Influence in action: the power of a nurse’s voice

Nurses are the cornerstone of patient care, and at HCA Healthcare we consider them the lifeblood of our organization. They’re with patients and their families during some of the most important and vulnerable moments in life.  And that means nurses, like all caregivers in our facilities, have the opportunity to make a difference, to positively impact both the outcomes and the experience of care for every patient.

The voices of nurses are important and influential.

As we head into 2020, “The Year of the Nurse and Midwife,” we are committed to giving nurses more of a voice to help drive the nursing agenda at HCA Healthcare than ever before.

We sat down with Jane Englebright, HCA Healthcare’s senior vice president and chief nurse executive, to learn about how our organization ensures that nurses are heard, respected and supported, and why that’s a priority for our organization.

A voice to impact change

HCA Today: Why is it important for nurses to have a voice in their profession?

Jane: In the United States, nursing is the largest healthcare profession, with more than 3.8 million registered nurses nationwide. Nurses, like myself, pursue this profession because we care deeply about improving peoples’ lives. We spend more time with patients than anyone else in a hospital. Nurses are insightful, creative and passionate about patient care, and they have an invaluable perspective. As we advocate for patients, our voices influence positive changes for the practice of nursing, and that ultimately improves patient care. So, it’s important for us as healthcare leaders to create open environments where nurses’ voices are not only heard – but acted upon, because it can lead to exciting advancements in patient care.

Professional practice councils in every hospital within HCA Healthcare provide a way for nurses to influence care delivery at the unit and facility levels.  These councils proactively identify issues and opportunities to improve care, and are venues for bringing forth new ideas and for testing innovations in care delivery.  The professional practice councils systematically raise the bar on nursing performance.

Listening to nurses through surveys and focus groups helps us understand what nurses need to advance their careers as well as to build and maintain a realistic work/life balance to care for their families.  For example, based on our ongoing conversations with our nurses, HCA Healthcare is investing up to $300 million in workforce development initiatives. Those programs include tuition reimbursement for most full-and part-time colleagues, student loan assistance, expanded certification offerings, and a dependent scholarship program for children of HCA Healthcare colleagues.

So, giving voice to nurses has significant benefits to our organization and our mission to care for and improve human life, but also to the amazing people who deliver that care with compassion and expertise.

A voice for patient care

HCA Today: How does a health organization like HCA Healthcare benefit when nurses are heard and supported?

Jane: Historically, the voices of nurses have led to better patient care. From Florence Nightingale to Clara Barton, we’ve seen that some of the greatest success stories in healthcare occur when nurses are given great latitude in guiding decisions that affect patients. That’s the approach we’ve taken at HCA Healthcare for many years now, and it has unlocked possibilities we and others in healthcare hadn’t yet realized existed.

For example, ten years ago, through our CNO Council, nurses asked for a tool to electronically document patients’ vital signs. During this time, documentation was done mostly room-to-room with pen and paper. Automation would create significant time savings for nurses, and would lead to better and safer care for our patients. When we asked companies to present their tools to a group of our nurses, all of the companies brought new vital sign solutions. A group of HCA Healthcare nurses tested and chose the right technology for them. The tool they selected didn’t exist until these nurses told us what they needed, and that probably wouldn’t have happened if we weren’t actively seeking their perspective.

What I love about healthcare is that it’s constantly evolving to provide great, evidence-based care. By working closely with nurses, we innovate and evolve our systems and processes to keep HCA Healthcare facilities on the forefront of technology and care delivery.

More recently, we worked closely with our nurses to develop Evidence-Based Clinical Documentation (EBCD), a documentation tool that helps nurses spend more time with their patients and less time documenting about their patients.

We surveyed more than 800 of our nurses for their feedback on advancing nursing practice at our hospitals. Through the survey, we found that a large portion of documentation was neither efficient nor effective.

And, thanks to our nurses, EBCD was born. The patient-centered focus of EBCD minimizes the time spent inputting data, and at the same time, allows the information that has been entered into the medical record to be extracted in a more meaningful way. As a result, we’ve seen our nurses save at least 30 minutes on documentation, per shift.

Nurses are amazing people, and when you have more than 94,000 of them, that’s an incredibly valuable resource.

A voice for the future

HCA Healthcare Today: Besides some of the surveys you’ve mentioned, what are some of the ways HCA Healthcare ensures nurses voices are heard and that their expertise is helping to drive the nursing agenda?

Jane: It’s true that surveying is just one of the ways we seek out the perspectives of our nurses, but before we talk about some of those other elements, I want to mention another survey you’ll be hearing about soon. We’ll be announcing the results of a survey we did recently on the younger generations of nurses, who now make up the majority of nursing.  We’re excited to share insight on what’s important to the next generation of nurses and nurse leaders.

But to your question, in addition to surveying routinely, we have a number of ongoing vehicles and venues to give voice to our nurses:

• Professional Practice Councils
  • We’re working to ensure that every HCA Healthcare hospital has one or more Professional Practice Councils to empower nurses to further patient care outcomes. Within these councils, nurses use their voice to share best practices and collaborate on topics related to patient outcomes, nursing quality and clinical practice standards and policies and procedures.
• Advisory Councils
  • HCA Healthcare has created specialty Advisory Councils to govern how best practices are shared across our nationwide system of hospitals. These councils include nursing representatives from each division and various clinical roles, including direct care nursing staff and nurse leaders.
• Nurses at every level of our organization
  • Nurses are best known for being on the frontlines of care, but they are stepping beyond nurse director and CNO titles, and into positions like CEO and COO. Nurses, now in C-suite roles, are helping to shape business and operational decisions across the enterprise.
• Vital Voices
  • In our organization, we take a continuous listening approach, using our Vital Voices program, where colleagues actively seek conversations to solve problems and generate ideas. This allows nurses to provide real-time feedback and see real-time improvement.
• HCA Healthcare Inspire App
  • Our nurses told us that they wanted an easy way to connect with each other while also having access to tools, advice and sample career paths that aid in professional development. After thorough insight, feedback and research, we put that connection in the palm of their hands with the HCA Healthcare Inspire App. It’s an easy way for nurses to recognize excellence, chart professional growth and connect with mentors. We’re rolling this out to our nurses this year and the feedback has been great.

I am honored to witness the voices of HCA Healthcare’s nurses every day and look forward to seeing our collective mission exemplified throughout “The Year of the Nurse and Midwife.”

Visit here for more information on nursing careers at HCA Healthcare.

HCA Healthcare is one of the largest employers of nurses in the country, with more than 94,000 registered nurses holding positions from bedside caregivers in a variety of healthcare settings to leadership positions throughout the organization. HCA Healthcare is a learning healthcare system that uses its more than 31 million annual patient encounters to improve patient care and save lives.