All About Nursing (22)

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Welcome to All About Nursing with your host Dr. Joyce Bachelon. Executive nurse advisor Dr. Bachelon will present a significant role in nurses play in providing healthcare in a multitude of healthcare settings.

Listen to some of today's key nurses who work and practice in academia settings and talk about the challenges they face in today's modern medical world. So please welcome the host of All About Nursing, Dr. Joyce Bachelor. Good evening.

I'm your host Dr. Joyce Bachelor and All About Nursing and we're live on the BBM Global Network and Tune in Radio. I'm excited to be continuing another year with the All About Nursing show. I started this show back in May of 2018 as a forum to showcase what nursing really encompasses.

It's a wonderful career choice that I have made and the profession just offers so many different opportunities to make a difference in people's lives and healthcare overall. And currently what I do is I serve as an Antrop Professor for the Texas Tech University Health Sciences Center School of Nursing. I teach in their Dr. Nursing Practice program which is really very exciting and rewarding to do.

And I'm also an executive nurse advisor for the Center for Advancement of Healthcare Professionals with the AMN Healthcare System. I do a lot of executive coaching and I'll share a little bit more about that this evening. I had the opportunity to be interviewed about why I decided to become a nurse and asked to just share some highlights of my career for Women's Empowerment Month in December of 2017. I enjoyed the opportunity to share my experiences to hopefully inspire others as well as educate the public about nursing in general.

There were a lot of people who had a lot of questions and interests in learning more about nursing. It reinforced for me the need for us to really be sharing what the profession encompasses and I wanted to really highlight as well some of the amazing work that colleagues that I work with are doing not only in their organizations but at the state, national and global level. I also go to many different nursing conferences and forums and I'm always amazed and actually inspired when I hear some of the latest research my colleagues are working on, the new innovative models of care that they're testing, they're involved in telehealth, improvements to really help make patients or actually make care much more available, particularly for people in underserved and rural areas. I look around and I realize that we're just talking to ourselves that there's really not a lot of other people in the room hearing about the spectacular work that nurses do which was another reason that drove me to want to do the show to be able to highlight that and have more individuals really understanding the role and impact that we're having.

I've been a nurse now for over 40 years and I've worked in a variety of different organizations and I've had different roles and I'm still very proud to be a nurse. I made my decision to pursue the nursing profession at age 5. I was involved in an accident that was crossing the street between park cars and was hit by a truck and I sustained several injuries at that time which required me to be hospitalized for an extended period of time. Back then I can just share with you that visiting hours were pretty restrictive, parents were only allowed to be in the room with their loved ones for just a few minutes like in the evening.

As you can imagine, this was a pretty scary experience and I remember I cried a lot because I was very afraid. I also had a body cast on that extended from above my waist to both my legs so I couldn't sit up and I couldn't really move and see what things were going on. It was really kind of just looking up at the ceiling or looking to the left or the right. It was pretty intimidating in many ways.

I can also share with you that I finally had a nurse who took the time to actually explain to me what was going on. I didn't understand because sometimes they would come in and they would draw my blood and the next thing I knew they were giving me a blood transfusion and I just thought that my blood must be bad and I would get very concerned and worried. Was your range for me to have some candy strippers and volunteers that would come and read to me or play games and was also extremely thoughtful when one of my neighbors was going to have a tons of elect to me. They placed her in the bed across for me so that I would actually have a familiar face that could actually be there to talk to me and keep me company which was really pretty amazing.

I really was so excited and impressed by her that I bowed that I would grow up in B-Laker someday to make a difference in somebody else's life like she had made mine from me in my life. Ironically, I learned that her name was Joyce and I thought that was pretty special and if I have a regret it's the fact that I never went back and found her to let her know the impact she really had on my life in long term. I can tell you that that whole experience also has made me a very big advocate for open visiting hours as a result of that experience. I have a lot of critical care background and when I worked in critical care as a staff nurse my peers were not always happy with me because there were a lot of restricted visiting hours and I tended to break those rules a little bit more especially when I knew that family members had just arrived from being out of town or you know they just came in from a trip overseas.

