2-way communication, the challenge of nurse retention and more: Q&A with Cleveland Clinic's CNO

With three Magnet-designated hospitals, Cleveland Clinic — among other well-noted areas of excellence — is one of the premier healthcare systems for nursing in the country. At the helm of the system's nursing program is Executive Chief Nursing Officer Kelly Hancock, DNP, RN.

Dr. Hancock is responsible for directing the clinical, academic and operational activities of the nursing staff across the Cleveland Clinic's main campus and health system as a whole. Dr. Hancock has been with Cleveland Clinic for more than two decades and has held the position of CNO since 2011. While leading nurses, Dr. Hancock has garnered many recognitions, including the 2011 Circle of Excellence Award from the American Association of Critical-Care Nurses, which is given annually to individuals who exhibit excellence in the care of acutely and critically ill patients.

Dr. Hancock recently spoke with Becker's about changes in healthcare, nursing excellence, burnout, leading nurses in the nation's top heart institute, challenges, inspiration and more.

Note: Responses have been lightly edited for length and clarity.

Question: Cleveland Clinic has been regularly recognized for excellence in nursing. What makes nursing at Cleveland Clinic different?

Kelly Hancock: Our main campus has been recognized as a Magnet facility, Fairview Hospital and Hillcrest Hospital are also both designated Magnet institutes, so across the system there is a high level of regard for nursing, offering many pathways to excellence. We are one of the first health systems in Ohio to gather all these recognitions. When you look at the history of the clinic, the importance of nursing has always been recognized at many different levels. Nurses here are committed to providing world-class care every day and fostering an environment of healing with compassionate relationship-based care. That's what makes it different here. When I welcome new hires, I say you can spend your entire nursing career here and do a variety of different things. Not many health systems can say that. We grow our own at Cleveland Clinic.

Q: How does the nursing department at Cleveland Clinic address work-life balance and burnout? How do you personally address burnout?

KH: It is great to be a nurse — caring for others is truly an astounding gift. However, it is a demanding profession, often requiring 12-hour shifts, rotating shifts, which can lead to sleep deprivation. The key to avoiding burnout is maintaining our own personal wellness. At Cleveland Clinic, we try to make sure nurses are offered a variety of wellness programs. We offer yoga, reiki and information on stress and weight management and a variety of different things we're really proud to have in place here. We want to keep people resilient. We also empower our front-line caregivers. Nurses have a voice on shared governance counsels and are able to come up with their own shift rotations to help support one another.

I find balance in my personal life by making sure when I say yes to something I say no to something else. I'm also a runner. I participate in 5Ks and 10Ks. Balance is achieved by maintaining your own well-being. The job of the nurse is to be the ultimate caregiver. But we also want our nurses to take care of themselves.

Q: For seven years, you led nursing practice at Cleveland Clinic's renowned Heart and Vascular Institute. How does that experience continue to influence the work you do today?

KH: My greatest experience in leading nursing at the top heart clinic in the country was learning that, as a leader, you have to make sure that the team is better than you are — I was surrounded by unique, diverse talent. I also learned the importance of relationship building and really becoming connected with those you serve. Respect isn't freely given, it's earned. At Cleveland Clinic, we are creating a shared vision of healthcare. As a leader of 20,000 nurses, I understand that having two-way communication with active listening is critical to delivering this vision. I'm really honored to lead this group.

Q: What is unique about the collaborative environment between nurses and physicians at Cleveland Clinic?

KH: These relationships are strong. Our shared vision and execution of good healthcare is the result of good relationships between our physicians and our nurses. I think having a collaborative environment increases autonomy for nurses as well. Our relationships are based on mutual respect and admiration. We are led by a physician and I sit on board of governors and board of directors. Any kind of committee or council we have, nurses have a voice. We've done a lot here internally to develop curriculum to facilitate intercommunication to get to that ultimate goal of providing premium care for patients.

Q: What are the biggest challenges you face as a CNO?

KH: Clearly the landscape of healthcare is changing. There are more and more demands and new technologies. At Cleveland Clinic, we want to ensure that we retain top talent at the bedside and in other roles. We want to ensure we have solid leadership at all levels of nursing. With the Affordable Care Act, we are seeing patients who haven't had care in years. This is a good thing, but also means these are high-acuity patients who require much more complex care and this can create challenges for front-line caregivers. I try to focus on how to better educate caregivers to provide the quality care our patients need.

Q: What inspires you?

KH: The work I do. I've been a proud clinic nurse now for more than 20 years. The ability of the profession of nursing to transform healthcare inspires me. I think about the 2010 IOM [Institute of Medicine] report on the future of nursing and how it's opened a new door of possibilities for nurses across the country. When I look at what our nurses have been able to do on the topics that are posed in that report, well, we are making them a reality. That inspires me.

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