4 lessons CEOs can learn from nurses

– Nancy Blake, Ph.D., RN, chief nursing officer at Los Angeles General Medical Center

No one is better at personalization than a nurse.

Nurses are the highly trained masters of individual care. They must see and notice, respond and act, meeting the unique needs of each patient in that moment.

Who better to learn from?

This is article 10 in a 14-part weekly series, in which I share insights from the Healthcare in the Age of Personalization Summit 2024. We heard from a wide range of healthcare experts: leaders from all facets of healthcare organizations, from the boardroom and the C-suite to the patient’s bedside. We discussed topics such as why personalization is important, how we can shape our organizational cultures to facilitate it, how to inject personalization into your employer brand, why better care requires respecting individuality, and how industry incentives work against personalization.[KP1] .

In this article, I share highlights from the panel discussion on what nursing can teach physicians and CEOs about how to lead in personalization.

Panelists included:

• Nancy BlakePh.D., RN, charge nurse, Los Angeles General Medical Center
• Rebekah MarshBSN, RN, Clinical Nursing Educator, Harborview Medical Center, UW Medicine
• Anthony Betzmanager, nursing operations, Wellstar Health System

Anthony Betz shared a story that gives us several clues about what nursing can teach the rest of us.

He said one of the facilities in the Wellstar Health System has created a virtual nursing platform, thanks to the nurses themselves.

“It was started by ward nurses who saw the need for personalized care,” he said. “We know demand is increasing and there aren’t as many nurses, and they saw that they were losing time with their patients. So they came up with this idea [for a virtual nursing platform] and they worked with senior leaders.”

He had the opportunity to see it in action as a patient spoke virtually to a nurse.

“After the virtual nurse finished going over some medication information with the patient, the patient looked at me and a few others in the room and said, ‘That was great. I’ve never spent so much time talking to a nurse.’”

It was a victory for the patient, but also a victory for the nurses.

As a result, “unit nurses can spend more time with their higher acuity patients,” Betz said. “They realized there was a need for that. The patients feel like they can be seen more.”

It also creates opportunities for nurses who need more flexibility in their work schedule.

“So far, the participating nurses in our pilot program are those who cannot work a standard hospital shift,” he said. “It creates an opportunity where they can still practice their craft and do what they love, while helping the team overall.”

As Rebekah Marsh noted, this story gives us so many great examples of what nursing can teach CEOs and other leaders about how to practice and deploy personalization.

“I just think this is a beautiful blend of using technology to create personalization, and I love that the nurses were involved from the beginning,” says Marsh. “I think that’s where the real magic happens when frontline staff at every level of practice are involved.”

Lesson 1 – Listen and act on the ideas of others

Sometimes leaders get stuck in their thinking she should be the ones who have the ideas.

But Betz said, “I believe as leaders we can reach out to our team members in our organizations and find those ideas and create the personalization that is so desperately needed.”

Dr. Nancy Blake has been a nurse for 44 years and has a Ph.D. in nursing. She agrees that people have ideas and they want those ideas to be heard. She said that too often new leaders come into a new job and feel like they have to demonstrate that they are confident and in charge. But she had some advice.

“New leaders should go on a listening tour,” said Dr. Blake. “You find out what the staff needs and then make a plan. I think CEOs try to take charge because they believe that’s what they should do. [Employees] want professional development, they want a healthy working environment. They want some control over their schedules and their professional lives. They have good ideas. I have to listen to their ideas, and I have to take risks and do things that are different. If we don’t listen to them, they will walk away and go somewhere else. Some things you drive [as a leader]should be their ideas, not your ideas.”

That’s why Marsh said she likes to think of her leadership role as more of a facilitator. “I describe myself as a facilitator of change. As many people as I can get involved in that change, it helps me feel more successful and I think it brings other people along with me as well.”

Lesson 2 – Work together before making decisions

Marsh spoke about nurses’ tendency to collaborate.

“When I walk into my inpatient units, I always see nurses working together at the nursing station,” she said. “As soon as a nurse has a question, they immediately involve their team before formulating their own individual plan.”

