From Bedside to Boardroom: The State of Nursing is Healthy in Southlake
Nurses of Texas Health Southlake: Traci Bernard, President, RN, Pam Hillery, RN, and Charlotte Campbell, RN
By Tracy L. Southers, APR
By definition, a nurse is a person who cares for the sick. While this is accurate, it does not begin to tell the whole story. In today's complicated world of healthcare reform, the role of nursing has evolved to include prevention, chronic disease management and patient education. In addition, an impressive body of evidence shows nurses make invaluable contributions to patient safety and satisfaction.
As the importance of nurses has grown, the overall supply is shrinking, but not due to a lack of interest in the profession. According to a report released March 2012 by the American Association of Colleges of Nursing, thousands of qualified applicants are turned away each year from nursing schools due to a shortage of instructors, classroom space and funding. Texas ranks sixth on the 2012 list of the ten states with the biggest nursing shortages (source: www.top-nursing-programs.com). The website also reports there is a dire need for more than 22,000 full-time nurses throughout the state, and this amount will increase to 70,000 by 2020 if the issues are not addressed.
National labor statistics support these estimates as registered nurse (RN) was the most in-demand occupation during 2012, with 246,000 online postings during August alone.
Currently, there are approximately 2.7 million RNs in the U.S., meaning they have been licensed by a state authority after passing qualifying examinations. With the enactment of the federal Patient Protection and Affordable Care Act ̶ which is intended to provide medical care for the nation’s more than 30 million uninsured ̶ combined with an aging baby boomer population, there is expected to be an avalanche of demand for healthcare professionals, medical assistants and care givers. The U.S. Department of Labor predicts a 26 percent increase in all nursing positions between 2010 and 2020.
These startling statistics beg the question: Will hospitals be prepared to meet the demand and still provide quality care?
Here in Southlake, the state of nursing is much healthier. At Texas Health Harris Methodist Hospital Southlake, currently the only overnight healthcare facility in the city, a game plan is already in place. According to President Traci Bernard, RN, administrators are well aware of the big picture and have developed a long-term program to maintain its high-quality staff and award-winning reputation.
"Retention is a high priority here because we realize good nurses are always in demand," says Bernard, noting her own hands-on nursing experience gives her valuable perspective. "We empower our nurses to make decisions, give them tools to be successful, offer continuing development opportunities, and treat them with respect. This is not case everywhere."
It seems to be paying off. Boasting a nursing vacancy rate of just three percent and an extremely low turnover rate of 1.6 percent, Texas Health Southlake has earned a 99 percentile ranking in employee satisfaction (as compiled by Press Ganey Associates), and has repeatedly been acknowledged as a stand-out employer on a national, state and local level: Best Places to Work, Modern Healthcare; Best Places to Work in Healthcare, Becker's Hospital Review; Best Companies to Work for in Texas, Texas Monthly; and Best Place to Work in Dallas Fort Worth- Midsize Company, Dallas Business Journal.
Additionally, Texas Health Southlake ranks in the top percentile nationally in all quality measures, confirms Jessica Hill, RN, quality and risk management director, which she says is a direct result of its nursing staff being 100 percent engaged in providing the highest, safest care possible.
Combined with a 99 percent patient satisfaction rating, Texas Health Southlake understands the fundamental business principle that happy employees equal happy (and healthy) customers.
Opened in 2004, Texas Health Southlake is a modern, well-equipped facility in a centrally located, desirable suburb. This certainly helps in recruitment and retention efforts, saving many nurses from long commutes and minimizing unexpected emergency care that is seen in other areas. Known as a surgical hospital, its bread and butter is scheduled appointments and procedures. Texas Health Southlake offers 17 specialties through its 300 on-staff physicians ranging from neurology, family medicine, orthopedics, plastic surgery and gynecology. While most of the procedures done are outpatient, there are 16 inpatient suites, along with six operating rooms and an emergency room open 24/7.
At 46,300 square feet, the building may be considered small by traditional hospital standards, but this is part of its appeal, says Charge Nurse Charlotte Campbell, RN, who joined Texas Health Southlake in 2007 and oversees 11 nurses in the pre-op department.
"I came here because I needed to get closer to home and I like the smaller atmosphere ̶ it's like a family," she comments. "Because we are a smaller facility, it's easier to get to know people and develop relationships with other departments. This makes for better communication and overall better care of patients."
Another contributing factor to its high retention rate is the low patient-to-nurse ratio of 3:1, which is well below the national average and has a critical impact on patient care.
"The patient-to-nurse ratio is very low compared to other hospitals and national statistics. Our nurses enjoy being able to care for three or four patients in our surgical unit," states Donna Grace, MBA, RN, vice president of patient care services. "As nurses, we are blessed to work in a field in which we can make a difference in someone else’s life. Having such a low patient load allows our nurses more opportunities to meet each and every need of our patients including having the time to listen."
