1 00:00:00,160 --> 00:00:02,399 Hi, everyone. Thank you for listening to the 2 00:00:02,399 --> 00:00:06,259 Becker's Healthcare Podcast. I'm Erica Carbajal with Becker's 3 00:00:06,399 --> 00:00:09,119 Hospital Review. And for today's episode, we are 4 00:00:09,119 --> 00:00:11,919 honored to be joined by Cece Brooks, senior 5 00:00:11,919 --> 00:00:15,344 vice president and chief nursing officer at Children's 6 00:00:15,404 --> 00:00:17,984 National Hospital in Washington, DC. 7 00:00:18,605 --> 00:00:20,524 Cecee, pleasure to have you on today. Thank 8 00:00:20,524 --> 00:00:21,744 you for taking the time. 9 00:00:22,045 --> 00:00:25,164 Thank you. Pleasure's all mine. Yeah. Well, to 10 00:00:25,164 --> 00:00:26,765 start us off, can you share a little 11 00:00:26,765 --> 00:00:29,000 bit about your role, the scope of your 12 00:00:29,000 --> 00:00:30,539 work at Children's National? 13 00:00:31,320 --> 00:00:34,119 Sure. So, as a chief nursing officer here 14 00:00:34,119 --> 00:00:36,619 at Children's National, obviously, I'm responsible, 15 00:00:37,640 --> 00:00:39,500 for the clinical nursing practice, 16 00:00:39,879 --> 00:00:41,719 that occurs not just within the four walls 17 00:00:41,719 --> 00:00:42,539 of the hospital, 18 00:00:42,995 --> 00:00:46,354 but within our ambulatory settings as well. And 19 00:00:46,354 --> 00:00:48,854 so, basically, I'm primarily responsible 20 00:00:49,475 --> 00:00:52,515 in working with my physician colleagues and partners 21 00:00:52,515 --> 00:00:55,554 and my operational leaders and making sure we 22 00:00:55,554 --> 00:00:56,454 have a solid 23 00:00:57,630 --> 00:00:59,789 delivery care model here that keeps all of 24 00:00:59,789 --> 00:01:01,890 our patients and our families safe. 25 00:01:02,909 --> 00:01:04,450 Great. Thanks for sharing, Cece. 26 00:01:05,069 --> 00:01:07,090 Well, what is one goal or priority 27 00:01:07,390 --> 00:01:09,790 that is really driving your work right now 28 00:01:09,790 --> 00:01:10,530 as CNO 29 00:01:10,909 --> 00:01:12,129 at Children's National? 30 00:01:13,125 --> 00:01:15,125 I think one of my my current goals 31 00:01:15,125 --> 00:01:17,284 and a goal that, I've had over the 32 00:01:17,284 --> 00:01:19,045 last few years is really to to make 33 00:01:19,045 --> 00:01:21,384 sure I'm creating a pipeline into nursing, 34 00:01:22,084 --> 00:01:23,864 through different programs and partnerships. 35 00:01:24,805 --> 00:01:26,905 You know, coming through COVID, which, 36 00:01:27,579 --> 00:01:29,180 was a game changer for all of us, 37 00:01:29,180 --> 00:01:31,200 we had to be very creative and innovative 38 00:01:31,260 --> 00:01:32,700 in how we made sure we had a 39 00:01:32,700 --> 00:01:36,000 robust workforce. So, for example, you know, utilization 40 00:01:36,060 --> 00:01:36,799 of apprenticeships 41 00:01:37,340 --> 00:01:39,280 that allows high school students 42 00:01:39,685 --> 00:01:41,685 and others who might be at an entry 43 00:01:41,685 --> 00:01:44,645 level position such as environmental services or food 44 00:01:44,645 --> 00:01:45,305 and nutrition 45 00:01:45,844 --> 00:01:48,084 to help create a clear path to nursing 46 00:01:48,084 --> 00:01:49,305 for those that are interested. 47 00:01:49,765 --> 00:01:51,465 I think it's important that we, 48 00:01:51,924 --> 00:01:54,344 have these opportunities for folks who may never 49 00:01:54,469 --> 00:01:56,709 have considered getting into health care because they 50 00:01:56,709 --> 00:01:58,310 find it kind of, 51 00:01:58,790 --> 00:01:59,290 complex. 52 00:02:00,069 --> 00:02:01,909 But this provides them the ability to tap 53 00:02:01,909 --> 00:02:04,729 into some resources that they never knew existed. 54 00:02:04,869 --> 00:02:07,590 So, you know, my biggest driving force here 55 00:02:07,590 --> 00:02:09,685 at at Children's National is to create a 56 00:02:09,685 --> 00:02:10,905 strong nursing workforce, 57 00:02:11,685 --> 00:02:13,365 because that's gonna be critical on how we 58 00:02:13,365 --> 00:02:14,745 deliver care in the future. 