'I never said no to an opportunity': MetroHealth's chief nursing officer on change

Melissa Kline, DNP, RN, did not intend to go into leadership when she started as a staff nurse at Cleveland-based MetroHealth. But over the last 20 years, she realized leadership is where she belonged.

"I love taking care of our patients and I really liked learning about how the unit functions," she told Becker's. "I started by helping schedule nurses, then became a charge nurse, and I got involved in different councils to develop performance improvement projects. That's when I realized I like doing that sort of thing."

Dr. Kline started as an assistant manager in 2003 and made her way up until she became chief nursing officer in 2015. 

"I never said no to an opportunity," she said. "When our CEO at the time asked me if I was interested in being chief nurse, all of a sudden I knew that's what I wanted to do. I hadn't set out for that position, but I said yes to it without knowing the salary. I just wanted to lead our nursing staff."

Here, Dr. Kline discusses the issues facing nurses, technological advances and leadership.

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

Dr. Melissa Kline: The greatest challenge is the pace of changes happening. There's a lot of changes in how we deliver healthcare. I think people are finally paying attention to prevention instead of just treating disease, so we have a focus on that prevention while also providing care within the hospitals. Those changes, coupled with a nursing shortage and technological advances like artificial intelligence and virtual care, means we are testing different care delivery models. After COVID-19, how do we keep the pace of change going in order to provide appropriate and quality care? It's a lot to change and adapt to.

Q: What concerns you most about the healthcare field?

MK: The shortage of care providers in all specialties, but especially primary care. How do we keep people engaged in the work and attract them to healthcare? It's very rewarding. There are many roles that are flexible but there are people who have to work holidays, night shifts and weekends. So being attractive to people in the workforce can be difficult.

We've been partnering with different education institutions like high schools and colleges to get the younger generation interested in healthcare and nursing. We have a nurse internship type program for juniors and seniors where they interact with nurses and get to shadow them on the job. But we also expose students to other careers in healthcare. There's something for everybody from marketing to information to quality to food and nutrition. Most people think of healthcare as front-line caregivers, and we try to show them all aspects of the field.  

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

MK: I am most excited about all the newer technology, such as artificial intelligence, and how that can be used to support nursing and nursing care. Part of nursing is the people aspect of care connection and I think we have to be careful about the use of technology and how it can help nurses focus on the relationships with patients to enhance outcomes. We've started doing virtual nursing in the inpatient units and have had great feedback from patients. Our nurses also like virtual nurses because it allows them to connect and interact more with the patients and reduces the administrative work so in-person nurses can focus on care.

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

MK: We're really taking a deep dive into healthcare disparities. For example, our patients have good blood pressure control, but some people are doing really well, and others not that well. How do we diminish the gap to ensure everyone is managing their blood pressure? We're looking into those disparities across multiple factors like sex and race to ensure that all in our community are healthy. That process is made easier by the electronic health record where we can collect and analyze demographic information and determine what processes may need to be implemented. Without the EHR, it would be very challenging to connect the huge volume of data to the different pieces that contribute to care.

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

MK: Don't expect your team to do something that you wouldn't do yourself. I think part of being a good leader is setting a good example and staying connected with your team. So whether that's being visible or jumping in to help, I think that says a lot about a leader.

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