Welcome to the Becker's Healthcare Podcast. I'm Chris
Sosa, the copy chief here at Becker's, and
I'm thrilled to be joined by Denise Harmon,
director of medical surgical pediatrics at Olympic Medical
Center in Washington.
Denise, thank you for joining us today.
You're welcome.
Denise, for those in the audience who are
maybe not familiar with you and the work
you've done, would you mind introducing yourself and
telling us a bit about your background?
Sure.
As you mentioned, I am the director of
the medical surgical pediatrics department here at Olympic
Medical Center.
We are a small rural community hospital
serving
the very, very far Northwest of Washington state.
My background is mostly
med surg.
I have had this position. It'll be three
years in April 0. Before that, I worked
as a bedside nurse in this department.
I've done a variety of things, some pediatric
home health,
long term care, some clinic work.
But I
love the the med surg department, so I
like the
the pace and the exposure to different things.
Our house, as I mentioned, our hospital is
a rural hospital.
My department happens to be the largest 1,
for what it's worth. It it has 40
beds, so that gives you an idea of
of what our hospital looks like
as a whole.
Yeah. I think that kinda covers my background.
It's pretty straightforward.
Well, terrific, Denise. If you wouldn't mind for
our audience, could you lay out some of
the top priorities today from the the angle,
the example that that you push forward?
Your background, that is, is from a rural
community hospital.
So our our top priorities
are making sure that our hospital
stays up to date with the with the
latest and greatest,
being that we are kind of remote ish.
It it does take a little bit of
time for kind of the newer stuff to
to hit
our our hospital.
1 of the unique things about our department
in particular, it we do have pediatric patients,
but we, also take care of adults. So
it's kind of a combination
adult medical surgical pediatrics.
So that means that our our nursing staff
has to be able to care for that
very, very diverse
population.
So our our main priorities are making sure
their education is up to date, making sure
that they
know what is going on in the world
of peds,
as the majority of our patients are not
peds.
So
that is
I am in constant contact with our local
pediatric clinic who has a relationship with some,
pediatric hospitals in the Seattle area.
They do a really good job of making
sure that we are, you know, updated on
any changes in processes
or, hey, you know, now we're treating this
condition differently. This is what we're doing now.
And
our main priority is making sure that our
nursing staff is familiar with those changes and
comfortable
with those changes so that they can provide
the care that our patients need.
Thank you for laying all that out for
our audience,
Denise. Speaking of changes,
looking at the next eighteen months or so,
how do you anticipate your role is gonna
change and the role of your team?
So,
I
am not sure how my role is going
to change. I know that we,
are
coming out of the post COVID,
slump, as I like to call it. We
had a huge amount of turnover.
You know, our organization as a whole is
kind of bouncing back from from that where
we were just kind of rolling minute by
minute, figuring things out. Now we've got time
to breathe and we're
we're refocusing.
So my role is
will remain the same. But I know that
it's going to shift into a different direction
with different responsibilities
as as things arise.
As far as my my team goes,
we had a large turnover of more experienced
nurses, so our team is relatively young. We
also
are finally coming out of the,
heavy
traveler
nurse,
population. We had quite a few open positions,
that we had filled with travelers and now
we are getting
nurses in. Some of those are fresh graduates,
some of them are experienced nurses from other
other areas. So
as we build our team back up to
permanent staff,
there are a lot of changes that come
with that. So we have to build a
lot more familiarity with our pediatric population.
How how we do things because they're they're,
you know, during COVID, I think people just
kind of
did the best they could with what they
had at the moment. And so there was
a lot of,
spur of the moment
decisions like, hey, this is what we're going
to do right now.
Not a lot of time to really
think through and develop a solid processes.
So we are working on
improving our pediatric
orientation and education
process for our nursing staff. So that is
more clear, more in line of what the
other facilities in our area are doing, where
we know that if we end up having
to transfer a pediatric patient out, that our
care is gonna line up with what their
next step in care will be at those
higher acuity facilities.
Making sure that our staff is comfortable
caring for pediatric patients. You know, we have
we have
brand new nurses out of nursing school who
are in their early twenties, no experience with
children
in any way, shape, or form. They tend
to get that deer in the headlights look
and
panic when you say, hey, here's a kid.
Let's, orient and train with them today. So,
getting them more familiar with that population.
We have been working really hard on building
better relationships with our pediatricians.
We have a great team
of pediatricians here that are
very good at making sure that
our staff knows what the plan is,
knows that they're a resource at any time
they can reach out. So
over the next eighteen months, we're gonna focus
on that education and building up those stronger
relationships and getting those policies and processes solidified
so that our staff is comfortable, and we
know that we are providing the best possible
care to our patients while they're here.
