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Welcome everyone, to the Becker's Healthcare podcast series. I'm Maria Mohammed,
writer in moderator with Becker's Healthcare.
I'm absolutely thrilled to have with me today. Amber Rolands,
chief Nursing Officer at South Arkansas Regional Hospital. Amber Burns,
very nice to have you on the podcast today. How are you?
I'm doing great, thank you. I'm, I'm really excited to discuss, um,
healthcare with everyone and share a little bit about what we are experiencing
in, um, rural Arkansas.
Yeah, of course. To get us started,
would you mind please introducing yourself and telling us a bit about your
background and organization?
Um, absolutely.
So I am the Chief Nursing Officer at South Arkansas Regional Hospital.
It is a 166 bed regional facility. Um,
something really interesting about our hospital is just recently in July,
we divested from a large corporation,
a for-profit corporation and we are now owned by a local governing
board. And, um, so we are non-profit now as of July.
So going through these changes and tons of new experiences,
learning lots of good resources, some good, some bad, um, but not,
not very common for us. Um, a little bit about myself. Uh, I,
most of my background is emergency room and most of it at large academic
facilities. And now I'm at a, a rural hospital, so it's quite a bit of a change.
Um,
I started out wanting to just be an ER nurse for the rest of my life and then
working, you know, bedside in a big trauma center.
I kind of had an epiphany watching all of the amazing nurses around me.
I just thought, um, I want to lead them differently. I want to, you know,
have a little more interaction, a little more engagement,
and really take care of the nurses. So I decided to go back to school,
complete my bachelor's. I got a supervisor role, um,
continued with school, finished my master's and then, um,
got a director role as an emergency room director.
Learned very quickly that whenever you're the director of a nursing department,
you now own a small business.
So I went back to school for an MBA so I could kind of learn the finance side
that they don't teach you or show you at all whenever you're doing bedside
nursing, um, and kind of advance from there.
Executive director took on several more departments, went back to school.
I'm just about done with my DNP. Um,
and this is my first CNO role and I've been in this hospital for about
16 months now.
Got it, got it.
Thank you so much for giving us that background on yourself and organization.
Um, so Amber, the first question I really wanted to ask you is,
can you tell me about your most successful project or initiative from the last
year? What issues were you trying to solve and also what drove the success?
Um, absolutely. So I guess the,
the most successful project that I've undergone in the last year would be that
in June of 2022, I started at the hospital.
I'm currently at South Arkansas Regional Hospital and we had about 50 ish
contract labor nurses and about 30 ish internal PRN agreement
arrangements where,
where temporary employees work for a higher pay rather than the PRN hours.
They work full-time hours. Um, and in June of 2023,
so one year later we were down to only two contract labor nurses in the
building. And those were both on a behavioral health unit that we just opened,
um,
in October of last year and down to only seven internal PRN agreements.
So the most successful project was definitely reducing that contract labor.
The issue to solve, um,
was that we had a full leadership change after a no confidence
vote by vote by the board,
and the staff in the hospital really needed healing.
But you can't grow with temporary people.
You can't build good culture with people that are not invested in the
organization. Um,
so my mission was to remove the contract labor nurses and nothing against
contract labor nurses. They're there when you need 'em, they do a great job,
but you really can't grow permanent culture, um, with temporary people.
So the driver I think was that we need to take care of our
staff. We needed to listen to them, we needed to make sure we were putting, um,
safety before financial gain.
And we really had to work on listening to the staff and finding out what they
needed. And of course, word of mouth, um,
travels really quickly through nursing. So, um,
if you're enjoying where you work,
then you tell your friends and you tell the other nurses that you know,
or that you've worked with in the past, and they wanna work at a good hospital.
And so they follow and they come.
So we've had a ton of success over the last year really removing contract labor
and now we have none. Um, and removing those internal agreements.
Got it, got it. Thank you so much for sharing.
That definitely sounds like a successful plan. Um,
and hopefully something you can keep up with in the next couple years.
As you know, the clinical workforce has changed a lot in the last few years.
What challenges are you still facing and how do you see the clinical workforce
evolving?
Yeah, I'm,
so I'm really proud to share that we have very limited available nursing
positions today at all. Um, in fact,
some of our departments in the hospital have a waiting list, um,
to be able to join our workforce. So, um, I'm really proud of that.
But of course it's not, um, without its challenges, like you said.
So though clinical workforce is definitely evolving, they are younger,
they are greener,
and they have a different work ethic than what my generation,
I'm a millennial than what my generation is really used to. And so, um,
we are learning that we have to meet them where they are, these younger nurses,
we have to ask them what they need and what they want.
And we have to really take time to challenge when someone says, we can't,
we can't do that, we can't go there, we can't change this.
And really ask why. Every time you hear that can't language.
So when someone says they can't do this, you wanna understand the, you know,
the where does this come from? Who said that you can't,
because I think a lot of organizations get stuck in old habits in tradition and
are afraid to make a lot of changes.
And so you really have to think about where the rules are made.
And a lot of times it's the organization making those rules themselves.
So who has the power or the autonomy to change those rules? Well, the,
the organization can so always ask why can't they change the rule
or the issue? And if staffing is a challenge,
then you really have to get creative, you know, ask why.
When you hear the can't ask what they want, um,
what is work-life balance to them and take care of them instead of, you know,
thinking about the traditions or what you're used to seeing or what you know
other people are doing,
it's okay to kind of step outside of those lines and do what works for you and
your organization.
Yeah. Great, great, great advice.
Thank you so much for giving us that insight and keeping on with the advice.
The last thing I wanted to ask you is,
what is your best advice for aspiring physician and nurse leaders?
Oh, absolutely. Um,
I think my best advice would be be intentional with your decisions.
Be consistent, almost being predictable. Um,
I think definitely challenge the status quo.
You don't always have to do what everybody else is doing. And then, um,
most of all, make sure you're on the right team. So I'm really blessed with, um,
full support from an amazing president and CFO and a great board.
They listen to my suggestions and they take a chance on me sometimes when I
wanna do something that's different or not what they're used to.
So make sure most of all, that you are on the right team.
Wonderful. Thank you so much for those final thoughts. Amber,
this has been an amazing and informative discussion. So again,
I wanna thank you so much for coming on Becker's Healthcare and I look forward
to connecting with you again soon.
Yeah, thank you so much.
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