59 00:02:15,764 --> 00:02:18,004 Yeah. Absolutely. And I know over the past 60 00:02:18,004 --> 00:02:20,324 few years, we've had, you know, heard from 61 00:02:20,324 --> 00:02:22,405 so many hospitals who are really focused on 62 00:02:22,405 --> 00:02:24,069 going more and more up stream, you know, 63 00:02:24,069 --> 00:02:26,069 working with the high schools, working with even 64 00:02:26,069 --> 00:02:28,409 elementary schools, and and getting 65 00:02:28,709 --> 00:02:30,549 just getting in front of those those students 66 00:02:30,549 --> 00:02:32,549 to plant that seed early and and start 67 00:02:32,549 --> 00:02:33,289 to show, 68 00:02:34,150 --> 00:02:36,150 younger folks what a career in health care 69 00:02:36,150 --> 00:02:36,969 could look like. 70 00:02:37,305 --> 00:02:39,705 What is how many high schools or what 71 00:02:39,705 --> 00:02:40,444 is the footprint 72 00:02:41,145 --> 00:02:42,685 of Children's Nationals partnerships 73 00:02:42,985 --> 00:02:43,965 look like right now? 74 00:02:44,344 --> 00:02:45,944 So we have a couple. You know, there's 75 00:02:45,944 --> 00:02:47,004 quite a few local, 76 00:02:47,784 --> 00:02:51,239 colleges and universities here like Howard and Trinity 77 00:02:51,239 --> 00:02:53,479 Catholic and some of the other schools, you 78 00:02:53,479 --> 00:02:56,439 know, GW in town that, you know, we 79 00:02:56,439 --> 00:02:57,500 are in a very 80 00:02:58,199 --> 00:02:59,099 rich environment 81 00:02:59,400 --> 00:03:01,259 as far as health care is concerned, 82 00:03:01,959 --> 00:03:04,379 but again it's all about access and opportunity. 83 00:03:04,680 --> 00:03:07,854 So we wanna make sure people have access 84 00:03:07,995 --> 00:03:09,995 and exposure to what we do here in 85 00:03:09,995 --> 00:03:10,974 health care. So 86 00:03:11,275 --> 00:03:12,495 even beyond nursing, 87 00:03:12,794 --> 00:03:15,354 I think sometimes people think nursing is little 88 00:03:15,354 --> 00:03:18,414 scary. Right? And, you know, coming through COVID, 89 00:03:18,474 --> 00:03:20,735 a lot of folks left the profession. 90 00:03:21,139 --> 00:03:23,620 And so I think with anything, creating those 91 00:03:23,620 --> 00:03:24,120 partnerships 92 00:03:24,500 --> 00:03:26,599 with our local colleges and universities 93 00:03:27,539 --> 00:03:28,840 and some of our other, 94 00:03:29,459 --> 00:03:31,400 community partners is just so 95 00:03:31,860 --> 00:03:32,360 important. 96 00:03:32,739 --> 00:03:34,675 Getting up stream, like you mentioned, in the 97 00:03:34,675 --> 00:03:36,915 high school is a program that we actually 98 00:03:36,915 --> 00:03:37,415 have, 99 00:03:37,875 --> 00:03:38,615 through one, 100 00:03:38,915 --> 00:03:40,455 one of our, local 101 00:03:41,155 --> 00:03:43,794 philanthropic supporters who's been a major donor to 102 00:03:43,794 --> 00:03:44,775 Children's National, 103 00:03:45,235 --> 00:03:46,135 and their 104 00:03:46,550 --> 00:03:49,770 their foundation's primary focus is to create 105 00:03:50,389 --> 00:03:50,889 nursing 106 00:03:51,189 --> 00:03:52,729 jobs for the future. 107 00:03:53,030 --> 00:03:54,949 And we actually have a goal of, like, 108 00:03:54,949 --> 00:03:55,750 5,000 109 00:03:55,750 --> 00:03:58,069 nurses in the next, you know, five or 110 00:03:58,069 --> 00:04:00,150 ten years. And and so I think we 111 00:04:00,150 --> 00:04:00,969 have a great 112 00:04:01,275 --> 00:04:03,995 support system at all levels. But to your 113 00:04:03,995 --> 00:04:06,875 point, getting upstream, I think, is is super 114 00:04:06,875 --> 00:04:09,194 important so that these kids can see there 115 00:04:09,194 --> 00:04:11,455 is a pathway to health care. 116 00:04:12,474 --> 00:04:14,474 Yeah. Certainly. Thanks, Cece. It's great to hear 117 00:04:14,474 --> 00:04:16,490 about that goal of 5,000 the next five 118 00:04:16,490 --> 00:04:17,389 to ten. Well, 119 00:04:17,930 --> 00:04:19,870 well, Cece, I know we talked about 120 00:04:20,410 --> 00:04:22,490 recruitment and and building the pipeline, so I 121 00:04:22,490 --> 00:04:24,990 wanna talk now a little bit about retention. 122 00:04:25,129 --> 00:04:26,350 I think nationally, 123 00:04:26,889 --> 00:04:28,330 you know, we've seen a lot of data 124 00:04:28,330 --> 00:04:30,935 and reporting that nurse staffing has has stabilized, 125 00:04:31,074 --> 00:04:32,435 you know, at least from where we were 126 00:04:32,435 --> 00:04:33,414 during the pandemic. 127 00:04:33,875 --> 00:04:35,654 And a big theme now is 128 00:04:36,435 --> 00:04:37,574 chief nursing officers, 129 00:04:37,954 --> 00:04:39,875 we hear a sentiment is that they're talking 130 00:04:39,875 --> 00:04:41,414 about the importance of individual 131 00:04:41,970 --> 00:04:44,529 lives career support and how important that is 132 00:04:44,529 --> 00:04:45,270 in retention, 133 00:04:46,370 --> 00:04:48,850 especially when it comes to those younger early 134 00:04:48,850 --> 00:04:51,569 career nurses. So wanted to ask about that. 135 00:04:51,569 --> 00:04:54,050 How does Children's National, you know, approach that 136 00:04:54,050 --> 00:04:55,970 at scale? Can you share an example of 137 00:04:55,970 --> 00:04:56,629 what that 138 00:04:56,985 --> 00:04:57,805 type of individualized 139 00:04:58,185 --> 00:05:00,204 support actually looks like in practice? 