Latest / Becker’s Healthcare - Clinical Leadership Podcast / Building the Future Nursing Workforce and Advancing Pediatric Care with Cicely “CC” Brooks

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Building the Future Nursing Workforce and Advancing Pediatric Care with Cicely “CC” Brooks · Becker’s Healthcare - Clinical Leadership Podcast

0:00
Hi, everyone. Thank you for listening to the
0:02
Becker's Healthcare Podcast. I'm Erica Carbajal with Becker's
0:06
Hospital Review. And for today's episode, we are
0:09
honored to be joined by Cece Brooks, senior
0:11
vice president and chief nursing officer at Children's
0:15
National Hospital in Washington, DC.
0:18
Cecee, pleasure to have you on today. Thank
0:20
you for taking the time.
0:22
Thank you. Pleasure's all mine. Yeah. Well, to
0:25
start us off, can you share a little
0:26
bit about your role, the scope of your
0:29
work at Children's National?
0:31
Sure. So, as a chief nursing officer here
0:34
at Children's National, obviously, I'm responsible,
0:37
for the clinical nursing practice,
0:39
that occurs not just within the four walls
0:41
of the hospital,
0:42
but within our ambulatory settings as well. And
0:46
so, basically, I'm primarily responsible
0:49
in working with my physician colleagues and partners
0:52
and my operational leaders and making sure we
0:55
have a solid
0:57
delivery care model here that keeps all of
0:59
our patients and our families safe.
1:02
Great. Thanks for sharing, Cece.
1:05
Well, what is one goal or priority
1:07
that is really driving your work right now
1:09
as CNO
1:10
at Children's National?
1:13
I think one of my my current goals
1:15
and a goal that, I've had over the
1:17
last few years is really to to make
1:19
sure I'm creating a pipeline into nursing,
1:22
through different programs and partnerships.
1:24
You know, coming through COVID, which,
1:27
was a game changer for all of us,
1:29
we had to be very creative and innovative
1:31
in how we made sure we had a
1:32
robust workforce. So, for example, you know, utilization
1:36
of apprenticeships
1:37
that allows high school students
1:39
and others who might be at an entry
1:41
level position such as environmental services or food
1:44
and nutrition
1:45
to help create a clear path to nursing
1:48
for those that are interested.
1:49
I think it's important that we,
1:51
have these opportunities for folks who may never
1:54
have considered getting into health care because they
1:56
find it kind of,
1:58
complex.
2:00
But this provides them the ability to tap
2:01
into some resources that they never knew existed.
2:04
So, you know, my biggest driving force here
2:07
at at Children's National is to create a
2:09
strong nursing workforce,
2:11
because that's gonna be critical on how we
2:13
deliver care in the future.
2:15
Yeah. Absolutely. And I know over the past
2:18
few years, we've had, you know, heard from
2:20
so many hospitals who are really focused on
2:22
going more and more up stream, you know,
2:24
working with the high schools, working with even
2:26
elementary schools, and and getting
2:28
just getting in front of those those students
2:30
to plant that seed early and and start
2:32
to show,
2:34
younger folks what a career in health care
2:36
could look like.
2:37
What is how many high schools or what
2:39
is the footprint
2:41
of Children's Nationals partnerships
2:42
look like right now?
2:44
So we have a couple. You know, there's
2:45
quite a few local,
2:47
colleges and universities here like Howard and Trinity
2:51
Catholic and some of the other schools, you
2:53
know, GW in town that, you know, we
2:56
are in a very
2:58
rich environment
2:59
as far as health care is concerned,
3:01
but again it's all about access and opportunity.
3:04
So we wanna make sure people have access
3:07
and exposure to what we do here in
3:09
health care. So
3:11
even beyond nursing,
3:12
I think sometimes people think nursing is little
3:15
scary. Right? And, you know, coming through COVID,
3:18
a lot of folks left the profession.
3:21
And so I think with anything, creating those
3:23
partnerships
3:24
with our local colleges and universities
3:27
and some of our other,
3:29
community partners is just so
3:31
important.
