Episode 4: Strive to Thrive — Providing Safe, Sustainable, & Supportive Nursing Environments

This transcript was generated automatically. Its accuracy may vary.

Cara Lunsford

Oh, hey, nurses. Welcome to the Nurse Dot podcast. Giving nurses validation, resources and hope. One episode at a time. Oh, Today on Nurse Dot podcast.

Charlie Shields

You know, one of the things I ask Amy is if you can take a CEO. Help them pass their competencies and actually learn how to do vitals and and blood sugars. Would that be helpful?

Cara Lunsford

Joining us today, Amy Peters, CMO and Charlie Shields, CEO of University Health. Kansas City University Health is the 2021 strive to thrive winner for the work that they do to create a safe, sustainable and supportive work environment for their staff. So, Charlie, you are the CEO of University Health, Kansas City. How long have you been the CEO of University Health?

Charlie Shields

So I've been in the system of university health, which was formerly Troon Medical Centers in Kansas. I've been with the system for about 12 and a half years and I've been the CEO for eight and a half of those years. So by CEOs standards today in the hospital world, that's actually a fairly long time. You know, this is the place I love and it'll be the place I studied over time.

Cara Lunsford

Is it like dog years? Is it like eight years is actually 80?

Charlie Shields

Well, during COVID, it certainly felt that way. That was a challenge. It was an at some point, you know, every every day felt like Groundhog Day. Remember that movie? Because we were dealing with the same things over and over.

Cara Lunsford

So. Oh, yes. And you know what? I love that you say it's like Groundhog Day because, well, first of all, one of my favorite movies. Bill Murray. Incredible. Right. But what I always take away from that movie is that he had the opportunity to get it better, like Tim to he got better and better and better because he kept having the same scenario over and over again.

Practice makes perfect, right?

Charlie Shields

So, no, as we would describe, he was a learner. Yeah, it's. It is actually. It's one of my favorite movies.

Cara Lunsford

Me too. Me, too. Charlie, I'm glad we have that in common. Well, I'm going to jump over here to you, Amy. Amy Peters, you are the CNO of University Health, formerly Truman Hospital. Correct. Now University Health, Kansas City and how long have you been with the University Health.

Amy Peters

Though? I have been with university health for 28 years. This has been my professional home since then. I've worked with Charlie since he started 12 years ago, and I feel very, very fortunate to have spent my career here.

Cara Lunsford

Did you start out at the bedside, Amy? Were you were you a bedside nurse at University Health?

Amy Peters

I was. I actually started working in the lab and went back to nursing school. I started as a bedside nurse in the ICU right at the time. Graduate nurses were kind of starting to be placed in specialty areas. And, you know, heard from my peers, You belong on the night shift, you belong in bed, serves. And so that was a little intimidating getting started.

But I absolutely loved working in our ICU. It was learning every day.

Cara Lunsford

And how long were you in the ICU before you started to move into other areas of administration management?

Amy Peters

I think it was six years or so, give or take. And my first management job was in the ICU. You know, again, I just very routine and widely view I need a good thing. So I loved working down in our critical care unit. So that was my first transition into management and leadership was within the ICU.

Cara Lunsford

Something must have inspired you to want to work through that kind of ladder. Was it things that you were seeing at the bedside? Was it things you were experiencing as a manager? What was that inspired that inspired you to leave the comfort zone?

Amy Peters

I think the turning point for me was once they knew enough to be dangerous in the ICU, I started working as a charge nurse and I didn't mind handling the family. Complaints are concerned. It just seemed that that was kind of a natural pull for me and I completely abandoned my plan to go to A.T. to school and continued a path to leadership.

But it was that really I know this is the way we do it, but is that the way we should be doing it? And how can I impact change within the ICU?

Cara Lunsford

Nurses have the ability to effect change when they venture out of their comfort zone and seek opportunities where they can be leaders.

Coming up after the break.

Charlie Shields

But at the end of the day, you know, nurses are our largest bloc of the workforce and the ones that have the most impact on patient care.

