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- Welcome everyone,
to the Becker's Healthcare podcast series.
I'm Ra Mohammed, writer
and moderator with Becker's Healthcare,
and I'm absolutely thrilled to have with me today.
Cynthia Whitaker, vice President of Operations
and Chief Nursing Officer at Gut three Corning Hospital.
Cynthia, it's very nice
to have you on the podcast today. How are you?
- I'm great, thank you, Mariah.
I am honored to be here today.
- Yeah. So glad to have you, um, too, get us started.
Would you mind please just introducing yourself
and telling us a bit about your background?
- Sure. Um, so I'm Cindy Whitaker.
I have been the Chief nursing officer
for Corning Hospital since 2020.
I actually started my career with Guthrie, uh, 12 years ago
as a brand new nurse in the ICU at one
of our sister hospitals, uh, Robert Packer Hospital.
And back then, you know, I never really had a clear idea of
what my career path was going to look like,
and I loved critical care nursing.
So during that time, I really thought I'm,
I'm gonna be a critical care nurse for my whole career.
It was, it was truly a passion.
Um, but I kind of found myself in the role
of charge nurse in the ICU.
And after doing that for, you know, over a year,
the staff would would say to me,
you know, you're really good at this.
You should, you should think about, you know,
being the manager one day.
You know, we really like it when you're here and,
and you keep things controlled and you're calm.
And you know, back then I was like, yeah, you know,
whatever, this is great, but I'm,
I'm gonna be a critical care nurse, you know, forever
because I love this so much.
And actually, uh,
Guthrie restructured their nursing leadership about a few
years after I was in the ICU
and a position came up for an assistant manager on one
of the trauma med surg units.
And I thought, Hmm,
this is an opportunity I never really thought about
for myself, but I had some life changes.
I had just had, um, my first, my first child
and the 12 hour shifts weren't working great for us anymore.
So I thought, you know, let me give this a try
and, you know, I went for it.
And, and I got the position.
And after being in that position for six months,
I was actually promoted to the manager of that unit, uh,
because, you know, I was so successful
with forming relationships with the staff,
improving engagement and staff satisfaction.
Um, after doing that for about a year, they decided
to give me another unit.
So I had a total of 60 med surg, uh, beds.
And I had an assistant manager
and an educator that worked with me.
And we were very successful as a team, again,
improving staff engagement
and patient outcomes, um, throughput.
Uh, we did, we did very well.
And when the chief nurse position came open at Corning
Hospital, which is a smaller hospital compared to
where I was at, I thought, you know, I never thought
of myself as being a chief nurse,
but this is an opportunity that's coming at the right time
and I think I'm gonna go for it.
And they took a chance on me
and I started in this job, you know, right.
Kind of in the middle of the pandemic.
And it was stressful and we struggled a bit,
and I've learned so much.
But it has been, um, it's been a wild ride.
It's been a very successful ride.
And in April of this year, Guthrie decided
to do some restructuring
and they joined their VP of operations
with the chief nurse role.
And I was, I was awarded that role at Corning.
And, you know, it has, it has been great so far,
learning more of the operation side, how, you know, EVS,
food and nutrition rehab, all those services fit in
with nursing operations.
Uh, it makes sense.
And, uh, it, yeah, like I said, it's, it's going very well.
And right now in my career, I'm just open to seeing
what opportunities continue to come along for me.
- Yeah, absolutely. Well,
congratulations on all your success.
I'm sure you have worked very hard to achieve all of it.
Um, for the next question I 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?
- Yeah, so I think during the pandemic, um, you know,
hospitals came across a lot of challenges
that maybe they didn't face, uh, prior.
And one of the things that,
that happened here at Corning was an increase, a major
increase in hospital acquired infections, especially during,
uh, the year E 2022.
That's really when the region that
that we're in upstate New York started
to see a rise in the covid positive patients.
Now, Corning Hospital is a 65 bed community hospital,
and one thing we saw
through the pandemic is an increase in acuity.
You know, we got sicker patients, patients
that we were unable to transfer out
because their, the bed availability
wasn't there in the community.
So we had to, you know, adapt and be flexible
and bring more resources in to, to care for these patients.
