CommonSpirit Health CNO Kathy Sanford on the challenges nurses face in times of change

Kathy Sanford, RN, is the new CNO of CommonSpirit Health, the organization created by the merger of Englewood, Colo.-based Catholic Health Initiatives and San Francisco-based Dignity Health.

In this role, she is responsible for 45,000 nurses and oversees several areas, including nursing practice, patient care services, care coordination, nurse education and nursing research. 

Ms. Sanford was previously senior vice president and CNO of Catholic Health Initiatives.

She also had a career in the Army Nurse Corps, which she finished as a colonel and chief nurse of the Washington Army National Guard.

Here Ms. Sanford discusses her new role, describes several challenges nurses face and discloses the most effective way to combat nurse bullying.

Note: The following responses were lightly edited for length and clarity.

Question: What is the biggest issue nurses face in today's healthcare environment?

Kathy Sanford: The amount and pace of change that's going on right now. There are a lot of things that we're welcoming that we think is great change — things about best practices and that we're getting outside the hospital and getting more into the [care] continuum. It's all great stuff, but it's change. Nurses are faced on a daily, weekly, monthly basis with new technology, new models of care, new ways of staffing, medication shortages, mergers, new companies, new colleagues. Even though [nursing is] a very learning profession and we're life-time learners, we are constantly in a stage of changing, and that adds to stress. 

Q: Many systems offer sign-on bonuses and other incentives to attract new nurses. What recruitment and retainment efforts does CommonSpirit make?

KS: We have sign-on bonuses. We have some retention bonuses. But more important than that, we have the things that would make people want to stay. Getting people and recruiting people isn't the issue as much as it is helping people enjoy their jobs and find joy in their jobs and want to be there. It's more important to us to create what we call an inspired culture of excellence for our employees and our clinicians. We want to encourage positivity and resilience, and make sure our leaders understand evidence-based leadership and really care about the people who are taking care of the patients, as well as the patients, because those two things are so closely connected.

A lot of the people you lose after you hire them [leave] within their first couple years of employment, and so we do something called stay interviews where we talk to the individuals about how they're finding meaning in their work and what we can do to improve their work experience, what we can do to meet their needs. It's less about the incentives and more about what can you do to make people feel good about their work and know how valuable they are and to do that individually. All nurses aren't the same.

Q: In your opinion, what is the most effective way to combat nurse bullying?

KS: [Nurse bullying is] like any kind of abuse. It must be talked about, it must be something that's not kept a secret, and it requires education of everybody. Sometimes people say, "Well, let's educate the leaders and the managers." But we must also educate the staff, the nurses themselves, about assertiveness, and the difference between being assertive and standing up for yourself and your patients and being unkind to other people. I think the No. 1 thing is education, and that includes assertiveness and learning to champion each other and confront bad behavior when it happens in an assertive way, while remembering everyone needs to be treated with kindness, even those whose behavior isn't good.

Q: What are your goals for 2019 amid the formation of CommonSpirit?

KS: We have five key strategies and those include improving access to high-quality care and ensuring we personalize care for acute and chronic patients. We also want to advocate for people who are vulnerable and struggling, and we want to use innovation, research and technology as part of our healing going forward. [Additionally], we want to create an inspired culture of excellence for nurses, employees and physicians. To do that, you must have an engaged team, and it goes with resilience, leadership education, high reliability and high quality.

As a new organization, and as the new CNO of CommonSpirit, in 2019 one of my biggest jobs is to listen and learn with my ears and my heart, to understand the challenges of caregivers across CommonSpirit Health so I can be part of helping them and help them help themselves. I've listened to a lot of nurses for a lot of years, and what they tell me is the things that make them more resilient are things like self-governance, being able to do self-scheduling, health programs, training and compassion skills, emotional support, even things like gratitude journaling and having quiet rooms for them. I know that's what nurses are telling me they want, but now I need to listen to a whole larger group of nurses because I do think what individuals need is different from individual to individual. I can't listen to all 45,000 nurses individually, but I can listen to them in groups as much as possible.

Q: What is one piece of advice you would give another hospital CNO?

KS: To remember to balance the needs of all stakeholders. With every decision we make, we must consider the effects of the decision on everybody who's going to be affected —the patients and their families, all the caregivers, the rest of the staff, the communities we live in, the populations we're taking care of, our leaders and the organization itself. I think sometimes we make decisions thinking of only one group of stakeholders, and we don't realize we need to consider everybody. Sometimes the scale of course will balance more for some stakeholders than others. You can't make a decision that is the best thing for everybody. But everybody should be considered so you understand how they're going to be affected, and you can help them in understanding the why of decisions, and they'll be better able to respond to those changes with resilience.

 

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