oncology nurse practitioner by training.
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  I've been taking care of GI oncology patients
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  for the last twenty some odd years.
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  Nursing is actually a second career for me.
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  Prior to nursing, I,
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  had time in education,
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  and, you know, I think all of our
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  experiences bring we carry with us to to
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  our work of today.
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  I've had the pleasure of being at Duke
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  for about the last year and a half.
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  Prior to that, I was out in Seattle
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  where I, served as the CNO, COO for
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  the Fred Hutchinson Cancer Center.
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  That's great to hear. And, you know,
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  really, really fascinating to have the kind of
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  career that you have in in terms of
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  looking at the education side and and really
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  a lot of experience. So,
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  first and foremost, can you tell me a
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  little bit about why the traditional approach to
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  nursing education isn't working anymore?
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  Well, I you know, it's interesting. I I
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  think it's multifactor.
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  We've got,
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  a generation
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  of learners
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  that have grown up with video, with rapid
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  information.
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  We've also got a generation
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  of the workforce that, you know, spent the
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  last part of their their intense education
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  in a pandemic.
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  So you take all of those factors together
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  and people just learn differently. They've got different
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  needs,
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  you know, and we're looking at how we
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  really ensure that people feel confident and competent
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  when they're starting their first jobs. We're on
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  much shorter trajectories as well. I mean, we're
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  looking at
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  taking people in early college programs. If you
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  look at what the Bloomberg grants are doing
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  around the country, they're partnering with local high
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  schools
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  to to take people from the community and
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  condense
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  into an early college type of program where
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  when they graduate,
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  they're ready to be in a healthcare workforce
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  in a CNA or a CMA or some
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  kind of a tech role.
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  That that's taking what traditionally
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  would have been probably six to eight years
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  of education
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  and shortening it down.
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  You know, we look at people that are
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  balancing a lot of things. They're not just
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  dedicating
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  all of their time to school,
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  but they're doing a broad variety of things.
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  And, you know, when you start a new
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  career,
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  there's automatically
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  a ramp up period.
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  But when you're in face to face,
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  you know, hands on patient care situations,
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  there's a level of intensity
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  and, you know, there's there's a level of,
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  I would say,
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  almost anxiety and fear
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  that can
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  take hold when you don't feel fully confident
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  in that situation.
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  And I think what we've done over the
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  last
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  decade or so, especially with our with our
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  new nurses,
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  is we've
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  taken them and we've not just slowly ramped
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  them up,
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  but we've brought them into high intensity
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  environments,
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  the ICUs,
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  acute care environments.
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  And we need to give those students or
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  those those those people who are transitioning into
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  practice
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  more of a ramp up period so that
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  they really feel like those skills are solidly
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  underneath them.
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  That makes a lot of sense. So, you
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  know, certainly
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  seems like a a great opportunity,
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  to to bring the newer clinicians in or
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  those students who are are really,
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  needed in the workforce, but as you mentioned,
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  haven't maybe had the the same time,
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  ramp up period or experience that traditional
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  nurses have. When you look especially at the
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  academic
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  medical center, setting, how is integrating that academic
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  and clinical training,
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  together
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  helping to solve that workforce shortage?
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  Well, we've got a unique opportunity. I mean,
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  when we can bring the school and the
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  the work environment closer together,
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  that allows us to to train people in
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  areas and get them hands on experience
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  in a much more controlled fashion in the
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  areas where they ultimately end up working.
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  So they don't go from a completely foreign
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  training ground
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  to the area where they're going to work
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  and try to learn
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  the environment, the culture, and all of the
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  elements of that new environment all over.
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  It it becomes a gradual ramp as part
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  of their education
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  And then when they're graduated and they're certified
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  and they're ready for practice,
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  their orientation
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  can be much smoother because they're familiar
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  with simple things like where things are, what
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  the culture of the unit is,
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  what the expectations are. And their transition to
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  practice can be much easier because they already
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  have that knowledge.
