Latest / Here to Serve - A United Regional Podcast / Andrea Anderle, Director of Clinical Education

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Andrea Anderle, Director of Clinical Education · Here to Serve - A United Regional Podcast

• United Regional: Welcome to Here to Serve, a United Regional podcast. I'm your host, Ryan Graves. My favorite part of being the Director of Patient Experience at United Regional is the incredible people that I meet and work with on a daily basis. And I want you to meet them too. Join us to meet the people behind the badge and to highlight those who are here to serve. Andrea, welcome to the Here to Serve podcast. Thanks. Great to be here. Glad to have you. We're going to talk about a lot of things today, but I want to start off with something. ⁓ You've sent me a video recently that was very disconcerting. I need to know where you found that video. I don't even know. I was having to clean up storage on my computer and I was deleting old stuff and I came across it and I thought, no way. Yeah. So I'll have to see if I can get it to our guys. We have to maybe put it in. so the video you sent me was of me ripping the arm off of a hospital mannequin. Yeah, in a closet. Like you're in a vault. I knew that video was gonna come back and get me at some point. So here's the story. We haven't got to talk, but I saved it. I'm like, know I'm gonna talk to her soon. I didn't even told you the story behind this video yet. So, Andrew has sent me a video randomly and said, what in the world? And I was at church and I opened it up and I just busted out laughing. It's just me just like yanking on a mannequin. It was barbaric. was, it really was. It got out of hand because it was never supposed to be that way. But long story short, Simeon and I, who is the media, manager at the time, or I'm not sure the exact title, but we're asked to create a funny video. ⁓ And when they said, we need a silly funny video, when we roll out Epic to the front line, we wanted, we're just like commercial for Epic being like a sidekick for all the staff. And they said, you guys be creative, have fun, know, world's your oyster, get after it. And so one the ideas we had was that we wanted the Epic computer to have like a face and a mouth and to be able to talk to the staff. And then we, from there said, well, it needs an arm so that it can like high five the staff. And so we went over to the education building. think it was Laura, whoever was there, maybe it was you. don't remember. I mean, that's probably five or more years ago. But said, hey, do we have a mannequin over here that we could get it? I thought we could like remove an arm. And they said, no, they're not removable, but we have one that's like gonna go in the dumpster if you wanna just take an arm off. It's much harder to get an arm off a mannequin than I thought it would be, first of all. Second of all, it was a little mannequin. It was a baby. Yeah. And then third of all, I'm midway like trying to get this arm off and I look up and Simeon's over there with the camera like laughing. And I remember thinking like, this is going to come back and haunt me someday. And apparently today's the day where it's coming back. But it was a little, arm. So that's like Saturday Night Live-ish skit with the little hands. Yep. then ⁓ I need to, haven't seen the video that actually it... with the video that was produced from it, but I remember people were high-fiving this little tiny hand. It was on the side of the computer. I had very Kristen Wiig vibes. Have you seen the Kristen Wiig with the little hands? That's the vibes it ended up with. Anyway, that was great. I had forgotten all about that. I'm glad I passed that along to you. But I did save it. I did not delete it. The video may not be done haunting me. Well, tell us who you are and what your role is at United Regional. All right, well, I'm the director of clinical education. I've been at United Regional for, gosh, next month, it's 33 years. 33, goodness gracious. in April it'll be 33 years. started out as a CA or a PCA, went through nursing school, was a nurse in our nursery, in our neonatal center. That got me through the first half of my career. And it's hard to say that I've been away from the bedside for about the last 15, almost 17 years, I think, doing education. My plan was never to leave the bedside, never. I had the best job in the world working with the babies and going to deliveries and seeing people at their finest at their best time in their life. But there was some times that I was missing things, missing things with my kids, because working shifts and weekends and holidays. Most people know about me, some people may not, that I have triplets. so... you you miss one thing and there's no do-overs with that, you know? I don't get another round at that. So I was just missing some really important stuff. And so I thought I need a job that's gonna allow me to do what I love to do, but also be at home when I need to be at home in the evenings and weekends. So I went back to school, got my graduate degree from TCU and became a clinical nurse specialist and started doing education. and clinical nurse specialist work for women's and children's, which