Cara Lunsford

Hello, nurses. I'm your nurse Ecom girl. Are you tired? Burned out, listless. Are you looking for peer support? The answers to all your problems are in this little website. Nurse dot com. Nurse dot com contains community allies, resources and education with nurse dot com you can browse your way to health. It's so easy to. So why don't you join the millions of thriving nurses who have their nurse life all in one place.

And check out nurse dot com today that's nurse dot com. Charlie, can you tell us what you value most about Amy's leadership?

Charlie Shields

Amy is a nurse's nurse. She will always advocate for the nurses in our organization. At the end of the day, you know, nurses are our largest bloc of the workforce. And the ones that have the most impact on patient care. So to have a strong CEO who's an advocate for the front line, the bedside nurses is really meaningful.

And I think as an organization, we're blessed to have Amy's leadership in that area.

Cara Lunsford

Everybody that I've spoken to at your institution, even though they might be tired, they really, really love working for university health. So I want to like I want to jump in to COVID really quick because the dark time was a tough time. But one of the things that you guys did that really made you stand out when we were awarding you with the Strive to Thrive award, was your presence on the floor, you know, coming down and actually being seen by your workforce, rolling up your sleeves and, you know, getting in there and helping?

Charlie Shields

You know what I would say? I mean, Amy's always been very involved in on the floors. I mean, we both of us try to be very visible. I think that was perhaps more important during COVID. And, you know, I had peers throughout the country that were working from home during COVID, and I just don't know how that works as a CEO.

That made no sense to me at all that you couldn't be in the hospital and seen what was happening. Frankly, it was a challenging time. It was a fascinating time because you get to see people do things differently and with new levels of creativity in the work and with dedication, that was just hard to imagine. So to be able to go out and be in the two hospitals on the floors, you know, it was a real privilege to get to see how people were responding.

You know, one of the things I asked Amy is if you can take a CEO, help them pass their competencies and actually learn how to do vitals and and blood sugars. Would that be helpful? And, you know, we we did that together. And that was Amy got back to be with patients at the bedside. I got to work with some amazing people.

And we just tried to help out, you know, every chance we could, you know, And sometimes it was doing vitals. Sometimes it's just pull pulling linens and dress, which sounds like a simple thing, but there's only so many people around that needs to be done. So that was that was kind of one of the fun things that that we started during that and thankfully have been able to continue.

And it's a you know, for me, it's just great connection with our workforce but also with our patients to be able to do that.

Cara Lunsford

From that time where you were on the floor and seeing what you were seeing during COVID, seeing the strain that it was putting on the system. Did you guys institute any new policies? Was there any distinct changes you made that you can think of?

Amy Peters

We really needed to think creatively and we needed to be much more flexible than we had with our workforce in the past because we had staff who were sick or caring for a sick family member or we were begging, Just work one more shift, just work one more shift. And so we had to figure out how do we take care of our workforce.

One of the things that we were able to do in that effort to help support and care for our workforce was we opened our renewal rooms and it just offered a very quiet place for nurses to go and just sit and take a deep breath and then go back on to the unit. When you're working as a nurse, it's hard to step away and say, Oh, I'm going to have some lunch or I am going to go take a restroom break because my patients need me.

And so there was a lot of very odd looks and you expect us to leave. We can even, you know, grab our lunch. And and it was, I think, a constant reinforcement. You need to step away and take that short period of time and then go back and take care of yourself so you can continue to take care of others.

And so that was, you know, helping to change the message and making it okay for nurses to do some self-care during the day.

Cara Lunsford

Maybe you don't have a chance to always go and use them, but the fact that your institution cares enough about you to even create that space for you. I laugh all the time because now I work for for a nurse dot com. We have this beautiful building in North Carolina. I go to it, I'm like, Oh my gosh, I have coffee and I have not just coffee, but like an espresso machine.

And I have food that I can just go and grab. And I think to myself, I'm like, sometimes in these big corporate companies, they're treating people better than in a hospital where people are like saving lives. And and you're like, they just need some food. Like, we need to have some, like, snacks, like real snacks, not not patient snacks that we're stealing from the patient rooms.

But it's really, really hard to say to a nurse, you have to go on a break. You have to go. And the nurse is thinking to themselves, Well, I got to give my patients to over to my colleague. And then my colleagues already got these really sick patients and oh my God, what am I going to do if I come back?

