Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / Denise Harman, Director of Medical/Surgical/Pediatrics at Olympic Medical Center in Port Angeles, WA

Transcript

Denise Harman, Director of Medical/Surgical/Pediatrics at Olympic Medical Center in Port Angeles, WA · Becker’s Healthcare -- Pediatric Leadership Podcast

• 0:00
  Welcome to the Becker's Healthcare Podcast. I'm Chris
• 0:02
  Sosa, the copy chief here at Becker's, and
• 0:04
  I'm thrilled to be joined by Denise Harmon,
• 0:06
  director of medical surgical pediatrics at Olympic Medical
• 0:09
  Center in Washington.
• 0:11
  Denise, thank you for joining us today.
• 0:13
  You're welcome.
• 0:14
  Denise, for those in the audience who are
• 0:16
  maybe not familiar with you and the work
• 0:18
  you've done, would you mind introducing yourself and
• 0:20
  telling us a bit about your background?
• 0:22
  Sure.
• 0:23
  As you mentioned, I am the director of
• 0:25
  the medical surgical pediatrics department here at Olympic
• 0:28
  Medical Center.
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  We are a small rural community hospital
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  serving
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  the very, very far Northwest of Washington state.
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  My background is mostly
• 0:41
  med surg.
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  I have had this position. It'll be three
• 0:44
  years in April 0. Before that, I worked
• 0:46
  as a bedside nurse in this department.
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  I've done a variety of things, some pediatric
• 0:51
  home health,
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  long term care, some clinic work.
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  But I
• 0:56
  love the the med surg department, so I
• 0:59
  like the
• 1:00
  the pace and the exposure to different things.
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  Our house, as I mentioned, our hospital is
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  a rural hospital.
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  My department happens to be the largest 1,
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  for what it's worth. It it has 40
• 1:11
  beds, so that gives you an idea of
• 1:13
  of what our hospital looks like
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  as a whole.
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  Yeah. I think that kinda covers my background.
• 1:21
  It's pretty straightforward.
• 1:23
  Well, terrific, Denise. If you wouldn't mind for
• 1:25
  our audience, could you lay out some of
• 1:27
  the top priorities today from the the angle,
• 1:30
  the example that that you push forward?
• 1:33
  Your background, that is, is from a rural
• 1:35
  community hospital.
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  So our our top priorities
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  are making sure that our hospital
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  stays up to date with the with the
• 1:44
  latest and greatest,
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  being that we are kind of remote ish.
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  It it does take a little bit of
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  time for kind of the newer stuff to
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  to hit
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  our our hospital.
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  1 of the unique things about our department
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  in particular, it we do have pediatric patients,
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  but we, also take care of adults. So
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  it's kind of a combination
• 2:08
  adult medical surgical pediatrics.
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  So that means that our our nursing staff
• 2:14
  has to be able to care for that
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  very, very diverse
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  population.
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  So our our main priorities are making sure
• 2:22
  their education is up to date, making sure
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  that they
• 2:27
  know what is going on in the world
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  of peds,
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  as the majority of our patients are not
• 2:32
  peds.
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  So
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  that is
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  I am in constant contact with our local
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  pediatric clinic who has a relationship with some,
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  pediatric hospitals in the Seattle area.
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  They do a really good job of making
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  sure that we are, you know, updated on
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  any changes in processes
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  or, hey, you know, now we're treating this
• 2:51
  condition differently. This is what we're doing now.
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  And
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  our main priority is making sure that our
• 2:58
  nursing staff is familiar with those changes and
• 3:01
  comfortable
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  with those changes so that they can provide
• 3:05
  the care that our patients need.
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  Thank you for laying all that out for
• 3:09
  our audience,
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  Denise. Speaking of changes,
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  looking at the next eighteen months or so,
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  how do you anticipate your role is gonna
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  change and the role of your team?
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  So,
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  I
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  am not sure how my role is going
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  to change. I know that we,
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  are
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  coming out of the post COVID,
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  slump, as I like to call it. We
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  had a huge amount of turnover.