led into education. And I always thought I'd go back to the bedside. I never, never wanted to leave. And people ask me all the time, do you miss working with the babies? And the answer is a resounding absolutely every day. There are times that I wish I was still over there, but at the same time, ⁓ I'm where God put me. So anyways, the director of education, we're overall housewide education. ⁓ We kind of have a, we have a hybrid department, which is not that uncommon in healthcare anymore, where I have a centralized education department, but we also have educators in each of the divisions that have a dotted line to me, and we collaborate really, really well together. So we've got subject matter experts in every division that ⁓ work through us, and then we also have house-wide educators. that's my job. And then there's other duties as assigned. You have many of those other duties. One of the downfalls of being creative and doing a good job is you get assigned all kinds of other things. I wanted to point one thing out you mentioned, and I've had a similar career path, different land and a different place, but very similar start at the bedside and never really thought I would leave that, but I wanted more stability for an hour, which is what pulled me away. But it's led to a whole other career path that didn't even exist, to be honest, when I moved. This director of patient experience thing didn't even exist when I moved into patient advocacy. Nursing is interesting that way. When anytime someone asks me about nursing, would it be a good career for me, for my personality, et cetera, et cetera, one of the answers I always give them is like, man, nursing is one of those careers where the sky's the limit. There's no one way to do nursing. It's just like so many different paths you could go down. And it's expanding now with the... I visited with Nomi not long ago, but I mean, you move into EPIC or EMR World, IT, IS, I mean, it is just ever expanding for nursing, which you can do. Absolutely, and I think you mentioned creativity, but it really just has your imagination is really what, because there were no clinical nurse specialists when I finished that career, when I finished that degree at TCU. There were none at United Regional. There were none in North Texas, and it was a something I had never heard of before, a CNS. In fact, I'm sitting in orientation at TCU and they kept talking about CNS, CNS, and the only CNS I know is Central Nerve System. I'm like, this is a degree that I can teach. That was my intent. I was gonna go to work at a college and teach. That was my whole plan. ⁓ And then the more that I got into the program and realized what a CNS was and how they were expert clinicians, but researchers and educators and advocates for nursing, and that liaison between physicians and nursing, thought, this is exactly what I wanna be, but I wanna be at the hospital. So ⁓ I wrote a job description and said, I think the hospital needs CNSs and this is what we can do. And ⁓ the leadership approved it and ⁓ side note, there was no funding for this type of position, but when I wrote it and I submitted it and they said, yeah, this is something that we think we could do. I mean, in one project, found $175,000 worth of missed charges that we could have captured. that's the kind of thing that a CNS does. They said, yeah, let's do it. And I said, well, there's a hitch. I have to pay back this grant to TCU, because it was a fully paid grant to go to school there for becoming a nursing instructor. ⁓ brought that back up to the CNO at the time and she brought it up to senior leadership and they said, okay, we'll pay it back. So I didn't have to go leave the hospital to go teach. I got to be a CNS at the hospital at the bedside. ⁓ That was thanks to our leadership, partly because I just had the guts to ask for it, but mostly because they saw the future. They could. envision it with me. Well, and I would say you helped them. I think that's one of your great, you have many strengths, but one of your great strengths is your creativity and vision for what could be, you know, and then ⁓ the courage to then step out and go, hey, let's see what we can do here. We can do this. Let's try it. And I think that's something that I'm curious. Did you, were you just kind of always wired that way? Do you think you developed that over time? That's something I aspire to be more creative and more like, step out and do things. I think I always was. My dad was a really, really creative person, real musical, artistic, and I'm not artistic by any means. I do play the bass guitar, so I I didn't know that, okay. But ⁓ I think I was just wired that way. Even after the 79 tornado, I was in second grade, and I can remember going around collecting things, thinking, this is the... Best like these are toys that aren't mine that I get to keep most Andrea thing I've ever heard Takes the tornadoes like hey, it's an opportunity opportunity to get new stuff and to build a new house and yeah, yeah Fantastic. So I think I was wired that way. Okay. Well, that's ⁓ That's that's helpful because I sometimes wonder like man How much of this came and I'm sure that you can develop creativity and be taught creativity