But with sicker patients, along comes with the chance of
more hospital acquired infections, more falls, you know,
it really impacts your quality outcomes.
So during 2022, we saw a major rise in our ,
our C diff and our CLABSI rates,
and just not something that we ever really had to deal with.
We, we never really had a lot of patients
with Foley catheters or central lines.
So I did some research
and I thought about how can we,
how can we handle this differently than we used to?
We, we need more awareness around
hospital acquired infections and
around the lines that we have here.
So in March of 2022, I started, um,
something called a daily device huddle.
And what we do in this is, is each morning our nurse leaders
have a safety huddle on their unit where they talk
with their staff, the frontline nurses,
which patients have a central line,
which patients have a Foley catheter,
and which patients, um, may have AAC diff order
that we still haven't collected.
And they talk about why is the line in,
when can it come out,
what are the barriers to it coming out?
Are there alternative devices
that we can use external catheters so we can,
we can get these out earlier.
And then they come to this device huddle.
And what's unique about device huddle is the presence
of the executive leadership team.
So I'm there, our president
of the hospital attends our chief medical officer,
our infection preventionist, and the nurse managers come
and they report out on, you know,
I have a Foley in this room.
It's in because of this, it's gonna come out on this day
or it can't come out because,
and we have conversation, we ask questions.
And when there's barriers presented, that's where
as the executive leadership team,
we can help remove those barriers.
So for example, you know, maybe we have a catheter that,
from the nursing's point of view,
it can come out the patient's ready, um,
but maybe the provider is not there yet.
They say, no, I wanna keep it another day or two.
That's where myself or my partner, my chief medical officer,
we can step in and just have a conversation
with the provider of, you know, what's in the,
what's in the best interest of the patient.
Um, so long story short,
we are now over a year later,
and we have been successful in reducing all cau, clabsi
and c diff rates to less than one.
And when we talk about an n you know, the number,
so in the past year
and a half, we've had one CAU in one c diff.
And what's unique about this is it actually has, uh, been
spread out to our other five
or four sister hospitals throughout Guthrie,
and they have all been able
to maintain their hospital acquired infection rates
to less than one as well.
And not only has this, you know, driven improved outcomes
for our patient, 'cause that's what it's about.
We want our patients to know
that they're safe when they come to get care here.
We've also really shifted our culture of safety.
We've empowered our caregivers to say, um,
you know, I need help.
I need to escalate this
and, um, have ownership over these lines.
These are really, you know,
nursing driven quality indicators, nurses drive
decreasing these hospital acquired infections
and getting these lines out.
Um, so I think, you know, that really has been my,
my most successful project over the past year.
And we continue to, to maintain that success.
And we've also seen, you know,
a shift in our engagement scores and our,
and our satisfaction scores along with, you know, improved,
um, culture of safety.
- Wonderful. Thank you so much
for giving us all that insight.
Um, the clinical workforce has changed a lot in the last few
years, as I'm sure you are well aware.
What challenges are you still facing
and how do you see the clinical workforce evolving?
- Yeah, I think this is a, there,
there's a lot to this question.
So, um, the clinical workforce changes daily, monthly.
I think one thing we can't deny is there are not enough
caregivers to care for the number of patients.
And, you know, specifically speaking in my, in my area,
you know, the biggest focus is on,
on having enough registered nurses.
Um, so I think that we as uh, nursing leadership
and hospital leadership in general, we have
to start thinking differently about how we're gonna care
for patients and how we're gonna continue to give quality
of care, um, than we, you know, differently than we used to.
One of the things that we're doing here
and throughout the Guthrie system is changing to a,
a team nursing model.
So this was a model that was, you know,
dumb back in the eighties,
but we're kind of bringing it
back, but doing it differently.
And what it really involves, it involves bringing RNs
and LPNs and care partners together
and bringing LPNs back into inpatient care when, you know,
a few years ago when we did primary nursing,
they were pushed back out to the clinics.
So we're bringing them back into inpatient care
and we put 'em in a team format.
So you've got an rn, an LPN,
and a care partner taking care of a group of patients.
What this allows us to do is really increase the number
of hands available to care for patients,
and it allows each individual to work at the top
of their license, um,
and allows the RN to delegate appropriately.
