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When 17 Nurses Got Pregnant at Once-and The Leaders Behind the Story · Nurse Leadership Dumpster Fire

• speaker-0: Seventine pregnant nurses on one unit made national news. speaker-1: But behind that feel-good story is one CNO who is managing staffing, culture, and engagement who made all of this possible. speaker-0: And she sat down with us to talk about all of it, including one controversial staffing model that is blowing up right now. speaker-1: It sure is, and she has some opinions to say about it. speaker-0: So let's get the facts straight. speaker-1: your back straight. Lisa, welcome to our channel. We're so excited to have you here. We have ⁓ some viewers that are excited to talk about a situation that's going on in your facility. And ⁓ so this situation was widely shared report from featuring hospital over the nursing department, Miami Valley Hospital. And there's a laboring delivery unit there that we came across in the report, and we were interested immediately ⁓ about the content itself. And then I realized that you and I have a connection. So ⁓ before we go into who you are and and what you do, could you explain what's going on in this labor and delivery unit and kind of give us a short history and what's going on right now? speaker-2: Yeah, so ⁓ gosh, we have twenty nurses now. The story originally was seventeen. We have twenty nurses, well, twenty nurses at one time that were pregnant. It's insane. Yeah. Right. ⁓ three of them have already delivered and the last will deliver in February of twenty seven. So it's this baby boom season that we are having at ⁓ Miami Valley Hospital. speaker-1: That is insane. Wow. speaker-2: ⁓ it's one of the premier system hospitals. That is pretty really it's pretty incredible. So I said three of them have already delivered and we've got them spread out over the next several months. So for context, we deliver about five thousand babies on that unit annually. So it's a very busy department. It's a big department. We have a hundred and seventy nurses that work on that unit. And so there's ⁓ in the scheme of things, it's a lot of it's a lot of women. It's a lot of ⁓ nurses that are gonna be off over a period of time. Yeah. But it's manageable. ⁓ and what's the thing that is just so super cool about this story is the sisterhood that these nurses have found together. These are labor and delivery nurses who deliver, you know, help others deliver babies all day. That's what they do. And Now they get it to experience that their colleagues are going to be supporting them through that. And we as an organization get to be a part of this life changing moment for these these nurses that they do for their patients all the time. So it's it's just really kind of cool. speaker-0: That is really cool. What a fun way to like have a connection that is beyond just the typical job. Yeah. and have to and be so supportive of each other to help make sure like I mean, they're gonna have to step in and cover a little bit here and there, maybe not perfectly, but that's a small turnaround time. Someone's gonna be on maternity leave pretty much for a while. speaker-1: Not the delivery, but then the after fact of like how long they're gonna be out afterwards. So this is like a cascading event sort of thing. speaker-2: Yeah. And the you know, these these nurses, they want you know, they're they're they're wanting to support each other in having a great delivery. So they want to do it for their colleague. They want their colleague to do it for them. And so they're really helping the manager own this challenge. Own this. I mean, it's not just like they've not dumped it on the manager's lap and said figure it out. ⁓ so I you know, I think It's a tribute to what how the manager leads in that area, ⁓ and the environment that they've created ⁓ together and the passion I think that these nurses have for what they do every day because they want to experience what they're offering to others. speaker-0: And to step up as a team is so cool. speaker-2: Yeah. speaker-1: Yeah, so the the manager's name is Amberly Seiner, is that right? speaker-2: Yes. That's right. That's right. speaker-1: So in that article I read, she said she wasn't really worried about covering the staffing. I think in part because you said this unit's very big. ⁓ but I like what you're talking about where the staff have stepped up to help and to participate in it. Can you talk a little bit about what she's doing that has created that environment? speaker-2: So I ⁓ there's several different things. ⁓ obviously, it's not just any one thing. From a from a system perspective, we have a lot of tools that we support our leaders are w related to workforce. The we have position control tools, we have staffing projection tools, and so working with s the system resources, Amberley and her director are able to look at what's the staffing and what's projection look like. What what do I have open? And so then we can proactively plan for gaps and then use our toolbox for some of the flexible staffing options that we have. But from an engagement perspective, we're pretty diligent about leveraging our employee engagement survey that we do, building action plans with our caregivers around how do we want to solve that, and then keeping that sort of front and center on a regular basis in staff meetings or in our unit based council meetings to keep that action plan alive. I don't