and all those sorts of things But there's certain people that are just wired They just think that way and see that way. think people have it in their heads. They just don't know how to get it out. And so I think that's what is the art form is being with people and getting it out of them. And you do that very well. We'll get into shared governance a little bit later, but I've watched you do that over the years. Anytime, I'll tell you right now, anytime I'm stuck creatively, And you're probably sick of this because I'm probably not the only one that does it, but I'm like, I bet Andrea will have ideas and I'm going to call you up and you always just start, you know, well, this, what about this? And it's a gift for sure. So speaking of creativity, I want to ask you one of the things, one of the coolest things I have seen, maybe, I mean, since I've been at United Regional, one of the most just innovative, creative, problem solving things has been the residency and the apprenticeship program that you guys have been working on. I mean, I'm just... I brag about this, I had nothing to do with it. I've literally had nothing and I brag about it all the time. I'm like, well, you should know about our apprenticeship program. Tell me a little bit about where that came from. Well, what it is, first of all, where it came from, how it's, I mean, it's morphed into kind of a whole thing. And so just fire away. Exciting, exciting stuff. The apprenticeship came from a call that I got from ⁓ Mary Rivard at Vernon College that said, hey, she had gotten a call from somebody at Texas Workforce. who had some money allocated to apprenticeships in healthcare, which have never existed before. So we went to Austin and we met with the Board of Nursing, the Department of Labor, the National Department of Labor, with the Texas Higher Education Coordinating Board, and got permission to use these Texas Workforce funds. It was a right your own. Like we had to build our own apprenticeship. There were no rules other than it had to comply with the Department of Labor. Now, I don't know about you, but. I knew nothing about apprenticeships other than that plumbers and electricians do it. That's about all I knew. So, first I had to learn about what are apprenticeships and what are the Department of Labor requirements. And really it's 2,000 hands-on hours is what is required of them and they have to be paid hours. So, since it had never applied to nursing before and prior to that, it was not legal to pay nursing students for clinical training time. So when you and I were in nursing school, we couldn't get paid for our clinicals. So this opened up the door for us to be able to hire senior nursing students. This is the way we wrote our program. And there's probably others now that have developed. We were the first one in Texas ⁓ who got the funds and who started it. And we started it with the LVN program and have ⁓ soon, very soon after that, rolled it out to the RN program. So here's kind of the lay of the land. We get them the start of their senior year. So I'm about to start recruiting for the next group of RN apprentices in April, and they'll start in June. So they'll work all summer during their time off, and these are the ones that are entering their senior year. We will match them up with a preceptor, a nurse preceptor, not a tech, not an aide. They will be with a nurse side by side, and they will get 2,000 hands-on clinical hours throughout the year. Now, to put that in perspective, nursing students, in their senior year get about 450 clinical hours. So over four times the number of hours that they would normally get. And the clinical hours that they do in their school program, I'm paying them hourly wages. No matter where they do them, they might be doing them at the state hospital or in Compass or anywhere else, but we're gonna pay them for those clinical hours as well as offer over 1500 supplementary clinical hours. So when these guys get done with this program, They are leaps and bounds ahead of their peers in confidence and in competence. Just overall role transition, they're there. And they, I've said before, there's no crying in apprenticeship. With our nurse residents, when we get them, those are any new graduate nurse that starts at United Regional is automatically enrolled in our nurse residency program. That's stressful. I don't know you remember what it was like to be a new grad nurse. Like there's nothing in school that can prepare you for being a nurse. it's not uncommon for nurse residents to tell me, I cried, I cried, you know, three days straight, because it's just stressful. There's no crying in apprenticeship because they have a year's worth of training that's not intimidating. They're not on their own. They know they're not gonna be ⁓ left to hurt anyone or make any mistakes. ⁓ So by the time they get out of it, the level of nurse that we have is just phenomenal. And all of this was to be done so that we could help fill that nursing pipeline. You know, there's a huge projection out there about the deficiency in nursing that we're going to have over the next 10 to 15 years. And we're gonna be in trouble if we truly have this decline in nursing as the baby boomers need