And then something's messed and that's going to fall on me. And even if we know that our our institution might support us from the liability of it on our conscience, just how we feel as ethical people trying to take yourself away, knowing that leaving might be unsafe. How do you guys tackle that? Because I know a lot of the nurses do feel like they get to practice safely for the most part at University Health, but I know that it's always a concern.

How do you handle that?

Charlie Shields

Well, I saw it was on the units that people sort of really working as a team and, you know, not just covering each other's patients. So if somebody could walk away for a second, but emotionally taking care of each other, I remember one of our combat excuse. You go up there, I noticed that our nurses hair was braided.

And so I started asking about that. And that was kind of part of their self-care. They braided each other's hair at the beginning of the shift, and that was how they supported and cared for each other. You know, I think they figured it out on their own how to support each other and create those opportunities over time. And I guess, you know, the only thing I would say that we did is just to encourage that kind of environment to happen.

I don't know if you might have some thoughts on that.

Amy Peters

I agree. It's the presence of our hospital leaders and talking with our staff. One of the things that I enjoy about our organization is when Charlie goes out in rounds, he's very approachable with our staff and listening and hearing them. Thank you for what you're doing today. We appreciate you. I think that had a lot to do with our nurses and keeping them encouraged and motivated and in tune with taking care of themselves during some really, really long and very, very difficult days.

Cara Lunsford

I think what you both said, it's you're very humble, which I appreciate, but I want to just say that the reason why those nurses are able to care for each other is because they receive that care.

Charlie Shields

I would like to think that our entire leadership team is we're all very approachable and particularly picking up from that on behalf of the patient. You know, we will do whatever we can to fix that. And sometimes it's because we did some wrong. I mean, sometimes it's a service recovery that we have to go back and fix something that just didn't go right.

Part of what's interesting about the job, as you know, is to be able to resolve some of those situations on behalf of patients or on behalf of staff. I mean, frankly, we're just doing some stupid and somebody needs to tell us and they do. A lot of times people want somebody to say, Yeah, we screwed up or sorry, we learned from this will do better next time.

I think that's what you want is a culture in your organization.

Cara Lunsford

I absolutely agree. Amy, do you have anything to say to that? I saw you nodding the whole time, but.

Amy Peters

I do feel that as an organization, we do support that culture. I was involved with a patient situation. The patient was frequently in the hospital and mom was a caregiver. And mom was just angry. You know, she was waiting for testing. She was waiting for her daughter to discharge. And we were just not moving as swiftly as we could have.

And it just was a matter of, I hear you. Let me go see what I can do. And, you know, it felt good to be able to go back and say, here's what we've got lined up. Our common goal is getting everything done so you can discharge and take your daughter home tomorrow. And we met that goal and mom had had been, you know, pretty direct with our staff.

And so our staff were a little bit ruffled and, you know, when following up the next morning, death, it oh, my gosh, it was an uneventful night. This patient got what she needed. I like to think that because whenever our staff nurses reached out and said, hey, this is going on, can you come help that we made things not only better for our patient, but helped provide our staff better working conditions in that overnight shift before we discharged?

Cara Lunsford

Oh. Welcome to a segment we call The Dark Spot, where you will hear more of your voice and a little less of mine. You can visit nurse dot com forward slash podcast to share stories, feedback and requests as a valued listener. You will also receive discounts on nurse dot com courses and C use by using code nurse dot at the checkout.

Oh In 2021, University Health Kansas City won the Strive to Thrive award for providing safe, sustainable and supportive work environments for their staff.

News Segment

Meet the nurse resident behind University Health receiving its most recent award. Monette Chas Alonzo proud of the excellent patient care that our dedicated staff provide. Monette wrote an essay about it and submitted it to Holly Blue APT. Strived to thrive. Award her words, move the judges heads.

And it warms my heart. It's amazing.

Monette says the culture of care at university health is incredible.

The amount of help you have here and the support is just absolutely incredible. So it's really easy to actually just start writing about how great it is here.

Charlie Shields, university health president and CEO, says This is who we are. We care for all.