know the details specifically of Amberly's action plan. ⁓ but given the situation, I can't help but believe that staffing is probably a part of making sure that that's happening. speaker-1: For sure. Yeah. Yeah. So your position is by title the system vice president and chief nursing officer and chief executive officer for Premier Health. Can you talk about the scope of that role and how you oversee the nursing practice across the system's major hospitals? speaker-2: So just a point of clarification, I'm the chief nursing officer and chief experience officer for a chief executive officer. Yeah, that's wrong. I wouldn't want to offend my boss my my boss's boss. I mean he's the CEO. Fair enough. so ⁓ Premier is has five hospitals. ⁓ Miami Valley Hospital is our flagship and the largest, but five hospitals, a large physician network, a home care division, ⁓ reference lab. I guess those are the cup the the components of premier. So my responsibility is both overseeing nursing practice in all of those settings as well as strategically planning for what what experience we want to create ⁓ for our patients and our our caregivers. speaker-1: Trying to give the audience like what your role means because chief nursing officer has several layers of that, because you could be just chief nursing officer of one hospital, but you're a chief nursing officer over several hospitals. So you're kind of like you're ⁓ you're with the whole organization, which is a I mean, really that's probably one of the highest positions you can be as a nurse, ⁓ in a in a organization, right? speaker-2: Yes, my yeah, my re like I said, my responsibility includes overseeing nursing practice across all of those entities, whether in the physician practice in the home care division or in in the hospitals and and making connections. So I mean, from a n from the my CNO hat, my big goal is building community around this ⁓ nursing, regardless of where you practice, whether you're an advanced practice in the physician network, you're an LPN. in in one of the offices, you're a home health aide going into patients' homes or most of our nurses, roughly we have five thousand across the system, work in the hospitals. That's where most of them work still. But there's we gotta make connections for the continuum for our patients too. speaker-0: I love that you said that because that's something that Cindy and I strive for. And that's what kind of what we're doing some of this for is so we can build those connections across the spectrum and help people understand the various roles that we all do and why, you know, sometimes there can be a negative connotation occasionally around leadership. But actually we we are nurses too and we do genuinely want to develop a good positive experience for everyone involved. Yeah. Love that. speaker-2: I like that. speaker-1: Yeah. So speaking of what you're talking about, how do you how do you stay connected to the frontline staff from this position? It gets really easy to get siloed and stuck in an office in I mean, I'm at a director level and I feel like I have a hard time not getting stuck in my office. So I can't imagine how much more challenging that has to be for you. So how are you doing that in like your actual practice? speaker-2: You know, it's such that's it's so important. And I you know, I I like to think of myself as really approachable and people will tell me anything and I have to remind myself that not everybody's gonna be honest with me, mostly because of my title, then my title can be scary, right? I mean the same thing is true as the director and even at the manager level, the and the further you get removed, the more scary those titles and the more ambiguity those titles can ⁓ bring. So I like to think about I've got to stay in touch with what's happening in the wild. So there's a couple of ways that I do that. First and foremost, it's with my leadership team and having intentional and meaningful conversations, both formal and informal drop-ins, as I do walkabouts or as and just touching base with leaders and leaders at all levels, managers, directors, and the CNOs that are at the hospitals. And then I have two advisory councils. One of them are direct care nurses from across the system. I meet with them every month and those council members serve like a two year term and and then we rotate members and get new members. But the intention with that council is two way communication, hearing what's going on, what's the pebbles in their shoes, what are frustrating them and I can also share my perspective about different things that they have questions about or they're wondering what's going on with this. We talk about what's happening with the profession within our organization and what we see is happening with the profession outside of our organization and how it might help our organization. So them building that relationship with me and getting to know me as just Lisa. ⁓ and and then, you know, I get to hear you know, what's really going on, what happened the last time they were working. And then I also have a a frontline leader advisory council. So these are like assistant managers and some nurse managers that are leaders of the direct care staff. So they're they're at the front line. And I learn a lot from them too. ⁓ so those two. And then each of our hospitals has a staffing committee. And the staffing committee is made up of fifty percent bedside caregivers. And then there's that's