140 00:05:01,064 --> 00:05:04,104 Sure. So Children's National have done an amazing 141 00:05:04,104 --> 00:05:06,925 job with providing nurses opportunity for 142 00:05:07,305 --> 00:05:09,120 both professional growth and development. 143 00:05:20,959 --> 00:05:23,379 Innovative in how we deliver care. And so 144 00:05:23,555 --> 00:05:24,295 our focus 145 00:05:24,834 --> 00:05:27,955 really hasn't just been on title changes. You 146 00:05:27,955 --> 00:05:29,895 know, I think sometimes when people think 147 00:05:30,355 --> 00:05:32,214 of career support, they're thinking, 148 00:05:32,675 --> 00:05:34,295 you know, what's my next 149 00:05:34,834 --> 00:05:36,834 pick something, you know, my next job or 150 00:05:36,834 --> 00:05:37,814 my next role. 151 00:05:38,430 --> 00:05:41,150 But we're actually looking at how do we 152 00:05:41,150 --> 00:05:42,770 invest more in nursing 153 00:05:43,150 --> 00:05:44,050 at the bedside. 154 00:05:45,069 --> 00:05:47,470 You know, for those that aspire to do 155 00:05:47,470 --> 00:05:49,870 more or to do something different, you know, 156 00:05:49,870 --> 00:05:52,125 we have those resources in place. We we've 157 00:05:52,125 --> 00:05:54,444 got a very robust learning and development team 158 00:05:54,444 --> 00:05:56,064 that specifically focuses, 159 00:05:57,085 --> 00:05:59,824 on leadership development and career opportunities. 160 00:06:00,845 --> 00:06:04,464 Again, I mentioned through philanthropic support, we obviously 161 00:06:04,525 --> 00:06:07,105 encourage our nurses to obtain higher level degrees. 162 00:06:07,810 --> 00:06:09,569 We want them to become certified in their 163 00:06:09,569 --> 00:06:10,069 specialty, 164 00:06:10,930 --> 00:06:12,930 but we also like them to participate in 165 00:06:12,930 --> 00:06:14,709 research. And so a lot of times 166 00:06:15,170 --> 00:06:16,389 when we talk about, 167 00:06:17,330 --> 00:06:19,250 career support, again, it doesn't mean you have 168 00:06:19,250 --> 00:06:21,410 to physically move. You can really learn and 169 00:06:21,410 --> 00:06:22,709 grow where you are. 170 00:06:23,285 --> 00:06:25,605 We do have tuition reimbursement available like a 171 00:06:25,605 --> 00:06:26,904 lot of health care systems, 172 00:06:27,764 --> 00:06:29,225 and we also have dedicated, 173 00:06:29,845 --> 00:06:33,464 special funds for attending conferences and other educational 174 00:06:33,605 --> 00:06:34,105 opportunities. 175 00:06:34,645 --> 00:06:35,944 And I think for us, 176 00:06:36,509 --> 00:06:38,670 we really believe that the more we invest 177 00:06:38,670 --> 00:06:40,829 in our nurses, the more patients and families 178 00:06:40,829 --> 00:06:42,449 will get that return on the investment. 179 00:06:43,149 --> 00:06:45,089 But I will say, like, the best retention 180 00:06:45,149 --> 00:06:47,550 strategy is really to make nurses feel valued 181 00:06:47,550 --> 00:06:49,730 and rewarded for the work that they do. 182 00:06:50,055 --> 00:06:52,214 So it just depends on where folks are, 183 00:06:53,814 --> 00:06:54,875 in their career. 184 00:06:55,254 --> 00:06:57,095 Because we do have some nurses, they're like, 185 00:06:57,095 --> 00:07:00,055 Cece, I'm fine where I am. I love 186 00:07:00,055 --> 00:07:00,954 what I do. 187 00:07:01,334 --> 00:07:02,555 I just want to 188 00:07:02,870 --> 00:07:05,910 to grow where I am. And so, again, 189 00:07:05,910 --> 00:07:06,970 that looks different, 190 00:07:07,910 --> 00:07:10,069 for where nurses are in their, 191 00:07:10,550 --> 00:07:11,050 career, 192 00:07:11,509 --> 00:07:13,990 and our learning and development team will help 193 00:07:13,990 --> 00:07:16,490 establish a specified career plan, 194 00:07:17,185 --> 00:07:19,365 through, you know, conversations and assessments. 195 00:07:19,985 --> 00:07:21,985 We have a lot of things online that 196 00:07:21,985 --> 00:07:25,105 folks can can learn more about, and, again, 197 00:07:25,105 --> 00:07:27,824 exposing them to opportunities outside of what they're 198 00:07:27,824 --> 00:07:28,725 currently doing. 199 00:07:29,569 --> 00:07:32,050 Yeah. Absolutely. And certainly so much value in 200 00:07:32,050 --> 00:07:34,770 in thinking about growth and and keeping folks 201 00:07:34,770 --> 00:07:37,029 in their current roles at the bedside too. 202 00:07:37,490 --> 00:07:39,029 CCB important. Yeah. 203 00:07:39,330 --> 00:07:42,069 And when you mentioned investing at the bedside, 204 00:07:42,210 --> 00:07:44,084 what does that what does that look like 205 00:07:44,084 --> 00:07:46,245 today? What does that entail in in terms 206 00:07:46,245 --> 00:07:46,745 of, 207 00:07:47,524 --> 00:07:49,464 technology and, like, different care models? 