us more. All of the Baby Boomer healthcare providers are retiring as well. So we're gonna be in ⁓ a sad shape if we don't do something right now to fill that nursing pipeline. And this was Texas Workforce recognizing that and putting money towards it. ⁓ Now, I'll tell you, we did get the grant and we've continued to get the grant. I've applied for it every year and we've gotten a little bit more money. ⁓ It really is a small fraction of the cost of what the apprenticeship is. Our organization has been phenomenal about... ⁓ investing in this. truly is an investment, but it's paid off. It's a worth, yeah. Yeah, absolutely. No brainer. And I find myself jealous. Like I come over and speak with the interns at least a couple of times during their, what do we call it? Rotation. residency? Yeah. Is it the residency? I come over and speak with a couple of groups of and it's always interesting to watch them throughout their journey. And but as I'm talking to them, I'm like, ⁓ I'm kind of like a little bit jealous. I'm going, man, this is so cool that that you guys are doing this and you're learning all this because that is not was not my experience. I know it wasn't. No, no, no. I used to when I still do give advice from time to time, people ask me, hey, I'm going to go into nursing school. What should I do? Et cetera, et cetera. And I always tell people are historically have always told them you need to go work in health care somewhere. Go be a PCA. Go be a tech. is gonna put you so far ahead of everybody else because you're comfortable in the healthcare setting, you're gonna learn so much. that's what I, it helped me tremendously when I was going to nursing school that I worked as a PCA at the same time, you know, because everybody else would show up for clinicals and be scared to death. And I'm like, Hey, I've already done half of this because I've been working. And now I'm like, go, go get in on this program right here because it is going to put you so far ahead. I got a funny story. I'm probably not funny, but just to solidify, when I've started nursing, I don't recall crying, I don't think I did. I'm sure I felt like crying a couple times though, especially that first little bit. You're just so overwhelmed, you're not prepared. ⁓ But I don't know, I was a year or two into nursing at the bedside and my leader came to me and said, hey, you're doing a good job, you're solid out here, we want you to start training folks. And so they gave me my first person to train. And ⁓ the way I'm wired, I'm an empath, I wanna help. I'm like, okay, I'm gonna make this so good for them. They're gonna love nursing when I'm done with them, you know, whatever. So their first day, I think I didn't give them hardly anything. I like took them with me all day long and tried to like take them under my wing. And I thought I did such a good job. And I found them crying in the break room at the end of the day. They were in the break room just like sobbing. And I was like, I guess I didn't do that kind of a job I thought I did. ⁓ And that was a kind of eye-opener for me is like this is tough like it's really tough and that person went on to become a great nurse and there was you know, but that first day or two is it's just a shocker, know, and so this yeah, this is taking care of all of that Do you remember your very first day in health care? I do I do too. I remember it I'm trying to ⁓ end of beginning of 07. So not quite 20 years and you're 30 what? Yeah, well this was, I worked at Bethania for two years prior to working at Wichita General, so really I'm 35 years, but they don't count those first two. So as a PCA, I was working in a med surge unit and they had just started a float pool and it was brand new, like we didn't have resource back then, so it was a float pool and it was only for unlicensed folks. And the rest of the hospital kind of really didn't even know that we existed. The rule was you were supposed to have, been through your first semester of clinicals in order to be able to qualify to be a CA and to be in this float pool? I had not. I was still in assessment class, but I was so eager to get in. I was working at a daycare center at the time and a furniture store. And I wanted to get into healthcare because I knew it would help me. So I go to interview and I was 19 years old, so naive. She asked if I knew how to take vital signs. I'm like, yeah, yeah, yeah, I do, I do. I was like a rat on crack. Yeah, I do, I do, do. I'm so excited. Yes, yes, yes. We just learned it last week. And she goes, all right, well, we're pretty desperate, so we'll take you. And I was so naive. I didn't even know that that was like a cut. I didn't know that. I was like, good, good, yeah. But then that first day, I was so scared. I was still living with my parents over by the stadium. And from the time it took me to drive from the stadium to the hospital, I prayed an entire rosary. Like, Hail Mary had no idea that she was hanging on for dear life as I was driving to get there because I was so afraid that I was gonna make dead people. Like, I was so That's the fear. I remember it all too well as like, I'm gonna kill somebody today. That's the nightmare, is I'm gonna make a terrible mistake. no harm. But