good. speaker-0: Yeah. speaker-1: Sorry, I just wanted to clarify. When you say you have a staffing committee, does that mean that you're guys you guys are doing staffing from a central perspective and everybody's working on it together on a facility wide level? Or are there layers of that? speaker-2: There there's I guess there's probably layers of that. This staffing committee is evaluating our staffing plan and they make recommendations, which includes, you know, what are the ratios that we're gonna staff the unit to? How what are the FTPs we're gonna budget for? You know, the the it includes that. It also includes things like what does our PRN contract look like? And how many hours should our PRN staff be doing? It includes things like how do we share staff when you know, when we've got five float nurses that are available and seven units say they need them. How do we determine who gets the float nurses? So on an annual basis, these staffing committees are evaluating our staffing plan and making recommendations, but they make the recommendations to the committee and then the committee, you know, does some challenges and then makes some overall recommendations to the nurse executive committee, which will ultimately make the final decision based on other budgeting, you know. Fun stuff. And so we l we have a lot of great discussions in that staffing committee. I mean I don't attend all of those staffing committees, and most of that is then funneled to me from the chairs of those staffing committees. And then the other way that I stay connected is three times a week on all of our inpatient units and several of our other areas, we do gamba walks. So nice. ⁓ and I don't walk speaker-1: Yeah. speaker-2: every time, but I do it regularly enough that I get a good feel for for what's happening and then I can recognize people or ask further ask further questions. So those are those are probably the key things when I think about how do I stay connected. speaker-1: It sounds like your frontline staff then will at least recognize who you are. I I know from when I was a frontline staff nurse, there was times that I had no idea who the medical director was or nursing officer was, you know, so and to have somebody at your level, I mean, I didn't even know we had a higher up CNO until I got detailed into a director position. Like I didn't even know how the structure of our organization worked. And so I think that's amazing that you prioritize that and that the staff know who you are and where you fit in the organization because I think that that helps the frontline staff understand when decision making's happening. speaker-2: Yeah. Yeah, and and Cindy you mentioned it's e it's easy to get stuck in your office 'cause you know, there's always a list of things to do and so you do have to prioritize it. ⁓ speaker-1: It sounds like that's like a core value to you. Yes. That frontline presence. speaker-2: And and I it fills my cup too. ⁓ you know, it's one of those things that I when I can go walk do my walkabouts, I remember why I love being a nurse when I when I do that too. speaker-1: That's amazing. So Lisa, when I met you, we were at AONL. We were staying in the same hotel and we just happened, we would eat breakfast near each other. And then we just my colleague Melissa and you and I would walk to the conference together, which was, I don't know, 10, 15 minute walk. And so you said earlier, you know, I like to think that I'm approachable. And I would say a hundred percent you are. I also was so shocked when you told me the role that you held because you came off as such a humble, level headed person. that it I was like, wait, you're like, ⁓ you're like up at that level. It it really surprised me. Not that all CNOs at that level, I guess I haven't even met that many CNOs at that level. So ⁓ but I was t I was pretty taken aback. And then as we prepared to have this interview, I started doing a little like finding trying to find out a little bit more about Lisa ⁓ because I about You know, we had lots of great conversations from like violent patients and staffing and magnet status and all of those things. But then I realized that you wrote this book called Ready to Lead. And I have to say I have read about half of it and I have been so impressed. ⁓ I wish that I had a book like this when I was a new leader. And I recognize the the drive and the passion in your heart that I think Teresa and I have also found the reason we do this whole channel and this podcast is to support and help other nurses feel empowered because going from a bedside nurse to a nurse leader is a thousand percent a different skill set. Yes. speaker-0: And that you're not really taught in school. Like you have some leadership and you some exposure, but it's not the same. And yes, br we were talking about your book yesterday a little bit, and and Cindy was just like, it's so it's not only practical, but it's also just so easy to understand and to absorb. So yeah, I think congratulations and thank you for doing putting your energy and heart into that. That's lovely. speaker-1: One the things you said, and I underlined it, and I just it really stood out to me and I think goes back to this whole like who you are as a person. ⁓ you said throughout my leadership career, people have asked me if I miss being a nurse and I let the sting of offense pass. I will always be a nurse. And then I tell them I'm still very much a nurse. I take the very