208 00:07:50,805 --> 00:07:54,084 Yeah. So, again, we have a, we've got 209 00:07:54,084 --> 00:07:54,884 a lot of, 210 00:07:55,764 --> 00:07:59,305 opportunities and and educational opportunities for nurses 211 00:08:00,250 --> 00:08:03,550 to have exposure to different roles and responsibilities 212 00:08:03,930 --> 00:08:06,569 within nursing. So, you know, whether that looks 213 00:08:06,569 --> 00:08:08,509 like a shadowing program for 214 00:08:08,889 --> 00:08:10,649 a nurse who may be on a medical 215 00:08:10,649 --> 00:08:13,310 surgical floor that might be interested in, 216 00:08:13,964 --> 00:08:16,685 joining the ICU team. You know, is there 217 00:08:16,685 --> 00:08:18,044 a way to have a day in the 218 00:08:18,044 --> 00:08:20,284 life? And so we do afford nurses that 219 00:08:20,284 --> 00:08:20,784 opportunity 220 00:08:21,324 --> 00:08:23,485 to to have a shadow experience if there's 221 00:08:23,485 --> 00:08:25,584 another area they may be interested in. 222 00:08:25,939 --> 00:08:28,180 Each of our our team members do have 223 00:08:28,180 --> 00:08:30,180 a certain dollar amount that is allotted for 224 00:08:30,180 --> 00:08:31,160 them to spend 225 00:08:31,620 --> 00:08:34,600 on their own professional career and development. Again, 226 00:08:34,820 --> 00:08:37,299 whether that's getting a certification and paying for 227 00:08:37,299 --> 00:08:37,799 that, 228 00:08:38,740 --> 00:08:40,360 or going to a conference, 229 00:08:40,964 --> 00:08:43,524 We do, through our shared governance and magnet 230 00:08:43,524 --> 00:08:44,024 structure, 231 00:08:44,404 --> 00:08:46,985 highly encourage our bedside nurses to participate 232 00:08:47,605 --> 00:08:48,345 in research, 233 00:08:49,444 --> 00:08:53,144 whether that's submitting abstracts to professional organizations, 234 00:08:54,730 --> 00:08:57,129 that often do, because I believe we have 235 00:08:57,129 --> 00:08:58,910 the smartest pediatric team, 236 00:09:00,009 --> 00:09:01,550 often results in, 237 00:09:02,090 --> 00:09:03,629 being called upon to do 238 00:09:04,090 --> 00:09:06,809 poster and podium presentations. And so these are 239 00:09:06,809 --> 00:09:08,029 our bedside nurses 240 00:09:08,574 --> 00:09:09,634 that get the opportunity 241 00:09:10,574 --> 00:09:11,074 to 242 00:09:11,454 --> 00:09:13,054 speak in front of, you know, hundreds of 243 00:09:13,054 --> 00:09:15,794 people depending on on their particular topic, 244 00:09:16,174 --> 00:09:18,334 and we have a team that invests in 245 00:09:18,334 --> 00:09:20,595 that and encourages that. So 246 00:09:20,909 --> 00:09:23,709 not just our HR learning and development team, 247 00:09:23,709 --> 00:09:25,490 but also we have a a very, 248 00:09:25,950 --> 00:09:27,649 nursing specific education, 249 00:09:28,909 --> 00:09:31,649 team that also focuses on career development. 250 00:09:32,429 --> 00:09:33,730 There's clinical laddering, 251 00:09:34,509 --> 00:09:35,009 opportunities 252 00:09:35,389 --> 00:09:35,889 available. 253 00:09:36,495 --> 00:09:38,335 So, those are some of the things that 254 00:09:38,335 --> 00:09:40,115 our team members have access to. 255 00:09:41,294 --> 00:09:42,914 Yeah. That's great. Thanks, Cece. 256 00:09:43,774 --> 00:09:45,235 What is one clinical 257 00:09:45,535 --> 00:09:48,990 trend or perhaps policy shift that you believe 258 00:09:48,990 --> 00:09:51,730 will have the most significant effect on pediatric 259 00:09:51,790 --> 00:09:53,149 care in the next few years? And, you 260 00:09:53,149 --> 00:09:55,790 know, there's a lot happening just at policy 261 00:09:55,790 --> 00:09:58,910 change level. And and how is Children's National 262 00:09:58,910 --> 00:09:59,970 positioning itself 263 00:10:00,350 --> 00:10:01,009 in response? 264 00:10:01,664 --> 00:10:03,845 Yeah. That's a that's a great question. 265 00:10:04,304 --> 00:10:06,945 You know, health care continues to evolve, so 266 00:10:06,945 --> 00:10:09,205 we've gotta learn how to evolve with it 267 00:10:09,345 --> 00:10:11,284 either at the same pace or even faster. 268 00:10:11,345 --> 00:10:14,144 And I think one of the biggest policy 269 00:10:14,144 --> 00:10:17,470 implications for pediatric health systems today is how 270 00:10:17,470 --> 00:10:20,269 do we support families related to vaccines? Right? 271 00:10:20,269 --> 00:10:22,509 There's a lot of discussion about that going 272 00:10:22,509 --> 00:10:24,850 on. This has become a rather controversial 273 00:10:25,149 --> 00:10:27,490 discussion that has to be handled very delicately 274 00:10:28,190 --> 00:10:30,110 while at the same time making sure we 275 00:10:30,110 --> 00:10:32,804 are providing evidence based recommendations to our patients 276 00:10:32,804 --> 00:10:33,784 and our families. 