As of December 2012, there were 103 nurses on-staff ̶ including full time, part time and as-needed known as PRN nurses ̶ and one open position. According to Grace, they anticipate hiring more nurses in 2013 only if replacements are needed. Given the shortage of quality nurses elsewhere, this is an enviable position to be in.
"Recruiting the right nurses that fit our needs and culture is essential due to the fact that our healthcare community is small. Being a fairly new facility in an established healthcare marketplace, I had the advantage of being able to recruit nurses I knew personally at previous facilities, or of having a nurse on staff who knew the candidates being interviewed," Grace explains. "I work directly with our human resources department to conduct interviews with both peers and managers before a hiring decision is made."
Beyond its favorable location and size, what really sets Texas Health Southlake apart is that it is a physician-owned hospital, as part of a joint venture with Texas Health Resources and Harris Methodist Hospitals. According to Bernard, this is a benefit to both its staff and patients.
"We have the ability to make changes quickly and get things done faster, without a lot of red tape. Doctors and nurses are amazed when a request for a new piece of equipment is made and it is delivered a few weeks later," says Bernard, noting this is done in direct support of its mission statement. "We are always looking for ways to improve patient care and the best way to do this is to listen to our front-line staff. "
Beyond listening, taking care of its staff is also a high priority at Texas Health Southlake. In charge of this wellness effort is Employee Health Nurse Pam Hillery, RN, who joined Texas Health Southlake in 2008 as a recovery nurse. As the title indicates, her primary responsibility is to ensure physicians and nurses themselves stay fit and healthy through exercise and a proper diet.
"Nurses take care of other people and this is a way to take care of themselves. It is important for us to set a good example for our patients by being proactive and making healthy choices," says Hillery. "Our leaders are genuinely interested in making Texas Health Southlake the best place to work ̶ they really make us feel special."
Called the Vitality Health Program, Hillery has established a year-round schedule of events and activities that includes cooking classes, weight loss contests, wellness seminars, boot camp at a local gym, and area marathons. Points are earned for participation and quarterly drawings are held for prizes.
"Not only does this help employees lose weight or lower cholesterol , but it is a great teambuilding exercise and allows employees to engage with each other outside of work," Hillery adds.
Lastly, being a nurse at Texas Health Southlake comes down to decision. For this reason, the hospital uses the acronym C.H.O.I.C.E to explain its core values and acknowledge that we all have a choice where we work as employees and where we receive care as a patient.
A Nurse-Led Organization
An increasing trend for registered nurses is to move into management positions at healthcare facilities. Recruiters say RNs make attractive candidates for healthcare executive positions because more than any other healthcare professionals, they understand the needs and perspectives of patients and have worked closely with physicians (source: www.allhealthcarejobs.com).
This is certainly the case at Texas Health Southlake. While it is a physician-owned hospital, it is a nurse-led organization as demonstrated by Bernard, Grace, Hillery and Hill, who are all RNs and have transitioned into management roles. Their combined efforts are setting the hospital's course for health and wellness in the future.
When Bernard, who began her career as a charge nurse in Indiana, arrived at Texas Health Southlake in 2005 from Baylor Regional Medical Center at Grapevine , one of her first tasks was to establish a culture for the one-year-old organization which she did by bringing in a new leadership team, instilling a customer service attitude, and implementing measurable standards.
"I understand how things work in a hospital so I had immediate credibility with the staff. I can step in and help if needed," she states. "As an administrator, I wanted to create an atmosphere where people enjoy coming to work every day. In my mind, there is no problem that does not have a solution."
Being a former charge nurse also helps Hill enforce policies and procedures designed to make sure every patient receives the best care possible.
"Everything I do involves nurses as they are the driving force of the hospital and very important to achieving our mission and meeting regulations. As a nurse myself, I understand that nurses are in a key position to improve the quality of health care through patient safety interventions and strategies," Hill says. "When I was on the floor, my patient focus was bedside. Now, I'm focused on staff empowerment, but the goal is the same."
Campbell agrees with her thoughts, "We are the patient's advocate and must notify the surgeon or anesthesiologist of any concerns. Ultimately, our responsibility is to the patient."
Grace, who transitioned into management early in her career and earned a M.B.A to pursue the business side of healthcare, cannot help but reflect upon her 37 years as a practicing nurse.
“A hero is someone who is remembered fondly by someone else for the rest of their lives. It is my hope that our nurses here at Texas Health Southlake are a hero to their patients."
Texas Health Southlake believes that people with higher well-being are healthier and happier, contribute more to their communities and jobs, and have lower health care costs. Fortunately for all of us who live or work in Southlake, it appears we are certainly in good hands.
Tracy Southers, APR, is president of WordPlay, LLC., a public relations agency in Grapevine, Texas.