best of what I love about nursing and I apply it to the teams I'm working with. Where how did where did that come from? You know, like what place in your heart was is that message? speaker-2: I've always wanted to be a nurse. I was nursing my baby dolls, my mom tells me when I was two and three years old. So I'm it's just I think nursing and being that wanting to take care of others has always been a part of me. And I love the leadership aspects of what I get to do now because the the things that I loved about taking care of patients, and so my clinical background was in neuro. Taking care of stroke patients and spinal cord injuries and other other neuro ⁓ diseases and injuries. And some of the most rewarding stuff was when they could do something today that they didn't do yesterday. You know, whether it was something they remembered as short, you know, or movement that they could do or and how they overcame some of the challenges that these patients were faced with. And when I think about that helping nurses grow into leadership or nurses grow into the potential of where they want to be in their career, it's very similar to that. It's how it's helping them see their see and reach their potential. ⁓ that I think that's what nurses do. That's what nurses do every day. Is help nature become their best get to their best health. And it's we're not curing things. necessarily. That's what our medical partners are, you know, more trained to do. We're helping patients get to to their best to their best health or to their best selves. speaker-1: I imagine that working on a neuro unit where you are really helping patients make incremental change very slowly gave you a real appreciation for patients and how long it can take to actually develop a leader and as yourself or as if you're mentoring or coaching somebody else. Which ⁓ personally I've struggled with that. I'm like, why isn't it better yet? You know, I've been working on this for two years. It should be fixed by now, you know. ⁓ so do you think that that's part of it? speaker-2: think yeah, yes, I think there's probably truth there. And I think there were certain disabilities, certain injuries that were not going to be overcome and we had to figure out how to compensate and work with the patient to compensate for them. So I think that's the other piece of it is we're n as leaders, we all have blind spots. As leaders we all have things that we're we're not going to be good at. And the And spending the energy where I can make a difference versus trying to fix all my flaws. I think that's the other piece of it. Is how do I leverage my strengths and the things that I can do to compensate or overcome this other thing versus spending a lot of time and spinning my wheels on fixing that that I'm probably never gonna be good at. speaker-1: I love that. Yeah, in your book you actually talked about strengths based leadership, which I agree with. And I think ⁓ I always felt like was a secret that leaders don't always know about. that you know, you want to try to align your people that are good at the things with the things and also what they want to do. I saw I've seen a lot of leaders just say, ⁓ I have this project that needs to be done, and you look bored or speaker-0: That first time. speaker-1: ⁓ not busy, so let's have you do it. But if it doesn't align with their what they're good at and what they wanna do, you know, you're probably wasting everybody's time. speaker-0: Lisa, what advice would you give a new leader entering or any of us in leadership? speaker-2: Spend time getting to know yourself. ⁓ get to know why you do what you do when the hair on the back of your neck stands up. Why? Why do you respond the way that you do? Why do how do you make decisions and why do you make the decisions that you do? So part of that is to get to know you better so that you can show up the way that you want to show up. But the other one is is discover what your purpose is. What's your core? What's your passion? Because when you know that about you and you can choose those areas that can feed your soul, ⁓ it's amazing what you can do and what and what you can overcome when you're feeding your soul. We as nurses have so many choices. We ha and we have so many choices in in how we want to spend our talent. But if we can stay in touch with what our purpose is, I think it overcomes a whole lot of resilient challenges and supports our well being. But all of that, I mean, all of that, get to know you better. That means getting feedback, being willing to hear the things you don't want to hear. ⁓ because then we're empowered to make decisions on how we want to show up. And where where we want to show up. speaker-0: Yeah. Can't make adjustments if we don't know about them. Right. Something I used to tell Cindy all the time is like if you don't give people feedback, you're not giving them the chance to make that improvement and be successful. And that's not right. That's not actually kind to do to them, to any of us. speaker-2: Yeah. speaker-1: I love the concept, Lisa, because it's ⁓ it's a very simple concept, but it there it's so vast as well. And, you know, all the aspects of what you're talking about. And I think in my experience, that has been the thing that's been able to keep me in leadership is being able to know what it is that fills my cup. You know, there's times that I'm dealing with very complex, challenging disciplinary cases that really eat at me and