The Importance of Talking It Through (Podcast)
Honest, collaborative discourse is essential to maximizing safety and elevating the patient experience.
Shannon Pengel. MSN, RN, NE-BC is Chief Nursing Officer of the Cleveland Clinic Main Campus Hospital. There, she provides leadership for nursing across the campus, where some of the world’s sickest patients are cared for. In an interview with Brian Bolwell, MD, for the podcast series “Beyond Leadership: At the Intersection of Leadership and Everything Else,” the veteran nurse leader describes how an earlier difficulty – doing shift work while raising a family – also created opportunity.
“I ended up working straight night shift for many years,” Pengel tells Dr. Bolwell. “Although that sounds terrible, in retrospect it probably was a pivotal moment in my career because I had the opportunity to become an informal leader. I was charge nurse every night. I became a preceptor of everyone that came on to night shift, and I had the opportunity to interact with my nurse manager every morning when she came into work and gave her a report of the floor.”
Pengel also describes the trajectory of the nursing profession as a whole, which has enabled nurses to play a larger role as healthcare partners.
“I think the professional practice of nursing has elevated tremendously over the past two decades through evidence-based research and publications and different manuscripts that we’ve produced, but also [in terms of] that collaboration and partnership with our physician leaders and administrators.”
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Brian Bolwell: Quality is so important, and mistakes that happen in the hospital are things that nobody wants to hear about. And certainly we need to prevent them. And yet it’s hard to eliminate them totally. What is our approach to trying to really drive down safety harm events and to make this as safe a hospital as we can, knowing that we’re the highest acuity hospital in the United States?
Shannon Pengel: I think a challenge that we face is really creating that culture of safety and psychological safety for our caregivers to speak up. I’m a firm believer in the just culture model of really looking through when an error does happen, really breaking that error down and trying to identify how it happens. There’s always human performance issues that we have to address. That’s kind of easy, you can address that. It’s the deep-rooted things within our culture that we really have to work and address. And so I think when either a mistake happens, or probably a better example is even when we have a rapid response or a clinical code on one of our units, really critically looking through and seeing what happened, not to point fingers, but we want to learn. From every event we have, we want to learn and we want to get that information to our caregivers so that we all learn. We have a large number of nursing caregivers to communicate to when things happen and we want to make sure, again, we all learn from each other.
That culture really around speaking up asking questions is critically important. And I think I try to role model that in the relationships that I form with providers. I’m a big proponent of this mutual respect collaborative relationship. We all bring something different to the table. I bring a different perspective as a nurse than you might bring as a physician. And we need to be able to have open dialogue about that without feeling attacked. It’s not about who’s right or wrong. It’s about the best outcome for the patient. And so I think that model is what I strive for and what I try to emulate and how I try to lead other leaders to develop in their institute.
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