How 1 nursing leader is trying to reduce violence, falls in her hospital

Lorie Rhine, MSN, RN, chief nursing officer at Raleigh, N.C.-based UNC Health Rex, has been a nurse for 41 years and although she never expected to be in leadership, she is happy she ultimately chose that path.

"As I've gone through my career, I realized that I could make a huge impact representing nursing and patients and being part of the executive team," she told Becker's. "I've been very interested in outcomes, quality, patient satisfaction and the voice of the nurse and found that the executive role was an opportunity to bring all four of those pillars together."

Ms. Rhine was appointed chief nursing officer in December. Here, she talks about issues in the field and what work excites her most.

Note: Responses have been lightly edited for clarity.

Question: What's the greatest challenge facing nurses right now?

Lorie Rhine: We would be remiss if we didn't talk about the nursing shortage, but I also think that really it is re-energizing ourselves, remembering why we became nurses in the first place and making sure that we have ourselves grounded in that passion. 

And I don't know that we've done as much future planning in nursing as we need to. We knew that we were going to be short nurses. That's not a big surprise to us. But we really haven't determined what different care models we could put into place and career opportunities and ladders we need to focus on and develop. Then there's focusing on how to have people work at the top of their license, such as advanced practice nurses. Are we driving evidence-based practice on all of our nursing units?

Q: What concerns you most about the healthcare field?

LR: Workplace violence is very concerning for me. I think we've become a society where there is definitely more violence that's occurring, and we're seeing it in our hospitals and in our clinics and really in every place that we are providing care. Unfortunately, we have very vulnerable patients who don't always feel well and our interactions with them are vital to their healing but sometimes it's difficult because of verbal abuse and physical abuse. So trying to figure out how to manage in that space and still support our community and patients.

We're actually looking at standing up a behavioral health response team to support our colleagues with managing behavioral health or aggressive patients and families. That will be a 24/7 service and it will be led by a nurse and a behavioral health expert who will round aggressive patients and help providers learn how to interact and de-escalate the situations.

Q: What new technology, innovation or research are you most excited about?

LR: We've been able to leverage virtual nursing for close to a year to do admission and discharge with great results. We're also looking at types of technologies that will allow us to prevent injuries for wounds and that can reduce falls. That technology we'll be piloting in a couple of our units. It's artificial intelligence that can watch patients and help us learn how they move prior to getting out of bed so we can reduce falls.

Q: What's something your hospital is doing that you're most proud of?

LR: I'm proud of the system's focus on how to support teammates and create a culture where people want to come to work and be part of the team. We're starting a pilot with executive rounding where executives are assigned to particular units and will spend hours in those areas making connections. 

Q: What's the best leadership advice you've received?

LR: Be honest and be yourself. I really think transparency is key and whenever you can be transparent and communicate your plan, that's where you're going to really have front-line staff and leaders behind you.

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