make me feel emotionally drained. And even though it's more work to go do other things, like add on other things, I've learned that if I mentor people and I go do those touch points, that that balances out that negativity drain. And so I've found, you know, if I'm feeling that way, like I need to call somebody up and say, Hey, let's have a let's have a mentor meeting. I need to like go talk to employees that are there for, you know, the engagement reasons and they care about the mission. Whereas you know, all I've been focused on is the employees that are just like those couple that are really draining and they need to go because they're really poisoning the water. speaker-2: Yeah. Yeah. Well I said earlier that I I love to go out on my walkabouts and that's part of what fills my cup. I get to stay in touch with some of the stuff that I love. by by s making sure that I'm spending time there. speaker-1: Going back to the staffing model you were talking about, Teresa sent me a little video about it actually this morning. I didn't even hear about it. But there is a facility on the East Coast that's getting a lot of publicity right now because they're planning to roll out a staffing model called bid staffing. And the way that it sounds like it's modeled is that a a nurse will sign up for a shift And it will be at a premium pay above their base rate. And then other people can sign up for the same shift and bid like lower amounts going down. So there's been a couple different perspectives that I found. One is like very sensational, and they're basically saying that they're they're gonna let people keep bidding until they get the lowest bidder, and then they're gonna take that nurse and say, ⁓ we're gonna take the cheapest version. I've also looked into like what the facility's perspective was, and their perspective was that they were trying to entice people to sign up earlier and entice them to sign up for shifts that are undesirable. It'll be interesting to see if they do actually go forward with it, because I'm wondering if they'll pull back because they're getting so much negativity. Is, you know, how's that actually gonna work? And you said we before we started recording that you've heard of those concepts and you have some opinions about them and I wonder, please tell us what your thoughts are about that. speaker-2: ⁓ you know, what I what I like about them is that individual nurses are putting a value, their own value on their time. They're saying, I'm gonna work for this. So at the individual this much. So they're putting there's so the nurse is saying, I'm willing to do it for this. And and other nurses might say, I'm willing to do it for this, and others for this. But I mean there are so many d dynamics that go into staffing. And we've talked about here is w how sometimes we escalate our staffing, our vacancies or where there's where there's gaps in staffing is you start out offering here and then pretty soon you're offering here and then you're offering here. And then at the last minute we're like, ⁓ my God, we gotta do this. Whereas if we could offer something higher sooner, we wouldn't go into the scrambling at the last minute to fill a need. And so this concept I think could potentially allow us not to get into the firefighting mode as much and potentially put patients at risk. I mean ultimately we're here to take care of the patients. So it's it's an interesting, I think, solution. It'll be it'll be really interesting to see how it plays out because there are there are so many dynamics. And yeah. speaker-1: Yeah, they said in the article that they're still planning to look at skill mix and what who who is able to do what. You know, it's not just gonna be based on who it's not just a body and a and a pay amount. Right. So it does sound like it does not sound like as diabolical as the person who presented it ⁓ did say it was. Yeah. I can also see the perception of that of ⁓ they're just gonna take the lowest bidder and then that will help them save money. They also said they're not actually gonna let anyone get paid less than their base salary. Yeah. So I think that's reassuring to me is you don't go lower than what you're already making. You would only potentially make more for working these shifts. So, you know, it's just another version of how media slat slants things and misinterprets it, but it's it's an interesting concept that I do wonder if they'll stick with it because they're getting really they're getting hit pretty hard with it right now. ⁓ I opt ⁓ speaker-0: I agree with you, Lisa. I like the idea that nurses get a bid for their time, what they feel and and willing to still help and pick up the slack for our team because I feel like that's one thing we do have with nurses for the most part. We are all in this together. I at least that's how I feel about nursing. And I love that idea and the concept of like being able to be like, I have this many years experience. I have these skills. I am more than willing to do that. But this is my time and it is valuable and and I need I want to get paid for what I feel I deserve. I like that that thought process behind it. How to make it happen is gonna be super challenging. Like you said, it's staffing is so complex. speaker-2: And it you know, on a single unit level, depending on the patient population that you might serve, a nurse manager's gotta consider, ⁓ I gotta make sure I have a Pell certified nurse, I have to make sure