And I think that's what makes us very proud of the nurses that we have in the halls. And I tell you, it makes it a great place to work.

In addition to an amazing trophy, Monette got a surprise Zoom call from singer entertainer Michael Bublé. A recent award recipe due to his support of frontline workers.

I thank you on behalf of every human being who you've rescued and helped, every person who has gone through tough times and is going to go through tough times yourself. This has changed the world. It really does. And you inspire us to be better people.

Something I try to say is just go out there and be infectiously positive, bring bring joy.

Cara Lunsford

If you had something that you wanted to say to like all the nurses in the United States about how to best get a response from your CNO, from your CEO, how to address issues so that you don't just come across as being complaining. You know, people always say like, oh, the nurses, they just complain. You can't make them happy.

How do they bring their issues to you?

Charlie Shields

I think the the biggest thing that if you're sitting in a leadership position, if somebody may come to you with a problem, it is always helpful if there's a solution in mind. They say, you know, this may not be the solution, but this is a solution. That's a lot better than just saying, I've got a problem and I don't know what the answer is.

You're the boss. You figure it out. I mean, the people that know are the problems or also know where the solutions are. And that's been helpful in many different areas where people come to say, you know, if you just do this, this will go a lot better. And so we go, Yeah, you're right and all of that. We'll do that.

And I don't know if you are talking about I mean, you have multiple venues by which nurses can, can express your concerns or suggestions and kind of be the voice of what's happening out there.

Amy Peters

You know, my reality is my email, it's the first thing I do in the morning is the last thing I do at night. That's not the reality of our nursing staff. And so we've had to think of creative and different ways to communicate with them and make sure that they hear what we as leaders have to say. And then in return that we as leaders hear what they need to say.

You know, I've got a social media account, my teenage daughters are mortified that I've got an Instagram and my youngest will critique me on my recent post and comment on my number of followers. So that was set up as another means of communicating with our nursing staff. You know, our phones are with us and if nurses are walking to lunch or taking a peek at the nurse's station and they see that post that reminds them of, Hey, this is available to you, that's that's what that is intended to do.

It's just another form of communication and messaging to our nursing staff. We have recently started specific equipment rounding in our emergency department. You know, one of the things that frustrates nurses, you know, regardless of where they work, is equipment that doesn't work. We've pulled in the key leaders of other departments who we either fix it right then and there or we follow our process and then we make a point to loop back with the department and say this issue has been resolved and here is the outcome.

The nurses were a little skeptical at first, but then we went back a couple of different times and we saw them coming up to us and saying, Hey, I need you to come in to triage, because here's what we need addressed in here. Or hey, come to this printer because it never prints out the way we needed to.

And so just I think with that consistency and that feedback, we hear you here's a problem. We have fixed it. You know, nurses are she can fix it anything. You know, nurses here's a problem and and I know in my experience involve them, engage them in whatever. And the majority of the time they will solve the problem. It's just a matter of, you know, as leaders hearing and and saying, oh, I hear you.

Yep, let's go forward and do this. Or hey, what about this? Would that work? Yeah, Nurses are very clever and creative and can solve all kinds of challenges.

Cara Lunsford

That's a great resource source that I think you just shared with all of the listeners here is be creative about how you can be accessible. You yourself still have to have a work life balance. Amy I'm sure that's very hard for you to manage as the CNO of a large organization like University Health. But sometimes when you make yourself available like that, people actually do respect it and then they only really use that channel when they really, really feel like they need it.

It's like, Well, I have it, so I don't need to worry because if I really need her, I can always get a hold of her. And that brings that level of anxiety down within your staff a lot. When you were talking about the equipment, the first thing that came to mind was, you know, that joke about the bladder scanner?

Where is the bladder scanner? Can someone go and steal it from another floor and like, you know, chasing down the bladder scanner there and not being enough of them when it comes to equipment? Is that something that you guys feel like you really try to focus on is just having enough of everything so that there's not that, you know, struggle.

Amy Peters

You know, your example of bladder scanners during the course of the pandemic, we had one we shared it between the floors, and our solution was, well, let's leave it outside our house supervisor's office. And if nurses needed, they could come check it out. Nurses don't have time to do that. I talked with another member of our executive team and said, Hey, here's the challenge.

