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This is Chris Sosa with the
Becker's Healthcare Podcast.

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I'm thrilled today to be
joined by Rhonda Thompson,

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chief Nursing Officer and senior Vice
President of Patient Care Services for

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Phoenix Children's Hospital. Rhonda,
thank you for joining us today.

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Thank you for having me,
Chris. I appreciate it.

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Excellent.

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Could you please introduce yourself and
tell us a bit about your background?

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Certainly, yes. Uh, this,
I'm Rhonda Thompson. I, uh,

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joined Phoenix Children's
in the summer of 2021,

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and I proudly serve as their chief nursing
officer and senior vice president of

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patient care services. And
basically, in a nutshell,

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that means that I'm responsible
for developing and advocating, uh,

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the organization's more
than 1400 nurses, um,

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but growing every day with the number
of nurses based on our growth, um,

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and collaborating with
our physician leaders, um,

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and everyone across the organization to
drive continuous improvement in clinical

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services and patient outcomes. Um,
I'm excited to be here with you today.

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Ronald.

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What would you say are your top
priorities in redefining nurse culture at

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Phoenix Children's?

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Um, well, you know, I think it's,
it's really what I've learned, um,

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especially after the
pandemic and, you know,

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some of the nursing students and
new nurses not having as many,

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uh, clinical opportunities
in an organization.

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And what I've learned from that experience
is helping them develop their softer

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skills in nursing. And what
I mean by that is, you know,

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how do I cope with what I'm gonna
see, what I'm going to hear,

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how I'm gonna feel? Um, you know,

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we have not only did did the pandemic
influence newer nurses and newly licensed

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nurses, but social media obviously has
an influence as well. And I, you know,

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I kind of coined this term at, when I
was talking to a nurse about, you know,

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swiping is not an option in
nursing. Um, you know, we,

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we've developed this kind of unique, um,

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skill of swiping past something on social
media if it's not something that we

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want to, to read or see or hear. And
we don't have that option in nursing.

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And so what does it take for, um,

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folks to be able to
walk into any room, um,

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and care for the patient and families
they might see, um, and, and, you know,

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deal with, and, you know, what,
what does that mean for them, um,

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and their coping skills? So, you know,
that's probably certainly a priority,

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you know, understanding, um,
you know, externally what they,

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what they've experienced, whether they
were in school during the pandemic, um,

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or shortly afterwards, uh, and what they
may need to be successful is important.

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So we do spend a lot of time with our
newly licensed nurses and their preceptors

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and our educators understanding where
they are, um, you know, for themselves,

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where they are and what,

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what they might need to help support
them in becoming a successful nurse.

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And then like every other CNO across
the country, you know, recruiting,

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um, onboarding, um, retaining, uh, our,

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our skilled and our intellectual
capital is important.

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Um, but what does that mean? It looks
a lot different than it does now. Um,

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you know, especially when I think about
the, the time that I spent at the,

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at the bedside and what was
important to me. So, you know,

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I think it's evolving. The, the, the, one
of the priorities is how do we evolve,

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um, with the, the newer nurses? What are,

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what are their needs? And those
are things like, you know, they,

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they are not accustomed necessarily
to, to working 12 hour shifts. Um, and,

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you know, I started
nursing, it was eight hours,

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and I remember the transition to 12, and
I thought it was the end of the world.

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Um, but now, you know, 12 hours is, is
not exactly an ideal shift for everyone.

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So we're looking at, you know, whether
we can do four hours, six hours,

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eight hours, any kind of
combination of shifts. Um,

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and that does mean a lot
more part-time or PRN staff,

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but what it means is that they're
engaged and they're, you know,

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fulfilled with their work schedule, uh,
which means that our patients, um, are,

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are better cared for. So, you know,

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I think those are probably
some of my top priorities.

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Besides offering nurses flexibility.

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What do you find is key
to retaining nurses?