I really thought that we needed to be there to make sure that the patient was going to be able to see their loved ones and so I always helped to stretch those rules and I thought I did what was right in terms of helping them be with their with their loved ones. It was my passion as I continued in my administrative life to also make those changes and have critical care finally become more of an open visiting hours policy which took a while and a lot of convincing I might say but I was proud that I never gave up on that. Now I am originally from Connecticut I currently live in Texas but I went to school at Hartford Hospital School of Nursing which was a diploma program back in the 70s. I really loved the program it was great they made a decision with one class that came in behind mine that they would close the school did a financial reasons in the fact that they really wanted nurses to begin to go back to school for their back all right degrees and we're going to close this particular program.

I continued to finish that program I thought it was an excellent school and I really didn't want to change at that time because I really believe I was getting a great education. When I finished my diploma I can also tell you that later in my career it became very clear that if I wanted to have what I call more doors open for more opportunities I would need to go back to school and I have done that and getting both my bachelors and my masters in UTL Science Center in San Antonio and I make some people kind of irritated when I tell them that back then I paid $25 for a full-time semester from my BSN in the program actually was two full-time semester so I paid $50 for my BSN. My master's back then was only $4 a credit hour so you can imagine when I went back to school to start working on my doctoral degree and realize the price difference over the years that tuition obviously had escalated significantly. I went into the Air Force ironically when I finished nursing school and I really thought that it was going to be a great experience and it was I was able to serve as an officer in the Air Force I was in charge of a surgical unit and when I first went in and then that's where I began my career in critical care nursing.

It was a pretty exciting time I worked at Wilford Hall Medical Center in Lackland Air Force Base at that time it was where everybody was air-backed in from all over the world when they had complicated issues going on and so I really learned a lot very quickly met a lot of phenomenal people and individuals that just really do an amazing job and take on extremely challenging cases and helped to really make a difference in those that are serving in our military. I finished my commitment in the Air Force and decided that I go back to civilian nursing because I really wanted to go back to school and I didn't think I would be able to do that so readily and be able to work as much as I needed to with the Air Force. So I will share a little bit more about that in a few minutes but right now this is all about nursing I'm Dr. Joyce Bachelor, we're live on the BBM Global Network and it's time for us to take a short break.

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I'm your host Dr. Joyce Bachelor. Prior to the break, I was sharing with you all that I had gone back to school for both my bachelor's and my master's degree at San Antonio years ago. I went back to school for my doctor's nursing practice degree which I finished in 2010, two weeks before my son graduated high school which was pretty phenomenal to be able to share with him.

I also was sharing with you that I had gone into the Air Force when I got out of nursing school. I went in as an officer and had an amazing opportunity and great exposure. I learned a whole lot very, very quickly. But I also wanted to be able to, as I was sharing with you, go back to school and I wasn't sure that I wanted to make the military my career.

So I began to work in critical care in San Antonio when I did complete my time in the Air Force and I found very quickly that I wanted to really move into a different sort of position. And I think once I finished my master's, I really wanted to see if there was a way for me to utilize the advanced knowledge and skills that I was gaining from that advanced education. Well ironically around that time I was also at a place where I was moving to Northern Virginia and I found out very quickly that having a master's degree in Northern Virginia is a very common thing. They had very unusual demographics whereas in San Antonio when I graduated I would have been one of very few people with a master's degree and Northern Virginia had quite a few.

So I had really wanted to be a cardiovascular clinician or specialist that had been my dream job for a really long time but there were no positions open. So ironically I was looking around trying to figure out so what else do I want to do and I thought well maybe I'll try leadership. And so I wasn't sure I was going to like it but I thought well if I don't like it I can always change. And again that's the beauty of the profession is that there's a lot of different choices and sometimes something works, sometimes it may not and if it doesn't you can then look to try to find something else that will.

So I went ahead and decided to try that and found that it actually was pretty much, it was rewarding but it was also very challenging. I gained an appreciation for the complexity of running a nursing unit and also being respectful of the people that I was in charge of and being sure that I really knew who they were, what they inspired to be the first time I can tell you I posted a schedule, I realized I was impacting their lives because I made their schedule and I posted a schedule and went to a cafeteria for lunch and decided that I'd wait and see how it went over because I was pretty worried that they wouldn't like what they had done. And I had to obviously grow from there because there were a lot of things that I'd be making decisions on that would be impacting them but I had to learn a different skill set in order to be successful. But I also found that I could really advocate differently and influence things in the organization to really assure that the patients and their families were well cared for and I got a lot of joy out of that as well as working with the nurses that I had to really help them see the kind of expertise and skills that I believe they had and sometimes they may not know but I would help to unleash their talents and be able to see them continuously growing and being able to really feel very fulfilled in the nursing career.

