This is Chris Sosa with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Rhonda Thompson,
chief Nursing Officer and senior Vice President of Patient Care Services for
Phoenix Children's Hospital. Rhonda, thank you for joining us today.
Thank you for having me, Chris. I appreciate it.
Excellent.
Could you please introduce yourself and tell us a bit about your background?
Certainly, yes. Uh, this, I'm Rhonda Thompson. I, uh,
joined Phoenix Children's in the summer of 2021,
and I proudly serve as their chief nursing officer and senior vice president of
patient care services. And basically, in a nutshell,
that means that I'm responsible for developing and advocating, uh,
the organization's more than 1400 nurses, um,
but growing every day with the number of nurses based on our growth, um,
and collaborating with our physician leaders, um,
and everyone across the organization to drive continuous improvement in clinical
services and patient outcomes. Um, I'm excited to be here with you today.
Ronald.
What would you say are your top priorities in redefining nurse culture at
Phoenix Children's?
Um, well, you know, I think it's, it's really what I've learned, um,
especially after the pandemic and, you know,
some of the nursing students and new nurses not having as many,
uh, clinical opportunities in an organization.
And what I've learned from that experience is helping them develop their softer
skills in nursing. And what I mean by that is, you know,
how do I cope with what I'm gonna see, what I'm going to hear,
how I'm gonna feel? Um, you know,
we have not only did did the pandemic influence newer nurses and newly licensed
nurses, but social media obviously has an influence as well. And I, you know,
I kind of coined this term at, when I was talking to a nurse about, you know,
swiping is not an option in nursing. Um, you know, we,
we've developed this kind of unique, um,
skill of swiping past something on social media if it's not something that we
want to, to read or see or hear. And we don't have that option in nursing.
And so what does it take for, um,
folks to be able to walk into any room, um,
and care for the patient and families they might see, um, and, and, you know,
deal with, and, you know, what, what does that mean for them, um,
and their coping skills? So, you know, that's probably certainly a priority,
you know, understanding, um, you know, externally what they,
what they've experienced, whether they were in school during the pandemic, um,
or shortly afterwards, uh, and what they may need to be successful is important.
So we do spend a lot of time with our newly licensed nurses and their preceptors
and our educators understanding where they are, um, you know, for themselves,
where they are and what,
what they might need to help support them in becoming a successful nurse.
And then like every other CNO across the country, you know, recruiting,
um, onboarding, um, retaining, uh, our,
our skilled and our intellectual capital is important.
Um, but what does that mean? It looks a lot different than it does now. Um,
you know, especially when I think about the, the time that I spent at the,
at the bedside and what was important to me. So, you know,
I think it's evolving. The, the, the, one of the priorities is how do we evolve,
um, with the, the newer nurses? What are,
what are their needs? And those are things like, you know, they,
they are not accustomed necessarily to, to working 12 hour shifts. Um, and,
you know, I started nursing, it was eight hours,
and I remember the transition to 12, and I thought it was the end of the world.
Um, but now, you know, 12 hours is, is not exactly an ideal shift for everyone.
So we're looking at, you know, whether we can do four hours, six hours,
eight hours, any kind of combination of shifts. Um,
and that does mean a lot more part-time or PRN staff,
but what it means is that they're engaged and they're, you know,
fulfilled with their work schedule, uh, which means that our patients, um, are,
are better cared for. So, you know,
I think those are probably some of my top priorities.
Besides offering nurses flexibility.
What do you find is key to retaining nurses?
You know, there's no magic pill, otherwise, I'd probably be a millionaire,
Chris, if I had the answer to all to, to that question. I think it's providing,
um, you know, a safe culture. I, I, I think, again, as,
as you know, communities have changed. Um, it wellness is important,
and so them feeling safe, them feeling like they have a voice, um, you know,
so I often, um, you know,
I'm on the floors talking with the nursing staff to make sure they feel like
they have a voice. We have a very robust shared governance structure,
so the nurses have an opportunity to be a part of our shared governance. Um,
so those are, those are important retention. Um, and then, you know,
just listening, I think that's key. Uh, you know,
I talk a little bit about going up to the units and, and rounding with them,
but it's, it's listening in every different capacity, whether that's on, um,
you know, a virtual meeting or I've, I've been asked to host different, um,
open forums for different staff. So, you know,
I think it's listening and being honest with, I don't have all the,
all the solutions, but I want to hear, um, how they're feeling,
what they're thinking, and,
and potentially hear some of their innovative ways to, um,
to create a, a better culture so that we retain great staff.
You mentioned the pandemic. Given the wave of rsv,
RSV and other illnesses we've seen over the past winter, uh,
how do you think the nursing staff has been affected by that as well?
Yeah, I mean, I think the pandemic in general, what we saw,
and this really relates to retention, is like everyone else, um, you know,
the pandemic forced many of us to just reprioritize our lives. You know,
we were, we potentially were isolated from family and friends. Um, and,
you know, once those things started lifting the, the isolation requirements,
people started asking themselves, you know, do, is this where I really wanna be?
Is this what I want to be doing? Um, so I think it's, you know,
I I think people reprioritized the same thing with, you know,
rsv and we're seeing, you know, as, as we have a younger generation of, uh,
of caregivers and providers within the organization,
many of them having young children, you know, the,
the fear of carrying something home with them. And so, you know,
ensuring that they feel safe in this environment, they have the PPE they need,
um, but also, you know, just being, um, empathetic to where they are. And,
you know, I think we've had, uh,
my leadership team and I have had a lot of conversation about what do they need?