Chase, I'm glad you mentioned, the younger nurses
and the amount of turnover you had. Certainly,
your organization is not the only 1. But
I'm curious as to
what you find are the most important resources
when you have a younger crop of, nurses
and other staff coming in.
So our our most important resources
are
our more experienced staff.
They they do a great job while we
have less than we had before.
They do a great job of kind of
calming that panic down. You know, you're you're
a new nurse. You feel like you don't
know anything. Everything is,
you know, appears to be
a huge deal when in fact it isn't.
So we utilize a lot from our experienced
nurses. They're they're great, kind of keeping people
in check and helping people out.
We have our education department has actually,
in the past few years, started a residency
program and it has
progressed over the years. It's it's a year
long program for them. The residents, they meet
weekly with their cohort.
They get to bounce ideas off of each
other. They get to work together with all
of the residents in the different departments to
kind of give each other
a bigger view of the of the hospital
as a whole and what everyone's different roles
look like. So there's that good
interdepartmental
communication.
Whereas, you know, we're not kind of siloed
out together. You know, med surg does their
thing.
The ED does their thing. ICU tele does
their thing. So we have really
worked to build those relationships between departments so
that we all get a better idea of
what's going on. So, you know, people are
a little bit more,
you know, we're we're giving each other a
lot more grace. And those those things, the,
more experienced nurses and the the continued education,
the residency program
have really really helped our new grads feel
more comfortable.
They're
you know more comfortable asking questions that they're
they
have really really
done
particularly
well.
We've noticed a significant improvement
in their ability to to,
you know, kind of flex on the fly
and handle things as they come up over
the past couple of years as they as
the Education Department has tweaked that residency program,
it has been a big help,
in getting those new nurses,
you know, comfortable and and ready to go.
Well, it certainly sounds like they're benefiting from
all the communication and infrastructure that you have
out at your organization.
Denise, the next and last question I would
ask, it's a 2 part question.
And 1 is, you know, what's getting you
really excited right now, I should say, about
the health care industry in general, and what
is making you a little nervous?
I think that what I'm what I'm most
excited about is
that
there's really
an a lot of collaboration
between organizations,
and I'm sure that it's not just specific
to to our hospital. I'm I'm I have,
you know, read white papers and done some
research and it and it seems as if
hospital
systems are communicating
better with each other
and kind of providing
tips and resources,
because we all essentially have the same issues
going on. And,
being able to reach out to to another
facility and and ask them, hey. How did
you handle this?
You know, what worked for you? What didn't?
That that collaboration,
is really,
really exciting to me. Particularly, I've been in
this role.
It'll be three years in April 0. So
I'm I'm wouldn't say I'm, like, you know,
know all the
things. So being able to have that collaborative
relationship with other organizations, I know I can
reach out to other hospitals in the Seattle
area or other places in Washington and kind
of say, hey, you know, your
your facility looks about like ours. What are
you doing to help solve this problem? And
it it really helps.
First of all, it helps reassure, you know,
me that, hey, it's not just us.
And it helps provide better continuity of care
for our patients. If, you know, we're all
kind of on the same page, we're all
working things out. We don't have to start
from scratch developing some kind of process if
someone else has kind of,
you know, worked through that and, you know,
lets us know what their hiccups were. It
is a real big turn, I think, for
health care,
which it benefits everyone.
Along the lines of what makes me nervous,
as I mentioned previously, we have adult and
pediatric patients.
We
don't have a lot of pediatric patients, and
the majority of our pediatric patients are, respiratory
patients. So we get them during, you know,
the flu season with RSV and that sort
of thing. We are seeing more kind of
post surgical
patients, you know, here for appendectomies
or, you know, a cellulitis patient.
But what makes me the most nervous is
the amount of time that it does take
to orient and train our nurses just based
on the low number of of pediatric patients.
Even a lot of our more experienced pediatric
nurses
are kind of like, hey, you know, it's
been a long time since we've had a
peds patient, you know, because maybe they didn't
work the week that the the patient was
here. And so
what makes me the most nervous is making
sure that that
my nursing staff
stays comfortable.
They keep their skills up, which
I working on that with our pediatricians,
you know, hey, what can we do? What
other resources do you offer,
in the kind of downtime between
pediatric patients?
But that is kind of where
the the nervousness comes in for for me
in our organization.
Denise, you have been incredibly generous with your
time and your insights today, and I want
to thank you for that. We absolutely cannot
wait to share them with everyone in our
audience, and we look forward to connecting with
you again soon.
Great. It was a good time. Thanks so
much for the opportunity.