And so I thought that was pretty exciting. I also found that I was really excited about working still in the critical care area and I've always had a passion for that kind of nature of the work. There's a lot more autonomy. When you work in the intensive care unit you work very closely with the physicians, the trustees, the pharmacists and others.

There was a lot of teamwork that had to go together to really be sure to provide the best care for the patients we were taking care of. But I also would share with you that I moved to a different organization in Northern Virginia and at that point began to work again in an integrated care unit that was basically a newer unit that needed to grow and I helped to expand that unit from an 8-bed to an 18-bed unit overnight. I really bring in a lot of different nurses and training them and helping to bring the additional skills to people that needed at that time. And then ironically I resigned to that position without having another job at the time because I found out that I was going to have a daughter and I had a desire to be able to take some time off, which I did.

I took off three months and I worked part time for six months and then I went back to full-time work. I had an amazing boss at the time who actually gave me a promotion to make sure that I would stay and I did some special project, administrative projects and things like that for her. And I felt extremely honored that she was really believing in my capabilities and when I was able to go back full-time I went back into more of an administrative role and found myself in charge of the critical care units and then went on to be in charge of transplant and emergency departments in other areas. And so I was truly thankful that I had somebody that was such a great mentor and somebody that I really learned a great deal from.

So that really then took me to a point where I had a boss that I was working for in Northern Virginia that I really liked at that time. Her boss moved to a different role in came down to Austin and he became the CEO of a system here in Austin and he recruited me to Texas. I was pretty excited because I came down to be in charge of cardiac and critical care, the emergency department, all the things that I loved and I did that for a while and then quickly learned that I was also going to be taken on the chief nursing officer job and I at that point didn't really think I was ready for that and I wasn't even sure what chief nurse did and I wasn't sure how I was supposed to learn what to do because there was no other chief nurse around. But it was a phenomenal opportunity and I started to figure out pretty quickly that I needed to find some people that could help mentor me as well as get engaged in the organization of American nursing executives because there's a lot of chief nurses there that I could learn from and became very familiarized with all the different standards and say what a chief nurse should do.

So I know that done a prior show. I had the opportunity to interview Dr. Pam Cipriano who was the president of the American Nursing Association in 2018 and Pam had cited that one of her great accomplishments when she was a chief nurse in Virginia was when her hospital obtained magnet designation. This is the highest status of nursing excellence that an organization can achieve and it's provided by the American Nurses credentialing center that is part of the American Nursing Association.

It is all research and evidence based standards that an organization has to be able to demonstrate in order to achieve the designation and I remember when she was talking about this it resonated so well with how I would also answer the question because one of the things I'm most proud of is that we had four hospitals that achieved magnet designation as a system back in 2002. We had shared governance model that went across the system. We had moved to really standardizing here in all of the facilities and I remember having to speak to my colleagues that were involved in this whole credentialing process because they needed me to understand that either all four-mated or they wouldn't get it at all and I'll tell you a little bit more about that in just a few minutes. We're coming to you live in the B.D.M.

Global Network in Tune and Radio for all about nursing. I'm Dr. Joyce Bachelum. I'll continue this conversation when we come back.

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I'm your host, Dr. Joyce Bachelor and all that nursing and we're live on PPM Global Network and Tune in Radio. Just prior to the break, I started sharing with you all that one of the things that I was most proud of when I was the chief nurse for the scene system is having four hospitals, a chief magnetic designation as a system back in 2002. At that time, less than one hundred, I'm sorry, less than one percent of the hospitals had achieved this designation.

And we were number 61, 2, 3 and 64 in the country at that time. And I share that because the thing that was important back then was really being able to have the kind of environment where the staff and I mean that inclusive of physicians and respiratory therapists, pharmacists, social workers, everyone to really have the right kind of environment to work in so that the patients and families and those that we care for would be much more likely to be receiving high quality care. The research and the evidence behind the designation standards still holds to be very true today. They have gone back in and looked at these hospitals that are a magnet, compared to non-magnet hospitals and those that are magnet designated consistently have better patient outcomes and better satisfaction and are more likely to be able to attract and retain nurses because they have a professional practice environment.

So that's been one of those things that I've always been extremely proud of and I knew that people would be excited and proud once they understood the designation of gaining the support and helping to influence initially was certainly challenging. And I had always approached it with a very holistic approach where everybody needed to be on board because while the standards may be very focused on nursing, nurses don't do it alone. We have to have strong and professional relationships with physicians and pharmacists, respiratory therapists, social workers, everybody, basically that patients need care from. And in order to do that, everybody had to be on the board.

