Transformational Leadership
Children’s Health nurse leaders identify current and anticipated trends in health care and advance nursing excellence by solving problems, fixing broken systems and empowering staff. Guided by the mission and vision of Children’s Health, our nurses lead and empower clinical decision-making across the organization.
Our nursing strategic plan cascades from the system’s organizational strategy to focus on five areas:
- Promote and advance the role of the nurse
- Prepare the future nursing workforce
- Transform nursing practice
- Advance professional nursing excellence
- Foster a culture of clinical inquiry
In 2022, we continued to build our nursing leadership team so we can focus on strengthening engagement, improving retention and developing our nurses for the long-term health of their career and the children under our care.
From a foundation of collaboration, our nurse leaders achieved phenomenal results on key projects, such as:
- Launch of weekend shifts for nurses who want to care for their families while continuing their career
- Succession planning for nurses working in acute care services
- Expanding community education about pediatric nursing challenges
Nursing Leads the Way with an Innovative Staffing Model
Nursing leadership is addressing workforce challenges faced not only by Children’s Health but also health care organizations nationwide. Our new staffing model, weekend-only positions, is designed to enhance work-life balance and provide flexibility for our current team members, support our efforts to recruit new staff to address current volumes and prepare for future growth.
In 2022, a team led by nursing leadership gathered input during listening sessions with nurses and input from the CNO Advisory Cabinet. Nurses expressed their desire to have more predictable and flexible schedules during the week with fewer weekend hours required. Some nurses expressed a desire to work weekends only, to prioritize weekdays for their own education or child and elder care.
A nearly year-long planning and implementation process came to fruition with the opening of applications for weekend-only positions in several inpatient departments on both Children’s Health campuses. Positions available for weekend-end only work include nurses, respiratory care practitioners, patient care technicians and surgical services team members.
Incentives are provided, including a maximum of 24 hours on shift between Friday night and Monday morning. In addition to competitive pay and differentials, these nurses and other team members receive a premium and full benefits based on eligibility. This program supports work-life quality for those who want to work fewer weekends and those who want more time off during the week, resulting in improved nurse retention, satisfaction and wellbeing.
Future-Proofing Nursing Leadership in Acute Care
Foresight and initiative combined to expand an existing Children’s Health leadership development program to include nurses with high potential. This is a crucial part of our succession planning for nurse managers, particularly in acute care.
The Leadership Academy at Children’s Health provides up-and-coming leaders an opportunity to:
- Lead in the organization
- Collaborate with others across the system
- Learn from executive leaders
- Complete projects that align with the organization’s strategic priorities
The program includes monthly classes, an assigned strategic priority project and partnership with a formal Leadership Academy mentor. The mentor offers support, guidance and professional development opportunities.
Based on the success of the Leadership Academy, the director of acute care services (ACS), saw the need to expand ways to grow new team leaders for future clinical manager roles. In just one example of additional professional growth advancing throughout the nursing department, one supervisor assessed a clinical nurse team leader for her learning and leadership potential and identified her as a strong candidate to become a clinical manager.
This nurse’s career goals included getting a master's degree in nursing administration and advancement in nursing leadership. She told her supervisor that her short-term career goal was to advance to clinical manager, while her long-term aspiration was to advance to a nurse director role and beyond.
This nurse went on to earn her master’s degree in nursing while also completing the Leadership Academy program. In 2022, she was promoted to a clinical manager position in ACS.
Expanding the Leadership Academy to clinical nurses proved so successful, the organization has expanded succession planning activities to support even more future growth of nurse leaders.
In fact, ACS restructuring fosters leadership development of clinical managers as Children’s Health prepares to expand both its hospitals. Rather than continuing the former structure of multiple units assigned to one clinical manager, ACS expanded coverage for each unit to be assigned one manager.
With the support and guidance of a full-time nurse leader, the new structure allows managers in ACS and Clinical Resource Team (CRT) to support the clinical teams through coaching, real-time feedback, monthly rounding and performance evaluations.
Growing Our Own Clinical Nurse Specialist Advanced Practice Registered Nurses
The Emergency Department used the hospital’s clinical nurse specialist (CNS) Grow Your Own program to fill its gaps in CNS applicants. In addition to the formalized curriculum of a graduate school of nursing for the CNS role, we developed organizational core competencies that Grow Your Own CNS team members follow for standardization of education and onboarding within the organization.
This is a unique, independent job description we created with a clearly defined scope of practice that aligns with the scope of an RN and not the scope of an advanced practice registered nurse (APRN). However, this role does focus the RN on aspects of the CNS role and trains them for the transition to CNS practice after completion of the formal education program and licensure by the Texas Board of Nursing, which is required at three years of hire into the advanced clinical nurse (ACN) role.
The ACN role serves as an expert clinician, educator, consultant, driver of evidence-based practice and change agent. The ACN is empowered to implement quality improvement initiatives using the organizational quality methodology, evidence-based practice and professional practice models to demonstrate nursing quality and safety outcomes. This nurse is involved in policy development, evaluation and interpretation of regulatory requirements, family-centered care and evaluation of quality metrics, such as hospital acquired conditions and nurse-sensitive indicators.
The CNS Grow Your Own program has created an ongoing succession plan for future CNS needs and replacements.
High Patient Volumes Drive Innovation
Two nursing directors helped educate the community with a December 2022 interview carried by KERA-Radio, a National Public Radio affiliate.
They discussed the year’s challenges and joys in an interview broadcast throughout North Texas. They explained that large numbers of new families moving into the area impacted patient volumes at Children's Health more than COVID-19. A population boom kept the Dallas and Plano campuses at full capacity month after month, just as the mask mandate was taken away and respiratory viruses surged.
Nursing teams systemwide rose to the challenge of more patients and new challenges, such as RSV in the summertime. Another obstacle: remembering to take time for self-care so you can stay in touch with your passion for nursing. The directors talked about the role of self-care in feeding a nurse’s ability to face high volumes while avoiding burnout.
“Nursing is hard work. But there is that capacity to have fun, as well. The most rewarding thing is when our team members are celebrated. They’re giving amazing patient care, and they’ve created a space where the patient and family feel safe, supported and well taken care of.”
In their radio interview, these two nurse leaders educated the public about their commitment to the mission of Children’s Health – to make life better for children – as well as how they are leading their teams to provide the best patient care possible.