This is a habit that can help leaders get out of the mindset that Dr. Blake described the mentality in which leaders think they have to come up with answers themselves.

“I work in an academic institution where we train new general practitioners,” says Marsh. “I see that the new GPs are under great pressure to make independent decisions and draw up care plans. And their second or third step might be to ask for help. But through that real collaboration, I learned that nursing is a safe space in a difficult healthcare environment.”

However, it’s not perfect.

“I think nursing is losing its thread,” says Marsh, “that we don’t work well together at all levels of organizational authority and we don’t always get that collaboration with our physicians. But basically, we are really good at not making decisions until we get a second and third opinion.”

Betz also agreed.

“There are a lot of transitions happening, so new leaders are emerging all the time,” Betz says. “The most effective leaders are those who take the time to get to know their people. Healthcare is so collaborative. You have to have those relationships. And if it’s just a superficial issue, when times get tough, it will be difficult to bring about change and act quickly.”

Lesson 3 – Cultivate and Celebrate Champions

Marsh recognized that we tend to place a high value on leaders making decisions, but first follower It is also so important that a real change initiative gets off the ground.

“We need someone who believes in the initiative enough to do the work and do it publicly,” Marsh said. “Celebrating champions is a wonderful way to celebrate change without taking all the glory. Celebrate as many champions as you can find the good work. I think there’s so much frustration in healthcare right now, and this is the kind of recognition that people are really looking for. You see me taking extra steps to do this, you recognize me because I do the right thing, you recognize me because I advocate for change. That’s what leaders can do to help people feel engaged and excited about the difficult work ahead.”

Dr. Blake talked about how her team becomes champions.

“We have been very successful in improving outcomes for our patients over the last three years because we have had unit champions driving this, but they have also had an empathetic ear,” said Dr. Blake. “We have an interesting model where we have an administrator, a physician leader and a nurse leader who form a triad that work together, and they come around the department every week and talk to the staff about any issues that arise.”

She said they are listening and trying to resolve the issues. Employees have the opportunity to make their voices heard because they see things happen when they do.

“If you listen and they see you actually solving or addressing the problem, they are more likely to speak up,” says Dr. Blake. “Your priorities should be to get your team to work together and make them understand that you win as a team and you lose as a team. Patient care should be team-oriented and focused on the patient, not the doctor, not the nurse. As a team you have to be focused on the patient’s needs.”

Marsh offered a perspective that reminded us why we need each other so much: Doctors need nurses, nurses need doctors, everyone in healthcare needs everyone.

“Think about the first health care providers in human history,” Marsh says. “I can’t imagine it was a doctor and a nurse. It was one person. I think of the specialization that has taken place in healthcare, including the development of entire professions such as nursing and medical professions. These are wonderful professions, but very specialized. I think both the nurse and the doctor are missing something in forming the care plan in our silos.”

We consider decision-making about the care plan to be the domain of the doctor. We regard the patient perspective and advocacy as the domain of the nurse.

“People get very upset when you say that physicians are not advocates and that nurses are not participating in care planning,” Marsh says. “We completely overlap, it’s a spectrum. If we know we overlap on that spectrum, we can’t make decisions without each other. If I could make one recommendation on how to move the conversation forward, it would be this: Go up to someone in person and talk to someone. Have a personal conversation.”

Lesson 4 – Be accessible, go personal

Speaking of personal interactions, Betz emphasized the importance of interaction between administrators and healthcare providers.

“Early in my training, I had a lot of opportunities to shadow doctors and nurses,” Betz said, “and I started asking people, ‘When was the last time you saw your administrator?’ I was surprised how often [their answer would be]”I can’t remember the last time they were here.” That really stuck with me. Now when I work on the nursing floor, I am so impressed that showing around and talking to team members is such an important part of nursing leadership.”

CEOs, take note.

“I believe CEOs, physicians and everyone in healthcare could also benefit from following rounding practices to impact the business,” he said. “At Wellstar it is known that our CEO, who is a nurse by profession, still makes rounds and will even work on wards with nurses next to them to discuss matters. And I think it’s critical for us to do that.”

Watch this short video to learn more from the panel.

Next time: Patient experience, safety, quality and equity in the age of personalization