3:32
Getting up stream, like you mentioned, in the
3:34
high school is a program that we actually
3:36
have,
3:37
through one,
3:38
one of our, local
3:41
philanthropic supporters who's been a major donor to
3:43
Children's National,
3:45
and their
3:46
their foundation's primary focus is to create
3:50
nursing
3:51
jobs for the future.
3:53
And we actually have a goal of, like,
3:54
5,000
3:55
nurses in the next, you know, five or
3:58
ten years. And and so I think we
4:00
have a great
4:01
support system at all levels. But to your
4:03
point, getting upstream, I think, is is super
4:06
important so that these kids can see there
4:09
is a pathway to health care.
4:12
Yeah. Certainly. Thanks, Cece. It's great to hear
4:14
about that goal of 5,000 the next five
4:16
to ten. Well,
4:17
well, Cece, I know we talked about
4:20
recruitment and and building the pipeline, so I
4:22
wanna talk now a little bit about retention.
4:25
I think nationally,
4:26
you know, we've seen a lot of data
4:28
and reporting that nurse staffing has has stabilized,
4:31
you know, at least from where we were
4:32
during the pandemic.
4:33
And a big theme now is
4:36
chief nursing officers,
4:37
we hear a sentiment is that they're talking
4:39
about the importance of individual
4:41
lives career support and how important that is
4:44
in retention,
4:46
especially when it comes to those younger early
4:48
career nurses. So wanted to ask about that.
4:51
How does Children's National, you know, approach that
4:54
at scale? Can you share an example of
4:55
what that
4:56
type of individualized
4:58
support actually looks like in practice?
5:01
Sure. So Children's National have done an amazing
5:04
job with providing nurses opportunity for
5:07
both professional growth and development.
5:20
Innovative in how we deliver care. And so
5:23
our focus
5:24
really hasn't just been on title changes. You
5:27
know, I think sometimes when people think
5:30
of career support, they're thinking,
5:32
you know, what's my next
5:34
pick something, you know, my next job or
5:36
my next role.
5:38
But we're actually looking at how do we
5:41
invest more in nursing
5:43
at the bedside.
5:45
You know, for those that aspire to do
5:47
more or to do something different, you know,
5:49
we have those resources in place. We we've
5:52
got a very robust learning and development team
5:54
that specifically focuses,
5:57
on leadership development and career opportunities.
6:00
Again, I mentioned through philanthropic support, we obviously
6:04
encourage our nurses to obtain higher level degrees.
6:07
We want them to become certified in their
6:09
specialty,
6:10
but we also like them to participate in
6:12
research. And so a lot of times
6:15
when we talk about,
6:17
career support, again, it doesn't mean you have
6:19
to physically move. You can really learn and
6:21
grow where you are.
6:23
We do have tuition reimbursement available like a
6:25
lot of health care systems,
6:27
and we also have dedicated,
6:29
special funds for attending conferences and other educational
6:33
opportunities.
6:34
And I think for us,
6:36
we really believe that the more we invest
6:38
in our nurses, the more patients and families
6:40
will get that return on the investment.
6:43
But I will say, like, the best retention
6:45
strategy is really to make nurses feel valued
6:47
and rewarded for the work that they do.
6:50
So it just depends on where folks are,
6:53
in their career.
6:55
Because we do have some nurses, they're like,
6:57
Cece, I'm fine where I am. I love
7:00
what I do.
7:01
I just want to
7:02
to grow where I am. And so, again,
7:05
that looks different,
7:07
for where nurses are in their,
7:10
career,
7:11
and our learning and development team will help
7:13
establish a specified career plan,
7:17
through, you know, conversations and assessments.
7:19
We have a lot of things online that
7:21
folks can can learn more about, and, again,
7:25
exposing them to opportunities outside of what they're
7:27
currently doing.
7:29
Yeah. Absolutely. And certainly so much value in
7:32
in thinking about growth and and keeping folks
7:34
in their current roles at the bedside too.
7:37
CCB important. Yeah.
7:39
And when you mentioned investing at the bedside,
7:42
what does that what does that look like
7:44
today? What does that entail in in terms
7:46
of,
7:47
technology and, like, different care models?