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You know, there's no magic pill,
otherwise, I'd probably be a millionaire,

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Chris, if I had the answer to all to, to
that question. I think it's providing,

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um, you know, a safe culture.
I, I, I think, again, as,

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as you know, communities have
changed. Um, it wellness is important,

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and so them feeling safe, them feeling
like they have a voice, um, you know,

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so I often, um, you know,

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I'm on the floors talking with the
nursing staff to make sure they feel like

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they have a voice. We have a very
robust shared governance structure,

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so the nurses have an opportunity to
be a part of our shared governance. Um,

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so those are, those are important
retention. Um, and then, you know,

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just listening, I think
that's key. Uh, you know,

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I talk a little bit about going up to
the units and, and rounding with them,

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but it's, it's listening in every
different capacity, whether that's on, um,

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you know, a virtual meeting or I've,
I've been asked to host different, um,

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open forums for different
staff. So, you know,

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I think it's listening and being
honest with, I don't have all the,

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all the solutions, but I want to
hear, um, how they're feeling,

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what they're thinking, and,

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and potentially hear some of
their innovative ways to, um,

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to create a, a better culture
so that we retain great staff.

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You mentioned the pandemic.
Given the wave of rsv,

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RSV and other illnesses we've
seen over the past winter, uh,

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how do you think the nursing staff
has been affected by that as well?

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Yeah, I mean, I think the
pandemic in general, what we saw,

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and this really relates to retention,
is like everyone else, um, you know,

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the pandemic forced many of us to
just reprioritize our lives. You know,

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we were, we potentially were isolated
from family and friends. Um, and,

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you know, once those things started
lifting the, the isolation requirements,

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people started asking themselves, you
know, do, is this where I really wanna be?

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Is this what I want to be doing?
Um, so I think it's, you know,

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I I think people reprioritized
the same thing with, you know,

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rsv and we're seeing, you know, as, as
we have a younger generation of, uh,

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of caregivers and providers
within the organization,

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many of them having young
children, you know, the,

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the fear of carrying something
home with them. And so, you know,

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ensuring that they feel safe in this
environment, they have the PPE they need,

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um, but also, you know, just being,
um, empathetic to where they are. And,

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you know, I think we've had, uh,

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my leadership team and I have had a lot
of conversation about what do they need?

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And, you know, I, my motto has
been, how do we open more doors?

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And sometimes that means they
need a break and, you know,

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they need a personal leave.
And, and we see that a lot with,

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especially newer moms. Um, you know, they,

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it's one thing to take care of someone
else's sick child, but, you know,

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potentially taking care of your own
is, is a different story. So I think,

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you know, in a nutshell, it's just
reprioritizing what, what matters, uh,

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to folks right now in,
in the moment. Um, and,

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and us being just understanding and
allowing some flexibility with that.

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I think you've touched a
little bit on this already,

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but given all the feedback that you've
been taking in and all the introspection

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and all the other data
you've been accumulating,

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how do you anticipate your role is
going to change in the next 18 months?

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Um, well, I think not just with the, the
growth of Phoenix Children's. I mean,

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in the next 18 months, we'll
have opened, um, at least two,

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if not three new facilities. Um,
so, you know, my role is expanding,

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um, which, which makes it even more
important than I'm listening and,

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and out with, uh, the staff in each
of these facilities. Um, you know,

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maybe a little bit of imposs
impossibility there, but, um,

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I'm gonna be optimistic that, that I can,

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and I think the other thing that's really,

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we all have to be cognitive of is
technology is changing in healthcare.

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And so, you know, my role
looks much different, um,

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today than it did even five years ago
with the use of technology and how,

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um, you know, I help support staff in,

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in the use of technology within their
day-to-day work. Um, so I think,

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you know, those are the two areas.
Um, and then I think from a,

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from a staff perspective, what's
gonna happen is, again, going back to,

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you know, how do we get, um,

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creative with recruitment and
retention and onboarding. Um, we've,

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we've looked at several
different models. We've, um,

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reinvented our nurse
residency program. Um,

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we've expanded it from
a year to 18 months.

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Now that doesn't mean
orientation is expanded,

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but what it means is the
ongoing support for those new,

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new nurse residents will,
will go on for 18 months. Um,

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and that goes back to the softer skills
I was talking about in coping. You know,

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this gives them an opportunity to
continue to meet with their cohort of,

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of new nurses and talk about what's
impacting them on a day-to-day basis.