277 00:10:34,485 --> 00:10:35,924 And for me, as much as I want 278 00:10:35,924 --> 00:10:39,384 kids in our hospital, you know, children's, we 279 00:10:39,445 --> 00:10:41,865 we focus on improving access to preventative 280 00:10:42,245 --> 00:10:44,804 care medicine. That's really what where the rubber 281 00:10:44,804 --> 00:10:45,784 meets the road. 282 00:10:46,399 --> 00:10:48,720 There is a tremendous amount of research out 283 00:10:48,720 --> 00:10:51,779 there that that confirms vaccines are safe, 284 00:10:52,639 --> 00:10:55,040 and and that's what we rely on, that 285 00:10:55,040 --> 00:10:56,420 evidence based research. 286 00:10:56,879 --> 00:10:59,200 Recently, I think we've all seen the national 287 00:10:59,200 --> 00:11:01,595 spike in the measles outbreaks, you know, and 288 00:11:01,595 --> 00:11:03,674 this is a disease that we previously thought 289 00:11:03,674 --> 00:11:05,214 had been totally eradicated. 290 00:11:05,995 --> 00:11:06,475 But, 291 00:11:06,955 --> 00:11:09,034 based on recent data, the rate we're going 292 00:11:09,034 --> 00:11:11,355 now, we will have either doubled or maybe 293 00:11:11,355 --> 00:11:12,174 even tripled 294 00:11:12,554 --> 00:11:15,355 the number of measles cases over the year 295 00:11:15,355 --> 00:11:15,855 nationally. 296 00:11:16,930 --> 00:11:19,490 For us here at Children's, we continue to 297 00:11:19,490 --> 00:11:22,050 provide education as we're starting to look at 298 00:11:22,050 --> 00:11:22,790 these trends 299 00:11:23,410 --> 00:11:23,910 nationally, 300 00:11:24,450 --> 00:11:26,690 making sure we have the appropriate policies and 301 00:11:26,690 --> 00:11:27,910 procedures in place. 302 00:11:28,610 --> 00:11:29,350 That includes, 303 00:11:29,705 --> 00:11:33,065 you know, for measles specifically, rapidly identifying kids 304 00:11:33,065 --> 00:11:34,845 who may be experiencing symptoms, 305 00:11:35,784 --> 00:11:38,825 minimizing that exposure as much as possible to 306 00:11:38,825 --> 00:11:40,985 others that may be in the hospital as 307 00:11:40,985 --> 00:11:42,205 as well as our staff 308 00:11:42,659 --> 00:11:44,919 through our, you know, different precaution standards, 309 00:11:45,299 --> 00:11:48,259 and then also providing early treatment. And so, 310 00:11:48,259 --> 00:11:50,259 you know, we are so fortunate to have 311 00:11:50,259 --> 00:11:52,519 a an amazing infection prevention team 312 00:11:52,899 --> 00:11:54,759 that tracks this very closely, 313 00:11:55,299 --> 00:11:57,700 along with with nursing. So we can make 314 00:11:57,700 --> 00:11:59,055 sure we're pivoting, 315 00:11:59,995 --> 00:12:02,315 as needed. So I think at the moment, 316 00:12:02,315 --> 00:12:03,855 that's probably our biggest, 317 00:12:05,115 --> 00:12:06,735 kinda clinical trend, 318 00:12:07,435 --> 00:12:09,215 that we're seeing in pediatric care. 319 00:12:10,250 --> 00:12:11,690 Yeah. And I and I think you raised 320 00:12:11,690 --> 00:12:13,769 just such a relevant point about just having 321 00:12:13,769 --> 00:12:15,950 to shore up policies and and education 322 00:12:16,409 --> 00:12:19,209 around what was once, you know, perhaps an 323 00:12:19,209 --> 00:12:20,889 afterthought or or not something that you had 324 00:12:20,889 --> 00:12:23,549 to think about as much as today with, 325 00:12:23,929 --> 00:12:25,389 the outbreaks that are resurfacing. 326 00:12:26,089 --> 00:12:27,825 And And I think another comment along that 327 00:12:28,065 --> 00:12:30,545 along those lines is, you know, measles is 328 00:12:30,545 --> 00:12:32,884 not something you see every day. Right? And 329 00:12:33,105 --> 00:12:36,144 we have a very young workforce that has 330 00:12:36,144 --> 00:12:37,264 never had to deal with, 331 00:12:39,179 --> 00:12:41,820 this type of of disease process. And so 332 00:12:41,820 --> 00:12:46,139 the education has been imperative, and we've, done 333 00:12:46,139 --> 00:12:48,460 a great job when when there have been 334 00:12:48,460 --> 00:12:51,554 kids that come in that we suspect may 335 00:12:51,554 --> 00:12:54,995 have measles that we we move quickly, right, 336 00:12:54,995 --> 00:12:57,574 because we wanna minimize that exposure. It is 337 00:12:57,634 --> 00:13:00,274 it is a disease that is, very highly 338 00:13:00,274 --> 00:13:02,674 transmittable, and so we have to do our 339 00:13:02,674 --> 00:13:05,190 part to keep our team members safe and 340 00:13:05,190 --> 00:13:07,049 also our other patients and families. 