So it was a very inclusive process which I think was helped to make it a lot more exciting and inclusive was really, really important at that time. When you hear a professional practice environment, what that really means is that there's ways that nurses have a voice and they have autonomy to really help with making decisions about the kind of things that they need in order to give the kind of care that they believe the patients they take care of really deserve. And I always think to myself that when people go into nursing, and I'm was this way initially as well, there's so much potential that you see and there's a lot of optimism about what can be done and idealism, I guess about how you can change things and make it better for people. And I always believe that in order to keep that kind of passion, people really needed to make sure that they had their voices heard.

I used to also use a technique called appreciative inquiry where you really have people stop and think about the work that they're doing and take time to find out what they're most proud of, what brings them joy at work, what matters most to them, if they can give you an example of a patient or family or a colleague that they really made a difference in their life, what would that be? And the part that's amazing is that the stories are very easy for them to begin to describe. And I think sometimes we don't stop and take the time for them to do that and it's important because we certainly spend a lot of time talking about the problems and the challenges and the work shortages were still basic, et cetera. But fortunately, there's still a lot of great things going on, but making sure that we don't lose sight of that and we take time to really remember that is extremely important.

As a consumer, I think it's important to know that when you see hospitals that have these designations like Magnet, Pathway to Excellence, it really doesn't mean something. These organizations have had better outcomes than non-magnet hospitals for a long time and the kind of work environment and the staffing tends to be better. And that's important when you're trying to look at where do you want to get your care done because you want it to make sure that you're going to get high quality care and have an organization that's going to be one that's focused on safety and positive outcomes. I want to share with you too, there's a big conference that is put on every year.

It's a Magnet, Nursing Conference. This is where staff and leaders share best practices and some of the things that they're doing that are really helping to make a difference and everybody can steal shamelessly from each other and hopefully spread some of these great ideas a lot faster by learning from each other. We used to have a saying everybody teaches everybody learns because we do both very quickly and alternating back and forth. The part that's pretty amazing is that I think this past year they had over 12,000 nurses in attendance and there's a special ceremony where those that have achieved the Magnet designation and those that have achieved their redesignation are honored and go across the stage.

And I wish people could be there, especially from insurance companies, CMS, Joint Commission and the Hospital Association, President and others, to see the fund that they have in the hats and the silly glasses and all kinds of things that they wear. But the whole the ceremony you can just see that the pride and ownership they have is palpable. And if everybody, every hospital had staff that were this committed to excellence, I think we'd see care and outcomes improved dramatically across the country. And I often think what would happen at four million nurses across the US really were empowered to make changes and have their voices heard.

I just think of the possibilities and improvements that we would see in outcomes. It's really quite energizing and one of the reasons why I always enjoy going to that conference is that I always remember that these are the things that I'm trying to influence and advocate for through some of the work that I do at the local, state and national level to really try to make things better for those that take care of the patients that we serve. I can share with you that, you know, the profession is certainly a very rewarding field, but it's also extremely challenging. And while I tell you about all the great things that we do, I would also share with you that right now healthcare workers are facing an enormous amount of pressure to decrease costs.

The pace of change right now is very, very fast. There's a Becker's report that you can subscribe to that's online that every time I read it, there's always a headline about the number of CEOs that have now been terminated or the whole leadership team at this organization has turned over or there's a vote of no confidence of this CEO that was in a newspaper in a local area. And you just, I read that and think, wow, we've got a lot of churn in the system. And as soon as you have people that are CEOs or chief executive officers or COOs, chief operating officers, turnover, I just know that chief nursing officers and others are also at risk of losing their positions.

And there's a lot of concern that I have when you have that kind of turnover in terms of what impact it may have on the organization as a whole. So right now, we're coming to you live in the BBM Global Network in tune and radio. This is all about nursing. I'm Dr.

Joyce Batchelor, the host of the show and we will be right back. So, I think it's also exciting to look at the impact of telehealth being able to manage things so that you don't have to leave home. You can have things managed while you're out living in a rural area. I used to always say if I had my way, I have a son and a daughter.