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Um, you know, we're, we're,
we're also looking at, um,

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our preceptor program and how that
might be impacting new hires. Uh,

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again, we, we have seen through, um,

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the turnover that we're asking younger
and younger and less experienced nurses

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to precept. And so my concern is we're
all, I mean, that's where we are.

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That's the reality of our world, but
how do we support them through that?

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So we're looking at the preceptor program
and will implement a new preceptor,

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um, orientation structure that
will be part of the nurse resident.

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So in their first six months,

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they're gonna learn some kind of
fundamentals of becoming a preceptor, um,

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and basic things, giving feedback,
you know, um, how to mentor, uh,

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a new student, et cetera. But,
you know, it's really, again,

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kind of going back to where
they are and, and where we are,

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and we've gotta figure out how
to get to them or at least, um,

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a compromise so that we
can help support them.

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You mentioned so many things that seem
to be definitely working for Phoenix

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Children's. How do you think other
health systems can implement these,

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and how much communication have you
had with people in your position?

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Well, I'm part of a phenomenal group, um,

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through the Children's Hospital
Association and the CNO forums. Um,

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we just actually met last week,
um, and there were 25 of us,

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uh, in a room at, at tables,

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and these are the exact things
that we're all talking about. Um,

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and then I got an email, uh,
just the end of last week,

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so even before the conference was over,

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asking for some details around the
preceptor program and how we're,

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um, you know, how we're building
that into our nurse residency.

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So we have a lot of discussion. Um, you
know, we have a LISTSERV through chha.

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Um, so I'm constantly in contact
with other CNOs about best practices,

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what's working for them. Um, you know,

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I think that the unique thing about
Phoenix Children's is, you know,

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there's not a lot of other children's
hospitals that are growing at the pace we

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are. Um, so that, you know, has
its whole, a whole other bucket of,

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of challenges around, you know, um,

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employing enough nursing
staff and support staff to,

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to build two new facilities.
Um, but it's just, you know,

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it's a great networking opportunity and
we really do learn from each other. Uh,

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you know, I think our, our clinical
nurse attending program, um,

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has been really well
received by other CNOs, uh,

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and I've had many folks reaching out
about that program, so, well, you know,

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I think there's a great support
system, thank goodness. Within,

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within the CNO group as well.

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Uh,

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you spoke about technology and other
changes that are certainly going to

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be, uh, part of your evolution. Uh,

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what other issue do you think deserves
to be talked about more in your field?

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Um, you know, for sure. Yeah, I, I mean,

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I can't say enough about technology and,
and how we're using that. Um, I think,

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you know, advocacy and community
health, um, and, and this is one thing,

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you know, I can tell you from 30 years
ago, uh, graduating nursing school, I,

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I had no idea what it meant to be a true
advocate for a patient. I, you know,

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I knew what it meant to care
for a patient and family, um,

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but I didn't really understand
the role of advo advocacy.

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And I think that's gonna be,
um, really important. Um,

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especially now with, you know, um,

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many things around
healthcare being politicized.

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It's gonna be important for
nurses and all providers, um,

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especially, you know, nurses
and physicians to be able to,

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to advocate and,

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and speak to our government relations
folks around what the needs are of

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patients, um, because it's
not just happening in these
four walls. And I, I, I,

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I talk about that all the time, that
the care we provide, um, you know,

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certainly is important
within these four walls,

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but it's even more important that we're
providing, um, the right resources,

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education, and care for our families
outside the four walls so that, you know,

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they, when they get home,
they don't have a nurse. Um,

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and so we need to be able to, to
help them care for themselves.

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And a lot of things around advocacy
and legislator legislation, um,

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you know, either help support
that or may not help support that.

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So it's important that, uh,
we all have a voice in that.

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Yes,

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and certainly advocating for patience
is the first priority that you have and

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any health system would have. Rhonda,

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thank you so much for your
time today and your expertise.

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Well, thank you, Chris. I
appreciate you having me.