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This is the Becker's Healthcare Podcast,

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created by the team of
Becker's Healthcare,

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a multimedia company devoted to
the people who power us healthcare.

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Four new 15 minute episodes are released
daily containing industry news analysis

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and thought leadership.

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From powerful healthcare decision makers
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Thanks for listening.
Now here's the episode.

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Welcome everyone, to the
Becker's Healthcare podcast
series. I'm Maria Mohammed,

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writer in moderator with
Becker's Healthcare.

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I'm absolutely thrilled to have
with me today. Amber Rolands,

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chief Nursing Officer at South Arkansas
Regional Hospital. Amber Burns,

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very nice to have you on the
podcast today. How are you?

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I'm doing great, thank you. I'm,
I'm really excited to discuss, um,

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healthcare with everyone and share a
little bit about what we are experiencing

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in, um, rural Arkansas.

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Yeah, of course. To get us started,

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would you mind please introducing
yourself and telling us a bit about your

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background and organization?

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Um, absolutely.

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So I am the Chief Nursing Officer
at South Arkansas Regional Hospital.

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It is a 166 bed regional facility. Um,

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something really interesting about
our hospital is just recently in July,

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we divested from a large corporation,

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a for-profit corporation and we
are now owned by a local governing

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board. And, um, so we are
non-profit now as of July.

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So going through these changes
and tons of new experiences,

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learning lots of good resources,
some good, some bad, um, but not,

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not very common for us. Um, a
little bit about myself. Uh, I,

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most of my background is emergency
room and most of it at large academic

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facilities. And now I'm at a, a rural
hospital, so it's quite a bit of a change.

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Um,

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I started out wanting to just be an ER
nurse for the rest of my life and then

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working, you know, bedside
in a big trauma center.

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I kind of had an epiphany watching
all of the amazing nurses around me.

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I just thought, um, I want to lead
them differently. I want to, you know,

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have a little more interaction,
a little more engagement,

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and really take care of the nurses.
So I decided to go back to school,

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complete my bachelor's. I
got a supervisor role, um,

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continued with school, finished
my master's and then, um,

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got a director role as an
emergency room director.

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Learned very quickly that whenever you're
the director of a nursing department,

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you now own a small business.

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So I went back to school for an MBA so
I could kind of learn the finance side

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that they don't teach you or show you
at all whenever you're doing bedside

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nursing, um, and kind
of advance from there.

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Executive director took on several
more departments, went back to school.

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I'm just about done with my DNP. Um,

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and this is my first CNO role and
I've been in this hospital for about

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16 months now.

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Got it, got it.

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Thank you so much for giving us that
background on yourself and organization.

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Um, so Amber, the first question
I really wanted to ask you is,

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can you tell me about your most successful
project or initiative from the last

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year? What issues were you trying to
solve and also what drove the success?

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Um, absolutely. So I guess the,

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the most successful project that I've
undergone in the last year would be that

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in June of 2022, I
started at the hospital.

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I'm currently at South Arkansas Regional
Hospital and we had about 50 ish

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contract labor nurses and about
30 ish internal PRN agreement

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arrangements where,

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where temporary employees work for a
higher pay rather than the PRN hours.

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They work full-time hours.
Um, and in June of 2023,

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so one year later we were down to
only two contract labor nurses in the

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building. And those were
both on a behavioral health
unit that we just opened,

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um,

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in October of last year and down to
only seven internal PRN agreements.

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So the most successful project was
definitely reducing that contract labor.

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The issue to solve, um,

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was that we had a full leadership
change after a no confidence

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vote by vote by the board,

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and the staff in the hospital
really needed healing.

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But you can't grow with temporary people.

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You can't build good culture with
people that are not invested in the

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organization. Um,

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so my mission was to remove the contract
labor nurses and nothing against

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contract labor nurses. They're there
when you need 'em, they do a great job,

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but you really can't grow permanent
culture, um, with temporary people.

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So the driver I think was that
we need to take care of our

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staff. We needed to listen to them, we
needed to make sure we were putting, um,

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safety before financial gain.

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And we really had to work on listening
to the staff and finding out what they

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needed. And of course, word of mouth, um,

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travels really quickly
through nursing. So, um,

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if you're enjoying where you work,

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then you tell your friends and you
tell the other nurses that you know,

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or that you've worked with in the past,
and they wanna work at a good hospital.

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And so they follow and they come.

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So we've had a ton of success over the
last year really removing contract labor

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and now we have none. Um, and
removing those internal agreements.

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Got it, got it. Thank
you so much for sharing.

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That definitely sounds
like a successful plan. Um,

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and hopefully something you can keep
up with in the next couple years.

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As you know, the clinical workforce has
changed a lot in the last few years.

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What challenges are you still facing and
how do you see the clinical workforce

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evolving?

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Yeah, I'm,

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so I'm really proud to share that we
have very limited available nursing

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positions today at all. Um, in fact,

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some of our departments in the
hospital have a waiting list, um,

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to be able to join our workforce.
So, um, I'm really proud of that.

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But of course it's not, um, without
its challenges, like you said.

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So though clinical workforce is
definitely evolving, they are younger,

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they are greener,

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and they have a different work
ethic than what my generation,

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I'm a millennial than what my generation
is really used to. And so, um,

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we are learning that we have to meet them
where they are, these younger nurses,

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we have to ask them what
they need and what they want.

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And we have to really take time to
challenge when someone says, we can't,

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we can't do that, we can't go
there, we can't change this.

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And really ask why. Every time
you hear that can't language.

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So when someone says they can't do this,
you wanna understand the, you know,

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the where does this come
from? Who said that you can't,

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because I think a lot of organizations
get stuck in old habits in tradition and

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are afraid to make a lot of changes.

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And so you really have to think
about where the rules are made.

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And a lot of times it's the organization
making those rules themselves.

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So who has the power or the autonomy
to change those rules? Well, the,

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the organization can so always
ask why can't they change the rule

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or the issue? And if
staffing is a challenge,

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then you really have to get
creative, you know, ask why.

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When you hear the can't
ask what they want, um,

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what is work-life balance to them and
take care of them instead of, you know,

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thinking about the traditions or what
you're used to seeing or what you know

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other people are doing,

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it's okay to kind of step outside of
those lines and do what works for you and

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your organization.

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Yeah. Great, great, great advice.

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Thank you so much for giving us that
insight and keeping on with the advice.

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The last thing I wanted to ask you is,

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what is your best advice for
aspiring physician and nurse leaders?

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Oh, absolutely. Um,

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I think my best advice would be be
intentional with your decisions.

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Be consistent, almost
being predictable. Um,

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I think definitely
challenge the status quo.

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You don't always have to do what
everybody else is doing. And then, um,

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most of all, make sure you're on the right
team. So I'm really blessed with, um,

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full support from an amazing
president and CFO and a great board.

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They listen to my suggestions and they
take a chance on me sometimes when I

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wanna do something that's different
or not what they're used to.

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So make sure most of all, that
you are on the right team.

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Wonderful. Thank you so much
for those final thoughts. Amber,

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this has been an amazing and
informative discussion. So again,

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I wanna thank you so much for coming on
Becker's Healthcare and I look forward

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to connecting with you again soon.

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Yeah, thank you so much.

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It's so important for leaders at the
top of organizations to keep learning,

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stay sharp,

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