7:50
Yeah. So, again, we have a, we've got
7:54
a lot of,
7:55
opportunities and and educational opportunities for nurses
8:00
to have exposure to different roles and responsibilities
8:03
within nursing. So, you know, whether that looks
8:06
like a shadowing program for
8:08
a nurse who may be on a medical
8:10
surgical floor that might be interested in,
8:13
joining the ICU team. You know, is there
8:16
a way to have a day in the
8:18
life? And so we do afford nurses that
8:20
opportunity
8:21
to to have a shadow experience if there's
8:23
another area they may be interested in.
8:25
Each of our our team members do have
8:28
a certain dollar amount that is allotted for
8:30
them to spend
8:31
on their own professional career and development. Again,
8:34
whether that's getting a certification and paying for
8:37
that,
8:38
or going to a conference,
8:40
We do, through our shared governance and magnet
8:43
structure,
8:44
highly encourage our bedside nurses to participate
8:47
in research,
8:49
whether that's submitting abstracts to professional organizations,
8:54
that often do, because I believe we have
8:57
the smartest pediatric team,
9:00
often results in,
9:02
being called upon to do
9:04
poster and podium presentations. And so these are
9:06
our bedside nurses
9:08
that get the opportunity
9:10
to
9:11
speak in front of, you know, hundreds of
9:13
people depending on on their particular topic,
9:16
and we have a team that invests in
9:18
that and encourages that. So
9:20
not just our HR learning and development team,
9:23
but also we have a a very,
9:25
nursing specific education,
9:28
team that also focuses on career development.
9:32
There's clinical laddering,
9:34
opportunities
9:35
available.
9:36
So, those are some of the things that
9:38
our team members have access to.
9:41
Yeah. That's great. Thanks, Cece.
9:43
What is one clinical
9:45
trend or perhaps policy shift that you believe
9:48
will have the most significant effect on pediatric
9:51
care in the next few years? And, you
9:53
know, there's a lot happening just at policy
9:55
change level. And and how is Children's National
9:58
positioning itself
10:00
in response?
10:01
Yeah. That's a that's a great question.
10:04
You know, health care continues to evolve, so
10:06
we've gotta learn how to evolve with it
10:09
either at the same pace or even faster.
10:11
And I think one of the biggest policy
10:14
implications for pediatric health systems today is how
10:17
do we support families related to vaccines? Right?
10:20
There's a lot of discussion about that going
10:22
on. This has become a rather controversial
10:25
discussion that has to be handled very delicately
10:28
while at the same time making sure we
10:30
are providing evidence based recommendations to our patients
10:32
and our families.
10:34
And for me, as much as I want
10:35
kids in our hospital, you know, children's, we
10:39
we focus on improving access to preventative
10:42
care medicine. That's really what where the rubber
10:44
meets the road.
10:46
There is a tremendous amount of research out
10:48
there that that confirms vaccines are safe,
10:52
and and that's what we rely on, that
10:55
evidence based research.
10:56
Recently, I think we've all seen the national
10:59
spike in the measles outbreaks, you know, and
11:01
this is a disease that we previously thought
11:03
had been totally eradicated.
11:05
But,
11:06
based on recent data, the rate we're going
11:09
now, we will have either doubled or maybe
11:11
even tripled
11:12
the number of measles cases over the year
11:15
nationally.
11:16
For us here at Children's, we continue to
11:19
provide education as we're starting to look at
11:22
these trends
11:23
nationally,
11:24
making sure we have the appropriate policies and
11:26
procedures in place.
11:28
That includes,
11:29
you know, for measles specifically, rapidly identifying kids
11:33
who may be experiencing symptoms,
11:35
minimizing that exposure as much as possible to
11:38
others that may be in the hospital as
11:40
as well as our staff
11:42
through our, you know, different precaution standards,
11:45
and then also providing early treatment. And so,
11:48
you know, we are so fortunate to have
11:50
a an amazing infection prevention team
11:52
that tracks this very closely,
11:55
along with with nursing. So we can make
11:57
sure we're pivoting,
11:59
as needed. So I think at the moment,
12:02
that's probably our biggest,
12:05
kinda clinical trend,
12:07
that we're seeing in pediatric care.
