BTC EP #020: The ER - How to Avoid the Revolving Door (Christy Spivey)

In this episode of Behind the Citgo, we sit down with Christy Spivey, Chief Nursing Officer at Novant Health Brunswick Medical Center, for a powerful conversation about breaking the revolving door of ER visits, improving community health, and building real partnerships around substance use disorder, mental health, and whole‑person care. Christy shares her journey from bedside nurse to CNO, the realities of emergency medicine, and why the ER—though open 24/7—is not designed to solve every crisis. We dig into collective impact, the importance of cross‑agency collaboration, and how Novant is working to create remarkable patient experiences while navigating the growing pressures on emergency departments. We also explore: Why many people end up in the ER for non‑emergencies How unmet social drivers of health complicate care The role of community paramedicine in reducing unnecessary ER visits How hospice and in‑home care models prevent avoidable crises The need for clear, accessible public education about where to seek help How recovery programs and hospitals can partner without creating system strain This episode is a masterclass in community health, systems thinking, and compassionate leadership.