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  You know, our organization as a whole is
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  kind of bouncing back from from that where
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  we were just kind of rolling minute by
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  minute, figuring things out. Now we've got time
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  to breathe and we're
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  we're refocusing.
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  So my role is
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  will remain the same. But I know that
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  it's going to shift into a different direction
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  with different responsibilities
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  as as things arise.
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  As far as my my team goes,
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  we had a large turnover of more experienced
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  nurses, so our team is relatively young. We
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  also
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  are finally coming out of the,
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  heavy
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  traveler
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  nurse,
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  population. We had quite a few open positions,
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  that we had filled with travelers and now
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  we are getting
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  nurses in. Some of those are fresh graduates,
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  some of them are experienced nurses from other
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  other areas. So
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  as we build our team back up to
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  permanent staff,
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  there are a lot of changes that come
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  with that. So we have to build a
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  lot more familiarity with our pediatric population.
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  How how we do things because they're they're,
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  you know, during COVID, I think people just
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  kind of
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  did the best they could with what they
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  had at the moment. And so there was
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  a lot of,
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  spur of the moment
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  decisions like, hey, this is what we're going
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  to do right now.
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  Not a lot of time to really
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  think through and develop a solid processes.
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  So we are working on
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  improving our pediatric
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  orientation and education
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  process for our nursing staff. So that is
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  more clear, more in line of what the
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  other facilities in our area are doing, where
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  we know that if we end up having
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  to transfer a pediatric patient out, that our
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  care is gonna line up with what their
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  next step in care will be at those
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  higher acuity facilities.
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  Making sure that our staff is comfortable
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  caring for pediatric patients. You know, we have
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  we have
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  brand new nurses out of nursing school who
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  are in their early twenties, no experience with
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  children
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  in any way, shape, or form. They tend
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  to get that deer in the headlights look
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  and
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  panic when you say, hey, here's a kid.
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  Let's, orient and train with them today. So,
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  getting them more familiar with that population.
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  We have been working really hard on building
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  better relationships with our pediatricians.
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  We have a great team
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  of pediatricians here that are
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  very good at making sure that
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  our staff knows what the plan is,
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  knows that they're a resource at any time
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  they can reach out. So
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  over the next eighteen months, we're gonna focus
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  on that education and building up those stronger
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  relationships and getting those policies and processes solidified
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  so that our staff is comfortable, and we
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  know that we are providing the best possible
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  care to our patients while they're here.
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  Chase, I'm glad you mentioned, the younger nurses
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  and the amount of turnover you had. Certainly,
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  your organization is not the only 1. But
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  I'm curious as to
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  what you find are the most important resources
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  when you have a younger crop of, nurses
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  and other staff coming in.
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  So our our most important resources
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  are
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  our more experienced staff.
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  They they do a great job while we
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  have less than we had before.
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  They do a great job of kind of
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  calming that panic down. You know, you're you're
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  a new nurse. You feel like you don't
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  know anything. Everything is,
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  you know, appears to be
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  a huge deal when in fact it isn't.
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  So we utilize a lot from our experienced
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  nurses. They're they're great, kind of keeping people
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  in check and helping people out.
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  We have our education department has actually,
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  in the past few years, started a residency
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  program and it has
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  progressed over the years. It's it's a year
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  long program for them. The residents, they meet
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  weekly with their cohort.
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  They get to bounce ideas off of each
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  other. They get to work together with all
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  of the residents in the different departments to
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  kind of give each other
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  a bigger view of the of the hospital
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  as a whole and what everyone's different roles
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  look like. So there's that good
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  interdepartmental
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  communication.
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  Whereas, you know, we're not kind of siloed
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  out together. You know, med surg does their
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  thing.
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  The ED does their thing. ICU tele does
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  their thing. So we have really
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  worked to build those relationships between departments so
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  that we all get a better idea of
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  what's going on. So, you know, people are
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  a little bit more,
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  you know, we're we're giving each other a
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  lot more grace. And those those things, the,
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  more experienced nurses and the the continued education,
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  the residency program
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  have really really helped our new grads feel
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  more comfortable.