I have an ACLS certified nurse, or you know, and I've got three people on orientation that I need to make sure they all have the right kind of preceptor. And so it's I mean, there's no way that we can just take the lowest bidder. I mean it it's it would be virtually impossible. Now sometimes might it work, you know, if all those other things are lined up. But I think it's there's there's way more decisions that go into it before Yeah. Before compensation. I mean there's l there's gonna maybe be bidders that are ruled out just because of the the competency or the skill set or it's not the right fit for the for this shift this day and based on the dynamic that's happening. ⁓ Staffing is complicated. speaker-0: So complicated. That's that's the that's the biggest challenge that any of us face, right? There's always another idea and another layer to try to figure out how to make it work better and how to make meet the needs of the patients and the staff that are doing it. It's it's super complex and there's no perfect one way. I think I think like the ideas of, you know, agency and staffing and bids and like there's always some sort of bonus or option that there's out there. So how can we get them filled sooner is smart. speaker-2: Yeah. So so we can proact with the plan. speaker-1: I don't know if you went to the session at AONL this last spring, Lisa, but there was one that was the survey that they did the prior year on like what is stressing out nurse leaders the most and it was it's like been ongoing the number one stressor for leaders right now and has been is staffing. So yeah, it's just it's such a hard thing to to try to tackle. speaker-0: Well, most of our nurses work for schedule and pay. They like their job too, but those are the other two components that usually drive certain types of nurses and and various things. Obviously, many of us are in it for a good reason, but that's one of those. speaker-1: Okay, well we're gonna wrap up here. It's been so fun to talk to you, Lisa. I feel like I have a million more questions I could ask you. ⁓ but I I appreciate your time and taking this out of your busy day and work week. So you work for Premier Health and you have your book, this great book that I recommend everybody check out, and you have a consulting business. So how can if youers wanna look you up or reach out to you, how can they get a hold of you? speaker-2: So ⁓ if you want to learn more about Premier Health and what's happening in in the great baby boom, my ⁓ work email is lmgosset at premierhealth.com. And if you're interested in learning a little bit more about ⁓ my book and and those kinds of things, you can also re reach me at Lisa at GossetInsights dot com. speaker-1: We'll put that in the description ⁓ when we do the when we publish this video. speaker-2: Awesome. It was great talking with both of you ladies as well. ⁓ speaker-0: And thank you so much for just taking the time and sharing your knowledge with us. That's awesome. We appreciate it. speaker-1: Yeah, and I hope to see you at A O N L next year. Maybe which hotel we're going to speaker-2: Yep. Teresa, we can celebrate your birthday. speaker-1: Yeah, we can. Let's do it. There we go. All right. Thanks, Lisa. speaker-2: Guys have a great afternoon. Bye. speaker-0: You have a good evening. Bye. Bye. speaker-1: Wow, that was incredible. Lisa, when she was talking about why she does what she does, I could just feel and see the emotion and that passion in her eyes. It was contagious. speaker-0: I also felt like it was so incredible. One of the things that really stood out for me is her desire to stay connected, which is exactly what we're trying to do. We wanna connect. We want to improve and increase our level of connection, not just where we work, but across the nation if possible, in a similar fashion, where Lisa is able to connect with five hospitals. Like it's incredible she creates that culture. speaker-1: It's so impressive that she's able to do that at such a high level of leadership and that she's able to stay grounded and down to earth. And clearly the culture that she's created in her hospital is widespread. And that has to be because of who she is and how she's shows up. And I just feel so inspired by her and I feel very renewed. This is gonna be something that I'm gonna be thinking about for a long time and how I show up in my own leadership. speaker-0: Yes. Agreed. Her approachability and humility, she creates a safe space even just over our interview and discussion we had. Like just so welcoming and kind and thoughtful and considerate. And you're just like, Thank you so much for taking time out of your busy day to have this conversation. Yeah. When you're doing such massive impact everywhere. speaker-1: Yep, totally. And I told her before the interview, I said, what because I've read like half of her book now. I told her I said, it just felt like a warm hug. Like I just I felt like so encouraged and safe. And I'm not even a new manager. I was even like having this reparenting experience of, you know, going back to those first days when things were dark and scary and like pretending that Lisa was there and helping me sort of heal a little bit from the trauma of that experience. So Yeah, I really am so impressed by her. So I hope you guys enjoyed the interview. I know we really enjoyed it and we look forward to bringing up some more awesome content for you in the future. speaker-0: And buy Lisa's book.