Hi, everyone. Thank you for listening to the
Becker's Healthcare Podcast. I'm Erica Carbajal with Becker's
Hospital Review. And for today's episode, we are
honored to be joined by Cece Brooks, senior
vice president and chief nursing officer at Children's
National Hospital in Washington, DC.
Cecee, pleasure to have you on today. Thank
you for taking the time.
Thank you. Pleasure's all mine. Yeah. Well, to
start us off, can you share a little
bit about your role, the scope of your
work at Children's National?
Sure. So, as a chief nursing officer here
at Children's National, obviously, I'm responsible,
for the clinical nursing practice,
that occurs not just within the four walls
of the hospital,
but within our ambulatory settings as well. And
so, basically, I'm primarily responsible
in working with my physician colleagues and partners
and my operational leaders and making sure we
have a solid
delivery care model here that keeps all of
our patients and our families safe.
Great. Thanks for sharing, Cece.
Well, what is one goal or priority
that is really driving your work right now
as CNO
at Children's National?
I think one of my my current goals
and a goal that, I've had over the
last few years is really to to make
sure I'm creating a pipeline into nursing,
through different programs and partnerships.
You know, coming through COVID, which,
was a game changer for all of us,
we had to be very creative and innovative
in how we made sure we had a
robust workforce. So, for example, you know, utilization
of apprenticeships
that allows high school students
and others who might be at an entry
level position such as environmental services or food
and nutrition
to help create a clear path to nursing
for those that are interested.
I think it's important that we,
have these opportunities for folks who may never
have considered getting into health care because they
find it kind of,
complex.
But this provides them the ability to tap
into some resources that they never knew existed.
So, you know, my biggest driving force here
at at Children's National is to create a
strong nursing workforce,
because that's gonna be critical on how we
deliver care in the future.
Yeah. Absolutely. And I know over the past
few years, we've had, you know, heard from
so many hospitals who are really focused on
going more and more up stream, you know,
working with the high schools, working with even
elementary schools, and and getting
just getting in front of those those students
to plant that seed early and and start
to show,
younger folks what a career in health care
could look like.
What is how many high schools or what
is the footprint
of Children's Nationals partnerships
look like right now?
So we have a couple. You know, there's
quite a few local,
colleges and universities here like Howard and Trinity
Catholic and some of the other schools, you
know, GW in town that, you know, we
are in a very
rich environment
as far as health care is concerned,
but again it's all about access and opportunity.
So we wanna make sure people have access
and exposure to what we do here in
health care. So
even beyond nursing,
I think sometimes people think nursing is little
scary. Right? And, you know, coming through COVID,
a lot of folks left the profession.
And so I think with anything, creating those
partnerships
with our local colleges and universities
and some of our other,
community partners is just so
important.
Getting up stream, like you mentioned, in the
high school is a program that we actually
have,
through one,
one of our, local
philanthropic supporters who's been a major donor to
Children's National,
and their
their foundation's primary focus is to create
nursing
jobs for the future.
And we actually have a goal of, like,
5,000
nurses in the next, you know, five or
ten years. And and so I think we
have a great
support system at all levels. But to your
point, getting upstream, I think, is is super
important so that these kids can see there
is a pathway to health care.
Yeah. Certainly. Thanks, Cece. It's great to hear
about that goal of 5,000 the next five
to ten. Well,
well, Cece, I know we talked about
recruitment and and building the pipeline, so I
wanna talk now a little bit about retention.
I think nationally,
you know, we've seen a lot of data
and reporting that nurse staffing has has stabilized,
you know, at least from where we were
during the pandemic.
And a big theme now is
chief nursing officers,
we hear a sentiment is that they're talking
about the importance of individual
lives career support and how important that is
in retention,
especially when it comes to those younger early
career nurses. So wanted to ask about that.
How does Children's National, you know, approach that
at scale? Can you share an example of
what that
type of individualized
support actually looks like in practice?
Sure. So Children's National have done an amazing
job with providing nurses opportunity for
both professional growth and development.
Innovative in how we deliver care. And so
our focus
really hasn't just been on title changes. You
know, I think sometimes when people think
of career support, they're thinking,
you know, what's my next
pick something, you know, my next job or
my next role.
But we're actually looking at how do we
invest more in nursing
at the bedside.
You know, for those that aspire to do
more or to do something different, you know,
we have those resources in place. We we've
got a very robust learning and development team
that specifically focuses,
on leadership development and career opportunities.
Again, I mentioned through philanthropic support, we obviously
encourage our nurses to obtain higher level degrees.
We want them to become certified in their
specialty,
but we also like them to participate in
research. And so a lot of times
when we talk about,
career support, again, it doesn't mean you have
to physically move. You can really learn and
grow where you are.
We do have tuition reimbursement available like a
lot of health care systems,
and we also have dedicated,
special funds for attending conferences and other educational
opportunities.
And I think for us,
we really believe that the more we invest
in our nurses, the more patients and families
will get that return on the investment.