12:10
Yeah. And I and I think you raised
12:11
just such a relevant point about just having
12:13
to shore up policies and and education
12:16
around what was once, you know, perhaps an
12:19
afterthought or or not something that you had
12:20
to think about as much as today with,
12:23
the outbreaks that are resurfacing.
12:26
And And I think another comment along that
12:28
along those lines is, you know, measles is
12:30
not something you see every day. Right? And
12:33
we have a very young workforce that has
12:36
never had to deal with,
12:39
this type of of disease process. And so
12:41
the education has been imperative, and we've, done
12:46
a great job when when there have been
12:48
kids that come in that we suspect may
12:51
have measles that we we move quickly, right,
12:54
because we wanna minimize that exposure. It is
12:57
it is a disease that is, very highly
13:00
transmittable, and so we have to do our
13:02
part to keep our team members safe and
13:05
also our other patients and families.
13:07
Sure. Sure.
13:09
Cece, I wanted to ask you as well
13:10
just about nurse residency programs. Obviously, those have
13:14
become really a cornerstone of early career retention
13:18
And one of the things I've been hearing
13:20
lately is
13:21
some nursing leaders talking about how their hospitals
13:23
and systems are revisiting or updating them to
13:26
reflect just the realities of today's new graduates
13:29
because I know a lot of those programs
13:31
were initially,
13:33
expanded or shored up during the COVID pandemic.
13:35
So
13:36
how is Children's National thinking about evolving its
13:39
residency program, and maybe what do you think
13:41
a strong program actually needs
13:44
to get right today that not might have
13:46
been a priority a few years ago? Right.
13:48
Great great question. You know, within our nursing
13:51
residency,
13:53
we developed a program called transition to practice.
13:55
So it's it's incorporated
13:57
into their residency
13:59
experience.
14:01
And, basically, there's about four different pillars in
14:03
that program,
14:05
because our goal is really not to just
14:07
focus on
14:08
clinical competency, which obviously
14:11
is the foundational and the primary pillar. We
14:14
want people to have those technical skills,
14:17
but there's so many other things that a
14:20
new nurse has to,
14:22
master,
14:23
over time. But how do we create a
14:25
program
14:27
that helps them with those steps, you know,
14:30
each of those steps along the way. And
14:32
so one of the things that we identified,
14:35
that's another pillar, is instilling,
14:37
confidence
14:39
in their comfort level within their own practice.
14:42
And so it's one thing for us to
14:43
teach you a technical skill,
14:45
how to administer medications,
14:47
how to do this, or how to do
14:49
that. But
14:51
at some point, we need to help them
14:52
with their level of confidence, especially if they're
14:54
new,
14:55
activities that they're learning.
14:57
You know, pediatric care can can be very
15:00
complex in that we take care of patients
15:03
from age zero
15:05
even up to beyond, you know, their younger
15:08
twenties, and so that takes
15:10
time to develop
15:12
those skill sets, but also that comfort level.
15:15
So we have, part of our one of
15:17
our pillars is really focused on how do
15:20
we grow their confidence.
15:22
A third kind of pillar really focuses on
15:26
how to help them cultivate a
15:29
their own robust
15:30
professional
15:31
identity.
15:33
Again, being a new nurse, it could be
15:35
very scary, especially in pediatrics where there's so
15:38
much to learn. You're learning not just how
15:40
to be a nurse, but you're also learning
15:42
how to be a professional, how to interact,
15:45
you know, with your patients and families, how
15:47
to represent nursing,
15:50
within the other disciplines,
15:52
and then creating your own high standard of
15:53
professionalism. Like, what is your
15:55
professionalism. Like, what is your North Star? What
15:58
what drives you?
15:59
How do we make
16:01
sure we, maintain a high level of integrity
16:04
in how we deliver care? And that's where
16:06
it comes down to the,
16:09
having a high reliable
16:10
organization.
16:11
We want our
16:13
nurse residents, even as novice nurses, to feel
16:16
comfortable with speaking up.
16:19
So if they see something, we want them
16:21
to say something. Right? And so that takes
16:23
time and courage to do that as well.
16:25
So that is something that we do focus
16:28
on.