And, you know, I, my motto has been, how do we open more doors?
And sometimes that means they need a break and, you know,
they need a personal leave. And, and we see that a lot with,
especially newer moms. Um, you know, they,
it's one thing to take care of someone else's sick child, but, you know,
potentially taking care of your own is, is a different story. So I think,
you know, in a nutshell, it's just reprioritizing what, what matters, uh,
to folks right now in, in the moment. Um, and,
and us being just understanding and allowing some flexibility with that.
I think you've touched a little bit on this already,
but given all the feedback that you've been taking in and all the introspection
and all the other data you've been accumulating,
how do you anticipate your role is going to change in the next 18 months?
Um, well, I think not just with the, the growth of Phoenix Children's. I mean,
in the next 18 months, we'll have opened, um, at least two,
if not three new facilities. Um, so, you know, my role is expanding,
um, which, which makes it even more important than I'm listening and,
and out with, uh, the staff in each of these facilities. Um, you know,
maybe a little bit of imposs impossibility there, but, um,
I'm gonna be optimistic that, that I can,
and I think the other thing that's really,
we all have to be cognitive of is technology is changing in healthcare.
And so, you know, my role looks much different, um,
today than it did even five years ago with the use of technology and how,
um, you know, I help support staff in,
in the use of technology within their day-to-day work. Um, so I think,
you know, those are the two areas. Um, and then I think from a,
from a staff perspective, what's gonna happen is, again, going back to,
you know, how do we get, um,
creative with recruitment and retention and onboarding. Um, we've,
we've looked at several different models. We've, um,
reinvented our nurse residency program. Um,
we've expanded it from a year to 18 months.
Now that doesn't mean orientation is expanded,
but what it means is the ongoing support for those new,
new nurse residents will, will go on for 18 months. Um,
and that goes back to the softer skills I was talking about in coping. You know,
this gives them an opportunity to continue to meet with their cohort of,
of new nurses and talk about what's impacting them on a day-to-day basis.
Um, you know, we're, we're, we're also looking at, um,
our preceptor program and how that might be impacting new hires. Uh,
again, we, we have seen through, um,
the turnover that we're asking younger and younger and less experienced nurses
to precept. And so my concern is we're all, I mean, that's where we are.
That's the reality of our world, but how do we support them through that?
So we're looking at the preceptor program and will implement a new preceptor,
um, orientation structure that will be part of the nurse resident.
So in their first six months,
they're gonna learn some kind of fundamentals of becoming a preceptor, um,
and basic things, giving feedback, you know, um, how to mentor, uh,
a new student, et cetera. But, you know, it's really, again,
kind of going back to where they are and, and where we are,
and we've gotta figure out how to get to them or at least, um,
a compromise so that we can help support them.
You mentioned so many things that seem to be definitely working for Phoenix
Children's. How do you think other health systems can implement these,
and how much communication have you had with people in your position?
Well, I'm part of a phenomenal group, um,
through the Children's Hospital Association and the CNO forums. Um,
we just actually met last week, um, and there were 25 of us,
uh, in a room at, at tables,
and these are the exact things that we're all talking about. Um,
and then I got an email, uh, just the end of last week,
so even before the conference was over,
asking for some details around the preceptor program and how we're,
um, you know, how we're building that into our nurse residency.
So we have a lot of discussion. Um, you know, we have a LISTSERV through chha.
Um, so I'm constantly in contact with other CNOs about best practices,
what's working for them. Um, you know,
I think that the unique thing about Phoenix Children's is, you know,
there's not a lot of other children's hospitals that are growing at the pace we
are. Um, so that, you know, has its whole, a whole other bucket of,
of challenges around, you know, um,
employing enough nursing staff and support staff to,
to build two new facilities. Um, but it's just, you know,
it's a great networking opportunity and we really do learn from each other. Uh,
you know, I think our, our clinical nurse attending program, um,
has been really well received by other CNOs, uh,
and I've had many folks reaching out about that program, so, well, you know,
I think there's a great support system, thank goodness. Within,
within the CNO group as well.
Uh,
you spoke about technology and other changes that are certainly going to
be, uh, part of your evolution. Uh,
what other issue do you think deserves to be talked about more in your field?
Um, you know, for sure. Yeah, I, I mean,
I can't say enough about technology and, and how we're using that. Um, I think,
you know, advocacy and community health, um, and, and this is one thing,
you know, I can tell you from 30 years ago, uh, graduating nursing school, I,
I had no idea what it meant to be a true advocate for a patient. I, you know,
I knew what it meant to care for a patient and family, um,
but I didn't really understand the role of advo advocacy.
And I think that's gonna be, um, really important. Um,
especially now with, you know, um,
many things around healthcare being politicized.
It's gonna be important for nurses and all providers, um,
especially, you know, nurses and physicians to be able to,
to advocate and,
and speak to our government relations folks around what the needs are of
patients, um, because it's not just happening in these four walls. And I, I, I,
I talk about that all the time, that the care we provide, um, you know,
certainly is important within these four walls,
but it's even more important that we're providing, um, the right resources,
education, and care for our families outside the four walls so that, you know,
they, when they get home, they don't have a nurse. Um,
and so we need to be able to, to help them care for themselves.
And a lot of things around advocacy and legislator legislation, um,
you know, either help support that or may not help support that.
So it's important that, uh, we all have a voice in that.
Yes,
and certainly advocating for patience is the first priority that you have and
any health system would have. Rhonda,
thank you so much for your time today and your expertise.
Well, thank you, Chris. I appreciate you having me.