Prioritize nurses and your health system will succeed, MUSC's CNO says

Patti Hart, DNP, MSN, RN, is the chief nursing officer of  Medical University of South Carolina Health's Charleston division, which includes MUSC Health University Medical Center.

Joining MUSC in July 2016 as associate chief nursing officer, Dr. Hart took over as interim chief nursing officer in August 2019 and was afforded the full-time position in November 2019. Currently one of the largest employers and providers of care in South Carolina, the MUSC Health system is expanding quickly, at present building a new children's hospital. 

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

Question: What is the greatest challenge you're facing in your current role? 

Dr. Patti Hart: Learning the role of CNO has been challenging, especially with so many competing areas and interests. Ultimately, though, my No. 1 priority is always to take care of my staff and ensure quality and safety of care provided.

Q: What do you think is misunderstood about nursing today? 

PH: Too often, executives don't think about the importance of their largest workforce: nurses. They don't realize that nurses directly influence all the key indicators contributing to an organization's success — cost, safety. One of the Medical University of South Carolina's strong suits is recognizing the value of nurses with strong assessment skills. If nurses start cutting corners, care quality and patient engagement automatically decrease. 

Q: What efforts can be used to reduce workplace violence for medical staff and nurses? 

PH: Most of the time, staff members have excellent relationships with patients and families — there are only a few patients who create issues. In response to some occurrences of physical abuse in the children's area of the hospital, we developed a behavioral response team. Now, an entire team responds when you call to help de-escalate the situation. Anyone can call the response number and an operator will designate a nurse, physician, security guard and social worker or chaplain to the team. The team then helps determine what is needed — medication, discussion, comfort, verbal de-escalation. Since the program's implementation, we have seen fewer physical injuries and intend to roll out the behavioral response team program throughout the whole hospital over the next six months.  

Q: What methods can be used to reduce nurse burnout?

PH: We've really put a lot of effort and money into creating a healthy work environment. Through that process, we've also empowered our nursing staff — they helped us revise staffing and scheduling policies to ensure everyone's safety. Our nurses actively engage in efforts to make us a better, healthier organization.   

Our nurses have also championed healthy eating and living — our facility was afforded a $10,000 grant and the Healthy Nurse, Healthy Nation Partners All In Award from the American Nurses Association. We also have a wellness program at our facility that recognizes progress and goal achievement. We created an assignment system to help make sure nurses get to their breaks and lunches. 

Workload was identified as a problem for our leadership team, so we're really trying to promote a healthy work-life balance. Our leadership administration measures how often we take lunch   to ensure we take the designated five hours a week. We're also working toward flexible hours for nurse managers. 

This year, we're focusing on building personal and team resilience. Leadership has to  understand the symptoms of burnout and how to mitigate them. It's difficult to reengage an employee when they are already burned out, making prevention and mitigation crucial. 

All of these initiatives and values are so important, especially for the Medical University of South Carolina — I don't see our growth slowing down. The best thing I can do in my role is provide our staff with the tools they need to grow as well. 

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