yeah. But, and I didn't know what I didn't know, but. You jogged my memory. I forgot all about this. But I was thinking of my first day of nursing, but I was thinking about my first day of PCA. So that would have been, I don't know, four years before that. But I had a, I walked in, since I was a nursing student, I walked in as a PCA to this, it was at South Texas facility, and they said, you know how to do vitals? And I was like, yeah, I know how do vitals, I'm a nurse student, you know, I'm level one nurse student. And I did vitals on the whole floor, didn't take any respirations. So I had blood pressure and pulse, and I was like ready to document, and then I looked and I was like, oh no, I didn't get respirations. and started over, going back and got respirations on everybody, and I bet I didn't tell anybody. I wasn't about to tell anybody that I went through the whole floor and didn't get any respiration, so. I have a very similar story. My preceptor when I was a CA was, we were going room to room to room, and she was that nurse that just kind of floated into the room and just took care of everything that she needed to do well. yeah, and hate those people. She would do her vitals and then walk out of the room and write them down. And so I thought when it's my turn, I'll do the same thing. I walked into the room, did the vitals and walked out. She goes, okay, what were they? And I'm like, I, no. The door has like a memory wipe on it or something. no idea. She had to go back in and retake them for me. No doubt, yeah. Well, I mean, so full circle, this program, like, I'm sure there's still people that, know, your first day is still gonna be nerve wracking no matter what, but it's a completely different experience. Not only for that person, but for the patients that are getting this person on their, early in their career. It's like it's a whole different level of nurses, safer, they're smarter, they're more confident. I mean, it's just, I can't say enough good things about it. And it's solving so many problems, it's putting out better quality nurses, but also recruiting people earlier, getting rid of some of that. There was an old, and I hate to speak in like broad strokes and pain everybody, but there was kind of that old mentality of nurses eat their young. I feel like that's just kind of... been done away with. Yeah, I don't see that anymore, especially in our culture. And these apprentices really have been ⁓ in in in culture aided in their units and their units really they they they are theirs. And so as a student, they are already being socialized into that group. And it's just been phenomenal. And I am so, so thankful for the investment that the organization has made in starting it. The vision to go this. Right, in the faith that, I mean, they could have told me no. Right, well, here's what's cool. My favorite part about all that is we were, Texas is a big place. There's a lot of hospitals in Texas. We were the first one to do this. That takes guts on your part and on the organization's part to go, hang on, let's just watch for a year or two, let everybody else figure this out, and then we'll do it versus going, no, no, we'll do it. We'll be the ones. That was awesome. So cool. So we've talked about it all over the country. Places have had us come, different conferences have had us come and do poster presentations on it. I get calls at least once a month. I'm working with a group from Texas Workforce down in South Texas. They're wanting to do it and they're having a hard time finding hospitals to want to partner with them. So I've been talking with those hospitals to help them understand the value of it. Yeah, that's incredible. ⁓ Well, real quick, I want to touch on and there's so many other things you do. but one that I'm involved in that I think is one of those things that I'm very proud of that we do as well is the Shared Governance Council. You're talk about, explain what that is, just at a high level and some of the things that they're working on. Shared Governance is something that we started back in 2007 and I was a part of rolling that out at the very beginning right when I got out of grad school. was one of the things that I learned about in grad school and brought. And it's really an opportunity for staff to have a voice at the table for how to make decisions that govern their practice, their environment. and the work that they do. And we've been unique from the very beginning in that ours was not just nursing shared governance. And if you read anything in the literature about shared governance, it's almost always nursing shared governance. So we've been interdisciplinary or multi-disciplinary from the very beginning. And this last year, this is the only hospital that I have ever heard of rolling out shared governance councils or unit practice councils throughout the entire organization, which is fabulous. So. So what it is, is we meet once a month in shared governance, and these are two representatives from every unit, just about, and then respiratory radiology, pharmacy, lab, all of the support services. And we divide up into three different councils, the people council, which I lead with is all about the people, all about professional