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  So then learning the skills and the specifics
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  of the the needs of the of patient
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  care,
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  medication administration,
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  wound care, all of those elements
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  that they need to be fully confident and
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  confident in,
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  those skills can be acquired in a in
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  a much more controlled
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  and we hope, you know, less anxiety provoking
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  environment.
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  That's fascinating to hear. You know, it certainly
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  seems like a really smart way to,
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  navigate
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  some of these challenges.
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  I think especially,
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  I'm curious why some of the early hands
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  on experience is critical to reducing,
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  you know, nurse burnout that we're hearing about
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  and improving retention as well.
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  Well, I I a
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  a a picture is worth a thousand words
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  for me. So if you imagine yourself,
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  as a new nurse
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  and you're on a unit and a patient
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  is under your care, and suddenly there are
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  subtle changes in that patient and they're getting
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  sicker,
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  and you need to then start to process.
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  You're taking vital signs. You're you're thinking to
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  call the resident or the intern or the
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  physician on call. You're you need to take
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  certain actions.
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  And if you don't feel
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  that you've got that
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  good solid base of knowledge and understanding underneath
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  you,
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  that can really invoke,
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  a feeling of fear and panic.
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  And no one ever wants to feel
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  that they don't have full confidence
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  and full control of a situation when they're
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  caring for another human being.
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  And when we think back to when we're
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  new in any situation, any of us, in
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  a new job, first day at work, first
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  day at school, that that pit of anxiety.
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  When you're a new nurse
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  and you're feeling that
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  daily
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  because you haven't had the opportunity to really,
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  really transition to practice
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  solidly and feel confident,
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  that tends to create
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  a condition of feeling burnt out.
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  You're constantly feeling anxious.
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  You don't feel like you've got everything you
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  need to be successful.
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  And that
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  ultimately what is leading a lot of our
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  staff to lead the profession.
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  They just don't feel well supported or confident
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  in the environment.
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  So by pulling it all together
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  and really supporting people through those early days
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  of their practice,
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  If if you don't have that anxious feeling
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  day in day out, you feel a little
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  bit better about coming to work. You feel
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  like you can handle more. You feel like
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  you can process more.
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  You feel more controlled.
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  That makes a lot of sense and, you
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  know, certainly
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  a great,
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  situation to be in if you are able
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  to have that sense of control and feel
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  a little bit more bandwidth to tackle the
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  challenging things that I know arise on a
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  daily basis for nurses and clinicians
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  across,
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  the health care organization.
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  Before we wrap up here, I'm curious
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  what,
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  this move
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  signals for the future of nursing at Duke
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  and nationwide.
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  Well, you know, at Duke, we're taking a
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  a very proactive approach. We we really wanna
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  support
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  our community,
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  so we wanna make sure that we're
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  offering the members of our community opportunities to
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  have not just jobs, but career paths at
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  Duke.
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  So when a CNA comes to to Duke
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  from one of our high schools,
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  when they've graduated,
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  we then have an opportunity to offer that
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  CNA a pathway to then become a registered
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  nurse
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  because we've got the academic partnerships right here
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  on-site.
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  So we can support someone financially and also
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  through course offerings
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  and program offerings for them to get their
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  education and their RN.
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  And the really neat thing is that we
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  also have the Graduate School of Nursing that's
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  right here on campus that we partner with.
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  So if someone wants to go on and
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  become a CRNA or an NP,
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  they can do that,
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  and they can do it without ever having
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  to leave Duke. We can support them
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  through
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  ensuring that they've got job flexibility,
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  that we can support them financially through scholarship,
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  through tuition reimbursement,
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  and but most importantly, we can we can
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  give them a professional
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  practice environment
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  that allows them that latitude to become fully
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  competent in the work that they're doing and
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  grow.
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  And I think that's the really unique opportunity
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  that we have here at Duke by bringing
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  undergraduate,
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  graduate, and the work environment all together under
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  one roof.
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  That's an amazing to hear. Doctor McDonald, thank
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  you so much for joining us on the
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  podcast today. This has been a really fun
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  and informative conversation, and I look forward to
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  connecting with you again soon.
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  Thanks so much, Laura. Have a great day.