16:29
And, you know, basically, our fourth pillar just
16:31
kinda moves us into that growth and retention
16:34
by, helping establish,
16:36
like, a clear pathway for career advancement when
16:39
they're ready.
16:40
And, again, going back to their ongoing,
16:43
professional growth because, you know, day one, yes,
16:46
we wanna make sure that you
16:49
are proficient,
16:51
but we know that we also wanna invest
16:52
in your future. And so,
16:55
we don't wait until they, you know, are
16:57
out of the program to talk about what
16:59
does your career what do you really wanna
17:00
be when you grow up, and let's figure
17:02
out how to help you get there.
17:05
So having those conversations at the beginning, I
17:07
think, has helped us go a long way.
17:09
We've seen a lot of great success in
17:11
providing
17:12
a more comprehensive residency,
17:15
program
17:16
that also includes mentorship.
17:17
You know, we encourage research from the very,
17:20
very beginning,
17:21
and then a healthy participation
17:23
in our, shared governance model so that our
17:26
residents know that you have a voice too.
17:29
Right? Whether you've been doing this for two
17:31
months or twenty years,
17:34
what you have to say is important, and
17:36
and this is how this is the platform
17:38
in in which you can use that voice.
17:40
So,
17:41
we shifted a little bit by surrounding,
17:45
our
17:46
clinical competency
17:47
with some of these other programs.
17:50
Yeah. Cece, it's it's interesting. And and I
17:53
know heard just a lot about that just
17:55
in terms of the intentionality
17:56
now about putting structures and resources in place
17:59
to really help ease that transition to practice
18:02
and and build toward that confidence, which is
18:04
so important.
18:06
Mhmm. Well, lastly, before we wrap up here,
18:09
what is one thing the broader health care
18:11
system
18:12
still maybe gets wrong or underestimates
18:14
about pediatric care today?
18:17
Wow. That's a that's a really loaded question.
18:20
You know,
18:22
our hashtag is kids are are everything, are
18:25
are everything. And and that holds true
18:28
because
18:30
saving
18:31
kids
18:32
and delivering great
18:35
pediatric
18:36
care,
18:37
you impact generations.
18:40
And so
18:42
I think sometimes,
18:45
our adult colleagues may not truly understand that
18:48
that, you know, pediatric
18:50
health care
18:51
is foundational
18:53
to
18:54
what adult health care is gonna look like,
18:57
you know, one, two, three decades
19:00
from now.
19:01
And, you know, the work we do
19:04
is innovative. Like, I think pediatric
19:07
care, especially
19:08
myself having
19:10
previous adult experience,
19:12
we tend to be a little bit more
19:14
innovative.
19:15
There's a lot of research that that happens
19:17
in the pediatric health care space
19:20
that is life changing.
19:22
And so, you know, having
19:24
a full appreciation
19:25
for that, I think, is very important.
19:28
Also, making sure we have
19:31
the appropriate
19:32
resources from a funding perspective
19:34
to be able to take care of these
19:36
kids to the best of our ability, but
19:38
also invest
19:39
in some of those innovative ways to deliver
19:42
care.
19:43
And so,
19:44
you know,
19:46
being in the pediatric health care business, you
19:48
know, you're not in it to make money.
19:50
Right?
19:51
Most of
19:53
most of our kids are on some type
19:55
of governmental
19:57
subsidy or funding
19:58
that, you know, doesn't always cover the cost
20:01
of their health care, but it's important to
20:03
what we do. It's something
20:04
that needs to be done. And so
20:08
I think continuing to invest
20:11
in research and education
20:14
surrounding
20:14
pediatric health care
20:16
will have
20:18
great positive ripple effects
20:21
in the future. Because if you could save
20:23
that one child
20:24
or or or,
20:26
cure that one disease, you're you basically are
20:30
are impacting generations
20:33
to come, but it starts with that pediatric
20:36
care.
20:37
Yeah. Some great closing thoughts there. Cece, so
20:40
wonderful to have you on today. Thank you.
20:43
Thank you.
20:44
Yeah. Absolutely. We look forward to continue following
20:47
the work that Children's National is leading to
20:49
enhance pediatric care and and and build the
20:51
workforce of the future.
20:53
Thank you. Appreciate it.