My daughter is now 29, my son is 26. But when they were younger, I just remember that especially as babies, the ear infections were always such a challenge, especially when they go to day cure, they're exposed to other children. And I used to say if I could have had a scope to put in my child's ear and just sent you the picture of what their ear drum looked like, it would have been a whole lot easier to just go to the drug store and pick up the medication rather than putting a crying child in a car and driving to be able to be seen and have the ear infection confirmed and then a prescription written. And that's actually technology that exists today, which is pretty exciting that we can start looking at how to do things very, very differently.

The use of artificial intelligence where people are again with things that already exist, but we've just never had them adopted into healthcare or beginning to look at how do we make the different types of systems that we have that are interoperability, how do we connect them anyway? Because it should be that there's one comprehensive story about a patient or a person or a consumer rather than what happens right now is that there's a bit of your story in the five or six or seven different systems and they all don't talk to one another. And it makes care much more disjointed and difficult because it's not all pulled together in a comprehensive way. Well, there's people looking at how to change that and I think that's a very exciting opportunity.

I've also had the opportunity here in Austin to work with helping them find organizations that will test looking at a robot that's being created. And you can imagine, I think we're going to see much more uses of robots, but there's one right now that can go up and down. The nursing units and it automatically is restocking things with 100% accuracy, which is pretty exciting. And we talked about how it would be amazing to be able to get the robot to do even more of what we call hunting and gathering in nursing, which means you're trying to find an IV pole, you're trying to find a thermometer, you need more sterile gloves or you need this or that and not having to have a caregiver run into all of that.

But to be able to have some kind of robot that would assist you in those kinds of things is pretty exciting. And so there's people working on all that. It's I think a whole other opportunity to come in and help us to really look at doing things very differently than what we've been doing for years. We are steeped in tradition, particularly in nursing and I think our challenges to be able to not only learn things more quickly as we're needing to change, but also unlearn things that we have relied on for a number of years that probably we don't need to continue doing.

So there's a lot of opportunities which I drive on and have fun with and help consult with organizations that are going through some of these different changes because I think there is a lot of waste in the system. We just need to make sure we start taking it out in the right places. There is an organization called the Institute of Health Care Improvement, iGi, that actually has had a triple A that's come out years ago that has hospitals really focusing on three major areas. One is reducing costs for better value, improving the patient experience, better care, and population health, better health for everyone.

And all these areas are things that organizations have been very committed to when there's some phenomenal examples of the things that hospitals and the staff there are doing to really make sure that things are done in as cost effective carrying manner as possible. The thing that's really been happening in the last few years is the understanding that you can't do that kind of work. If you also don't look at the work environment that the healthcare providers are working in. And one of the things that's been put out recently is what's now called the quadruple aim.

We're really looking at calling upon leaders to focus on how to create joy and meaning in the workplace because if the people that are taking care of patients and families are not engaged, do not feel healthy, do not feel joyful or not really enjoying what they're doing, it's going to show and the kind of hear that will result. And so there's a lot of people that are probably skeptical when they hear this, but it's really trying to look at how do you really find out if your team feels, for example, there's three questions. Am I treated with dignity and respect by everyone? Do I have what I need so I can make a contribution that gives me meaning to my life and am I recognized and thanked for what I do?

Those are three very basic questions that I know I've been encouraging and have worked with several individuals that are asking their teams those questions to begin to get at what are some of the things that we need to change. So right now this is all about nursing. I'm your host, Dr. Joyce Bachelor.

We're live on the Beacon Global Network in Tune & Radio and it's time to take a short break. Animal lover, author, artist and public speaker Patricia Dali Life is a Renaissance woman in her own right, a lover of animals from a young age, Patricia lives on a farm in Virginia and has rescued neglected thoroughbred horses, keeping them or finding them safe havens. She is also a published author and her book's document real life experiences that she shares in her passionate stories, taking the reader around the world in a colorful kaleidoscope of life, an accomplished artist, Patricia Dali Life's oil painting speaks her animals, portraits stills nature and abstract, and she allows the brush to paint the image in an organic natural way. A public speaker Patricia is motivated to continually wonder about life and advocates for all of us to do the same and document our own unique history.

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I'm Dr. Joyce Batchley, the host of this show. I was starting to tell you all a little bit about what we now call the Quadrupa Lane, which is where the leaders in the hospital organizations and others of healthcare entities are being asked to really focus on creating joy and meaning in the workplace. And one of the things that people are being encouraged to do is to ask three very basic questions.