341 00:13:07,590 --> 00:13:08,490 Sure. Sure. 342 00:13:09,029 --> 00:13:10,950 Cece, I wanted to ask you as well 343 00:13:10,950 --> 00:13:14,470 just about nurse residency programs. Obviously, those have 344 00:13:14,470 --> 00:13:17,769 become really a cornerstone of early career retention 345 00:13:18,524 --> 00:13:20,044 And one of the things I've been hearing 346 00:13:20,044 --> 00:13:20,944 lately is 347 00:13:21,324 --> 00:13:23,884 some nursing leaders talking about how their hospitals 348 00:13:23,884 --> 00:13:26,524 and systems are revisiting or updating them to 349 00:13:26,524 --> 00:13:29,725 reflect just the realities of today's new graduates 350 00:13:29,725 --> 00:13:31,404 because I know a lot of those programs 351 00:13:31,404 --> 00:13:32,144 were initially, 352 00:13:33,200 --> 00:13:35,600 expanded or shored up during the COVID pandemic. 353 00:13:35,600 --> 00:13:36,100 So 354 00:13:36,480 --> 00:13:39,360 how is Children's National thinking about evolving its 355 00:13:39,360 --> 00:13:41,680 residency program, and maybe what do you think 356 00:13:41,680 --> 00:13:43,540 a strong program actually needs 357 00:13:44,000 --> 00:13:46,240 to get right today that not might have 358 00:13:46,240 --> 00:13:48,804 been a priority a few years ago? Right. 359 00:13:48,945 --> 00:13:51,445 Great great question. You know, within our nursing 360 00:13:51,664 --> 00:13:52,164 residency, 361 00:13:53,264 --> 00:13:55,924 we developed a program called transition to practice. 362 00:13:55,985 --> 00:13:57,445 So it's it's incorporated 363 00:13:57,904 --> 00:13:59,125 into their residency 364 00:13:59,584 --> 00:14:00,084 experience. 365 00:14:01,490 --> 00:14:03,649 And, basically, there's about four different pillars in 366 00:14:03,649 --> 00:14:04,389 that program, 367 00:14:05,089 --> 00:14:07,649 because our goal is really not to just 368 00:14:07,649 --> 00:14:08,549 focus on 369 00:14:08,929 --> 00:14:11,269 clinical competency, which obviously 370 00:14:11,809 --> 00:14:14,690 is the foundational and the primary pillar. We 371 00:14:14,690 --> 00:14:17,110 want people to have those technical skills, 372 00:14:17,465 --> 00:14:20,024 but there's so many other things that a 373 00:14:20,024 --> 00:14:21,705 new nurse has to, 374 00:14:22,024 --> 00:14:22,524 master, 375 00:14:23,625 --> 00:14:25,945 over time. But how do we create a 376 00:14:25,945 --> 00:14:26,445 program 377 00:14:27,144 --> 00:14:30,279 that helps them with those steps, you know, 378 00:14:30,279 --> 00:14:32,440 each of those steps along the way. And 379 00:14:32,440 --> 00:14:34,220 so one of the things that we identified, 380 00:14:35,000 --> 00:14:37,019 that's another pillar, is instilling, 381 00:14:37,399 --> 00:14:37,899 confidence 382 00:14:39,160 --> 00:14:41,899 in their comfort level within their own practice. 383 00:14:42,040 --> 00:14:43,800 And so it's one thing for us to 384 00:14:43,800 --> 00:14:45,365 teach you a technical skill, 385 00:14:45,665 --> 00:14:47,044 how to administer medications, 386 00:14:47,825 --> 00:14:49,345 how to do this, or how to do 387 00:14:49,345 --> 00:14:50,245 that. But 388 00:14:51,184 --> 00:14:52,544 at some point, we need to help them 389 00:14:52,544 --> 00:14:54,865 with their level of confidence, especially if they're 390 00:14:54,865 --> 00:14:55,365 new, 391 00:14:55,665 --> 00:14:57,365 activities that they're learning. 392 00:14:57,904 --> 00:15:00,649 You know, pediatric care can can be very 393 00:15:00,649 --> 00:15:03,309 complex in that we take care of patients 394 00:15:03,529 --> 00:15:04,669 from age zero 395 00:15:05,129 --> 00:15:08,169 even up to beyond, you know, their younger 396 00:15:08,169 --> 00:15:10,110 twenties, and so that takes 397 00:15:10,490 --> 00:15:11,549 time to develop 398 00:15:12,345 --> 00:15:15,144 those skill sets, but also that comfort level. 399 00:15:15,144 --> 00:15:17,625 So we have, part of our one of 400 00:15:17,625 --> 00:15:20,424 our pillars is really focused on how do 401 00:15:20,424 --> 00:15:21,804 we grow their confidence. 402 00:15:22,745 --> 00:15:25,725 A third kind of pillar really focuses on 403 00:15:26,509 --> 00:15:28,589 how to help them cultivate a 404 00:15:29,309 --> 00:15:30,529 their own robust 405 00:15:30,909 --> 00:15:31,409 professional 406 00:15:31,789 --> 00:15:32,289 identity. 