And it allows increased amount
of time at the bedside with the patient.
And I think, you know, we've done this on our nursing units
and we've been successful
and we've been able to improve outcomes,
but I can see how it applies to other areas as well.
So I think as leaders, we're gonna have to continue
to be proactive about areas where there are going
to be shortages such as, uh, respiratory therapy, um,
physical therapy, ot,
and then how can we be creative with those care models
so we can continue again
to provide high quality care to patients.
You know, we look at respiratory therapists,
so maybe we need to add some more techs
or to the respiratory therapy team, you know,
and have RT techs that can break down equipment
or put equipment together, clean equipment, um, so
that our respiratory therapists can work more at the top
of their license, um,
and handle the patient care that they need to handle.
And it's always gonna be different upon in each region,
you know, what, what your shortage is.
But I think that it's really about being ahead
of what's happening in the workforce
and being proactive about how are we going to
be ready to face this so that our patients don't feel
any difference in, in, in their care,
that they're getting the quality
of care that we've always given.
So I just, I wanted to mention as well, um,
virtual virtual care, virtual care is still up and coming
and, and it's expanding.
Um, but I think this is gonna continue
to be very important in the inpatient world
and using our technology to provide virtual support.
So we're talking about virtual sitters, um, telemetry techs,
virtual ICU nurses, virtual med surg nurses, people
that can provide extra support, uh, to the inpatient staff
that are hands-on and support in the way
that they can do documentation.
You know, when, when here at Guthrie we look at
how many hours a day a nurse spends just documenting,
it's really quite, it, it opens your eyes, right?
And we need people to be able to,
at the bedside providing physical care to patients.
And that's one thing we've already started
doing here at Guthrie.
So we actually have virtual ICU nurses
and virtual med surg nurses, um,
and they can pop right in through cameras
and patients' rooms and they can document turns
and they can document admissions
and discharges, they can talk with families.
Um, and this is also huge
because it provides a support, especially
to our newly licensed nurses just coming out of school.
You know, that's where our biggest pipeline
of new nurses is coming anymore is,
is our new grads every year.
And having these experienced nurses virtually
where they can just ask them questions
or they can pop in, you know, through cameras in the rooms
and help help these nurses, um, I think that's gonna be huge
for recruitment and retention.
And I, you know, I'm really proud to say
that Guthrie is ahead of the game in this area.
- Yeah, it certainly sounds like it.
So thank you so much for sharing all that insight.
And before I let you go, the last thing I wanted
to ask you is, what is your best advice
for aspiring physician nurse leaders?
- So, my best advice,
and I think what has gotten me, um,
the farthest in my career is to be authentic.
Be you know, your values and stay true to them.
And when you are an authentic leader, it is, it makes it
that much easier to make real connections with people.
And I have found that ha relation, my relationships
with others has really, uh, helped me in inspiring
change and, um, moving initiatives forward.
And I think another really important component is practicing
self-awareness, knowing yourself
and recognizing when you're wrong
and being, being okay with admitting that.
One of my mentors, I think, um, one of her greatest pieces
of advice to me was, you know, the, the two best attributes
that a leader can have is humility and vulnerability.
Um, because when the people you work with can, can see
that you are human too, and you make mistakes
and you can admit it, you know that that goes a long way
with people and really valuing yourself,
taking breaks when you need it, right?
The pandemic taught us anything.
It taught us that, uh, healthcare workers in general, we,
we burn out easily and we need to be aware of that.
And then lastly, you know, network
and take advantage of opportunities when they come along.
Um, I think that, you know, during my career,
things have come along and they felt right at the right time
and I was able to take advantage of that.
And, um, you know, we should,
we should always have our eyes open
and be ready for the next thing.
- Yes, I completely agree.
Thank you so much for those final thoughts.
This has been an amazing and informative discussion.
So again, I wanna thank you so much
for coming on Becker's Healthcare.
We really do appreciate it,
and I look forward to connecting with you again soon.
- Thank you. And again, I really appreciate the opportunity.
- Of course, - It's so important for leaders at the top
of organizations to keep learning, stay sharp,
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