development, rewards and recognition, retention, those kinds of things, engagement. And then we have a quality council, which is the one that you're sitting on with, which is about service and quality metrics, making sure we're taking great care of patients. And then the third one ⁓ is community, which is a new one this year. So really, really excited to see what that one does about bringing the community, our awareness about community needs and helping the community know more about us. And then we also have a hospital user group, which is our informatics type of group. So they meet once a month for half the day. And ⁓ they come up with amazing projects and it's really having them be the voice and the hands and the feet of the people that get things done. ⁓ It's been miraculous, amazing to see how many people have been in shared governance and then have become leaders after that over the years since 2007. ⁓ So it is a leadership development opportunity for staff too. Yeah, I totally agree. I've seen you've watched that and seen that and you can kind of also when you're working, you can start to pick out like, hey, this person. This person is a natural leader, right? They care, they want it, they're leading already. It's cool to see. I know all of those things are a tremendous, they don't just happen. They're a tremendous amount of work behind the scenes. You've developed what I would call just a crap team in the education department and you guys do so many things across the entire organization that is very much appreciated. So thank you for all that you do. all that you're doing, anything we haven't talked about today that you're excited about or anything upcoming that you wanna share. We do have an upcoming symposium. I'm not sure when this is gonna air, but September 24th and 25th, we have the Advances in Healthcare Symposium that's gonna be phenomenal. ⁓ But the only other thing that I would say is that ⁓ anybody watching this who is in healthcare, I don't want anybody to underestimate the influence that they have on people's lives. We have, and you've said this before, that healthcare is sacred. Sacred, ⁓ And I totally believe that. And if you were to see ⁓ people's lives on a timeline, like in history, you remember there's all those dots on the timeline and the significant events and things changed. Right. And so I think all of us have a ⁓ life with dots on it. And you could probably name those dots when things changed. know, when you graduated high school, that was the event. But a lot of those dots are related to healthcare. Amen. You know, when you had your first kid, or when your dad got cancer, or when your mom had a heart attack, or when, there's a lot of healthcare dots, because things are different before and after dad died. That's a big dot. ⁓ You don't forget the things that are on that dot. ⁓ My dad dying in our hospital years and years ago was one of those dots, and I remember the faces, the names of everyone that cared for him 35 years ago. And I can remember what they said to me, and I can remember how they made me feel. And I think they don't necessarily, if we are those healthcare providers, we don't necessarily remember, it's not a dot on our timeline, it's just another day at work. But I don't want anyone to underestimate the influence that they've got on people, on really impacting their lives. We are in a field that, are those dots on those timelines and we have an opportunity to really. make an impact in their lives, whether we realize it or not. And so I want everyone to just take pause and recognize that every conversation that they have in that day is going to be remembered by someone for probably their lifetime. Andrew, that is so well said. Could not agree more. ⁓ I would even take it and say people measure time from those. You notice those big events, people like, I had my surgery in 07, so that would have been 08. Absolutely. big of a deal. getting, know, having a healthcare experience, people literally measure time from it. AC, I mean, you know, it's like that big. Before surgery, after surgery, yes. It's like that big of a thing people remember and they'll remember it for the rest of their lives. And I get those calls frequently, good and bad, where they'll talk about something that happened 10, 15, 20 years ago. But the way this person, the way they treated me, the way they me feel, good. or bad, it's with them for life. It's with them for life. ⁓ And so that is a great place and I would wholeheartedly agree it is sacred. So I tell people often, ⁓ my heart is gonna determine what comes across in this room when I walk in there. And my heart, I decide what's in my heart before I get in the building. I gotta decide before I get here, no matter what's going on in my life, I'm about to have some sacred conversations today. I don't want this person to remember this for the rest of their life, in a negative light, right? That they deserve better than that. So awesome, Andrea. Thank you for sharing that. That's clearly in your heart. comes across in everything that you do. Well, we are blessed to do what we do. Amen to that. Well, thank you for coming on. As always, enjoy visiting with you. Absolutely. Thanks for having me.