407 00:15:33,309 --> 00:15:35,230 Again, being a new nurse, it could be 408 00:15:35,230 --> 00:15:38,509 very scary, especially in pediatrics where there's so 409 00:15:38,509 --> 00:15:40,429 much to learn. You're learning not just how 410 00:15:40,429 --> 00:15:42,289 to be a nurse, but you're also learning 411 00:15:42,565 --> 00:15:44,745 how to be a professional, how to interact, 412 00:15:45,205 --> 00:15:47,685 you know, with your patients and families, how 413 00:15:47,685 --> 00:15:48,825 to represent nursing, 414 00:15:50,085 --> 00:15:51,545 within the other disciplines, 415 00:15:52,325 --> 00:15:53,415 and then creating your own high standard of 416 00:15:53,415 --> 00:15:54,185 professionalism. Like, what is your 417 00:15:55,440 --> 00:15:58,000 professionalism. Like, what is your North Star? What 418 00:15:58,000 --> 00:15:59,139 what drives you? 419 00:15:59,600 --> 00:16:00,980 How do we make 420 00:16:01,279 --> 00:16:04,100 sure we, maintain a high level of integrity 421 00:16:04,799 --> 00:16:06,879 in how we deliver care? And that's where 422 00:16:06,879 --> 00:16:08,340 it comes down to the, 423 00:16:09,325 --> 00:16:10,384 having a high reliable 424 00:16:10,764 --> 00:16:11,264 organization. 425 00:16:11,644 --> 00:16:12,865 We want our 426 00:16:13,245 --> 00:16:16,845 nurse residents, even as novice nurses, to feel 427 00:16:16,845 --> 00:16:18,705 comfortable with speaking up. 428 00:16:19,804 --> 00:16:21,245 So if they see something, we want them 429 00:16:21,245 --> 00:16:23,860 to say something. Right? And so that takes 430 00:16:23,860 --> 00:16:25,779 time and courage to do that as well. 431 00:16:25,779 --> 00:16:28,179 So that is something that we do focus 432 00:16:28,179 --> 00:16:28,679 on. 433 00:16:29,059 --> 00:16:31,620 And, you know, basically, our fourth pillar just 434 00:16:31,620 --> 00:16:33,799 kinda moves us into that growth and retention 435 00:16:34,100 --> 00:16:35,879 by, helping establish, 436 00:16:36,485 --> 00:16:39,205 like, a clear pathway for career advancement when 437 00:16:39,205 --> 00:16:39,865 they're ready. 438 00:16:40,245 --> 00:16:42,665 And, again, going back to their ongoing, 439 00:16:43,285 --> 00:16:46,565 professional growth because, you know, day one, yes, 440 00:16:46,565 --> 00:16:48,665 we wanna make sure that you 441 00:16:49,285 --> 00:16:50,024 are proficient, 442 00:16:51,059 --> 00:16:52,980 but we know that we also wanna invest 443 00:16:52,980 --> 00:16:54,679 in your future. And so, 444 00:16:55,379 --> 00:16:57,540 we don't wait until they, you know, are 445 00:16:57,540 --> 00:16:59,220 out of the program to talk about what 446 00:16:59,220 --> 00:17:00,740 does your career what do you really wanna 447 00:17:00,740 --> 00:17:02,820 be when you grow up, and let's figure 448 00:17:02,820 --> 00:17:04,440 out how to help you get there. 449 00:17:05,045 --> 00:17:07,605 So having those conversations at the beginning, I 450 00:17:07,605 --> 00:17:09,765 think, has helped us go a long way. 451 00:17:09,924 --> 00:17:11,684 We've seen a lot of great success in 452 00:17:11,684 --> 00:17:12,184 providing 453 00:17:12,724 --> 00:17:14,345 a more comprehensive residency, 454 00:17:15,045 --> 00:17:15,545 program 455 00:17:16,164 --> 00:17:17,545 that also includes mentorship. 456 00:17:17,940 --> 00:17:20,419 You know, we encourage research from the very, 457 00:17:20,419 --> 00:17:21,159 very beginning, 458 00:17:21,619 --> 00:17:22,919 and then a healthy participation 459 00:17:23,460 --> 00:17:26,179 in our, shared governance model so that our 460 00:17:26,179 --> 00:17:29,139 residents know that you have a voice too. 461 00:17:29,139 --> 00:17:31,555 Right? Whether you've been doing this for two 462 00:17:31,555 --> 00:17:33,815 months or twenty years, 463 00:17:34,355 --> 00:17:36,434 what you have to say is important, and 464 00:17:36,434 --> 00:17:38,515 and this is how this is the platform 465 00:17:38,515 --> 00:17:40,434 in in which you can use that voice. 466 00:17:40,434 --> 00:17:40,934 So, 467 00:17:41,795 --> 00:17:44,295 we shifted a little bit by surrounding, 468 00:17:45,394 --> 00:17:45,894 our 469 00:17:46,589 --> 00:17:47,490 clinical competency 470 00:17:47,950 --> 00:17:49,569 with some of these other programs. 471 00:17:50,990 --> 00:17:53,069 Yeah. Cece, it's it's interesting. And and I 472 00:17:53,069 --> 00:17:55,390 know heard just a lot about that just 473 00:17:55,390 --> 00:17:56,609 in terms of the intentionality 474 00:17:56,910 --> 00:17:59,710 now about putting structures and resources in place 475 00:17:59,710 --> 00:18:02,765 to really help ease that transition to practice 476 00:18:02,825 --> 00:18:04,984 and and build toward that confidence, which is 477 00:18:04,984 --> 00:18:05,644 so important. 478 00:18:06,184 --> 00:18:08,924 Mhmm. Well, lastly, before we wrap up here, 479 00:18:09,144 --> 00:18:11,464 what is one thing the broader health care 480 00:18:11,464 --> 00:18:11,964 system 481 00:18:12,265 --> 00:18:14,044 still maybe gets wrong or underestimates 482 00:18:14,345 --> 00:18:16,125 about pediatric care today? 