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  They're
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  you know more comfortable asking questions that they're
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  they
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  have really really
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  done
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  particularly
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  well.
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  We've noticed a significant improvement
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  in their ability to to,
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  you know, kind of flex on the fly
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  and handle things as they come up over
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  the past couple of years as they as
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  the Education Department has tweaked that residency program,
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  it has been a big help,
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  in getting those new nurses,
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  you know, comfortable and and ready to go.
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  Well, it certainly sounds like they're benefiting from
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  all the communication and infrastructure that you have
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  out at your organization.
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  Denise, the next and last question I would
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  ask, it's a 2 part question.
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  And 1 is, you know, what's getting you
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  really excited right now, I should say, about
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  the health care industry in general, and what
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  is making you a little nervous?
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  I think that what I'm what I'm most
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  excited about is
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  that
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  there's really
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  an a lot of collaboration
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  between organizations,
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  and I'm sure that it's not just specific
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  to to our hospital. I'm I'm I have,
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  you know, read white papers and done some
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  research and it and it seems as if
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  hospital
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  systems are communicating
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  better with each other
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  and kind of providing
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  tips and resources,
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  because we all essentially have the same issues
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  going on. And,
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  being able to reach out to to another
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  facility and and ask them, hey. How did
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  you handle this?
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  You know, what worked for you? What didn't?
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  That that collaboration,
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  is really,
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  really exciting to me. Particularly, I've been in
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  this role.
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  It'll be three years in April 0. So
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  I'm I'm wouldn't say I'm, like, you know,
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  know all the
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  things. So being able to have that collaborative
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  relationship with other organizations, I know I can
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  reach out to other hospitals in the Seattle
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  area or other places in Washington and kind
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  of say, hey, you know, your
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  your facility looks about like ours. What are
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  you doing to help solve this problem? And
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  it it really helps.
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  First of all, it helps reassure, you know,
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  me that, hey, it's not just us.
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  And it helps provide better continuity of care
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  for our patients. If, you know, we're all
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  kind of on the same page, we're all
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  working things out. We don't have to start
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  from scratch developing some kind of process if
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  someone else has kind of,
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  you know, worked through that and, you know,
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  lets us know what their hiccups were. It
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  is a real big turn, I think, for
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  health care,
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  which it benefits everyone.
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  Along the lines of what makes me nervous,
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  as I mentioned previously, we have adult and
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  pediatric patients.
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  We
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  don't have a lot of pediatric patients, and
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  the majority of our pediatric patients are, respiratory
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  patients. So we get them during, you know,
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  the flu season with RSV and that sort
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  of thing. We are seeing more kind of
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  post surgical
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  patients, you know, here for appendectomies
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  or, you know, a cellulitis patient.
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  But what makes me the most nervous is
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  the amount of time that it does take
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  to orient and train our nurses just based
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  on the low number of of pediatric patients.
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  Even a lot of our more experienced pediatric
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  nurses
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  are kind of like, hey, you know, it's
• 11:58
  been a long time since we've had a
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  peds patient, you know, because maybe they didn't
• 12:02
  work the week that the the patient was
• 12:04
  here. And so
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  what makes me the most nervous is making
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  sure that that
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  my nursing staff
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  stays comfortable.
• 12:12
  They keep their skills up, which
• 12:15
  I working on that with our pediatricians,
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  you know, hey, what can we do? What
• 12:20
  other resources do you offer,
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  in the kind of downtime between
• 12:25
  pediatric patients?
• 12:27
  But that is kind of where
• 12:29
  the the nervousness comes in for for me
• 12:32
  in our organization.
• 12:35
  Denise, you have been incredibly generous with your
• 12:37
  time and your insights today, and I want
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  to thank you for that. We absolutely cannot
• 12:41
  wait to share them with everyone in our
• 12:43
  audience, and we look forward to connecting with
• 12:45
  you again soon.
• 12:46
  Great. It was a good time. Thanks so
• 12:48
  much for the opportunity.