Here's how much bladder scanners are. I know it seems like it's a silly request. The nurses would be giddy with bladder scanners. Can I have one for every floor? And we were able to do that. My associate chief nurse and I went and passed out bladder scanners and the nurses were like, Oh my gosh, we get to keep it on our floor today.

Now you get to keep it on your floor forever. This is the one that goes here. We do try and figure out how to keep the best possible equipment in the hands of our frontline caregivers and, you know, because that's what they need to take care of our patients.

Cara Lunsford

I wish I could just bow to you right now, both of you, because as someone who has had to chase that bladder scanner down and nearly fight someone for it, you know, you want to see two nurses go to blows, try to have both of them running to the bladder scanner at the same time.

Charlie Shields

So those are kind of easy wins, though. I mean, you know, it's you know, it's not like you're buying a new car or something. I mean, these things are you know, a lot of what we do is not cheap, but it's not so overly expensive. And you're you're saying, okay, you got this, you know, highly educated, you know, for the most part, particularly during COVID, highly compensated personnel taking care of the patients.

And you're not going to give them a simple tool to do that. I mean, that makes no sense. You know, I will tell you kind of our big push moving forward and this is this kind of came out of COVID. But as we were experiencing just like everybody else, the staffing challenges, it's you know, it's just hard right now.

It's hard to find enough people to do the work. And what we're trying to figure out long term is how do we use the technology differently in health care? So, you know, we've been working with teachers for decades now, and there is absolutely no question that we've improved quality, we've improved safety with the h.r. But i don't know that anybody would argue it made us more efficient.

And so, you know what we talk about and we got a lot of work to do on this, but how do you use the technology in a manner that lets the nurse be a nurse and the staff that is not providing care and assistance to patients use the technology to offload that. That's what we hear all the time from nurses.

You know, I just want to do what I'm trained to do and let me care for my patients. And then in an hour and a half my day sitting at a keyboard is not that. And that's what we're trying to do. That's what we've challenged our technology partners to do. I can only find so much help. So let's let's let our help, you know, and our nurses and or techs and frankly anybody notarization do what they're supposed to do and let the technologies unload some of that stuff off of us.

And we've got a long way to go. But and then gets the next big push.

Cara Lunsford

That's so exciting to hear, Charlie, because first of all, I think nurses who are listening to this podcast are going to be like, Oh my gosh, they hear us. They they hear that we just want to be at the bedside. We just want to be able to do the work that we signed up to do. Moral distress and moral injury comes from exactly that.

Not being able to do the very job that you signed up to do and that you're not able to do it safely. So anything that takes them from the bedside is what takes them away from that ability to provide safe, patient care. So you guys have talked about equipment, which is huge. You know, I know you kind of like minimize it a little bit like that's easy.

Everybody should be doing that. Charlie, Amy, I will tell you, that is not true. A lot of people are not doing that. And it is a big reason why their staff is unhappy. They don't have the tools. Imagine if you were a police officer and you didn't have a gun and you didn't have a bulletproof vest and you you didn't have like the basic tools of your trade, that would be a very unsafe environment to work in because you can't do proper care without proper access to equipment.

So what you guys are doing is huge. I don't even know if I know of a hospital that has a bladder scanner on every floor, but I think you guys rank at least number one in my book for having that. So equipment is is huge. Also, I will say resources people who for example, there are hospitals like UCLA that have lift teams, have transport teams so that if you're an ICU nurse, you're not leaving the bedside right.

To go take your patient down to the scanner, MRI or CT. In the meantime, you're having to leave your other patient right? So how do you guys address that just in terms of resources for your staff?

Amy Peters

Specific to our ICU, we do have a team at a radiology that when we need to move our critical care patients to CT or to MRI or for any procedure, we do have nurses who are previous critical care nurses that work in our radiology department now. So that is one resource. And then we do have patient transporters that help throughout the rest of the hospital.

We are very hands on nurses. We we provide direct patient care. We work with each other. You know, if I'm out on the unit and something is to turn, then I can help you turn your patient. I'm not out all the time for every turn. But in those times, right? I am happy to jump in. There's some days where it's all hands on deck and, you know, that's how we we team things out and help get our patients taken care of.