483 00:18:17,079 --> 00:18:19,259 Wow. That's a that's a really loaded question. 484 00:18:20,440 --> 00:18:21,179 You know, 485 00:18:22,359 --> 00:18:25,480 our hashtag is kids are are everything, are 486 00:18:25,480 --> 00:18:28,220 are everything. And and that holds true 487 00:18:28,839 --> 00:18:29,339 because 488 00:18:30,554 --> 00:18:31,054 saving 489 00:18:31,674 --> 00:18:32,174 kids 490 00:18:32,714 --> 00:18:34,174 and delivering great 491 00:18:35,034 --> 00:18:35,534 pediatric 492 00:18:36,154 --> 00:18:36,654 care, 493 00:18:37,194 --> 00:18:38,575 you impact generations. 494 00:18:40,075 --> 00:18:40,894 And so 495 00:18:42,569 --> 00:18:43,710 I think sometimes, 496 00:18:45,609 --> 00:18:48,650 our adult colleagues may not truly understand that 497 00:18:48,650 --> 00:18:49,950 that, you know, pediatric 498 00:18:50,250 --> 00:18:51,069 health care 499 00:18:51,369 --> 00:18:52,190 is foundational 500 00:18:53,369 --> 00:18:53,869 to 501 00:18:54,454 --> 00:18:57,195 what adult health care is gonna look like, 502 00:18:57,335 --> 00:18:59,835 you know, one, two, three decades 503 00:19:00,454 --> 00:19:01,275 from now. 504 00:19:01,974 --> 00:19:04,075 And, you know, the work we do 505 00:19:04,454 --> 00:19:06,714 is innovative. Like, I think pediatric 506 00:19:07,015 --> 00:19:07,835 care, especially 507 00:19:08,295 --> 00:19:09,355 myself having 508 00:19:10,009 --> 00:19:11,789 previous adult experience, 509 00:19:12,970 --> 00:19:14,409 we tend to be a little bit more 510 00:19:14,409 --> 00:19:14,909 innovative. 511 00:19:15,450 --> 00:19:17,929 There's a lot of research that that happens 512 00:19:17,929 --> 00:19:19,789 in the pediatric health care space 513 00:19:20,490 --> 00:19:21,950 that is life changing. 514 00:19:22,329 --> 00:19:24,029 And so, you know, having 515 00:19:24,484 --> 00:19:25,384 a full appreciation 516 00:19:25,684 --> 00:19:27,465 for that, I think, is very important. 517 00:19:28,404 --> 00:19:30,505 Also, making sure we have 518 00:19:31,045 --> 00:19:31,785 the appropriate 519 00:19:32,085 --> 00:19:34,184 resources from a funding perspective 520 00:19:34,724 --> 00:19:36,404 to be able to take care of these 521 00:19:36,404 --> 00:19:38,404 kids to the best of our ability, but 522 00:19:38,404 --> 00:19:39,625 also invest 523 00:19:39,950 --> 00:19:42,349 in some of those innovative ways to deliver 524 00:19:42,349 --> 00:19:42,849 care. 525 00:19:43,309 --> 00:19:44,049 And so, 526 00:19:44,829 --> 00:19:45,490 you know, 527 00:19:46,109 --> 00:19:48,750 being in the pediatric health care business, you 528 00:19:48,750 --> 00:19:50,450 know, you're not in it to make money. 529 00:19:50,589 --> 00:19:51,089 Right? 530 00:19:51,710 --> 00:19:52,529 Most of 531 00:19:53,195 --> 00:19:55,195 most of our kids are on some type 532 00:19:55,195 --> 00:19:56,015 of governmental 533 00:19:57,035 --> 00:19:58,414 subsidy or funding 534 00:19:58,795 --> 00:20:01,275 that, you know, doesn't always cover the cost 535 00:20:01,275 --> 00:20:03,275 of their health care, but it's important to 536 00:20:03,275 --> 00:20:04,494 what we do. It's something 537 00:20:04,954 --> 00:20:07,295 that needs to be done. And so 538 00:20:08,289 --> 00:20:10,390 I think continuing to invest 539 00:20:11,809 --> 00:20:13,589 in research and education 540 00:20:14,049 --> 00:20:14,549 surrounding 541 00:20:14,930 --> 00:20:16,470 pediatric health care 542 00:20:16,849 --> 00:20:17,589 will have 543 00:20:18,369 --> 00:20:20,549 great positive ripple effects 544 00:20:21,205 --> 00:20:23,125 in the future. Because if you could save 545 00:20:23,125 --> 00:20:24,265 that one child 546 00:20:24,725 --> 00:20:25,845 or or or, 547 00:20:26,644 --> 00:20:29,865 cure that one disease, you're you basically are 548 00:20:30,644 --> 00:20:32,025 are impacting generations 549 00:20:33,045 --> 00:20:35,545 to come, but it starts with that pediatric 550 00:20:36,340 --> 00:20:36,840 care. 551 00:20:37,779 --> 00:20:40,420 Yeah. Some great closing thoughts there. Cece, so 552 00:20:40,420 --> 00:20:42,840 wonderful to have you on today. Thank you. 553 00:20:43,059 --> 00:20:43,720 Thank you. 554 00:20:44,180 --> 00:20:47,059 Yeah. Absolutely. We look forward to continue following 555 00:20:47,059 --> 00:20:49,827 the work that Children's National is leading to 556 00:20:49,827 --> 00:20:51,907 enhance pediatric care and and and build the 557 00:20:51,907 --> 00:20:53,127 workforce of the future. 558 00:20:53,827 --> 00:20:55,287 Thank you. Appreciate it.