First one, meaning I am treated with dignity and respect by everyone. Secondly, do I have what I need so I can make a contribution that gives meaning to my life? And third, am I recognized and thanked for what I do? These are actually three powerful questions that leaders are asking their teams so that you can really begin to understand what matters most to the people that you work for, really understanding more about them is extremely important.

And being able to look at are there simple things that could be done to take some of the hassles out of the workplace? And the whole thing about respect, I think that people need to be paying attention to this. I know that in nursing we still have, which just kills me, a lot of bullying that goes on where we have always been known and unfortunately that sometimes we eat our young. And it's hard to believe we're still doing that, but we're really trying to get leaders prepared better so that these kinds of behaviors are just not tolerated because you can't do a good job when you're fearful about speaking up or asking a question or wanting to have someone come and look at something you know, you're more likely to make a mistake if in fact you feel like people are not going to treat you with respect and dignity.

And it certainly can be a high intense situation sometimes and people can get a little short because we are humans, but being able to really keep people understanding that we need to be able to work respectfully together because I know for me, I don't hear well when someone is yelling at me and many times have also said, you know, I can't really hear this right now and so I'm going to walk away and we'll come back when you've calmed down because otherwise this is not going to be a constructive conversation. But I also would say I have a lot of experience in having done that kind of thing and first few times I would try doing something like that. I would also share with you my heart rate was probably about 350 beats because it's not normal to want to be able to take on and be in that kind of intense confrontation. So really trying to start working with staff to really find out, you know, what makes them happy, what makes them feel energized, you know, how do you celebrate the kind of accomplishments that they had on a shift, you know, a story about their patient that they're really, really proud of that would give them some pride and joy and really being more intentional on also the kind of recognition people would want and finding out how people want to be recognized.

You know, sometimes if people are real introverts, they don't want to be recognized by coming up in front of a group. They'd rather have something more private given to them. But there's a lot of ways that you could do it, but being very intentional on how well have you sat down to look at, you know, who have you recognized and thanked recently, and it needs to be everybody really trying to have that kind of an environment. So why is this such a big deal?

Well, there's a lot of research that's been going on that shows more and more than that our clinicians are feeling pretty burnt out. There's a lot of compassion fatigue where they've also given themselves so much to people and they're seeing some horrific situations sometimes and that they're just becoming very fatigued, as well as then just less engaged for whatever reasons. The physician suicides have increased as a result of workplace demands that they're experiencing. There's now a group studying nursing suicide rates to better understand what we may need to be doing to take care of the very people that we rely on to take care of all of us and our families.

And so burnout is definitely concerned because we also know that when people are not at their best, they're more likely to not be as courteous and sensitive to potentially make more errors, to snap at each other and just make a situation worse. I had Dr. Bob Dent on a couple of shows back in 2018. He has done a lot of work at his organization in Midland, Texas.

He was serving as the president of the American Organization of Nursing Sex at the time. But in his role as his chief nursing officer of Midland, he has had a tremendous passion on improving the health care environment. His organization was really not doing very well, which he readily shared, and the outcomes and the kind of environment that he had was something that he knew that he had to do something about because he also understood that without changing that, there was not going to be the improvement in the outcomes that were important for patients as well as for staff. And again, the cost of turnover with staff nursing and other people in general, it's a lot of money to bring in new people.

And when you have a high turnover rate, it really is very expensive as well as you're spending a lot of time on trying to figure out how to snap every day, which ends up not being very joyful for people that are doing their in leadership roles or staff nurses that are in charge, because there's no funding calling people and begging them to come in for four hours, six hours, eight hours, whatever, number of hours. And so he shared a lot about what they had done to really create a culture of ownership, and there's actually three publications that he shared that he's been involved in. And it's been pretty exciting to see the turnaround that has occurred, but it's taken a lot of diligence and being very consistent with, again, setting expectations and holding people accountable and not tolerating people that are not doing a good job. I used to get irritated with my leaders when they would say to me, well, but she's a good nurse, so we don't really want to say anything about the way she behaved with this other person because she's really a good nurse.

My challenge always was, well, she's a really good nurse. She would not be behaving this way towards colleagues or families or anyone else. And so they may have good clinical skills, but it's beyond that in terms of what's expected here. But being really be consistent on that is really important.

I know that when I had somebody that, when I was early in my career as a leader, I had someone that was just totally out of line and was in a pretty public setting when it's occurred. And I was not in a place where I was going to tolerate that. And I had to go through a lot of different steps to make sure that the Human Resource Department and my boss and others were going to be supportive of me, but I can tell you that when I terminated that person, people understood that I was very serious about the kind of environment and behaviors that I expected them to have. And so sometimes it takes something pretty dramatic like that.