But I will say, like, the best retention
strategy is really to make nurses feel valued
and rewarded for the work that they do.
So it just depends on where folks are,
in their career.
Because we do have some nurses, they're like,
Cece, I'm fine where I am. I love
what I do.
I just want to
to grow where I am. And so, again,
that looks different,
for where nurses are in their,
career,
and our learning and development team will help
establish a specified career plan,
through, you know, conversations and assessments.
We have a lot of things online that
folks can can learn more about, and, again,
exposing them to opportunities outside of what they're
currently doing.
Yeah. Absolutely. And certainly so much value in
in thinking about growth and and keeping folks
in their current roles at the bedside too.
CCB important. Yeah.
And when you mentioned investing at the bedside,
what does that what does that look like
today? What does that entail in in terms
of,
technology and, like, different care models?
Yeah. So, again, we have a, we've got
a lot of,
opportunities and and educational opportunities for nurses
to have exposure to different roles and responsibilities
within nursing. So, you know, whether that looks
like a shadowing program for
a nurse who may be on a medical
surgical floor that might be interested in,
joining the ICU team. You know, is there
a way to have a day in the
life? And so we do afford nurses that
opportunity
to to have a shadow experience if there's
another area they may be interested in.
Each of our our team members do have
a certain dollar amount that is allotted for
them to spend
on their own professional career and development. Again,
whether that's getting a certification and paying for
that,
or going to a conference,
We do, through our shared governance and magnet
structure,
highly encourage our bedside nurses to participate
in research,
whether that's submitting abstracts to professional organizations,
that often do, because I believe we have
the smartest pediatric team,
often results in,
being called upon to do
poster and podium presentations. And so these are
our bedside nurses
that get the opportunity
to
speak in front of, you know, hundreds of
people depending on on their particular topic,
and we have a team that invests in
that and encourages that. So
not just our HR learning and development team,
but also we have a a very,
nursing specific education,
team that also focuses on career development.
There's clinical laddering,
opportunities
available.
So, those are some of the things that
our team members have access to.
Yeah. That's great. Thanks, Cece.
What is one clinical
trend or perhaps policy shift that you believe
will have the most significant effect on pediatric
care in the next few years? And, you
know, there's a lot happening just at policy
change level. And and how is Children's National
positioning itself
in response?
Yeah. That's a that's a great question.
You know, health care continues to evolve, so
we've gotta learn how to evolve with it
either at the same pace or even faster.
And I think one of the biggest policy
implications for pediatric health systems today is how
do we support families related to vaccines? Right?
There's a lot of discussion about that going
on. This has become a rather controversial
discussion that has to be handled very delicately
while at the same time making sure we
are providing evidence based recommendations to our patients
and our families.
And for me, as much as I want
kids in our hospital, you know, children's, we
we focus on improving access to preventative
care medicine. That's really what where the rubber
meets the road.
There is a tremendous amount of research out
there that that confirms vaccines are safe,
and and that's what we rely on, that
evidence based research.
Recently, I think we've all seen the national
spike in the measles outbreaks, you know, and
this is a disease that we previously thought
had been totally eradicated.
But,
based on recent data, the rate we're going
now, we will have either doubled or maybe
even tripled
the number of measles cases over the year
nationally.
For us here at Children's, we continue to
provide education as we're starting to look at
these trends
nationally,
making sure we have the appropriate policies and
procedures in place.
That includes,
you know, for measles specifically, rapidly identifying kids
who may be experiencing symptoms,
minimizing that exposure as much as possible to
others that may be in the hospital as
as well as our staff
through our, you know, different precaution standards,
and then also providing early treatment. And so,
you know, we are so fortunate to have
a an amazing infection prevention team
that tracks this very closely,
along with with nursing. So we can make
sure we're pivoting,
as needed. So I think at the moment,
that's probably our biggest,
kinda clinical trend,
that we're seeing in pediatric care.
Yeah. And I and I think you raised
just such a relevant point about just having
to shore up policies and and education
around what was once, you know, perhaps an
afterthought or or not something that you had
to think about as much as today with,
the outbreaks that are resurfacing.
And And I think another comment along that
along those lines is, you know, measles is
not something you see every day. Right? And
we have a very young workforce that has
never had to deal with,
this type of of disease process. And so
the education has been imperative, and we've, done
a great job when when there have been
kids that come in that we suspect may
have measles that we we move quickly, right,
because we wanna minimize that exposure. It is
it is a disease that is, very highly
transmittable, and so we have to do our
part to keep our team members safe and
also our other patients and families.
Sure. Sure.
Cece, I wanted to ask you as well
just about nurse residency programs. Obviously, those have
become really a cornerstone of early career retention
And one of the things I've been hearing
lately is
some nursing leaders talking about how their hospitals
and systems are revisiting or updating them to
reflect just the realities of today's new graduates
because I know a lot of those programs
were initially,
expanded or shored up during the COVID pandemic.