Cara Lunsford

I wanted to do the turning for my patients because I gave me an opportunity to see their skin. I do a little skin check. I do, you know, So we use that opportunity for assessment. I love that you guys have the transport team. Do you use LV ends at your hospital?

Amy Peters

We do use upturns. We don't do that throughout all of our units. We've got a couple of our larger units where we have it's an all in LPN, a skill mix. We ended up needing to modify our policy as we were getting our options back and getting them started. We realized that our scope of practice within the organization was a bit more limited than within the state of Missouri.

And and so we did change our scope of practice to to support Aprns practicing at top of license with the goal of really helping to take on a bigger part of patient care, which then allowed our orients to focus on our end specific care and interventions. So that was the intention. But we have had LPN that are very excited to come and work in acute care.

It has opened up another path for some of our staff who are patient care techs, and their ultimate goal is to become an R.N. But for right now they are in an LPN program with the plans that I'm going to work, and then I'm going to go back to school and finish my education. So that has opened up a pipeline for nurses as well.

We're very excited to support. And you know, what can we do to help facilitate getting you through school and then having you come back and continue to stay and work with us.

Cara Lunsford

I really think that there's a huge value that comes from bringing people in who can do skill oriented types of things, placing new tubes, placing Foley's giving meds, giving certain types of injections, really utilizing those people to what you said to the full extent of their license, which then lightens the load for the registered nurse who can really focus on those assessments, that big picture that we want them to be focusing on and that collaboration with the physicians and that multidisciplinary approach that we want them to be a part of.

So my hat's off to you there because I think that this is a path forward and I think we should all be like taking notes. I hope people are taking notes. So as we finish up here, you guys have both provided a wealth of information for sure. I think you are there at the top of one of the best places to work in the United States.

Your heart is in it. Your heart is in the right place. And your staff all be they I'm sure they're tired. I'm sure they're burned out. I'm sure they're dealing with moral distress and all kinds of things and having to balance that work life balance. But at the end of the day, if they know that you're there and you care about them and that you're creating an environment where they can have those relationships with their teams, that is what will keep them there, their team relationships will keep them there.

And that loyalty to the hospital, you said moving forward 2023 and beyond that, you're really looking for ways to keep those nurses more at the bedside, help them to do the work that they love, what they signed up to do, and really lean on technology to take the weight off of them. Wherever you can take the weight off of them.

What do you have to say for nurses going into the next five, ten years? What do you hope for them?

Charlie Shields

Well, what I would say is, you know, we learned so much about how to be flexible and creative during COBRA. You my hope is we just don't go back to operating in the same way we've always operated. We thought we take some of those learnings and take that creativity. We learned to use the technology differently, that, you know, you can make this an even better profession.

Charlie Shields

And I think that's a goal. We're all a little bit blessed. Universelle I mean, we're two things. We're a safety net hospital and we're an academic medical center. So our nurses in particular, they work here because the mission I mean, it's not because of them internally. I mean, it's the mission. You know, many of our patients come from very challenging background.

And I think it's what energizes our nurses. We just want to make sure they can do that work even better, more efficiently, and allow them to do what they were trained to do. And if we can figure that out, I think it's an industry that will be better for nurses in the long run. And, you know, it's not just our goal, it's the goal.

You know, every other hospital administrator I talked to, How do you figure that out? Because we're not going back to where we were pre-COVID. Things are changing.

Cara Lunsford

Well, this has been an honor and a privilege, as it was the first time I got to talk to you guys and I'm really excited to get this out to the listeners for everyone to be able to hear from you directly. I have a feeling that some nurses are going to be going back to their to their administration saying, hey, we want we want a bladder scanner on every floor to because Charlie said we can have one, you know, setting the standard.

Cara Lunsford

And I think that you guys are really one of the ones that are doing it well, doing it better. And setting a gold standard for the rest of us all to try and achieve. You know? So I thank you for that. I'm very grateful and thank you for your time.

Charlie Shields

It's been great being with you. Thank you.

Amy Peters

Thank you.

Cara Lunsford

Thank you, guys.