When leading a team of 30,000, self-care is essential: 5 Qs with Cleveland Clinic's CNO

 When Meredith Foxx, MSN, started her nursing career 22 years ago, she never  expected to be leading nearly 30,000 nursing caregivers at one of the nation's top health systems — Cleveland Clinic. 

"I'm pretty sure I can't say when I walked into the building that May day in 1998 that I had any thoughts of where I'd be in 2020," Ms. Foxx said. 

As executive CNO of the health system, she oversees everything nursing related, including nursing practice to staffing and retention. A Cleveland native, Ms. Foxx found her way back to her hometown 16 years ago when she joined Cleveland Clinic as a pediatric clinical nurse specialist. In October 2020, she was appointed executive CNO. 

While never predicting she'd end up where she is now, Ms. Foxx always had an itch for leadership. 

"I always sought out leadership opportunities whether formally or informally," Ms. Foxx told Becker's. "I was stepping up to the plate to be a charge nurse, I was leading a committee on how to have an effective primary care team models nursing. Moving on to advanced practice, I immediately wanted to improve processes either around the care of pediatric oncology patients, and then improving any of the processes within pediatrics in the ICU." In 2004, she was asked to lead the health system's first coordinating council of shared governance. 

When asked where she can be found around the city outside of Cleveland Clinic, "That is very easy," Ms. Foxx said. "Any Cleveland sports event starting with the Browns, then the Indians and the Cavs — lifelong Cleveland sports fan." 

Becker's caught up with Ms. Foxx to discuss her leadership style and how she practices self-care.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What piqued your interest in the nursing or healthcare profession?

Meredith Foxx: I always as a young child and growing up had a significant interest in sciences and I have definitely always been a people person. When I thought about what I wanted to be when I grew up, [I thought] how could I match science with being a people person. Obviously, healthcare is one of the first things that stood out in terms of working in an industry or a field. I had some family members that worked in hospitals that were nurses, so I think that definitely had some influence — talking to them or knowing what they did.

Q: How would your staff characterize your leadership style?

MF: I would fit myself into the visionary style … attempting to lead with an optimistic, innovative approach. I want to be collaborative and engage all of my teams. In this day and age, with the large scope and team that I have, I have to be very strategic, understand what we're up against in healthcare and our profession moving forward. I've also seen myself as a coaching leader in the past, obviously completely changing [now,] but I think your leadership style morphs as you change roles and take on different responsibilities. 

Q: What's the biggest lesson you've learned from your staff? 

MF: It's important to be humble. It's important to be vulnerable at times. Know what you don't know and rely on people's experience and what they've brought to healthcare. Rely on people's expertise and know that you can always be learning from others on how to do things better for our patients and for our teams.

Q: As a leader, how do you practice self-care? Does that translate to your ability to safeguard your team's well-being?

MF:  I am a true believer that you have to role model this as a leader. The only way your team will do it is if they see you doing it, because that is their ability to get permission to do that. I would say over time, I tried to be very mindful of how I do that. When I say that, I specifically mean stepping away from work, and if I take my time off, I am off. There's somebody else that can cover, so if I take a day off or a week off, I don't have to be connected to my phone.

It has to be about role modeling because people need to see you do it … and feel comfortable seeing you do it to do it themselves. 

Working out helps me clear my head — either starting my day that way or ending my day that way. If it's ending my day, it's a good way to clear my mind and be able to think more creative and strategic and get kind of out of the day-to-day. Get those endorphins going and definitely promote the positive sense of self. The other thing is I try to read things that are not related to healthcare or my profession. It doesn't necessarily need to be fiction or some sappy romance, but something that is not healthcare related. We can learn from other industries, we can learn from other things, but really spend some time outside of the industry per se.

Q: You've been at Cleveland Clinic for more than 16 years. What's something you wish you knew your first day at CC? 

MF: My first day at Cleveland Clinic Campus, I was 21 years old. I was a nursing student doing my summer associate, nurse extern job here. The entrance I walked into doesn't even exist anymore. When I look back on that, I was here to take care of pediatric patients, and I was so excited to be doing that, but if I had to look and say, 'What do I wish I knew?' It's the immense scope and influence that Cleveland Clinic has in our community and the United States in healthcare and worldwide, and how fortunate we are to live in Northeast Ohio to have this type of healthcare, and this organization supports the community and its people in my backyard. I've definitely taken advantage of all the opportunities at the Cleveland Clinic. Obviously, where I am today, I would not be here if I was not afforded lots of opportunities with different leaders. But I don't think that I realized all of those opportunities were there and that the sky was the limit at that time. 


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