So
how is Children's National thinking about evolving its
residency program, and maybe what do you think
a strong program actually needs
to get right today that not might have
been a priority a few years ago? Right.
Great great question. You know, within our nursing
residency,
we developed a program called transition to practice.
So it's it's incorporated
into their residency
experience.
And, basically, there's about four different pillars in
that program,
because our goal is really not to just
focus on
clinical competency, which obviously
is the foundational and the primary pillar. We
want people to have those technical skills,
but there's so many other things that a
new nurse has to,
master,
over time. But how do we create a
program
that helps them with those steps, you know,
each of those steps along the way. And
so one of the things that we identified,
that's another pillar, is instilling,
confidence
in their comfort level within their own practice.
And so it's one thing for us to
teach you a technical skill,
how to administer medications,
how to do this, or how to do
that. But
at some point, we need to help them
with their level of confidence, especially if they're
new,
activities that they're learning.
You know, pediatric care can can be very
complex in that we take care of patients
from age zero
even up to beyond, you know, their younger
twenties, and so that takes
time to develop
those skill sets, but also that comfort level.
So we have, part of our one of
our pillars is really focused on how do
we grow their confidence.
A third kind of pillar really focuses on
how to help them cultivate a
their own robust
professional
identity.
Again, being a new nurse, it could be
very scary, especially in pediatrics where there's so
much to learn. You're learning not just how
to be a nurse, but you're also learning
how to be a professional, how to interact,
you know, with your patients and families, how
to represent nursing,
within the other disciplines,
and then creating your own high standard of
professionalism. Like, what is your
professionalism. Like, what is your North Star? What
what drives you?
How do we make
sure we, maintain a high level of integrity
in how we deliver care? And that's where
it comes down to the,
having a high reliable
organization.
We want our
nurse residents, even as novice nurses, to feel
comfortable with speaking up.
So if they see something, we want them
to say something. Right? And so that takes
time and courage to do that as well.
So that is something that we do focus
on.
And, you know, basically, our fourth pillar just
kinda moves us into that growth and retention
by, helping establish,
like, a clear pathway for career advancement when
they're ready.
And, again, going back to their ongoing,
professional growth because, you know, day one, yes,
we wanna make sure that you
are proficient,
but we know that we also wanna invest
in your future. And so,
we don't wait until they, you know, are
out of the program to talk about what
does your career what do you really wanna
be when you grow up, and let's figure
out how to help you get there.
So having those conversations at the beginning, I
think, has helped us go a long way.
We've seen a lot of great success in
providing
a more comprehensive residency,
program
that also includes mentorship.
You know, we encourage research from the very,
very beginning,
and then a healthy participation
in our, shared governance model so that our
residents know that you have a voice too.
Right? Whether you've been doing this for two
months or twenty years,
what you have to say is important, and
and this is how this is the platform
in in which you can use that voice.
So,
we shifted a little bit by surrounding,
our
clinical competency
with some of these other programs.
Yeah. Cece, it's it's interesting. And and I
know heard just a lot about that just
in terms of the intentionality
now about putting structures and resources in place
to really help ease that transition to practice
and and build toward that confidence, which is
so important.
Mhmm. Well, lastly, before we wrap up here,
what is one thing the broader health care
system
still maybe gets wrong or underestimates
about pediatric care today?
Wow. That's a that's a really loaded question.
You know,
our hashtag is kids are are everything, are
are everything. And and that holds true
because
saving
kids
and delivering great
pediatric
care,
you impact generations.
And so
I think sometimes,
our adult colleagues may not truly understand that
that, you know, pediatric
health care
is foundational
to
what adult health care is gonna look like,
you know, one, two, three decades
from now.
And, you know, the work we do
is innovative. Like, I think pediatric
care, especially
myself having
previous adult experience,
we tend to be a little bit more
innovative.
There's a lot of research that that happens
in the pediatric health care space
that is life changing.
And so, you know, having
a full appreciation
for that, I think, is very important.
Also, making sure we have
the appropriate
resources from a funding perspective
to be able to take care of these
kids to the best of our ability, but
also invest
in some of those innovative ways to deliver
care.
And so,
you know,
being in the pediatric health care business, you
know, you're not in it to make money.
Right?
Most of
most of our kids are on some type
of governmental
subsidy or funding
that, you know, doesn't always cover the cost
of their health care, but it's important to
what we do. It's something
that needs to be done. And so
I think continuing to invest
in research and education
surrounding
pediatric health care
will have
great positive ripple effects
in the future. Because if you could save
that one child
or or or,
cure that one disease, you're you basically are
are impacting generations
to come, but it starts with that pediatric
care.
Yeah. Some great closing thoughts there. Cece, so
wonderful to have you on today. Thank you.
Thank you.
Yeah. Absolutely. We look forward to continue following
the work that Children's National is leading to
enhance pediatric care and and and build the
workforce of the future.
Thank you. Appreciate it.