To have people understand that you're going to hold them accountable to the kinds of things that are important because we're there to take care of the patients and families. And you can't do that when you've got people very, very fearful to speak up and ask questions. So I thought that his whole journey was extremely wonderful to hear from. And that's just one.

I have a lot of colleagues that have been doing tremendous work in this arena and really being inclusive and trying to make it much more interprofessional. Teamwork and collaboration because when the team works together and everybody's really feeling like they can speak up and challenge one another, the patients and families will win. So this is all about nursing. I'm your host, Dr.

Joyce Bachelor. We're live on the BDM Global Network and Tune in Radio. And we'll continue this when we come back. Patricia Faye, whether Harlow is passionate about the environment and conserving our natural resources.

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Joyce Batchelor and all about nursing. We're live on the PBM Globe Network and in radio. I was sharing with all of you a little bit about the quadruple aim and putting joy and meaning back into the work prior to the break. And the importance of this being since we are seeing nationally an increased trend of more caregivers being burned out, feeling less joy, disengaged from their work, and the suicide rate with physicians has gone up, and there's great deal concern, and now they're studying the nursing suicide rate.

We're trying to look at what we need to be doing differently in our work environments. As you all know, you certainly don't want to come to a hospital or other health care setting and have people that are feeling burnt out or compassionate fatigue, because you're trusting yourself to them and believing that they're going to be there to take care of you. And we know that we make mistakes and have less courtesy and sensitivity when people are tired and feeling burnt out. So there's a lot of work going on to try to really help change the work environments that we currently have.

One of the things that I would share with you is that in the last several years, about the last five years, I've really been focusing a lot on leadership development, and I know that there's an Institute of Medicine, the Future of Nursing, reports states that nurses are leaders at all levels. I'm at a point in my career where I'm really trying to get back to the profession and helping to assure there's an adequate pipeline of leaders who are ready to tackle the upcoming challenges and also to create new possibilities, because I think there's a lot of exciting things going on that can really help to make health care and patient care even more exciting than it's been. With the help of two amazing colleagues, I created a Chief Nursing Officer Academy that was designed for a new and less than three years of experience, you know, and as a fire and a chief nursing officer, and it's been very rewarding work. I often tease that I learned how to be an effective chief nurse by the smacking syndrome.

People would say things like, who told you that was okay? What were you thinking? And what business is out of yours? And I think, okay, well, maybe there's a way to help people avoid some of that.

And so I have had some amazing mentors along the way. I have certainly also made some mistakes that I've learned from and spent time trying to really get better at. I was extremely fortunate to be a Robert Wood Johnson Executive Nurse Fellowship. That was really a transformational experience for me.

It was three years of people really working closely with you to help you really grow. And they really helped us learn a lot about ourselves in terms of how effective we were or not, and how to really improve health care even more so, and how to expand the boundaries and really take and look at bringing different people together so that you tended to think outside of the four walls of the organization that you worked in. So I was very fortunate. I shared with you that I went back to school for my Doctor of Nursing Practice degree.

And part of the requirement is I did a project that was focused on onboarding and culturally new Chief Nursing Officers. It's been amazing to take this work to a different level, which I would have never imagined when I did the decide on the project that I was going to work on. But to now have the opportunity to take the learnings that I have from there and put it into an academy to really help new nurses or those that are starting to be has been very, very exciting. I'm hoping that through some of this, there's a way to really help get people groomed the right way and hopefully doing the kinds of things that they need and having the support that they need to take on different challenges.

It's always fun to watch people coming together when they are doing this because when they first meet each other because what they learn quickly is that they have a lot in common and that they're really not as alone as they thought they are. So you're listening to all about Nursing Live and the BBM Global Network and TuneIn Radio. I'm Dr. Joyce Bachelors, the host of this show and hopefully tune in for us next week.

Thank you. You've been listening to All About Nursing with your host Dr. Joyce Bachelors. Tune in each week and get a daily dose of nursing and the healthcare services they provide and how the nurses are finding innovative ways to address the key healthcare issues they're facing today.

Here on Dr. Joyce Bachelors, All About Nursing. You've been listening to the BBM Global Network. The ideas, views and opinions of this broadcast are those of the participants of the program and are not necessarily the ideas, views and opinions of the BBM Global Network Company.